Can we stop the rise of diabetes?

1 in 13 adults in Wales live with diabetes, and this figure increases every year. It was exacerbated by the pandemic due to a break in NHS activity leading to canceled appointments. Levels could be even more impacted by the continuous rise in the cost of living as healthy foods become more expensive.

With the Minister of Health and Social Action, Eluned Morgan, who is to give a statement in the SeneddTuesday (June 13) Regarding diabetes, this article provides the latest statistics on the prevalence of the disease in Wales and what the Welsh Government is doing to prevent diabetes.

Diabetes in Wales

Wales has the highest rate of diabetes in the UK, with over 200,000 people (8% of adults) living with the disease. There are an estimated 65,500 people living with undiagnosed type 2 diabetes in Wales.

People with diabetes are unable to properly produce insulin, a hormone that regulates blood sugar. Patients with type 1 diabetes cannot make insulin at all. People with type 2 diabetes do not produce enough insulin or make insulin that does not work properly. Type 2 diabetes is the most common account for 90% of cases.

Proportion of diabetes cases by type

Source: How many people in the UK have diabetes? 2021-2022. Diabetes UK.

While some people with type 2 diabetes can lower their blood sugar to a safe level, called delivery, this change is not always permanent. This means most people will live with it for the rest of their lives.

In the long term, diabetes can lead to several serious health complications including heart attacks, strokes, and foot or eye problems. Caring for people with diabetes costs NHS Wales £500m a year.

Diabetes is increasingly common, with number of diagnosed cases doubling in 15 years, until 2021, in the United Kingdom. This is mainly due to more people developing type 2 diabetes.

However, unlike type 1, type 2 diabetes is preventable. Type 2 diabetes is linked to a number of risk factors, including excessive weight gain. Therefore, lifestyle changes, such as increasing physical activity and improving diet, can reduce the risk of developing type 2 diabetes.

Nearly half of type 2 diabetes cases can be prevented with lifestyle changes

Source: Prediabetes. Diabetes UK.

The toll of the pandemic

Diabetes UK Cymru has published a report in 2021 which highlighted the impact of the COVID-19 pandemic on people with diabetes.

People with diabetes are at a higher risk of serious consequences coronavirus infections. Cymru reports on diabetes in the UK that 1 in 4 people who died during the pandemic had diabetes in England and Wales.

Diabetes care has also been impacted during this time and has struggled to rebound from the height of the pandemic. Diabetic patients require regular appointments with their diabetes team to reduce their risk of developing complications associated with the disease.

However, Diabetes UK Cymru reported November 2021 that a third of people with diabetes said they had canceled consultations that had still not been rescheduled. The same proportion had had no contact with the team responsible for their care since the start of the pandemic.

The importance of resuming routine services for people with chronic conditions, such as diabetes, was also highlighted in the Health and Social Affairs Committee report. report on the impact of the backlog of waiting times in Wales.

Diabetes United Kingdom Wales reported that the use of diabetes technology, such as devices that continuously monitor blood sugar, has helped many patients manage their condition during the pandemic. However, this technology is often only offered to patients with type 1 diabetes.

To cope with the impact of the pandemic, Diabetes UK Wales recommended that the Welsh Government:

• invests in diabetes care, support and prevention as a top priority;
• ensures that more people have access to life-changing diabetes technology; And
• works to reduce inequalities in the management of diabetes.

Cost of living impact

According a report by Public Health Wales on the cost of living, soaring food prices may also have an impact on rates of obesity-related diseases, including diabetes. Food prices have continued to rise since the end of 2021, with the UK annual food inflation rate to 19.1% in April 2023.

Healthy foods now cost triple the price of unhealthy foods, making less healthy options the more affordable choice. However, these less healthy options increase the risk of obesitya key risk factor for diabetes.

Diabetes already disproportionately affects people living in more deprived areas From Wales. However, with Public Health Wales reports that the soaring cost of living will exacerbate pre-existing inequalities, this gap in diabetes rates could widen further.

When asked about what the Welsh Government is doing to tackle the impact of the cost of living crisis on diabetes in January 2023, the minister said:

We understand that cost of living issues are going to have an impact on people, and we are aware that those who will pay the most are the poorest in our society. That is why we have targeted our funding to these people.

You can find further information on the cost of living assistance currently available in our guide.

Preventing Diabetes in Wales

The Welsh Government has published its Healthy Weight, Healthy Wales strategy in 2019, a requirement of the Public Health (Wales) Act 2017. This aims to help people maintain a healthy body weight by promoting healthy lifestyle habits. It was hoped that these changes would reduce the risk of diabetes, as well as other obesity-related conditions. The strategy is backed by £13 million in funding, over its lifetime, to achieve its targets by 2030.

As part of the strategy, the All Wales Diabetes Prevention Program was introduced, the first of its kind in Wales.

By monitoring blood sugar, people at risk of developing type 2 diabetes are identified and enrolled in the program. They attend a half-hour consultation with a specialist healthcare assistant who gives them advice on how to prevent the development of type 2 diabetes.

Patients can then be referred to other services to help them make changes within the All Wales Weight Management Pathway. THE National Exercise Benchmark Program provides access to a 16-week tailored exercise program, while weight management services, such as Foodwise for lifeeducate participants on healthy eating habits and lifestyle choices.

The All Wales Diabetes Prevention program has has shown some successpatients who participated in the pilot study having lower blood sugar levels after one year than the others.

After this success, the program is being rolled out across Wales. This is supported with £1m funding per yearpromised until 2024, by the Welsh government as part of the Healthy Weight, Healthy Wales programme.

More generally, the Healthy Weights, Healthy Wales Strategy Update 2022-2024 includes other plans to help people make healthier choices. The Welsh government has said it will introduce legislation on calorie labeling in restaurants and takeaways, limit price promotions for unhealthy food options and restrict junk food advertising by 2024. It will encourage also active travel, such as cycling, through measures including the £1m investment. in e-bike systems.

Article of Ailish McCaffertySenedd Research, Welsh Parliament