Sun, Oct 23, 2011 - Page 9 News List

Diabetes is scary, it is growing and is becoming a global crisis

By Jon Henley  /  The Guardian, LONDON

On Barbara Young’s office table is a graph. A bar chart, actually: Four columns of green, purple, red and bright blue showing the progression, in England, of rates of coronary heart disease, stroke, cancer and diabetes over the past five years. The first two are flatlining or falling. Cancer, in red, is rising, but slowly. Trace a line between the blue bars from 2005 to last year and it soars off the chart.

“Diabetes,” Young says flatly, “is becoming a crisis. The crisis. It’s big, it’s scary, it’s growing and it’s very, very expensive. It’s clearly an epidemic and it could bring the health service to its knees. Something really does need to happen.”

Baroness Young is, admittedly, the chief executive of Diabetes UK, Britain’s main diabetes charity and campaigning group. It’s her job to say such things. However, the figures are behind her all the way: Diabetes is fast becoming the 21st century’s major public-health concern. The condition is now nearly four times as common as all forms of cancer combined and causes more deaths than breast and prostate cancer combined. About 2.8 million people in the UK have been diagnosed with it; an estimated 850,000 more probably have type 2 diabetes, but don’t yet know. Another 7 million are classified as at high risk of developing type 2; between 40 percent and 50 percent of them will go on to develop it. By the year 2025, more than 5 million people in Britain will have diabetes.

The implications for the National Health Service (NHS), obviously, don’t bear thinking about. Diabetes already costs the service around £1 million (US$1.6 million) an hour, roughly 10 percent of its entire budget. That’s not just because the condition generally has to be managed with medication or insulin, but because by the time they are diagnosed, around half the people with type 2 — by far the most common and fastest growing form — have developed a longer-term complication.

Cardiovascular disease, for example, will kill 52 percent of people with type 2 diabetes, who are also twice as likely to have a stroke in the first five years after diagnosis as the population at large. Almost one in three people with the condition will develop kidney disease and diabetes is the single biggest cause of end-stage kidney failure. You are up to 20 times more likely to go blind if you have diabetes.

“The cost of some of these complications, in terms of medical and social care, unemployment benefits, everything, is just enormous,” Young says. “People can’t work, can’t drive ... and so many personal tragedies. People with diabetes have a foot amputated 70 times a week in England, and 80 percent of those amputations wouldn’t have been necessary if it had been caught earlier and looked after properly.”

Recently, Young says, she met a former ballerina.

“No one had told her, when she was in her 20s and 30s, that maybe it wasn’t such a good idea, might be dangerous even, to keep her blood sugar level deliberately high, for energy. She just had her heel amputated,” she says.

Nor is this, of course, a national epidemic. Around the world, 285 million people now have diabetes, a figure expected to climb to 440 million within 20 years. In North America, one in five men over 50 have the condition; in India, it’s 19 percent of the population; in parts of the Middle East, 25 percent. On the tiny Pacific island of Nauru, very nearly one in three people has diabetes. This goes some way to explain why some countries are taking a tough stance on health — Denmark has imposed a “fat tax” of 16 kroner (US$2.93) per kilogram on saturated fat in a product, while France is adding just over £0.001 to the price of fizzy drinks (although zero-calorie “diet” versions are exempt).

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