Sitting on the Diabetes Time-Bomb
by Lissa Cook

Diabetes in Scotland is being described by doctors as an epidemic - a label normally reserved for infectious diseases like flu.

New research, exclusively available to BBC Radio Scotland's "Investigation", makes alarming reading.

Big increases in obesity and an aging population will mean a 60% increase in diabetes in just 15 years, according to Dr Sarah Wild, who is a senior lecturer in epidemiology and public health at the University of Edinburgh.

The Health Minister, Andy Kerr, acknowledges that the Scottish Executive has a big problem on its hands.

He says there are 250,000 diabetics in Scotland today and that could rise to as many as 500,000 in five to 10 years.

There are two types of diabetes.
In the rarer type 1 the pancreas makes no insulin and people usually develop the condition as children or young adults.

Most diabetics have type 2 where the insulin the body produces doesn't work properly or they don't produce enough. It usually occurs in older people but because obesity is a major risk factor, more younger people are getting it. (often there is enough serum insulin but a resistance has developed rendering it ineffective - ed)

High price
Kerry is 30 but she was only 13 when she found out she had type 2 diabetes. She admits she was very overweight.

She says: "I ate a normal teenage diet, eating chocolate when I wanted to eat chocolate, eating crisps when I wanted to eat crisps. It wasn't a healthy diet. I wasn't one to be eating fruit or veg. I didn't really do a lot of running round." And she's paid a high price for her teenage rebelliousness."I recently found out that my kidneys aren't working as well as they should be and I'll be on dialysis within the next five years. That was a big shock to me. I haven't coped too well and I've been on anti-depressants since," said Kerry.

"We are almost suffering from a modern malnutrition - we are simultaneously overfed and under-nourished" Joanna Blythman, Food Writer.

David a Glasgow taxi driver, was just 35 when he was diagnosed as a type 2 diabetic.
He says it came as a shock. But he admits that he had nobody else to blame but himself. He was nearly 20 stone and did little exercise.

He's since lost 4.5 stones through changing his diet and going to the gym regularly and his doctor's taken him off his medication.

The statistics are clear - the heavier you are the more likely you are to develop type 2 diabetes.

Heart disease
If you put on a stone and a half you're three times more likely to get diabetes. If one parent is diagnosed, the risk for their children increases three-fold. If both parents are affected the risk increases seven-fold.

Joanna Blythman is an investigative food writer in Edinburgh. She says: "In Scotland we have a particular problem - we are almost suffering from a modern malnutrition - we are simultaneously overfed and under-nourished, so you have people eating far too much of the wrong kinds of food."

Dr Wild says the cost to the health service is enormous: "Already, although people with diabetes only form about 3% of the population it's been estimated that the cost to the NHS takes up about 9% of the budget. So, the increasing cost will be considerably greater than the increasing number of people with diabetes."

With £10bn spent on health care in Scotland - that's already almost £1bn being spent on diabetes and its complications. Left untreated, diabetes can lead to complications including heart disease, strokes, the loss of sight and even lower limb amputation.

Healthy eating
Mr Kerr says the key is the prevention and anticipation of ill-health. He believes the executive is bringing about a revolution in healthcare.

Mr Kerr cites initiatives like "Hungry for Success" which promotes healthy eating in schools; active school coordinators to get children involved in physical education; and "Centres for Working Life", which encourages employers to promote diet and exercise in the workplace.

But he admits that if the executive isn't successful, then it will have a time-bomb on its hands.
BBC News, 5th March 2007

DIABETES RESOURCE
The ABC's of Disease by Phillip Day