Diabetes: Tailored Prevention Messaging

Martyn Day Excerpts

Thursday 24th October 2019 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I am grateful to the hon. Member for Strangford (Jim Shannon) for securing this debate and for his personal account of his experience. He covered diet, control and tablets in his general summary of the issue. He highlighted the importance of prevention, the correlation between poverty and lifestyle, the importance of messaging to different sections of our society and the value of digital solutions.

We also heard from the hon. Member for Heywood and Middleton (Liz McInnes), who also has direct experience of the issue. She emphasised the importance of the difference between types 1 and 2. Most of my comments will be about type 2. The right hon. Member for Leicester East (Keith Vaz), a very knowledgeable Member, covered a range of points. It is impossible to disagree with anything I have heard today. I thoroughly enjoyed the presentations.

I am not diabetic, but when I phoned my office to tell my office manager that I had a debate about diabetes today, she thought I said that I had diabetes. She said, “I’m not surprised, with your lifestyle and diet.” There may be some lessons there that we all need to take away. We need to look at our diets, in particular.

We have heard about the scale of the problem in Northern Ireland and England, and I have to say that the Scottish situation is not dissimilar. In 2016, more than 257,000 people were living with a diagnosis of type 2 diabetes across Scotland, and every year 17,000 people are diagnosed with it. It is estimated that about 10% of cases of type 2 diabetes remain undiagnosed. Diabetes Scotland estimates that more than 500,000 people in Scotland are at high risk of developing type 2 diabetes. The NHS spends about 9% of its total health expenditure treating type 2 diabetes.

It is estimated that more than one in 16 people across the UK has diabetes, whether diagnosed or undiagnosed. Around 80% of diabetes complications are preventable, so just think how much we could save the NHS by tackling the problem, as well as the benefits that could be brought to people’s lifestyles. We should not short-change ourselves by cutting back on the diabetes spend—it is a spend-to-save area. Many of those complications are preventable or can at least be significantly delayed through early detection, good care and access to appropriate self-management tools and resources.

Being overweight is the most significant risk factor for the development of type 2 diabetes. Diabetes can be prevented with targeted weight management interventions that provide individuals with the support, skills and resources to improve their health and delay the onset of type 2 diabetes. As we have heard, recent studies have shown that it is possible to reverse a recent diagnosis of type 2 diabetes through intensive weight management programmes, which would enable the individual to achieve remission.

As obesity and lifestyle are such significant factors, what we do with our young people is critical. The SNP Scottish Government have a plan to halve childhood obesity by 2030, and that sits at the heart of the diet and healthy weight delivery plan. The Scottish Government’s commitment to legislate on the restriction of point-of-purchase junk food promotions will be a major help. I hope that we will see action from the UK Government on advertising, particularly on TV and in the media, because that would make a big difference. In 2019-20, the Scottish Government invested an additional £1.7 million in weight management services for children and young people. Targeted messages are a key component of the Scottish Government’s diabetes prevention, detection and intervention framework.

The Scottish Government’s framework “A Healthier Future: Framework for the Prevention, Early Detection and Early Intervention of type 2 Diabetes” was published in 2018—the Library briefing contains links to it, so hon. Members can see the full details. The framework is supported by £42 million until 2023, and it was produced in collaboration with the prevention sub-committee of the Scottish Diabetes Group, which comprises informed specialists in diabetes, dietetics, maternal health, public health, primary care and obesity.

Wider support should be available for all individuals who have been identified as at risk. Health and social care professionals should signpost individuals to the support groups that are available to them. A Local Information System for Scotland, or ALISS, is a programme funded by the Scottish Government and delivered by the Health and Social Care Alliance Scotland. The objectives are to increase the availability of health and wellbeing information for people living with long-term conditions, disabled people and unpaid carers, and to support people, communities, professionals and organisations who have information to share. The sharing of information is critical. The Scottish Government also published the diabetes improvement plan in 2014, with prevention as its No. 1 priority.

It is important to get the right messages to people, and methods of communication must also be considered. Modern-day flexibility and the use of mobile phones in everyday life means that they are an ideal tool to support people with diabetes, whose conditions needs constant management. Additionally, they can provide effective methods of support to patients in rural and remote locations where access to healthcare providers is limited. However, we must be careful when adopting such practices because there are drawbacks, such as the digital divide. Mobile phone use is lower among some groups, such as the elderly, the poorest and people with disabilities, so face-to-face contact remains a vital communication tool.