While there is a clear impact on health
issues, what wider impact does the
disease have on society at large?
The clinical conditions are significant:
blindness, strokes, heart attacks and other
serious conditions, impacting hugely on the
individual as well as their family. That has an
effect on health and social care services. On a
population level, the number of adults with Type
2 diabetes will continue to rise, reaching almost
9.5% of the adult population by 2030. We also
know that the population level is not randomly
distributed, because of the concentration of
both obesity and diabetes within population
sub-groups such as minorities. We see this
driving health inequality, too. Whether at the
individual, family or community level, the
impacts of this disease are quite prevalent.
In terms of helping to inform and
drive your work in this area, how
important are co-operation and
exchange with other countries?
Co-operation is incredibly important as one of
the things we are keen to do in England is to
move at pace and at scale when it comes to
addressing the diabetes epidemic. We are
already reaching out to other countries that
have implemented a structured programme to
manage pre-diabetes and are looking at ways
that they have worked to bend the epidemic
curve by intervening earlier. Programmes such
as this have been implemented in the United
States and in the state of Victoria in Australia.
We are already collaborating with international
partners, and when we look at the potential
across Europe, there are huge opportunities. In
part this is because there are other countries
in western Europe facing similar challenges.
They have already been reaching out to us to
learn about our approach, what we are hoping
to learn, and how we plan on translating the
evidence into action. We are implementing the
programme and it will generate lots of
riven by increases in overweight and obesity, unhealthy
diet and physical inactivity, the prevalence of Type 2
diabetes is on the up across Europe, leading to increasing
engagement with the matter amongst decision makers and health
In England, Public Health England (PHE), the government agency charged
with improving health and wellbeing and reducing health inequalities, is
moving to tackle the diabetes epidemic with the National NHS Diabetes
Prevention Programme. As 80% of all cases of Type 2 diabetes are
preventable, the programme is focused on intensive lifestyle change
interventions. Initially, 10,000 people at high risk of developing Type 2
diabetes will be targeted, with a national rollout following; seven
demonstrator sites are pioneering the first phase of the programme.
Initiatives on a variety of schemes, from weight loss to physical activity and
from cooking to nutrition, are being advanced under the programme in the
hope that effective public health interventions will be gleaned.
Indeed, PHE argues that a successful national programme for England
could save tens of thousands of lives and millions of pounds for the UK’s
Speaking to PEN, PHE’s director of health and wellbeing, Professor Kevin
Fenton, provides an insight into the diabetes challenge and the public
health response required.
What are the key trends around Type 2 diabetes and the
wider health challenges in England today?
For us in England, and certainly across the United Kingdom, diabetes is
actually a very serious public health issue. We estimate that it affects
nearly 3.2 million people in England, and there are 4.6 million at high
risk of developing diabetes in the near future. This has huge cost
implications for us as a nation in terms of premature mortality and the
contribution of diabetes towards cardiovascular disease, including heart
attacks and strokes, but also in terms of microvascular disease, leading
to amputations and other complications including blindness. It really has
a huge impact on the NHS budget, of which we believe 10% is driven by
diabetes in the country.
Not only do we have a huge current and potential burden on the
population, but we know that diabetes is largely preventable, as well.
This is the call to action that we are putting in place here in England: to
really get the nation to focus first of all on the obesity epidemic that is
driving high rates of Type 2 diabetes and, specifically, on what more we
can do to better manage diabetes.
I S S U E S E V E N
H O R I Z O N 2 0 2 0 P R O J E C T S : P O R TA Lwww.horizon2020projects.com
M E TA B O L I C D I S E A S E S
A response to Type 2 diabetes
With diabetes threatening public health and weighing heavy on European
Professor Kevin Fenton,
of Public Health England, details the
efforts being made in England to tackle the problem