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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

D

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

policy leaders.

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

healthcare system.

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 L

www.horizon2020projects.com

154

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

health systems,

Professor Kevin Fenton,

of Public Health England, details the

efforts being made in England to tackle the problem