The NHS is facing a type 2 diabetes epidemic. Huge amounts of NHS money and time could be saved if more focus was given to better detection, lifestyle management and appropriate use of medication.
Of the 66 million people in the UK, around 3.7 million have been diagnosed with diabetes. “That’s a significant proportion of the population, but it’s just the tip of the iceberg,” warns Dr Stephen Lawrence, Principal Clinical Teaching Fellow, Warwick Medical School, University of Warwick. “There are also an estimated 500,000 people who are yet to be diagnosed.”
Plainly, diabetes is a medical epidemic, but the current stresses on the National Health Service are well-documented. Is it able to cope with the increasing numbers diagnosed with the disease?
Some people with diabetes have to take in excess of six tablets a day.
80% of NHS money on diabetes could be saved
“Around 10% of the NHS budget is spent on diabetes treatment,” says Dr Lawrence. “That’s approximately £10 billion — or about £1 million an hour. The sobering thing is that 80% of the money we spend on diabetes care and treatment is driven by potentially avoidable complications. If we were to improve detection, lifestyle management and appropriate use of medication we could make a significant impact on that enormous cost. Yet, despite pressure on the system, good outcomes regarding diabetes care are achieved in this country.”
Innovative and revolutionary medications
Today’s treatment has certainly revolutionised lives. “We now have medication that helps control glucose, blood pressure and promotes weight loss,” says Dr Lawrence. “We also have ultra-long-acting insulins that are injected once a day and offer the confidence of good control without hypoglycaemic episode risk. Pharmaceutical companies are really listening to the needs of patients and their prescribers.”
Gut microbiota could contribute to diabetes
Lawrence has a “wish list” for further medical breakthroughs. For example, interesting studies are underway to investigate the association between gut microbiota, obesity and diabetes. He would also like to see an improvement in medication delivery. “Some people with diabetes have to take in excess of six tablets a day,” he says. “So I think the future is a polypill: one tablet that combines all the necessary baseline medication needed to control diabetes. This would reduce tablet burden — and improve adherence to treatment.”
