Professor Stephen Bain
Assistant Medical Director for Research & Development for ABM University Health Board, Clinical Lead for the Diabetes Research Unit, Cymru
Urgent action is needed for the nearly one million people who have type 2 diabetes, and may be already developing some of its complications, but don’t know it.
In type 2 diabetes, as in all medical conditions, early diagnosis is key to optimal patient outcomes. But the stark truth is that there are 850,000 undiagnosed cases in Britain, according to Diabetes UK. This means that one in 70 people who have the condition don’t know it, and are missing out on vital treatment.
Diagnosis problems
Professor Stephen Bain, clinical lead for the Diabetes Research Unit Cymru based at the Swansea University, Wales, says: “Part of the problem is that the early symptoms of type 2 diabetes – feeling tired, needing to go to the toilet more often, increased thirst and blurred vision – are often mistaken for signs of ageing and overlooked. What’s more the condition tends to develop gradually, over a long period of time, so people may not be aware of it, at first. And the consequences can be serious. Persistent high blood glucose can cause vascular damage in vital organs, increasing significantly the risk of strokes, heart attacks, kidney failure, blindness and amputations,” explains Professor Bain.
But we can change this, he adds. “The aim is to diagnose patients early, so they can receive treatment promptly, as there is good scientific evidence that keeping blood glucose levels at, or near, normal values can reduce the occurrence of many of the complications of type 2 diabetes.”
An advantage, in this regard, is that there is a wide range of new medications available today that are more effective and less likely to cause side effects such as hypoglycaemia and weight gain than previously used treatments, says Professor Bain.
What can be done to reduce the number of late or no diagnoses?
Increasing public awareness, not just of the symptoms of the condition, but also of its risk factors, is crucial, according to Professor Bain. “Being overweight, lack of exercise, unhealthy food choices and smoking can increase the chances of developing type 2 diabetes,” he says. “If we can bring attention to this, people will be more likely to talk with a doctor or nurse and seek a diagnosis if they think they are at risk.”
He adds: “Wider access to screening is also crucial. There is no national screening programme for diabetes in the UK at the moment. There is, however, a focus on identifying people at high risk among those who present to primary care, so they can be screened. The diagnosis of diabetes using blood tests has changed in recent years. We now know that people don’t need to fast, so it’s probably going to make screening larger numbers of people easier.”
Clearly, the threat posed by undiagnosed type 2 diabetes to patients and health systems is serious – but not without solution.
