Challenges for “every health system in the world” as over one billion predicted to have diabetes by 2050
23 Jun 2023 --- Globally, diabetes is one of the leading causes of death and disability. Currently, half a billion people are living with the disease, and that number is expected to more than double by 2050, reaching up to 1.3 billion people, according to a new study in The Lancet.
“The rapid rate at which diabetes is growing is not only alarming but also challenging for every health system in the world, especially given how the disease also increases the risk for ischemic heart disease – caused by reduced blood flow to the heart – and stroke,” says Dr. Liane Ong, lead author and lead research scientist at the Institute for Health Metrics and Evaluation (IHME) at the University of Washington’s School of Medicine, US.
“While the general public might believe that Type 2 diabetes is simply associated with obesity, lack of exercise and a poor diet, preventing and controlling diabetes is quite complex due to several factors. That includes someone’s genetics and logistical, social and financial barriers within a country’s structural system, especially in low- and middle-income countries.”
Recently, the UK government postponed its planned “two-for-one” junk food ban, arguing that the cost of living crisis prevails and, therefore, such a ban would contribute to more expensive grocery shopping.
Nutrition Insight speaks with Hattie Burt, senior policy and international projects officer at Action on Salt and Sugar, about what the ban means for public health, obesity and diabetes.
“The [UK] government’s data shows that multi-buy promotions on unhealthy food cause people to spend 20% more than they intended. This is because these promotions are typically applied to less healthy food and drinks high in salt, sugar and fat, rather than the staple products essential for feeding and nourishing us,” she says.
Stafford says that we need a complete picture of how diabetes has impacted populations at a granular level.Various causes
The study in The Lancet says that out of all global diabetes cases, 96% are Type 2 diabetes. It identifies high body mass index as the primary risk factor for developing the disease, followed by dietary choices, environmental or occupational risk, tobacco use, low physical activity and alcohol use.
“Some people might be quick to focus on one or a few risk factors, but that approach doesn’t consider the conditions in which people are born and live that create disparities worldwide,” says Lauryn Stafford, second author and Post-Bachelor Fellow at IHME.
Stafford argues that those inequities ultimately impact people’s access to screening and treatment and the availability of health services. “That’s precisely why we need a complete picture of how diabetes has impacted populations at a granular level.”
Expensive food
Rising food prices are a global problem, and the government should ask supermarkets and multinational food manufacturers to do everything they can to make healthy food more affordable, details Burt.
“The restrictions are a crucial component of the government’s evidence-based childhood obesity strategy, designed to work with existing location promotion restrictions and the delayed advertising restrictions to reduce excess and unnecessary calories in the diet. By postponing this policy, the government has made it harder for people to buy healthier food.”
“It is clear that the nation’s health is not a priority for this current government,” she adds.
The government must automatically enroll all eligible families for the NHS Healthy Start Scheme, which provides access to healthy fruit, vegetables, milk and vitamins to those who need it most, Burt suggests.
“Access to the scheme makes staple, nutritious foods more available for low-income families, but around 200,000 families are missing out on an estimated £68 million (US$86.4 million) of nutritious food because they do not know they are eligible.”
Another recent postponement by the UK government was restricting advertising of unhealthy food and drinks before 9 PM on TV and online. The policy was pushed forward to October 2025 – the same as the “two-for-one” ban – and health groups accused the government of “bowing to the food industry.”
“This crucial policy, currently delayed until October 2025, would stop people being bombarded with cues to buy products high in salt, sugar and fat, leaving them freer to make healthier choices,” Burt underscores.
An ounce of prevention
The UK government recently announced £40 million (US$50.8 million) of new funding to increase access to pharmaceutical treatments for obesity.
The government must also go further and implement policies limiting salt, sugar and saturated fat levels in food and drinks, given the strength of evidence linking these to ill health and preventable deaths, Burt stresses.
She details that the UK government recently announced £40 million (US$50.8 million) of new funding to increase access to pharmaceutical treatments for obesity, reduce pressure on the NHS and cut waiting lists.
“However, continuing to delay planned evidence-based measures to stop people from getting obesity in the first place will simply add to the NHS workload. The only true way to reduce pressure on the NHS and cut waiting lists is for the government to implement promised preventative measures, including restricting advertising and multi-buy offers on unhealthy food.”
Recently, the American Academy of Pediatrics published a report on new guidelines to tackle the epidemic of child and adolescent obesity in the US. In addition to nutritional diets, weight loss drugs or surgery are being proposed as an extra measure. Weight-loss drugs for obesity have also been criticized for not being a long-term solution, as scientists claimed it to be a short-term solution.
By Beatrice Wihlander
