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Hmm, well, OK……..

Type 2 diabetes used to be a condition linked to ageing and getting older. It’s the most common metabolic chronic condition in elderly people in the UK, and the likelihood of developing diabetes increases dramatically after the age of 45. People of south Asian heritage have a higher prevalence of type 2 diabetes, and I’ve grown up watching my grandparents and elderly relatives develop it, one after another. India is often referred to as the “diabetes capital of the world”, accounting for 17% of the total number of diabetes patients worldwide.

But in Britain, recent data has shown a major change in the profile of who is getting diabetes: it’s now young people. The number of under-40s being diagnosed with type 2 diabetes has risen 39% in the past six years. This was especially the case for people from deprived areas and those from black and south Asian backgrounds. In 2022, Diabetes UK highlighted that the number of children receiving treatment for type 2 diabetes in England and Wales had increased by over 50% over the previous five years.

So, is the change in hte population being studied as a result of immigration the reason for the rise in diagnosed diabetes?

Guess which possible cause this professor of public health does not discuss? Sure, sure, the immigration supposition could be wrong but it does need to be considered so that it can be ruled out, right?

27 thoughts on “Hmm, well, OK……..”

  1. The Meissen Bison

    a condition linked to ageing and getting older.

    Gosh! ageing and getting older. This is where I stop reading.

  2. Bloke in Germany

    Diabetes has also become a purely lab diagnosis despite guidelines requiring presenting at least one symptom to diagnose.

    This accounts for a lot of the increase in diagnosis, but clinically there are actually pros to this approach. If you meet even the broadest of lab diagnostic criteria you probably ought to consider moving more and eating less carb, to delay the time at which you get put on the path to insulin. Equally since symptoms (though admittedly not usually first symptoms) include legs falling off, going blind, and kidney failure, you might want to consider treatment long before these become an issue.

  3. Last year I was sent for an endoscopy and was surprised to find on the consultants letter that they had me down as having Type2 Diabetes. I checked with my GP who looked at my recent blood analysis and confirmed that I don’t have it. They had probably just looked at my age (72) and presumed that I did, far easier than actually checking!! Statistics and damned lies it is then.

  4. 50 years of removing saturated fat from our diets and replacing it with carbohydrates will have that effect……

  5. “Got a nasty condition due to your genetic heritage? Get yourself to the UK, as they have free treatment!”

  6. A significant increase in the number of young fatties, as can be seen on any high street, is a pretty obvious factor.

    Cut down on the takeaways, limit yourself to two visits to Greggs every day and do some exercise, any bloody exercise. That’s type 2 sorted in, at a guess, in 90% of cases.

    When I was diagnosed at 60 I attended a pretty decent nhs course explaining the scary consequences of not losing weight. At lunch time, we all brought our own, several lardos who had complained shrilly about how nothing they did ever worked were chugging litre bottles of chocolate milk with their sandwiches followed by large bags of crisps. One perfectly matched pair had previously shared a full pack of biscuits with and after their morning coffee. The sound of crunching was monotonous.

  7. …more than a third of adults under 40 with type 2 diabetes are from the most deprived quintile in England. Of those aged 26-39 with type 2 diabetes, 32% are from Asian backgrounds and 7% are Black, much higher than the proportion of the general population from these backgrounds (12% and 4% respectively) x

    I sort of agree with BiG: we’d like to know if the increase in diagnosis is consistent with an increase in symptoms, or if the trend is consistent with how much insulin is dished out each year.

    There has been an increase in minor amputations, but when you google this you get
    Patients with diabetes that are male, from the most deprived areas, aged over 65 or of white ethnicity had greater risk of amputation
    Definitely a rich area for research. Asians and Whites need not apply though.

  8. I thought we had this type 2 diabetes nonsense sorted already?

    Lose 10% of your body weight in about 30 days and the symptoms largely go away.

    Remove the vast amount of carbs from your diet and replace it with protein and healthy fats and the symptoms stay away.

    If the weight begins to creep up again, use intermittent fasting to manage it back down.

    Dump the car and walk wherever you need to go in your local area.

    It all adds up.

  9. I was 54 when I was diagnosed in 2013. I was a little overweight and, though I didn’t have a desk job I had become a bit sedentary after staying very fit up to my mid 30s. So, I improved my diet and got myself fit again, started cycling to work, started swimming again and started doing the parkrun every Saturday. I’ve mostly managed to stay off the meds since then by doing lots of exercise, I have regular checkups and if my blood glucose levels go up I have to take pills for a while until it comes back down. Taking personal responsibility is the key as I see it.

  10. Ignore this person.

    It’s Devi Sridhar, the fangirl, confidante, loud supporter (and who knows what else, get what I mean?) of Nicola Sturgeon.

    Repeatedly issued flawed and unscientific analysis during COVID which was criticised heavily for lack of understanding and venturing into a specialism outside her own.

    Adopted the Murphy approach of ignoring and where possible blocking unfavourable evidenced comment in science journals, or on social media.

  11. @TMB

    Are “ageing and getting older” really synonymous? We get older at the chronological rate of 1 year per annum, but isn’t ageing a biological process that can go faster or (preferably, and worth making lifestyle changes for) slower than that? “Senescence” sounds a bit more technical but same idea, no?

  12. Oh Devi. What more proof does one need that a professorship in the UK is worth bugger all?

  13. My cardiologist refers to “your mythical diabetes” because my HbA1c has been hovering just above the threshold for years and years.

    For quite some time I was a diabetic while we were in Britain (threshold = 48 mmol/mol) but non-diabetic when we were in NZ (threshold = 50).

  14. The Meissen Bison

    Anon – yes but that’s not a distinction that is being made here. It’s the ageing as a result of getting older that’s causing the problem.

  15. “ But in Britain, recent data has shown a major change in the profile of who is getting diabetes: it’s now young people. ”

    Or change in diagnosing behaviour in order to feed the medical pharmaceutical industry complex.

    There is now a symptomless ‘disease’ pre-diabetes. By definition everyone who does not have diabetes is ‘pre-diabetic’ – so it’s a very easy diagnosis to make with plenty of scope to sell test kits and treatments.

  16. @dearieme

    I’m in much the same situation. My HBA1c has fluctuated between 42 and 55 for the last 20 years. If it goes up a bit I go on a 5/2 diet for three months and bring it back down.

    I had two interesting conversations with my doctor about Type 2.

    In the first, she said to me, “I know that if you say you’re going to lose half a stone in three months, you’ll come back and it’ll be done. Some of my newly-diagnosed patients, they’re about 20 stone, they can barely even fit in the chair, and when I say to them ‘Is there any chance you could lose a little weight?’, they look at me and say ‘But Doctor, I eat like a sparrow’.”

    In the other, I asked her whether I would live longer if I lost a couple of stone and kept them off.

    She said, “You’d probably live for another two or three years, but you’d spend the next 20 or 30 years not eating any of the things you like. Do you think that’s a fair trade-off?”

    I replied, “No, not really.”

    “No,” she said. “Neither do I.”

  17. Iliam Dhone:

    But you’d also be less likely to be spending those remaining 20 or 30 years visiting that doctor, or in waiting rooms, or suffering months of wondering what your latest test results are going to be.

    I’m not saying that your doctor’s advice is wrong: it’s always about trade-offs. Just that dying in 27 years’ time rather than thirty doesn’t mean that those 27 years are going to be as comfortable as they will be for the first 27 years of the person who does go on to live for thirty.

  18. Reading some of the comments above, I can only presume it’s the perils of visiting a doctor. What are diabetes tests? They seem best avoided.

  19. BIS, the HbA1c blood test shows what your average blood glucose level has been for the previous six weeks or so. 58 mmol/mol is borderline diabetic. If you score below this level but are close you are pre-diabetic meaning that you don’t need treatment but it wouldn’t be a bad idea to look at your diet and exercise levels and possibly lose some weight as you are probably at risk of diabetes further down the line.

    As for diabetes itself, well managed, either by meds or diet and exercise, it isn’t really that serious. Not well managed or ignored, consistently high blood glucose causes all kinds of really serious health problems. I think that if you have it it’s better to know about it so that you can treat it.

  20. Further to @deareime… One wonders whether the increase in the numbers classed as “diabetic” is rather like the sudden, overnight, increase in those classed as “overweight or obese” – namely that the medical profession has been indulging in its favourite exercise of moving the goalposts..?

  21. @Baron Jackfield

    In case you missed it, you might want to go up to the top of the thread and have a look at @big’s comment, which has a very good answer to your question.

  22. @Paul, Somerset

    Yes, perfectly true. But keeping my blood sugar in the range it’s been for the last 20 years is not likely to be associated with negative health outcomes, particularly since all my other blood readings (which I have measured at least once a year) are spot on.

    As a point of interest, a meta study was conducted of 3.5 million people to determine the correlation between weight and longevity. Its results shocked the medical profession: the overweight outlived the slim. The truly obese died youngest and the very thin also died fairly young. The report suggested that the slightly-to-somewhat overweight suffer more cardiac events than thinner people but are also – and this is the intriguing bit – much more likely to survive them.

  23. @Baron Jackfield: as I understand it (as an amateur) –

    (i) swapping to HbA1c blood tests as a definition of diabetes did, of itself, increase the numbers reported compared to use of the previous definition.

    (ii) In Britain the GPs were offered financial incentives to discover and report more diabetic patients. Incentives proved to matter.

    (iii) Anyway HbA1c readings rise naturally with age so if you fail to correct for an ageing population you can scream about an epidemic of diabetes.

    I don’t know how close the analogy is to the campaign to make everyone take statins, but it seems to bear some resemblance. See also Global Boiling, Covid, …

  24. @Anon…

    BiG’s summary combines well with mine to produce the effect that we’re discussing… I’m not disputing that lab-testing probably gives more consistent results than observational diagnosis, but if the limit is reduced from (say @dearieme’s NZ 50, which was presumably the UK’s number at some point) to 48, the symptomless group falling between 48 and 49.99 are suddenly going to be “diabetic”.

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