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Obesity and sedentary lives put 5m Britons at risk of type 2 diabetes

Five million Britons are at risk of developing type 2 diabetes because people are increasingly overweight and live sedentary lifestyles, according to a fresh warning from the NHS.

Public Health England (PHE) said that the 5 million have high blood glucose levels, which are a precursor of type 2 diabetes – a condition that already affects more than 3 million in the UK and costs the NHS up to £10bn a year to treat.

Duncan Selbie, the PHE chief executive, said the figure demonstrated that it was necessary to introduce a countrywide prevention programme involving education, encouragement and support for people to lose weight and become more physically active.

“We know how to lower the risk of developing type 2 diabetes: lose weight, exercise and eat healthily, but it’s hard to do it alone,” Selbie said. He promised to introduce a scheme that would “support people along the way” to help them protect their health.

Many of those who become diabetic suffer complications such as blindness and foot amputation. Type 2 diabetes is linked in 80% of cases to obesity and inactivity – and in England, 62% of adults are obese or overweight.

The charity Diabetes UK has already warned that the soaring numbers of those who have been diagnosed could bankrupt the NHS, as the costs “continue to spiral out of control”.

Professor Melanie Davies, co-director of the Leicester Diabetes Centre, said the new figures for people at risk of diabetes demonstrated that people’s “sedentary lifestyle does come with consequences and unless people move more they could end up with unwanted health complications. We are becoming the sofa generation and this inactivity, together with an increasing consumption of unhealthy foods and obesity, is leading to more cases of type 2 diabetes.”

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The diabetes prevention programme, a joint initiative by NHS England, the PHE and Diabetes UK, has begun demonstration projects in seven areas of the country to test what works and what is acceptable to people in their local community.

An evidence review that PHE will publish on Wednesday suggests that a quarter of those at risk (26%) could stave off the disease with such support. It also shows that people supported by diabetes prevention programmes lose on average 1.57kg more weight.

Professor Jonathan Valabhji, national clinical director for diabetes and obesity at NHS England, said the interventions for diabetes would not be the same as those required for tackling obesity.

Those at risk will be identified, often through the NHS health check, by a blood test that will show a raised glucose level – but despite the link to obesity, about 20% of people with type 2 diabetes are not overweight.

They will then be referred to a local provider commissioned to offer courses lasting between nine and 18 months, with at least 13 face-to-face sessions, probably in groups of 10 to 15 people, which the studies have shown to be most effective. These would include education on nutritious eating and physical activity as well as help in losing weight if appropriate.

“We’re looking for providers who can step up to the mark and deliver the programme,” Valabhji said. “We haven’t got the capacity to deliver within the NHS 5m interventions.”

Trials in Finland, the US, Japan, China and India have shown 30%-60% reductions in type 2 diabetes incidence over three years. Experts believe it will be important to tailor prevention programmes not only to the UK but to specific populations at risk within the UK. In Bradford, for instance, the target is everyone of south Asian origin and over the age of 23.

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Risks vary from one local authority to another, the new statistics show, with the highest proportions of people with raised blood glucose levels in Harrow, north-west London (14%), Dorset (13.4%), and Wolverhampton (13.2%), in the West Midlands. The local authorities with the lowest prevalence of people at risk are Brighton and Hove in West Sussex (8.5%), Islington, north London (8.6%), and Hammersmith in west London (8.7%). Higher rates are generally in areas with high ethnic minority or older populations, or both.

Barbara Young, the chief executive of Diabetes UK, said it is “really important that people at high risk of developing type 2 diabetes are given evidence-based support to reduce their risk.

“While the NHS diabetes prevention programme is a major step in the right direction we now hope to see greater support from all areas of national and local government to encourage people to lead healthy and active lives.”
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