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Diabetes sufferers are not necessarily to blame

Dr Ben Daniels

140986345 227x300 Diabetes sufferers are not necessarily to blame

According to recent research about to be published, Type 2 diabetes treatment will use £16.9bn of the NHS budget as the number of diabetics rises from 3.8 million to 6.25 million by 2035. This has fueled scaremongering media reports with talk of “diabetes bankrupting the NHS within a generation”. Unlike other diseases, discussion about type 2 diabetes often results in debate about who is to blame. The head of diabetes UK states that the NHS needs to improve its care of diabetics. Other commentators recommended the government should be blamed for not taxing sugar rich food and others suggest supermarkets are responsible because of the cheap unhealthy foods that they push. The other obvious villains in the piece are the diabetics themselves who are usually portrayed as unrepentant fatties who can’t stop shoveling down the doughnuts? I’m not convinced that looking to blame any one group, especially those who have the condition, serves any purpose other than demonizing the disease and alienating the sufferers.

Firstly it is important to state that Type 2 diabetes isn’t solely caused by obesity. Age and genetics play a significant role too, but I accept that significant improvements in diet and lifestyle habits would cause levels of the disease to plummet and would also significantly reduce complication rates for those already with the condition.

Part of my job is to improve the lifestyle of my patients but the more bullish I am about the advice I give, the more defensive and unresponsive my patients become. Early on in my career I remember having a patient with a BMI of 40 who insisted she only ate lettuce. When I suggest this couldn’t be true, the ensuing battle escalated to a full blown row. We got nowhere and the result was that she completely disengaged from any of the support services available and completely failed to gain control of either her weight or her diabetes. The longer I’m a doctor, the more I realise that sticks rarely work with regard to encouraging lifestyle changes. As with any addiction, the addict needs to admit the problem to themselves before he or she can accept any help and change behaviour. Deep down most of us have issues with food at some level and I am no exception.

I spend a lot of my time explaining the perils of excess sugar to my patients and so this week I decided to practice what I preach. I completely banned myself from eating any sugar during my working day. How hard could it be? It was going well on Monday until one of my morning patients bought me a Twix bar. It sat on my desk goading me for at least 3 patients but then temptation got the better of me. The shiny gold wrapper poked out of the bin mocking my poor will power for the rest of the morning. The afternoon was going well until our nurse brought in some home baked chocolate brownies to celebrate her birthday. It seemed rude not try one and they looked so much more appetising than the pot of sunflower seeds I had optimistically brought in to stave off that predictable mid-afternoon sugar craving…..Changing diet and lifestyle habits that we have held for all of our lives are hard. Our brains are trained to respond positively to the reward of a sugary treat, well mine is anyway.

Fortunately for my diabetic patients, we have a fantastic new community diabetes team. The nurses who run it are enthusiastic and welcoming and offer clear non-judgmental advice and support on everything related to diabetes. They don’t preach or lecture, but just allow patients to come and ask questions, meet each other, dispel myths and hopefully motivate themselves  to make the changes they need to take control over the disease.

Right now I’m slim, young and active, but I’m certainly not immune to getting diabetes one day. For those of you “holier than thou” who can live on a diet of porridge oats and celery, I salute you, but for the rest of us mere mortals lets perhaps look at some more practical ways of helping fight diabetes rather than solely looking to vilify the victims of the disease. Our community diabetes team is brilliant but I really wish we had a similar service to help overweight patients before they develop the disease. Practical, simple, non-judgement support would be a real investment and potentially pay for itself many times over if it successfully reduced diabetes rates. We do need to work hard together to effectively prevent and treat type 2 diabetes, but ultimately if the NHS collapses, it will do so because of underfunding and government privatisation. Let’s not blame type 2 diabetics who already have enough on their plate. (pun intended)

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  • maias

    I thought stress could trigger the onset of Diabetes type 2.
    The best thing for T-2s to snack on is a ‘lost Inca crop’ – a root called Yacon . It’s eaten raw and is sweet but the human body can’t absorb the sugar. Dragon fruit is also meant to be okay. Trouble is, you need to be in a place where it’s cheap!

  • michaelw3357

    After 20 years of rotating shift work I was diagnosed with T2 diabetes. I recently noticed this interesting article from the BBC. 
    http://www.bbc.co.uk/news/health-17680882

  • http://www.facebook.com/ellie.chard Ellie Chard

    Having been a type one 55 year old for the last 32 years I know that its all about healthy living and we in society have to ensure that everyone can afford fruit, vegetables and lots of exercise for everyone to participate.  I also tell everyone walking is free if money is the reason for not exercising!

  • SpinMD

    I was diagnosed with T2 over 5 years ago, and I can say with complete confidence that the weight gain prior to diagnosis was not a cause, but a symptom: without treatment, I was unable to use the sugar I was eating, and hence the craving for more (Mars bars and Coca-Cola). I put on 15kg. 

    Now i am on Metformin, I no longer crave sugar – I don’t actually like it very much – which was how I was until a few years before I was diagnosed.  I have lost the 15kg. 

    I have talked to quite a few other diabetics, and a lot of them that this was their experience too.

    I strongly suspect the real culprit is the weed killers and fertilisers widely used n the 1950’s and now banned.

  • Guest

    “Part of my job is to improve the lifestyle of my patients but the more
    bullish I am about the advice I give, the more defensive and
    unresponsive my patients become.”

    This comment reveals the key to the treatment of diabetes, a disease which I believe has its roots in our culture. I have no doubt it will be received by patients as a reproach. Forget genes and lifestyle, diabetes is caused by lack of self esteem and a lack of hope; a deeply rooted thought within the patient’s  psyche that he is worthless and deserves to die. And so his brain puts his hormonal system and metabolism to work on this task of self destruction completely autonomously. Obesity’s relationship with diabetes is not causal. It is comfort eating. Both conditions correlate with lack of self esteem. This lack of self esteem is the reason this disease is becoming more common in our individualistic British culture where the value set of ‘winners’ equates to getting rich and having sex. In my opinion until we change this value set in favour of a culture which places kindness above criticism we will make little progress with this disease.

    By all means optimise lifestyle and diet. These will slow the effect. But the opponent is a malign thought, and you can only defeat a malign thought with a good thought.

    Have a nice day!

  • Joanne Davis

    I contracted T2 about six years ago and I was slim! (still am) my grandmother had T2 and so did my mother. I think it’s hereditary but I did crave very sweet things and did eat and drink sugary products but not to excess. 

  • colwood

    Threatening to throw people out of windows because they disagree with you?  Perhaps you would prefer to live in North Korea or some other dictatorship where such actions are commonplace?

  • http://profiles.google.com/sj2503 Stephen Jones

    I’m type 2 diabetic and grossly overweight, but the weight problem started because of another endocrine condition which caused bone and muscle growth, which in turn caused mobility problems which led to weight problems and finally diabetes.  Of course I’m probably now classed as a leech on society, workshy or any one of the other nasty little comments which follow someone who has difficulty in getting employment by the followers of Herr Cameron and his nasty party.

    This government has tried to, and in part succeeded in demonizing anyone who has the audacity to claim a benefit regardless of their reasons for being on a benefit and unfortunately they seem to have the backing of a large number of brain dead morons who just believe and accept everything which is spoon fed to them by a Tory propaganda machine, which if you look closely has similar parallels with the Nazi party, in the way that Hitler demonized the Jews, etc to get what he wanted.  People often question the morality of the German people during those dark days, yet we can see the same thing happening in this country to a lesser extent, because the people who support this Tory led government are allowing, indeed supporting the vicious cuts that their glorious leader is making to the poorest in our society, while at the same time feathering the nests of the richest groups, which guess what, Cameron and his government happen to be part of.  “All in this together”, yes, pull the other one.

  • http://www.facebook.com/suanni Susan Taylor

    Maybe instead of pointing fingers money should be put into researching a cure for T2 diabetes

  • DancingMice

    I vote We victimise the foreign/Channel Isles based billionaires who own and lead thecUK’s media, without whom Ken Livingstone and Labour would be running the country.(albeit possibly in coalition with the LibDems & Green)


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