World diabetes day: Why the UK’s South Asian communities need to take action
Today is World Diabetes Day and in my clinic I’ll see several patients whose hearts have been damaged by diabetes. I’ll treat them and encourage them to make lifestyle changes. And I hope they have the support of their families because it isn’t easy being a patient with diabetes who has heart problems. Over the coming years I fully expect to see many more patients with heart disease directly caused by diabetes because we are in the grips of a diabetes epidemic.
In 1996 the number of people in the UK with diabetes was 1.4 million. Now that number is closer to three million and by 2025 it is estimated that five million people will have diabetes. Currently the NHS spends 10 per cent of its budget on diabetes – about £10 billion. It’s predicted that within the next 25 years the direct costs of treating diabetes will rise to 17 per cent of the budget, driven by our rising rates of obesity which is the single biggest risk factor for developing Type 2 diabetes. These costs don’t account for the complications associated with diabetes and that’s where my work as a cardiologist begins.
I see people whose hearts have been ravaged by the condition. If you have diabetes you have about twice the risk of developing a whole range of conditions that affect your cardiovascular system compared to someone free of diabetes. Cardiovascular disease accounts for 44 per cent of deaths in people with Type 1 diabetes and 52 per cent in people with Type 2 diabetes, the latter being the form of the disease that can be prevented.
Cardiologists aren’t the only medical specialists being kept busy by the UK’s growing number of diabetes patients. My colleagues who look after the kidneys know that diabetes is the single most common cause of end stage renal disease. Diabetes is the leading cause of blindness in people of working age in the UK, keeping the ophthalmologists busy. Even obstetricians have to manage diabetes as incidence of Type 2 diabetes rises in young pregnant women risking the health of unborn babies.
On their own these statistics alarming enough but for British Asians the news is even worse. I’m of South Asian origin and I know my risks of developing diabetes are far higher than someone whose ancestors were white Europeans. If I was of white European origin I’d only just be in the age range when I might be developing Type 2 diabetes but as an Asian male I could have developed it my twenties. And if, as an Asian diabetic, I was to go on and develop heart disease, my chance of dying prematurely is far higher than any other ethnic group.
Faced with such challenges I’ve been working with colleagues at the health charity, the South Asian Health Foundation to teach and empower not only healthcare professionals but also the UK’s diverse Asian communities about diabetes and its consequences.
We are committed to reaching this community group which so many health experts describe as ‘hard to reach’ and giving them the tools to fight back against the threat of diabetes. The work we’ve done suggests South Asians aren’t hard to reach but you have to focus your information, so that it’s relevant to their lives, concerns and culture. Our goals are simple. Firstly, to prevent as many people in the UK of South Asian origin from developing diabetes. And secondly, ensuring that those who already have it know how to take care of themselves, so that heart disease, kidney failure and blindness are kept at bay.
Last year we launched ‘SACHE Diabetes’ an educational programme delivered in temples, mosques and gurdwaras from Birmingham to Glasgow, tailored for each South Asian community we worked with. Often we worked in multiple languages alongside local healthcare professionals, known and trusted by the people we wanted to reach.
SACHE provided factual information, attempted to dispel myths about diabetes and addressed the stigmatisation related to diabetes among South Asians. Many South Asians with diabetes hide their condition, making it difficult for them to get the support of their families or optimum medical support.
In 10 sessions we reached more than 800 people, referred many of them to their GPs to get checked and disproved the commonly-held belief that South Asians are difficult group to educate on health matters. Rather, I think it’s a case that conventional health promotion programmes do not know how to reach out to these communities.
For some communities, you have to tailor the information so that it is culturally and linguistically sensitive and will make a difference to their health outcomes. I’m serious about making a difference to the health of all my patients and preventing many more of them from developing diabetes.
Dr Kiran Patel is a Consultant Cardiologist at Sandwell and West Birmingham Hospitals NHS Trust and Chairman of Trustees at the South Asian Health FoundationTagged in: diabetes, South Asian, South Asian Health Foundation, World Diabetes Day
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