Diabetes prevention needs to start at home and in schools, leading doctor warns

Dr Eva Orsmond.

By Sarah Slater

Diabetes prevention needs to start with educating children at home by parents and in school by teachers, a leading doctor is warning.

Dr Eva Orsmond, outspoken broadcaster, former Operation Transformation medic and director of the Orsmond Clinics which specialises in the treatment of diabetes, weight loss and obesity, believes that Type 2 diabetes can be reversed with a change in lifestyle and eating habits.

This should start with lifestyle changes is vital to curtailing the Type 2 diabetes epidemic here and moves to tackle the concerning issue should not be based solely on medication, she says.

This year, €153m or 10% of the €15.3bn national health budget will be spent on diabetes care according to the Department of Health.

Dr Orsmond said: “We need to stop calling it a chronic progressive disease, as most healthcare professionals do.

“Lifestyle is the main contributing factor to this disease as it doesn’t appear out of nowhere. Poor food choices make children and adults overweight, the excess weight creates visceral fat, the visceral fat results in insulin resistance, and insulin resistance results in Type 2 diabetes.

We need to start the prevention with our children. Children should be weighed and their height measured and developmental milestones monitored in school setting.

“Home-economics should be compulsory and the importance of healthy diet should be enforced and children motivated to follow it. Childhood obesity will lead to even higher Type 2 diabetes epidemic.”

An extensive study by the International Diabetes Federation (IDF) Diabetes Atlas, found that in Ireland, there are 164,984 people or 4.65% of the population living with diabetes Type 1 or Type 2. A staggering 77,983 people remain undiagnosed.

Worldwide 425 million people have diabetes. This figure is projected to rise to 629 million by 2045, with 80% of the burden carried by low-income and middle-income countries.

The figures for Ireland also show that the number of deaths attributed to diabetes in 2017 was 1,091.

The Federation estimates that by the end of last year, four million people will have died from diabetes. The study also shows that almost half of those who died from the disease were under the age of 60, while half of those with the illness did not know they suffered with it.

Up to 223 countries were involved in the study.

According to the Irish Diabetes Society and the HSE there is no national diabetes register, which is a problem as there is no definitive data on the number of people living with the condition here.

Dr Orsmond added: “We need to start telling people that the most effective treatment is not drugs but weight loss. Weight loss gets to the root cause of this disease and halts it while drugs just delay the progression of the disease, they don’t stop it.

“In this country are all too often led to believe that Type 2 diabetes is a condition whereby the body does not make enough insulin, and that the insulin the body does produce doesn’t work as well as it should. The role that excess weight and abdominal obesity play in Type 2 diabetes is rarely discussed.

The idea of taking personal responsibility for this excess weight and encouraging people to do something about it.

“It is a topic that is never raised. Instead, people are nudged in the direction of a life where they manage their condition with medication, and not just medication for their diabetes but for all of the ancillary ailments that go hand in hand with it.

“So why, then, is more not being done to show those with Type 2 diabetes that they do not need to take medication for the rest of their lives? They are provided with free medication under the Long-Term Illness Scheme, free retinal screening and in some cases a medical card, but where is the emphasis on curing this disease through weight loss and dietary change?

“Where are the free weight loss clinics which would tackle the cause of the disease? Where is the personal responsibility? Under the Long-Term Illness Scheme, the other listed chronic conditions are not lifestyle related: in my opinion, Type 1 diabetes should be on this list, but Type 2 diabetes should not.”

In a statement the HSE explained that:

  • “There is currently no accurate figure for the number of people living with diabetes. Ireland does not have a National Diabetes Register. This deficit represents a significant barrier to improving diabetes care for individuals living with Type 1 and Type 2 diabetes in Ireland.

    “Achieving the goal of developing and maintaining a National Diabetes Register will require commitment and buy-in from many stakeholders including the Department of Health, the Irish General Practice Community and several Divisions within the HSE.

    “The most important stakeholder by far is the Irish General Practice Community. The negotiations around a new GP contract are key to securing buy-in from Irish General Practitioners to allow Ireland work towards developing a National Diabetes Register.

    “The experience in other countries would strongly suggest that if a National Register/Audit of Care can be initiated then the resultant data will generate many important questions for future audit and research.

    "It is a key priority of the National Clinical Programme for Diabetes to demonstrate the benefits of developing and maintaining a register for individuals living with diabetes."

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