Behind the headlines – Type 2 and Hospital Admissions by Helen Dickens
Many of you will have no doubt seen articles in the media today about the numbers of hospital admissions for people living with Type 2 diabetes. But what are these numbers really saying, and what impact does this sort of reporting have on perceptions of diabetes treatment. In this blog we’ll look at this in a bit more detail.
The headlines do not make positive reading: “Hospitals Deluged by 5000 Diabetics Every Day” cried the front page of the Daily Mail. We know that people with diabetes of all kinds are familiar with this narrative, that those with the condition, and particularly those with Type 2, are putting excess and unreasonable strain on our health service.
So what’s the real story behind these stats? Despite the huge figures reported in the media, the 2018/19 Hospital Episodes Statistics from NHS show that during this period, Type 2 diabetes was only recorded as the primary cause – that is, the reason for admission into hospital – in 27,000 cases.
At Diabetes UK, we don’t believe this narrative is fair, or that it is a helpful way to address either the rising prevalence of Type 2 diabetes, or the very real need to support people living with long term health conditions with appropriate care.
It’s true that cases of Type 2 diabetes are on the rise. And it’s true that many of these cases are related to ongoing high rates of obesity at all ages in our society. But hospital admission stats don’t tell us the whole story. While yes, increasing numbers of hospital admissions are for people living with diabetes, the data reported today does not distinguish between those who are in hospital because of their diabetes, and those who are in hospital for a different reason, who also have diabetes.
This distinction is incredibly important. People with diabetes can end up in hospital for any of the same reasons people without diabetes do. The fact is, everyone – regardless of whether they have diabetes or not – can experience health conditions or accidents that put them in hospital.
Suggesting that everyone with diabetes in hospital – and particularly everyone with Type 2 diabetes in hospital – is there because of their own choices and through their own making feeds into a dangerous, unhelpful narrative that does nothing to challenge the stigma that continues to impact on the lives of all people with all Types of diabetes.
Yes, the rise in Type 2 diabetes is being driven – in large part – by the rise in obesity. But we know that our society makes it very difficult to make healthy choices. That’s why we’ve been calling on the Government to take action on a range of measures to reduce consumption of food high in fat and sugar that include: restricting price promotions for unhealthy food; a ban on advertising unhealthy foods before 9pm, as we know children are exposed to a large amount of advertising for unhealthy foods during family viewing times; extending the soft drink industry levy (sugar tax) to milk based drinks; and incentivising further reduction in the sugar content of all soft drinks.
But we know the Government can go further still: we want to see them putting forward proposals for new fiscal incentives and disincentives that ensure the food and drink industry go further and faster in reducing sugar and calories in everyday products. This could include new levies on industry, sanctions for those within industry who don’t comply with reformulation programmes, and incentives aimed at increasing consumption of healthy food like fruit and vegetables.
Developing Type 2 diabetes isn’t, in most cases, an inevitability, and good work is taking place to support those at risk of developing it reduce or remove their risk altogether. But for those who do, it’s not helpful to demonise them for needing the support of healthcare professionals. We know that GP practices where as many people as possible with Type 2 diabetes are meeting treatment targets have fewer hospital admissions in people with Type 2 diabetes. That’s why those living with Type 2 diabetes need good quality care – in the primary and secondary care arenas – to reduce their risk of complications, and they need access to diabetes education and psychological support to help them to manage their condition effectively and meet treatment targets.
The headlines don’t tell the full story – and it’s not right for a narrative of blame and shame to dominate our national discussion around the complexities of Type 2 diabetes. What we need is a society, and a health service, that support healthy lifestyles, interventions to prevent Type 2 from developing in the first place, and to support good management to prevent complications in the long run.
Ultimately, the thing to remember is that health checks and routine appointments – the healthcare essentials everyone with diabetes is entitled to – are there to keep you as healthy as possible, for as long as possible. Our advice to everyone with diabetes – whatever their Type – is to remember their health is incredibly important, and maintaining it is impossible without the support of clinicians across the health service.
Helen Dickens is the Assistant Director of Policy and Campaigns at Diabetes UK