COVID-19: Type 2 Diabetes

Question

Asked by

To ask Her Majesty’s Government what steps they are taking to support people at high risk of developing type 2 diabetes who have gained weight during the COVID-19 pandemic.

My Lords, helping people to achieve and maintain a healthy weight is one of the most important things we can do to improve our nation’s health, as I am sure many noble Lords agree. Our world-leading strategy to meet this challenge was published in July 2020 and reflects the significant work undertaken over recent years to halve childhood obesity and create a healthier environment to help people maintain a healthy weight.

My Lords, new NHS research reveals that people seeking help to lose weight are significantly heavier now compared with those who sought help pre-pandemic. With type 2 diabetes closely linked to obesity and local public health services shown to be highly cost-effective in helping people to lose weight, what assessment has the Minister made of the link between the cuts in funding and the increasing levels of obesity and diabetes, and will the NHS evidence now drive the Government to commit to reversing public health grants and properly funding services that are essential to tackling obesity?

I am sure that noble Lords will agree that it is really important that we tackle these issues and respond to the weight increases over the Covid-19 lockdowns. In March, the Government announced £100 million of extra funding for healthy weight programmes to support children, adults and families to maintain a healthy weight. Additionally, more effort has been put into providing access to information.

My Lords, currently one in 10 people in the UK are suffering from type 2 diabetes, a figure which has doubled in the past 15 years. It already gobbles up an unsustainable 10% of the NHS budget. As my noble friend said, it is preventable and treatable through maintaining a healthy weight, diet and exercise; there is no need for expensive medication. Can my noble friend continue to encourage systematic support so that people can achieve these objectives?

I thank my noble friend for that question and recognise the work she did with the Centre for Social Justice on this issue. The Government are keen to drive the NHS diabetes prevention programme, which plays a pivotal role in supporting those at risk of developing diabetes. During 2018-19, over 100,000 people took up the programme. In 2019-20, NHS England delivered the long-term-plan target, supporting around 120,000 people on the programme.

My Lords, does the Minister agree that all those over the age of 40 who are obese, and those who record a high score on the diabetes type 2 assessment, should be offered a blood glucose and haemoglobin A1c test? If he does not agree, can he say why?

The Government, in conjunction with the Department of Health and Social Care and many other partners, including Diabetes UK, are looking at the most effective way to tackle diabetes but also to understand the trade-offs that must be made and the balance of considerations. I will write to the noble Lord on the detail of his question.

In addition to the link between Covid and weight gain, some people can develop diabetes after an acute Covid-19 infection. The causes are not fully understood. What research into this connection are the Government encouraging?

The Government and the Department of Health and Social Care are reviewing the many impacts of Covid-19 that noble Lords will acknowledge. We are still trying to understand the various implications of lockdown. We have seen increases in weight leading to more type 2 diabetes. I will write to the noble Lord giving a detailed answer to his question.

My Lords, as my noble friend Lady Jenkin has already mentioned, we have known for many years that reducing weight can reverse type 2 diabetes. With others, I was doing this successfully over 60 years ago. This draws attention to the urgent need for an even greater campaign to deal with the 71% of people in the UK over the age of 30 who are obese or overweight.

The Government have implemented weight-management services. Tier 2 behavioural weight-management services have been provided by 98% of local authorities thanks to the distribution of £30.5 million as part of the adult weight-management services grant. Additionally, £12.8 million was invested in an NHS digital weight-management programme for individuals with multiple long-term conditions, as well as NHS staff. There are a number of other programmes related to weight management which I may well go into in answering a later question.

I am sure that the Minister is aware of the great social inequality in levels of obesity, as there has been with Covid levels. If you cannot afford a healthy diet you run a much higher risk of developing obesity. What measures will the Government explicitly put in place to support those on lower incomes to easily afford healthy diets—for example, factoring the costs of healthy diets into benefit levels, boosting healthy-start vouchers and introducing fruit and vegetable prescriptions? Right now, if you want to get a lot of calories to make you feel full, the cost differential is around a factor of 10.

In response to the increases in weight due to Covid-19, but also before, which led to more type 2 diabetes, the Government, the DHSC and the NHS have been looking in detail at how to respond. Further details will be made available.

My Lords, I am glad that the Government recognise that this is a huge problem, and the dangers that being overweight brings, especially during Covid. However, does my noble friend not recognise that the strategy, good as it may be, is not working? Is it not time to revert to the situation when I was young, when it was not socially acceptable to be grossly overweight, and to push individual responsibility? Government policy should tell people that they must not eat so much.

I am beginning to wish I had eaten a full breakfast. With any strategy or programme, we always have to be careful about unintended consequences. As we focus more on obesity and make more people aware of healthy living and healthy eating, it is important to have the right balance and to be aware of the impact this can have, so that we are not creating more problems, concerns and anxieties for those who suffer from eating disorders.

My Lords, one in three deaths during the first period of the pandemic were among people with diabetes. Obesity accounts for most of the risk of developing type 2 diabetes and, even without the problems of the pandemic, a type 2 diabetic, such as me, at my age, is expected to put on one or two kilos every year. Will the Minister now look to reverse what the King’s Fund says is, in real terms, a £1 billion cut in local authority public health budgets since 2015, and at providing even more support for programmes such as GP referral to fitness classes, which can help people manage their diabetes more effectively?

As well as looking at the important role that funding can play, it is important to do better with the money available. There are many things we can do to make sure that the programmes we have are more effective, but I repeat that we have to make sure that they work and we have to look at the evidence. When discussing the evidence internally in the department, I have been told that many of these programmes will be reviewed after five years to make sure that they are effective and do not lead to unintended consequences.

My Lords, the Minister made reference to the well-being strategy in his opening Answer. In the interest of joined-up government, I also urge him to take notice of another strategy, the Dimbleby review of the national food strategy. None of these problems will be resolved unless we go to their root, which is our attitude to food availability and the supply chain.

The Government will consider a number of inputs in looking at the most appropriate strategy to address type 2 diabetes and, as many noble Lords have referred to, the increase in weight of many in our population during lockdown. The Government will consider the evidence of the Dimbleby independent review throughout the development of our food strategy.

My Lords, all supplementary questions have been asked, so we now move to the next Question.