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Written on 2nd April 2020 by

Leading diabetes charity, Diabetes UK estimates that 3.9 million people in the UK are living with a diagnosis of diabetes. 90% of those who are known to have diabetes have Type 2. In addition, the charity believes that a million more people are unaware that they have Type 2 diabetes, because their condition has not yet been diagnosed.

Excluding the recent impact of the coronavirus outbreak treatment of Type 2 diabetes accounts for nearly 9% of the annual NHS budget, a total of £8.8 billion each year.

One in six of all hospital patients has diabetes, often not as the main reason for their admission but as an underlying condition which prolongs their stay in hospital and makes readmission more likely, slows their healing, and significantly increases their risk of death and serious complications.

In addition to the 4.9 million current sufferers of Type 2 diabetes, right now a further 5 million people in England are estimated to be at high risk of developing the disease. What’s so sad about these figures is that, unlike Type 1 diabetes, which is less common and incurable, Type 2 diabetes can often be prevented with a few lifestyle changes.

What is diabetes?

Diabetes occurs when there are excessive levels of blood sugar (or glucose) in someone’s blood. The two main types of diabetes are called Type 1 and Type 2.

Type 1 diabetes is less common than Type 2. Nobody knows why Type 1 occurs except that it is not directly connected to lifestyle. In Type 1 diabetes, the body’s immune system attacks the cells which make an essential hormone called insulin. This hormone controls the amount of blood sugar by moving it out of the blood and breaking it down to make fuel for the body (energy). Type 1 diabetes is a serious, lifelong condition which must be controlled by regular insulin injections.

Type 2 diabetes is much more common. It occurs when the body becomes resistant to insulin or cannot make enough insulin to control the level of sugar in the blood. If caught early, Type 2 diabetes can often be managed with lifestyle changes. If left to progress over time, medication may be needed to control it.  The good news is that for most of those who know they are at risk, Type 2 diabetes can be prevented.

Who is at risk of Type 2 diabetes?

The risk of developing Type 2 diabetes is higher for people who:

  • are over 40 and white;
  • are over 25 and African-Caribbean, Black-African, Chinese or South Asian;
  • have a family history of diabetes;
  • are overweight;
  • have high blood pressure;
  • have a history of heart attack or stroke;
  • have a history of schizophrenia, bipolar illness or depression, or are on anti-psychotic medication;
  • have had polycystic ovaries, gestational (related to pregnancy) diabetes, or a baby weighing over 10 pounds.

Some of these risk factors can’t be avoided, but there is a lot that can be done by individuals who are at risk to prevent or delay the development of Type 2 diabetes.

What can I do to reduce my risk of Type 2 diabetes?

Type 2 diabetes is preventable. The key to prevention is healthy lifestyle choices. Changes in behaviour towards a healthier lifestyle have been proven to make a difference.

Ways to reduce your risk of developing Type 2 diabetes include:

  • eating healthily;
  • exercising or moving more;
  • or losing excess weight.

Many people find it’s easier to make these changes by:

  • choosing a form of exercise that they enjoy;
  • setting realistic goals;
  • introducing one change at a time and making that one change a daily habit;
  • seeking advice and help from a professional, such as a GP;
  • joining a support group, such as a weight loss programme.

One of the most effective ways of getting the information, motivation and support you need to make these changes is by joining the NHS Diabetes Prevention Programme.

What is the NHS Diabetes Prevention Programme (NHS DPP)?

The NHS DPP is a joint commitment by NHS England, Public Health England and the charity Diabetes UK to run a behavioural programme to support people in lowering their risk of Type 2 diabetes.

The Healthier You: NHS Diabetes Prevention Programme (NHS DPP) identifies people who are at high risk of the disease and refers them onto a free behaviour change programme. By doing so, the programme aims to reduce the number of people affected by Type 2 diabetes each year and the cost of Type 2 diabetes to the NHS. To date 300,000 people have received help from the programme.

The nine month behaviour change programme was initially styled by some as an NHS ‘diabetic bootcamp’ but it is intended to be educational, supportive and motivational. Those who are referred to the NHS DPP receive individually personalised help to reduce their risk. This includes education about healthy eating and lifestyle, help with exercise or physical activity and losing weight if that is needed. Taken together, these changes have been proven to prevent or significantly delay the development of the Type 2 form of the disease.

How do I join the NHS Diabetes Prevention Programme?

If an individual is at risk of developing Type 2 diabetes and is eligible for the NHS Healthier You Diabetes Prevention Programme, they can be referred by a health professional, such as their GP.  Participation in the programme is free. 

To be eligible, the individual must be:

  • aged 18 years or over;
  • registered with a GP practice in one of the areas where the programme is taking place;
  • have high glucose levels which put them at risk of Type 2;
  • not be pregnant;
  • be able to take part in light to moderate physical activity.

What happens on the NHS Diabetes Prevention Programme (NHS DPP)?

Once an individual has been referred to the programme by their GP or health practitioner and their place is confirmed, they will :

  • have an initial one-to-one assessment with a Health & Wellbeing Coach to assess their health, understand their individual needs, motivations and goals for the programme;
  • join a local group programme, where they will receive nutrition guidance and support, personalised help with making changes necessary to prevent Type 2 diabetes and meet their goals, and exercise sessions and advice;
  • have an end of programme one-to-one review with their Health & Wellbeing Coach to review and  celebrate their achievements and learning so far and help set ongoing goals.

Why is prevention of Type 2 diabetes so important?

Diabetes is one of the UK’s biggest health challenges of the 21st century. Around 22,000 people with diabetes die prematurely in the UK each year.

Diabetes affects all aspects of an individual’s health. Serious complications of the disease include  hypoglycaemia (low blood sugar), damage to eyesight from retinopathy and blindness, heart disease, kidney damage,  nerve damage and amputation. In addition to its own complications, diabetes is associated with many other conditions, such as thyroid disease, coeliac disease, dental problems and muscular conditions.

There is still no cure for diabetes. The good news is that, if the risk is recognised early, its most common form, Type 2, can be prevented.

In a recent case we helped a diabetic amputee client claim compensation for negligent medical care. Our client, who was suffering from Type 2 diabetes, went to see the nurse practitioner about a warm, potentially infected, swollen and discharging right foot wound, having stepped on glass the day before.

The nurse failed to refer him to a MDFC team and administered antibiotics without checking the patient’s systemic health putting him at risk. Three days later he went to A&E who also failed to check his medical history, his diabetic health and sent him home.

Eventually he was taken to hospital and a below knee amputation was carried out. He has undergone eight operations and has extreme stump pain which means that he can’t tolerate prosthesis without further surgery. He is wheelchair dependant, unable to work in his former job and has suffered a psychiatric injury.

We pursued a claim and secured full liability judgment for the claimant, together with an interim payment of £100,000 for pay for the trial of prosthesis. We are now working with our experts to value the claim.

If you have suffered an amputation through a delay in treatment email our specialist lawyers mednegclaims@boyesturner.com.