Global and national measures to tackle the diabetes epidemic: A step in the right direction

I was interested to read some reports that have been published in the past couple of months and I wanted to share my thoughts about them with you.

Everywhere you look there seems to be evidence of the increase in the prevalence of diabetes. The World Health Organization (WHO) has published a report on diabetes, which shows that the global incidence rate of type 1 and type 2 diabetes has quadrupled since 1980, rising from 108 million cases to 422 million in 2014 (WHO, 2016). The report concludes that there must be a more integrated effort to better manage non-communicable diseases (NCDs), such as diabetes and cardiovascular disease, in order to yield improved health outcomes. It also includes recommendations for national governments, such as prioritising the prevention of obesity and strengthening the health system response to diabetes in primary care. 

As part of the 2030 Agenda for Sustainable Development, member states have set an ambitious target to reduce premature mortality from NCDs, including diabetes, by one third, achieve universal health coverage and provide access to affordable essential medicines – all by 2030. I wonder if our newly launched Diabetes Prevention Programme (NHS England, 2016) will stem the flow of new members to the “Diabetes Club”? 

Diabetes and its complications bring about substantial economic loss to people with diabetes and their families, and to health systems and national economies through direct medical costs, as well as loss of work and wages. The major cost drivers are hospital and outpatient care, including monthly prescriptions. The Health and Social Care Information Centre (HSCIC) has just published data showing the number of items and cost of all prescriptions that were dispensed in England last year (HSCIC, 2016). The report shows that over 1 billion prescription items were dispensed in the community, at a total cost of £9.27 billon, which was an increase of 4.7% from 2014. The largest share of prescription items dispensed was to treat cardiovascular conditions, at a cost of over £1 billion. 

As far as diabetes treatments are concerned, including oral medications and insulin (but not blood glucose test strips), the new data shows that £936 672 500 were spent last year. As someone with type 1 diabetes, I know that my own monthly prescription cost runs into a couple of hundred pounds. 

Of the top 20 items prescribed over the last year, across all therapeutic areas, metformin came in at number twelve, with 1.8 million prescriptions. As we know, many people with diabetes have many more medications to take alongside their diabetes medication. The number one prescribed medication was simvastatin, with 34.4 million prescriptions. 

Lastly, diabetes is now included as a top priority for the Department of Health (DH) 2015–2020 Delivery Plan. The DH published its Shared Delivery Plan, which summarises the main priority objectives for 2015–2020 (DH, 2016). The plan identified ten objectives, including improving treatment and care for people with diabetes, so that they can better manage their condition and avoid associated complications. The plan also focuses on access to innovative medicines, which will be supported through the implementation of the findings in the Accelerated Access Review (available at: http://bit.ly/1CPNXXb).

Sobering reading, don’t you think? But lots of potential action to be taken. I guess we just have to wait and see what the future brings and gauge whether any of these initiatives bear fruit. In the meantime, keep up the great work ladies and gentlemen working in diabetes care!