Diabetes and its complications are fast becoming the UK’s No. 1 health threat, outstripping smoking-related diseases, cancer and drugs. Type 2 or so-called ‘adult’ diabetes, is the commonest form of diabetes and it’s greatly on the increase – teenagers and even some children are now getting it. We need to find out why.
Why is type 2 diabetes a problem?
Type 2 diabetes is more serious than people think because of its complications. It is the commonest cause of blindness, kidney failure and amputation. Heart attacks and strokes are three times more likely in type 2 diabetes.
When does type 2 diabetes start?
If the day that diabetes strikes is the explosion, then a fuse has been burning for months and sometimes years beforehand. Most people diagnosed with type 2 diabetes have probably had it for at least 10 years without realising it. Up to 50% already have complications when they are first diagnosed. While patient and family cope with the impact of the explosion, EarlyBird is trying to find out what ignites the fuse in the first place, what keeps it burning and – crucially – how to put it out before it detonates. There is evidence that the fuse is lit early in childhood, long before the symptoms become obvious. In some, the fuse that leads to diabetes will burn very slowly; in others, it will burn more rapidly and we need to know to control it.
Why the intense interest now?
The key reason is the rising frequency of diabetes and its impact on the health service. Diabetes alone now affects five percent of the population, but consumes ten percent of the NHS budget. Only recently, however, has it become clear that diabetes is not a disorder on its own, but part of a much broader ‘metabolic syndrome’. In the past, blood vessel narrowing, heart attacks and stroke were looked upon as complications of diabetes. Now we recognise them all as outcomes of a single disturbance – insulin resistance. Insulin resistance results largely from lifestyle factors such as overnutrition and underactivity. Their most obvious result is obesity, and upper body obesity in particular seems to be associated with insulin resistance. It is this issue – why some children but not others become insulin resistant – that sets the scene for the EarlyBird Study. We need to understand why if we are to prevent the epidemic affecting our children – and we need to understand quickly.