Tackling the global diabetes time bomb
Sir Michael Hirst became a champion for diabetes 20 years ago.
It was about that time the UK Member of Parliament watched his young daughter grapple with Type One diabetes.
He made it his mission to help her — and millions of others like her.
Sir Michael is now the president of the International Diabetes Federation and travels the world urging governments, stakeholders, and everyday individuals to take diabetes more seriously.
He is on the Island speaking at the Bermuda Diabetes Association’s Health Summit, taking place from now until Friday.
• Why is it important for the Island to take a stronger stance in fighting diabetes?
You will know diabetes is a significant disease in Bermuda. The prevalence rates are high, especially compared to the UK. There is also a significant prevalence of pre-diabetes here. People, who unless there is some very positive intervention, are at serious risk of developing Type Two diabetes. Diabetes isn’t something that just happens like that, it takes a considerable number of years to develop, so if we can be more successful at highlighting the cases of people in the pre-diabetes stage we can prevent or postpone the development of Type Two Diabetes.
•So why is prevention so important?
Type Two diabetes is being diagnosed in people at an increasingly young age, sometimes in their 20s and 30s. It’s not only a health issue, but also an economic development issue. People of working age who become sick with the complications of diabetes can lose their lives to it because some of the complications are potentially fatal. So instead of being productive members of the work force they are not able to contribute to the development of a nation in the way they could if they were healthy. Our message to government is they shouldn’t just see it as a health issue, but as an investment. If a nation invests in the health of its people not only will they have more healthy citizens, but also people who contribute more to the development of the country and their quality of life will be better. If you’ve lost your sight due to retinopathy; your limb due to neuropathy; are on dialysis for hours each week; incapacitated through a stroke or housebound due to a heart attack then you can’t contribute as much as you might otherwise if you were healthy. Within the International Diabetes Federation (IDF) we talk about things at a macro level and national level, but behind every one of these cases is a person with diabetes who has a family who may well be financially dependent on them. Those people are entitled to a decent quality of life and can be left at a very disadvantaged state if these complications develop and can’t be tackled properly.
• What would you say to someone with pre-diabetes, if anything?
The most simple message you will hear is: eat less and walk more. I don’t want to be flippant about it, but that’s a pretty good maxim for people.
I understand that you have a very close and personal connection to diabetes. Can you explain what that is?
Yes, my daughter was diagnosed at the age of four with Type One diabetes. It’s an autoimmune disease where the body attacks the cells that produce insulin. For those who have it, it’s absolutely necessary to maintain stable blood sugar levels to survive. My daughter was diagnosed as a little girl and I was painfully aware of some of the shortcomings of care in the UK. I was a Member of Parliament myself then. The equipment we were offered to inject her insulin was a terrifying looking glass syringe that had to be sterilised. My eureka moment came when I was given an orange fruit to inject and I struggled with doing even that. I said to the nurse sharply, ‘There has to be an easier way to inject than this?’. She produced this beautiful insulin syringe, but then said you have to pay for this. Children who develop Type One diabetes have to take insulin several times a day in order to stay alive. In Bermuda they have been giving children pumps for many years now that are covered by insurance, but that wasn’t available to us then.
• What did you do to start getting your daughter better care?
I was campaigning to get disposable syringes added to the drug tariff and was eventually successful in getting that. Not because of the strength of my advocacy, but because the government had made free syringes available to drug users to curtail the spread of HIV. I said, this isn’t fair. I saw it as a complete injustice that those abusing drugs could get needles for reasons I wasn’t. I didn’t come into politics to see an injustice and not fight against it, so I did.
• What is the state of diabetes elsewhere in the world right now?
Diabetes is increasing in every country across the globe. There is no country that has cracked it yet, but Finland has made a great deal of progress. They had a national programme called DEHKO. They had a debate about what needed to be done and got the buy in from all the stakeholders and then took action in promoting exercise and healthy diets and making the relatively modest lifestyle changes that help to keep Type Two diabetes at bay. What it has done is lead to a reduction in cardiovascular disease and fewer people who are dying of heart attacks and stroke in that country.
• Are there any up-to-date statistics on how many people have diabetes in the world today?
Ten per cent of people with diabetes have Type One and the other 90 per cent have Type Two or are at risk for developing Type Two. The numbers will rise because medical advancements help people live longer with diabetes, but at the moment there are over 700 million people in the world with diabetes or who are at serious risk of developing it.
In another 20 years it’s predicted there will be over one billion people with diabetes or who are at serious risk of developing it. People dismiss it as a disease of the rich and plenty, but it’s far more widespread than people think. It’s predicted four out of five people with diabetes will be in the developing world and people of working age. Their economies will be further drawn back and held back by the burden of disease.
• The public is encouraged to come out to a free diabetes seminar tonight at the Hamilton Princess at 5.30pm. Global leaders in the fight against diabetes will be speaking, including Dr Petra Wilson, CEO of the IDF; Dr Belma Mandala, a leading doctor and researcher on gestational diabetes; and Anne-Marie Felton, past vice-president of IDF and the co-founder and current president of the Federation of European Nurses in Diabetes. To reserve a spot e-mail firstname.lastname@example.org.
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