hen I was

training, type 2 diabetes was only seen

in late middle age,” says Jane Armitage,

a professor of epidemiology at Oxford

University. “You saw it in 60-year-olds,

and you saw it, rarely, in 40-year-olds.

Now, I see it in teenagers.”

Back in 1996, just 1.4 million people

were known to have the disease. Today,

it is estimated to affect about 4.7 million,

making it one of Britain’s biggest killers.

But it’s a quiet one. Only 3.8 million have

been diagnosed, leaving swaths of the

population unaware. Diabetes currently

costs the NHS around 10% of its budget,

yet it’s cruelly underfunded. It was, until

recently, thought to be incurable.

By damaging blood vessels, diabetes

has the potential to cause problems in any

part of the body. It can lead to blindness

if it affects blood vessels in the retina;

it can cause nerve damage if it affects

those in your feet. It causes kidney

damage, sometimes leading to renal

UK than all cancers and dementia put

together, yet Diabetes UK, the nation’s

largest diabetes charity, has an annual

income of around £40m – compared

to Cancer Research UK, which draws in

more than £600m. All of which poses

two questions: what’s driving this sharp

rise? And, more pressingly, why aren’t

we paying more attention to it?

KNOW YOUR RISK

There are two main kinds of diabetes.

Type 1 is rarer, accounting for less

than 10% of cases. It’s an autoimmune

disease: your body’s defences attack

the cells that produce the hormone

insulin, which helps to control blood

sugar levels. Type 2 is the one that most

people think of when they say “diabetes”.

It occurs when the body becomes less

adept at producing insulin, or less

sensitive to the hormone. There are

many factors that influence type 2

diabetes. Your family history is important,

as is your ethnicity. People of south

Asian origin, for instance, are six times

more likely to get the disease.

One big reason for the increase in

rates is, ironically, we’re living longer. “In

middle age, about one in 10 people have

it, but by the time you’re 70, it’s one in

five,” says Julia Critchley, a professor of

epidemiology at St George’s, University of

London. But the key factor is the nation’s

creeping weight gain, and men are less

likely to notice. Middle-aged men are

“In middle age, one

in 10 people have it,

but by the time you’re

70, it’s one in five”

W

“

failure. It increases

the risk of heart

attack and stroke.

These effects are

insidious: many

people live with the

disease for a full

decade before

they are diagnosed,

and around a third of people already

have complications – eye damage,

kidney damage – by the time it’s

identified. According to a report

by Diabetes UK, type 2 sufferers can

expect to live about 10 years less, on

average, than people without it.

Yet, despite this grim litany, it remains

in many ways a hidden illness. Sure,

we’ve all heard of it, but people rarely

run sponsored half-marathons for

diabetes like they do for breast cancer or

Alzheimer’s. It affects more people in the

disproportionately

affected and are

twice as likely as

women to be living

with diabetes

undiagnosed.

Some of this is

biological: men

need to gain far less weight to develop

the disease. But it’s also habit. “Men

simply don’t access their GPs as often as

women,” says Alice Connolly, a dietitian

who specialises in weight management

and diabetes. “Since symptoms are

often silent, most will find out they have

diabetes as a result of investigations for

something unrelated.” Statistics back

this up: only 16% of people diagnosed

have proactively asked for a test. We’re

leaving a lot to chance – and, increasingly,

luck is not on our side.

A WEIGHTED DEBATE

Then there’s our second question: why is

it so under-resourced? According to Dan

Howarth, head of care at Diabetes UK,

MISSING THE POINT:

DIABETES ISN’T JUST

ABOUT MEDICATION

much of this is simple stigma. Society can

unjustly stereotype those with type 2 as

“lazy people who don’t want to look after

themselves”, he says, which, of course, is

not the case. It’s the same reason that lung

cancer receives less attention than breast

cancer: people feel that the victims are to

blame. Critchley concurs, citing “lack of

understanding and victim blaming”.

In patients, or those at risk, this

message can be internalised. Because

diabetes is a disease of lifestyle, we

might reason that it does not pose the

same threat as something we perceive

to be beyond our control, such as cancer

or dementia. This lack of urgency

is a problem, because type 2 can be

managed effectively if it’s caught early.

96 MEN’S HEALTH