By 2014 it is estimated there will be four million people in the UK with diabetes – double from just 15 years ago. Fuelled by the western world’s obesity epidemic the condition is putting a serious burden on health services. But what can be done? HILARIE STELFOX reports

TYPE 2 diabetes used to be called age-onset diabetes because it was found, not surprisingly, in older people.

Today children as young as 12 or 13 are turning up with the condition in the Calderdale and Huddersfield NHS Trust area, alongside increasing numbers of middle aged and elderly patients. In Kirklees and Calderdale there have been 1,200 new cases in the last year – 90% Type 2.

The dramatic rise, says Diabetes Specialist Dr Vijay Bangar, is a direct result of better diagnosis and the obesity epidemic sweeping the western world.

As a physician for the trust he sees adult diabetic patients but has diagnosed patients as young as 16 with Type 2.

“I have been working in this field for the past 20 years and it is becoming more common,” he says. “We are finding Type 2 diabetes in people who are younger. Diabetes increases with age and body mass index – by the age of 50 one quarter of the population is obese and has a body mass index of more than 30, which is the major risk factor.”

According to Audit Commission data, members of the South Asian and Caribbean communities are even more likely to succumb to diabetes.

More than one quarter of South Asians over the age of 60 has the condition and generally this ethnic group is five times more prone to diabetes than the white population. Genetics does play a part in determining which people will develop the condition.

Type 2 diabetes occurs when the body does not produce enough insulin to maintain a normal blood glucose level, or when the body is unable to effectively use the insulin that is being produced.

“When your weight goes up, “ says Dr Bangar, “your insulin requirement goes up proportionally to your weight. At the start your insulin rises but there is a point at which the pancreas (which secretes insulin) can’t produce any more and then the blood glucose starts to rise. Eventually the insulin level starts to drop.”

He explains this process by likening the body to a car: “If you were to drive your car with your foot flat to the floor then it would be all right for a while but eventually the pistons would go and the car would break down.”

Caught early enough, it is possible to reverse the process and avoid diabetes but as many as 20% of all patients have already developed complications by the time they are diagnosed.

Complications include everything from heart disease and high cholesterol to failing eyesight and erectile dysfunction. In severe cases, diabetic patients may have to have feet or legs amputated because the condition affects blood circulation.

Despite the fact that diabetes is both a serious condition and can have serious consequences, Dr Bangar says he’s surprised by how many patients feel unable to address the primary cause – their obesity: “Patients tend to fall into two categories – the ones who try to reverse it, but these people are few and far between, and those who unfortunately carry on doing exactly what they were doing.”

Tackling obesity, he believes, is a complicated challenge for society: “We have lost touch with nature. So much of our food is calorie dense and easily available. People tend to eat according to the clock, filling up every four hours whether they need it or not.