Like my hon. Friend, my wife is younger than me. It must be a Northern Ireland DUP MP thing—we look for younger wives to keep us young. I am not sure if that is right or wrong, or if it is politically correct to say that, but my wife is nine years younger than me. She understands the issue of me and diabetes.
Some 10% of people with diabetes have type 1 and 90% have type 2. I will refer to both throughout my speech, and I encourage hon. Members to do the same and to acknowledge the different factors at play with each. We can manage type 2 with medication, provided we control what we eat and what we put in our bodies. Of those living with diabetes, we have the broadest cross-section of society. The condition affects all genders, ages, ethnicities and financial situations. However, too often I see that policy makers and clinicians fall into the trap of treating people with type 1 or type 2 diabetes as homogenous groups that will respond to the same approach and message, but they respond in different ways.
During this debate I want to focus on four things: the primary prevention of type 2 diabetes; the need to offer different messaging to ensure that the support is appropriate for each individual living with diabetes; the necessity of preventing the complications of all forms of diabetes; and innovations in technology—there is marvellous technology —and patient pathways that can improve outcomes for people living both type 1 and type 2 diabetes. I wish that I had known 12 months before I was diagnosed that the way I was living—the lifestyle, the stress—was putting me at risk. We all need a bit of stress; it is good and keeps us sharp, but high stress levels with the wrong eating and living habits is harmful. I do not drink fizzy lemonade any more because it was one of the things pushing me over the edge. That was probably why I lost most of the weight fairly quickly.
Let us talk about prevention. Today more than 12 million people are at increased risk of type 2 diabetes across the UK. More than half of all cases of type 2 diabetes could be prevented or delayed. If I had known a year before my diagnosis, I could have stopped the downward trend in my health, but I did not know, and I wish that I
had done. Many in this House offer leadership on type 2 diabetes prevention; the right hon. Member for Leicester East is certainly one of them. England is a world leader on this front, having recently committed to doubling its national diabetes prevention programme.
I was pleased to attend a roundtable discussion last summer, chaired by the hon. Member for Enfield, Southgate (Bambos Charalambous), at which we considered the link between obesity and diabetes and the importance of tailored messaging for the different subsets of the population. During the discussion I met the inimitable Professor Valabhji, the national clinical director for obesity and diabetes at NHS England, whose leadership in this space should be celebrated. I put that on the record because his knowledge and help for those around him, and his research into and development of how we deal with diabetes, are incredible.
For people with type 2 diabetes, there is the additional aspiration of achieving remission. I echo colleagues’ congratulations to the deputy leader of the Labour party, the hon. Member for West Bromwich East (Tom Watson). We watched him almost shrink. One day I stopped him and said, “Tom, is everything all right?” He was losing so much weight, but it was his choice to diet as he did. He is an inspiration for many people because of what he has done, and I commend him for it. The concept of remission can be alienating, however, because it is not possible for every person with type 2 diabetes.
Central to the effectiveness of all types of support for the individual and the wider population is the messaging used, which is what this debate is about. Tailored messaging should be developed for the sub-groups most at risk of type 2 diabetes. For example, those in the most deprived areas of the country are nearly 50% more likely to be obese and have type 2 diabetes than those in the most affluent areas: there is type 2 diabetes in areas where people do not have the same standard of living.
Obesity is responsible for around 85% of someone’s risk of developing type 2 diabetes. Additionally, south Asians are six times more likely to develop type 2 diabetes than Europeans are. It is a well-known cliché that men are not so open or proactive—I can say this is true—about their health needs, and men are 26% more likely than women to develop type 2 diabetes. I am willing to speculate, as one who fell into that category, that that is in part due to messaging not being in a format that reaches men. I did not know what it was, did not know what it meant, did not know what the symptoms were, but it was happening.
We need to focus some of the messaging on the importance of prevention and the risk of type 2 diabetes for men. Will the Minister commit to ensuring that all messaging to support those with type 1 and type 2 diabetes, as well as for type 2 diabetes prevention, is tailored to the relevant sections of our society?
I have to manage my diabetes every day. I take my tablets in the morning and at night. I am careful about what I eat. By and large, I manage it. I check my sugar levels every morning. The doctor tells me to check and I do it every day so that I know where I am. I am a creature of habit; I do it all the time so that I know exactly where I am. Some days it is out of kilter, probably because I transgressed and had a cream bun when I knew it was the wrong thing to have. None the less, we do such things.
On self-management, the average person with diabetes will spend just three hours a year with a healthcare professional. That means that they will spend most of their time managing the condition themselves and will need appropriate education. The right hon. Member for Leicester East chairs the all-party parliamentary group on diabetes. He organised a seminar where we looked at healthcare professionals and how people manage their own condition and therefore need appropriate education. The current delivery of structured education does not reflect the varying needs of each individual living with diabetes. We are all different.
The best efforts of healthcare professionals and those who provide education often focus on perfect self-management or no self-management at all. In reality, the daily struggle of living with a long-term condition means that every marginal improvement should be seen as a true achievement. We have to manage it and encourage ourselves as we move forward. We have to make sure that by moving a step forward we can then move forward again. There has been an admirable drive to increase the uptake of education, but education alone will not help an individual manage the ups and downs of living with the condition. They need the tools and confidence, as well as the education, necessary to manage their condition.
When I speak to people in my constituency who live with diabetes, they often highlight the feeling of isolation. I am sure we can all agree today that there is a need to provide each of those individuals with the support they need to take away the isolation. Being a diabetic can be lonely if someone does not know how to manage it. They might think they are doing the right thing when they are not. Issues have been highlighted to me about the delivery and format of education programmes. Digital solutions and coaching services should be explored. The Minister referred to that in a conversation that we had prior to this debate. I look forward to her response. We always get something positive from her, and we will certainly get something positive today.
Will the Minister commit to ensuring that the delivery, format and content of structured education programmes is improved through the use of digital solutions, and that national guidelines are adapted to accommodate that? Health apps could also be used to refine and augment diabetes training programmes by enabling clinicians to learn from patients about what motivates them and therefore what support to provide.
I want to congratulate the hon. Member for Wolverhampton South West (Eleanor Smith) on her leadership on how health apps can be used to improve care and patient self-management. Many MPs in this House are diabetic or have an interest in diabetes. That is why we are here today. We are either diabetic or interested in the matter and here to make a contribution. I commend and thank right hon. and hon. Members for their commitment.
Will the Minister commit to undertaking an extensive public engagement and education programme, using digital platforms where appropriate, to showcase effective and evidence-based health apps and encourage their wider usage? Support needs to be tailored to individuals’ particular needs, in recognition that no single solution works in self-management for everyone. Everybody’s needs are different. I was the first diabetic in my family. When the doctor diagnosed me as a diabetic he asked
me about my mum and dad and my wife’s mum and dad, and whether there was anybody in my family tree with the condition, but there was no one there. Unfortunately, my condition was caused by my diet and my lifestyle, so I created the problem. It was not hereditary, but it is how we deal with such things and tailor our responses that matters.
I have recently been convinced that health coaches—the Minister will comment on this—can play a key role in this space. Coaches can bring a distinct non-clinical skillset that poses questions for patients to help them devise the solutions that work for them, to help build their self-confidence and self-motivation—in stark contrast to the more prescriptive approach taken in clinical settings. Coaching needs to be clearly defined, and the full range of support that coaches can provide to support tailored prevention messaging needs to be identified. I look to the Minister’s response, because I believe it will have some positivity in relation to what we seek and what will happen.
It has been brought to my attention that the health service may ultimately need to decide whether to adopt a population-based approach to support improved outcomes across the entire population, or a more targeted approach aimed at those facing the greatest barriers to effective self-management. Will the Minister ensure that the health system explores the full range of ways in which health coaches can support people living with long-term health conditions, as well as carers and family members, through the development of an NHS definition of health coaching? Does she agree with me—and I hope with others in the House—that the UK has an opportunity to be an exemplar in the use of health coaches? It is an excellent opportunity and I hope that through the Minister we can make those changes.
I want finally to discuss the potential of innovations and technology in addressing issues related to self-management. That is what I do—I self-manage my diabetes. A flexible approach to the provision of structured education is vital to support self-management. Once equipped with the information and skills necessary to self-manage, people must have access to, and choice from, a range of proven technologies to help them manage their condition in everyday life. There has been a big investment in technology recently in the NHS.
We welcome the Government’s commitment to the extra spend on health, which we talk about regularly. All us in the House are particularly appreciative of the Government commitment. People with type 2 diabetes are now provided with glucose monitors; my hon. Friend the Member for South Antrim (Paul Girvan) referred to those in an intervention. However, people are offered little education on how to use them appropriately. There may be something more that we can do about that. It is good to have the technology, and to be taking steps forward, but it is also good for people to understand how to use it appropriately for management.
The level of investment in innovative hardware for people with type 1 diabetes is substantial and should be commended. However, individuals can be left lost if timely support is not available to help them to interpret and utilise those tools as a means of preventing complications. Many people with type 1 diabetes choose not to access the technologies now available to them. Why is that? I
do not know the reason, but it is a question we must ask. I believe that it is partly because of a lack of individual awareness. In the case of my diabetes, that would be right. It could, potentially, be linked to a lack of information. If information is not being provided, I should hope that something could be done about that.
Later in the month an event is being held in Parliament, chaired by the right hon. Member for Knowsley (Sir George Howarth). The event, held in partnership with the type 1 diabetes charity JDRF, is to do with the development of a new report on access to technology for people with type 1 diabetes, “Pathway to Choice”. I look forward to reading the report when it is published, and I know the Minister will be keen to read it.
All of us with an interest in diabetes—and that is why Members are here for the debate—will be interested to read it. Can the Minister inform colleagues here today what measure will be introduced to ensure that all people living with either type 1 or type 2 diabetes can access the latest proven technologies that are right for their situation?