By Angela Mitchell
COVID-19 has brought unprecedented challenges to people living with diabetes in Scotland – more than 312,000 of them – on a multitude of levels. From reduced access to healthcare, to the impact of worsening mental health, and the challenges in living well with their condition.
The pandemic has also brought more attention to how serious diabetes is. Figures released in the early months showed that one in five deaths from Covid in Scottish hospitals were people with diabetes. And we know the impact is not equal. Stark inequalities already exist for people living with diabetes, with rates 80 per cent higher in our most deprived communities and people living in poverty more than twice as likely to develop life-altering complications. Complications like heart attacks, strokes and amputations. And Covid-19 has only worsened inequalities.
This week, Diabetes Week, has provided an opportunity to reflect and refocus. Reflect on the harm that the pandemic caused and celebrate the progress we have made over the past 100 years since insulin was discovered. Importantly, we also must refocus our efforts to ensure diabetes does no harm, particularly in the wake of the pandemic.
We know that our healthcare professionals are working hard to clear the backlog of health checks, consultations and referrals. Alongside this, Scottish Government has committed to an NHS recovery plan within the first 100 days of the new parliament.
This is vital for people living with diabetes, but we must ensure that tackling health inequalities is a core part of it. Ninety per cent of people living with diabetes have type 2 and reducing our rates of obesity can hugely impact on the risk of developing this. Yet a range of factors make it difficult for people to select – or have the option to select – healthier foods. Ultimately, the amount of money that someone has in their pocket dictates what they can buy and often the cost-effective choice is not the healthy choice. For households in the lowest income decile, 75% of disposable income would need to be spent on food to meet the UK Government’s Eatwell Guide costs. That ideal diet is simply out of reach for too many.
There are also real challenges in managing your condition when living on a low income. Diabetes is a relentless condition that requires careful monitoring – which is far less easy to do if you’re juggling insecure work, food insecurity, caring responsibilities or money worries. We know that the risk of diabetes is not equal, the impact it has is not equal and the pandemic has only exacerbated this.
Yet as we recover, there is an opportunity to tackle these issues. And, if the pandemic has taught us anything, it’s that we can make massive, wholesale change when we need to. As one of the fastest growing and potentially devastating health issues we face, we need our recovery to focus on real change for everyone at risk of and living with diabetes. In a society that believes in fairness, it’s only the right thing to do.
Angela Mitchell is National Director, Diabetes Scotland
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