World Diabetes Day: Sugar tax will not be enough to solve obesity crisis

In the UK, 11.5 million people are at increased risk of developing Type 2 diabetes. UK celebrity chef Jamie Oliver has championed the concept of a sugar tax or fizzy drink tax while in Mexico, a consumer campaign led to the introduction of taxes on snacks and sugar-sweetened beverages. It appears to have reduced soft drink consumption by at least 6% over the year 2014, rising to 12% by the end of the year, and 17% among lower-income consumers – a big improvement in public health nutrition.

Taxes on sweetened beverages have followed elsewhere – Barbados, Chile, the Navajo nation in the US as well as the city of Berkeley, California. Such moves to reduce soft drinks consumption have not always been successful, of course, with heavy investment in attack advertising and lobbying by the beverage industry, especially in San Francisco against a fizzy drink tax, and in New York City when former mayor Michael Bloomberg attempted to limit serving size containers in fast food outlets.

According to Robin Hewings, head of policy at Diabetes UK: "High consumption of sugary foods and drinks is helping to fuel the rise of obesity and in turn the rising tide of Type 2 diabetes, a serious health condition that can lead to amputations, blindness and stroke.

"Diabetes UK support calls to introduce a tax on sugar-sweetened beverages as recommended in the recent Public Health England Sugar Reduction report. However, this measure on its own will not be enough to solve the obesity crisis.

"We also want to see a retail environment which is more supportive of consumers making healthy dietary decisions including: clear and consistent food labelling; reduction in the sugar and fat in foods and drinks and a reduction in portion sizes to cut overall calorie intake; restrictions on marketing junk foods to children; and greater investment to make it easier for people to be more active."

The human and financial cost of diabetes

The International Diabetes Federation has called the condition an epidemic. With one death every six seconds, diabetes is now a bigger killer than HIV, tuberculosis and malaria combined. The IDF estimates most countries spend between 5% and 20% of their healthcare budget on the disease.

"Diabetes is one of the biggest health challenges we currently face, and there are 11.5 million people in the UK at increased risk of developing Type 2 diabetes as a result of their waist circumference or being overweight," Hewings said.

"Diabetes is the leading cause of preventable sight loss in working age people, is responsible for 135 amputations in England each week and every year over 20,000 people die early as a result of diabetes. As well as the human cost, Diabetes accounts for 10% of the annual NHS budget."

What is diabetes?

Diabetes is a condition where there is too much glucose in the blood because the body cannot use it properly. If not managed well, both Type 1 and Type 2 diabetes can lead to devastating complications. Diabetes is the leading cause of preventable sight loss in people of working age in the UK and is a major cause of lower limb amputation, kidney failure and stroke.

Type 1 diabetes

People with Type 1 diabetes cannot produce insulin. About 10% of people with diabetes have Type 1. No one knows exactly what causes it, but it is not to do with being overweight and it is not currently preventable. It usually affects children or young adults, starting suddenly and getting worse quickly. Type 1 diabetes is treated by daily insulin doses, taken either by injections or via an insulin pump. It is also recommended to follow a healthy diet and take regular physical activity.

According to Libby Dowling, senior clinical adviser at Diabetes UK, this is "an autoimmune condition where the insulin producing cells in the pancreas have been destroyed, meaning that they can no longer produce insulin".

She added: "The cause is unknown, but it is not to do with being overweight or any lifestyle factors and it isn't currently preventable. It is most commonly diagnosed under the age of 40 [though can appear in later life] and is the most common form of diabetes found in childhood. Type 1 diabetes is always treated with insulin, either by and injection or via an insulin pump."

Type 2 diabetes

People with Type 2 diabetes don't produce enough insulin or the insulin they produce doesn't work properly (known as insulin resistance); 85% to 90% of people with diabetes have Type 2. They might get it because of their family history, while age and ethnic background puts them at increased risk.

They are also more likely to get Type 2 diabetes if they are overweight. It starts gradually, usually later in life, and it can be years before they realise they have it. Type 2 diabetes is treated with a healthy diet and increased physical activity. It is more common in the over 40 age group (but over 25 in the South Asian population).

"Type 2 diabetes is often treated with lifestyle factors initially – following a healthy balanced diet, getting regular physical activity and losing excess weight," Dowling said. "However it is a progressive condition, and it is likely that medication will be required, which may include insulin."