Published on 1 August 2023

Problems for people living with diabetes highlighted in new report during economic crisis.

The cost-of-living crisis has come under the spotlight in a recently published report looking at the impact on healthcare providers looking after people living with diabetes.

The report calls for “urgent action” to combat the latest public health emergency and minimise the impact on diabetes.

Since late 2021, healthcare providers have bee affected by the economic crisis, where the cost of necessities exceeds the income of individuals and families.

The report by Zesha Saleem, Reza Zaidi FRCP was recently published in Practical Diabetes and highlights that the financial emergency followed immediately after the unprecedented pandemic, that had already put the NHS under considerable strain.

The report found that 92% of UK households have found their ‘daily expenses had increased’ compared to the previous year.

The report said: “This is due to many factors, such as rising inflation, frozen wages and continuously rising daily costs. According to the Institute for Government, inflation is ‘eating into nominal wages, which leads to the “real” fall of income’. This economic crisis has sent shockwaves across society, with 92% of UK households reporting that their ‘daily expenses had increased’ compared with a year ago.”

The report looks at various ways income can affect physical and mental health. Improvements in wellbeing can be achieved by higher earning and access to healthier food options, and opportunities to exercise by attending fitness classes and gyms.

The report said: “Across the entire economic distribution, higher income is associated with better health.

“The rising cost-of-living crisis has the ability to further worsen health outcomes for people with low income. From an inability to afford heating and being vulnerable to respiratory diseases, to the risk of malnourishment from low quality and quantity food intake, the cost-of-living crisis can have enormous impact. Furthermore, there is also a risk of mental health deterioration and build-up of psychological problems from the crisis.”

UK coin and pound notes.

People with long-term health conditions, including diabetes, can be among the worst affected in times of health and economic crisis.

The report said: “This was evident in the outcomes during the height of the Covid-19 pandemic. Among the 4.25 million diabetes-related deaths during 2006–2021, there was a significant surge of more than 30% in mortality during the pandemic.7 Over time, the risk of micro- and macrovascular complications increases if glycaemic levels are sub-optimally managed.”

Additional impacts of people living with diabetes included the rising cost of travelling to appointments with healthcare professionals, and ability to store essential medication, such as insulin, affected by higher heating bills.

The report said: “For people with diabetes on insulin therapy, such changes to reduce energy bills would have detrimental effects on the viability of insulin stored in fridges and, as a result, on glycaemic management.”

In addition, for people living with diabetes-related foot conditions there can be a substantial risk of worsening neuropathic pain during periods of cold weather.

Report authors added: “This risk would be compounded for those who switch off heating for long periods to avoid further rise in costs.”

Two glasses of cola.

Rising food costs are also a factor, with the recent ‘sugar tax’ on certain products, although this has also resulted in reduced obesity rates. However, many people with diabetes at risk of hypoglycaemia (low blood glucose levels) also consume a sugary snack alongside adjustments to insulin doses, to avoid complications.

The report suggested some measures where in place to reduce problems caused to families with diabetes, including the NHS England led ‘Core20Plus5’ approach for children and young people with diabetes – to improve uptake of technology in type 1 diabetes and care process measurement in type 2 diabetes in the most deprived areas to reduce health inequalities.

In addition, there are further suggestions that charities could focus on quality of heating in homes for the vulnerable, living with diabetes. Recent studies found that every £1 spent on improving warmth in vulnerable homes could result in £4 in health benefits.

Report authors suggested: “This could not be more pertinent than in a long-term condition like diabetes.”

The report added: “This public health emergency needs an urgent, collaborative effort from many areas to (a) mitigate the immediate, negative effects of the current crisis, and (b) focus efforts on long-term reduction of health inequalities for people with diabetes.

“Integrated diabetes care between different levels of health care providers is now embedded in many areas within the NHS. However, the focus needs to be shifted to the most vulnerable in society in this current cost-of-living crisis by improving access to screening programmes, health care checks and appointments. This could be done with increased appointment frequency closer to home, improved access to and utiIisation of technology for virtual appointments, via grants/funding from local charities and health boards.”

The report concluded: “A significant amount of the annual NHS budget is spent on dealing with complications of diabetes. The cost-of-living crisis is more than just a financial pinch – it is a public health emergency. The consequences can impact all aspects of diabetes care, for people living with the condition and for health care services. Urgent action is needed from all levels of influential organisations to mitigate the negative consequences, both in the short and long term.”

Read the report in Practical Diabetes

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