DRWF Trustee Dr Shivani Misra on the new NHS programme for people diagnosed with type 2 diabetes aged under 40

BBC Today programme introduces latest NHS programme designed to support people aged 18-39 to manage living with type 2 diabetes.

Listen to an interview with DRWF Trustee Dr Shivani Misra, discussing the latest NHS programme to support people aged under 40 newly diagnosed with type 2 diabetes.

The Today programme on Radio 4, broadcast on 29^th August, featured a special report on the NHS bringing in a system of extra health checks for people under 40 living in England, living with type 2 diabetes.

The T2Day: Type 2 Diabetes in the Young programme was created to support a rising number of 18 to 40-year-olds being diagnosed with the condition.

Dr Shivani Misra, Consultant in Diabetes and Metabolic Medicine and a Senior Researcher at Imperial College London, and DRWF Trustee, helped develop the new NHS programme, and was interviewed to discuss why this was so important.

Dr Misra said: “Our recent analysis has shown that there are now 140,000 adults in England between the ages of 18 and 40 living with type 2 diabetes. Concerningly, the rate of increase is much higher in under 40s. We have seen an 18% increase in people diagnosed with type 2 diabetes under 40, relative to 11% in the rest of the population.

“Earlier onset type 2 diabetes seems to be linked with increasing levels of obesity. Our analysis has also shown that people from certain minority ethnic groups in England are more susceptible to earlier onset of type 2 diabetes.

“I think it is driven probably by obesity, also the intrinsic susceptibility of some populations to earlier onset.”

Type 2 diabetes is commonly linked to lifestyle, and people who are overweight are more likely to develop the condition. However, Dr Misra offered caution at the suggestion “ultra proceeded foods” could be in part responsible for this age group developing type 2 diabetes, or genetic factors.

Dr Misra said: “I think at this point, this is speculation. I have not seen any research studies that have specifically looked at the impact of ultra processed foods on younger people with type 2 diabetes. As clinicians, who look after these individuals, we recognise that the presentation is very complex and that there are multiple factors. And indeed, diet may be one of them. But I think it is important not to underestimate the other factors that may be involved.

“In general, when some conditions present early on there is likely to be a genetic susceptibility, but again, that might only be a small part of the whole puzzle.”

Whether being diagnosed at a young age, in this case under 40, with type 2 diabetes, could present a better or a worse chance of being able to manage your condition over time, was also discussed.

Dr Misra said: “This is the concerning feature of earlier onset type 2 diabetes. It seems from the studies that the earlier you are diagnosed, the faster you progress to complications and the more likely you are to have some of the adverse outcomes that we are trying to support our affected patients with.

“Really, that’s why we’ve developed the new programme called T2Day, recognising the needs of younger individuals and making sure that they get the support they need, right from the offset.

“Our analysis shows that younger people seem not to be accessing the care that they need to and we can track this using measurements called cares processes.

“In our analysis, it looks like they are less likely to receive the care processes, and so in designing T2Day with other experts, what we are trying to do is really shine a light on this group and make sure that people know that they need to come in and get the support that they need to around these complications.”

Dr Misra added: “The things that we can do are for example, ensuring that they have good diabetes control, which we can measure using a blood test called HbA1c, making sure cholesterol levels are targeted, along with blood pressure.

“In women, who have early onset type 2 diabetes, making sure they are adequately prepared for pregnancy. Ensuring that they are on the correct treatments, things that are going to help them to control their blood sugars and getting access to weight management services.

“With T2Day, we are hoping to develop all of this, through a greater number of appointments, with flexibility around how these are developed for younger people living with type 2 diabetes.

“One of the reasons I have focussed my research on this group is because they are at huge risk of developing multiple long-term conditions, from an early, including all of the traditional complications that we see from type 2 diabetes. These are people of working age, sometimes with young families. We really need to get in there early and support them. That is exactly what this new programme is trying to do.”

Listen to the full interview with Dr Shivani Misra on the BBC Today programme here from around 51 mintues

Read more about the T2Day: Type 2 Diabetes in the Young programme here

Read more about type 2 diabetes