The diabetes crisis being masked by skinny jabs

More people in their twenties and thirties in England, particularly women, are being diagnosed with Type 2 diabetes, according to a major new population study. Researchers at Imperial College London found rates of diagnosis are rising rapidly among people under 40, while falling slightly in older groups (who still make up the largest proportion of diagnoses). They found that body mass index (BMI) at diagnosis has been increasing more quickly in younger adults than in older adults. “We have known for a long time that obesity is linked to Type 2 diabetes, but what is new from this study is the scale of the change in younger adults. We think that the earlier onset of severe obesity in young people is increasing risk in early life and pulling down [diagnosis] age,” lead researcher Dr Shivani Misra says. The study suggests the rise is particularly noticeable in white, Asian and Black women aged 20–29, and in white women aged 30–39. While ethnic minority groups are disproportionately affected with early-onset Type 2, Misra adds, “we now see that incidence is also increasing in white populations too… this public health challenge is broadening”. Type 2 diabetes is a condition where there’s too much sugar in the bloodstream, caused by insulin resistance, or the body becoming resistant to the effect of insulin. Insulin is the hormone produced by the pancreas, which helps keep glucose (sugar) levels in the blood normal. It is different to Type 1 diabetes, which is often diagnosed in childhood. Shorts While the availability of GLP-1s (like Ozempic and Mounjaro) have signalled a worrying shift towards extreme thinness in the media, a longer-term obesity crisis is quietly unfolding in the background and contributing to this rise in Type 2 diabetes cases, the research suggests. The trend is particularly concerning, given Type 2 diagnosis can be more aggressive in younger people, increasing the risk of long-term complications, according to Diabetes UK. Jess Potter was diagnosed with Type 2 diabetes two years ago, aged 38. Her diagnosis was a shock and prompted a major lifestyle overhaul. “I’ve had a binge eating disorder for about 15 years. I’ve always turned to food, particularly sweet treats, for comfort, boredom, procrastination or to avoid feelings. For years, I would eat in secret and hide the wrappers afterwards. It consumed my life and filled me with guilt and shame. I’ve never really eaten that healthily and always eaten big, carb-heavy portions,” she says. “I was very overweight, nearly obese in terms of BMI, and wasn’t very active.” Jess says the symptoms that eventually persuaded her to see a doctor peaked after spending New Year’s Eve with friends. “I don’t drink anymore, but I did that night and I remember feeling really hungover for about two weeks after. Something didn’t feel right. “I was really thirsty, kept getting headaches and generally feeling ill. When I got my results, the doctor said, ‘You’ve got diabetes, your numbers are really high and you’ve probably had it for quite a long time’.” Jess’s HbA1c (which tests your average blood sugar levels for the last three months) was 98. A normal reading (for non-diabetics) is below 42mmol/mol. “I couldn’t believe that I’d been diagnosed at 38. I’d always assumed it was an older thing,” she says. Her father, who also had a binge eating disorder, was diagnosed with Type 2 diabetes later in life. He now has kidney failure. “I’ve seen first-hand how bad it can get. My dad buried his head in the sand a bit. He was never told that he could do anything about it. “The [GP] talked me through the damage diabetes can do to your cardiovascular system, how it can damage your eyesight and cause nerve damage in your feet, which is how diabetic people can lose limbs. It was terrifying – I’ve got two young children. I cried for days.” ‘I’d read it was possible to put Type 2 into remission with lifestyle changes,’ says Jess (Photo: Jess Potter) Jess started taking metformin, a prescription-only medication. But she also went about making lifestyle adjustments. “I’d read it was possible to put Type 2 into remission with lifestyle changes.” She started following a low-carb diet and increased her protein intake. The fear, she says, stopped her from binging on chocolate and biscuits, too. “I learned about how movement, even just going for a 10-minute walk after a meal, can lower glucose spikes. I started adding short bursts of activity, like little hill runs on the walk back from school drop off, or 10 squats after meals or while brushing my teeth.” Now, two and a half years since her diagnosis, Jess has lost 20kg, has a healthy BMI and is no longer trying to lose weight for health reasons. She also says her binge eating disorder is finally under control, thanks to self-hypnosis techniques. “My HbA1c is now in the non-diabetic range, my last test was 40.” In an era with the availability of weight-loss medication, it might seem surprising that there has been a rise in such obesity-related illness. Why? Jess herself says she doesn’t feel GLP-1s would offer a solution to her binge eating, and wouldn’t want to take weight-loss medication long-term, so says she’d have concerns about what happens if she did take the jabs and then stopped. Dr David Cavan, a consultant endocrinologist who specialises in diabetes, believes the rise in cases among younger generations is largely a product of changes to our food environment, “which has changed beyond recognition”, he says. “Years ago, we were taught that Type 2 is a condition of middle aged and older people, that it only happens to people over the age of 40. Now we see people diagnosed in their 2twenties, or even as children.” While there are multiple risk factors which can influence your risk of developing Type 2, including ethnicity and family history, lifestyle-related factors such as obesity and poor diets are significant, Cavan says. “We shouldn’t be blaming people for getting it. There are now nearly 600 million people around the world with diabetes. Most of those have Type 2. Only 25 years ago, that figure was closer to 150 million. The food industry has formulated foods to make us crave them, want to eat more, and they’re at a price which makes them accessible. “When you eat lots of foods which are high in sugar and refined carbs, your body produces a huge amount of insulin, which sets into motion this problem of high insulin and insulin resistance. The system can become overwhelmed, and part of the way the body responds to that is by becoming resistant to insulin,” Cavan says, which causes Type 2 diabetes. Heather Daniels, a registered dietitian with a focus in the area, says she isn’t surprised by the latest data and is seeing patients with pre-diabetes and Type 2 diabetes get younger. “I see lots of people with pre-diabetes in their twenties and thirties. “Junk and ultraprocessed food definitely has a role to play. I think we’ve lost track of what normal portion sizes are, too,” Daniels says. “I see people who think they’re following a relatively healthy diet. If you have a plate of chicken, potatoes and vegetables, for most people, the potatoes are the largest of the three, and vegetables are just a token gesture. “Then there’s lack of activity, most people are not as active as they should be. People often sit all day at their desk and then have really big portions of refined carbohydrates,” she explains. Associate professor Misra argues that while it certainly plays a role, it’s probably an “oversimplification” to just blame the rise of ultra-processed foods (UPFs). “There are so many things that have changed in the way that we eat and live our lives over the last 30 years; meal times; snacking; the walkable neighbourhood; public transport; fewer green spaces. All of these things on their own probably don’t have a big effect, but when you bunch them all together, they do.” The authors note their findings highlight an urgent need to rethink approaches to Type 2 and obesity prevention and early detection, with a bigger focus on younger adults. Weight loss medication, such as GLP-1s, could play a part in this strategy, alongside healthy lifestyle advice. “GLP-1s can be really helpful in enabling people to lose weight and put diabetes into remission, but they’re not a panacea and are not without problems,” Cavan says. “Reversing diabetes requires lifelong changes in lifestyle and eating habits.”