Insulin Discovery Centenary

Part of the debate – in the Scottish Parliament on 1st September 2021.

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Photo of Gillian Mackay Gillian Mackay Green

I, too, thank Emma Harper for bringing the debate to the Parliament. As the motion states,

“there are more than 312,000 people living with diabetes in Scotland”,

a number that has more than doubled in the past 20 years. My younger cousin was diagnosed with type 1 diabetes at a similar age to Paul O’Kane’s constituent, and I very much recognise that my aunt had to take many of the same decisions that Emma Harper has talked about this evening, and they were not popular with a cousin who had three non-diabetic cousins.

We need a greater focus on prevention if we are to reduce the number of people being diagnosed with diabetes. About 90 per cent of people with diabetes have type 2, and reducing levels of obesity will help to prevent further diagnoses. Tackling the obesogenic environment will be central to achieving that, and I look forward to the Government introducing legislation to restrict the use of promotions on food and drink that are high in fat, sugar and salt.

We must address the health inequalities that continue to plague Scotland. Obesity rates are highest among those from the most deprived communities, and no one should be subject to food insecurities in 21st century Scotland, but it is still the case that food banks are being used.

According to a report published by the UK Parliament Select Committee on Food, Poverty, Health and Environment, the inability to

“access a healthy, balanced diet” places people at greater risk of developing obesity, as they may be

“both overnourished with calories and at the same time undernourished in relation to key nutrients.”

As I have mentioned, our food environment is saturated with low-cost, unhealthy foods. The select committee found that

“healthy food has been shown to be three times more expensive, calorie for calorie, than less healthy alternatives.”

We cannot expect people to eat healthier diets until we address the fundamental issues of poverty and access to affordable, healthy food.

We also need to address unequal access to care, as has been highlighted tonight. Many complications arising from diabetes are preventable, as they arise mainly through poor glycaemic control—or when blood sugar levels are too high. In the past few years, great advancements have been made in the development of technologies that help people to maintain good glycaemic control. However, those technologies are not available to all, and there is a postcode lottery in Scotland. Constituents have written to me about being unable to access that technology, which monitors glucose levels day and night and can make a substantial difference to how people with diabetes manage their condition. Some people with diabetes have had to pay for those technologies themselves, but not everyone is able to do so. Diabetes Scotland is calling for clear guidance to health boards that technology such as glucose monitors, insulin pumps and looping should be made available to all those who need them, and I urge the cabinet secretary to give serious consideration to that. I would be grateful if the minister had anything to say on the matter.

Covid-19 has highlighted the health inequalities that continue to plague Scotland, and we cannot afford their widening further. Health and wealth are inextricably linked, and the poorest people in the UK are 2.5 times more likely to have diabetes at any age than the average person. People with diabetes in deprived areas or from minority ethnic backgrounds are less likely to have key health checks, putting them at increased risk of developing complications. We need to ensure that everyone has access to the resources that they need to manage their condition and prevent complications, with dedicated information campaigns that raise awareness of the symptoms and encourage people to get checked.

Having a long-term health condition can undoubtedly take a huge toll on mental health, and having diabetes makes people more vulnerable to developing a serious illness if they catch Covid-19. The pandemic may have been a particularly distressing time for people with diabetes. Some people with diabetes will have been shielding, which may have put them at greater risk of isolation and loneliness, and others may have had appointments postponed, all of which can have a serious impact on mental health. People with diabetes are more likely to experience anxiety and depression, and research conducted by Diabetes UK found that seven out of 10 people with diabetes feel overwhelmed by their condition and are not getting the emotional support that they need.

It is vital that we do not view diabetes simply as a physical condition in isolation from mental health. We need to talk more openly about how long-term conditions can affect mental health, ensuring that emotional support is integrated into physical healthcare.

There have been incredible advancements in diabetes care and treatment since the discovery of insulin, and we must now do more work to ensure that everyone can benefit from them. If we give people the tools, resources and support that they need to manage their diabetes, we can substantially improve their quality of life.