10% of NHS budget is spent on t2 diabetes vast majority is self inflicted, aibu to think they should contribute?

[Lauranda]

Its estimated that the cost will go up 17% by 2020. Something needs to change or the NHS will collapse.

Maybe make people that are overweight pay something towards their treatment would in courage people to eat better and exercise more.

The vast majority of pregnancies are self inflicted. I hope you think they should pay too OP. Plus all the sporting injuries, DIY injuries, car accident injuries etc. Or is it just overweight people you want to pick on?

By the way Lauranda, diet alone has a pretty negligible effect on reducing cholesterol levels

Assuming people with type 2 diabetes "inflict" it on themselves through over eating then they are paying for it through increased tax on unhealthy foods. Same with car drivers and petrol, same with smokers and cigarettes. In fact, with the exception of black market goods, you're taxed for most choices you make.

Forgot to say, the biggest cost to the NHS and tax payer over all is people living longer than ever before. Your logic is therefore faulty. If your concerned about saving the NHS money you should be encouraging people to be overweight as in the long run it's cheaper for them to have diabetes and die at 65 than to have a healthy lifestyle and live to100.

Let's try again:

HOW DO YOU CALCULATE WHO NEEDS TO BE CHARGED FOR THEIR T2 DIABETES MEDS?

As I said before weight if thought to be a symptom, not a cause in many cases.

How do you know what and how people are eating over the years? This isn't something caused by a week if cutting loose.

Even if T2 diabetes could categorically in all cases be attributed to lifestyle, how would you know what exercise they've been taking over the years? If adults get it due to poor diet and lifestyle templates set up as children, should they be accountable as adults when the damage has already been done?

How do you weed out what were choice factors leading to diabetes or genetics or just bad luck?

If we're talking in terms of costs to the NHS, diabetes costs are well down the line to heart disease and alcohol and car accidents. How is targeting a condition with so many variables and not one of the biggest drains on the NHS effective?

I can see the reasoning behind expecting the population to take responsibility for their own health and costs but how applicable is it?

Perhaps the best way to start is to cut out free care for choices. IVF and maternity services? Car and personal insurance should be mandatory to cover accidents for higher risk activities such as driving, cycling or any sports? Those things are much easier to regulate and implement?

And I know that you have been asked this umpteen times before but if you could just indulge me and answer either A or B

are you

A - talking about health issues that are to do with weight and unhealthy eating and people who are fat and advocating demanding additional payment only from people who are overweight

or

B - talking about ALL choices and lifestyles people have that can have a negative impact on their health and have the potential to lead to increased costs to the nhs. This list includes but is not limited to; smoking, drinking, taking drugs, having a stressful life, indulging in risky hobbies ... and advocating demanding additional payment from all people who make any choices that have the potential to result in health problems?

...This makes me racist?

No, it makes you appear ignorant.

I'm shocked that a diabetes professional has never heard of people reversing it.

Please Google it there are thousands of examples.

www.ncl.ac.uk/magres/research/diabetes/reversal.htm

It has been possible to work out the basic mechanisms which lead to type 2 diabetes. Too much fat within liver and pancreas prevents normal insulin action and prevents normal insulin secretion. Both defects are reversible by substantial weight loss.

"Maybe make people that are overweight pay something towards their treatment would in courage people to eat better and exercise more."

It hasn't worked in America then where obesity is more common than here. Maybe you need to read more about the psychology of behaviour in relation to health? Money is rarely a motivator.

Diabetes isn't technically reversible. Yes, you can achieve non-diabetic results by improving your diet and exercising (and therefore losing weight) but if you stop doing that, the diabetes will come back. Or it might just come back anyway, regardless of anything you do.

"Assuming people with type 2 diabetes "inflict" it on themselves through over eating then they are paying for it through increased tax on unhealthy foods."

... if unhealthy foods actually did have an additional tax levied on them.

It's obvious the OP's suggestion is completely unworkable.

But what arises from this thread is an acknowledgement that the massive increase in obesity levels in the past 20 years in the UK will bring the NHS to its knees, particularly as a very overweight population ages.

I think that if you pay for your own healthcare you can do what you like, and it's no one else's business, but being negligent about your health is antisocial when you are relying on a centrally funded public health care system.

And many people ARE negligent about their health.

Lots of unhealthy foods are vat free as they are classified as essentials, such is biscuits.

The assumption that Type 2 Diabetes is 'caused by' obesity and unhealthy lifestyle makes me cross as it is a very simplistic and unfair assumption.

My friend's 64 yr old Dad is currently in hospital being treated for a cardiac arrhythmia. He has type 2 Diabetes that is currently treated with both insulin and tablets.
He became Type 2 Diabetic aged about 50 - he had been passing urine frequently and was very tired and thirsty. He was put on tablets.
Then he started losing too much weight and his sugars were too high so he was given insulin as well.

He has never been overweight, never smoked, worked as a builder in the fresh air and so got lots of exercise daily, he had a typical 1950s working class diet as a kid (not his fault), he has no family history of diabetes.

He was just unlucky.

Sadly he will cost the NHS a lot as he has now got complications - it was estimated that he may have been diabetic or pre-diabetic type 2 for up to 10 years before his diagnosis and in all that time the high blood sugars were damaging his health.

An early screening programme for pre-diabetes and type 2 diabetes would save the NHS money.

It has been possible to work out the basic mechanisms which lead to type 2 diabetes. Too much fat within liver and pancreas prevents normal insulin action and prevents normal insulin secretion. Both defects are reversible by substantial weight loss.

You are over simplifying things. Slim people get Diabetes too and many people's bodies have irreversible damage from Diabetes. My husband is Type 2 and reduced his weight to within a healthy weight range. Guess what? Still Diabetic.

You make it sound as if Diabetics are just too lazy to diet and the issue would be solved if they all lost weight. Not so.

Yes, there are examples of people in the early or pre stages having excellent results, but Diabetes is not simply a disease caused by eating too many fatty foods.

I've come across suggestions that being overweight is not a cause of diabetes, but that it's the other way around, that being an undiagnosed diabetic is having an effect on weight.

I do know that my dad was slim and fit (very fit) for many, many years, and only put a lot of weight on in the 2-3 years before being diagnosed as diabetic, so I think there may be something in this.

Well said MissBattleaxe

The people who are being simplistic on this thread are those who are arguing that lifestyle is not the only issue when it comes to diabetes - because they're arguing against a point that nobody on this thread has made.

We all know that diabetes is a complex disease with both genetic and environmental factors.

But the bottom line is that the MASSIVE INCREASE in type 2 diabetes in the under 50's in particular is strongly linked with the MASSIVE INCREASE in obesity in this population.

So, TREAT the PROBLEM. There is very little real practical support to help those with weight problems. I went to the dr, he handed me a leaflet that pretty much told what I already knew. Wow! That's really going to help me deal with my emotional issues related to food.

Charging me for healthcare won't solve the problem. More likely it'll exacerbate it.

What would help; properly subsidised and low cost access to exercise regimes and sport facilities which are encouraging and supportive, self help groups and counselling, guidance and education, and generally less judgement from smug, self satisfied idiots.

my vague understanding is that lack of exercise not weight is the big risk factor for T2 Diabetes. Not that I blame anybody anyway.

but if I did it would be urban planners & wider society for designing cities & urban space so badly that it's difficult to get anything done without driving.

Missey what help would you idealy want the state to provide for obese people?

Didn't Missey say? Education, practical support, subsidised exercise programmes and gym membership. And obviously that is assuming that someone is overweight simply because of their diet and exercise, which is a very simplistic way to look at it.

I go to a specialised eating disorders clinic every week because of complex food issues due to autism. (Would I have to pay for this under the OPs proposed scheme because I'm overweight?) Anyway the consultant I see says that being overweight does not causes diabetes and only those who are ill-informed think it does. He says that fluxuating blood sugar levels cause diabetes and they also cause obesity. So there is correlation between the two NOT causation. At the clinic the focus is on stabilising the blood sugar and weight loss/gain is only used as an indicator of how stable it is.

I go to a specialised eating disorders clinic every week because of complex food issues due to autism. (Would I have to pay for this under the OPs proposed scheme because I'm overweight?) Anyway the consultant I see says that being overweight does not causes diabetes and only those who are ill-informed think it does. He says that fluxuating blood sugar levels cause diabetes and they also cause obesity. So there is correlation between the two NOT causation. At the clinic the focus is on stabilising the blood sugar and weight loss/gain is only used as an indicator of how stable it is.