C3 Collaborating for Health believes that only by working together can we make it easier to be healthy.

Diabetes in the UK workplace

This briefing document has been produced by C3 Collaborating for Health. There is further information on diabetes in the workplace on the interactive website 3FOUR50*, including presentations and video footage from a workshop on Diabetes as a model for chronic disease prevention and management in the UK workplace, held in February 2010.

This can also be downloaded as a two-page printable pdf here >>

How much of a problem is diabetes in the UK?


What is diabetes?

Diabetes is a condition in which a person has a high blood-sugar level either as a result of the body not producing enough insulin, or because body cells do not properly respond to the insulin that is produced. Type 1 diabetes can appear in childhood, and is not linked to lifestyle factors – but type 2 diabetes is much more common, and appears later in life: 90% of adults with diabetes have type 2 diabetes.

Key UK statistics

  • In 2008, almost 1 in 20 people (3.86%) in the UK had diabetes: 2.5 million people have been diagnosed, and up to another 0.5 million are undiagnosed.
  • By 2025, it is predicted that more than 4 million people will have diabetes.
  • Around 410 people are diagnosed with diabetes every day.
  • 60% of people with diabetes are not receiving the recommended care.

Sources: Diabetes UK; National Diabetes Audit.

The effects of diabetes

The disease, if not managed, can have extremely serious complications, including greatly increased risk of cardiovascular disease and limb amputation. Diabetes is also the leading cause of blindness in the UK working-age population. Psychosocial care for people with diabetes is also very important – depression is about twice as prevalent in people with diabetes as in the general population, and poor mental health is a major cause of sickness absence and lack of productivity at work.

Risk factors for diabetes

A number of lifestyle factors are important in the development – and prevention – of type 2 diabetes. High levels of physical activity, a healthy diet, a normal weight, not smoking and consuming alcohol in moderation, together decrease the likelihood of getting the disease by up to about 80%. Other risk factors also increase the likelihood of developing the disease, such as aging and ethnicity, with South Asians at particularly high risk. Diabetes rates rise as obesity rises: since 1996, obesity rates in England have gone from 17.5% to 24%, and the number of people with diabetes has increased from 1.4 million to 2.5 million.

Taking action

Diabetes and its complications are a very significant, and growing, burden on the NHS. Diabetes UK estimates that up to 10% of the NHS’s budget – £1 million an hour – is being spent on the disease.

The government is taking action on the disease: for example, the English National Service Framework on Diabetes established 12 standards on diabetes (including its prevention), and there are many Local Diabetes Networks around the country.

Workplace as health-place: an acknowledged priority?

In the UK, we spend up to 40% of our waking hours at work, for anything up to 40 years or more. The workplace is a key community in which to take action on the major risk factors for diabetes.

Employers

So, is diabetes becoming an issue for employers in the UK? Particularly given that the workforce is aging, it should be: prevalence of the disease rises sharply in middle age – in England, diabetes prevalence is 1.2% among 25–34-year-olds, but by age 55–64 prevalence is 8.5% among men and 6.0% among women.

Some companies are leading by example, providing health screening, healthy cafeteria options, showers and bike storage for those who want to cycle to work. BT’s recent Work Fit: Diabetes campaign (run with support of the union and Diabetes UK) found that, of the 5,200 people who completed an online risk assessment, 2,003 were at ‘medium risk’ of developing the disease, and 341 at ‘high risk’.

Key workplace health statistics

  • Sickness absence accounted for 172 million working days in 2007.
  • The cost to employers of sickness absence is £13.2 billion annually.

Source: CBI, May 2008

Government

The government is also increasingly recognising the importance of the workplace as a ‘health place’: the national obesity strategy, Healthy Weight, Healthy Lives (2008), for example, stated that ‘Our vision is a future where all employers value their employees’ health, and where this is put at the core of their business plans.’

In 2006, Dame Carol Black was appointed as the National Director of Health and Work in England, and produced a major report, Working for a Healthier Tomorrow: Dame Carol Black’s Review of the Health of Britain’s Working Age Population, which highlights the ‘shift in attitudes … necessary to ensure that employers and employees recognise … the key role the workplace can play in promoting health and well-being’. The government’s response includes plans for a National Centre for Working Age Health and Well-being, and it undertook a major review of the health of the workforce of the NHS itself (which is, with the Indian railways and Chinese army, one of the largest employers in the world).

‘If we can’t sort out diabetes, which has very clear diagnostic criteria, and where there is a lot of evidence on how it can be prevented and treated, then we might as well pack up and go home’
(Dr Clare Davison, GP and diabetes lead for Newham PCT, cited in the MODEL report)

Useful sources

3FOUR50 interactive website: http://www.3four50.com

C3 Collaborating for Health: http://www.c3health.org

Dame Carol Black, Working for a Healthier Tomorrow: Dame Carol Black’s Review of the Health of Britain’s Working Age Population (2008): http://www.workingforhealth.gov.uk/Carol-Blacks-Review/

Bupa, Healthy Work: Challenges and Opportunities to 2030 (2009 – with the Oxford Health Alliance, The Work Foundation and RAND Europe): http://www.bupa.com/our-commitment/publications

Diabetes at Work website (US): http://www.diabetesatwork.org/

Diabetes: Finding Excellence – Facing the Multi-faceted Challenge of Diabetes (the MODEL report) (2007): http://www.novonordisk.co.uk/Images/2007/.pdfs/MODEL_Final_LR.pdf

Diabetes UK: http://www.diabetes.org.uk/

Healthy Weight, Healthy Lives: A Cross-Government Strategy for England (2008): http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_082378

Improving Health and Work: Changing Lives (the Government’s response to Dame Carol Black’s Review) (2008): http://www.workingforhealth.gov.uk/Government-Response/

National Obesity Observatory, International Comparisons of Obesity Prevalence: http://www.noo.org.uk/uploads/doc799_2_International_Comparisons_Obesity_Prevalence2.pdf

* 3 risk factors (poor diet, tobacco use, lack of physical activity) cause FOUR chronic diseases (cardiovascular disease, type 2 diabetes, many cancers and chronic lung disease) that account for over 50% of the disease burden in the world.