Why might a leading diabetes charity offer dietary advice that is likely to increase the need for medication?

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Diabetes UK is the UK’s largest and most prominent diabetes charity. Have a look here and you will se the charity proudly proclaiming that: We stand up for the interests of people with diabetes by campaigning for better standards of care. However, I’m doubtful that Diabetes UK is fulfilling its brief in this respect, seeing as it continues to suggest that diabetics should include starchy carbohydrates which every meal (see herefor more on this). You’ll see that Diabetes UK’s advice on this matter starts like this: At each meal include starchy carbohydrate foods such as bread, pasta, chapattis, potatoes, yam, noodles, rice and cereals.

Yet, these starchy staples break down into sugar, and some of them can release their sugar quite quickly into the bloodstream too. And if we eat them in quantity, like we often do, that only adds to their disruptive effects. Now, what rationale is there for diabetics to include at each meal foods that are disruptive to blood sugar? Here’s at least some of Diabetes UK’s ‘logic’ on this: The amount of carbohydrate you eat is important to control your blood glucose levels.

This is perhaps the vaguest and woolliest sentences I have ever read. What does it mean? I suppose what Diabetes UK would like people to take it to mean is Diabetics need to eat starchy carbohydrates with every meal.

However, I reckon there’s another, far more relevant way of interpreting this sentence which goes something like: The more starchy carbohydrate you eat, the more out-of-control your blood sugar level will be, the more ‘diabetic’ you will be, and the more likely you are to start to take medication for this or to need to increase your medication regime. Remember the advice to eat generally sugar-disruptive starchy carbs with each meal comes from the UK’s largest diabetes charity which, it says, campaigns for better standards of care for diabetics.

What sort of care is it referring to, do you think? Because on the face of it, it doesn’t look like nutritional care is part of its remit. And if that’s the case, maybe what’s being referred to here is medical care including medication.

Now, that would help to explain why Diabetes UK recently had a bit of a PR push on the idea that many diabetics are not taking their medication as prescribed. See this story from the Guardian in the UK for a typical instance of how this story was reported. The story, details the hundreds of thousands that are not taking their prescribed diabetes medication, and warns of the ills that may befall them as a result.

If Diabetes UK were so very concerned with the health of diabetics perhaps they could start by giving some decent nutritional advice for a change. How about starting by telling diabetics that the more starchy carbohydrate they eat, the more likely they are to require medication, and the more of the medication they are likely to need over time.

Elsewhere, I read that Douglas Smallwood, chief executive of Diabetes UK, has said it is a “tragedy” that many diabetics do not take their prescribed medication. My opinion is that the real tragedy here is the fact that Diabetes UK gives advice which makes it more likely to need that medication in the first place.

Those of you who clicked on the link to the Guardian newspaper and read it may have noticed that the Diabetes UK research was, in fact, partnered by the Association of the British Pharmaceutical Industry. Now, looking on the Diabetes UK website I can find no mention of where the charity derives its funding. Under ‘Corporate Partners’ Diabetes UK states this (and only this):

UK funds research for a future without diabetes while teaching children and adults to live with diabetes today. Our corporate partners provide vital and valued support to our work.

In the UK, 2.3 million people have been diagnosed with diabetes and more than half a million people have the condition but don’t know it yet. These figures are set to double by 2010.

Diabetes can develop at any age and those with friends or relatives with diabetes will understand how difficult it can be to learn to live with the condition.

People are being diagnosed with diabetes at an alarming rate; each year 100,000 people are diagnosed with Type 2. One in 20 of your employees, colleagues, friends and family will develop diabetes in their lifetime.

Lots of scary stuff about diabetes there, but no detail at all about who the corporate sponsors are and to what extent they fund Diabetes UK.

I was, however, able to find a letter in BMJ from 2003 that draws our attention to the need for charities and patient advocacy groups to declare their funding [1]. In this letter, the author states: Diabetes UK received around £1m from 11 pharmaceutical companies manufacturing diabetes drugs but this is not mentioned in the annual report.

I don’t want to come across unduly cynical, but is it right that a diabetes charity should have a less-than-transparent financial relationship with the drug industry. And is it right that this charity should be giving nutritional advice that, at the end of the day, looks likely to benefit the pharmaceutical industry. And after all of this, should it then go on to partner with that pharmaceutical industry in ‘research’ highlighting the need for people to take their diabetes medication. Or did I miss something?


1. Hirst J. Charities and patient groups should declare interests. Letter BMJ 2003;326:1211

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