An Analysis of the Prevention of Diabetes Type 2 Among People in UK and the City of Bradford

This report analyses the disease of diabetes, which is the main point of concern in urban world today. It focuses on the prevention and early diagnosis of Type2 Diabetes in order to reduce the burden on the healthcare system and improve the overall health of the population.

Running Head: Urban Health profile
Urban Health profile
An Analysis of Urban Health Issue

1
Urban Health profile
AN ANALYSIS OF THE PREVENTIION OF DIABETES TYPE 2 AMONG PEOPLE IN
UNITED KINGDOM AND THE CITY OF BRADFORD
In today’s world, the urbanization has become a worldwide trend and it is having a very
significant effect on the people and their health. There was study done that by the year 2050,
more than 70% of the world population will be living in the cities. There are various factors,
which are the cause of the urban health issues (Hassan, 2013). They can be urban governance,
characteristics of the population, natural environment and the built environment, development in
terms of the economic and social life, emergency management related to health and the security
of the food. Cities bring opportunities but then they also bring issues and challenges in terms of
health. Today’s world is facing many more issues in health like TB, AIDS, pneumonia, non-
communicable diseases, diabetes, road accidents and other injuries and many more (Olokoba et
al., 2012).
The environment in urban world is actually the home for half of the population of the world and
from that; the 2/3rd of the population has diabetes. This situation is very alarming for all the
people. In the year 2014, Cities changing diabetes in which Mexico, Copenhagen, Houston and
many other countries participated in a program-started name. This report analyses the disease of
diabetes, which is the main point of concern in urban world today (Kaku, 2010).
RATIONALE OF THE REPORT
The type 2 diabetes which is also known as T2DM in short is actually a disorder which is related
to the metabolism that allows the sugar to collect in the blood flowing in the body because of the
low ability of the body to metabolize glucose. It was earlier found out that this disease occurs in
the middle-aged people but recently it has been seen that it has increased and happening to
children as well (Gov., 2002). Even in the children, the body becomes resistant to the natural
impacts of insulin. This disease progresses but this can easily be managed with changing the
lifestyle and by including the physical activity on a regular basis. This needs a little bit of weight
reduction too. There can be injections and medications taken which will keep the insulin to
regulate the blood sugar levels.

2
Urban Health profile
In UK, more than 2.6 million people were detected of Type 2 diabetes and about 740,000
remained undiagnosed. This disease is costly as well as serious health diseased, which mostly
occurs in minority communities who are majorly at risk because of their culture and ethnicity
(UK, 2010).
There were new figures displayed which depicts that approximately 3.7 million people
were diagnosed of diabetes type 2 and then in the year 1998, the total number was
increased to 1.9 million more. Since 2017, a further increment in the data is seen when it
comes to the type 2 diabetes and type 1 too. The total number according to the year 2017
has come down to 3,590502 to 3,689,508 (UK, 2015).
The West Yorkshire city of Bradford is one of cities of UK is one of the highest in type 2
diabetes. It is found that in every one of 10 people i.e. 10.4% people live with the
diagnosis of type 2 diabetes. As compared to other cities, Richmond in London is one of
the lowest in type 2 diabetes. It has only 3.6 million people affected out of the total
population. In case of the average is taken out nationally then the number comes down to
6.6% (UK, 2017).
Totally one can say that 9 out of 10 people suffer with the disease of diabetes type 2. This
can be said because approximately 1 million people live with the condition who actually
does not even know that they have diabetes as they are not even diagnosed of it. The
undiagnosed population is still counting but the approximate number has reached to 4.6
million (Chaudhary et al., 2016).
Type1diabetes is presently not preventable but in type 2 diabetes, 3 out of five cases could
be prevented by making some lifestyle changes and pushing oneself towards the healthier
changes. This will even help other people to understand the risk for oneself for developing
the condition. People will even get to know how to reduce the diabetic impact on the body.
This can easily be done by doing the early diagnosis for the ones who are at high risk. If
the whole of United Kingdom is considered, the estimate is done of about 12.4 million
population have bigger danger of type 2 diabetes and there is a major reason of having

3
Urban Health profile
diabetes is obesity. Obesity leads in the cause of the majority of the diseases that cannot
be prevented (WHO, 2016).
Out of every 5 women, 3 are obese which comes down to the percentage of 59% and out of
every three men, 2 are obese which comes down to the percentage of 68%. This is the data
of the people who were overweight in their first primary school of England. The
percentage increases to 34% till the time they leave from the primary school (ADA, 2002).
Consumption of Sugar in UK and Diabetes data
Source: (Google, 2018)
Obesity is one of the most important causes for any disease but especially it is an
important reason of getting diabetes as obesity creates fat in body and particularly in the
waist line which is a clear sign sometimes that the person has diabetes. It is accountable
for the 80% risk of the total danger of development of the type 2 diabetes & underlies the
present worldwide spread of the condition. As mentioned above, in UK out of the 3
people, 2 are overweight or obese. There has been an increase in the total number since the
year 1980 to 2013 and that increment is of 13% in total. This was the study that suggested
26% of boys and 29% of girls are obese. Most of the people are obese in England. The
data involves 61% of the adult people and 30%are kids who are between 2 to 15. This
proportion was also increased to the year 2011 and got to 58 % to 65% of men and 49 to
58% to women (Dendup et al., 2018).

4
Urban Health profile
In the treatment, it is recommended to the adults that they should remain active daily.
They should exercise at least half an hour a day. Or majorly, they can add to 150 minutes
of exercise to intensify their activity for 10 minutes. The simple way is to work out 30
minutes per day for 5 days per week. There are great results which can be found when a
person exercises for improving his or her muscle strength and do vigorous exercise. The
adults can also avoid having the sedentary lifestyle and they should not sit at the same
place for a longer period of time. Approximately 39% of the men and 29% of the women
are actually recommended to consume themselves in daily lifestyle of exercise and not
encouraging the sedentary lifestyle.
Diabetic people data
Source: (Google, 2018).
URBAN HEALTH CONTEXT AND DETERMINANTS OF TYPE2 DIABETES IN
LONDON AND CITY OF BRADFORD
People who live in Bradford receive the health warnings with regards to diabetes. According to
the people of NHS, approximately 11,000 people out of all Bradford might be at risk of having

5
Urban Health profile
the type2 diabetes in the next span of coming 10 years. Since the year 2017, 1200 people are
already referred to the NHS diabetes prevention programme in Bradford. The cost of treating this
disease is approximately £6 billion each year and out of 6 people 1 has diabetes in the hospitals.
As discussed, diabetes is linked with the obesity, Bradford and all UK has very high obesity
levels and hence this is the data that can be presented on behalf of the Bradford city.
GP and the other professional of healthcare in Bradford use the prevention week of diabetes for
urging the citizens of Bradford in order to found out that they are at risk and so that they can take
action for this disease.
Since the years 2008 to 2009, the occurrence of the number of patients is continuing to rise by
each passing year. There are a total number of 34, 378 patients of diabetes in Bradford district
who age above 17 years. Presently the data of the occurrence of diabetes is 8% for the total
district if it is compared with England on the whole which is 6.4%.
Yorkshire Data of Diabetes
Source: (Google, 2018).

6
Urban Health profile
The eye disease diabetic retinopathy is known to be as one of the cliché cause of sightlessness in
United Kingdom. Screening which is normal provides quick detection of the disease and efficient
treatment of the sight intimidating diabetic retinopathy. In the year 2013 to 2014, there were 20
cases of the vision loss which was related with the eye illness in Bradford. The rate of this vision
loss for the diabetic in this region was 6 per 100,000 populations. These residents were higher as
compared to England which was 3.2 per 100,000.
CCG also known as Bradford City Clinical Commissioning Group is remembered for the
innovative work it has done related to the diabetes by named among seven activist sites for the
NHS diabetes avoidance programme. This was actually the joint proposal taken by NHS England
& UK diabetes that objectifies to necessarily decrease number of population in England who
suffer with diabetes or else it is expected to at least have the type 2 diabetes by the year 2025.
There are some of the major pointers for diabetes. They are:
 Public Health Outcomes Framework Indicator 2.17. Recorded prevalence of diabetes in
the population registered with GP practices aged 17 years and over.
 Public Health Outcomes Framework Indicator 2.21. Access to non-cancer screening
programmes - patients of offered diabetic eye screening who attend a digital screening
event.
 Public Health Outcomes Framework indicators 4.12. Preventable sight loss due to
diabetic eye disease and glaucoma.
 Quality & Outcomes Framework aspires for lipid, BP and glycogenic control.
Via Bradford beating diabetes campaign, various different events are running within Bradford
District for making the people aware more about this disease, to be active and choose a healthy
lifestyle and at last also to decrease the amount of public who are detected with this disease in
city Bradford. There are actions involved about the awareness of the advice presentation for
diabetes & at no cost tests & events for highlighting the significance of foot care of public
having diabetes (BradfordGOV, 2016).
Occurrence of Long Term conditions in Bradford: The occurrence of the disease in Bradford
population is majorly same if compared with England, so the SRG is expected to have the
average risk of ignoring the admissions which are linked with the long-term situations. The city

7
Urban Health profile
and the district of Bradford both have high diabetes levels but the city particularly has the lower
levels of hypertension if compared with England on an average. If SRG locality displays a high
and low average number of long term situation which us linked with the ignored admissions by
Bradford, this may give an indication of how well is the locality being managed. Further the
system indicators are looked into this report, that involves indicators like CCG’s avoidable
emergency admissions.
Deprivation: This is related to the higher up GP and A&E services and to the increased
occurrence of the long-term health issues. Public Health England “fingertips tool” gives derails
of the Bradford Local community’s complete deprivation results by displaying the scores in the
year 2010 as worse and craven as better than England average. IMD i.e. index of multiple
deprivation differs in council areas of England. This index involves 38 separate indicators related
to deprivation across 7 domains: Income, job, wellness and disability, knowledge skills and
training, obstacles to housing and services, crime and living atmosphere (Kirwan et al., 2017).
Rurality: Bradford is a very different region. It is densely populated and is an urban region. It has
7% of the population which is living in rural areas. Hence, the occurrence of long term
conditions like asthma is expected more in Bradford if it is compared with England or cities like
Airedale etc.
Health and Cost Implications
If Type2 Diabetes is not treated on time, it can create long term issues like kidney disease,
retinopathy, diabetic neuropathy and macro vascular issues, amputations of limbs etc (Inzucchi,
2012).
Type2 Diabetes has various outcomes which are not good for the individual but also on the
community as well & health maintenance services as well. This is very challenging illness and it
decreases the life expectation and also the excellence of life of single person or the sufferer and
the family too. It also impacts on the physical discomfort and drain on the finances because of
the costs which goes in the treatment too. When coming to the terms for diagnosis, the
complication develops and there are side effects too of taking medications which could lead to
anxiety and depression. This could also decrease the capability of earning further perpetuating
the cycle pf poverty and can also lead to isolation socially (CQC, 2016).

8
Urban Health profile
It can lead to higher up emergency services and inpatient services. About 19% of the people who
suffer with Type2 Diabetes are admitted to the hospital every year and they cover about 9% of
the beds in the hospital and have the increase length of stay. This can cause the strain on the
health of life and health care facilities as there are many non-sufficient resources which are
available both beings and otherwise for public with other health care requirements. At last, the
cost exhausted on the cure of corpulence and diabetes is higher than it is spent on Police services
or even in judiciary services. NHS’s financial costs on diabetes is approximately 8.7 Pounds
billion per annum and is accounting for 9% of the total budget, 80% of the money is spent for
treatment in which advanced complications occurs and includes dialysis and amputations (Allen
& Wallace, 2015).
Interventions & Strategies for addressing Diabetes
Decreasing the fatness is actually the major feature for decreasing the long-term occurrence of
type2 diabetes & it is the one of 7 PHE main concern areas. Bradford people were more pushed
towards the maintenance of the lifestyle and healthy living since this disease is considered to be
the lifestyle disease. These lifestyle change includes the exercising and eating healthy. Via NHS
Health Check Programme, population aged between 40 to 75 are screened for heart risks factors,
renal disease by giving the personal review of the factors related to behaviors which may higher
up the risk of developing any disease and offers professional advice on living change. Finally, it
identifies new diagnosed disease with serious conditions (Diabetes, 2018).
This NHS programme had advantages too. It is successful to identify the new cases of non-
diagnosed diabetes, although this number is negligible if compared with the undiagnosed people.
Then, it also has developed awareness related to diabetes in the city and the requirement for
lifestyle changes. Though, there are some of the limitations which are seen. The screening is
dependent on the age, young public is at risk and particularly Bradford people are bypassed,
hence early detection is must and missing that would be harmful. Early age detection is
necessary but it cannot be done via screenings. There are some results of the screenings which
are based on the probability of prevalence of the illness and nothing on the real occurrence. In
addition to that, people who are chosen for blood glucose testing based on the diabetic riddle of
program, overlooks approx 29% of people who are with undiagnosed diabetes, henceimportant
changes that would have been vital in achieving essential physical condition gains. At last, there

9
Urban Health profile
is restricted follow-up act to safeguard obedience for suggested routine changes (Gassasse et al.,
2017).
Recommendations
Lifestyle needs to be changed in order to reduce the obesity so that one can prevent himself from
the type2 diabetes. There are some of the recommendations which can help in the reduction of
this disease. They are:
 Improving the glycemic control and decreasing the blood pressure and cholesterol would
be recommended (WHO, 2010).
 Vulnerable groups and communities which have the disadvantage of the treatments must
be targeted. For example: People of Bradford are to be kept in mind and there are other
major cities in UK which can easily be targeted for better treatments.
 To decrease the number of total UK population with T2DM, Bradford is one of the place
to start with as the major population from that district is diagnosed with this disease.
 Patients should be taken to the personal care who are diagnosed with diabetes as they
need higher amount of care in the hospitals. One should be enabled to be in more control
of their own life and can lead a healthy and a better life (Pratley, 2013).
Conclusion
This report focuses on the disease which is very dangerous to all the humans if once they are
diagnosed with this. This is known as Type2 Diabetes or T2DM. This disease actually is a
lifestyle disease which occurs majorly because of the people who are obese and do not lead a
healthy lifestyle. People who are regular with their routines and eat healthy and limited will
never even touch this disease. Obesity is to be reduced and this report also displays the graph of
the Bradford city in UK which has the maximum number of the population diagnosed with type2
diabetes (Ong et al., 2018). Bradford spends too much cost in treating this disease as compared
to other diseases and other services including judiciary services too. This essay holds the data of
Bradford population with this disease and also hold the data for England and United Kingdom on
the whole. In conclusion one can say that human beings due to urbanization are so empowered
with technology that they do not move their bodies. With the inclusion a healthy lifestyle daily,
one can be healthy and live longer.

10
Urban Health profile
References
ADA, 2002. Implications of the United Kingdom Prospective Diabetes Study. 25(1).
Allen, L. & Wallace, V., 2015. NHS Bradford City CCG. [Online]
Available at: https://www.england.nhs.uk/rightcare/wp-content/uploads/sites/40/2016/09/
Casebook_-Bradford-CCG_Beating-Diabetes.pdf
[Accessed 11 July 2018].
CQC, 2016. Summary of data relating to urgent and emergency care services in the Bradford &
Airedale System Resilience Group. [Online]
Available at: https://www.cqc.org.uk/sites/default/files/20161025_bradford-airedale-data-profile-
report_final.pdf
[Accessed 11 July 2018].
Chaudhary , M. J. N., Bojerenu, M. M., Safdar, M. & Marwat, . J., 2016. Effectiveness of
diabetes education and awareness of diabetes mellitus in combating diabetes in the United
Kigdom; a literature review. Journal of Nephropharmacology, 5(2), pp. 110-115.
Dendup, T., Feng, X., Clingan, S. & Astell-Burt, T., 2018. Environmental Risk Factors for
Developing Type 2 Diabetes Mellitus: A Systematic Review. International Journal of
Environmental Research and Public Health , 15(78).
Diabetes, C. C., 2018. URBAN DIABETES UNDERSTANDING THE CHALLENGES AND
OPPORTUNITIES. [Online]
Available at: http://www.citieschangingdiabetes.com/content/dam/cities-changing-diabetes/
magazines/CCD-briefing-book.PDF
[Accessed 11 July 2018].
Gassasse, Z., Smith, . D. & Finer, S., 2017. Association between urbanisation and type 2
diabetes: an ecological study. BMJ Global health, 2(4).
Gov, O., 2002. Prevalence of diagnosed diabetes mellitus in general practice in England and
Wales, 1994 to 1998. [Online]

11
Urban Health profile
Available at: www.ons.gov.uk/.../prevalence-of-diagnosed-diabetes-mellitus-in-general-practice-
i
[Accessed 11 July 2018].
Hassan, B. A. R., 2013. Overview on Diabetes Mellitus (Type 2). Journal of Chromatography
Separation Techniques, 4(3).
Inzucchi, S. E., 2012. Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered
Approach. Diabetes Care, 35(6), pp. 1577-1596.
Kaku, K., 2010. Pathophysiology of Type 2 Diabetes and Its Treatment Policy. JMAJ, 53(1).
Kirwan, J. P., Sacks, J. & Nieuwoudt, S., 2017. The essential role of exercise in the management
of type 2 diabetes. Cleveland Clinic Journal of Medicine, 84(1).
Olokoba, A. B., Obateru, . O. A. & Olokoba, L. B., 2012. Type 2 Diabetes Mellitus: A Review
of Current Trends. Oman Medical journal, 27(4), pp. 269-273.
Ong, S. E., Koh, J. J. u. K. & Toh, S. A. E. S., 2018. Assessing the influence of health systems
on Type 2 Diabetes Mellitus awareness, treatment, adherence, and control: A systematic review.
PLOS.
Pratley, R. E., 2013. The Early Treatment of Type 2 Diabetes. The American Journal of
Medicine, 126(9).
UK, D., 2010. Diabetes in the UK 2010: Key statistics on diabetes. [Online]
Available at: https://www.diabetes.org.uk/resources-s3/2017-11/diabetes_in_the_uk_2010.pdf
[Accessed 11 July 2018].
UK, D., 2015. Diabetes: Facts and Stats. [Online]
Available at: https://mrc.ukri.org/documents/pdf/diabetes-uk-facts-and-stats-june-2015/
[Accessed 11 July 2018].
UK, D., 2017. Facts and Stats. [Online]
Available at: https://diabetes-resources-production.s3-eu-west-1.amazonaws.com/diabetes-

12
Urban Health profile
storage/migration/pdf/DiabetesUK_Facts_Stats_Oct16.pdf
[Accessed 11 July 2018].
WHO, 2016. Global report on diabetes.
WHO, 2010. Recommendations for preventing diabates. [Online]
Available at: www.who.int/dietphysicalactivity/publications/trs916/en/gsfao_diabetes.pdf
[Accessed 11 July 2018].