Diabesity: The 'tidal wave' of diabetes and obesity that could soon cost New Zealand $3.5b a year

When we think of Easter we often think of treats, chocolate eggs and hot cross buns. But when treats become the norm, it can be a problem - a huge problem.

You've heard of type 2 diabetes and obesity. Well, combined they make up a new epidemic, known as 'diabesity' - and New Zealand is facing a worrying tsunami of it.

Doctors are calling for New Zealand to address our sugar culture and treat sugar as seriously as alcohol.

Two years ago, Jorja James had type 2 diabetes and was in poor health. She puts it down to bad diet and inactivity.

"I was a bottle of Coke a day person," she explained.

"When I first turned up to work I would always have my bag of lollies, my bag of chips, a packet of biscuits and my Coke and then I'd be sitting down all night answering phones."

But she had one big motivating factor to change.

"My grandchildren - so I could be around for them… now I can run around with them and all sorts of stuff, carry them around now, because I couldn't do it before."

She took up exercise, ate healthily, and in just eight weeks she reversed her type 2 diabetes, which she'd had for 15 years. She's now back to prediabetes levels having lost 20kg and four dress sizes.

Obesity is one of the main drivers of type 2 diabetes.
Obesity is one of the main drivers of type 2 diabetes. Photo credit: Getty

But James is an exception. Within the next 20 years, the number of people with type 2 diabetes is expected to rise by up to 90 percent, to nearly 500,000 people.

It's estimated it will cost the economy $3.5 billion per year by 2040.

'We've been warning it's coming'

Counties Manukau is the dialysis capital of New Zealand - it's a title it would rather not have.

"If you walk around the hospital wards, about one in five patients will have diabetes," says Dr Gary Jackson.

"We're estimating we've got about 45,000 people across our community with diabetes - and it's going up by about 2000 a year."

He says there are actually 3000 new cases a year, but that's offset by around 1000 people with the disease dying each year.

The number of Kiwis with type 2 diabetes is expected to rise by up to 90 percent within the next 20 years.
The number of Kiwis with type 2 diabetes is expected to rise by up to 90 percent within the next 20 years. Photo credit: Getty

The renal unit at Middlemore Hospital is over-capacity; every bed is full, and some patients are having to have dialysis on the ward. It's something that's happening more and more as numbers increase by 7 percent a year.

They've opened up extra evening shifts and are now having to do dialysis through the night - and yet it's still not enough to keep up with demand.

Dr Chris Hood says not only are they seeing more people, but they're also seeing younger people.

"People who are blind, facing dialysis, with unmanageable coronary artery disease, in their 30s." 

And there are dire consequences. It's taking a toll on patients and on healthcare workers -  burnout is a real issue.

One of the main drivers of type 2 diabetes is obesity - together they make up what's being called the diabesity epidemic.

"They're almost the same thing - it's 80 to 90 percent of the problem," explains Dr Hood.

Dr Jackson says he doesn't think you can tackle one issue without the other.

"We can keep putting in dialysis machines, but it's $60,000 a pop every year."

He's been warning for decades the type 2 diabetes tsunami was on its way.

"I've been working here for 20 years and we've been warning it's coming and we can see it's coming and we just count the numbers," he said.

"If we don't change our settings around the obesogenic environment about how overweight people are getting, overweight leads to obesity, this leads to more type 2 diabetes - it's a very steady trajectory."

'We need to treat sugar like alcohol'

Boxer Dave Letele, better known as the Brown Buttabean, is fighting diabetes in the community. He sees 2000 people a week and his From The Couch programme - for people who can't stand for too long - is over-subscribed.

He says when you're cash poor and time-poor, unhealthy food is a much easier choice.

"And this is the problem, when people are time-poor and they're bombarded with unhealthy food choices, of course they're going to pick the cheaper option that's available everywhere."

Jorja James agrees: "It was cheaper to buy all that stuff instead of buying the healthier stuff, so that's what I chose."

Doctors say sugar needs to be treated like alcohol.
Doctors say sugar needs to be treated like alcohol. Photo credit: Getty

Doctors say the health sector can't fix the problem; they believe society needs to wake up and politicians need to show some leadership.

"It needs New Zealand just to take sugar seriously. It kills far more people than alcohol but we don't treat sugar like alcohol, but we need to get to a point where we are," Dr Hood said.

Associate Health Minister Peeni Henare says the Government is looking into a solution.

"As the minister responsible here, we'll be looking at all the levers at our disposal to make sure we can avoid this tidal wave, if you like, of diabetes," he said.

"My hope is that we can provide an announcement sometime soon."

Dr Jackson says it's this simple: force the food industry to reduce the sugar in their products.

"Reduce our salt, reduce our sugar; to really improve the health of the population with very little investment from the Government just takes a bit of will."

Because where there's a will, there's a way.

"It's very simple: you watch what you eat, you don't drink fizzy drinks and you go for a walk," says Letele.