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The sweet truth - diabetes toll is declining

Friday, 02 February 2018

Alarmism about diabetes does not stand up to scrutiny, says Nick Cater.

The Menzies Research Centre has come to be suspicious of the claims of the public heath industry. As we discovered with our research into the social cost of alcohol and our recent argument against sugar tax, the claims too often turn out to be exaggerated, confused or just plain wrong.

So what are we to make of claim by the George Institute that a 30 per cent reduction in kilojoules in sugar-sweetened soft drink would stop 47,000 people dying from Type 2 diabetes?

Using pure common sense, we think it’s nonsense. In 2015 there were 4662 deaths from all types of diabetes, that’s Type 1 and Type 2. If we assume cutting the amount of sugar in soft drinks by less than a third will enable every one of those poor people to stay alive - a supposition that is in itself improbable - it will take more than 10 years to reach the claimed total.

As usual, the public health argument relies on simple causal relationships: rising levels of obesity are caused by rising intakes of sugary drinks and that obesity is responsible for deaths from diabetes.

Let’s check the evidence. The obesity rate is certainly increasing:

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Yet the death rate for diabetes is in retreat:

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Claims that the number of deaths from diabetes are rising are correct if we consider the absolute numbers. The number of deaths doubled between 1968 and 2015. But wait a minute. So did the population. The relative number of deaths was static.

The diabetes death rate adjusted for age is the figure that matters. It fell dramatically from World War II until 1980, and has fallen further since. In 1968 there were 25 recorded deaths from diabetes for every 100,000 Australians; in 2015 there were 16.

The reason we may think Type 2 Diabetes is becoming more common is not because we’re eating sugar, but because we’re getting older. Diabetes, as any GP will tell you, is largely an affliction of age. The median age of death from diabetes for men in 2015 was 79; for women it was 84.

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Taxing soft drink to save us from the scourge of diabetes is like trying to fix Alzheimers by taxing Paddle Pops.

If it sounds like the public health lobby is running out of puff, it is because it is. Hundreds of millions of dollars, most of it public money, is spent every year on preventative health. Millions more flows from the World Health Organisation for research and advocacy. The salaried finger-waggers are naturally reluctant of disembark from the candy train.

Yet preventative health advocates are running out of diseases to prevent. The death rate from potentially avoidable causes fell by 44 per cent between 1997 and 2014, thanks to advances in diagnosis and treatment.

Australians are 6.5 times less likely to die of heart disease than they were in the 1960s; four times less likely to die of influenza or pneumonia; and 5.5 times less likely to die from cebro-vascular failure. The chances of that an Australian their late 60s will survive for another year are 3.4 times greater than they would have be in 1968.

If we insist on blaming anyone for diabetes, it’s not Big Sugar. The blame surely belongs to the Big Medicine for keeping us breathing longer than we have any right to expect.

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