Session 4. Paul Cromme lecture. Life time achievement award

Confronting the strange pandemic of Type 2 diabetes

  David Matthews
  Professor of Diabetic Medicine at the University of Oxford

David Matthews is Emeritus Professor of Diabetic Medicine at the University of Oxford.

He has wide experience in clinical medicine, teaching and research. He was the Founding Chairman of the Oxford Centre for Diabetes, Endocrinology and Metabolism, having fundraised for its construction and set up its research and teaching infrastructure.

He has taught medicine, statistics, research processes and administration both at established UK and international venues and online. He established the annual residential Robert Turner Course in research training in Oxford. He was elected an NIHR senior fellow. He gave the Diabetes UK Banting lecture in 2010.

He founded the Oxford Health Alliance which continues to give grants to elected ‘Tseu Fellows’ from lower middle income countries.

He has 360 peer-reviewed papers; a recent citation count was >91,000, H index 92. He was a member of the UKPDS steering committee; Co-chair of the CANVAS trial. He is currently Chair of the steering group of VERIFY and a member of the board of the FOCUS study. He has particular interests in the world epidemic of non-communicable disease (NCD).

He is past President of the European Association for the Study of Diabetes of which is now an Honorary Fellow and recipient of the Albert Renold Medal. He is currently the Chair of the Trustees of the Oxford Hospitals Charity.

We are currently facing a global pandemic of obesity and Type 2 diabetes. In some settings, the population prevalence of Type 2 diabetes is 50%, and half of those affected will die from diabetes-related complications. Eight centuries ago, an epidemic of bubonic plague swept across Europe, killing at least half of its victims. This was termed by some as ‘The Black Death’. Drawing analogies between this Black Death of the 14th century and the modern-day pandemic of Type 2 diabetes one can view both diseases in terms of aetiological agents, reservoirs, vectors and predisposing toxic environments; populations can be considered as highly susceptible to the ‘transmissible’ agents of Type 2 diabetes. These are calorie excess, inadequate food labelling, poorly regulated advertising, cynically engineered social peer pressure for calorie consumption, poor town planning, and encouragement of sedentary lifestyles. Many aspects of modern life are detrimental to health and these may not be simply the result of individual choice or personal ‘fault’ in what has now become a widespread toxic environment.

In tackling a pandemic of a contagious microbial pathogen, breaking the cycle of transmission is paramount. In the diabetes epidemic the improvement of the environment is also paramount; this can only be achieved by political will and prompt, decisive legislation backed by science and the medical community. Far from fearing that such measures edge us towards a ‘nanny state’, the public should expect responsible governments and health-care providers to safeguard them from the toxic milieu that puts them at risk of obesity and its complications – including diabetes. Communities and populations have the right to have their health protected.

Professor Matthews will address the issues of the ‘NCD* mindset’, genetic excuses, the laissez faire attitude of governments, the problem of the power of commercial interests, and the difficulties involved in community intervention studies. He will outline some ideas and views on the way ahead.