English: Thank you very much, Deputy Llywydd. I'd like to start by thanking Jenny Rathbone, Dai Lloyd and Jack Sargeant for bringing this important debate on diabetes prevention before the Senedd today, and I'd also like to thank Jayne Bryant for the work that she's been doing with the cross-party group. This is an important motion, and I know that diabetes is a significant problem that is growing globally, and also in Wales. We must tackle this very serious situation that has an impact on so many lives and so many individuals in our nation. In 2019-20, around 192,000 people in Wales had diabetes, as Jenny mentioned, and that's around 7 per cent of our adult population. It's also important, as Jenny said, to differentiate between the two types of diabetes: type 1, which is not preventable, and type 2 diabetes, where there is a great deal we can do to prevent the condition from developing. Now, in the latest figures that we have, the cost of treating diabetes for the health service is topping around £126 million or 1.9 per cent of the NHS budget. If we also bear in mind those patients that are treated for cardiovascular disease and other complications arising from diabetes, then we do reach that figure of 10 per cent that Jenny referred to. So, you're quite right in noting that figure in your motion, and this highlights the importance of secondary prevention, namely preventing the complications from arising by managing the condition well - not just prevention, but also investment in those services that prevent those complications from arising. Now, the scale of the challenge facing us has been highlighted by the pandemic. We've seen how people suffering from diabetes are over-represented in the deaths related to COVID. Although people with diabetes aren't necessarily at greater risk of catching COVID, it does appear that diabetes risk factors and complications mean that the outcomes are likely to be worse if they do contract the virus. We know that obesity or high blood pressure, ethnicity or deprivation are some of the multiple factors that contribute to the development of serious COVID conditions. Our national approach to diabetes is outlined in the delivery plan for diabetes in Wales, and this has been extended for a further year so that we can develop a follow-on programme. What we know is that there is a clear and significant link between type 2 diabetes and obesity. And studies suggest that around 90 per cent of adults with type 2 diabetes weigh more than they should in order to be healthy, or are obese. And we also know that obesity is linked to a range of other serious health conditions, like cancer, heart disease and stroke. Now, in addition to the significant impacts on quality of life, it has a significant impact on mental health too. And that's why it's crucial that we continue to focus on prevention and reducing the rates of obesity. Over 60 per cent of adults, and one in four primary school children, are overweight or are obese here in Wales. So, that's why today I am announcing investment of over £6.5 million to help to tackle obesity and diabetes in Wales. And the funding will be targeted at children and older people, in order to help them to maintain a healthy weight. And this will help to deliver what will be announced on 18 March, namely our 'Healthy Weight: Healthy Wales' delivery programme for 2021-22. Now, £5.5 million of the funding will be provided for specific programmes, under 'Healthy Weight: Healthy Wales'. And that will help to promote key developments across services, in order to prevent obesity and manage weight. And it includes almost £3 million additional funding for obesity services across our health boards. And this funding - and this is important to highlight - does include £1 million of additional funding per year over the next two years. And this will enable us to take early steps to prevent illness and to prevent the impact of ill health and inequalities, by supporting the work of developing prevention pathways, which is based on that model that you mentioned in the Afan valley. A pre-diabetes education pathway, provided by trained healthcare support workers, is provided for people who have had a higher glucose reading in the past, or who are at risk of developing pre-diabetes in the future. So, the Afan valley programme is being evaluated by the Diabetes Wales research institute. And we know that some of the outcomes are very promising indeed - as you mentioned. And I'm sure that those who proposed the debate will be interested in knowing that an evaluation of efficiency and economic cost has been undertaken by Swansea University. And what we know is that it works, and that is why we are providing this additional funding, to ensure that we do see that pilot being developed across Wales. So, the pilot provided us with evidence; we can see that preventative intervention the length and breadth of Wales. This will allow us to meet the challenge, the increase in type 2 diabetes, to improve the health of those who are affected, and to provide healthcare that is based on value, as you noted, Jenny. The expectation is that at least one healthcare cluster -
Welsh: Diolch yn fawr, Dirprwy Lywydd. Hoffwn i ddechrau trwy ddiolch i Jenny Rathbone, Dai Lloyd a Jack Sargeant hefyd am ddod â'r ddadl bwysig yma ar atal diabetes gerbron y Senedd heddiw. Diolch hefyd i Jayne Bryant am y gwaith mae hi wedi bod yn ei wneud gyda'r grŵp trawsbleidiol. Mae hwn yn gynnig pwysig, a dwi'n gwybod bod diabetes yn broblem sylweddol sy'n tyfu drwy'r byd, ac mae'n tyfu yng Nghymru hefyd. Mae'n rhaid inni fynd i'r afael â'r sefyllfa ddifrifol yma, sydd yn effeithio ar gymaint o fywydau ac ar unigolion yn ein gwlad ni. Yn 2019-20, roedd tua 192,000 o bobl yng Nghymru gyda diabetes, fel gwnaeth Jenny gyfeirio ato, sef tua 7 y cant o'n poblogaeth sy'n oedolion. Mae'n bwysig hefyd, fel mae Jenny wedi'i ddweud, i wahaniaethu rhwng y ddau fath gwahanol o diabetes: math 1, sy'n rhywbeth na ellir ei atal, a diabetes math 2, lle mae lot allwn ni ei wneud i atal y cyflwr rhag datblygu. Nawr, yn y ffigurau diweddaraf sydd gyda ni, mae'r gost o drin diabetes i'r gwasanaeth iechyd yn cyrraedd tua £126 miliwn neu 1.9 y cant o gyllideb yr NHS. Os ydyn ni'n ystyried hefyd y cleifion sy'n cael eu trin ar gyfer clefyd cardiofasgiwlar a chymhlethdodau eraill sy'n deilio o diabetes, wedyn rydym ni yn cyrraedd y ffigur yna o 10 y cant oedd Jenny wedi cyfeirio ati. Felly, rydych chi'n iawn i nodi'r ffigur yna yn eich cynnig chi. Mae hyn yn tanlinellu pwysigrwydd atal eilaidd, sef atal cymhlethdodau diabetes rhag datblygu trwy reoli'r clefyd yn dda. Nid dim ond atal diabetes yn y lle cyntaf sy'n bwysig, ond hefyd buddsoddi yn y gwasanaethau sy'n rhwystro'r cymhlethdodau rhag digwydd. Nawr, mae maint yr her sy'n ein wynebu ni wedi cael ei danlinellu gan y pandemig. Rydym ni wedi gweld sut mae pobl sy'n dioddef o diabetes wedi eu gorgynrychioli ymhlith y marwolaethau sy'n gysylltiedig â COVID. Er nad yw pobl sydd â diabetes o reidrwydd mewn mwy o berygl o ddal COVID, mae'n ymddangos fel bod ffactorau risg diabetes a'i gymhlethdodau yn golygu bod canlyniadau yn debygol o fod yn waeth os ydyn nhw'n dal y feirws. Rŷn ni'n gwybod bod gordewdra neu bwysau gwaed uwch, ethnigrwydd neu fod yn ddifreintiedig yn rhai o'r ffactorau lluosog sy'n cyfrannu at ddatblygiad salwch COVID yn fwy difrifol. Mae ein dull cenedlaethol o ymdrin â diabetes wedi ei amlinellu yn y cynllun cyflawni ar gyfer diabetes yng Nghymru, ac mae hwn wedi ei ymestyn am flwyddyn arall er mwyn cael cyfle i ddatblygu'r rhaglen olynol. Nawr, beth rŷn ni'n gwybod yw bod yna gysylltiad clir ac arwyddocaol rhwng diabetes 2 a gordewdra. Ac mae astudiaethau'n awgrymu bod tua 90 y cant o oedolion sydd â diabetes math 2 yn pwyso mwy nag y dylen nhw i fod yn iach, neu'n ordew. Dŷn ni'n gwybod hefyd fod gordewdra'n gysylltiedig ag amrywiaeth o gyflyrau iechyd difrifol eraill, fel canser, clefyd y galon a strôc. Nawr, yn ogystal ag effeithio'n sylweddol ar ansawdd bywyd, mae'n cael effaith sylweddol ar iechyd meddwl hefyd. A dyna pam mae'n hanfodol i ddal ati i ganolbwyntio ar atal a lleihau cyfraddau gordewdra. Mae dros 60 y cant o oedolion, ac un o bob pedwar o blant ysgol gynradd, dros eu pwysau neu'n ordew yma yng Nghymru. Felly, dyna pam heddiw dwi'n cyhoeddi buddsoddiad o fwy na £6.5 miliwn i helpu i daclo gordewdra a diabetes yng Nghymru. A bydd yr arian yn cael ei dargedu at blant a phobl hŷn, i'w helpu i gyrraedd a chynnal pwysau iach. A bydd hwn yn helpu i ddelifro'r hyn a fydd yn cael ei gyhoeddi ar 18 Mawrth, sef ein cynllun cyflawni, 'Pwysau Iach, Cymru Iach', ar gyfer 2021-22. Nawr, bydd £5.5 miliwn o'r cyllid yn mynd tuag at raglenni penodol, o dan 'Pwysau Iach, Cymru Iach'. Bydd yr arian yn helpu i hyrwyddo datblygiadau allweddol ar draws gwasanaethau atal gordewdra a rheoli pwysau. Ac mae'n cynnwys bron i £3 miliwn o gyllid pellach ar gyfer gwasanaethau gordewdra ar draws ein byrddau iechyd. Ac mae'r cyllid hwn hefyd - ac mae hwn yn bwysig i'w danlinellu - yn cynnwys £1 miliwn o arian ychwanegol y flwyddyn dros y ddwy flynedd nesaf. A bydd hyn yn ein galluogi ni i gymryd camau cynnar i atal salwch a lleihau effaith iechyd gwael ac anghydraddoldeb, drwy gefnogi'r gwaith o ddatblygu treialon llwybr atal cyn-diabetes, sy'n seiliedig ar y model yna roeddech chi'n siarad amdano yn nyffryn Afan. Mae'n cynnwys llwybr addysg cyn-diabetes, sy'n cael ei ddarparu gan weithwyr cymorth gofal iechyd wedi eu hyfforddi, ar gyfer pobl sydd wedi cael darlleniadau glwcos gwaed uwch yn y gorffennol, neu sydd â risg o ddatblygu cyn-diabetes yn y dyfodol. So, mae rhaglen dyffryn Afan yn cael ei gwerthuso gan uned ymchwil Diabetes Cymru. Rŷn ni'n gwybod bod rhai o'r canlyniadau'n addawol dros ben - fel roeddech chi wedi cyfeirio atyn nhw. A dwi'n siŵr y bydd gan y rheini sydd wedi cynnig y ddadl ddiddordeb mewn gwybod bod gwerthusiad o effeithlonrwydd a chost economaidd wedi ei gynnal gan Brifysgol Abertawe. A beth rŷn ni'n ei wybod yw ei fod e'n gweithio, a dyna pam rŷn ni'n rhoi'r arian ychwanegol yma, i sicrhau ein bod ni'n gallu gweld y peilot yna yn cael ei ddatblygu ar draws Cymru. Felly, mae'r peilot wedi rhoi tystiolaeth i ni; gallwn ni weld yr ymyrryd ataliol ledled Cymru. Bydd hyn yn ein helpu ni i ymateb i'r her, y cynnydd mewn diabetes math 2, i wella iechyd y rhai sydd wedi eu heffeithio, ac i ddarparu gofal iechyd sydd wedi ei seilio ar werth, fel roeddech chi wedi ei nodi, Jenny. Y disgwyl yw y bydd o leiaf un clwstwr gofal iechyd -