More support needed for people with diabetes in England

According to a recent survey by the Healthcare Commission, people with diabetes in England are not receiving sufficient care.

The study surveyed over 88500 people from 1500 practices and primary care trusts and found that only 11% had attended a course aimed at educating them about their condition and how to manage it.

In addition, 17% of people did not know if they had type 1 or type 2 diabetes.

Although 68% of people who had been admitted to hospital in the last 12 months believed all the hospital staff knew of their condition, one in ten reported that none of the staff provided adequate care to manage their condition.

Suitable food was ‘rarely or never’ provided for 11% of individuals in hospital and 9% said the food was ‘rarely or never’ received at a suitable time to help with diabetes management.

The aim of the study was to assess the improvement of diabetes care since 2001, when the Government’s National Service Framework for diabetes was published.

All people with diabetes are currently offered an annual check-up.

Jonathan Boyce from the Healthcare Commission commented: ‘We are pleased the survey results have shown that nearly all people with diabetes are now getting regular check-ups including screening for complications. What we now need is consistency in the help and support offered by the NHS. It is crucial that people with diabetes are able to access all the resources and expertise to enable them to manage the care of their diabetes more effectively.’

According to Sue Roberts, National Clinical Director for Diabetes, standards of care are rising but that there is still ‘unacceptable variation in standards’.

The results of this survey have been sent to primary care trusts to allow them to identify where improvements in care could be made.
BBC News, 11 April 2007

British people are worst in Europe at controlling diabetes
A recent survey demonstrated that among Europeans, British people with diabetes are the worst at controlling their blood glucose concentration and do not understand the impact this will have on their health.

People with diabetes from the UK, France, Germany, Italy and Spain were questioned regarding their perceptions on what risks were associated with their diabetes and how well they were controlling it.

Despite Britain’s target HbA1c levels being the highest in Europe at 7.5%, it had the lowest proportion of individuals achieving this level.

Results showed that many people thought their blood glucose levels were ‘OK’ or ‘a little high’ when they were, in fact, above national recommendations. People were also unrealistically optimistic about how well they were doing.

Simon O’Neill, Director of care, information and advocacy services at Diabetes UK said: ‘There is no such thing as mild diabetes. It is a serious condition, yet this European survey highlights that this message is failing to get through.’
Times Online, 16 April 2007

Fast food in Japan blamed for increase in type 2 diabetes
The success of fast food chains in Japan is pushing the population towards a health crisis. Calorie-crammed food such as doughnuts and giant hamburgers are becoming increasingly popular among adolescents.

An estimated 23 million Japanese people have metabolic syndrome and, according to a study released recently, up to a fifth of 5–12-year-old Japanese children who are overweight have, or are at risk of developing, symptoms of this condition.

The greatest risk group are middle-aged ‘salarymen’. However, type 2 diabetes is now affecting children as young as 9 years.

As fast food outlets experience record sales, experts worry that Japan will be affected by diet-related diseases to a much greater extent than developed countries.

Tom Gill, Asia–Pacific regional co-ordinator for the International Obesity Task Force, warns that there will soon be dramatic increases in stroke, diabetes and hypertension. He comments: ‘When you have rapid transformations in lifestyle, that’s when you see the worst outcomes.’
The Observer, 8 April 2007

Maggots clear MRSA from diabetic foot ulcers
Researchers at the University of Manchester have successfully used maggots to treat diabetic foot ulcers infected with MRSA.

Not only were 12 of the 13 wounds completely healed from infection, but it also occurred in record timing; a mean of 3 weeks, compared with the usual 28-week conventional treatment period.
    Depending on ulcer size, green bottle fly larvae were applied between 2 and 8 times for 4-day periods. The maggots eat only dead tissue and bacteria, which allows healing of the healthy tissue.

Professor Andrew Boulton, who published these results in Diabetes Care, said: ‘This is very exciting. If confirmed in a randomised controlled trial, larval treatment would offer the first non-invasive and risk-free treatment of this problem.’
The Times, 3 May 2007

High blood glucose increases the risk of cancer in women
Research in Sweden has identified an increased risk of cancer in women with raised blood glucose levels.

The study assessed 64500 people and found that a high level of glucose in the blood is a predictor of pancreatic, skin, womb and urinary tract cancers.

For women under 49 years of age, there was also a link to breast cancer.

Women had a 26% greater chance of developing cancer if they were in the top 25% of blood glucose readings after fasting, compared with the bottom quarter.

The research spanned 13 years and identified 2478 cases of cancer. Hyperglycaemia risk was also found to increase significantly with age.

This study emphasises the need for careful monitoring and control of blood glucose in people with diabetes.
BBC News, 21 March 2007

Three new genes linked to diabetes 
Researchers from the University of Dundee have identified three new genes that predispose diabetes. This brings the total of diabetes-linked genes to nine.

The researchers discovered that there are two versions of each gene, one of which predisposes people to type 2 diabetes. The other reduces the risk.

The high-risk type increases the risk of development of type 2 diabetes by 10–20%.

A further 9000 UK samples were studied to confirm the findings.

Professor Andrew Hattersley, Peninsula Medical School, Exeter, said: ‘We now have significantly more pieces to the jigsaw that will help us understand the mechanisms behind type 2 diabetes.’ He continued: ‘Each piece of new knowledge takes us a step closer towards a future with improved prevention and treatment of this.’
BBC News, 26 April 2007

Should smokers be granted time off work to kick the habit?
According to new public health recommendations, smokers should be allowed time off work to attend quitting clinics.

These guidelines have been issued by the National Institute of Health in preparation for the public smoking ban in England that comes into force in July.

Smokers cost companies £5 billion annually owing to loss of productivity, absenteeism and fire damage. This proposal suggests that the extra productivity from people quitting will outweigh the costs of time lost while they are attending the clinics.

Given that smoking raises blood glucose levels and increases the risk of serious cardiovascular complications in people with diabetes, this could be good news from a health perspective, providing the scheme is successful.
BBC News, 25 April 2007

A few steps towards supporting diabetes care
On April 20, over 8 million steps were taken by people across the globe in an effort to raise awareness of the importance of exercise for people with diabetes.

The ‘1 day, 1 km, 1 purpose’ campaign saw walks in an eclectic variety of locations from by the Egyptian pyramids to processions on Ipanema beach in Brazil to Nordic ski pole walking in Oslo.

Among the 6000 plus people who participated were over 2000 employees of Merck Serono.

Don Cowling, General Manager of Merck Serono, said: ‘We understand that lifestyle interventions, such as exercise, are instrumental in helping patients manage their condition’. He adds that the campaign will ‘help to highlight the importance of regular exercise together with treatment.’
Professional Medical Media, 30 April 2007

Junk food banned in schools
MSPs have unanimously backed a new legislation to ban junk food in Scottish schools. The law states that standards of nutrition must be met and allows the council to provide children with free healthy snacks, milk and drinking water.

Education Minister Hugh Henry said that the aim of the new legislation was to meet nutritional standards.

‘We do not support universal free school meals for all, we do want to target resources where they are needed the most and that is what we are doing.’

Audrey Birt, Director of Diabetes UK in Scotland, said: ‘The number of children with type 2 diabetes is soaring and this is strongly related to poor diet and lack of physical activity.’ She continues: ‘Families need to understand the importance of a healthy lifestyle in preventing ill health and be given the support they need to help their children make healthy choices.’
BBC News, 15 March 2007

Divabetic T-shirts – a new fashion trend?
For some time now, fluorescent, 80s-revival clothing, complete with a bold statement identifying the wearer’s political or social attitude, has sold with great popularity in high-street stores.

Charities are now joining the fashion bandwagon and producing their own merchandise in a battle to create the most ironic, darkly comical slogans for people with major illnesses.

Diabetes charities have produced T-shirts with ‘Divabetic’, ‘Death By Chocolate (Seriously)’ and ‘My Pancreas Works On AAA Batteries’.

Backing the American Cancer Society are slogans such as ‘Got Morphine?’, ‘Chemo Commando’ and ‘Professional Pin Cushion’.

Other illnesses are represented by ‘Blow Me – I’m Asthmatic’, ‘Dyslexics Have More Fnu’ and ‘I Have a Brain Tumour… What’s Your Excuse?’

There is debate over whether it is supportive or insulting for a non-sufferer to sport these items.     However, if it catches on, perhaps more rare conditions will be brought to light in the public eye, increasing support for a wide range of charities.
The Guardian, 29 April 2007

Bigger coffins for the obese
Crematoria are having to widen their coffins and furnaces to accommodate the rising incidence of obesity in Britain.

A standard coffin is 16–20 inches wide but 41-inch versions are being produced in Lanarkshire, Scotland, and Lewisham Council has ordered a special cremator from the USA able to accommodate coffins 44 inches wide.

This coincides with a recent report that Australia is remodelling its ambulances to cope with the sharp rise in overweight people.

The rate of obesity has risen from 8% of women and 6% of men in 1980 to 24% of both sexes in 2004 and is predicted to escalate to at least a third of the population by 2010.

Hazel Hardin of the Local Government Association said: ‘The death of a loved one is always a difficult time and having to decamp to another area for the cremation just adds to the ordeal.’
BBC News, 18 April 2007