I was shocked to read two major reports issued last week, which show that people with diabetes are not getting the levels of care they need from the NHS. I wanted to let you know as soon as possible about these important findings, so this post replaces the one you might have been expecting!

The charity Diabetes UK, in its report State of the Nation 2012: England, points out that the NHS is falling woefully short of the vision it set itself in 2001, for diabetes services to be delivered by 2013. The report says that diabetes prevention and management have not been successfully tackled, meaning that diabetes continues to increase, along with its associated complications and costs.

In fact, over just the last five years, the number of people diagnosed with diabetes in England has increased by 25 per cent, from 1.9 million to 2.5 million. On top of this, it is estimated that some 850,000 people have diabetes but don't yet know it. There has also been a huge growth in complication rates. Diabetes is now the biggest single cause of amputation, stroke, blindness, and end-stage kidney failure.

So, what has gone wrong? Diabetes UK points to wide variability across the country, which means that there are still significant numbers of people with diabetes who do not have access to the standards of care they need and deserve. There has to be more accurate, early diagnosis, more effective treatment and better adherence to the standards regarding laboratory tests.

Doctors have plenty of guidance on the checks that should be made on each person with diabetes, and yet the report reveals that two-thirds of adults with type 1 diabetes and half of people with type 2 diabetes fail to get the annual tests and investigations that they should. For children, the figures are scandalously worse. In England, an incredible 96 per cent of children don't receive all of the annual routine health checks. That is simply shameful.

Even if you are getting the tests you need, don't assume that the treatment you are prescribed will put things right. On average, in England, only 63 per cent of diabetics undergoing treatment have blood sugar (glycosylated haemoglobin, HbA1c) within the recommended level. For blood pressure and cholesterol, these averages drop to 51 per cent and 40 per cent respectively. The report sums up the standard of diabetes care in England as "too little, too late, too variable".

A Hospital Stay Could Damage Your Health If You Have Diabetes

You might think, quite reasonably, that if you need to go into hospital for any reason you will at least be in the right place to get your diabetes properly looked after. Sadly, that could not be further from the truth, as the second major report published last week shows. The National Diabetes Inpatient Audit 2011 took a snapshot of the care people with diabetes received in hospitals in England and Wales during one week last September. Its findings make appalling reading.

During the seven days of the audit, almost one third of the patients experienced at least one medication error. These errors led to severe hypoglycaemia (low blood sugar) or diabetic ketoacidosis (a consequence of consistently high blood sugar) in a lot of cases.

According to Dr Gerry Rayman, the diabetes specialist leading the audit: "The majority of hospital doctors and ward nurses still do not have basic training in insulin management and glucose control". He was particularly critical of the cases in which people had developed diabetic ketoacidosis, saying: "Its occurrence is negligent and should never happen."

Patients' other main complaints were that they were not allowed as much control over their own diabetes as they would have liked, and that the hospital did not provide the right type of food to help them manage their diabetes. If you have been following this blog, you will know just how important it is to be in control of your blood sugar levels and the best way for most people to do that is through their diet.

So, what can you do to make sure you do not become a victim of the overstretched, under-trained, inadequate and occasionally downright incompetent NHS care provision for people with diabetes? My top ten suggestions are these:

• Be aware of the signs and symptoms of diabetes; if you think you may have diabetes, talk to your doctor.

• If you have been diagnosed with diabetes, ask your doctor to explain the disease and the treatment options to you in depth; if you are not satisfied, ask for a referral to a specialist.

• Every person with diabetes should get a planned programme of nine recommended checks each year; make sure you get these tests regularly.

• Follow a low glycaemic load diet and cut right back on sugar and simple carbohydrates.

• Get regular exercise and lose weight if you need to.

• If you have to go into hospital, take with you any medications you have been given and any treatment plan or test results from your doctor or specialist, to show to hospital staff.

• Check everything, especially medications you are asked to take – mistakes are commonplace on hospital wards – and don't be afraid to question anything that doesn't seem right.

• Ask hospital staff to explain to you what medication you are being given and why; if you are not happy, insist on talking to a consultant or senior doctor.

• Ask family and friends to bring in low GL food items for you, if the hospital menu is unsuitable.

• If you feel that your blood sugar levels are not being properly controlled, say so and ask to see a senior member of the medical staff if necessary.

Wishing you the best of health,

Martin Hum PhD DHD
Nutritionist
for Real Diabetes Truth

***Highly Recommended***

The hidden sickness that's spiraling developed countries into chronic disease and illness...?

Discover the kitchen spice that can help regulate your blood
sugar levels and ward off diabetes... plus much, much more!

More than 3 million adults now suffer from diabetes in the UK...
Whilst the government and health authorities are sstruggling to get a grip on this growing epidemic, the answer has been right under
their noses all along...

By eating nutrient-packed foods - better known as Super Foods
- you can help reverse chronic diseases like diabetes, heart disease, osteoarthritis and even cancer...

Read here how to unleash the the secret healing powers of Nature's ultimate foods

Bear in mind we are not addressing anyone's personal situation and you should rely on this for informational purposes only. Please consult with your own physician before acting on any recommendations contained herein.

Sources:

1. State of the Nation 2012: England. Diabetes UK. May 2012.

2. National Diabetes Inpatient Audit 2011: Key findings about the quality of care of inpatients with diabetes in England and Wales. Health and Social Care Information Centre. May 2012.

It is well established that heart attacks and strokes are the major cause of death in people with diabetes, so it is not surprising that doctors have tended to prescribe statin drugs to such patients in an attempt to reduce the risk. Statins are a class of drugs that reduce levels of cholesterol, an essential substance in the body that has become the scapegoat for the growing problem of cardiovascular disease. Statins are the world's best-selling drugs with an estimated 30 million people taking them every day.

Now, though, the Food and Drug Administration in the United States has issued new labelling guidelines for statin drugs, warning users that taking them can result in elevated blood sugar levels, diabetes and memory loss. This is in addition to their previously known side effects of muscle damage and liver disease.

The first signs of a link with diabetes were evident as long ago as 2004, with a research report that statin drugs disrupt insulin signalling, the process through which insulin moves glucose from the bloodstream into muscle and fat cells. The implications of this study appear to have been ignored, however, until two recent meta-analyses took a hard look at the link between statins and diabetes.

The first of these, published in June 2011, involved 33,000 patients enrolled in five major clinical trials using statins. It concluded that, overall, statin use caused around one additional case of diabetes for every 500 patients treated and the higher the dose, the higher the risk. This figure is a bit misleading, though, since it includes earlier trials of the weaker statin drugs. The more potent versions being prescribed today are likely to be linked to a much bigger diabetes problem, especially at higher doses.

How statins block an essential metabolic pathway

The second meta-analysis, the results of which were published in January 2012, looked at data from almost 154,000 postmenopausal women. It revealed that women taking statins had a 48 per cent greater risk of diabetes, compared with similar women not taking statins. These findings are not just chance occurrences. By blocking the production of cholesterol in the liver, statin drugs also block the production of a related substance called dolichol, which plays an important role in sugar metabolism and insulin sensitivity.

Incidentally, dolichol levels have been found to be unusually low in people with Alzheimer's disease, which could go some way towards explaining why statin use has also been linked with memory loss. In my blog post of 13 January, I explained the way in which diabetes and dementia are related and the idea that Alzheimer's disease may be "insulin resistance in the brain".

So, what do you do if you are currently taking statins? Before anything else, talk to your doctor and show him or her these findings. Don't be fobbed off with assurances that this is a minor side effect that is outweighed by the benefits of taking statins. A 2011 Cochrane Review showed, basically, that taking statins does almost nothing to reduce heart attack risk in people who have not previously experienced a heart attack.

If you already have diabetes, your cholesterol level is not likely to be an additional risk factor. And don't let your doctor persuade you that statins will reduce your likelihood of peripheral neuropathy (nerve damage) as a complication of diabetes, either. A 2002 population study estimated the risks of neuropathy in statin users and concluded that long term exposure to these drugs significantly increased the risk.

Eventually, mainstream medicine will accept the simple truth that sugar, not cholesterol, is the real culprit in heart disease. It is a truth that the junk food and soft drinks industry, as well as the pharmaceutical giants making millions from their statin drugs, will go to any lengths to keep from us.

In the meantime, keep in mind what Hippocrates, the father of medicine, said: "Let food be your medicine and your medicine food". While drugs may play a useful role in some situations, for the vast majority of us, whether or not we have been diagnosed as having diabetes, eating healthily and getting enough exercise remain our best front line defence against heart disease.

Wishing you the best of health,

Martin Hum PhD DHD
Nutritionist
for Real Diabetes Truth

***Highly Recommended***

The hidden sickness that's spiraling developed countries into chronic disease and illness...?

Discover the kitchen spice that can help regulate your blood
sugar levels and ward off diabetes... plus much, much more!

More than 3 million adults now suffer from diabetes in the UK...
Whilst the government and health authorities are sstruggling to get a grip on this growing epidemic, the answer has been right under
their noses all along...

By eating nutrient-packed foods - better known as Super Foods
- you can help reverse chronic diseases like diabetes, heart disease, osteoarthritis and even cancer...

Read here how to unleash the the secret healing powers of Nature's ultimate foods

Bear in mind we are not addressing anyone's personal situation and you should rely on this for informational purposes only. Please consult with your own physician before acting on any recommendations contained herein.

Sources:

1. Siddals KW, Marshman E, Westwood M, Gibson JM. Abrogation of insulin-like growth factor-I (IGF-I) and insulin action by mevalonic acid depletion: synergy between protein prenylation and receptor glycosylation pathways. J Biol Chem. 2004; 279(37):38353-9.

2. Preiss D, Seshasai SR, Welsh P, Murphy SA, Ho JE, Waters DD, DeMicco DA, Barter P, Cannon CP, Sabatine MS, Braunwald E, Kastelein JJ, de Lemos JA, Blazing MA, Pedersen TR, Tikkanen MJ, Sattar N, Ray KK. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis. JAMA. 2011; 305(24):2556-2564.

3. Culver AL, Ockene IS, Balasubramanian R, Olendzki BC, Sepavich DM, Wactawski-Wende J, Manson JE, Qiao Y, Liu S, Merriam PA, Rahilly-Tierny C, Thomas F, Berger JS, Ockene JK, Curb JD, Ma Y. Statin use and risk of diabetes mellitus in postmenopausal women in the Women's Health Initiative. Arch Intern Med. 2012; 172(2):144-152.

4. Taylor F, Ward K, Moore TH, Burke M, Davey Smith G, Casas JP, Ebrahim S. Statins for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2011; (1):CD004816.

5. Gaist D, Jeppesen U, Andersen M, García Rodríguez LA, Hallas J, Sindrup SH. Statins and risk of polyneuropathy: a case-control study. Neurology. 2002; 58(9):1333-7.