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Author: VWheelock

277. Auditing Diabetes in Ireland

New report A report entitled “Audit Report of the HSE Midland Diabetes Structured Care Programme” (1) has just been released in Ireland, which was conducted in counties Longford, Westmeath, Laois and Offaly. It was concluded that the Programme was delivering care to patients with diabetes in accordance with the recommended national guidelines. It was demonstrated that: • there have been improvements in glycaemic control since previous audits; • prescribing levels of secondary preventative medications are extremely high; • the incidence of complications has improved considerably over time despite increased numbers of patients being enrolled onto the programme. All of this sounds very laudable and it has to be accepted that within the context of the national policy, some progress has been achieved. However if we stand back and consider the bigger picture, it is evident that the prospects are grim. As the report itself acknowledges about 9% of people in Ireland have Type 2 Diabetes (T2D). This figure may well be an underestimate and in any case all the expectations are that the incidence of the disease will continue to increase. Impact of diabetes It is acknowledged that for those with T1D, life expectancy may be reduced by more than 15 years. For those who have had T1D for up to ten years, life expectancy is likely to be reduced by between five and seven years. It is also...

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276. Low-carb Diets for People with Diabetes: Latest Position Statement from Diabetes UK

A little progress Diabetes UK has just released its latest statement on the use of Low-carb diets for those suffering from diabetes (1). Up to now this organisation, which is the leading charity on diabetes has set itself against recommending this approach so it is a step forward to accept that: “Low-carbohydrate diets can be safe and effective in the short term in managing weight, and improving glycaemic control and cardiovascular risk in people with Type 2 diabetes.” The importance of this is that it goes against the official advice in the Eatwell Guide which recommends that we should: “Base meals on potatoes, bread, rice, pasta or other starchy carbohydrates. Choose wholegrain where possible.” And that: “Starchy food should make up just over a third of the food we eat.” (2) Of course this advice begs the question: “What should replace the carbs?” The statement makes no attempt to provide an answer. Since it cannot be protein, there has to be an increase in the fat content of diet. However the statement confirms the official position that saturated fats (SFAs) should be restricted with the emphasis on the unsaturates. Those familiar with my blogs will know that the case against the SFAs is flawed and there is actually conclusive evidence to show that these fats not dangerous but many of them are important nutrients in their own right. Furthermore...

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271. Constructive Ignorance in Ireland

In a previous blog I used the term “constructive ignorance” to describe the action of the Health Professionals Council in South Africa (HPCSA) in charging Professor Tim Noakes with professional misconduct for his views on a diet, which is low in carbohydrates and high in healthy fats (LCHF). This is certainly not an isolated example as there have been essentially similar issues in other countries. Constructive Ignorance has been defined by my colleague Richard North as follows: “There was a time – a long time ago – when I thought that information was the antidote to ignorance. All I had to do, I thought, was to get to the right people and tell them what they needed to know – the correct information – and all would be well with the world. Only latterly did I identify what I came to call “constructive ignorance”, after “constructive dismissal”, where people quite deliberately foster a state of ignorance. Largely, I surmised, they have adopted their narratives and need to protect them with a wall of ignorance. Otherwise, they crumble under the assault of facts, and their holders are faced with the inconvenience of having to rebuild them.” (1). The latest is in Ireland, where Patricia Daly has been in trouble with the Advertising Standards Authority of Ireland (ASAI). One of her websites offers training courses for those looking to implement a...

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259. Diabetes is a Flood of Sugar

A flooded house If you are unlucky enough to be flooded at home because of a burst water pipe, the first thing you would do is to locate the source and stop the water coming in as fast as possible. You would be absolutely astounded if you were told that this could not be done. There are uncanny parallels between this household disaster and Type 2 Diabetes (T2D). The only difference is that the flooding is caused by excessive amounts of sugar in the body. Water is essential if a house is to function effectively while the body needs some glucose. A household has a plumbing system to ensure that the water is controlled. Similarly the body uses the hormone insulin to control the glucose. If these systems are defective, then the water and glucose can no longer be controlled. As a consequence the water causes extensive damage to the property and the glucose does exactly the same in the body. Tackle the source So the obvious way to treat T2D is to cut down on the quantity of glucose that enters the body. This is easily done by reducing the amount that enters the body in the diet by eating much less sugar and foods, which contain starch that is broken down to glucose. All of this is perfectly logical and reasonable. Yet unbelievably, this advice is rarely...

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275. Dr Tanya Malpass FRCP. Another Recovery from Cancer by Changing Diet

Background At the Public Health Collaboration Annual Conference in Manchester I met Dr Tanya Malpass who explained how she developed cancer but has recovered. When we spoke she was looking very well and so I asked her to describe her experience. Here is her story. The initial stages The first indication I had that there was anything wrong, was back in January 2015 when I started talking in spoonerisms.  It was all a bit of a laugh to start with and most people didn’t notice when I got tongue-tied (apart from close friends), but it was totally out of character (and out of my control). After a couple of weeks, my friends persuaded me that it was no longer funny and forced me to seek help. The GP tried to assure me that it was probably attributable to stress or tiredness, but because I had enough ‘ticks’ on the clinical algorithm for a possible stroke, he referred me for an urgent MRI. To be frank, I think he was ‘bending the rules somewhat as I has no neurological signs whatever, apart from saying ‘soon’ instead of ‘spoon’ or ‘exact’ instead of ‘extract’. I doubt I would have been referred so promptly if I had not been a doctor myself! Bob the Blob Sitting with a neurologist, my scan up on the screen, I heard him say: “Well, it’s not a stroke”.  I...

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