Diabetes warning for North East despite low spend on drugs for condition

By Craig Thompson

North Tyneside has the lowest amount of money spent of drug prescriptions for diabetes.
New figures on Thursday reveal the near-doubling cost of diabetes drugs to the NHS in England over the last decade.
Experts claim this exposes a dire need for prevention of the condition and is an indictment of “years of inaction” by governments.
Around £2.6 million is spent every day on prescriptions, making diabetes the most expensive of all drug sectors.
Over the last financial year 49.7 million items were prescribed to treat and manage the condition, up from 27.1 million 10 years ago - almost one item for every person in the country.
New figures show that £956.7 million was spent on drugs for diabetes prescribed by GPs, nurses and pharmacists in 2015/16 - some 10.6% of the cost of all primary care prescriptions in England.
This is almost double the cost of 10 years ago, when it was £513.9 million, or 6.6% of the overall spend on drugs.
In the east London borough of Newham, 17.9% of money spent on drug prescriptions was for diabetes, the highest percentage of all clinical commissioning groups in the country.

That is more than double the spend in North Tyneside, which at 7.4% was the lowest.
In Warwickshire North, the cost per person treated in 2014/15 was £415, the highest in England, compared with the lowest of £239 in Northumberland.
Despite the seemingly little amount spent on prescriptions for the drugs, there has been a worrying increase in the number of people living with diabetes in the North East, prompting a major health warning for 2016.
More than 6,000 new cases of the condition were diagnosed in the region during the past 12 months compared to the previous year.
Around 90% of diabetics have Type 2, where the body does not produce enough insulin or that which is produced does not work properly.

It is linked to lifestyle factors such as being overweight, and health campaigners say a huge proportion of the near-£1 billion cost to the taxpayer is being spent on a condition that could be prevented.
Tam Fry, from the National Obesity Forum charity, said: “Individuals with Type 1 diabetes (when the body cannot produce insulin) need treatment. There is no doubt about that.
“But a significant part of the near-£1 billion will have been spent treating people with Type 2 diabetes - with the root cause of that condition, obesity, being entirely preventable.
“The cost of treating Type 2 is an indictment on years of inaction by successive UK governments to stem the epidemic we now have. Undoubtedly the figures will escalate until Whitehall produces a workable strategy to help curb more people from getting fat.”
The Royal College of Nursing also called for a “greater focus” on preventing Type 2 diabetes.
Helen Donovan, its public health professional lead, said: “There is a close association between the increase in obesity and Type 2 diabetes and the prevention of both is essential. Encouraging healthier lifestyles would not only save the NHS money, it would improve countless lives.”
Not properly managed, diabetes can lead to sight loss, limb amputation, kidney failure and stroke.
The Department of Health said it is taking “strong action” on tackling the condition, establishing the world’s first diabetes prevention programme.
A spokeswoman said: “We know childhood is the best place to start with a healthy lifestyle. Our comprehensive childhood obesity strategy will build on measures we are already taking, like the soft drinks industry levy.”
More than 4,500 people are diagnosed with diabetes across the UK every week, according to Diabetes UK, with 235,000 over the last year.”

http://www.chroniclelive.co.uk/news/north-east-news/diabetes-warning-north-east-despite-11702352

Essential Facts About Insulin and Diabetes

From upmc.com

Types of Diabetes

There are two distinct types of diabetes:

In Type 1 diabetes, the pancreas does not produce insulin. Sugar is unable to get into the cells, so the sugar level in the blood increases. When the sugar level rises above normal, it results in high blood glucose, called hyperglycemia. Children and young adults are most frequently diagnosed with Type 1 diabetes.

• In Type 2 diabetes, the pancreas still produces insulin, but the body doesn’t use it properly. “Higher levels of insulin are needed to make cells take up the sugar, and the body may not be able to produce enough insulin to meet this increased need,” said Michelle Griffith, MD, medical director at the UPMC Center for Diabetes and Endocrinology. Over time, untreated Type 2 diabetes can result in damage to your eyes, kidneys, nerves, and heart. You are more likely to develop Type 2 diabetes if you are overweight, sedentary, have high blood pressure or cholesterol, or have a family history of Type 2 diabetes. People with Type 2 diabetes can sometimes get the condition under control with lifestyle measures such as diet and exercise, although some may still need to use insulin or oral medications.

Symptoms of Diabetes

Common symptoms of diabetes include:

• Extreme tiredness
• Increased thirst
• Weight loss
• Blurry vision
• Frequent urination
• Wounds that don’t heal well

However, if you have Type 2 diabetes, you may experience only some of these symptoms or none at all.

What Is Insulin?

Insulin is a hormone that plays a major role in your health — and in your risk of developing Type 2 diabetes.
Normally, your pancreas produces insulin, which helps move glucose out of your blood and into your cells. Insulin attaches to receptors on these cells, allowing glucose to enter them. Much like fuel powers a car, glucose gives your body the energy it needs to function.

Using Supplemental Insulin

If you have diabetes, you should work with your doctor to determine your target blood glucose level. A normal blood glucose level is between 70 and 130, before a meal. At bedtime, a typical goal is to have blood glucose between 110 and 150. The goal for A1C is less than 7 percent. Your doctor can help determine what your personal goals should be.
“Individual factors, such as history of low blood sugars or other health conditions, may cause you to need a personalized target that is higher or lower than usual,” Dr. Griffth said.
Your doctor may recommend treating diabetes with supplemental insulin to help keep your blood sugar in the right range. This can involve giving yourself shots of insulin on a regular basis. Fortunately, insulin shots typically cause minimal pain because the needles are short and thin, and the shots are placed into fatty tissue below the skin.

http://share.upmc.com/2016/08/what-is-insulin/

Risk Factors For Diabetes And Heart Disease In Women Rise Before Menopause

By Rhodi Lee

Health experts previously believed that risk factors for heart disease, diabetes and stroke in women increase in severity after menopause, but findings of a new study suggest otherwise.

Researchers have found evidence suggesting that risk factors linked to heart disease, stroke and type 2 diabetes such as high blood pressure, elevated blood sugar levels and abnormal cholesterol level increase before, and not after, a woman goes through menopause.

Study researcher Mark DeBoer, from the University of Virginia, and colleagues found that the rapid increase in the risk factors begins before the last menstrual period. The dangerous period lies before and during menopause, but the transition begins earlier and progresses faster in black women.

For their study published in the Journal of the American Heart Association on Aug. 3, DeBoer and colleagues looked at the medical records of about 1,500 women, who were tracked for a period of 10 years as they transitioned through menopause.

The researchers looked for five risk factors for heart disease and stroke, namely large waistline, low levels of good cholesterol called HDL, high blood pressure, high blood fat levels and high blood sugar, which altogether are known as metabolic syndrome.

Metabolic syndrome significantly boosts a person's risk of developing type 2 diabetes, heart disease and other health problems.

The researchers found that the severity of metabolic syndrome in women rapidly increased during the premenopausal and perimenopausal periods, which is right before menopause.

The increased risk appears to be more related to the changes that happen as women go through menopause and less to the changes that occur after menopause. "These data suggest that the higher prevalence of MetS in postmenopausal women may be caused more by changes during the menopausal transition than by postmenopause," the researchers wrote in their study. "These findings may thus have implications regarding the timing of cardiovascular risk relative to menopause." The take-home message, the researchers said, is that women should pay attention to their lifestyle and make changes if needed before menopause. They urged women to ensure that their weight is under control, and that they eat a healthy diet and are getting sufficient amounts of exercise. The researchers acknowledged that everyone should eat better and get enough exercise, but the transition years to menopause offer a good window of opportunity to make lifestyle improvements. "The years transitioning to menopause may represent a 'teachable moment,' when patients are especially receptive to learning and putting into practice healthy habits that can make a difference in their cardiovascular disease risk," DeBoer said.

http://www.techtimes.com/articles/172465/20160803/risk-factors-for-diabetes-and-heart-disease-in-women-rise-before-menopause.htm

Diabetes drugs cost NHS nearly £1bn a year

From the guardian.com

The cost to the NHS of prescribing drugs for diabetes has soared to almost £1bn a year, as the number of people diagnosed with the disease has risen sharply alongside the surge in obesity.
The NHS in England spent £956.7m on drugs last year prescribed by GPs, nurses and pharmacists to treat and manage the condition. That sum represents 10.6% of the cost of all prescriptions issued by NHS primary care services in 2015-16.
The health service now spends more on medication for type 1 and type 2 disbetes than for any other ailment. The number of diabetics across the UK as a whole has recently risen to more than four million and has increased by 65% over the last 10 years.
The cost of diabetes drugs has almost doubled in a decade, new data from NHS Digital show. That £956.7m was a huge rise on the £513.9m it spent on them in 2005-06 which, at the time, was just 6% of the NHS’s total drugs bill.
Diabetes is thought to cost the NHS about £10bn, once the cost of treatment, including amputation and hospitalisations for life-threatening hypoglycaemic attacks, is included.
Last year a total of 49.7m items were prescribed for diabetes, compared to 27.1m a decade years earlier, when just 53 items were prescribed for every 100 people; that had risen to 91 last year.
Just under nine in 10 (89.1%) diabetics have been diagnosed with type 2 diabetes, which is closely associated with people’s lifestyles, especially their weight.
However, type 1 diabetes – whose sufferers include Theresa May – is an autoimmune condition. It often emerges in childhood, though the prime minister, 59, was only diagnosed with it in 2013. May injects herself with insulin at least twice a day.

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Helen Donovan, the Royal College of Nursing’s health professional lead, said: “These stark figures show the need for a greater focus on preventing type 2 diabetes. Encouraging healthier lifestyles would not only save the NHS money, it would improve countless lives.”
Donovan said cuts to nursing support for diabetics meant that some patients were not getting the help they needed to manage their illness. “This is bad for the health service’s finances but more importantly it can be devastating for patients,” she added.
Diabetics are more likely to have a stroke or suffer from heart disease and develop a range of other illnesses.
NHS Digital’s findings show that the West Midlands is the region of England with the highest proportion of people over the age of 17 who are diabetic: 7.5%. The south central area has the lowest prevalence rate, at 5.6%.
The east London borough of Newham spends proportionately more of its drugs budget than anywhere else in England on diabetes medication, at 17.9%. North Tyneside spends the lowest, at 7.4%. Newham also dispensed the highest proportion of drugs for diabetes, at 9%.
The spend on medication differed widely in different parts of England. The cost per patient treated was highest in Warwickshire North, at £415 a head, and lowest in Northumberland (£239).

https://www.theguardian.com/society/2016/aug/03/diabetes-drugs-cost-nhs-1bn-a-year-presciption
           

Five social and cultural factors that drive the rise of diabetes in cities

From citieschangingdiabetes.com

Cities are on the frontline of the global diabetes crisis. Recent research by the Cities Changing Diabetes coalition investigated how the epidemic is playing out in five cities across three continents and impacting the lives of millions of urban citizens globally.
Here we reveal some of the surprising social factors and cultural determinants driving the rise of urban diabetes worldwide.

1. Mexico City: Belief that negative emotions cause diabetes

In Mexico City, diabetes is the leading cause of death. The research uncovered a popularly held belief that diabetes is a psychological issue caused by negative emotions, such as anxiety or stress (‘susto’).

Iztac, a 44-year-old woman from Mexico City, personifies this finding. Her type 2 diabetes has led to and exacerbated her loss of vision. Yet she feels that her diabetes is much more a consequence of living with stress due to family and working problems, a fact that she believes is inherent living in the city and with the city dynamics.
The research found that the belief that diabetes is an emotional or psychological issue is a barrier to meeting the physical demands necessary for preventing and managing the disease.

2. Copenhagen: Living alone and lack of social support

In Copenhagen, the number of people with diabetes could nearly double by 2040. The research found that living alone was an indicator of vulnerability, with a number of participants experiencing difficulties with being on their own.
This is evident in the case of Karen, a 55 year old woman living alone in Tingbjerg. “I hear the same story every time I go to the GP: ‘Mind your diet’. I do think about what I’m supposed to eat and what I should avoid, but when I’m sitting alone and thinking about life, it doesn’t matter.’
The research found that living alone can influence people’s ability to take care of their health. Some explained how unsatisfied they were eating alone – consequently, many do not bother preparing a proper meal, and instead end up choosing easy solutions, increasing vulnerability to diabetes.

3.   Houston: Social blindness to being obese

In Houston, we get a glimpse into the future of cities in the developed world. Despite having an advanced health system, obesity is a significant public health challenge, with 32% of adults self-reporting as obese. By 2040, one in five Houstonians will have diabetes. Obesity seems to impact the normative body images, and when these change, so do the perceptions of what ‘a healthy body’ might look like. “I see some people come to my store and I just cringe and think to myself that I am skinny compared to these people”, one lady, overweight and at risk of type 2 diabetes, told researchers.

The study found that comparing your own body size and physical shape favourably to others creates a scenario where change can be perceived as un-necessary  This can ultimately have a detrimental effect on people’s management of their weight and health.

4. Shanghai: Social stigma and negative beliefs

In Shanghai, the increase in the prevalence of diabetes is fuelled by rising obesity, and increasing elderly population.
Researchers found that many participants experience negative beliefs around diabetes as well as significant societal disapproval. In part, this stigma seems linked to the perception that diabetes is a condition of the elderly and ‘weak’, especially when a diagnosis of diabetes is made at a young age.  “I got diabetes when I was about 30 years old, and my parents didn’t want anybody to know I had it, so we didn’t receive help from others” one man with type 2 diabetes told researchers.
The study found that negative beliefs impact the diagnosis, care provision, and physical and mental wellbeing of those affected by diabetes.

5. Tianjin: Wealth, memory of hunger, and miracle cures

In Tianjin, an industrial and fast-growing city, diabetes is an epidemic. The recent memory of hunger and resource shortage is contributing to an obesogenic environment.
Researchers encountered misconceptions surrounding the cause of diabetes. One person with type 2 diabetes reported:  “Once I met a person who suffered from diabetes. When he died, I was invited to dress him. When I lifted his quilt, a disgusting smell came up to me. Suddenly I realised that it was a curse from the dead man’s ghost. At that moment I thought that I might have diabetes as well. I was diagnosed with diabetes within a month!”
The study also detected similarly strong-held beliefs in ‘miracle cures’ among some in the population, which can create biological risks and psychological ill health.

http://citieschangingdiabetes.com/2016/08/02/five-social-and-cultural-factors-that-drive-the-rise-of-diabetes-in-cities/

Higher BMI linked to increased risk for diabetes, but not heart attack or death

By Stephen Feller

WASHINGTON, Aug. 1 (UPI) -- Higher BMI can influence the development of a range of health problems, though researchers in a recent study could not confirm previously recognized links between obesity and risk for heart attack or death.
Researchers at Umeå University in Sweden found in a study of identical twins that while a higher BMI increases risk for type 2 diabetes, they did not find evidence it also increases risk for heart attack or death.
BMI is calculated by a person's height and weight, and has been found to be a good predictor of risk for heart disease, high blood pressure, gallstones and certain cancers, according to the National Institutes for Health.
The new study compares health outcomes of identical twins in order to rule out other genetic causes for disease, providing a relatively even view of the effects of high BMI, the researchers said in a press release.
For the study, published in the journal JAMA Internal Medicine, researchers analyzed data on 4,046 monozygotic twin pairs with different BMIs collected between 1998 and 2003 for the national twin registry in Sweden.
Among heavier twins, with an average BMI of 25.9, 5 percent had a heart attack and 13.6 percent died. The numbers were similar among leaner twins, with an average BMI of 23.9; 5.2 percent had heart attacks and 15.6 percent died during the follow-up period. Even among twins with BMI above 30, researchers report the prevalence of heart attack and death stayed the same.
Risk for onset of diabetes was nearly twice as likely for heavier twins, however, and the likelihood that a heavier twin would develop the condition grew depending on the difference in BMI between siblings.
"Higher BMI was not associated with an increased risk of MI [myocardial infarction] or death but was associated with the onset of diabetes," researchers write in the study. "These results may suggest that lifestyle interventions to reduce obesity are more effective in decreasing the risk of diabetes than the risk of cardiovascular disease or death."

http://www.upi.com/Health_News/2016/08/01/Higher-BMI-linked-to-increased-risk-for-diabetes-but-not-heart-attack-or-death/9611470058008/

This Simple Diet Change May Help You Avoid a Diabetes Diagnosis

By Sam Becker

Sometimes, simple changes can have profound effects on your wellness. It’s sort of like the “butterfly effect”, in that a small, seemingly inconsequential shift in behaviour or attitude can have drastic ramifications down the line. When it comes to your diet, making the decision early in life to eat better can and will save you from health problems later in life. And if a new analysis is to be believed, one really simple change can even spare you from a diabetes diagnosis.
The secret? Eat at home more often. It’s as easy as that.
According to a recently published study in the journal PLOS Medicine, there’s a strong link between the number of meals an individual eats a home and the risk of Type 2 diabetes. Researcher Qi Sun, of the Harvard T.H. Chan School of Public Health, dove into prior studies to come to this conclusion, with the new analysis pointing to unhealthy food at restaurants — and the high availability and affordability — as a major factor driving obesity rates. Remember, obesity and diabetes often go hand-in-hand.

The idea, according to the analysis, is that more and more people are eating out, and choosing options that aren’t as healthy or nutrient-rich as foods they would eat at home. As a result, people eat calorie-rich foods that fuel obesity rates, which in turn makes for a higher diabetes risk.
The analysis says, “Consuming food prepared out of the home has been linked to poor diet quality, weight gain, and diabetes risk, but whether having meals prepared at home (MPAH) is associated with risk of type 2 diabetes (T2D) remains unknown.”. By looking at the eating and dietary habits of more than 58,000 women and 41,500 men from the mid-1980s through at least 2010, the researchers found eating meals at home, particularly evening ones, led to a 15% reduced risk of diabetes.
Essentially, the analysis finds that eating at home is healthier — something many people would consider to be common knowledge. But as the availability of cheap, fast, unhealthy food has become more ubiquitous around the world, people are getting fatter. And when more people are overweight or obese, more cases of diabetes pop up. By taking steps to eat at home, you’re thereby taking steps to leading a healthier life.
Clearly, there are benefits to eating at home. So, why don’t more of us do it? In a day and age when UberEATS exists, it can be so easy to look through the fridge and decide you don’t feel like cooking. But it’s that extra bit of effort, especially at the end of the day, that seemed to make the biggest difference in most studies.

With that in mind, strategize a bit and try to come up with some easy, healthy, and cost-effective meals you can make at home. There are a million recipes out there for every budget and diet type, all you have to do is dig around a bit. It can be easy to replace a carb and calorie-heavy meal you’d get from a restaurant with a much healthier alternative.
One way a lot of people take the stress out of their strategy is by cooking or preparing meals in batches. That is, once or twice a week, make huge meals that you can portion out during the week. For example, on a Sunday evening, cook up four chicken breasts and some rice, and refrigerate three of them for dinners for the next few days. Yes, it’s a bit boring, but if you want to save yourself some time and effort, it can be really cost-effective and much healthier than jetting to Little Caesar’s.
If you’re willing to make the effort, it can pay off big down the road — and dodging a diabetes diagnosis is only the start.

http://www.cheatsheet.com/health-fitness/diet-change-avoid-diabetes.html/?a=viewall