The best diet for optimal blood sugar control & health
Author: kaitiscotland
I am a Scottish doctor who is working to improve the outcomes for people who have diabetes using a low carb diet, and advanced insulin techniques when necessary. Professionally I provide expert witness reports in the clinical forensic and family medicine areas and I also provide complementary therapies. I enjoy cooking, cinema, reading, travel and cats.
Cancer death rates in the UK are their lowest level on record.
This level peaked in 1989 and is now 29%. About 250 in every 100,000 die from cancer each year. This is 11% lower than ten years ago.
Cervical cancer has shown the greatest fall in death rates. Deaths have fallen 75% in the last 50 years. Much of this is due to cervical screening programmes. The progress is likely to continue as there has been a great impact in cervical cancer prevention since the vaccination programme against HPV started in 2008.
NICE has approved an important new pill for menopausal flushes. It is non-hormonal and can be taken by women who can’t take oestrogen based HRT products. This usually means women who have had a previous diagnosis of breast cancer or a high risk of getting it.
The drug is called Fezolinetant and will be marketed under the name of Veoza by Astellas Pharma. It can be used for moderate to severe flushes and sweats and 45 mg is taken once daily.
It is a neurokinin 3 receptor antagonist that blocks nerve pathways in the brain that trigger vasomotor symptoms.
My comment: This is a breakthrough drug which will help a lot of women who have previously been unable to get effective treatment. Because it is non-hormonal, it will treat symptoms, but there won’t be the other bone and vascular protection afforded by oestrogen based HRT. After other surgeries eg for hysterectomy and oophorectomy in a case of endometriosis, the patient is put into an immediate menopausal state, but can’t take oestrogen HRT because it can make the endometriosis grow again. I’m delighted that this drug is now available.
Firstborn children are known to outperform their later born siblings in adulthood regarding earning capacity and IQ. It has now been shown that these differences start really early in babyhood from research published in JAMA.
In Japan, 2,000 sibling pairs were tested regarding cognitive skills and developmental milestones. By six months of age, the older siblings outperformed the younger ones. Some of the differences evened out by the age of 12 months, but deficits in fine motor skills and personal-social areas persisted.
This difference however is paralleled by lower parental engagement for second born and subsequent children. Resources become diluted as families grow.
My comment: I do remember slacking off with my second son compared to my first. The first one got everything done by my Penelope Leitch book.
The second got warmer and more social baths, far fewer photographs taken, was able to decide his own bedtimes, decided when he was ready to get toilet trained, I found him trying to change his own nappy, and I didn’t bother trying to get him to eat vegetables or anything he didn’t immediately like. He also stayed on bottled milk far longer. He was able to get these himself out of the fridge. Unlike baby #1 I didn’t warm up the milk after one month of age and he took it chilled.
I hope my lack of diligence in one side of the equation gave me more time to spend talking to him and playing with him on the other. He did speak far later though.
They have both done very well in adulthood although the limited dietary intake persists. I do think the younger child had a better time of it with a more relaxed parenting style.
A study published in Psychiatry indicates that cannabinoids don’t do much, if anything, for mental health improvement.
A systemic review of 54 clinical trials involving over 2,500 participants, showed no consistent benefit for anxiety, depression, or post traumatic stress disorder.
Limited evidence of benefit was seen in insomnia, Tourette’s syndrome and autistic spectrum disorder, but the study quality was low.
My comment: As a doctor I was aware that some patients got a benefit from cannabis/cannabinoids for chronic pain and multiple sclerosis. I’m also aware that some dogs are being given cannabinoids for various complaints and also been told that sometimes it makes a big difference.
Kengo Miyoshi, Assistant Professor, Tokyo states that to avoid weight regain with GLP-1 drugs, Japanese patients enter a programme of structured support to maximise the effectiveness of the intervention.
The drugs are regulated and are only given where there are obesity related co-morbidities and functional impairment. The drugs are only started after six months of lifestyle modification which includes dietary, exercise, psychological and behavioural modifications. These should be continued lifelong. At the six month point, GLP-1 drugs are prescribed but for a maximum of 68-72 weeks. The exit criteria is established at the outset. The continued support mitigates the “weight regain” effect.
Randomised controlled trials have shown that exercise makes a big difference to the effects of the drugs during and after GLP-1s are stopped. While on the drugs, exercise promotes greater fat loss, preservation of lean muscle mass, improved insulin sensitivity, increased cardiorespiratory fitness, and physical functioning. When the drugs are stopped, the preserved lean muscle mass, higher exercise expenditure and sustained physical activity lead to less fat regain. The metabolic improvements need to be supported by structured care long term. Obesity is after all a long term condition and needs to be supported as such.
In a Norwegian cohort study of more than 1.3 million births, they found factors that both increased and decreased the chances of the baby developing multiple sclerosis in adulthood.
The relation between social media use and adolescent wellbeing may not be as simple and linear as many people believe.
In a large Australian cohort followed over three years, moderate after school social media use was associated with better wellbeing than either heavy use or none at all.
Although heavy users were more likely to report low wellbeing in early adolescence, non-users had worse outcomes later on. The patterns varied by sex and age.
My comment: I understand that Australia is planning to ban smart phone use in schools and that some schools in the UK want this or are already doing this now.
Smart phones are little personalised computers that can be used as blood glucose monitors, with the right equipment, calculators, dictionaries, fact checkers, spelling checkers, payment systems, foreign language tutors, game consoles, alarm clocks, fitness checkers, social media hubs, weather forecasters, newspaper sources, bus and train timetables and purchases, and can enable family to keep in touch with their child and vice versa. I can easily see why they could be of real use to everyone and a loss to schoolchildren, particularly type one diabetics, who use them responsibly.
Unfortunately they can also be a source of harm, particularly regarding mental health, when online bullying occurs.
My children are now adults and small mobile phones were around when they were teenagers but since neither myself or my husband had smart phones we never considered getting them for our children.The iphone came out in the USA in 2007 and cost $495-$595 dollars. The only children who had smart phones were those children who came from disadvantaged homes, who were paid £30 a week to attend school. The more affluent working and middle class kids didn’t have them. The Freestyle Libre hadn’t yet been invented and wouldn’t be for a considerable time.
I can see that a blanket ban on smartphones would have disadvantages. If I had had one as a teenager, I can see that it would have been marvellous for all school work, homework, getting to school and even getting up in the morning. The single subject that it would have boosted enormously was language learning. Struggling with a difficult mathematical or science topic? Calculus springs to mind. You tube video could probably explain it much better than some teachers. Although I think blanket bans go too far, I’m not sure what rules would need to be put in place to prevent misuse of social media and how these could be enforced. It’s a problem that I avoided but something that at least some of you will need to decide now or in the future.
The Cholesterol Treatments Trials Collaboration set out to get reliable information on the side effects of statins. These are one of the most commonly prescribed drugs. The long list of side effects that are included in product information and in the BNF are mainly based on non-randomised and non-blinded studies and could be subject to bias.
The Collaboration did a meta-analysis of 19 randomised controlled trials covering 100,000 participants.
The side effects were:
Muscle pain
Diabetes
Less commonly there were:
abnormal liver function tests
urinary composition alteration
oedema (fluid retention)
There were no reliable indication of these previously reported symptoms:
Adapted from BMJ 21-28 Feb 2026 Harmful effects of sexual choking.Anouska Victoire et al NSW Australia.
Strangulation and manual choking during consensual sex is becoming increasingly normalised in the media and also in real life. Medical awareness of the hidden risks, harm, and death in both consensual and non consensual acts is increasing too.
Strangulation is the application of external pressure to the neck that compresses internal structures including blood vessels, the airway, nerves, and endocrine glands. The effects can be serious and can include death. Recent studies have shown that structural and functional changes in the brain can result even during consensual episodes, particularly if these are repeated. Strangulation has also been associated with higher risk of homicide in those experiencing intimate partner violence. Carotid artery dissection, thyroid and brain injury can result.
Mainstream media and pornography tend to romanticise sexual choking and strangulation. But they don’t spell out the risks. In an Australian study of young adults aged 18-35, 57% of respondents said they had been sexually strangled, and 51% reported having strangled a partner. This included men, women, trans and gender diverse individuals. 61% said they had seen this on pornography sites and 40% from films.
Directors of Forensic Sexual Health Services and A and E consultants both in Australia and the UK, suggest that specific enquiries into sexual choking and strangulation should be part of the routine history taking when taking a sexual history.
The UK government is currently implementing legislation banning the publication and possession of pornography depicting strangulation and suffocation.
Education of the general public regarding the dangers of this activity is urgently needed. Sadly, some couples who enjoy this activity and who have got away with it so far, seem reluctant to stop. Sexual choking may be popular in the media and glamorised but it is wrong to portray it as safe as long as it is consensual.
The national cancer plan for England aims to reduce cancer onset and improve the five year survival rate to 75%. It lists 31 steps that should bring us closer to that goal. These include improving patient centredness, care pathways, preparation for treatment, and prevention.
Many people think that cancer should be treated as a chronic condition. Half of us will get cancer and 38% of new cancer diagnoses are in those over 75.
Shared decision making should be realistic and forward looking, discussing interventions and alternatives with patients in line with their values and wishes. Not everyone wants excessive treatment or to face the risk of major complications. End of life care may be their priority instead.
The cancer plan wants to support palliative care hubs and hospice outreach services. Clinicians need to be realistic with patients. Sometimes the quality of time matters to the patient a lot more than quantity.
Physical activity should be promoted to cancer patients. The 2025 Challenge trial showed that an exercise programme reduced the risk of death from bowel cancer by 37% and of recurrent or new cancer by 28% over eight years. In this study, both arms were given information, but the extra intervention was support to actually accomplish the exercise programme. Patients need simplicity, clarity and practical information.
30% of cancers are preventable and action on smoking, obesity and highly processed food needs to be taken. The cancer plan advocates for genomic testing. But with or without this, we can all reduce our chances of getting cancer by physical exercise and activity.
Exercise can reduce the risk of breast cancer by 25% and bowel cancer by 45%.
The plan wants to move towards pre-emptive, data driven cancer care, using genomics, artificial intelligence, digital diagnostics and personalised treatment pathways. Yet, it does not tackle current problems such as recruitment freezes, diagnostic bottlenecks, and a shortage of radiology and histopathology workforce. For instance the target turnaround of histopathology is 98% within ten days. Currently it is achieved 68% of the time.
My comment: My husband and I were picked at random to be included in a target of 5 million UK residents in the Future Health study. They asked about basic health characteristics, previous personal and family history, and will test some baseline blood tests and elicit our genomes. We won’t personally benefit from this, but it is hoped that amassing data about what genes are related to various health outcomes may help others in the future.