Author: kaitiscotland

Adapted from BMJ 15 June2024 Global burden of type 1 diabetes in adults aged 65 years and older. 1990-2019.

The number of people from 21 regions and 204 countries was collated in this study. The number of older adults with type one diabetes increased from 1.3 million in 1990 to 3.7 million in 2019.

This was due to a decrease in deaths from type one diabetes in young people, who therefore had the fortune to be able to grow old. There is also an increasing amount of type one diabetes occurring in the population both young and old. The older population of people with type one diabetes are also living longer and in better health. This is mainly a tribute to better diagnosis and treatment.

The prevalence (the total number of people counted who have the condition) increased from 400 to 514 per 100,000 people.

Mortality decreased from 4.74 to 3.54 per 100,000 people.

Disability life adjusted years (DALYs) decreased from 113 to 103 per 100,000 people.

Mortality rates fell 13 times faster in countries with a high sociodemographic index compared to low to middle index countries. The measures included education level, per capita income and lowest fertility rates.

The countries with the most older people with type one diabetes were in high income countries such as North America, Australasia, and Western Europe.

The highest disability rates were found in southern sub-Saharan Africa, Oceania and the Caribbean. A high fasting glucose level remained the highest risk factor for disability among older adults.

Adapted from BMJ 27 July 24

Some types of endometriosis can increase the risk of ovarian cancer by almost ten fold.

Endometriosis affects 11% of the female population and causes half of all cases of pelvic pain and female infertility.

A large cohort study from Utah found that women who were diagnosed with endometriosis were 4.2 times more likely to get ovarian cancer over their lifetime than those who had never been diagnosed.

Deep infiltrating endometriosis was associated with a 9.66 fold increased risk compared to superficial peritoneal endometriosis which gave a 2.82 increased risk.

In a separate Dutch study in 2021, Adenomyosis (related to Endometriosis) was also shown to increase cancer risk, the relative risk being 1.5.

My comment: The background risk of a woman developing ovarian cancer is 2%. Many women diagnosed with endometriosis will need surgery to remove it, to divide adhesions and in severe cases may opt for a hysterectomy. If they are having extensive surgery anyway removal of the ovaries seems a very good idea. Screening women for ovarian cancer has been tried and unfortunately has not been found to be successful. I wonder if studies in the subgroup of women with endometriosis is something that will happen in future. Adenomyosis is when the endometrial deposits are located in the uterine muscle and are found at hysterectomy.

The EchoSOS phone app is an alert app that you load onto your phone PRIOR to a holiday abroad or before undertaking any sort of adventure activity particularly away from a city.

I found out about this from several readers of the Times who had responded in the comments section about the disappearance of a man in his sixties in a mountainous area of southern France. This follows on from the loss of several other tourists in Mediterranean countries over the summer.

One said that it had saved her life more than once.

It is a free app. You put in your personal details, contact numbers of relatives or friends, your blood group, medical history, allergies and medication. You then allow the app tracking and response permissions.

Should you have a medical or other emergency in your home, city, or outside location, you can press the emergency button. Obviously, you still have to have some sort of signal for this to work.

The app takes note of your details, your location and transfers this to the nearest emergency response number to your current location. This means that you should be able to speak to a relevant dispatcher without the palaver of finding emergency numbers.

Several tourists have died because they have not been able to contact emergency services or have not been able to give their locations if they did. For readers of this blog, many of whom have diabetes, the ability to contact emergency services fast and being able to be located precisely is of even more relevance.

Please pass this information on to anyone that you think will benefit.

Adapted from BMJ 23 March 2024

Compared to people who sleep 7 to 8 hours each night, people who slept for five hours or less were more likely to develop type two diabetes. The risk increased in those getting 3-4 hours a night. This risk was present even when people eating a “healthy” diet were compared. This study was done in the UK Biobank participants.

It is already known that night shift workers have an increased rate of metabolic syndrome and cancer. They also have lower life expectancy rates.

If you are sleep deprived, you will also be aware that you tend to eat more, particularly carbohydrate containing foods.

For many people they don’t have a choice over whether they even get the chance to sleep. They may have long commutes, work shifts, work night shifts and have high noise levels when they are trying to sleep either by night or day. A new baby is a particular difficulty especially in the first year of life.

Socioeconomic deprivation is associated with poorer outcomes for many medical conditions. The scale of the problem for those with type one diabetes is stark. A UK study has shown that type ones are diagnosed with sight threatening diabetic retinopathy three times as commonly as those in the least deprived areas.

This could be due to many reasons. Food intake, attendance at clinics, care over injections, education, stress, leisure activities and support. It does point to the fact that changing what you do can make a substantial difference to health outcomes. 80% of the money spent on diabetes is for treating the complications of diabetes rather than on prevention.

Adapted from BMJ 25 May 2024

The World Values Survey Wave 6 2010-14 asked people from many different world countries what mattered the most to them. The topics that they said were grouped into six categories and these were ranked for the countries.

These were ranked in the world overall as being in order: Family, Work, Friends, Leisure Time, Religion and then Politics. How would you have answered?

There were some interesting differences. Almost all countries said that Family was the most important thing to them. Those in the Netherlands said Friends. People from Ghana said Work. Quatar, Egypt and Algeria all said Religion. All of these countries put Family in second place, so Family is still extremely close to people’s hearts all over the world.

Work and Friends seemed to be the most popular second choices.

Work was the next highest priority in Brasil, Ecuador, Peru, Romania, Azerberjan, India, Kyrgystan, Armenia, Thailand, Zimbabwe, Columbia, Mexico, and Uruguay.

Friends were the second highest priority in Argentina, Belarus, Cyprus, Kazakhstan, Poland, Rwanda, Slovenia, Taiwan, Australia, Estonia, Germany, Hong Kong, Japan, New Zealand, Sweden, Russia, Singapore, Spain, Ukraine, USA, China, South Korea, Lebanon, Uzbekistan, Turkey, and Georgia.

When it came to lowest priorities almost all countries agreed that Politics was what they cared about least. The Netherlands, Australia, Estonia, Germany, Hong Kong, Japan, New Zealand, Sweden, China and South Korea all put Religion last.

Leisure Time tended to be on the low end of priority too, but never the lowest.

If you are looking for the most fun, I think that the Netherlands is the place. They ranked Friends, Family and Leisure Time way above Work, Politics and Religion. I don’t know that they would be keen on overtime though!

Other fun prioritising countries are Australia, Estonia, Germany, Hong Kong, Japan, New Zealand, Sweden, Russia, Singapore, Spain, Ukraine, and the USA.

The least fun countries from this survey seem to be Algeria and Ghana. They both rank Work, Religion, and Family ahead of either Friends or Leisure Time.

When comparing my priorities with those in other countries it would seem that the clear winner for me is Uruguay.

Adapted from BMJ 18 May 24

Nature Medicine has published the results of the use of the Zoe METHOD study on 347 people.

They were allocated either general advice on cardiometabolic health or were trained and supported to use the Zoe app for 18 weeks. The Zoe users are trained to individualise their diet with feedback on their gut microbiome and post meal blood glucose and triglyceride levels.

What improved: Triglycerides reduced, weight lowered, waist circumference reduced, energy levels improved, and sleep improved.

What didn’t change: LDL-C concentration, hip circumference, blood pressure and glucose levels.

My comment: I only know one woman who used the Zoe app. She said that as a result she increased the variety and amount of fruit and vegetables she was eating and reduced sugar and starch intake. She had lost weight and felt more energetic. When I answered the Zoe questions myself I was advised that it wasn’t a suitable programme for me due to my irritable bowel syndrome and wheat intolerance as these foods are encouraged as a major part of the diet. It seemed reasonably priced to me and could be a good help for people to understand the effect food has on their metabolism.