A news story this week reported that scientists have improved the naturally occurring enzyme that can ‘eat’ plastic.

Good news, eh? Few people fail to be moved by the sight of the oceans brimming with waste. We all want to cut down on plastic and our use of it.

When you have diabetes, particularly type one, you use more plastic than most people. It wraps itself around individual pump components, it shields needles and it’s what lancets are made from. I hope the plastic-eating enzyme hurries up in its development so I’ll be able to chuck all that junk into a machine in my house.

The only figures I can find relate to general medical waste in the US. The market is expected to increase from $10.3 billion in 2015 to $13.3 billion in 2020. As rates of diabetes increase, that figure will only get higher.

I can’t find many specific tips to help us reduce the plastic we use for we diabetics, but here are some ideas I came up with…

  • Can you choose reusable pens, instead of disposable ones? This will depend on your insulin and what the manufacturers offer. Perhaps we should ask them to provide permanent devices if they don’t?
  • Recycle what you can—in my case, I throw the clean needle covers and empty test tube tubs into the recycling bins.
  • Nearby animal sanctuaries might be able to use old syringes to feed baby animals or give them meds. (Not sure about this one—check it out with your shelter.)
  • Small local businesses that do mail orders might take the polystyrene packing you get with any ordered supplies.
  • Finally, donate your old insulin and medical gear. If you have sealed, unopened packets of insulin, needles, lancets, infusion sets for pumps, unopened test strips and more, please give them a charity if you can. Insulin for Life works to distribute insulin and supplies to disadvantaged people. It operates in nine countries, including Germany, Australia, the UK and the US and distributes to 74 places.

Do you have imaginative ideas for what to do with diabetes-related medical waste? I’d love to know. Please feel free to comment.

 

 

ADA Reveals Diabetes Now the Costliest Health Condition

At the end of March, the American Diabetes Association released a report on diabetes’ fiscal impact. Guess what? It’s scarily high.

Diabetes is now the costliest chronic condition in the country. Diagnosed diabetes expenses in the US totalled $327 billion in 2017. The data indicates that one of every four healthcare dollars in spent by someone diagnosed with diabetes. And one of every seven is spent directly treating the condition and its complications.

The Economics of Diabetes in the US in 2017 kicked off the ADA’s annual call to congress event. More than 150 diabetes advocates meet with members of congress and staff, urging them to make diabetes a national priority.

The report showed that the economic costs of diabetes increased 26 percent from 2012 to 2017, thanks to its increased prevalence and the rise in cost per person living with the condition. The costs include $237 billion in direct medical bills and $90 billion in reduced productivity. The largest contributors to the costs of diabetes are higher use of prescribed medications, hospital in-patient services, medications and supplies.

These costs are passed on to all Americans thanks to higher medical costs, higher insurance premiums and taxes, reduced earnings, lost productivity, premature mortality, and intangible costs in the form of reduced quality of life.

ADA’s chief scientific, medical and mission officer, William Cefalu said: “From our new economics report, it is very clear that diabetes bears a significant impact on our nation, both in its toll on the lives of the millions affected by it, and the economic costs for all.

“The most important solution we have is continued and increased investment in critical diabetes research, care and prevention to improve diagnosis and treatment, and to help us turn the tide through diabetes prevention. These efforts can help us to improve health outcomes for people with diabetes – and hopefully decrease the cost of diabetes.”

 

EC-Funded Project Researches T1 Diabetes Cure

Have you heard of the LSFM4LIFE project? This week, I received an email about European Commission funded work into a potential permanent cure for type 1 diabetes.

The base of the research is a cellular therapy, growing human pancreas organoids (mini organs) from adult stem cells. The organoid of the pancreas then produces insulin, freeing type 1s from daily insulin injections.

Currently, the project is at the research stage. It involves eight partner teams from six different countries who are working to develop tools and technologies for cell-based therapy. The partners come from academia and industry, and include Goethe University, the University of Cambridge, InSphero and Sparks and Co.

Incidence of type 1 diabetes is increasing by 3 to 4 percent every year, especially among children.

You can read more about the project here: https://lsfm4life.eu/lsfm4life-in-depth/ and there’s a quick explanation of it on YouTube here.

 

 

Junk Food and Cancer Risk

diabetes diet by Emma BairdThe news this week carried a story about how regular consumption of junk food might increase cancer risk.

The French study, which was published in the British Medical Journal, looked at more than 100,000 people with an average age of 42. It looked at the association between ultra-processed food and the overall risk of breast, prostate and colorectal cancer, adjusting for known risk factors.

The study found that ultra-processed food intake was associated with higher overall cancer risk. A 10 percent increase in the amount of ultra-processed foods in the diet was associated with a 10 percent increase in the risks of overall and breast cancer. The study’s authors said further research was needed to understand the effects of food processing in this association.

The foods experts warn could be linked to cancer include:

  • Fizzy drinks
  • Crisps
  • Biscuits
  • Chocolate bars and sweets
  • Instant noodles and soups
  • Ready meals
  • Packaged breads and rolls
  • Savoury or sweet packet snacks.

One of the advantages of following a low-carb diet is that it’s difficult and expensive for food manufacturers to offer ready-made alternatives, which could be one of the reasons why it’s never soared in popularity in the same way veganism has, for instance.

If you embark on a low-carb diet, you’re almost forced to cook from scratch. There are ‘junk food’ low-carb alternatives such as the bars that market themselves that way, but they are prohibitively expensive and not that nice.

The foods listed above (except for diet fizzy drinks) are all high in sugar and carbs. Researchers recommend people eat more fruit and veg to minimise cancer risk. Welcome to the low-carb world and the Diabetes Diet, full of salads, broccoli, cabbage, aubergines, peppers, courgettes, beans, berries, apples and more!

 

 

 

 

 

 

Death of Diabetic Driver Who Missed Hospital Appointments to Avoid Fines

The delivery firm DPD hit the headlines this week – for the wrong reasons.

One of the firm’s drivers died from diabetes-related causes. According to his wife, he’d started missing hospital appointments because the company fines you £150 for not working, if you can’t find someone to drive on your behalf. As a franchisee, the onus is on the driver to find his or her replacement if that person needs to take time off for medical reasons.

Don Lane worked through the busy Christmas period, despite feeling ill. He collapsed in late December and died on 4 January.

Mr Lane’s story was widely reported. An article in the Independent said Mr Lane had worked for 20 years for the company at its Bournemouth depot. His widow Ruth told the Guardian that he’d missed appointments because he was worried about being fined, having previously been fined for taking time off for an appointment in July when he visited a specialist about the damage to his eyes caused by diabetes.

Labour MP Frank Field, the chair of the Commons Work and Pension Select Committee, said the loss of life represented a new low for the gig economy. In a statement, DPD emphasised that Mr Lane was “self-employed”, and said it was “devastated” by Mr Lane’s death, but that self-employed couriers are contracted to provide a service, and they can provide a substitute if they can’t carry out the job.

They added that they were wrong to charge him for attending his appointment in July.

Horrifying, isn’t it? If you feel strongly about this, and would like to do something about it, you can choose not to use DPD for parcel delivers where possible. This might mean changing your shopping habits or asking companies you regularly buy goods from which courier firms they use. You can also make your feelings known via social media – @DPD_UK on Twitter.

The Plunge

diabetes dietHello fellow and female diabetics, and the friends who support us. This week, I’d like to talk about The Plunge.

If you are on insulin or other blood glucose-lowering medications, you’ll know The Plunge. It’s where your blood sugar drops at an alarmingly rapid rate usually because of insulin or other medicines. It feels very unpleasant.

What’s it like? Explaining diabetes feelings to non-diabetics is tricky, and it needs a lot of imagination. You search your vocabulary and powers of observation for ways to describe it and still come up short. Metaphors work the best, but they are still hard to think up.

The Plunge works well for me because it signifies a roller-coaster. There you are at the top; then suddenly, you’re heading to the bottom at super-fast speed.

Signs of fast-dropping blood sugars include tiredness, a lot of yawning, shakiness and confusion. They are also all symptoms of hypos.

One of the reasons we promote The Diabetes Diet (low-carb eating) is that it makes The Plunge easier to avoid. This is because you won’t need to take as much fast-acting insulin with your meals. Using fast-acting insulin can be a be a bit like picking up a sledgehammer to crack a nut. It isn’t subtle stuff, that’s for sure.

This isn’t a guarantee. Sometimes, you’ll need extra insulin to cover unexpected high blood sugar levels, and The Plunge may result.

But overall, using lower levels of insulin to cover meals means steadier blood sugar levels overall. Dips up and down are far less dramatic and therefore don’t feel as yucky. (This is a technical term.)

How do you experience The Plunge, and can you think up better ways to describe than I can?

Obituary: Gian Franco Bottazzo who discovered that type one diabetes was an auto-immune disease

Gian Franco Bottazzo was born in Venice in 1946. He died there on 15 September 2017.

After graduating at the University of Padua he moved to London in 1973 to study immunology with Deborah Doniach. A year later they published their paper in the Lancet proving that type one diabetes is associated with the development of antibodies to the insulin producing pancreatic beta cells. This paper stimulated a wave of research into the immunological basis of thyroid and pituitary diseases.

Bottazzo enjoyed speaking about his research, and gave his talk the title, ” Death of a beta cell: homicide or suicide?”

As a young man, Bottazzo, nearly missed out on his medical career as he was a promising football player and came close to signing for Venezia, which was in the Premier League at the time. Fortunately he completed his studies.

For many years Bottazzo held professorial appointments in London and published on the HLA antibodies. In 1998 he returned to Italy to work as scientific director to the Baby Jesus Hospital in Rome.  He leaves a wife and daughter.

 

BMJ 9 December 2017