Pol Pot Noodle Kamikaze Attack on the NHS

Introduction

In this post we provide

1. A specific example of a Pol Pot noodle kamikaze attack on the NHS.
2. Indirect evidence via HbA1c levels that such attacks must be widespread.
3. Direct evidence of the effects of such attacks on the individuals concerned and the NHS.

The quantitative data for the post are taken from the National Diabetes Audit 2011-2012.

http://www.hscic.gov.uk/catalogue/PUB12421/nati-diab-audi-11-12-care-proc-rep.pdf

http://www.hscic.gov.uk/catalogue/PUB12738/nati-diab-audi-11-12-mort-comp-rep.pdf

Specific Example of a Pol Pot Noodle Kamikaze Attack on the NHS.

It is well known that carbohydrates cause blood glucose levels to rise and that exposure to high blood glucose levels may lead to diabetic health complications. Consider now the following statements [My italics and colouring] from:

http://www.diabetes.co.uk/forum/threads/low-carb-didnt-work-for-me.62717/page-7#post-611949

“So, a diet of Pot Noodle, Instant porridge, cup a soup, toast, maybe fruit, or fish or burger, and chips”.

“Prawns in a bubbly type batter, prawns in a crispy batter, duck pancakes with plum sauce, balti samosas, duck skewers in a sweet sauce, curry chicken bites, breadcrumb battered mozzarella. Char siu and sweet chilli sauce. So, my BS crept up for a while, peaked at 11.3 at three hours, then fell to 8.5 after 5 hours”.

Keep this up and it will be “Sayonara”.

In the next section we shall investigate the extent of such Pol Pot noodle kamikaze attacks on the NHS.

Widespread Evidence of Pol Pot Noodle Kamikaze Attacks on the NHS.

The NICE Clinical Guidelines provide targets for HbA1c (it should be noted that many of us consider these targets to be too high!). The targets are:

1. For Type 2: HbA1c < 48 mmol/mol.
2. For Type 1: HbA1c < 58 mmol/mol.

Table 1 provides the NHS results for diabetics in England and Wales.

Table 1 NHS HbA1c Results

Target	% Type 1	% Type 2
HbA1c < 48 mmol/mol	7	26
HbA1c < 58 mmol/mol	27	66

It can be seen only a minority of diabetics reach the NICE guidelines and, therefore, the majority are in danger of inflicting Pol Pot noodle kamikaze attacks on themselves and the NHS.

In the next section we shall investigate the current extent of such Pol Pot noodle kamikaze attacks on the individuals concerned and the NHS.

Current Extent of Pol Pot Noodle Kamikaze Attacks on the Individuals and the NHS.

If a diabetic has prolonged periods with higher than normal blood glucose levels there is increased risk of health complications and pre-mature death. These health complications include:

1. Angina – Chest pain due to temporary restriction in blood supply to the heart muscle.
2. Myocardial Infarction – Heart attack due to the interruption of blood supply to a part of the heart, causing heart cells to die.
3. Heart Failure – Due to the heart not maintaining blood flow sufficient to meet the needs of the body.
4. Stroke – The rapid, permanent loss of brain function following disturbance in blood supply to the brain.
5. Major Amputation – Surgical removal of the leg above the ankle.
6. Minor Amputation – Surgical removal of toes or a part of the foot below the ankle.
7. Renal Replacement Therapy (RRT) – Life-supporting treatments (dialysis and transplantation) required to treat end stage kidney disease (ESKD).
8. Retinopathy Treatment – Treatment for sight threatening diabetic damage to the back of the eye.
9. Diabetic Ketoacidosis – Severe lack of insulin means the body cannot use glucose for energy and the body starts to break down other body tissue as an alternative energy source.

Table 2 provides an authoritative and comprehensive picture of the extent of the Pol Pot kamikaze attacks on the complications of diabetics and the additional risk over and above that of the general population admitted to hospitals in England and Wales between April 2010 and March 2012.

Table 2 Hospital Admissions

Complication	Admissions	% Added Risk
Angina	292926	76
Myocardial Infarction	36974	55
Heart Failure	198205	74
Stroke	58348	34
Major Amputation	2609	222
Minor Amputation	6251	337
Renal Replacement Therapy	678451	164

In addition, the number of diabetics who died between 1 January and 31 December 2012 was 75669 with additional risk over and above that of the general population of 38%

The extent of the individual suffering and the burden on the NHS resources is truly staggering. Are the Pol Pot noodles worth it?

John