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Saturday 31 August 2013

Saturday night is music night.


Pearls of Wisdom from HCP's

Having moved house fairly recently I am looking for a new GP. Of course the treatment of diabetes is my priority and this has brought to mind some of  the priceless advice I have received from HCP's over the years. Judge for yourselves.

On diagnosis in A & E after collapsing with a food allergy. Pleasant young Staff nurse to me "I don’t want you going home worrying that this will mean a change to your lifestyle. It only means taking a few pills each day! “

Diabetes Dr. in Practice at first visit after diagnosis. “Oh dear! T2s are normally large, you’re certainly not large, we will have to ensure you get enough to eat“.

Upon telling another GP I wished to stop taking Avandia. “Just because the Daily Mail says so, doesn't make it so." "Fatal heart problems? But most diabetics DO have heart disease! " Upon my insisting, "Everyone is handing them back you know. Its just that we were told to resist”.

Specialist Diabetes Nurse in Practice. “No, no pioglitazone is a very safe drug". Me, “But rosiglitazone caused my macular oedema”. Nurse, “Pioglitazone will be fine, its been used for years.! “ (NHS leaflet says, "NOT recommended for those with macular oedema, will make the condition WORSE!)

GP new to Practice upon receiving a letter from senior diabetologist. “Why would you want to stick pins in yourself? I help at a hospital diabetes clinic and meter readings don’t mean a thing to me!"

Having had to cancel one appointment for a steroid eye injection, I had been forced to wait a further six months for another appointment as the procedure had to be done in an operating theatre. I was horrified to find I had an infection in the eye a few days before the due date and worried about what a further delay would mean for my eye condition spoke to my GP who said, “Well, if they won't do it they won't do it” (with a nonchalant shrug). He was very helpful though and prescribed me 2 x Ig metformin pills instead of 4 x 500 mg  "for the psychological effect". I was meant to feel better taking 2 pills instead of 4 !

Finally, maybe my favourite. Diabetes Nurse in Practice after blood test ordered by Dr. “So we will see you next month for your review". Me: "I only had it a few weeks ago, its not due for 6 months the Dr said“. Nurse: “Oh I see what it is, someone has not updated the computer”. Me: “Ok, goodbye”. Nurse: “Could you just come in anyway to make the computer right”!

Just a small selection from many etched into my memory. I am sure everyone has their own favourite HCP quote.

Please share, it’s good to know we are not alone…...


Addenbrooke's Hospital 'shackled' to fast food contract !

The boss of a Cambridge hospital has told the BBC he would like to ban fast food from the site, but is "contractually shackled" to provide it.
He was asked if he also planned to ban fast food, and remove certain outlets from the hospital's food court. Dr McNeil said: "If we could we would, but at the moment we're contractually shackled... but that's next, yes." The hospital has a number of cafes and restaurants, including a burger chain and a pizza chain.

But a spokesman said the hospital offered a number of healthy food options to staff, visitors and patients using the food court. He added: "We continue to work with our retail partners to ensure there are balanced food choices available... and are implementing further healthy options in the very near future" The hospital's contract with Gentian, a company which owns and manages retail facilities within NHS hospitals, runs until 2024.

Full story here.

Friday 30 August 2013

Chemical weapons and the stench of hypocrisy !

The big talking point over the last week is chemical weapons. Who used them is still being investigated, and they are indeed terrible weapons. Our Prime Minister did his best last night to get us involved in another war, and failed. But what’s all the fuss about chemical weapons ? Is it more acceptable to kill non combatant innocent men, women and children with cruise missiles, laser guided smart bombs and missile launching un-manned drones ? If people were trying to kill my family the method would not figure too high on my list of priorities. Stopping them would be my main priority with any method that worked, full stop. This is what war is all about, and it is never pretty. Let’s not kid ourselves war is ever anything less than total destruction and horror. The only winners are the arms manufacturers and we are one of the largest arms exporters in the world.

So why all the fuss about chemical weapons ? Could it be the aforementioned ‘acceptable weapons’ are way beyond the scope of the average terrorist to manufacture or steal. Could it be that chemical weapons may soon find their way out of Syria and be used in your town in the future ? We are hearing the great and the good tell us, the users of chemical weapons have committed a heinous crime and must be punished, but where do you draw the line ? In war there is no line. World War Two resulted in 60,000,000 deaths. We have learned nothing from history and the carnage never stops, and it won’t stop, because the human race are the most stupid animals on earth. The only animal to destroy his own environment and poison the land and the sea. We destroy each other for religious beliefs, for the colour of a mans skin, for profit and greed. As Einstein said, mans intelligence is limited, his stupidity is infinite.


Quote of the week !

"That’s not to say I think LC is wrong. I just think it’s woefully incomplete and everyone needs to recongnize Atkins is dead"

Richard Nikoley Free The Animal Blog.

We used to have FTA in our sidebar, then Richard went batshit.


Testosterone Boom: Pharma Firms Spread Male Menopause Myth !

 "Man, oh man," read the words emblazoned on a white tent set up in the pedestrian zone of the German city of Erfurt. Those who ventured inside received information on a dramatic scientific finding: One in three men over the age of 60 suffers from "testosterone deficiency syndrome." If left untreated, this dastardly condition can cause excess weight, anemia, hot flashes, osteoporosis, lowered sex drive and bad moods.

This same tent will be making appearances through November in Augsburg, Saarbrücken, Hanover and other German cities. Here, men over the age of 40 can have their testosterone level checked at no cost. They can also learn how to counteract testosterone deficiency: either get more exercise, or apply testosterone gel to their skin.

This traveling testosterone counseling service provided by the "German Society for Men and Health" was not born out of a purely charitable impulse -- there is a marketing angle at work here as well. The organization is funded by pharmaceutical company Jenapharm, the leading manufacturer of testosterone gel.

It's one of five companies that sell the male sex hormone, which is rubbed into the skin, and business couldn't be better. This can be seen in the number of prescriptions issued through Germany's statutory health insurance funds. The Scientific Institute of AOK, one of Germany's largest insurers, analyzed this data on behalf of SPIEGEL and found that prescriptions for testosterone gel more than tripled between 2003 and 2011. The most recent statistics show 390,000 daily doses per year. In Germany, a month's supply of the product costs around €60 ($80).

The booming business in testosterone gel provides a prime example of the ways in which pharmaceutical companies exaggerate illnesses to create new markets for their products.

The testosterone trend comes with attendant risks. Used in excess, the male hormone can promote the growth of prostate cancer and increase the risk of heart attacks and strokes. American doctors Lisa Schwartz and Steven Woloshin recently warned in the medical journal JAMA Internal Medicine that this widespread use of testosterone is "a mass, uncontrolled experiment that invites men to expose themselves to the harms of a treatment unlikely to fix problems ... that may be wholly unrelated to testosterone levels."

More on this story here.

Thursday 29 August 2013

Damon Gameau: That Sugar Film Pitch Teaser.

'That Sugar Film' is a feature documentary being made by Madman Entertainment and Old Mates Productions. It is a bold and colourful ride exploring all things sugar. We look at sugar's prevalence in society and see if it is having any major effects on the mind and body.
As part of the film, our host and director, Damon Gameau, who has eaten little to no sugar in the past 2 years is putting himself through a 'Super Size Me' inspired adventure of consuming 40 teaspoons of sugar per day found in common food and drinks. This is only marginally above the average daily amount consumed by teenagers world wide. 
He will be monitored by a team of doctors and scientists from Australia, New Zealand and the USA. He will also head out on an international journey and be joined by many familiar faces who are willing to look at sugar a little more closely.
While Damon is taking part in the experiment he will be keeping a daily diary here of what items he has consumed to reach 40 teaspoons a day. Take note that there will be little consumption of perceived 'junk' food but rather he will be highlighting the hidden sugars that are found in many 'healthy' marketed products.


Two days no internet a real bonus !

We have been decorating our lounge which required a breakdown of our computer system. When I set everything up, no internet. First thought, slash wrists and call it a day. Towards the end of day two, I thought I am enjoying this. No wacko lowcarb anti  posters posting negative comments here. No ambulance chasing lawyers wasting my time, my BP plummeted. Engineer turned up this afternoon and bad internet connection found and sorted.

So, I am thinking, is this internet doing my health any good ? Would I be better off fishing and walking around my beautiful local park, would I be better off walking my local three mile nature trail and smelling the wild flowers.

Just a thought.


 Local river walk and nature trail.

My private fishing club main lake.

Wednesday 28 August 2013

Antipsychotics triple risk of diabetes in kids, young adults

CLEVELAND, Ohio-- Antipsychotic drugs increased the risk of diabetes in children and young adults according to a recent study in the journal JAMA Psychiatry by researchers at Vanderbilt University.

Children who took the drugs—whose brand names include Risperdal, Seroquel, Abilify and Zyprexa—had a three-fold increased risk of Type 2 diabetes compared to children with the same conditions who took other medications.

The study group included 28,858 children in the Tennessee Medicaid program who had recently started antipsychotic medication. They were compared to more than 14,000 children who had similar diagnoses but were treated with other medications, including mood stabilizers (such as lithium, Depakote, Tegretol and Trileptal), antidepressants (such as Paxil, Zoloft, and Elavil), stimulants (such as Ritalin and Adderall), and drugs like Clonidine and Xanax.

The researchers tracked the kids and young adults, who were between 6 and 24 years old, for 12 years. The increased risk occurred within the first year of starting the antipsychotic medication, rose with cumulative doses, and persisted for up to a year after the children stopped taking the drugs.

The children were prescribed the drugs for conditions such as bipolar disorder, autism or behavioral problems, for which there were other medications available. Kids who had a diagnosis such as psychosis or schizophrenia, for which antipsychotics are considered the only effective treatment, were excluded from the study.

“What we’ve noted is that particularly for children there’s a lot of use [of antipsychotics] for what you’d call behavioral disorders, and that use has skyrocketed over the past 15 years,” said Wayne Ray, senior author of the paper.

“That led us to ask the question of how safe these drugs are.”

The study’s results were no surprise to Dr. Mackenzie Varkula, child and adolescent psychiatrist at the Cleveland Clinic’s Fairview Hospital and Dr. Molly McVoy, Program Director of Child and Adolescent Psychiatry at University Hospitals Case Medical Center.

“We’ve seen this clinically for a long time and have been waiting for the research to make its way through,” Varkula said.

The doctors said they see children who gain weight almost immediately—up to five pounds in the first week-- when they start taking antipsychotic medications.

“Those are the kids that we’re watching very closely,” McVoy said, monitoring for blood sugar and other changes that may indicate an increased risk of diabetes.

The current study adds to an increasing body of evidence linking the medications to diabetes, rapid weight gain, obesity and insulin resistance. Most of the research has been in adults, however.

Studies like the one at Vanderbilt cannot determine if the drugs cause diabetes. Butprevious research has shown that the weight gain associated with their use likely plays a role, as does an influence on the way the body reacts to insulin.

Doctors have been prescribing the drugs to children at a rapidly-increasing rate since they became available in the 1990s. Last year a study found that the number of antipsychotics prescribed to children and teens in the U.S. has quadrupled since they became available, and they are now prescribed in approximately the same proportion to children and teens as they are to adults.

“I think we have a lot of doctors starting kids on these medications because it might be helpful,” Varkula said. “Part of the problem is that we don’t have a lot of research on kids.”

“I think there are quite a few kids taking these drugs appropriately,” for schizophrenia, bipolar and severe aggression, said Varkula, but, she added that the odds of severe mental illnesses like schizophrenia or psychosis, which require antipsychotics, emerging at such a young age are extremely low.

McVoy said despite the increase in prescribing, the absolute number of children taking the medications is still small. “Most of my kids are not on them,” she said.

Yet the Vanderbilt study, which compared kids taking the drugs to those using different medications for the same conditions, raises the question of whether they’re necessary or should be used only as a last resort. About 87 percent of the children in the study were taking the newer “atypical” antipsychotic drugs, which include the brand namesClozarilRisperdalAbilifyGeodonSeroquel and Zyprexa.

All of the drugs in this class carry a “black box” warning from the Food and Drug Administration on their labels warning of the risk of high blood sugar and diabetes. The black box warning is the strongest safety action the FDA can take short of recalling a medication.

Ray, of Vanderbilt, recommends caution when prescribing an antipsychotic for a child.

“You should consider other alternatives first,” he said. “There are many other adverse effects of antipsychotics in children and adolescents, and in the children that we studied, there are other alternatives. If an antipsychotic is prescribed there needs to be close monitoring.”

Varkula said that parents should “ask specifically what the symptoms are the drugs will be treating, and what they should be looking for in terms of improvement and side effects they should report.”

“Make sure it’s really worth it,” she said.

Varkula and McVoy said that the current research won’t likely change the way they treat patients, but only because they’ve known about the potential risk for a while. McVoy said primary care doctors and pediatricians, who manage more patients and can’t follow research on antipsychotics as closely as psychiatrists, will likely benefit more from the knowledge.

“There are some patients where these medications have absolutely saved their lives, without exaggeration,” McVoy said. “This is why we need these kinds of long-term studies. We just don’t have great data.”


Getting the Statin Story Wrong: Physician-'Journalists' Must Do a Better Job

It’s not uncommon for me to wake up (in the Central time zone, where I live) and have a message from someone in the Eastern time zone already waiting for me, asking when I’m going to comment on some news story.

Recently I had one of those days.  The messenger was Charlie Ornstein of ProPublica, who’s also president of the Association of Health Care Journalists.

Before 9 a.m. Central time one recent day, he tweeted:

“Paging @garyschwitzer:  @CBSHealth: New wonder drug? Statins may have use beyond cholesterol.”
The CBS report in question was a live in-studio chit-chat with Dr. Holly Phillips, a “CBS News medical contributor.”

On the CBS website, the headline was: “New wonder drug? Statins may have use beyond cholesterol.”   A few quick observations:

1. That “may have” projection about statins is not new.  Drugmakers are in the business of constantly searching for new uses for old drugs.
2. And yes, statins are old drugs.  So why did the online and on-air stories refer to them as “new wonder drugs”?
3. Finally, the story was about a study.  The study only looked at statin harms/safety.  It didn’t look at benefits.  It didn’t even mention Alzheimer’s disease.  So, with no analysis of benefits, why did the online and on-air stories refer to them as “new wonder drugs”? And in the freeze-frame image from CBS, above, you’ll see that the subheadline is “THE BENEFITS OF STATINS.” That’s NOT what the study was about!
Dr. Phillips said:
“In addition to lowering cholesterol, statins lower inflammation in the body, particularly in the blood vessels,” said Phillips. “Inflammation is linked to a number of other diseases: Alzheimer’s disease, a number of forms of cancer, strokes. So by lowering that, we could theoretically lower many of these diseases.”

That’s a mighty big if.  And that’s NOT what the study in question was about.

So what was the story all about?

If it was about the study, it missed the mark, going way outside the boundaries of what was reported in the study.

If it was an attempt to promote statin use, it was journalistically unsound. The anchorman even asked Dr. Phillips what advice she gives her patients about statins.  You know what?  I don’t care what advice she gives her patients, and I don’t think CBS viewers should either. At that moment, she’s on the air as a journalist.  She shouldn’t be put in the position – or allow herself to be put in the position – of dispensing medical advice in this setting.

Finally, even in reporting on the supposed safety of statins, it’s important to clarify and delineate the population you’re talking about.  If you’re talking about using powerful drugs in healthy people for preventive reasons, you better be real clear about that.  And this study’s analysis of the statins-and-diabetes link is worth noting in that context.  But there are other safety concerns for statins in the primary prevention context as well.

So, there you go, Charlie.  Probably  predictable.  But so was the CBS story. And so are many health care stories by leading U.S. news media:

Of the almost 1,900 stories we’ve reviewed on in the past 7+ years, two-thirds fail to adequately quantify the potential benefits of the interventions they report on.

You can't blame all of this on poorly trained journalists.  This is an example where a physician-"journalist" on a big-time TV network didn't get it right. 


Tuesday 27 August 2013

How could Atos class such a sick man as fit for work?

Is ATOS fit for purpose ?
Most of us at one time or another would likely have heard or read about the welfare state being abused in one way or another,be it a millionaire with a large property portfolio with multiple housing benefit claims with multiple aliases or the disability living allowance claimant who receives thousands of pounds per year due to extremely poor mobility yet is then filmed playing football,well,you get the picture BUT on the other side of the coin are many individuals who have through no fault of their own,found themselves very sick or chronically disabled and I then firmly believe in the welfare state principles and as a civilised society,believe these individuals should be looked after medically and financially but this is not the case and the system is fundamentally flawed.
This is a snippet from an article recently which highlights this...

Let’s say you work for Atos in one of its Assessment Centres in Lancashire.
Your job is to assess people on disability ­benefits to see whether they are fit for work.
A 58-year-old man, who’s done 30 years hard graft, comes in for a “Work Capacity Assessment”.
He is suffering from diabetes with multiple complications and mental health problems.
He is almost blind, with incurable damage to both his eyes.
He suffers from frequent ­hypoglycaemic attacks that often result in total loss of consciousness and sometimes ­hospitalisation.
He is often incontinent. He suffers from depression.
He relies on friends, carers and family to shop for him and struggles to cross a road unaided.
He has no feeling in his feet – another complication of his diabetes.
He has suffered with gangrene and over the winter he had badly burned his feet on an electric heater.
On the day of his assessment, his feet are bandaged.
Say you had all that information in front of you. Would you write on your piece of paper “Fit for work”?
When Zulfiqar Shah, from Blackburn, was assessed by Atos, his assessor gave him zero points. He needed 13 to qualify for benefits.
His family says the decision almost killed him – a diabetic who could no longer afford to eat.
“I told them I wasn’t afraid to work, but that at the moment I was not well enough to,” Zulfiqar says, quietly. “But they didn’t listen.”
When his sister Zahida, 46, picked Zulfiqar up from the assessment centre he was wearing only one shoe, not even realising he was walking with his ­bandaged, burned foot on the pavement.
“Any human being seeing him for five minutes could see that my brother was neither physically or mentally able to work,” Zahida says.

I would suggest that a radical change in the current system needs to happen and SOON.


GPs charge disabled up to £130 to appeal fitness-to-work decisions !

Doctors are charging sick and disabled people up to £130 for medical evidence to appeal decisions about their fitness to work, The Independent has learnt. NHS GPs are telling patients they will only provide the necessary details to challenge controversial Work Capability Assessments if they pay. Others are refusing to help at all.

Citizens Advice say in many areas GPs are helping with an appeal only if patients pay a fee of between £25 and £130. There are also reports from 15 of its centres that family surgeries are refusing to provide evidence at all.

GPs who refuse to help – or charge increasingly high fees – argue that writing up medical evidence takes up time when they could be helping patients.
But Gillian Guy, chief executive of Citizens Advice, said: “Charging sick and disabled people more than £100 for medical evidence beggars belief. This process is clearly failing.”

More on this story here.

Monday 26 August 2013

Dairy products and the risk of type 2 diabetes: a systematic review and dose-response meta-analysis of cohort studies


Background: The association between intake of dairy products and the risk of type 2 diabetes has been investigated in several studies, but the evidence is not conclusive.
Objective: We conducted an updated systematic review and dose-response meta-analysis of dairy product intake and the risk of type 2 diabetes.
Design: We searched the PubMed database for prospective cohort and nested case-control studies of dairy product intake and risk of type 2 diabetes up to 5 June 2013. Summary RRs were estimated by use of a random-effects model.
Results: Seventeen cohort studies were included in the meta-analysis. In the dose-response analysis, the summary RRs (95% CIs) were 0.93 (0.87, 0.99; I2 = 33%) per 400 g total dairy products/d (n = 12), 0.98 (0.94, 1.03; I2 = 8%) per 200 g high-fat dairy products/d (n = 9), 0.91 (0.86, 0.96; I2 = 40%) per 200 g low-fat dairy products/d (n = 9), 0.87 (0.72, 1.04; I2 = 94%) per 200 g milk/d (n = 7), 0.92 (0.86, 0.99; I2 = 0%) per 50 g cheese/d (n = 8), and 0.78 (0.60, 1.02; I2 = 70%) per 200 g yogurt/d (n = 7). Nonlinear inverse associations were observed for total dairy products (P-nonlinearity < 0.0001), low-fat dairy products (P-nonlinearity = 0.06), cheese (P-nonlinearity = 0.05), and yogurt (P-nonlinearity = 0.004), and there was a flattening of the curve at higher intakes.
Conclusions: This meta-analysis suggests that there is a significant inverse association between intakes of dairy products, low-fat dairy products, and cheese and risk of type 2 diabetes. Any additional studies should assess the association between other specific types of dairy products and the risk of type 2 diabetes and adjust for more confounding factors.

You couldn’t make it up !

The deep-fried Mars bar vs porridge: Two Scottish favourites go head to head.


The health effects of that fabled Scottish snack, the deep-fried Mars bar, are to be tested in a clinical trial which will form the first scientific study into the impact that the snack, reputedly most popular in Glasgow, has on the human body.

Researchers at Glasgow's Western Infirmary hospital will compare the effects with those that occur after eating a more conservative, and healthier, Scottish dish – a bowl of porridge.

"The deep-fried chocolate bar... has been cited as a symbol of all that is wrong with the high-fat, high-sugar Scottish diet," says Professor Matthew Walters, the lead consultant for stroke in West Glasgow, who is director of the Scottish Stroke Research Network. "Despite the snack's reputation, no medical research has been performed to examine the effects of consuming a deep-fried chocolate bar on the human body, and that is what we are going to do," he explained.

Folklore has it that the deep-fried Mars was first eaten in 1995 in Aberdeen. By 2004, a survey of 627 fish-and-chip shops in Scotland, published in The Lancet, showed that 22 per cent sold deep-fried Mars bars. Average weekly sales were 23 bars, but 10 shops reported selling up to 200, with a typical price of 60p. Other foods that the fish-and-chip shops had been asked to fry include Snickers bars, bananas, and Creme Eggs.

Full story here. 

Meanwhile here.

A Mars spokesperson said: “We are really flattered that customers of Carron Fish Bar like our product so much that it has now become a flagship product for the store. ”No application for a protected geographical indication has been filed to date. “Should an application be filed, unfortunately, we wouldn't be able to support it as deep-frying one of our products would go against our commitment to promoting healthy, active lifestyles.”

Sunday 25 August 2013

SFAs do not impair endothelial function and arterial stiffness


Background: It is uncertain whether saturated fatty acids (SFAs) impair endothelial function and contribute to arterial stiffening.
Objective: We tested the effects of replacing SFAs with monounsaturated fatty acids (MUFAs) or carbohydrates on endothelial function and arterial stiffness.
Design: With the use of a parallel-designed randomized controlled trial in 121 insulin-resistant men and women, we measured vascular function after 1 mo of consumption of a high-SFA (HS) diet and after 24 wk after random assignment to the HS diet or diets that contained <10% SFAs and were high in either MUFAs or carbohydrates. The primary outcome was a change in flow-mediated dilation (FMD), and secondary outcomes were changes in carotid to femoral pulse wave velocity (PWV) and plasma 8-isoprostane F-III concentrations.
Results: For 112 participants with data available for analysis on the specified outcomes, no significant differences were shown. FMD with the HS reference diet was 6.7 ± 2.2%, and changes (95% CIs) after 6 mo of intervention were +0.3 (−0.4, 1.1), −0.2 (−0.8, 0.5), and −0.1 (−0.6, 0.7) with HS, high-MUFA (HM), and high-carbohydrate (HC) diets, respectively. After consumption of the HS reference diet, the geometric mean (±SD) PWV was 7.67 ± 1.62 m/s, and mean percentages of changes (95% CIs) were −1.0 (−6.2, 4.3) with the HS diet, 2.7 (−1.4, 6.9) with the HM diet, and −1.0 (−5.5, 3.4) with the HC diet. With the HS reference diet, the geometric mean (±SD) plasma 8-isoprostane F-III concentration was 176 ± 85 pmol/L, and mean percentage of changes (95% CIs) were 1 (−12, 14) with the HS diet, 6 (−5, 16) with the HM diet, and 4 (−7, 16) with the HC diet.
Conclusion: The replacement of SFAs with MUFAs or carbohydrates in healthy subjects does not affect vascular function. This trial was registered at Current Controlled Trials ( as ISRCTN 29111298.

This Government couldn’t run a whelk stall !

In my sixty plus years, I have never seen a more incompetent bunch of imbeciles running the Government. Time after time, they U turn on policy, because the policy was ill thought out, and this mob are controlled totally, by think tanks and opinion polls. The latest scheme from these incompetents is to take certain food establishments off the watch list by public health inspectors. See link below. As always it gets worse !

Check out how much money these slagoons have blown to achieve zilch in the NHS. Have a guess, one million ? one hundred million ? How about one thousand million pounds ? how about one thousand four hundred million pounds. Yes that’s right 1.4 billion pounds to increase the waiting list and demoralise most NHS workers.

Camaroon is making a lot of noise about Syria over the weekend. Anyone with a slight grasp of reality knows, Camaroon dare not scratch his arse without permission from  America. WTF did we become such a bunch of wasters and limp wristed automatons ? At one time we ruled the largest Empire in the history of the world, now we cannot run a whelk stall.


Link to £1.4bn 'wasted' on NHS redundancies here.

Link to food inspectors here.

Prospecting for gold.

When you go prospecting for gold you have to put in a lot of work before you get lucky. It’s the same when looking for diabetics to help. The reality is you rarely know who you have helped. That’s cool, not everyone takes the time to let you know, but when they do it makes all the work worth while. Over five years ago, some fellow diabetics showed me the light, to diabetic salvation. They taught me about lowcarbing. I had taken the advice of medical professionals and after a couple of months of trying to control very high BG numbers and failing, I gave lowcarb a try. Within five days my BG dropped to non diabetic numbers. I was so naive I thought I was lucky or maybe different to other diabetics. I soon realised, I was just a run of the mill, bog standard diabetic, and almost anyone could do what I had done. Problem solved, all I had to do was tell everyone all about lowcarbing, easiest job I ever took on, or so I thought ! I have lost count of the times I have thought of that last statement, and almost fell off my chair laughing. But hey, maybe it’s the way I go about spreading the good news. Talking of good news, this was emailed to our team yesterday.

“Hi there,
I just wanted to thank you for all the information you provide on your website.

I am not (yet anyway) a diabetic but having recently found out that my Grandparents and now an Uncle are type 2 diabetics I have had a big wake up call. I am in my late forties and overweight. I have tried Weight Watchers and Slimming World and on each occasion I have lost 3 stone only to regain 4!  It was while looking for information on diabetes for my Uncle that I came across your website. I am now following a low carb diet and not only am I losing weight I am also no longer hungry all the time.  I am trying to persuade my Uncle to follow your advice but he is confused and afraid of all the diet advice given by the NHS. I have been horrified by the lack of support he has been given and that by following their diet book he has gained another stone in weight.

I am hoping that by following your lifestyle tips I can avoid or at least delay type 2 diabetes.

Many thanks,

Full name and email address supplied.


This is for Ray: Amy Macdonald - Footballer's Wife


Saturday 24 August 2013

Saturday is music night


Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets.

European Journal of Clinical Nutrition (2013) 


Very-low-carbohydrate diets or ketogenic diets have been in use since the 1920s as a therapy for epilepsy and can, in some cases, completely remove the need for medication. From the 1960s onwards they have become widely known as one of the most common methods for obesity treatment. Recent work over the last decade or so has provided evidence of the therapeutic potential of ketogenic diets in many pathological conditions, such as diabetes, polycystic ovary syndrome, acne, neurological diseases, cancer and the amelioration of respiratory and cardiovascular disease risk factors.

The possibility that modifying food intake can be useful for reducing or eliminating pharmaceutical methods of treatment, which are often lifelong with significant side effects, calls for serious investigation. This review revisits the meaning of physiological ketosis in the light of this evidence and considers possible mechanisms for the therapeutic actions of the ketogenic diet on different diseases. The present review also questions whether there are still some preconceived ideas about ketogenic diets, which may be presenting unnecessary barriers to their use as therapeutic tools in the physician’s hand.

Full paper here. 

Great article highly recommended Eddie.

Friday 23 August 2013

How Glucose Fluctuation Affects Coronary Artery Disease in Type 2s

Elevation in oxidative stress level can damage cell and tissue....

Previous studies have shown that oxidative stress levels can increase during acute or chronic blood glucose fluctuation in body in type 2 diabetes (T2DM) patients. Elevation in oxidative stress level can damage cell and tissue. Therefore, it is essential to assess the relationship between coronary artery complications and fluctuation in glucose level.

This trial aimed to evaluate the effect of chronic fluctuation in glucose in normal and T2DM patients regarding cardiovascular complications.

Participants were assigned to 3 groups: T2DM patients with cardiovascular complication (group C, n=92), T2DM patients without cardiovascular complication (group B, n=56) and healthy control group (group A, n=40).

Blood glucose fluctuation was recorded at 8 time sessions, which were 0:00–3:00, 3:00–6:00, 6:00–8:00, 8:00–11:00, 11:00–13:00, 13:00–17:00, 17:00–19:00, and 19:00–24:00. Continuous glucose monitoring system (CGMS) for 72 hours, indexes of mean blood glucose (MBG), glucose standard deviation (SD), the largest amplitude of glycemic excursions (LAGE), the average amplitude of glycemic excursions (MAGE), the number of effective blood glucose excursions (NEGE), and postprandial glucose excursions of 3 dinners, CPR, HbA1 were recorded. Syntax score, an angiogrpahic scoring system was used for comprehensive evaluation of coronary lesion in group C.

The results showed significant different in glycemic excursions among three groups. Higher SYNTAX scores were associated with SBP, CRP, MAGE, and HbA1c levels and were significantly correlated at 6:00-8:00 and 11:00-13:00 time points in group C. The findings of this study showed that T2DM participants had higher fluctuation in blood glucose compare to normal healthy participants. Moreover, T2DM participants with cardiovascular complication had even higher fluctuation compare with T2DM participants without cardiovascular complication.

In conclusion, the study suggests that glucose fluctuation in blood can be a risk predictor for occurrence and progression of cardiovascular disease in T2DM patients. This can be a beneficial tool in clinical treatment for T2DM patients.

Zhang X, Xu X, Jiao X. et al. The Effects of Glucose Fluctuation on the Severity of Coronary Artery Disease in Type 2 Diabetes Mellitus. J Diabetes Res.2013;2013:576916 

Check out the J Diabetes link for the full study.


Quote of the day.

"All-Bran, Traditional Porridge Oats and Natural Muesli are all low on the Glycemic index."

Noblehead at

Nigel has insulin to keep down the very rapidly rising blood glucose these cereals will bring about for the average non insulin using diabetics.The GI is a minefield for most and cannot be relied upon. Check out the late Barry Groves video for the facts on the low GI diet. Well worth your time.Eddie and the lowcarb paradox.

Over the last five years or more, the lowcarb lifestyle has enjoyed a remarkable achievement record in controlling diabetes at Countless members have reported blood glucose reduced to non diabetic, huge weight loss when required, improved lipids, a reduction in medication, some on nil medication. The good news goes on and on. The fact is other than reports from lowcarbing diabetics, the good news ranges from slim to non existent. I have never read a success story, where a member stated I have increased my carbohydrate consumption, and have improved my diabetes control, and improved my long term health.

So, if you accept lowcarb has been a tremendous success over the years, the $64,000 question has to be, why have so many lowcarbers been banned ? Why have Doctors and healthcare professionals been railroaded off by around a dozen lowcarb antis ? Why has the forum not become a shining beacon for lowcarb and common sense ? I learnt a long time ago to follow the money. So, lets have a closer look at and the money.

" doesn't belong to Sitefinders, it belongs to the community." says one page at  Sitefinders, but is this true ? Another page at sitefinders states, the site can be leased. Another page implies make us the right offer and you can buy the site. Owned by the community, I don't think so. Although on the forum 99% of the work is done by the "community" free of charge, will they be recompensed if the site is leased or sold ? not a chance. Also, the forum is used as a marketing tool and emails are sent to the members selling a range of products and services, even the banned members such as some of our team, receive the big sell.

I have been involved with sales and marketing for many years, and I have imagined a situation where I have been tasked with leasing or selling the site. Who do I contact first ? A local farmer that sells fresh produce, or a fruit and vegetable company ? No way, I would be talking to pharmaceutical companies or makers of BG meters etc. outfits that lowcarb was the last thing they wanted to be involved with. Because there is little or no money in low carbing. Low carbing diabetics (type two's only) often require nil or minimal medication and cost big pharma a fortune. Low carbing makes no money for junk food outfits. Are you getting the big picture ? are you following the money ?

Click on screen shots to enlarge.

Yesterday Gezza was posting on Twitter he was about to spill the beans on a big pharma and conspiracy and wanted a reporter to investigate. Could Gezza be on to something ? Today the forum  of flog is posting on twitter  “Sorry for confusion, DCUK is not a charity we are a genuine diabetes resource not connected to any pharma company” and “Our increase in forum members is organic and not manufactured in any way” Time will tell and my money is on Gezza is off on another bender, but you never know these days, and as always follow the money.


Thursday 22 August 2013

Colorectal cancer risk increased with bariatric surgery

The risk of colorectal cancer was significantly increased among people who had undergone obesity surgery in a retrospective cohort study of more than 77,000 obese patients enrolled in a Swedish registry.

The increased risk for colorectal cancer was associated with all three bariatric procedures – vertical banded gastroplasty, adjustable gastric banding, and Roux-en-Y gastric bypass – and increased further over time, reported Dr. Maryam Derogar, of the Karolinska Institutet, Stockholm, and her associates. No such pattern over time was seen among the obese patients who did not have surgery.

"Our data suggest that increased colorectal cancer risk may be a long-term consequence of such surgery," they concluded. If the association is confirmed, they added, "it should stimulate research addressing colonoscopic evaluation of the incidence of colorectal adenomatous polyps after obesity surgery with a view to defining an optimum colonoscopy surveillance strategy for the increasing number of patients who undergo obesity surgery. The study was published online in the Annals of Surgery (2013 [doi:10.1097/SLA.0b013e318288463a]).

To address their "unexpected" finding in an earlier study of an apparent increase in the risk of colorectal cancer after obesity surgery, but no increase in the risk of other cancers related to obesity, they conducted a retrospective cohort study using national registry data between 1980 and 2009, of 15,095 obese patients who had undergone obesity surgery and 62,016 patients who had been diagnosed with obesity but did not undergo surgery. They calculated the colorectal cancer risk using the standardized incidence ratio (SIR), the observed number of cases divided by the number of expected cases in that group.

Over a median of 10 years, there were 70 colorectal cancers in the obesity surgery group; and over a median of 7 years, 373 among those who had no surgery. The SIR for colorectal cancer among those who had surgery was 1.60, which was statistically significant. Among those who had no surgery, there was a small, insignificant increase in risk group (a SIR of 1.26). In the surgery group, the risk increased over time in men and women, up to a twofold increased risk among those patients followed for at least 10 years, a pattern than was not observed in the obese patients who had no surgery.

The "substantial increase in colorectal cancer risk, above that associated with excess body weight alone, more than 10 years after surgery is compatible with the long natural history of colorectal carcinogenesis from normal mucosa to a malignant colorectal cancer," the authors wrote. Why the risk was increased is not clear, but one possible explanation could be that the malabsorption effects of the gastric bypass procedure results in local mucosal changes, the authors speculated. Previously, they had identified rectal mucosal hyperproliferation in patients who had undergone obesity surgery, present at least 3 years after the procedure, a finding that was "associated with increased mucosal expression of the protumorigenic cytokine macrophage migration inhibitory factor," they wrote.

The study’s strengths included the size of the sample, long follow-up, and the validity of Swedish national registry data, while the limitations included the retrospective design and the lack of data on body weight over time.

As in the United States and other countries, obesity has been increasing in Sweden, with a corresponding increase in bariatric surgery. Over the last 20 years, the prevalence of obesity in Sweden has doubled, and the annual number of obesity operations performed has increased from 1,500 in 2006 to almost 4,000 in 2009, according to the authors.

The study was supported by the Swedish Research Council. The authors had no conflicts of interest to declare.

Graham Scoop Of The Year and the Gezza memorandum !

What treachery is being uncovered at the forum of flog ? Has the forum all been a shill operation for big pharma ? Has Gezza gone batshit ? The plot gets stranger by the minute ! Welcome to the crazy world of diabetes.


Today on Twitter.

A Little Taste of The Good Life.

I have always loved the TV programme of this name for many reasons and can watch any number of repeats but never because I was tempted to emulate the "self sufficiency" movement. I can’t think of anything worse. Farming on any scale does not appeal, no offence to farmers, and yes I have met quite a few.

Let me say right away that I am no gardener. I may choose what I would like to grow and interfere with my husband's plans and point out the deficiencies (which is probably why my rare visits are not welcomed) but I am happy to leave the actual cultivation to him. Over the years I have lived in various types of property with gardens large or small or non-existent. In all of them, I have noticed that people will find some way of growing not only flowers but fruit and vegetable in the most unlikely and unpromising places.

Of course this is easier these days. You can buy planters to fit around drain pipes, tomato plants for hanging baskets, and ready made germinating kits to use indoors as well as mini greenhouses; and all for a pound or less in the budget stores. The number of fruits and vegetables which can be grown in containers or pots is amazing. The list is endless including, cucumbers, potatoes, strawberries, green and runner beans, turnips, carrots, lettuce, peppers, even blueberries etc etc.

This is on my mind because we recently moved to a house where the garden had once been an allotment. There were raised vegetable beds and espaliered fruit trees and many “anonymous” plants, so we have watched with interest to see what cropped up! {sorry}. We have had enough green and runner beans to feed an army but passed them on to the neighbours, some of whom returned the compliment with other produce. We had a bumper crop of strawberries, great to accompany my breakfast yogurt, and between our planting and the stuff already growing have not had to buy any salad ingredients for some time.

I realise that many of you are probably keen gardeners and know all this, and more already, and others will say that they haven't the time. My own reaction to all this at first was to groan at the thought of endless hours preparing fruit and veg for freezing.  Looking around at what is available to grow nowadays I realised that I could grow my own celeriac and aubergines, even avocados, all of which seem to know when I want them and promptly disappear from the shelves.

No, it is not going to replace the weekly shopping trip but there is a great deal of satisfaction in knowing exactly where at least some of your food comes from and that it is truly organic. Also that it hasn’t been flown halfway around the world before it reaches your plate. We are too used to expecting to be able to eat anything at any season. I think there is something special about being able to eat fresh vegetables, locally grown in season. Some people never have this pleasure so even as an occasional treat it is worthwhile. Of course children love to watch and have a hand in growing things too. They love to help and may even learn to view vegetables in a different light.

I am now reconciled to a mini version of the Good Life, as you can tell but I am still not entirely convinced that I want the freezer to be taken over by excess produce. We still have a superfluity of runner beans for example. It occurred to me that before refrigeration food was stored in other ways so I may experiment with this. Moist sand is one medium I believe and jute sacking and the like. Any tips gratefully received. I can no longer be bothered with pickling, bottling and the like and  think I should avoid jam making. Why deliberately put yourself in temptation's way.

Of course, as diabetics, fresh food is especially important to us. Growing our own, even in a small way, may help ourselves and others to appreciate the benefits of fresh veg from a reliable source and also remind us how things should taste. So much shop-bought produce tastes bland and tired and not everyone has a choice of shops within easy reach.

I shall probably continue to do my gardening by proxy, but the celeriac is doing well.  Next year we will try the aubergine and avocados, maybe in a container. Diabetic or not we wont have to worry too much about beating the rush in the supermarket.

Happy growing, and may your fingers always be green!


Children need more exercise - especially girls, study says !

Half of all UK seven-year-olds do not do enough exercise, with girls far less active than boys, a study suggests. University College London researchers found just 51% of the 6,500 children they monitored achieved the recommended hour of physical activity each day. For girls, the figure was just 38%, compared with 63% for boys. Half of the group also spent more than six hours being sedentary each day, although some of this would be spent in class, the researchers acknowledged.

 Dr Ann Hoskins, of Public Health England, agreed. She said: "This study highlights that there is still much to do to keep children and young people active as they grow older, especially girls. "The new school year is the perfect time to make healthy changes, swapping short car or bus journeys with walking or scooting to school."

More here.

Another blast from the past

Christine Cashin registered dietition, an update.

I spoke today to the Policeman re. the complaint received from a “Welsh Female” re. the comment “Welsh Bint” I found him to be a gentleman. He explained he had received a complaint from a member of the public and he was duty bound to investigate the matter. I informed him the search facility on the blog could not find this phrase, but may have been posted as a comment. He is going back to the complainant, who has a copy, and will hopefully give him information re. post date of the offending comment. He is coming back to me with the relevant information. I have agreed as a gesture of goodwill to remove the comment from this blog.

Maybe this is a good time for Chris to comment on this blog. A fair chance to explain her side of the debate/dispute. A chance to give us some sound information for maintaining our non diabetic BG numbers, our lipids of teenagers, our lack of scurvy and osteoporosis. Our lack of or minmal diabetes medication.Our lack of constipation and mood swings etc. etc.

Perhaps she will congratulate us on our ability to astound our healthcare professionals with every blood test and diabetes review.

Over to you Chris, don't hang around on Carbo's cess pit, feel free to post here ! Or give me a call, you have my number.


PS. We have found the post and deleted the comment that caused offence !


As the ETYM forum disappears into the ether, a priest has been summoned for the last rites. How could it have gone so wrong ? A tough as they come bunch of lowcarbers setting up their own blog. It surely must be a success, right ! Err no. Well let me tell you why. As soon as they got their own forum, lowcarb was a taboo subject ! Although most of the members and forum owners were lowcarb, lowcarb was a keep away from subject. We were told “this is not a lowcarb forum” game over. So many of the well controlled members are lowcarbers, they know there is no other way ! Goodbye members etc. Some of the forum owners swiftly left, including me, later I was banned as a member. The remaining board members too lazy or lacking true conviction to fight the cause. Another UK forum bites the dust. Let me tell you folks, the first five years are the worst. I know this for a fact ! Ya gotta have staying power, or you are wasting your time !


Click on screen shot to enlarge.

Wednesday 21 August 2013

Carbsane quote of the week !

"Yeah, I think the LC folks especially have a distorted view of normal weight. I myself will never be a "normal weight" and that is fine with me."

Carbsane aka Evelyn Kocur the morbidly obese blogger that rubbishes lowcarb, and her hate list runs from A to Z of the lowcarbing and Paleo world. She knows it all, other than how to lose weight of course. "I myself will never be a "normal weight" Too right Evie !

Evie on twitter. 

19 Aug
Thanks! In other news, my stalker blog has gone poof.

We're still here Evie !

The Ugly Side of Statins. Systemic Appraisal of the Contemporary Un-Known Unknowns

Cardio-vascular specialists have witnessed and actively participated in the revolutionary developments that have occurred in their field of specialization over the last few years. Cutting-edge technologies have led to dramatic improvements in life-expectancy and quality of life. An open-mind and pioneering attitude are necessary when exploring new frontiers to improve our patients’ health. However, naive indiscriminate acceptance of novel mainstream therapies is not always advisable and prudence is required in unearthing harmful, covert side effects. An objective review of contemporary vascular research was performed and industrial bias was sifted out for a fresh prospective on how to promote primary cardiovascular prevention with attainable lifestyle adjustments [1]. A comprehensive review of Pubmed, EM-BASE and Cochrane review databases was undertaken for articles relating to cardiovascular primary prevention and statin side effects with the aim of harmonising their roles within contemporary clinic practice. Particular attention was paid to large-scale randomised controlled trials on contemporary cardiovascular pharmacotherapies and their specific adverse effects on metabolic pathways which feature prominently in cardiovascular primary prevention and regenerative programmes. There is a categorical lack of clinical evidence to support the use of statin therapy in primary prevention. Not only is there a dearth of evidence for primary cardiovascular protection, there is ample evidence to show that statins actually augment cardiovascular risk in women, patients with Diabetes Mellitus and in the young. Furthermore statins are associated with triple the risk of coronary artery and aortic artery calcification. Cardiovascular primary prevention and regeneration programmes, through life style changes and abstaining from tobacco use have enhanced clinical efficacy and quality of life over any pharmaceutical or other conventional intervention.

 The PDF can be downloaded here:
Consultant vascular and endovascular surgeons at University Hospital Galway, Sherif Sultan and Niamh Hynes carried out the research.

The consultants' paper, called 'The Ugly Side of Statins' is published in the Journal of Endocrine and Metabolic Diseases.

The research states that statins, which are one of the world's most prescribed drugs, could increase the risk of diabetes and cataracts in young people.

It says the drugs can also cause an increased risk of cancer in elderly people.

They add that there has 'actually been active discouragement to publish any negative studies on statins', which is a 20-billion a year industry.