‘Inadequate’ NHS diabetes care causing patients ‘harm’ By Mike Tighe

People with diabetes need to check their blood sugar levels.

NHS diabetes care is ‘inadequate’ and some patients come to further harm due to poor care in hospital, a leading specialist says.

Dr Gerry Rayman, national clinical lead for inpatient diabetes, warned many hospitals had no specialist diabetes nurse.

He said many hospital patients had diabetes, and called the situation ‘quite alarming’.

The Department of Health said work was under way to improve care standards.

Speaking on BBC Radio 4’s You and Yours, Dr Rayman, head of the diabetes service at Ipswich Hospital NHS Trust, said: “We know that one in three hospitals don’t have a specialist diabetes nurse, which is really quite alarming when we know that one in six people in hospital have diabetes.

“Unfortunately, many people in hospital with diabetes do come to harm as a result of, I’m afraid to say, inadequate care in hospital.”

Diabetes accounts for 11% of all NHS inpatient expenditure, and costs the service around £23.7bn last year, a figure projected to increase to just under £40bn by 2035.

Two types

Diabetes complications

  • Diabetes that is not controlled can cause many serious long-term problems.
  • Excess glucose (sugar) in the blood can damage the blood vessels, contributing to heart disease, strokes, kidney disease, impotence and nerve damage.
  • Uncontrolled diabetes is the most common cause of blindness in people of working age.
  • People with diabetes are also 15% more likely to have an amputation than people without the condition.

In Type 2 diabetes, not enough insulin is produced or the insulin that is made by the body does not work properly.

It tends to affect people as they get older and usually appears after the age of 40, but increasingly is seen in younger, overweight people. It accounts for 90% of all cases.

Type 1 diabetes, a condition which usually means insulin cannot be produced at all, is responsible for the other 10%.

Adrian Sanders, chair of the all-party parliamentary group for diabetes, claimed there was plenty of evidence out there to support Dr Rayman’s assessment.

He said the government was aware that a disproportionate number of people occupying hospital beds have diabetes, and their hospital stays are longer.

He said the government – and the last Labour administration – had encouraged more support for people with diabetes in primary care.

“That’s actually a very good policy for people whose condition doesn’t present complications or specialisms. And that’s why you need specialist care for those who present with specialist problems.”

Barbara Young, chief executive at Diabetes UK, said diabetes was a serious condition which could lead to devastating long term complications including blindness, kidney failure and amputations.

She said: “The tragedy is that for many people with diabetes, complications could have been avoided if the health checks were in place to spot any signs and if the appropriate care and treatment were applied.

“For example, up to 80% of amputation cases due to diabetes could be avoided if problems are identified early enough and treated appropriately.”

Personal responsibility

A key area of contention is whether diabetes is an issue for social or personal responsibility, with some arguing for tougher regulation of the food industry, whilst others argue healthy diet is strictly a matter for the individual.

Last week a ten-minute rule bill was introduced in the House of Commons by Keith Vaz arguing for the reduction of sugar content in soft drinks by 4%.

However, Paul McArdle, of the British Dietetic Association, cautioned against putting too much emphasis on sugar in food.

He said: “Food labelled ‘suitable for diabetics’ comes from the misguided principal that everything for people with diabetes is about sugar.

“The main focus for this group is losing weight and having a healthy diet, as this helps people with diabetes manage the condition.

“Around 60-90% of type two diabetes is caused by people being overweight, with more than half of that being preventable by having a healthy lifestyle.

“The bigger issue is good food labelling which can enable consumers of food to make healthy choices.”

Audit for improvement

The Department of Health issued a statement which accepted that good diabetes care was very important in hospital – and elsewhere.

“That is why the National Diabetes Inpatient Audit reviews diabetes management in hospital each year and feeds results back to individual hospitals to take appropriate action.

“NHS Diabetes is working with clinicians through their Inpatient Network to improve care.

“The Audit has already shown some improvements in care but more needs to be done.”

Merck Profit Tops Analyst Estimates on Diabetes Drugs

Merck & Co. (MRK), the second-largest U.S. drugmaker, reported first-quarter profit that beat analyst estimates on higher sales of diabetes treatments.

Net income rose 67 percent to $1.74 billion, or 56 cents a share, from a year earlier, the Whitehouse Station, New Jersey- based company said today in a statement. Earnings per share excluding one-time items beat by 1 cent the 98-cent average of 18 analyst estimates compiled by Bloomberg.

Revenue climbed 1.3 percent to $11.7 billion, boosted by higher sales of the Januvia and Janumet diabetes drugs. Merck has been cutting thousands of jobs and trying to boost demand of existing products to prepare for when asthma treatment Singulair faces cheaper copies in August. Analysts say the focus now turns to the company’s medicines in development after research setbacks in recent years.

“Merck is emerging from a challenging 2011,” said Tony Butler, an analyst with Barclays Capital Inc. in New York, in a April 16 research report. “The stock has been on a path of recovery since last November, but this has been more correlated with the dividend increase and flow into the pharma sector as a whole than a restoration of sentiment around Merck’s innovation core.”

Merck boosted its dividend by 11 percent in November, the first increase since 2004. First-quarter net income in 2011 was $1.04 billion, or 34 cents, when Merck took a $500 million charge to settle a dispute with Johnson & Johnson. (JNJ)

Merck Shares

Merck rose less than 1 percent to $38.57 at 10:11 a.m. New York time. The shares had gained 9.7 percent in the 12 months before today.

Merck reiterated its 2012 forecast for earnings excluding one-time items of $3.75 to $3.85 a share, with net income projected to be $2.04 to $2.30. Revenue this year will be at or near 2011 levels on a constant currency basis, Merck said. At current exchange rates, sales would be hurt by 2 to 3 percent, according to the company.

Sales of Januvia jumped 24 percent to $919 million, while revenue from Janumet surged 29 percent to $392 million. The company’s human papillomavirus vaccine Gardasil increased 33 percent to $284 million.

Merck has five major products in development that the company is focusing on over the next two years. Investors are concerned about Merck’s research operations after the company halted a study of its experimental blood thinner vorapaxar, said Butler.

“Investor reactions toward these five candidates can be described as lukewarm if not cynical,” Butler said in the report. “Operational results in the quarter are unlikely to change sentiment, and we believe that Merck needs to deliver on pipelines to restore enthusiasm towards the stock.”

To contact the reporter on this story: Shannon Pettypiece in New York at spettypiece@bloomberg.net

To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net

 

May 1, 2012 ~ Diabetes Living Today® ~ No Sugar Added® Open Forum

Diabetes Living Today® radio program, provides listeners with education, inspiration and motivation to live healthy and well with diabetes. Whether you have diabetes or know someone who does Diabetes Living Today® radio program offers experience, insight, education and tips to manage life with diabetes. Through interviews, including “World Class” Research Scientist, physicians and people living with diabetes, living well tips and questions from the listening audience, host Kitty Castellini and Endocrinologist Dr. Joseph J. Fallon, Jr. are there every step of the way to offer guidance, advice, and most of all, support.

This week Kitty and Dr. Fallon will host their No Sugar Added®  “Open Forum.”

 

Listen to Diabetes Living Today® :

May 1, 2012 ~ Diabetes Living Today® ~ No Sugar Added® Open Forum

 


April 10, 2012 ~ Diabetes Self Management with Stephanie Smith,Registered Dietitian and Certified Diabetes Educator.

Stephanie Smith, RD, CDE

Stephanie Smith, RD, CDE: Registered Dietitian and Certified Diabetes Educator provides outpatient nutrition counseling at Underwood Memorial Hospital in Woodbury, NJ.  She has provided nutrition care to patients at Underwood Memorial Hospital since 2003.

Stephanie graduated with honors from Messiah College with her Bachelor of Science in Nutrition and Dietetics. She spent time working in community nutrition with the WIC program and moved on to complete her dietetic internship with Sodexho in Philadelphia.

She teaches diabetes self management and nutrition as part of Underwood’s Diabetes program, an American Diabetes Association recognized program.  She also provides nutrition therapy for a variety of nutrition related issues including weight management, gastro intestinal disorders, cardiac, and food allergies.

Listen to Diabetes Living Today® interview:

April 10, 2012 ~ Diabetes Self Management with Stephanie Smith,Registered Dietitian and Certified Diabetes Educator.


 

March 14, 2012 ~ Dr. Leonard Krivy Talks about Diabetes and Transplantation

Dr. Leonard Krivy is a nationally recognized educational consultant, author, broadcaster and newspaper columnist.  In his distinguished career, he’s been a teacher, career counselor, college dean, Director of Philadelphia’s Commission on Higher Education, Executive Director of the College of Allied Health Professions at Hahnemann Medical College, consultant and advisor on education to colleges, labor industry and government.

In recent years he has concentrated on individual counseling; specializing in guiding students to and through college; graduate and professional schools.

He offers unique expertise: detailed first-hand knowledge of educational systems and institutions; developed skills in advanced placement and counseling; and understanding of and an affinity for young people – a combination that affords and unduplicated personalized service.

Over the years, I’ve answered your questions on Schools and Schooling on CBS radio and in my newspaper columns.  I’ve met with numbers of you in my private educational counseling practice, where I specialize in high school; college, graduate and professional school advisement and placement, and in educational and vocational testing.  I also provide complete expert and confidential financial aid counseling for college, graduate and professional school.

For information on the wide range of educational and career planning services offered, or for an appointment, please call

Remember the right guidance is of lifelong importance.  I look forward to helping you.

1765 Fireside Lane
Cherry Hill, NJ  08003

Cherry Hill 856/428-1282
Philadelphia 215/545-1555

FAX 856/428-6910

Email: lpkphd@aol.com

Listen to Diabetes Living Today®

March 14, 2012 ~ Dr. Leonard Krivy Talks about Diabetes and Transplantation


March 13, 2012 ~ Diabetes Living Today® ~ No Sugar Added® Open Forum

Diabetes Living Today® radio program, provides listeners with education, inspiration and motivation to live healthy and well with diabetes. Whether you have diabetes or know someone who does Diabetes Living Today® radio program offers experience, insight, education and tips to manage life with diabetes. Through interviews, including “World Class” Research Scientist, physicians and people living with diabetes, living well tips and questions from the listening audience, host Kitty Castellini and Endocrinologist Dr. Joseph J. Fallon, Jr. are there every step of the way to offer guidance, advice, and most of all, support.

This week Kitty and Dr. Fallon will host their No Sugar

 

Listen to Diabetes Living Today®

March 13, 2012 ~ Diabetes Living Today® ~  No Sugar Added® Open Forum

March 6, 2012 ~ Diabetes Living Today® No Sugar Added® Open Forum

Diabetes Living Today® radio program, provides listeners with education, inspiration and motivation to live healthy and well with diabetes. Whether you have diabetes or know someone who does Diabetes Living Today® radio program offers experience, insight, education and tips to manage life with diabetes. Through interviews, including “World Class” Research Scientist, physicians and people living with diabetes, living well tips and questions from the listening audience, host Kitty Castellini and Endocrinologist Dr. Joseph J. Fallon, Jr. are there every step of the way to offer guidance, advice, and most of all, support.

This week Kitty and Dr. Fallon will host their No Sugar Added®  “Open Forum.”

 

Listen to Diabetes Living Today®

March 6, 2012 ~ Diabetes Living Today® No Sugar Added® Open Forum

February 22, 2012 ~ Cardiologist, Dr. Perry J. Weinstock from Cooper University Hospital on Cardiovascular Disease and Diabetes

Perry J. Weinstock, MD, FACC, FNLA

Perry J. Weinstock, MD, FACC, FNLA is Head of the Division of Cardiovascular Disease, Director of Clinical Cardiology and Deputy Chief of the Department of Medicine at Cooper University Hospital.  Dr. Weinstock was formerly the Director of Clinical Cardiology at Thomas Jefferson University Hospital in Philadelphia, Pennsylvania.

Dr. Weinstock is an Associate Professor of Medicine at UMDNJ/ Robert Wood Johnson Medical School.  He graduated with Honors from Robert Wood Johnson Medical School where he was elected to Alpha Omega Alpha medical honor society.  He then completed his residency in internal medicine and his fellowship in cardiovascular disease at Thomas Jefferson University Hospital in Philadelphia, PA.  He is board certified in internal medicine, cardiovascular disease, and clinical lipidology. His clinical interest is in the area of preventive cardiology and he is a Diplomate of the American Board of Clinical Lipidology and Fellow of the National Lipid Association.  Dr. Weinstock was elected as President-elect of the Board of Directors of the Northeast Lipid Association, a division of the National Lipid Association. He serves on the Editorial Board of the Journal of Clinical Lipidology and is also a reviewer for the American Journal of Cardiology and the Journal of Critical Care Medicine.  He is Past President of the American Heart Association Affiliate in New Jersey and is presently serving on the Board of Directors of this organization.  Dr. Weinstock has served on the State of New Jersey Obesity Prevention Task Force and, in May of 2010, was elected Vice Chair of the State of New Jersey Task Force on Sudden Death in Athletes. He also is Chairman of Cooper University Hospital’s Cardiology Performance Improvement Committee.

Dr. Weinstock is an award winning clinician recognized regionally and nationally for his abilities.  He has been repeatedly named “Top Doc” in every major publication in the region including Philadelphia Magazine, New Jersey Monthly Magazine, South Jersey Magazine and SJ Magazine.  In addition, he has been recognized among the “Best Doctors” in America.  He has been invited to lecture on the subject of dyslipidemia and coronary disease risk reduction throughout the United States and Canada.

Listen to Diabetes Living Today® Interview:

February 22, 2012 ~ Cardiologist, Dr. Perry J. Weinstock from Cooper University Hospital on Cardiovascular Disease and Diabetes

 

 

February 7, 2012 Diabetes Living Today® ~ No Sugar Added® Open Forum

Diabetes Living Today® radio program, provides listeners with education, inspiration and motivation to live healthy and well with diabetes. Whether you have diabetes or know someone who does Diabetes Living Today® radio program offers experience, insight, education and tips to manage life with diabetes. Through interviews, including “World Class” Research Scientist, physicians and people living with diabetes, living well tips and questions from the listening audience, host Kitty Castellini and Endocrinologist Dr. Joseph J. Fallon, Jr. are there every step of the way to offer guidance, advice, and most of all, support.

This week Kitty and Dr. Fallon will host their No Sugar Added®  “Open Forum.”

 

Listen to Diabetes Living Today®

February 7, 2012: Diabetes Living Today® ~ No Sugar Added® Open Forum

 


January 31, 2012 ~ Diabetes Living Today® ~ No Sugar Added® Open Forum

Diabetes Living Today® radio program, provides listeners with education, inspiration and motivation to live healthy and well with diabetes. Whether you have diabetes or know someone who does Diabetes Living Today® radio program offers experience, insight, education and tips to manage life with diabetes. Through interviews, including “World Class” Research Scientist, physicians and people living with diabetes, living well tips and questions from the listening audience, host Kitty Castellini and Endocrinologist Dr. Joseph J. Fallon, Jr. are there every step of the way to offer guidance, advice, and most of all, support.

This week Kitty and Dr. Fallon will host their No Sugar Added®  “Open Forum.”

 

Listen to Diabetes Living Today®

January 31, 2012 ~ Diabetes Living Today® ~ No Sugar Added® Open Forum