DIABETES- SUGAR IS NOT ALWAYS SWEETER!
W L MEDICAL
DIABETES- SUGAR IS NOT ALWAYS SWEETER!
BY CONOR MAGEE MD FRCS, CONSULTANT SURGEON
It is a startling fact that a physician from hundreds of years ago could time-travel to 21st century Wirral and still diagnose diseases we have today. One such disease is diabetes- or to be more precise diabetes mellitus“ the siphoning through of the sweet urine”. Our time-travelling doctor would diagnose diabetes by firstly taking a history- the story of the problem. Typical symptoms such as passing large volumes of urine, tiredness, recurrent skin infections would be noted. Next, they would perform an examination- namely tasting the urine to see if it was sweet. Now- that is something I am glad the 21st century has progressed on!
Diabetes Mellitus is a disorder of blood sugar control- the body is unable to reduce the sugar concentration in the blood- the sugar levels cause vast amounts of urine to be produced hence it’ s name. The high sugar levels also predispose to infection and damage nerves and blood vessels- particularly in the feet, eye and kidneys, leading to foot ulcers and amputation, blindness and kidney failure.
Most people understand that diabetes can occur if the body does not produce the hormone Insulin- it is Insulin that lowers the body’ s blood sugar level and keeps it at a normal concentration. Type 1 diabetes occurs when the body can’ t produce Insulin, patients are usually diagnosed in childhood and it was invariably a fatal disease- a devastating diagnosis for parents and their children. This was recognised by the ancient Greeks who considered life with diabetes to be“ short, disgusting and painful”.
Indeed, it was only in the 1920s that scientists identified Insulin and used it to treat diabetes- a landmark event in medicine that led to the Nobel prize. Countless lives have been saved by Insulin and today patients with type 1 diabetes can expect to lead a normal life. But the surprising thing is the commonest form of diabetes today is type 2 diabetes- unlike type-1 this form of diabetes is caused by the body becoming resistant
to Insulin. Type 2 diabetes is 9 times more common than type- 1! In fact, in the UK there are over 3 million people with type- 2 diabetes. The body doesn’ t care whether it’ s type 1 or type-2 diabetes, the damage is just the same. The difficulty is that as type- 2 diabetes presents more insidiously, more damage can take place before it is diagnosed.
But why are there so many more patients with type-2 diabetes- I’ m afraid the answer is largely in our own hands( or forks to be more precise). Obesity is the single biggest driver for type-2 diabetes, as a nation we are getting fatter. As your BMI creeps up slowly the risk of diabetes increases much, much faster. There are a lot of undiagnosed diabetics out there- if you have a high BMI ask you GP to check your blood sugar, we know that early treatment is the best treatment!
The need for early, effective treatment is reinforced by the sheer cost of diabetes to the NHS. The NHS spends £ 25,000 per minute on treating diabetes. That’ s right- per minute. Imagine burning five hundred £ 50 notes every minute.
Fortunately, surgeons have discovered that there is an operation that can cause type-2 diabetes to go into remission, patients can achieve sugar control without the need for medication. What is truly remarkable is that this is due to a side-effect of the operation we use to make severely obese patients lose weight( an operation called the gastric bypass)- but the magic comes in that the diabetes can disappear even before weight loss takes place!
This form of surgery for type 2 diabetes has been recommended by all the professional diabetes societies and I expect to be very busy over the next few years performing this life-saving surgery! That’ s a lot of information in a short article, I need a cup of tea. One lump or two?
Mr Magee operates at Spire Murrayfield Hospital and can be contacted there. He can be followed on Twitter @ mageefrcs.
wirrallife. com 67