Early detection - Closed

We hear how much diabetics cost the NHS in terms of money, complications and now, as a percentage of the whole bill, however the cost of the simple finger tip blood test is minimal to say the least. Our chemists are taking on the role - free of charge. They, of course, see that increased drug dispensing will pay for the up front cost, the NHS is prepared to pick up the high longer term bill but will not pay the lower price for early detection.

My example appears far more common than current thinking would allow. At 45 with healthy diet, not over weight, regular exercise, not a heavy drinker, non smoker presenting regular ongoing symptoms to my GP:- infections taking a long time to clear up, impotence, skin rashes and a family history of diabetes - my 75 year old Father had recently being diagnosed type 2 - I was not diagnosed until a urine sample at the hospital where I was being investigated for a possible tumor in the lung (which turned out to be an abcess)showed high sugar content, next day confirmed by blood test to be diabetes. The severity of the abcess was due to the undiagnosed diabetes and resulted in major lung surgery,

I now at the age of 48 have heart failure, an apical thrombosis in the heart, retinopathy, impotence, poor circulation and reduced lung capacity. I am consdered to be one of the higher maintenance patients at my local practice.

Because I was initially considered too young and didn't fit the perceived profile the test was not carried out - until in my opinion it was too late. I was already seriously unwell and it is believed that I had been diabetic for up to five years.

I can see no justification for not testing everyone regularly from the age of 40, rather than waiting until they are 65 or older when, given current trends, it will be too late.

There are a couple of issues that we need to get right about diabetic screening.

The single blood test will miss many diabetics and those with glucose intolerance.

Glucose tolerance tests are time consuming and inconvenient for simple screening purposes.

In the USA a more successful method that combines the accuracy of the GTT with the convenience of the single blood test has been developed.

In this, the patient eats a wafer biscuit of a certain dose of carbohydrate and then gets a blood test one hour later. If the blood sugar is 7.8 or more they have some sort of glucose metabolism problem.

Remember that the criteria set for diabetes has been artificially set too low for resources reasons. If you have "just" glucose intolerance you are still at risk of diabetic complications. It will just take a bit longer to get them.

So, if the screening method is altered you will pick up more people with glucose metabolism problems.

If you are ill advised enough to put that person on a high carbohydrate/low fat diet as currently goes on what will happen?

Ironically, the glucose intolerant will worsen their blood sugars and wear out their pancreatic beta cells even faster than on a more balanced diet. This puts them at even more risk of complications and a diabetic diagnosis than if they had not been detected in the first place.

It has been found that the drug metformin reduces the progression of glucose intolerance to diabetes by 30%. If you have a "diagnosis" of type 2 diabetes in this country you get given metformin and free prescriptions.

I suggest stop messing about and give those with glucose intolerance access to metformin and advice that will prevent rather than accelerate the so called "disease progression" to diabetes.

I think Diabetes UK has done well in highlighting the massive problem of undetected and undiagnosed Type 2 Diabetes. The numbers are frightening and I feel that the Health Service may be heading for melt down if this issue is not taken seriously and measures put in place to identify undiagnosed diabetics.

In tandem with the detection message ther also needs to be a healthy lifestyle message coming through. If more could be done to prevent or delay the onset of type 2 diabetes by people taking more exercise, eating a healthy balanced "diet" and aiming to achieve a healthy BMI then there will be less of a strain on the Health Service in later years. Reducing the risk of Type 2 diabetes and of complication caused by undetected diabetes will save the NHS a fortune in procedures and treatments of diabetic comiplications.

I think that government should fund yearly workplace health checks where healthy lifestyle messages and the risks of diabetes are included along with checks for diabetes and other health risks. This workplace assessment cost could actually save the NHS money in the long run. But hey what do I know?

I was diagnosed early as a result of consulting my GP about pains in my thighs. As a result of the early diagnosis I have been able to educate myself [with my GP's assistance and the internet] and two years down the line I am stable with no diabetic complications. My health is better than I anticipated pre diagnosis and I have secured a good employment. The future for me is positive and bright. I am one of the lucky ones.

I believe that those deemd to be in high risk groups should automatically be screened [GIT]as a matter of routine as is the case for Breast Cancer / smears etc. Early detection of a liklihood of developing diabetes will give many the chance to make adjustments to their lifestyles and offset the development of T2 diabeteas much earlier. The cost of routine screening will inevitably be recovered as the incidence of T2 development is 'delayed/offset'.

Had I been aware that [and I presume here] that at some point in the past I was in fact on the wrong side of a GIT then given an education on what diabeteas means and is then I would certainly have altered my lifestyle towards a more sensible format.

Fear is a big motivator and given enough fear, the general population will for the most part respond in a positive way. Give them the education and the fear will disappear.

The big problem with government and those institutions that rule our everyday lives is that they continually make the mistake that the average person on the street is not capable of understanding complicated issues.