Health: Diabetes

Baroness Masham of Ilton Excerpts

Thursday 2nd July 2015 Lords Chamber

[Baroness Masham of Ilton (CB)]

My Lords, I thank the noble Lord, Lord Harrison, for initiating this debate. I consider him an expert on this subject. If one has a long-term condition, one knows at first hand the ins and outs of the condition and, if one accepts the situation, one knows how important it is to look after oneself to the best of one’s ability, but not everybody who has diabetes is like the noble Lord. Many people deny having it and are fearful that it will interfere with their life, their job and their insurance.

My husband was found to have type 2 diabetes after he had a stroke. It was never decided whether the stroke triggered the diabetes or the diabetes triggered the stroke. It was not an easy time because my husband loved food, such as ice cream. I found a place which made wonderful ice cream, and some of it was specially made for diabetics. Are these special foods suitable for diabetics? I hear it is debatable.

One of my friends in your Lordships’ House went for an occupational health check up and it was found that he is diabetic. It was suggested that he went for a teaching session at St Thomas’ Hospital, but his GP said that it was not necessary and that he would see to it. The receptionist was difficult about making a suitable appointment, and the result is that he has not had proper advice and is not testing himself.

I cannot stress enough the need for prevention if at all possible as diabetes is complex and needs careful attention as it progresses. It is important that NHS England sees that CCGs are looking after their diabetic patients. The situation for the NHS is chronic. In the UK, there are currently 3.2 million people living with diabetes, which costs the NHS £10 billion in direct costs and £23 billion in indirect costs. One in seven hospital beds is occupied by a diabetes patient. By 2025, the estimate suggests that there will be 4 million people living with diabetes. NHS England recently launched the national obesity and diabetes prevention programme. It is a joint initiative between NHS England, Public Health England and Diabetes UK and aims significantly to reduce the 4 million people in England expected to have type 2 diabetes by 2025. It is good news that these bodies are working together instead of struggling in isolation. If all patients were able properly to manage their condition, many complications could be avoided.

Just think of having diabetes and suffering from dementia. One in four people admitted to hospital with heart failure, a heart attack or a stroke has diabetes, and every week there are 100 amputations as a result of diabetic complications. It is clear that the condition is not always managed properly. I have seen various numbers about amputations across England in the research done by the All-Party Group for Vascular Disease. Care is very patchy across the county. Will the Government try to improve the treatment and results of poor hospitals so they reach the standards of the best? There should be a national standard across the country. In London, at hospitals such as St Thomas’ and King’s College Hospital at Denmark Hill, the results are good, while in the West Country and some places in the north the results are poor. There are elements of a patient’s regime which should be managed and balanced: food, exercise, the correct medication and no smoking.

If a person is on insulin, they will know that different types of insulin can act very differently in different people. Insulin regimes suitable for individual patients are tailored by diabetic care teams and are different for both type 1 and type 2 patients, as they have separate needs. I found, with my husband’s different complications, that the specialist diabetic nurse was invaluable. Things could get very complicated, and being able to telephone and get advice was very important. I only wish that all health trusts realised how important specialist nurses are for specialised conditions, of which there are many.

It is good that technology is improving and is now available so that patients can gain an instant reading of their glucose levels. Any programme of education for people with diabetes should include information and an explanation about the different technologies and treatment options available.

Ongoing research is so important for these costly long-term conditions. I read recently that type I diabetes can be reversed with a cheap and effective inoculation that has been used to treat tuberculosis for a century. Will the Minister look into this and perhaps write to us about it so that we know whether it is accurate? It would be good news for patients, but it must be accurate otherwise their hopes may be raised falsely.

Yesterday, I met Ben Moody from the Juvenile Diabetes Research Foundation, Dr Martin Tauschmann and Dr Hood Thabit, who are part of a team at the University of Cambridge doing work on the artificial pancreas, which connects an insulin pump to a continuous glucose monitor so that it automatically delivers just the right amount of insulin at just the right time. It would take away a lot of the burden for type 1 diabetes, as people with type 1 might do six to 10 injections, and a similar number of finger-prick blood checks, a day. They have to count carbohydrates in every meal and cannot exercise, eat or drive without taking into account the effect of their condition. It is positive and good that experts are working to improve the lives of people with diabetes, which is an increasing worldwide problem.