Diabetes-related Complications

Ronnie Cowan Excerpts

Tuesday 7th June 2016 Westminster Hall

[Ronnie Cowan (Inverclyde) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Pritchard. I thank the hon. Member for Dewsbury (Paula Sherriff) for securing this debate.

I unashamedly turned to a much more informed source of information than me while putting this speech together. My sister, Linda Irvine, has been an insulin-dependent diabetic for 36 years. She knows the system inside out and has experienced the good and the bad of the NHS. In that time, she has seen many changes in the treatments provided. In 1980, she was fortunate to be diagnosed on what she considered the cusp of change. She had been subjected to horror stories of painful injections and severe restrictions in diet, along with a lack of understanding from doctors and nurses not familiar with the medical condition. In those days, injections were delivered in glass syringes with barbaric steel needles, which had to be kept steeped in methylated spirit and which obviously restricted away from home activities. Insulin was bovine or porcine and the peak effect of it was three to four hours after administration, making the timing of meals a bit of guesswork.

Shortly after my sister’s diagnosis, a new synthetic form of insulin, termed human insulin, was laboratory-developed. That made it cheaper to produce in larger quantities. From 1982, human insulin started to replace animal insulin as the primary treatment. It was developed further in the 1990s and now starts to take effect within 30 minutes of injection, making control of blood sugars more predictable. Syringes also became plastic, smaller and had finer needles: much easier to carry on you if you were out. Syringes have now been replaced by pre-loaded pens that are much more convenient and easier to draw up.

The introduction of insulin pumps is also an increasingly available initiative that Linda benefited from during her last two pregnancies, but she was unable to keep them because of an allergic reaction to the needle. She was not born lucky. Food was also a big problem in those days, with no light or sugar-free options on the market and diabetic drinks or biscuits available only in chemist shops. They were overpriced and frequently unpalatable. Nowadays, there are many options and most are readily available in high street stores.

We might think that nowadays it is all plain sailing, but unfortunately it is not. Diabetes complicates life immeasurably. It takes the spontaneity out of everyday activities, particularly with children and grandchildren. “Can we go to the park?” “Wait till I’ve checked my blood sugar.” “Can we go swimming?” “I need something to eat first.” “Why do we have to leave? We’ve only just got here.” “I’m due a meal soon.” On occasions, after she had injected, usually in a public toilet, and when the restaurant service was very slow, she would slip into a hypo. “Why are you sliding down the seat, mum, and heading for the floor?” It is not only mums who suffer from diabetes. All four of my sister’s children were able to dial 999 and tell the operator that she was diabetic by the age of three.

If we are leaving the house now, Linda carries a large bag with two insulin pens, needles, blood monitor, testing strips, lancets, a bottle of Lucozade—other drinks are available—and some kind of carbohydrate such as a packet of crisps or a sandwich to have in case her blood sugars go too low. She always carries a card explaining that she has diabetes and two emergency phone numbers in case she collapses.

Travelling abroad through different time zones can really complicate matters, too—not to mention the embarrassment of carrying syringes through airport security. As for dietary requirements on airlines—don’t go there. Of course, another area of concern is driving. As with most medical problems, insurance is always steeper and more complicated, DVLA requirements more stringent, and licences harder to acquire and keep.

What does my sister have to look forward to? The long-term problems of diabetes are well documented: cardiovascular disease, kidney damage, foot problems, eye disease, nerve damage, tooth and gum disease, thyroid problems, skin problems, constant infections and, unsurprisingly, mental health issues. It is therefore a cause close to Linda’s heart that the treatment of children with type 1 diabetes should be as up-to-date as possible, to ensure that their exposure to long-term problems is minimised.

Linda is now waiting for a kidney and pancreas transplant. Current research involves stem cell transplantation and chimera pigs where embryos are created with organs hopefully compatible for human transplant. Of course that is controversial and raises all kinds of ethical questions. But what if it was your child? What if it was your sister?