The role of the intestine in type 2 diabetes …

Researchers at the University of Adelaide have discovered that the way the gut ‘tastes’ sweet food may be defective in sufferers of type 2 diabetes, leading to problems with glucose uptake.

This interests me greatly as I have type 2 diabetes. I developed the condition after an operation on an infected Meckel’s Diverticulum necessitated removal of a section of my small intestine. The Meckel’s was undiagnosed for over four years as bleeding from my bowel, noticed by a young hospital doctor prior to an operation on my bladder, was ignored by my then General Practioner. Following the operation, I began to experience unnerving symptoms, most disturbing of which was falling asleep immediately after eating potatoes. Yes, it sounds weird now but at the time it was quite frightening. For some reason, my GP referred me to a hospital clinic that dealt with irritable bowel syndrome. At the clinic my urine was tested; I was told I had glucose in my urine and should report it to my GP. My GP, however, told me I was not nearly fat enough to have diabetes and ignored it. Two years later, the GP retired and another GP was appointed to the practise. I told him about my symptoms, he referred me to a diabetes clinic and type 2 diabetes was diagnosed.

I was told many times that I was not fat enough to have diabetes and I admit that I was quite lean. I certainly did not fit into the classification of a patient who might be considered at risk of diabetes. But if my diabetes was not caused by being overweight what did cause it? This new Australian study may offer an insight. My intestines had been infected for a number of years by the deteriorating condition of the Meckel’s and the operation on the small intestine caused more trauma.

My diabetes has now progressed and I am insulin dependent. It would be interesting to know if my pancreas was affected by the trauma to my intestine or if, once I had the condition, it progressed in a way that would be considered ‘normal’.

Isn’t the human body wonderful – a biological machine that can malfunction in so many ways and needs regular inspections and maintenance by mechanics (doctors and nurses) who actually know what they are doing!


NHS Accident and Emergency Departments

In my experience …

There is nothing wrong with A&E Departments that a full review of incompetent, inefficient and ineffective GP services, particularly focusing on out-of-hours services, could not cure.

Benefits payments and abuse

Benefits payments are not just made to lazy cheats who refuse to work. For some, benefits can mean the difference between barely managing to survive and suicide.

Before the new Pope was inaugurated media headlines seemed full of stories about children who were sexually abused by priests. Of course, priests aren’t the only abusers and sexual abuse isn’t the only way in which children are damaged. Physical and emotional abuse take their toll. And abuse is far more prevalent than we like to admit.

Disability isn’t restricted to physical damage and deformity. One the most depressing aspect of abuse is that abused children often become socially withdrawn adults incapable of living a normal life; abuse can result in apparently normal people being unable to function within society because of their experiences.

Some are so damaged that they find it impossible to trust anyone. They cannot work, they cannot join clubs or societies. They survive by isolating themselves from society, some receiving therapy, some surviving by their own devices because therapy has been unable to help them.

Some can be seen shuffling down the road, unwashed, unkempt. Some manage to keep themselves clean and tidy but as soon as they are faced with having to interact with other people immediately withdraw into their shells.

Of course, some victims can put their abuse behind them and function normally. They can hold down a job, maintain relationships, have families and bring up their own children. Others cannot. For them, benefits aren’t a lifestyle; they are necessary for their very survival.

By lumping everyone on benefits as shirkers, by labelling abuse victims as benefits cheats, politicians like David Cameron and Iain Duncan Smith are causing the suffering of abuse victims to continue, indeed to become far worse. Ans all those who are jumping on the bandwagon and ranting that they shouldn’t have to pay benefits from their taxes are just as culpable, just as guilty as those who committed the original abuse.

Is Adaptation the only Driver of Evolution?

Is Adaptation the only Driver of Evolution?

If evolution is driven by something that allows life to change over mere thousands, or even just hundreds, of years why are species not even more diverse than they are now? What eventually restricts the diversity of life on Earth?

Whether sexual preference selection, autonomous genetic change, temporary epigenetic adaptation eventually influencing long-term genetic adaptation, a combination of all these or something else allows species to evolve, what stops them from evolving beyond a certain point?

Fact is, nothing can survive unless its environment allows it. A human cannot live unsupported in the Antarctic or in the bubbling caldera of a volcano; it is not adapted to survive in such environments. In the end, adaptations that allow species to survive in their natural environment is the endgame.

Asking whether there are influences on evolution other than adaptation by natural selection is just tweaking. Darwin was right about the ultimate influence on evolution: it is the natural environment.

Except for one species, as far as we know, unless individuals of a species fit into their natural environment they are destined for failure. Unless a species can adapt to a changing environment it is destined for extinction. In evolution, the environment is king.

Collateral Damage

David Cameron promised victims of phone hacking that he would instigate the recommendations of the Leveson report as long as they were not ‘bonkers’.

Well, the recommendations have been analysed by many commentators and there is general agreement that they are well-considered and anything but bonkers.

Cameron was also shown during the Leveson inquiry to have had a close relationship with at least one editor and possibly more.

But now Cameron has declared that he will not support any regulation of the media that is based in law.

There is no reason why a law should not be drawn up that lays down minimum levels of acceptable behaviour by the media regarding unwarranted intrusion into the behaviour of others in their private lives but still does not interfere with the freedom of the media to investigate suspicious behaviour that suggests corruption or criminality.

Cameron’s refusal seems to suggest collusion with the media to thwart the promise he made so openly to victims of phone hacking. Has he broken his promise? It looks that way. Does that make Cameron corrupt? Even if he is, I can’t see the lily-livered Lib Dems willing to lose their role in government by voting against him so it looks as if he will get his own, and the media’s way. Unless something drastic happens, it seems that the victims, as usual, will be thrown aside as ‘collateral damage’.

The problems with economic theory

Many economists and politicians become obsessed with a particular theory and lose sight of reality. Too often, economists are trained in the theories of monetarism or government intervention and reject alternatives. They do not like change.

However, the very nature of the competitive economic models on which modern society is based causes constant change. One country finds a way to increase its productivity or invents a new technology and the others are left behind. For the losers it is then necessary to develop new ways to increase their own prosperity, either through increases in productivity or invention of their own new technologies. The competitive economic models decree that there are always winners and losers but they swap and change as they become more or less competitive.

With that ebb and flow comes the need to adapt economic theory to suit the prevailing conditions; by rejecting a particular economic theory, the intransigence of economists and politicians condemns their country to stagnation and demise.

For an economy that is stagnating it is important that government intervenes and increases investment. As the economy improves, private companies take over, government intervention can be decreased and the cost of intervention can be recouped as increased revenue leads to increases in tax revenues.

Over time, the economy inevitably becomes overheated and inflation increases. The need then is for monetary policy to steer the economy, preferably without causing a drop in investor confidence. If confidence drops, investors take flight and the economy begins to deflate or stagnate.

Now, it may be that monetary policy has not caused the reduction in confidence but that the prevailing world economic situation has changed. If monetary policy is not eased correspondingly, further deflation or stagnation results. Eventually a complete reversal is required and government intervention becomes imperative once again.

Similarly, too much government intervention, or an inability to recognise changes in the global economy requiring a change to monetary policies, can cause private investors to scare and deflation and stagnation again results.

The art of economic management lies in being able to recognise and respond to internal and external changes. Obsession with a particular economic theory means that the economy is damaged unnecessarily, a cure not being forthcoming until there is a change in government.

Britain is particularly affected by economic intransigence. It has always produced a plethora of inventors and those willing to risk their money for economic reward in the middle or long term but this has, especially in the last thirty or forty years, been severely damaged by the inability of economists and politicians to adapt to changes in the global economy. This has resulted in a severe loss of confidence and the emergence of short-termism in the minds of investors and business leaders. Politicians try to blame others but the truth is that they are wholly to blame. It is not the fault of one political party; it is the fault of all politicians, no matter what their political inclinations.

So what has changed in recent years that is so damaging? In the past there was one saving grace, the length of a political term. Four years was insufficient time for a particular economic theory to cause lasting damage. However, in recent years there has been a tendency for political parties to remain in office for two or three terms and the extension of the political term to five years bodes ill for the long-term future of the British economy.

Mid Staffordshire Public Inquiry Report Published

Mid Staffordshire Public Inquiry Report Published

I guess everyone must have heard about the report by now. Many patients were left to die in the most horrendous conditions – and this in NHS hospitals.

In some ways this is far worse that the Dr. Harold Shipman affair. Shipman’s patients died because Shipman sought to steal his patients wealth by killing them and altering their wills in his favour. He had a goal in mind and was determined to achieve it. The real fault in the Shipman affair lay with the inspection and regulation of doctors.

The Mid Staffordshire report found that patients died not because they were killed by a criminal who wished to enrich himself. They died because no one cared enough and the system drowned out those who did. Oh, families and friends cared – and they had a right to expect those paid to care while their loved ones were in hospital would ensure they were safe. But too many doctors and too many nurses did not care; managers did not care; health care assistants did not care; those who were expected to monitor and regulate the service did not care.

Of those, the managers, in fact, must come out reasonably well. Managers are not employed to care; managers are employed to look after the figures and to administrate the system. Managers are expected to try to save money and cut the amount of time and expense doctors and nurses require to do their jobs properly. Managers are tyrants with pens and clipboards, computers and slide rules. Managers manage the system; they are not required to manage patients.

Why did doctors not perform their ward rounds properly? Why did nurses not notice the smell of faeces and vomit? Why did health care assistants not notice that meals were being left or that patients were lying in their own excrement? Because they were expected to manage the system. It’s as if everyone wanted to be a chief, no one was prepared to be an Indian.

Will anyone be prosecuted for allowing this dreadful situation? Can’t imagine it myself. Those in authority will attempt to make this disappear as soon as possible. Politicians will promise that systems will change; professional bodies will say that they will ensure training is improved and unions will continue to whine that it wasn’t the fault of their members. In the end the only change will be that bureaucracy will increase and those responsible for the care of patients will be able to hide even further in the woodpile.

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