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.

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.

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.

Supporting local businesses in Deal, Kent

Most of my Christmas presents have been bought online this year. However, while staring at the screen I thought: I really should do more to support my local town centre shops. Why that thought should have popped into my head I have no idea but it seemed a good one.

I have a number of health issues that cause me problems, especially when going out. The worst of them is Rheumatoid Autoimmune Disease. It used to be called Rheumatoid Arthritis but the name has changed recently. My hands are turning outwards, fingers are bent and even with medication they are painful so a trip into town isn’t a decision made lightly. But, I thought, yes, it is important to support local businesses so off I went.

I have a little car with a few adaptations which make driving easy, so that is no problem. I’d be housebound without the support of Motability, mind. Finding a parking space is usually not a problem as Dover District Council has provided disabled parking bays. I must admit to being somewhat peeved when I see people park in disabled bays then jump out of their cars and hurry into the town. I would love to be able to hurry but, well, that’s life, isn’t it?

Anyway, I hobbled my slow way into the town centre. One of the presents I needed was a pair of quality jeans promised to a relative. I made my way to Marks and Spencers but the jeans were in such a muddle it was too painful to lift them to see the sizes clearly. All the staff were busy so I gave up and left the store. There used to be a menswear shop in the town, John’s Menswear, where staff were always pleased to help but that has gone now, like so many of the little shops.

I also needed some women’s toiletries so I made my way into Superdrug. Searching the rows of toiletries and so-called perfumes, I was approached by a member of staff who asked: ‘Do you need any help?’ I declined, saying that I was just looking, thanks. She then hung around and I felt as if I was being watched in case I stole something. Maybe she felt she was there for me if I did need help but that wasn’t the impression I got. Mind you, I hadn’t been completely honest. My thoughts when she asked if she could help went something along the lines of: I could get far better products online paying not much more than the rubbish you have available here.

So, another failure. Next I called at a small, local shop. I didn’t notice the name. I found what I wanted and as I went to pay tried engaging the member of staff in polite conversation. The disinterest was as apparent as the mobile phone she had been speaking into before I went to the till. I shall not be going there again.

What a contrast I found when I went into a small shop called Lynda’s. Many years ago it was called Lynda’s Drug Store and I still know it by that name. The staff were polite and helpful and chatted away in a very friendly manner. They quickly found what I wanted. It’s a great pleasure to do business in a shop like that.

Next I called into Poundland, a truly horrifying experience. The queue was long and there were no seats. After an interminable length of time, I gave up, put the product back on its shelf and left without buying anything.

By this time I was exhausted, cold, in pain and felt thoroughly deflated. Only my visit to Lynda’s gave me any hope, but not enough. I shall not be returning to Deal town centre in the near future and definitely not for shopping. Why should I when I can get everything I need from the comfort of home, the majority of products arriving within a day or two at the most. Local town centres? You can keep them.