Dashboard

E-Commentary


Sponsored

Richard Lane, former President of DUK, describes the significant improvements in diabetes education since he was first diagnosed in the 1970s, and briefly describes DAFNE (Dose Adjustment For Normal Eating), one of the official UK adult courses for managing type-1 diabetes. Also, a patient with type-1 describes how helpful she found some voluntary diabetes educational courses.

view in full page
joined 10 years, 11 months ago

Rajiv Dhir

Deputy Chief Pharmacist, Wandsworth Clinical Commissioning Group; Clinical Champion, Diabetes UK

Rajiv Dhir is a pharmacist who works as Deputy Chief Pharmacist at Wandsworth Clinical Commissioning Group (CCG), London. He is also a Clinical Champion for Diabetes UK.

Since graduation from University of Brighton in 1993, he has held a variety of positions mainly in Primary Care. After completion of his pre-registration training at Boots the Chemists, he continued working there gaining more experience in different roles (relief pharmacist, store manager and Professional Development Pharmacist). In 1999, he completed his post-graduate diploma in Clininal Pharmacy and was awarded a distinction.

Rajiv has been a pharmacist for over 24 years. He started his career working in community pharmacy before working in various roles in primary care, before taking on a role as Deputy Chief Pharmacist at Wandsworth Clinical Commissioning Group. The main focus of this role is to maximise benefit and minimise risk associated with medicines, as well as making the best use of resources allocated for prescribing.

Rajiv has a specific interest in diabetes and has completed diploma level modules on diabetes in primary care at Kings College London. Being a member of the various local diabetes committees allows him to develop and shape policies to help patients and clinicians manage Type 2 diabetes. Recently he has been involved with working with GPs and nurses to overcome barriers to optimising treatment in patients with poorly controlled diabetes. The role involves engaging with healthcare professionals across all sectors, as well as with patients, to make a positive impact on patient care.

In his role as one of Diabetes UK Clinical Champions, Rajiv looks at prescribing in the frail and elderly population with Type 2 diabetes. The aim of the project is to reduce the risk of hypoglycaemia and treatment-related harm, for example fall-related fractures, and improve the quality of life for people with moderate or severe frailty.


view this profile
joined 10 years, 11 months ago

Roni Sharvanu Saha

Consultant in Acute Medicine, Diabetes and Endocrinology

Dr Roni Sharvanu Saha is a consultant in acute medicine, diabetes and endocrinology in the Acute Medical Unit at St George's Hospital, London.


view this profile
joined 10 years, 11 months ago

Sachin Patel

General Practitioner

Dr Patel is a GP Principal in West Wandsworth. He looks after a large and diverse diabetic population in Putney & Roehampton and is the lead GP for diabetes at Mayfield Surgery.

He has completed post graduate training in diabetes and is the Clinical Diabetic lead for West Wandsworth on the clinical reference group for Wandsworth CCG.


view this profile

 

 
What causes breast and oral cancer, heart disease, strokes, liver cirrhosis, depression, memory impairment and reduced fertility? . . . . . . . . Alcohol.

More dangerous than heroine

NHS figures show that alcohol related hospital admissions peaked in 2010 when over a million people were admitted. Alcohol Concern predicts that by 2015, the annual number of hospital admissions due to alcohol will reach 1.5m, and cost the NHS £3.7bn a year. A 2010 study in The Lancet suggests that alcohol is more dangerous than heroine. A study by the Independent Scientific Committee on Drugs agrees, and ranks alcohol as three times more harmful than cocaine or tobacco.

The WHO's 2014 Global Status Report on Alcohol and Health said that in 2012 there were 3.3m alcohol related deaths worldwide, and called on governments to implement policies to reduce the harmful use of alcohol.
 
 
˜Yes minister" government response
The UK government guidelines on drinking are being reviewed. Currently, they suggest hat a women should not drink more than two to three units of alcohol per day, and a man three to four units. But medical experts argue that people don't realise how much they're drinking.

Liver
Although the toxicity of alcohol is complex, there's a significant relationship between the greater the alcohol intake per week, and the greater the liver damage.  Over the past 25 years, UK deaths from liver disease have increased by 500%; the overwhelming majority alcohol related. Only in the last few years has this increase slowed. Alcohol has a bigger impact than smoking on health because alcohol kills at a younger age. The average age of death for someone with alcoholic liver disease is their 40s.

Heart
Moderate alcohol consumption raises good cholesterol, stops the formation of blood clots in the arteries, and helps protect against heart disease. Drinking more than three drinks a day has a direct and damaging effect on the heart. Heavy drinking, particularly over time, can lead to high blood pressure, alcoholic cardiomyopathy, congestive heart failure and stroke. Heavy drinking also puts more fat into the circulation of the body, which is dangerous for the heart.
 
Cancer
The link between alcohol and cancer is well established. Cancer occurs when DNA is altered. Acetaldehyde is a toxic created when alcohol in the liver is broken down by an enzyme, and has been shown to damage DNA. When you drink, the acetaldehyde corrupts DNA. One of the most common genetic defects in man is our inability to counteract the toxicity of alcohol.
 
A 2011 study published in the British Journal of Medicine estimates that alcohol consumption causes at least 13,000 cancer cases in the UK each year. Cancer experts say that for every additional 10g per day of alcohol drunk, the risk of breast cancer increases by approximately seven to 12%.

Other conditions
Studies also show that increasing alcohol intake by 100g per week increases bowel cancer risk by 19%. A recent report in BioMed Central's Immunology Journal found that alcohol impairs the body's ability to fight off viral infections. Studies on fertility suggest that even light drinking can make women less likely to conceive while heavy drinking in men can lower sperm quality and quantity.

Takeaway
It's time for governments to implement policies to reduce the harmful effects of alcohol.
view in full page