How a £6 blood test could end daily in­sulin in­jec­tions

Scottish Daily Mail - - News - By Kate Fos­ter Scottish Health Ed­i­tor

A SIM­PLE blood test could al­low some pa­tients with di­a­betes to come off their gru­elling regime of daily in­sulin in­jec­tions.

Doc­tors say the test has found that some pa­tients di­ag­nosed with type 1 di­a­betes could be treated with tablets in­stead.

The find­ing could rev­o­lu­tionise the lives of many who are on a ‘mis­er­able’ regime of mul­ti­ple daily blood tests and in­jec­tions.

Doc­tors at the Western Gen­eral Hos­pi­tal in Ed­in­burgh, who made the dis­cov­ery, say all pa­tients di­ag­nosed with type 1 di­a­betes should be given the sim­ple £6 screen­ing test.

And they are hope­ful it will soon be rolled out across Scot­land.

The dis­cov­ery came when a pa­tient at the hos­pi­tal’s Meta­bolic Unit, who had been pre­vi­ously di­ag­nosed with type 1 di­a­betes, was ac­tu­ally found to have a rare ge­netic form of the con­di­tion in­stead.

This was only picked up when the clinic in­tro­duced a C-pep­tide blood test into its screen­ing, which mea­sures how much in­sulin pa­tients are pro­duc­ing.

The doc­tors found she was pro­duc­ing a small amount of in­sulin that could be boosted with tablets in­stead of in­jec­tions.

The ‘sur­prise’ dis­cov­ery led the clinic to screen hun­dreds more pa­tients pre­vi­ously di­ag­nosed with type 1 di­a­betes, and sev­eral were found to have forms of di­a­betes that meant they could be treated with tablets.

Around seven of the 400 pa­tients screened have been able to com­pletely come off in­sulin, and doc­tors ex­pect more will fol­low.

The clinic is un­der­stood to be the first in the UK to have used the test to rou­tinely screen all of its pa­tients in this way.

Pro­fes­sor Mark Stra­chan, a con­sul­tant in di­a­betes and en­docrinol­ogy at the Western Gen­eral Hos­pi­tal, be­lieves thou­sands of pa­tients di­ag­nosed with type 1 di­a­betes across the UK could take tablets in­stead of in­sulin.

He said: ‘Type 1 di­a­betes re­ally is a mis­er­able con­di­tion and pa­tients have to have in­jec­tions ev­ery day, or use an in­sulin pump, and do fin­ger­prick blood tests. It is very re­stric­tive.

‘I be­lieve ev­ery­one who has

been di­ag­nosed with type 1 di­a­betes should have this test. Most of them will still need to take in­sulin but hun­dreds of peo­ple across Scot­land, and thou­sands across the UK, may not.’

In type 1 di­a­betes, the body’s im­mune sys­tem at­tacks the cells of the pan­creas that make in­sulin, which means pa­tients need to have reg­u­lar in­sulin in­jec­tions.

In some rare ge­netic forms of di­a­betes, the pan­creas is not able to pro­duce enough in­sulin but tablets can boost pro­duc­tion.

Some pa­tients with type 1 di­a­betes, par­tic­u­larly those di­ag­nosed many years ago, may ac­tu­ally have type 2 di­a­betes, or a rare ge­netic form of the dis­ease, or even a dif­fer­ent form of type 1 di­a­betes which means they are still pro­duc­ing in­sulin. These groups are the pa­tients the screen­ing test can de­tect.

Type 2 di­a­betes, which is linked with obe­sity, is the com­mon­est form of the con­di­tion, af­fect­ing about 87 per cent of the es­ti­mated 250,000 Scots with the con­di­tion.

The ma­jor­ity of the re­main­der have type 1 di­a­betes, which is caused by a fault in the body’s im­mune sys­tem which leads it to kill the vi­tal cells in the pan­creas. But some pa­tients have rare forms of di­a­betes, where a ge­netic ab­nor­mal­ity means they are not able to pro­duce enough in­sulin.

Dr Emily Burns, head of re­search com­mu­ni­ca­tions at Di­a­betes UK, said: ‘Dif­fer­ent forms of di­a­betes can be dif­fi­cult to ac­cu­rately di­ag­nose ev­ery time. Tests are avail­able to spot rare forms of di­a­betes, or to iden­tify mis­di­ag­no­sis, which can be life-chang­ing for a per­son.’

A Scottish Gov­ern­ment spokesman said: ‘Ac­cu­rate di­ag­no­sis and treat­ment of di­a­betes are key pri­or­i­ties for the Scottish Gov­ern­ment.

‘We are con­sid­er­ing the re­sults found from the work un­der­taken in Ed­in­burgh and the im­pli­ca­tions of wider use in Scot­land.’

‘Hard to di­ag­nose ac­cu­rately’

Pa­tients: ‘Mis­er­able’ rou­tine

Pro­vid­ing a help­ing hand: Josh Lit­tle­john at the So­cial Bite Vil­lage in Gran­ton

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