Carbs fall out of favour for diabetics
‘Since the advice to eat more fruit and carbohydrates, type 2 diabetes has increased threefold’
Sensible people take no notice of expert advice about what they should or should not eat, secure in the knowledge that the latest fad will eventually be shown to be false. There is, however, one group for whom that advice, first promulgated exactly 35 years ago, has proved disastrous. Maturity onset (or type 2) diabetes is, as we all know, a condition of carbohydrate intolerance where either the pancreas produces insufficient insulin for the body’s needs, or the tissues are resistant to its action. Either way, the body’s metabolism can no longer utilise the sugars in carbohydrate-based foods, the levels of glucose in the blood rise and the unused energy is laid down as fat.
Thus, historically, those with type 2 diabetes were advised to restrict the amount of bread, pasta, potatoes, etc, consumed in favour of meat and dairy products. This dietary regime combined with weight loss was often sufficient to restore their blood sugar levels to normal. Then, back in 1982, an alliance of influential nutritionists and epidemiologists reversed this logical advice on the grounds that meat and dairy products contain wicked saturated fats that push up the cholesterol, causing tens of thousands of premature deaths from a heart attack.
Those with type 2 are particularly prone to heart disease and so it was decreed that they, too, should abjure meat and dairy products, eat lots of “healthy” fruit and carbohydrates instead, and take pills to control their blood sugar. Consequently, since then the prevalence of type 2 has increased threefold. Many people with the disease, being overweight, have considerable difficulty in controlling their condition – and the cost of treating diabetes has soared. A catastrophe indeed.
Since saturated fat has been exonerated from causing heart disease, wiser counsels are beginning to prevail. While it is understandable that those responsible are reluctant to admit they might have been wrong, the pressure group Diabetes UK, which initiated those dietary changes three decades ago, has recently and, without fanfare, changed the advice on its website from commending “five to 14 portions of starchy foods a day” to “you may need to reduce your carb intake”.
Chilli treatment
The gentleman recently featured in this column who is much discomforted by a peripatetic “Chinese burn” sensation in his back, worse when lying down, has prompted a couple of plausible explanations. Retired dermatologist David Murray notes this burning, stinging sensation is typical of notalgia paresthetica (from the Greek notos meaning back, algia meaning pain) first described by a St Petersburg neurologist in 1934 and caused by inflammation of the sensory nerves as they exit the thoracic spine. This may sometimes be a mechanical problem that improves with osteopathic manipulation, but it responds best to treatment with capsaicin cream, derived from chillis. Alternatively, if less likely, it is suggested this could be a variation of post-herpetic neuralgia that may occur in the absence of the typical shingles rash. Weighing in: the advice for a type 2 diabetes diet has quietly changed
Hearing loss
There is no easier, and certainly no more successful, medical procedure than syringing the ears of wax by using a fine stream of warm water under pressure. It takes no more than 10 minutes, and the doctor or nurse is more than rewarded by the patient’s thanks for having their hearing so dramatically restored.
But no more. Surgeries in Hampshire and Surrey, and probably elsewhere, have started charging for this service – one ear £50, two ears £75 – or they suggest that their patients go elsewhere to have it done for a similarly extortionate fee.
“I am 85 years old and on a fixed income,” writes one woman who was “fobbed off ” with the excuse that the equipment was broken.
The depressing implications of this small but significant privatisation for doctors’ perception of their “duty of care” needs no elaboration.