Community Voice Health

Dr. Roni Saha

An excellent speaker, a captivated audience and a topical subject all contributed to our successful December meeting, sealed afterwards with mince pies and seasonal drinks.

Dr. Roni Saha is a Darzi Fellow and Senior Registrar in Diabetes, Endocrinology and Medicine at Hillingdon Hospital, so he spoke with authority.  He noted that diabetes is a life-long condition, caused by lack of insulin, a hormone secreted by the pancreas. 

There are two types of diabetes. Type1 hits children and young people, symptoms are  extreme thirst, weight loss, tiredness and excessive urine.  Onset can be swift and quickly fatal.  Immediate treatment with injected insulin is essential.

Around 90% of diabetics have Type 2 diabetes, with older onset and similar milder symptoms, but it may be undetected for years.  It is initially treated by control of diet, lifestyle and tablets.

In 2008 there were 2.5 million diabetics in the country.  Hillingdon has 12,000 diabetics, 6% of the population, which is higher than the national average. Most are cared for by GPs, practice nurses, or by specialist diabetes nurses in the community.

Self-help is important.  Patients can control diet, wound care and lifestyle.  Drinking enough to avoid dehydration is important.  Eating little and often is beneficial.  Eating early in the day is better than a late main meal .  Exercise burns off excess energy.

Doctors have many tools.  Tablets can control liver production of sugar, stimulate production of insulin, encourage muscles to use more sugar, or control appetite.  Insulin can be injected.  There are new treatments, such as surgery to reduce stomach size.  Ongoing research on transplant of pancreatic or stem cells is contentious. Hillingdon is fortunate in having a lot of local expertise.

Patients with high level blood sugar may not feel unwell, but low blood sugar causes dangerous symptoms such as confusion and shakiness – which must be addressed by swift intake of sugar.

Diabetes has serious complications – kidney disease, blindness, infections, foot ulcers, stroke and heart disease, particularly angina.  Long term care is essential for all diabetic patients. 

Quality of care and outcomes vary across London, with many causes - different lifestyles, differences in GPs’ care, different prevalence in racial groups.  In Hillingdon, life expectancy varies by 6 or 7 years.  One in five hospital in-patients has diabetes, so hospital care is a factor too. 

Diabetes UK, a charity, raises awareness and is a great source of information via leaflets and its website, http://www.diabetes.org.uk/  -  Better education is vital.

Comments (0)

Name

Email

Comment

smaller | bigger

Subscribe via email (Registered users only)

I have read and agree to the Terms of Usage.

Add Comment