Newspaper article The Evening Standard (London, England)

Diabetes Jab Won't Halt the Epidemic; MEDICAL NOTES

Newspaper article The Evening Standard (London, England)

Diabetes Jab Won't Halt the Epidemic; MEDICAL NOTES

Article excerpt

Byline: DR MARK PORTER

YESTERDAY'S announcement that British scientists are about to start testing a new vaccine against diabetes is an exciting development, but one that I fear is unlikely to halt an epidemic that is predicted to consume a tenth of the NHS budget by 2011.

The vaccine, due to start human trials next summer, is designed to protect against the most serious form of the condition - type-one diabetes - which usually strikes early in life and is caused by irreversible damage to insulin producing cells in the pancreas.

The exact cause of the damage remains unclear, but it is thought to be due to a combination of genetic predisposition and an environmental trigger, such as viral infection. The vaccine blocks this process and, if trials prove successful, could be used to protect those at most risk of developing diabetes (with a strong family history), and to slow progression of the disease in people who are newly diagnosed.

Unfortunately, type one is the least common. The recent explosion has been in type-two diabetes, which typically starts in middle age and is associated with weight. The pancreas still functions normally, but either can't meet the everincreasing demands of an obese body, or is thwarted by changes in the tissues which reduce the potency of the insulin it produces ("insulin resistance").

Nine out of 10 of the 1.8 million people known to have diabetes in the UK have type two, and numbers are growing rapidly - up 400,000 in the past eight years. More worrying still are the million or so people in the early stages of type-two diabetes but don't know it. The longer the condition remains untreated, the more likely it is to lead to long-term complications such as stroke, heart attack, kidney damage and blindness.

Not everyone with type-two diabetes is overweight, but the vast majority are, and a healthy diet and exercise regime will do more to stem the epidemic than any vaccine - particularly for the following high-risk groups: .Women with abnormally high sugar levels during pregnancy.

. The overweight - obese women are nearly 30 times more likely to develop type-two diabetes than women of a healthy weight.

. Men and women who carry their weight around their midriff (known as "apples"). Men should try to maintain a waist measurement of less than 36ins, and women less than 32ins.

. Anyone with a family history of the condition - type-two diabetes is partly genetic, too.

.Those of African-Caribbean or South-Asian descent, in whom the condition is up to five times more common.

Early telltale signs of diabetes include lack of energy, excessive thirst, needing to pass water more often, blurred vision and/or troublesome minor infections such as thrush. For more advice and information on diagnosis and treatment visit www. …

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