Five million adults in England 'at risk of diabetes'

By Dominic HughesHealth correspondent, BBC News

• 26 August 2015
 
• From the sectionHealth

Image captionPublic Health England analysed blood-sugar levels to estimate the number of people at risk of developing type-2 diabetes

Up to five million people in England are at risk of developing type-2 diabetes, according to new data from Public Health England.

Type-2 diabetes is closely linked to diet and obesity and affects about 3.2 million people across the UK.

The NHS says diabetes causes 22,000 early deaths and costs the health service more than £8bn each year.

But health experts believe more than a quarter of people can reduce the risk of developing the condition.

Diabetes arises when the body loses the ability to use or make insulin, a hormone that helps regulate the amount of sugar in blood.

Public Health England (PHE) says its latest analysis shows about five million adults in England are now pre-diabetic, also known as non-diabetic hyperglycaemia.

That means they are at risk of developing type-2 diabetes.

Public Health England says its calculations have produced the most accurate and robust estimate so far.

Last year, research published in the British Medical Journal suggested a much higher figure - one third of all adults in England - and the charity Diabetes UK quotes a UK-wide figure of about 18 million people at risk of developing diabetes.

But these calculations used a broader definition of pre-diabetes than that used in this latest analysis.

Some doctors have questioned the value of the pre-diabetic diagnosis, arguing that only a small number - perhaps one in 10 - will go on to develop diabetes.

Diet and exercise

But the NHS is preparing to roll out a diet, weight loss and exercise programme that has been shown to reduce the diabetes risk for a quarter of those who take it up.

PHE chief executive Duncan Selbie said people needed support if they were to combat the risk posed by type-2 diabetes.

"We know how to lower the risk of developing type-2 diabetes: lose weight, exercise and eat healthily, but it's hard to do it alone," he said.

"PHE's evidence review shows that supporting people along the way will help them protect their health, and that's what our prevention programme will do."

Diabetes UK chief executive Barbara Young said it was important to warn people about a condition that could have devastating complications such as blindness, amputations and early death.

"As well as helping to reduce the human cost of type-2 diabetes, this would also go a long way to helping to reduce costs to the NHS," she said.

"The NHS spends 10% of its entire budget managing diabetes And unless we get better at preventing type-2 diabetes, this figure will rise to unsustainable levels."

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• Diabetes cases soar by 60% in past decade

  17 August 2015
• Repeated antibiotic use linked to diabetes

  25 March 2015
• Pre-diabetes label 'worthless', researchers claim

  16 July 2014

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Brain cells 'burn out' in Parkinson's disease

Brain cells in Parkinson's disease exhaust themselves and die prematurely, burning out like an "overheating motor", an early study suggests.

Canadian researchers say the findings might help explain why only small parts of the brain are affected in the disease.

Parkinson's is caused by a loss of nerve cells in certain areas of the brain - but why these cells are vulnerable has been a mystery.

The work appears in Current Biology.

Tremor and stiffness

An estimated 127,000 people in the UK have Parkinson's disease, which can lead to a pronounced tremor, slow movement, and stiff and inflexible muscles.

In this paper, scientists from the University of Montreal studied the disease in mice cells.

They found, unlike other similar brain cells, neurons most often involved in Parkinson's disease were complex and had many more branches.

The cells also had much higher energy requirements, producing more waste products as they met this need.

Researchers suggest it is the accumulation of these waste products that triggers cell death.

Prof Louis-Eric Trudeau said: "Like a motor constantly running at high speed, these neurons need to produce an incredible amount of energy to function.

"They appear to exhaust themselves and die prematurely."

The team hope this finding may help create better experimental models of Parkinson's and identify new treatments.

'Rekindle interest'

They suggest, for example, that medication could one day be developed to help reduce the energy requirement of cells or increase their energy efficiency.

Dr Arthur Roach, at the charity Parkinson's UK, said:"Out of the billions of cells in the brain, it is always the same small group that degenerate and die in Parkinson's. We don't know why only these cells are affected.

"This study provides strong support to the idea that it is the unique structure and function of these cells that makes them especially susceptible to a damaging process called oxidative stress.

"We hope that this study will rekindle interest in the approach, and even lead to new treatments based on the most up-to-date ideas about oxidative stress."

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Blood test 'detects cancer relapse'

By James Gallagher

Health editor, BBC News website

• From the sectionHealth

A blood test may be able to save lives by finding cancers that have started to grow again after treatment, a study suggests.

Scientists at the Institute of Cancer Research in London found traces of breast cancer eight months before doctors would normally have noticed.

In the trial, the test found 12 cancers out of the 15 women who relapsed.

Experts said there was still some way to go before there was a test that could be used in hospitals.

Surgery to remove a tumour is one of the core treatments for cancer.

However, a tumour starts from a single cancerous cell. If parts of the tumour have already spread to another part of the body or the surgeon did not remove it all then the cancer can return.

Relapse

Fifty-five patients who were at high risk of relapse because of the size of the tumour were followed in the study published in Science Translational Medicine.

The scientists analysed the mutated DNA of the tumour and then continued to search the blood for those mutations.

Fifteen patients relapsed and the blood test gave advanced warning of 12 of them.

The other three patients all had cancers that had spread to the brain where the protective blood-brain barrier could have stopped the fragments of the cancer entering the bloodstream.

The test detected cancerous DNA in one patient who has not relapsed.

Image captionCancerous tissue can be detected when it enters the bloodstream

None of the women in the study were told that cancerous material had been detected as it would have been unethical to base decisions on such an unproven prototype.

But the hope is that detecting cancer earlier means treatments including chemotherapy can start sooner and improve the odds of survival.

Dr Nicholas Turner, one of the researchers, told the BBC News website: "The key question is are we identifying that these women are at risk of relapse early enough that we could give treatments that could prevent the relapse?

"That is unknown from this research and we hope to address it in future studies.

"[But] we're really talking about a principle that could potentially be applied to any cancer that has gone through initial treatment for which there's a risk of relapse in the future."

More work needed

The analysis of the blood is relatively cheap. However, investigating the DNA of the tumour for mutations in the first place is still expensive.

The price is coming down as the field of cancer medicine moves from treating tumours in whichever part of the body they are discovered, towards drugs that target specific mutations in tumours.

Dr Nick Peel, from Cancer Research UK, said: "Finding less invasive ways of diagnosing and monitoring cancer is really important and blood samples have emerged as one possible way of gathering crucial information about a patient's disease by fishing for fragments of tumour DNA or rogue cancer cells released into their bloodstream.

"But there is some way to go before this could be developed into a test that doctors could use routinely, and doing so is never simple."

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