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Diabetes prescriptions now cost NHS £1bn, figures show

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Diabetes prescriptions are costing the NHS in England ..

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Diabetes prescriptions are costing the NHS in England more than £1 billion a year, according to figures from NHS Digital.

The total cost of the prescriptions has risen significantly – by more than £422 million – in the last 10 years.

Almost one in 20 prescriptions written by GPs are now for diabetes treatment.

The biggest increases are seen in treatments for type 2 diabetes, which affects around 90% of diabetes patients.

Robin Hewings, head of policy at the charity Diabetes UK, said the figures reflect a dramatic rise in the incidence of diabetes.

"The number of people diagnosed with diabetes has doubled in the last 20 years, and it is responsible for 26,000 early deaths per year alongside serious complications such as blindness, amputation or stroke.

"This data shows that diabetes prescribing costs £1bn, but it is estimated that the total cost to the NHS is over £10bn a year, so the real price we have to pay for diabetes is not medications, but the devastating and expensive complications."

Mr Hewings pointed out that drug costs have not risen significantly during this period, and that the increase in prescribing costs is largely a result of the rise in prevalence of type 2 diabetes.

The rise in diabetes

  • There are now over three million people in England with a diagnosis of diabetes. The number has doubled over the last two decades and there are nearly 100,000 diagnoses per year.
  • 92% of recorded diagnoses of diabetes relate to type 2 diabetes. Type 2 diabetes, unlike type 1, is closely linked to lifestyle factors and is preventable through lifestyle change.
  • Almost seven out of 10 men are overweight or obese (66.8%) and almost six out of 10 women are overweight or obese (57.8%) in England.

Source: NHS England

Type 2 diabetes is caused by the body not producing enough insulin, or by the body's cells not reacting to the insulin that is present, resulting in high blood sugar.

It may be controlled by diet, or by antidiabetic drugs or insulin, or both.

Type 2 is caused by a variety of factors, some of which are out of people's control, but more than 80 percent is caused by obesity or being overweight.

In overweight and obese people, type 2 diabetes can be prevented and reversed by losing weight.

The NHS England figures also include the cost of devices used by people with diabetes to monitor their condition.

Nearly £477 million was spent on antidiabetic drugs in 2017-18. Over the same year, around £350 million was spent on insulin, and £181 million on diagnostic and monitoring devices.

Professor Jonathan Valabhji, national clinical director for diabetes and obesity at NHS England, said: "Thanks to better diagnosis and treatment, the NHS is caring for more people than ever before with diabetes, and this new data highlights the urgent need to prevent type 2 diabetes from developing in the first place.

"The NHS Diabetes Prevention Programme has now reached over a quarter of a million people at high risk of type 2 diabetes."

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NHS ‘should not prescribe acne drug’

The parents of young people who have killed themselves and patients unable to have sex are calling f..

The parents of young people who have killed themselves and patients unable to have sex are calling for the NHS to stop prescribing acne drug Roaccutane.

Ed Henthorn said it had caused him erectile dysfunction, psychosis and suicidal thoughts.

And one man who believes his son killed himself after taking the drug said the risks "are just too high".

Manufacturer Roche said "millions of patients worldwide have benefited from taking the drug".

The majority of those who take the drug have a positive experience.

'Pretty overwhelming'

"I used to think about girls… but my feelings, thoughts, just faded away," Ed Henthorn told the BBC's Victoria Derbyshire programme.

He was 19 when he took Roaccutane. He describes his acne as mild but bad enough to want to treat.

After three weeks he started to experience side-effects, including reduced energy and sex drive.

Then he experienced erectile dysfunction.

"That was why I decided to stop taking it," he said. (more…)

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Spina bifida: Keyhole surgery repairs baby spine in womb

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In a UK first, doctors have used keyhole surgery to successfully repair the spine of a baby with spina bifida while it was still inside the womb.

Surgeons at King's College Hospital say the procedure is not a cure, but could be the difference between some children learning to walk or not.

Sherrie Sharp and her son Jaxson had the operation 27 weeks into the pregnancy.

Spina bifida was diagnosed after the routine 20-week pregnancy scans.

They showed Jaxson's spine and spinal cord were not forming correctly.

Gaps in the developing spine meant the cord was bulging out of his back and was left exposed to the amniotic fluid in the womb.

This damages the crucial nerves in the spinal cord and could lead to paralysis, a loss of sensation in the legs and problems controlling the bladder and bowels.

The longer the spinal cord is left exposed, the greater the damage.

Sherrie, 29, and from West Sussex, said the news was a shock, but an abortion was a "definite no". (more…)

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Less chemotherapy better for older or frail patients with advanced stomach and oesophageal cancers

Less chemotherapy is as effective at controlling disease for elderly or frail patients with advanced..

Less chemotherapy is as effective at controlling disease for elderly or frail patients with advanced cancer of the stomach or oesophagus (food pipe), and leads to fewer side effects such as diarrhoea and lethargy. These are the results of a Cancer Research UK funded study, presented prior to the ASCO conference today (Wednesday).

“Increasingly were realising its not just age that affects how well someone can tolerate their treatment and we need to do more work to understand how other conditions or aspects of frailty might play a role.” Dr Peter Hall, Cancer Research UK Edinburgh Centre[contfnewc]

Results from the GO2 trial could change the standard of care for patients who cant have full dose chemotherapy due to their age, frailty or medical fitness.

The study, which ran at hospitals all over the UK, coordinated from the University of Leeds, involved 514 people with stomach or oesophageal cancer. Their average age was 76 and the oldest was 96 years old. All were either frail, elderly or medically unfit, and for those reasons would be unlikely to tolerate full-strength treatment, which involves three chemotherapy drugs.

Patients went through a careful medical assessment, then went onto chemotherapy with just two drugs* and were allocated at random to receive them at either full-strength, medium-dose or low-dose. They were then carefully monitored to see how well the cancer was controlled, whether they had symptoms and side-effects, whether they felt their treatment was worthwhile, and what overall effect it had on their quality of life.

The researchers reported that the medium and lower doses of chemotherapy were as effective as the full-strength dose for controlling the cancer. But when the researchers looked at the overall effect of treatment, including quality of life, they reported that it was the lowest dose treatment that came out best.**

Around 15,800 people in the UK are diagnosed with stomach and oesophageal cancers every year***. Almost half (45%) of these people are 75 and over****. By 2035, this proportion is projected to rise to 55%*****, because of the UKs ageing population. This study, is one of few phase III trials in the country that seek to address how to best care for and treat this increasing population of elderly or frail cancer patients.

These findings also open up the possibility of more older and frail patients being able to take part in clinical trials.

Professor Charles Swanton, Cancer Research UKs chief clinician, said: “These valuable results reduce fears that giving a lower dose chemotherapy regimen is inferior and could make a huge difference for patients with stomach or oesophageal cancer who cant tolerate intensive courses of treatment.

“Older or frail patients are often not considered for new drug trials or standard of care therapy as theyre less able to tolerate combination chemotherapy. These trials are critical to provide much needed evidence on the effectiveness of new therapies and combination approaches, helping us develop new treatments for this growing group of patients.”

The researchers also assessed whether there were differences for the patients in the study who were under 75, or less frail, who might be expected to benefit from stronger treatment; but will be reporting that the lowest dose treatment gave the best results for them as well. (more…)

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