Guardian 'diabetes is biopsychosocial'

Article in today's Guardian (https://amp.theguardian.com/society/2018/oct/24/diabetes-ticking-time-bomb-nhs)
about diabetes being a time-bomb for the NHS. This bit:

"Professor Khalida Ismail, professor of psychiatry and medicine at King’s College London and an honorary consultant liaison psychiatrist at King’s College hospital NHS foundation trust. “We have to move away from thinking of diabetes as a medical condition,” she said. “It’s a biopsychosocial condition.”"

 

India.

There are, apparently, millions of people in India, thin, active, otherwise healthy people, who are type 2 diabetic.

It's not a lifestyle, or social condition, lifestyle can exacerbate it but the same can be said for many, many medical conditions.

Saying it's not a medical condition is, on the face of it, absurd.

 

I'm almost speechless at that bit of the article hence I didn't comment after Ismail's bit.

 

How does someone become a professor of psychiatry AND medicine? Clearly the entry requirements for the job aren't very high.

 

Not just India. There is a subset in Western countries too, this just gets ignored. I put this challenge to a medical researcher decades back, at a major hospital, and they checked the endocrinology department. It happens, and its not explained by many current hypotheses. The current models were mostly developed on obese people and rats.

 

Typically psychiatrists are doctors.

 

You can choose whatever name you like. I am a professor in Connective Tissue Medicine - a speciality I invented and of which I remain the only professor!

 

Whoa, I never knew that! I learn something new every day.

 

I have a family member who was diagnosed with type 1 diabetes at the ripe old age of four years old.

Given the experiences of most people on this forum I am.sure you can understand just how.much more difficult it was for her parents who had various other friends & family members who were quick to tell them it was they way they fed their child. Even though their older sibling was perfectly healthy.

In those days they had to test the blood sugar levels at least four times a day. You can imagine how a very independent four year old took that - and it can be quite sore.

People who should have been supporting them were judging them. Just what they needed.

Why don't these BPS fanatics go and label the terminally ignorant and judgemental for a change, instead of making the lives of the afflicted even more difficult?

 

Yes, I knew that. But my first thought (from a position of profound ignorance on the subject) would be that a Professor of Medicine was someone who dealt with biomedical illness as a generalist and possibly diagnosed things like sepsis or bacterial infections or viral infections or various kinds of arthritis or orthopaedic issues, but wasn't involved in surgery. So, in that circumstance psychiatry wouldn't come into it at all. But obviously I got it wrong.

 

Very wise. That way there can be no guilt by association.

 

Type 1 diabetes is autoimmune and not lifestyle at all, though this fact is getting lost and some people with it are suffering because of it. The likes of Professor Ismail not making the distinction clear doesn't help.

In type 2 diabetes, a genetic phenotype which gives an evolutionary advantage in marginal environments, they call it "thrifty" because sugars are handled differently for times of hardship, causes a disease when food is plentiful. A bit like fair skinned people in Australia getting skin cancer.

The point is that most people eat too much but their pancreas can cope. In type2 diabetes the pancreas can't deal with it. There is a lifestyle element in that you can eat less, stay a healthy weight, stay fit but most people don't do that either.

It is all very complicated made worse by the fact that diabetes is a number of blood glucose, over it diabetic, under it not, instead of looking at the genetics. So technically you can cure diabetes by lowering your blood sugar level but your pancreas is still not healthy.

No one is looking at the root cause as the money is to be made by treating it. Doesn't surprise me that a BPSer is right in there hoping for a share of the loot, no matter the cost to the patient.

 

This is all very troubling. There really seems to be put quite an effort into redefining any disease as "biopsychosocial". This is returning to the past. I wonder if the BPS believers are aware of the fact that their ideas are old. And if they're aware, the question is: What does that say us?

 

Yes. There's also a worry in The Guardian, yet again, reporting this rubbish.

 

https://twitter.com/user/status/481082358264004609


One name here seems VERY familiar....

 

That's not unreasonable on certain levels but as long as BPS is 99% psychosocial it's not gonna lead to good outcomes, quite the opposite in fact.

They seriously need to clean house on their pet project before forcing it on people who can't object or will have no means of complaints. Because it's guaranteed that there will not be a process to report harm from these treatments, same as ME patients face with GET and CBT.

It's incredibly irresponsible to speak of massively deploying something that has exactly 0 objective evidence to date. Lots of subjective evidence, fine, but that just means a lot more work needs to be done until it can compete with decades of actual research that has produced ample objective evidence and has demonstrable success.

So much damn wishful thinking.

 

Plus ça change, plus c'est le même drivel.

Editr is it la même drivel.

 

It's "supported by Sanofi"

"The Sanofi group conducts its business in the United Kingdom through its subsidiaries Aventis Pharma Limited, Fisons Limited, Genzyme Therapeutics Limited and Genzyme Limited"

http://www.sanofi.co.uk/l/gb/en/layout.jsp?scat=7CF435AE-4B79-4FDE-837B-3AFA25D76B2F

 

Just tweeted to Dr Aseem Malhotra. Wonder what he may make of it ....