Monday, 30 June 2025

Urgent action needed as new research reveals gaps in fatty liver disease diagnosis and care

New research released to coincide with Global Fatty Liver Day has found that fatty liver disease is being consistently overlooked, leading to late diagnosis. 

This discovery comes from analysis of a survey of patients with fatty liver disease, which found that more than half reported receiving no support following their diagnosis, and a third were diagnosed at a late stage.

Fatty liver disease, also known as MASLD (Metabolic dysfunction-Associated Steatotic Liver Disease), is estimated to affect up to 1 in 5 people in the UK. The main risk factors are being overweight, an unhealthy diet or living with type 2 diabetes.

A survey conducted by the British Liver Trust found that among 687 people living with MASLD:

• 68% were overweight or obese

• 35% had type 2 diabetes

More than half (55%) said they had received no support with weight management, eating a healthy diet or physical activity, which is the cornerstone for successful treatment of this disease. In the early stages, reducing weight and improving diet can either halt disease progression or even reverse liver damage. 

Additionally, over a third of respondents said their diagnosis came at a late stage, when it was too late for effective treatment.

With an estimated two thirds of the UK population classed as overweight or obese, the charity is calling for better awareness among both the general population and healthcare professionals. The British Liver Trust is urging widespread, systematic case finding, including routine testing and liver scanning for people at risk—to enable earlier diagnosis and better outcomes. 

The charity also highlights the need for new treatments to be introduced alongside comprehensive education for healthcare professionals, to ensure patients receive appropriate support at the right time.

MASLD is affecting an increasing number of people across the UK. Mortality rates in England alone rose by 44% between 2019 and 2023, with the highest rates seen in the North of England.

Pamela Healy OBE, CEO at the British Liver Trust, told That's Health: “For too long, widespread misunderstandings around liver health have meant that large numbers of people are unaware of the risks to their liver from being overweight, or from eating too much unhealthy or ultra-processed food. People are frequently told how these lifestyle factors increase their risk of heart disease and type 2 diabetes, but the risk of fatty liver disease is rarely discussed.

“We want to see MASLD to be given the same attention as other major conditions, and we need effective changes to ensure that everyone at risk receives the right treatment at the right time.”

Sara’s father was told he had a fatty liver in 2014 and only received one scan in 2016. In 2024, he was diagnosed with MASLD and died just four months later in July 2024, aged 62. Sara and her family are still trying to come to terms with his tragic, and ultimately preventable, death: “If we’d got that MASLD diagnosis a little bit sooner, if he’d just had a few more weeks, and if he had been put under surveillance a few years earlier, they would have seen his liver was getting worse and it wouldn’t have got to this point.”

“MASLD is a growing public health concern across the UK,” said Professor Philip Newsome, a leading liver expert from King’s College Hospital London and medical advisor to the British Liver Trust. “We are seeing promising advances in research with several new treatments showing encouraging results. However, there is an urgent need to translate these developments into clinical practice, ensuring early detection and better treatments are embedded within the NHS to deliver real benefits for patients.”

https://britishlivertrust.org.uk

Saturday, 28 June 2025

Thursday, 26 June 2025

The Curious Case of Fad Medical Diagnoses: Stress, Viruses, and Obesity

Medicine is a science, but it's also a product of its time. While human biology doesn’t change overnight, our understanding—and interpretation—of it often does. 

Over the decades, we've seen waves of what can only be described as fad medical diagnoses, where particular conditions become fashionable explanations for a broad spectrum of symptoms. 

At one time, it seemed every illness was caused by stress. Then, viruses took the blame. More recently, obesity has become the go-to culprit. But why do these diagnostic trends happen?

A Brief History of Blame

1. The Stress Epidemic (1970s–1990s)

In the late 20th century, as society became increasingly fast-paced, stress emerged as the catch-all diagnosis. From ulcers to insomnia, palpitations to headaches—everything was explained away as "just stress." While stress does have real physiological effects, its popularity as a blanket diagnosis often masked underlying issues. Mental health was poorly understood, and doctors lacked the tools or time to probe deeper.

2. The Virus Craze (1990s–2010s)

With the rise of better viral testing and media attention on outbreaks like swine flu, SARS, and Epstein-Barr, viruses became the next fashionable explanation. Vague, lingering illnesses like chronic fatigue syndrome or fibromyalgia were sometimes attributed to "post-viral" syndromes, even when no clear viral trigger was identified. It was often a medical shrug: "It must’ve been a virus."

3. The Obesity Blame Game (2010s–present)

As obesity levels rose globally and its links to chronic illness became undeniable, it began to overshadow other potential causes. Tired? Breathless? Achy joints? All too often, the patient hears, “Well, you need to lose weight.” 

While obesity is a risk factor for many conditions, the danger of overdiagnosing based on weight is that legitimate, unrelated issues might be missed, or dismissed entirely.

Why Does This Happen?

Time Pressure in Healthcare

Modern medicine often runs on tight schedules. GPs and consultants have limited time, and when a patient presents with nonspecific symptoms, it’s tempting to default to a commonly accepted explanation.

Lack of Diagnostic Certainty

Medicine doesn’t always have clear answers. When faced with a “mystery” illness, especially one that doesn’t fit textbook criteria, clinicians sometimes reach for diagnoses that feel safe, familiar, and broadly accepted.

Media and Public Perception

Popular health scares and media narratives shape both patient and doctor expectations. When stress, viruses, or obesity dominate headlines, they become part of the cultural consciousness—and diagnoses tend to follow.

Bias and Stigma

Sadly, stigma plays a role. Patients who are overweight or anxious may not receive the same level of investigative care, and their symptoms might be prematurely written off. This can lead to missed or delayed diagnoses.

The Risks of Fad Diagnoses

Misdiagnosis and Delayed Treatment: Patients may suffer longer because the real issue isn’t being addressed.

Erosion of Trust: Patients who feel dismissed may lose faith in the healthcare system, becoming less likely to seek help.

Overmedication or Undertreatment: Treating the wrong cause, such as prescribing antidepressants for stress when the issue is hormonal, can do more harm than good.

A Better Way Forward

Healthcare professionals and patients alike must be aware of the tendency toward diagnostic shortcuts. Good medicine demands curiosity, listening, and a willingness to dig deeper: Even when the answer isn’t obvious. Diagnostic trends will always exist, but critical thinking and personalised care must remain the gold standard.

Last notes:-

Just as fashion changes with the seasons, so too does the lens through which we view health. But while trousers can be swapped out easily, medical diagnoses affect lives. We must resist the urge to settle for convenient answers, and instead strive for accurate, compassionate, evidence-based care—no matter how “in vogue” a diagnosis might be.

Wednesday, 25 June 2025

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Monday, 23 June 2025

"Surrounded by Idiots?" Maybe It Is You…?

There’s a saying that pops up in moments of frustration: “I’m surrounded by idiots!” 

Whether muttered under your breath at work, shouted into a pillow after a tedious family gathering, or casually vented over a pint at the pub, it’s a phrase most of us have used.

But here’s the hard question:

What if the problem isn’t them… but you?

The Idiot Paradox

Let’s imagine a scenario. You go to work and nobody seems to understand your brilliant ideas.

 The drivers on the road are dangerously slow, or stupidly fast. The people in the shop queue can't operate the card machine. Your friends never quite get your jokes. Even your cat seems to be ignoring your commands.

At what point do you stop and ask:

Is it really possible that everyone else is wrong, all the time?

This isn’t to say you are the problem, but if the same issues repeat themselves across different settings, it’s worth a bit of healthy self-reflection.

The Dunning-Kruger Effect in Action

The Dunning-Kruger effect is a psychological phenomenon where people with low ability at a task overestimate their ability. In plain English: the less you know, the more confident you might feel. That could mean you’re mistaking your own gaps in knowledge for others’ incompetence.

It’s a humbling thought: And a powerful one.

Are You Communicating Clearly?

Sometimes, the issue isn’t about intelligence but communication. If people constantly misunderstand you, could it be that you’re speaking in jargon, rushing, or assuming shared knowledge?

Imagine turning up to a pub quiz and expecting everyone to know the capitals of obscure former Soviet states. If they don't, are they “idiots”? Or did you bring the wrong expectations?

The Control Freak Trap

Do you find yourself thinking, “If people would just do things my way, everything would work better”?

That’s a red flag. Wanting things done your way doesn’t make your way the best, it might just make you a bit of a tyrant in disguise.

Letting go of perfectionism and embracing the different (and often equally valid) ways people think and work can be liberating, and massively improve relationships.

Maybe You’re Just Tired

Honestly, if everyone seems like an idiot, you might simply be knackered. Exhaustion, stress, burnout, all can affect how tolerant, patient and forgiving we are. A good nap, a meal and a vent to a mate might bring the world back into balance.

Ask Yourself These Questions:

Do I hear the same feedback from different people?

Am I quick to judge others without giving them a fair chance?

Do I ever apologise when I get something wrong?

Could I explain this concept/idea to a 10-year-old? If not, is it actually that clever?

Do I assume good intentions, or immediately think people are being stupid or lazy?

Final Thoughts: It’s Not About Blame: It’s About Growth

This isn’t a call to self-flagellation. We all have moments where we lose patience. But if you’re always surrounded by idiots, take a breath and consider: could I be doing something differently?

Sometimes the most intelligent thing you can do is question your own assumptions.

And if after all that reflection you still think you’re surrounded by idiots… at least now you’ll know how to handle them more gracefully.

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Monday, 16 June 2025

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Saturday, 14 June 2025

Addressing the Postcode Lottery in NHS Healthcare: Why Where You Live Shouldn’t Determine the Care You Get


In a country that prides itself on having a National Health Service (NHS) free at the point of use, it seems contradictory — even unjust — that the quality of care one receives can still be influenced by where they live. 

This phenomenon, known as the "postcode lottery," is a growing concern across the UK. It highlights stark regional variations in access to treatments, waiting times, specialist care, and even basic services. For a health system built on equity, this inconsistency raises serious questions.

What Is the Postcode Lottery?

The term “postcode lottery” refers to the variation in public services based on geographical location. In healthcare, it means that patients in some regions may have access to life-enhancing or life-saving treatments that are unavailable just a few miles away. 

This is not due to medical need or clinical appropriateness, but because of local funding decisions, administrative inefficiencies, or staffing shortages.

Real-Life Examples of the Inequality

Cancer Treatments: Access to the latest cancer drugs can vary from one NHS Trust to another, with some areas offering cutting-edge therapies while others cite budget constraints.

Mental Health Services: Waiting times and available therapies for mental health support differ widely. A child referred for mental health services in one part of the country might be seen within weeks, while another elsewhere could wait months.

IVF Treatment: Some Clinical Commissioning Groups (CCGs) offer three rounds of IVF treatment, while others offer just one — or none at all.

GP and Dental Services: The number of GPs and NHS dentists per capita is significantly lower in some regions, leading to long waits and overstretched services.

Why Does It Happen?

Several factors contribute to this disparity:

Decentralised Decision-Making: Local Integrated Care Boards (ICBs, formerly CCGs) decide how NHS funds are spent in their areas, resulting in different priorities and service levels.

Staffing Shortages: Rural or deprived areas often struggle to attract and retain skilled medical professionals.

Socioeconomic Factors: Areas with high levels of deprivation often face higher health needs but may receive proportionally less funding.

Infrastructure and Resources: Legacy infrastructure, hospital capacities, and even transport links affect how care is delivered and accessed.

The Impact on Patients

The postcode lottery doesn’t just affect statistics; it impacts real lives. Delayed diagnoses, lack of access to innovative treatments, and long waits for referrals can worsen patient outcomes. It can also contribute to increased anxiety, financial strain (as patients may choose to go private or travel long distances), and a sense of injustice and inequality.

Addressing the Postcode Lottery

National Standards and Accountability: The NHS must implement and enforce more uniform national standards, ensuring that minimum service levels are guaranteed across all regions.

Transparent Data Sharing: Making data on regional disparities public can drive accountability and help patients and advocacy groups campaign for change.

Better Funding Allocation: Funding models should take into account local health needs and deprivation levels more fairly, ensuring that areas with greater needs receive proportional support.

Centralised Access to Treatments: High-cost treatments and specialised services should be commissioned at a national level where possible, to prevent disparities driven by local budget decisions.

Incentivising Workforce Distribution: Offering financial incentives, career development opportunities, and housing support for healthcare workers in under-served areas could help address staffing imbalances.

Digital Health and Telemedicine: Expanding remote consultations and digital health tools can bridge gaps, especially in rural or underserved areas, improving access to GPs and specialists.

Final Thoughts

The NHS is often described as the “jewel in the crown” of British society, but the postcode lottery tarnishes that reputation. A truly equitable health service must offer consistent, high-quality care regardless of geography. It is time for policy-makers, NHS leaders, and the public to demand an end to the postcode lottery and push for a system that delivers on the promise of universal care — equally and fairly for all.

Friday, 13 June 2025

Monday, 9 June 2025

Friday, 6 June 2025

Thursday, 5 June 2025

What’s the Best Time of Day to Take Insulin if You Have Type 2 Diabetes?

For those living with type 2 diabetes, managing blood sugar levels is a daily balancing act. For some, this includes taking insulin. 

But one common question that arises is: when is the best time of day to take insulin if you have type 2 diabetes? 

The answer depends on the type of insulin you're using, your lifestyle, your meals, and your individual treatment plan. Here’s a breakdown to help you understand the best timing and why it matters.

Understanding the Types of Insulin

Before discussing timing, it’s helpful to understand the main types of insulin prescribed for type 2 diabetes:

Basal (long-acting) insulin: Works steadily over about 24 hours. Examples include insulin glargine (Lantus), detemir (Levemir), and degludec (Tresiba).

Bolus (rapid- or short-acting) insulin: Taken before meals to manage blood sugar spikes. Examples include insulin lispro (Humalog), aspart (NovoRapid), and regular insulin.

Premixed insulin: A combination of long-acting and short-acting insulin in one dose.

Best Times to Take Insulin for Type 2 Diabetes

1. Long-Acting (Basal) Insulin

For those who take once-daily basal insulin, the timing is often flexible — but consistency is key.

Evening or bedtime is commonly recommended, especially if morning fasting levels are high.

Morning administration may suit those who experience low blood sugar overnight or have issues with remembering a bedtime dose.

Same time every day: Choose a time that you can consistently stick to — whether that’s after brushing your teeth in the morning or before bed.

Tip: Some insulins, like Tresiba, have more flexibility and don’t need to be taken at exactly the same time each day.

2. Mealtime (Bolus) Insulin

If you're on a basal-bolus regimen, rapid-acting insulin is usually taken:

10 to 15 minutes before a meal, or

Immediately after eating, if blood sugar was low beforehand or if meals are unpredictable.

The goal is to match the insulin peak with the post-meal rise in blood sugar.

3. Premixed Insulin

This is usually taken twice daily, around 30 minutes before breakfast and dinner. Timing is crucial, as it contains short-acting components that need to align with meals.

Things to Consider When Timing Your Insulin

Meal Patterns: Regular meal times help you plan insulin doses more effectively.

Exercise Routines: Physical activity can lower blood sugar, so timing around workouts is important.

Sleep Schedule: Avoiding overnight hypoglycaemia is key; some people need adjustments based on their sleeping patterns.

Shift Work or Irregular Schedules: May require a tailored approach with help from your diabetes care team.

Consult Your Healthcare Provider

Everyone’s diabetes journey is different. What works for one person may not suit another. Always consult your GP, diabetes nurse, or endocrinologist before making changes to your insulin routine. They may recommend adjustments based on your HbA1c results, glucose monitoring data, lifestyle, and other medications.

Final Thoughts

The best time to take your insulin depends on the type of insulin you use and your daily schedule. The key is consistency and coordination with meals and activity. Managing type 2 diabetes with insulin may seem daunting at first, but with the right support and routines, it becomes part of everyday life.

Wednesday, 4 June 2025

NHS Hospitals that Specialise in Treating Gastroparesis

Gastroparesis is a chronic condition in which the stomach takes too long to empty its contents, leading to symptoms such as nausea, vomiting, bloating, and malnutrition. 

While it can be a difficult condition to manage, the NHS does offer specialist treatment at selected hospitals across the UK.

In this post, we explore NHS centres that provide advanced care for gastroparesis patients, including surgical options such as gastric electrical stimulation (GES), which may help in severe cases.

Leading NHS Hospitals for Gastroparesis Treatment

University College London Hospitals (UCLH) – London

UCLH is one of the leading centres for gastrointestinal motility disorders. With a dedicated gastrointestinal physiology unit and experts such as Dr Anton Emmanuel and Mr Majid Hashemi, UCLH offers detailed diagnostic testing and both medical and surgical treatment for gastroparesis.

Visit UCLH Website https://www.uclh.nhs.uk/our-services/find-service/gastrointestinal-services-1/gastrointestinal-physiology

Broomfield Hospital – Chelmsford, Essex

Broomfield Hospital is home to one of the UK’s most experienced gastroparesis specialists, Mr Sri Kadirkamanathan. The hospital is known for performing gastric electrical stimulation (GES) procedures, helping patients with drug-resistant symptoms regain some quality of life.

Aberdeen Royal Infirmary – Scotland

With surgeons such as Mr Bruce Duff and Mr Ken Park, Aberdeen Royal Infirmary is recognised for its skill in gastrointestinal surgery. The hospital offers advanced treatments for gastroparesis, including GES implantation.

Glasgow Royal Infirmary – Scotland

Another respected Scottish centre, Glasgow Royal Infirmary provides specialist surgical care for gastroparesis under the expertise of Mr Grant Fullarton, with options like GES available for appropriate patients.

Ninewells Hospital – Dundee

Ninewells Hospital takes a multidisciplinary approach, combining surgical expertise (led by Mr Afshin Alijani) with nutrition and intestinal failure support (Dr Reynaulds). This makes it an excellent choice for patients needing holistic care.

Wishaw General Hospital – Scotland

Mr Hakim Benyounes at Wishaw General Hospital provides specialist surgical services for gastroparesis, including access to GES therapy for eligible cases.

Gastric Electrical Stimulation (GES): What You Need to Know

GES is a treatment involving a surgically implanted device that sends mild electrical pulses to the stomach muscles. It is typically reserved for patients with severe gastroparesis who haven't responded to other treatments.

However, it’s important to note that NHS England does not routinely fund GES due to limited long-term evidence of its effectiveness. Some patients may access it through private healthcare or as part of clinical trials.

NHS England Clinical Commissioning Policy on GES https://www.england.nhs.uk/wp-content/uploads/2018/07/Gastroelectrical-stimulation-for-gastroparesis.pdf

Finding a Specialist Centre

You can use the Medtronic clinic finder to locate NHS and private centres across the UK and Ireland that offer gastric electrical stimulation:

Medtronic Clinic Finder https://www.medtronic.com/uk-en/patients/treatments-therapies/neurostimulator-gastroparesis/clinic-finder.html

If you're in Wales or Northern Ireland, your GP may refer you to a specialist centre in England or Scotland.

Further Support and Resources

For more information and patient support, we recommend Guts UK – a national charity offering resources, helplines and real-life patient stories:

 Guts UK – Gastroparesis https://gutscharity.org.uk/advice-and-information/conditions/gastroparesis

Gastroparesis can be a life-altering condition, but specialist care is available within the NHS. From advanced diagnostics to surgical therapies, the right help is out there – and understanding your options is the first step towards managing your condition.

Have you been treated at one of these hospitals? Please your experience in the comments, and let others know they’re not alone.

You can help Ellie Dyson, a friend of That's Health, by donating to her appeal to raise the funds for a private GES operation for her:- https://www.gofundme.com/f/gastric-pacemaker-to-help-me-live-my-life

Tuesday, 3 June 2025