What the papers say – weekly digest (05/04/24)

Your weekly digest of the top healthcare stories, covering news published from 01/04/2024 – 05/04/2024.

The Guardian

Patients are dying needlessly every year due to vulnerable Britons with heart problems not being given antibiotics when they visit the dentist, doctors have said. Almost 400,000 people in the UK are at high risk of developing life-threatening infective endocarditis any time they have dental treatment, the medics say. The condition kills 30% of sufferers within a year. A refusal to approve antibiotic prophylaxis (AP) in such cases means that up to 261 people a year are getting the disease and up to 78 dying from it, they add. That policy may have caused up to 2,010 deaths over the last 16 years, it is claimed. That danger has arisen because the National Institute for Health and Care Excellence (Nice) does not follow international good medical practice and tell dentists to give at-risk patients antibiotics before they have a tooth extracted, root canal treatment or even having scale removed, the experts claim. The doctors – who include a professor of dentistry, two leading cardiologists and a professor of infectious diseases – have outlined their concerns in the Lancet medical journal. In it, they urge Nice to rethink its approach in order to save lives, citing pivotal evidence that has emerged since the regulator last examined the issue in 2015, which shows that antibiotics are ‘’safe, cost-effective and efficacious’’. Infective endocarditis (IE) is an infection of the heart’s inner lining and the valves that separate each of the heart’s four chambers. In about 30%-40% of cases it is caused by bacteria in the mouth getting into the bloodstream as a result of poor oral hygiene or invasive dental treatment.  The bacteria can then inflame damaged heart valves and also artificial heart valves. An estimated 397,000 Britons are at risk of developing the condition as a direct result of undergoing dental treatment because they have had a congenital heart condition or have previously been treated for a cardiac condition, for example by having a pacemaker or ventricular assist device implanted. Patients are being put in danger because Nice’s position is at odds with the European Society of Cardiology and the American Heart Association, both of which say high-risk patients should receive antibiotics before dental treatment, the doctors allege. The medicines regulator used to support that approach. But in 2008 it changed its position. It said it had concerns about possible side-effects, such as the risk of fatal anaphylaxis, which outweighed potential benefits. In the joint opinion piece in the Lancet Regional Health – Europe, the doctors say that switch led to ‘’a significant increase in IE incidence’’. An extra 35 people a month get IE as a result of it, according to evidence the Lancet published in 2015. Data showing the number of dental procedures in which antibiotics would need to be given to prevent one case of IE ‘’suggest that 41-261 cases (including 12-78 deaths) could be prevented annually in the UK’’. Switching to dentists routinely administering antibiotics to high-risk patients when they treat them would be cost-effective for the NHS even if it prevented just 1.4 cases of IE a year, they state. Nice’s switch in 2008 to opposing antibiotics may have led to as many as 6,700 extra cases of IE and 2,010 deaths during the 16 subsequent years, according to Martin Thornhill, a co-author of the paper and professor of translational research in dentistry at Sheffield University.

A smartphone app could help detect the leading cause of early-onset dementia in people who are at high risk of developing it, data suggests. Scientists have demonstrated that cognitive tests done via a smartphone app are at least as sensitive at detecting early signs of frontotemporal dementia in people with a genetic predisposition to the condition as medical evaluations performed in clinics. Frontotemporal dementia is a neurological disorder that often manifests in midlife where the part of the brain responsible for skills such as the capacity to plan ahead and prioritise tasks, filter distractions and control impulses shrinks as the disease progresses. About one-third of such cases have a genetic cause, but research into the condition has been hampered by problems with early diagnosis and difficulty tracking how people are responding to treatments that may be effective only during the early stages of disease. ‘’Most frontotemporal dementia patients are diagnosed relatively late in the disease, because they are young and their symptoms are mistaken for psychiatric disorders,’’ said the study’s senior author, Prof Adam Boxer, of the University of California, San Francisco (UCSF). Smartphones are already attracting interest as a tool for diagnosing and assessing Alzheimer’s, Parkinson’s and Huntington’s diseases. To investigate their utility in frontotemporal dementia, Boxer and his colleagues collaborated with the US-based software company Datacubed Health to develop an app that could record people’s speech while they engaged with cognitive tests, including executive functioning assessments. Dr Adam Staffaroni, a clinical neuropsychologist at UCSF and the study’s first author, said: ‘’We also created tests of walking, balance and slowed movements, as well as different aspects of language.’’ They tested the app in 360 adults at high genetic risk of developing frontotemporal dementia, including some who had not developed any obvious symptoms. The research, published in Jama Network Open, found that the app could accurately detect dementia in such individuals and might even be more sensitive to the earliest stages of the condition than gold-standard neuropsychological evaluations that are usually performed in the clinic. Although there are no immediate plans to make the app available to the public, Staffaroni said it could help bolster research. ‘’We hope that smartphone assessments will facilitate new trials of promising therapies,’’ he added. ‘’Eventually, the app may be used to monitor treatment effects, replacing many or most in-person visits to clinical trial sites.’’

The Telegraph

ADHD and autism referrals have risen fivefold since the pandemic amid fears that doctors could be over-diagnosing the conditions. More than 172,000 people were waiting for a diagnosis as of December 2023, which was more than five times higher than the 32,220 four years earlier, the Nuffield Trust think tank said. Experts have said the rise is unlikely to be ‘’simply due to better recognition or help-seeking’’ and suggested ‘’diagnostic creep’’ was leading doctors, particularly in private clinics, to over-diagnose the conditions. The NHS has set up a national attention deficit hyperactivity disorder (ADHD) task force to investigate ‘’the rate of growth within the independent sector and the potential variation in the models and thresholds being used’’ as well as whether it is appropriate to prescribe powerful stimulant drugs. Ministers believe that the surge in adults being signed off work with mental health conditions and behavioural disorders, including ADHD or autism, is a leading cause of Britain’s worklessness crisis. A record 9.25 million people aged between 16 and 64 are neither working nor looking for a job, according to the Office for National Statistics. More than 52,000 adults receiving personal independence payments from the Government list ADHD as their main condition, with most of these aged between 16 and 29. This number is up from 38,000 in 2022. Mel Stride, the Work and Pensions Secretary, said that Britain’s approach to mental health was in danger of having ‘’gone too far’’  with the ‘’normal anxieties of life’’ being labelled as an illness. New analysis of referral data by the Nuffield Trust found that 79 per cent of people who had been waiting 13 weeks or longer had not had their first appointment with a specialist, up from 44 per cent in December 2019. Between October and December last year, those who had their first appointment waited an average of nine months from referral, which is five months longer than at the end of 2019. The number of people being prescribed powerful medication for ADHD has surged by 51 per cent to 230,000 over the past three years, including a 146 per cent increase among those aged 30 to 34. Thea Stein, chief executive of the Nuffield Trust, said the rise in demand for assessments was ‘’extraordinary, unpredicted and unprecedented’’. ‘’It is frankly impossible to imagine how the system can grow fast enough to fulfil this demand,’’ she said. ‘’The challenge is that we have an obsolete health service model in place to deal with this avalanche of need.’’ She called for a joined up approach across education, the health service, and wider society, but said ‘’pumping more money into the current model certainly isn’t the solution’’. It is estimated that there are up to 1.2 million autistic people and 2.2 million people with ADHD in England. ADHD can lead to problems including impulsivity and concentration difficulties, which can have a lifelong impact and cause problems at school. An NHS spokesman said: ‘’The NHS is fully committed to supporting and improving the lives of those with ADHD and autism, which is why we have published new guidance to help local areas manage the 50 per cent increase in referrals they have seen over last year.’’

A fat gene which makes an adult six times more likely to be obese has been found by scientists. About one in 6,500 adults – or 10,000 people in the UK – are thought to have the faulty version of the BSM gene, also known as ‘’Bassoon’’. It is active only in the brain and researchers believe it is the first fat-linked gene to be exclusively associated with adulthood obesity.  It is also more potent than any other genes previously found to increase the risk of obesity. How the gene causes weight gain is unknown but the scientists think it may be that affected people have problems making new neurons and the subsequent neurodegeneration could worsen appetite control. About 70 people in a study of the 500,000 UK Biobank participants were found to have the defective gene. ‘’These are whacking great big mutations that were not anything subtle,’’ Prof Giles Yeo, from the Medical Research Council’s Metabolic Diseases Unit, told the Telegraph. ‘’Previously discovered genes have almost always been associated with childhood obesity. Big children, big adults, essentially.’’ He said that this is the first gene linked solely to adult obesity and those who possess it are up to 1st 6lb heavier, on average. ‘’It is reasonably rare, we are not saying it is a common cause of obesity, but it is present in the general population and it does really have a big difference in body size,’’ Prof Yeo added. ‘’We think what is happening – and this is just thinking at the moment because we haven’t really nailed it down – is that having these mutations may very well slow down the ability to generate a couple of new neurons every so often,’’ Prof Yeo said. ‘’The hypothesis is that mutations in this gene influence the circuitry controlling food intake as we get older and as we get into adulthood.’’ The faulty genes may be interfering with the sensation of satiety so that even though the body is full, the mind wants more food. Drugs which are known to help weight loss, such as Ozempic and Wegovy, work by interfering with the brain’s processing of satiety and therefore stop the sensation of needing to eat. However, this category of drugs, known as GLP-1s, work by interfering with a different pathway in the brain, and will likely have no impact on the hunger caused by the flawed Bassoon gene. Prof Yeo added: ‘’Bassoon probably does slow down the effectiveness of how these drugs will work, I think. We don’t know yet, just to be clear, but the drugs will probably still work and you’ll still lose weight on them. I predict that weight-loss drugs will work in people with this gene, but not as well.’’ The true mystery the scientists are now trying to crack is why this gene, which is present from birth, only takes effect in adulthood. Future studies on animals will induce the genetic condition as it is too uncommon to easily study in people and see why, and when, the gene becomes active. It is possible, the scientists say, that it is linked to increased autonomy in adulthood or is a hormone-induced phenomenon brought on by puberty. The findings are published in the journal Nature Genetics.

The NHS waiting list could be two million people longer than previously thought, new data from the Office for National Statistics (ONS) has suggested. A representative survey of almost 100,000 adults in England found that 21 per cent were waiting for an NHS appointment, test or medical treatment. It means that about 9.7 million – more than one in five people – are waiting for an NHS appointment when the survey’s results are extrapolated across the country, the ONS said. Official waiting list data up until the end of January said that 6.3 million people were waiting for 7.6 million appointments because some people are on two or more lists. The NHS does not include those waiting for follow-up appointments or check-ups because they have already started a programme of treatment. The survey also found that one in seven patients on the waiting list had been waiting for longer than a year for an appointment or treatment despite NHS figures suggesting it is fewer than one in 20. While NHS data shows that 321,394 patients have been waiting longer than 12 months for a first appointment after a referral, the ONS survey found the number waiting longer than a year was likely to be closer to 1.35 million. Just over 14,000 people have been waiting 18 months according to NHS figures, but ONS suggests this could actually be more than 670,000 people, a year after the number waiting was supposed to have been eliminated. The survey was carried out between Jan 16 and Feb 15 2024 by NHS England and the ONS and involved 90,000 adults aged 16 and over in England. NHS England was approached for comment.

A GP surgery in Kent asked patients to bring their own batteries for blood pressure and heart checks in order to reduce waste. The practice told anyone having a 24-hour electrocardiogram (ECG) or 24-hour blood pressure test that they would have to bring in two AA batteries. The surgery said the machines used for the tests, usually issued to patients at a hospital, had been donated and offered convenience to anyone needing the check-up, as the nearest hospital was about 10 miles away. A medical centre spokesman told Kent Online the measure was in place as part of efforts to minimise costs and stop wastage. ‘’Our 24-hour ECG recording machine is an additional service we provide, having been donated by fundraising efforts of the Friends of Marden Medical Centre. It is a convenient alternative to going to hospital for the check. It requires fresh batteries every time it is used to make sure it works properly. Providing new batteries each time would be costly and create wastage, and we found rechargeable batteries were not effective. This policy is in line with our drive to support sustainability and a greener NHS, as patients can use the batteries they provide at home afterwards.’’ It cost around £4 for a pack of four Duracell AA batteries. The GP was rated ‘’outstanding’’ by inspectors from the Care Quality Commission (CQC) after a visit in 2019. In 2022, the British Medical Association outlined guidance on what GPs should charge patients for. This included certificates, whether it be a private sick note for employers, a certificate for insurance purposes, or a freedom from infection certificate which can be used for school, travel or employment. Taking extracts from records or providing health reports was also said to be chargeable, but there was no mention of batteries. It comes after surveys found public satisfaction with GP services at an all time low. Last week a report by the King’s Fund and Nuffield Trust think tanks found more people were dissatisfied with their family doctor than ever before. On Wednesday a survey of 90,000 adults published by the Office for National Statistics found one in 10 people had been unable to make contact with their surgery the last time they had tried. It said it took two or more days for most people to hear back for those who did make contact. An NHS spokesman said: ‘’Almost two thirds of people are happy with their experience and millions more are being given appointments compared to before the pandemic. NHS data shows there were 30.5 million appointments delivered by GPs and their teams in February, compared with 24.7 million in February 2020.

Deaths from prostate cancer will double by 2040, a Lancet report said. The number of men being diagnosed with prostate cancer globally is set to rise from 1.4 million in 2020 to 2.9 million a year in 2040, while annual deaths could increase from about 375,000 to 700,000. Experts said the true figures were ‘’likely to be much higher’’ because of under-diagnosis. As a result, better testing and diagnosis rates are needed, The Lancet will say as it launches its commission on prostate cancer at the European Association of Urology Congress this weekend.

Almost 100 victims of the infected blood scandal have died since the final compensation recommendations were made a year ago, as charity has said. The Infected Blood Inquiry, which is set to publish its final report on May 20, recommended on April 5 last year that payments be expanded to include the children and parents of victims, but none of this group have received money. Rachel Halford, chief executive of the Hepatitis C Trust, has called for the Government to ‘’immediately establish a full compensation scheme’’.

An Ozempic-like drug slows down Parkinson’s symptoms and could protect against disease progression, a study suggests. Lixisenatide, a drug of the same category as Ozempic and Wegovy, is already authorised for use in the treating of diabetes patients and is given as a daily injection. Data from a study of 156 people with Parkinson’s found that the 78 people taking the drug every day for a year saw no decline in their physical symptoms. The drug shows promise as a potential treatment, but did have significant side-effects. The findings are published in the New England Journal of Medicine.

Deutsche Bank is preparing to roll out ‘’reset and recovery pods’’ for menopausal women at its new London office. The German investment bank is building private booths specifically designed to support employees going through menopause. Each pod features reclinable chairs, as well as cooling and lighting controls designed to support individuals struggling with menopause or perimenopause symptoms, such as hot flushes and migraines. The pods are part of Deutsche Bank’s new wellness suite, which once finished in July this year will include physiotherapy facilities, GP clinics, a mindfulness space and a multifaith prayer room. The facilities were also designed to support workers with neurological conditions, such as ADHD and autism.

The Times

Nearly 500,000 antidepressant prescriptions are being issued to children each year, despite guidelines that say they should be used only in the most severe cases. The figure reveals the scale of the mental health crisis among the young. Charities say many children are being given pills – despite the risk of side effects – because waiting lists for psychological services are too long. Prescriptions for under-18s in England have increased 44 per cent since 2015, according to data presented to parliament last week, rising from 312,000 in 2015-16 to 448,515 in 2022-23. Last year 3,920 of those were given to children under the age of ten. The National Institute for Health and Care Excellence advises that under-18s should not be given antidepressants for ‘’mild’’ depression, and in ‘’moderate to severe’’ cases pills should be considered only alongside psychological therapy. The guidelines also say that patients under-18 should be prescribed antidepressants only after assessment by a specialist child psychiatrist. However, an NHS report in 2022 said a sample of 21,000 teenagers on antidepressants had found only one in four had visited a psychiatrist before they were given the pills. Possible side effects in children include thoughts about suicide and self-harm and, for older teenagers, impaired sexual drive and function. Marjorie Wallace, chief executive of the charity SANE, said: ‘’We have created a generation of lost, lonely and disconnected young people. There is no doubt that we are facing an epidemic of mental ill health among this group. But… we should not be handing out antidepressants to children simply because there’s nothing else to offer.’’ A leading US psychologist has warned that a ‘’phone-based childhood’’ is causing a collapse in the mental health of young people. Jonathan Haidt, a professor at New York University, said the growing problem was unlike anything to affect children in the past 100 years and the prevalence of smartphones was depriving young people of the ‘’essential’’ real-life play and experiences enjoyed by previous generations. ‘’People say, ‘Should we just try to improve things a little bit by making the social media content a little healthier?’ That’s like saying, ‘Can’t we design guns with bullets that are nicer?’’’ Haidt said social media was ‘’intrinsically bad’’ for girls , some of whom spent ‘’literally the majority of their waking hours thinking about what people are saying about their looks’’. Dr Elaine Lockhart, who chairs the Royal College of Psychiatrists’ child and adolescent faculty, said antidepressants could be effective for young people who were very unwell. ‘’We’re not just talking about ordinary sadness or teenage angst. For severe depression, it’s important to treat it. If we have something like an antidepressant that is going to help someone, working alongside psychological therapies, we need to consider using it.’’ A health department spokesman said: ‘’We want to ensure every young person gets the mental health support they need. That’s why we’ve increased spending by more than £4.7 billion in cash terms since 2018-19 and we are increasing the coverage of mental health support teams in schools to reach at least 50 per cent of pupils in England by March 2025. The decision to prescribe a particular medication is a clinical one and should be based on patients’ medical needs and best interests.’’

Hospitals are preparing to cut spending on doctors and nurses by hundreds of millions of pounds after being ordered to plug a £4.5 billion hole in the NHS budget. Chief executives at hospitals, mental health trusts and community services in England have been ordered to review staffing levels and draw up plans to close some services and merge others. They are also looking at banning or restricting the use of some agency workers. NHS bosses have been alerted in recent days to the scale of the cuts needed after negotiating financial plans for next year. The health service in England has a budget of £165 billion for the 2024-25 financial year, which starts next week. The budget rose by 3.2 per cent in real terms between 2018-19 and 2023-24. Spending has been put under additional pressure by the cost of covering strikes by junior doctors which NHS England has said has cost more than £1.5 billion and affected more than 430,000 patients’ appointments. The British Social Attitudes survey, published last week, showed public satisfaction with the NHS has dropped to its lowest in 40 years. The NHS relies on agency staff to fill some of the 40,000 vacancies it has for registered nurses, and locum doctors are regularly needed to fill gaps on rotas. Some can earn thousands for a single 12-hour shift. Agency spending is costing the NHS £3.2 billion a year, the equivalent of an extra 31,000 full-time nurses. The health service has met its target of recruiting 50,000 nurses and has also increased the numbers of doctors, but agency staff have cost it £3.5 billion in the past 12 months – a figure 11 per cent higher than before the pandemic, but £400 million less than the previous year. For the new financial year, NHS England has told hospitals they must cut agency spending by as much as £1 billion. The scale of overspending has alarmed Downing Street, forcing senior figures in NHS England to issue some of the worst-performing areas blunt instructions to cut costs. One leaked email, seen by The Times, was sent to NHS chiefs in southwest London after a meeting between NHS England and other regional executives. Among 20 points to consider, including ‘’agency restrictions/bans’’ and a ‘’non-essential training freeze’’ it says: ‘’All chief executives to consider what services should be stopped or consolidated.’’ This could mean some services such as local clinics are shut or merged with others. In the Mid and South Essex area, the NHS is forecasting a £60 million deficit. Tracy Dowling, the chief executive, said: ‘’We will have to make difficult choices and some of those things will be in the short term… we have got to get control of the financial situation.’’ Similar messages were issued across the country. Saffron Cordery, deputy chief executive of NHS Providers, said services had been stretched by the need to pick up the pieces from a shortage of social care and other community services. She said an ageing population and poor public health meant patients in hospital were sicker and staying longer, needing more care. ‘’Trust leaders are being pushed to the very limits of what is possible, and there will be a situation where they have to make difficult choices about keeping basic services going versus investing in quality and improvement for the future,’’ she said. ‘’We are in a situation where we will be patching something that’s already a bit patched-together.’’ NHS England said: ‘’NHS organisations are developing plans for the new financial year and will be looking to deliver the best value for taxpayers and patients within the resources available.’’

Vaping can increase the risk of developing heart failure, a study has suggested. Researchers tracked 175,000 adults in the United States and found those who use e-cigarettes were 19 per cent more likely to develop heart failure over a four-year period. This increased risk was calculated after adjusting for other factors that can cause the condition, such as whether the participants smoked tobacco or were obese. The study, presented yesterday (Tuesday) at a meeting of the American College of Cardiology, provides the most conclusive evidence yet that vaping may cause heart failure – an incurable condition that means the heart is unable to pump blood around the body properly. Previous research has found evidence that e-cigarettes can put strain on the cardiovascular system by raising blood pressure and heart rate, making artery walls stiffer and less elastic. There are mounting concerns over the possible long-term health effects of vaping, contributing to a decision by the government to ban disposable vapes and restrict flavours. An investigation by The Times revealed how organisations linked to the tobacco industry have spent years playing down the risks of vapes, which health officials have enthusiastically promoted as tools to stop smoking. Dr Yakubu Bene-Alhasan, the lead author of the new study, of Medstar Health in Baltimore, said: ‘’More and more studies are linking e-cigarettes to harmful effects and finding that (they) might not be as safe as previously thought. The difference we saw was substantial. I think the research is long overdue, especially considering how much e-cigarettes have gained traction. We don’t want to wait too long to find out eventually that (vaping) might be harmful, and by that time a lot of harm might already have been done.’’ The research is observational and therefore cannot prove cause and effect. It involved 175,667 US adults, with an average age of 52, 3,242 of whom developed heart failure over the four-year follow up period. E-cigarette use was associated with a statistically significant increase in the risk of the most common type of heart failure, known as ‘’heart failure with preserved ejection fraction’’, meaning the heart muscle becomes stiff and does not properly fill with blood. More than a million patients in the UK have heart failure, symptoms of which include exhaustion and breathlessness, with few treatment options. More than 4.5 million people in the UK vape, according to latest data from the Office for National Statistics, and the habit is most common in those aged 16 to 24. A study last month by University College London found vaping damages cells in a similar way to smoking tobacco, causing changes that are linked to lung cancer. Most experts agree that vaping is significantly less harmful than smoking, and the NHS recommends that e-cigarettes should be used as a stop-smoking tool. Unlike cigarettes, vapes do not burn tobacco to produce tar or carbon monoxide, which are proven to cause cancer, but they do contain high levels of nicotine, but they do contain high levels of nicotine, which is highly addictive and raises the heart rate. James Leiper, associate medical director at the British Heart Foundation, said: ‘’This is the largest study yet to show a clear link between vaping and an increased chance of developing heart failure, a debilitating disease that prevents your heart from working properly. If you are concerned about your heart and circulation health, it is sensible to take steps to stop vaping.’’

Tens of thousands of children and adults with type 1 diabetes will be offered an ‘’artificial pancreas’’ on the NHS in a world-first initiative. The groundbreaking hybrid closed-loop system continually monitors a person’s blood glucose and automatically adjusts the amount of insulin given to them through a pump. It will mean that some people with type 1 diabetes will no longer need to inject themselves with insulin and can rely on the pump to administer the correct dose. Trials have shown that the device could help to prevent life-threatening hypoglycaemic and hyperglycaemic attacks, where blood sugar levels are dangerously high or low. These attacks can lead to seizures, coma or even death. Diabetes charities have called yesterday’s (Tuesday’s) introduction of the technology a ‘’landmark moment’’ for the NHS and those living with the condition. About 340,000 people are living with type 1 diabetes in the UK. Local NHS systems in England will now begin to identify those who could benefit from the hybrid closed-loop system. Scotland is also offering the new device, and Wales and Northern Ireland could soon follow suit. Clare Hambling, the NHS England national clinical director for diabetes, said: ‘’This is another example of the NHS leading the way in healthcare, rolling out these groundbreaking devices across England over the next five years. This transformative technology holds the power to redefine the lives of those with type 1 diabetes, promising a better quality of life as well as clinical outcomes.’’ The National Institute for Health and Care Excellence (Nice) approved the artificial pancreas for use in the NHS in December 2023, and NHS England has since set out a five-year plan for how to provide it to those eligible. Nice recommends the technology should be rolled out to under-18s and pregnant women with type 1 diabetes, as well as adults with the issue who have an average blood sugar level, or HbAlc, of 7.5 per cent or higher. The introduction of the device follows a pilot by NHS England, in which 835 adults and children with type 1 diabetes were given the technology to improve the management of their condition. Gemma Lavery, 38, from Plymouth, took part in the trial of the artificial pancreas and said it was a ‘’game changer’’, adding: ‘’I no longer have to worry about work-related stress affecting my blood glucose levels, as the closed loop helps to sort this out before it becomes a problem. I can have a full night sleep without worrying about regular low glucose levels hindering my morning routine and I have found that my diabetes is more stable.’’ The health minister Andrew Stephenson said: ‘’People living with type 1 diabetes face the constant stress of needing to monitor their blood glucose levels to stay healthy and avoid complications. This new technology will ease the burden on patients and allow them to manage their condition more easily, without needing to draw blood or wear a continuous glucose monitor.’’ While the device takes over the role of the pancreas in the production of insulin, it cannot replace the organ entirely and so could not help those with other pancreatic diseases, such as cancer. As well as producing insulin to break down glucose, the pancreas also produces enzymes for digestion, which help the body to break down carbohydrates and fats.

Women’s risk of suffering heart attacks and strokes increases rapidly after the menopause and catches up with that of men, research suggests. The female sex-hormone oestrogen has a protective effect on the heart, meaning younger women are at lower risk of heart disease than men. During menopause, which typically occurs between the ages of 45 and 55, the ovaries stop producing as much oestrogen, which causes periods to stop as well as other changes. A new study, presented at an American College of Cardiology conference, has found the drop in oestrogen means women’s heart disease risk accelerates and quickly becomes comparable to that of men of the same age. The study looked at 579 women who had been through the menopause and were being treated with statins to lower their cholesterol, matched with 579 men of the same age and health. The participants had two scans, a year apart, to assess the levels of plaque in their arteries, a key marker of health disease. Plaque was found to accumulate in the arteries of postmenopausal women twice as quickly as it did in men. Researchers said that doctors should be more proactive in screening postmenopausal women for heart problems and ensure that older women were not being ‘’under-treated’’.