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Diabetes’ effect on mental health explored

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NEW research from Diabetes UK has found that seven out of ten people feel overwhelmed by the demands of living with diabetes, significantly affecting their mental and physical health.

The survey of more than 2,000 adults with Type 1, Type 2 and other types of diabetes from across the UK shows that the majority (three quarters) of those who feel overwhelmed say that this affects how well they can manage the condition.

In order to explore the links between mental health and diabetes, the charity collected extensive insights from people affected by the condition and healthcare professionals from across the UK.

The findings, published in the report “Too often missing: Making emotional and psychological support routine in diabetes care”, show that diabetes is much more than a physical condition.

Management of physical symptoms 24/7 – for example checking blood glucose levels, or managing diet – alongside the continual need to make decisions and take actions in order to reduce the likelihood of short and long-term complications, can affect every aspect of day-to-day life.

The research revealed that the relentless nature of diabetes can impact people’s emotional, mental and psychological wellbeing and health, from day-to-day frustration and low mood, to specific psychological and mental health difficulties such as clinical depression and anxiety.

Three-quarters of those needing specialist mental health support to help manage the condition, such as from a counsellor or psychologist, could not access it. Seven out of ten people with diabetes also reported that they are not helped to talk about their emotional wellbeing by their diabetes teams.

Healthcare professionals surveyed also revealed that there was more to be done in this area. Specifically, 40 per cent of GPs say they are not likely to ask about emotional wellbeing and mental health in routine diabetes appointments, while only 30 per cent feel there is enough emotional and psychological support for people living with diabetes when needed.

The report marks the launch of a Diabetes UK campaign to make the emotional and psychological demands of living with diabetes recognised and provide the right support to everyone who needs it.

Diabetes UK Cymru is marking the launch with an event on Wednesday 22 May at the Norwegian Church in Cardiff Bay from 12 pm to 2 pm.

The charity is urgently calling on each of the four nations’ health services to create national standards for diabetes emotional and mental healthservices. These should ensure that everyone is asked how they are feeling as part of every diabetes appointment and that a mental healthprofessional with knowledge of diabetes is part of every diabetes care team.

Dai Williams, National Director, Diabetes UK Cymru, said: “The day-to-day demands of managing diabetes can be a constant struggle, affecting people’s emotional wellbeing and mental health. In turn, people tell us that struggling emotionally can make it even more difficult to keep on top of self-management. And when diabetes cannot be well managed, the risk of dangerous complications, such as amputations, kidney failure and stroke increases.

“Diabetes services that include emotional and psychological support can help people improve both their physical and mental health, reduce pressure on services, and save money.

“Mental health and physical health go hand in hand, but services for people with diabetes don’t always reflect this. We need to bridge the divide between physical and mental health services to ensure those with emotional and psychological difficulties related to their condition do not have their needs overlooked. It is critical that all diabetes care sees and supports the whole person, and explores what matters most to them.”

Diabetes UK is launching a petition to call for national standards for diabetes mental health support and services.

To find out more about the campaign and sign the petition go to www.diabetes.org.uk/missing

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Welsh residents unaware of the early signs of dehydration according to new resarch

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PEOPLE living in Wales are unaware of the five most common signs of dehydration, according to research from Aqua Pura.

Even though more than half (55%) of residents believe they know the symptoms of dehydration, the new research reveals many don’t know the early warning signs.

More than two thirds (65%) don’t think having bad breath/a dry mouth is a symptom of dehydration, while half (50%) don’t think dark coloured urine is a tell tail sign. In reality, both are early warning signs which shouldn’t be ignored.

Early signs which residents in Wales don’t think are signs of dehydration (but actually are) include (% of survey sample):

·       Bad breath/dry mouth (65%)

·       Feeling dizzy (53%)

·       Dark coloured urine (50%)

·       Fatigue (48%)

·       Headache (42%)

“Dehydration can lead to a number of health problems such as constipation, muscle tiredness, urinary tract infections and headaches, so it’s concerning to see that so many people are unaware of the early signs. It’s known that having a good level of hydration can help to maintain higher energy levels, better weight control and faster thinking.

“As we approach the summer months and temperatures across the country rise, it’s important that people take the time to drink more to keep their fluid levels topped up and avoid any unwanted health issues. This fluid can in fact come from a variety of drinks and foods, but plain water is a great calorie and sugar free option to ensure you stay hydrated,” comments hydration expert, Dr Stuart Galloway of the University of Stirling.

From fizzy drinks and fresh orange juice, to tea and coffee the research reveals residents of Wales are unaware that drinks other than plain water can contribute to hydration levels.

In fact, almost two fifths (17%) of those surveyed don’t think that sparkling water contributes, let alone fizzy drinks.

Top 10 drinks residents of the Wales don’t think help with hydration

1.     Wine (68%)

2.     Beer/larger (66%)

3.     Cider (64%)

4.     Coffee (53%)  

5.     Hot chocolate (47%)

6.     Fizzy drinks (44%)

7.     Fresh juice (21%)

8.     Tea (25%)

9.     Sparkling water (17%)

10.  Dilutable juice (13%)

“Many will be surprised to see drinks like wine and coffee on the list, as they’re often thought to dehydrate you. Alcoholic drinks will lead to dehydration, but only if you drink more than one or two servings. A similar situation occurs with caffeinated drinks, for example, a black coffee is mostly boiling water so this makes up part of your daily water intake. The dehydration effect of caffeine starts to kick in after around a litre of regular coffee, up until then it can be classed as part of your daily intake of water. However, often the best and healthiest way to ensure you’re getting your daily intake of water is by drinking plain still or sparkling water,” adds Dr Stuart.

Even though drinking water is the easiest, and healthiest, way to get to the recommended daily amount of water, the nationwide survey reveals almost one in 10 (7%) admit they don’t drink any water at all. Those in the baby boomer generation, aged between 55 – 73, are the most likely to not drink any water at all, with one in seven (14%) saying this is the case.

Dr Stuart’s top tips of staying hydrated this summer:

·       Be aware of the signs of dehydration such as dry mouth and dark coloured urine

·       Alongside the fluids you drink, choose foods such as fruits and vegetables which have a high-water content as this all helps to keep you hydrated throughout the day without you even thinking about it

·       The hotter you get, the quicker you’ll get dehydrated so make sure you’re dressing for the weather and don’t spend too much time out in the sun

·       If you’re going out for the day, or even just spending an afternoon at the shops, make sure you take some water with you to stay hydrated on the go

“It’s our mission here at Aqua Pura to keep the nation hydrated – especially over the summer when more people are out and about, exploring their local area. The good news is that it’s easy to keep hydrated simply by drinking water – something that is plentiful here in the UK thanks to our climate. It means we’re all able to enjoy fresh water from the hills – in our case from the Lake District – to help keep us healthy.

“In a bid to help people stay hydrated, we’ve created a hydration calculator so Brits can work out how much water they should be drinking this summer. We hope this will help people to truly understand how much water they should be drinking,” adds Kelly Hall, Aqua Pura.

To calculate how much you should be drinking, visit www.aqua-pura.com.

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Childhood hepatitis outbreak – four more cases in Wales under investigation

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PUBLIC HEALTH WALES is investigating four more cases of acute hepatitis among children.

Health officials have identified 17 cases in Wales, an increase of four cases since the last update on 6 May.

UK Health Security Agency launched an investigation in April after hospitals reported a rise in cases of acute childhood hepatitis with no known cause.

Typically, UK hospitals see about 20 cases a year that are not caused by common hepatitis viruses, but cases this year are nearly 10 times higher.

A number of hypotheses are being investigated and the information gathered so far increasingly suggests that the rise in these cases may be linked to adenovirus infection, with other factors likely to be playing a role.

Dr Ardiana Gjini, Consultant in Communicable Disease Control for Public Health Wales, said:

“Hepatitis can cause jaundice and inflammation of the liver, so parents and carers should be aware of the symptoms of jaundice – including skin with a yellow tinge which is most easily seen in the whites of the eyes.

“We are reminding the public to familiarise themselves with this and other symptoms of hepatitis in light of these UK cases.

“In addition, the importance of maintaining normal hygiene routines, especially ensuring that children wash their hands properly, help to reduce the spread of many common infections.

“Parents and carers are reminded that they should keep their children away from school and seek advice from a GP or an appropriate specialist if their child experiences any symptoms linked with hepatitis.”

Hepatitis symptoms include:

  • dark urine
  • pale, grey-coloured poo
  • itchy skin
  • yellowing of the eyes and skin (jaundice)
  • muscle and joint pain
  • a high temperature
  • feeling and being sick
  • feeling unusually tired all the time
  • loss of appetite
  • tummy pain

Regular updates on the ongoing investigation into the cases in the UK can be found on the UKHSA website.

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Monkeypox Q&A: how do you catch it and what are the risks? An expert explains

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THE LATEST outbreak of monkeypox has, at the time of writing, reached 17 countries with 110 confirmed cases and a further 205 suspected cases. It’s a fast-moving story, so if you need to catch up on the latest, here are answers to some of the most pressing questions.

How is monkeypox spreading?

The first patient in the current outbreak had returned to the UK from travels to Nigeria where monkeypox is endemic. However, cases are now spreading among people who have not travelled to west or central Africa, suggesting local transmission is occurring.

Monkeypox usually spreads by close contact and respiratory droplets. However, sexual transmission (via semen and/or vaginal fluid) has been posited as an additional possible route. The World Health Organization (WHO) says: “Studies are needed to better understand this risk.”

Most cases in the current outbreak have been in youngish men, but the virus can spread to anyone.

There are no confirmed cases in Pembrokeshire at the present time.

What are the symptoms?

Early symptoms are flu-like, such as a fever, headaches, aching muscles and swollen lymph nodes.

Once the fever breaks, a rash can develop, often beginning on the face and then spreading to other parts of the body – most commonly the palms of the hands and soles of the feet.

Monkeypox lesions.
Evolution of monkeypox lesions. UK government/Wikimedia

How deadly is monkeypox?

Monkeypox is mostly a mild, self-limiting disease lasting two-to-three weeks. However, in some cases, it can cause death. According to the WHO, the fatality rate “in recent times” has been around 3% to 6%. The west African monkeypox virus is considered to be milder than the central African one.

Monkeypox tends to cause more serious disease in people who are immunocompromised – such as those undergoing chemotherapy – and children. There have been no deaths from monkeypox in the current worldwide outbreak, but, according to the Daily Telegraph, one child in the UK is in intensive care with the disease.

Why is it called monkeypox?

Monkeypox was first identified in laboratory monkeys (macaques) in Denmark in 1958, hence the name. However, monkeys don’t seem to be the natural hosts of the virus. It is more commonly found in rats, mice and squirrels. The first case in humans was seen in the 1970s in the Democratic Republic of the Congo.

Is monkeypox related to smallpox and chickenpox?

Monkeypox is related to smallpox – they are both orthopoxviruses – but it is not related to chickenpox. Despite the name, chickenpox is a herpes virus, not a poxvirus. (How “chicken” got in the name is not entirely clear. In his dictionary of 1755, Samuel Johnson surmised that it is so named because it is “of no very great danger”.) Nevertheless, the vesicles (little pus-filled blisters) caused by monkeypox are similar in appearance to those of chickenpox.

Are cases likely to continue rising?

Cases are likely to continue to rise significantly over the next two-to-three weeks, but this is not another pandemic in the making. Monkeypox doesn’t spread anywhere near as easily as the airborne virus SARS-CoV-2 that causes COVID-19.

Has monkeypox evolved to be more virulent?

RNA viruses, such as SARS-CoV-2, don’t have the ability to check their genetic code for mistakes each time they replicate, so they tend to evolve faster. Monkeypox is a DNA virus, which does have the ability to check itself for genetic mistakes each time it replicates, so it tends to mutate a lot slower.

The first genome sequence of the current outbreak (from a patient in Portugal) suggests that the virus is very similar to the monkeypox strain that was circulating in 2018 and 2019 in the UK, Singapore and Israel. So it is unlikely that the current outbreak is the result of a mutated virus that is better at spreading.

How is monkeypox diagnosed?

In the UK, swab samples taken from the patient are sent to a specialist laboratory that handles rare pathogens, where a PCR test is run to confirm monkeypox. The UK Health Security Agency has only one rare and imported pathogens laboratory.

Is there a vaccine for it?

Vaccines for smallpox, which contain the lab-made vaccinia virus, can protect against monkeypox. However, the vaccine that was used to eradicate smallpox can have severe side-effects, killing around one in a million people vaccinated.

The only vaccine specifically approved for monkeypox, Imvanex, is made by a company called Bavarian Nordic. It uses a nonreplicating form of vaccinia, which causes fewer side-effects. It was approved by the US Food and Drug Administration and the European Medicines Agency in 2019 – but only for use in people 18 years of age or older.

UK health secretary Sajid Javid said that the UK government will be stocking up on vaccines that are effective against monkeypox. The UK currently has about 5,000 doses of smallpox vaccine, which has an efficacy of around 85% against monkeypox.

Are there drugs to treat it?

There are no specific drugs to treat monkeypox. However, antivirals such as cidofovir and brincidofovir have been proven to be effective against poxviruses in animals and may also be effective against monkeypox infections in humans.

By Ed Feil, Professor of Microbial Evolution at The Milner Centre for Evolution, University of Bath

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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