Treating serious gum disease in diabetics can help to lower their blood sugar levels, a new study has found.

Edinburgh University scientists have found reducing gum inflammation in people with diabetes can help minimise complications with the condition.

It is thought when bacteria infect the mouth causing inflammation the chemical changes reduce effectiveness of insulin and raise the levels of blood sugar.

Treatment to reduce inflammation may therefore help reduce blood sugar.

The findings are published as part of the international Cochrane Collaboration.

Dental institute

The team, including researchers from UCL Eastman Dental Institute, Peninsula Dental School and Ottawa University, said their findings highlighted the need for doctors and dentists to work together in the treatment of people with diabetes.

Dr Terry Simpson, honorary research fellow at Edinburgh University’s dental institute, who led the study, said: "This research confirms that there may be a link between serious gum disease and diabetes.

"It highlights the role dentists can play in managing the condition, given that gum disease is very treatable.

"By far the most important aspect of diabetes management is the use of insulin, drugs and diet to control blood sugar levels but maintaining good dental health is something patients and healthcare professionals should also recognise.

"Although the benefit in terms of insulin management is small, anything we can do to promote the wellbeing of people with diabetes should be welcomed."

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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By Maddy Savage
BBC News

Some 65% of doctors say they can "rarely" offer psychological therapy to depression sufferers within two months of referral, a study suggests.

The Royal College of GPs survey of 590 UK doctors also found 15% said access to psychological services was only "usually" possible in that timeframe.

The survey is part of a campaign by mental health charity Mind calling for better access to therapies.

The government says it is working hard with the RCGP to achieve this.

Depression affects one in 10 people a year, with more than half of those experiencing more than one episode.

Manifestos

The National Institute for Clinical Excellence (NICE) recommends talking therapies as the best form of treatment for mild and moderate depression.

Mind’s campaign is being backed by the Royal College of Psychiatrists.

It challenges all political parties to make a guarantee in their election manifestos, to offer evidence-based therapies to all those who need them within 28 days of requesting referral.

In 2007, the government earmarked £173m to boost the number of cognitive behavioural therapists available on the NHS.

The Improving Access to Psychological Therapies (IAPT) programme aims to treat 900,000 extra people in England by 2010/11, with half of them moving to recovery and 25,000 fewer on sick pay and benefits.

Delay ‘cost me my marriage’

RCGP chairman Professor Steve Field said: "There has been substantial improvement in the last few years but there is a long way to go.

"It is essential that the current programme is completed within the next Parliament with adequate funding for training and employing extra therapists.

"If we can treat people early we can keep people in work, keep them off medication and help them get on with their lives."

Mind chief executive Paul Farmer said talking therapies could save lives, and it was crucial that people who needed help received it as quickly as possible.

"Waiting months and months for urgent treatment would not be acceptable for patients with other health problems, and it should not be acceptable for patients with depression," he said.

A Department of Health spokesperson said more than 230,000 people had already benefited from the IAPT and that almost three quarters of primary care trusts now offered this service, up from a quarter two years ago.

But in a statement it added: "There is still work to do and we will work closely with the Royal College of GPs and others to achieve this."

‘Misery’

Opposition parties have also pledged to widen access to talking therapy treatments.

Tory shadow health minister Anne Milton said: "In the same way that physical conditions get worse when not treated, a mental health condition will also deteriorate. This must be improved.

"We will make sure that GPs have better information about the effectiveness of talking therapies."

A Lib Dem spokesman said: "We are totally committed to ensuring that people with mental health problems are given guaranteed access to the treatment that they need and we want to work with Mind and the Royal College of GPs to find out what the spending implications would be of a 28-day guarantee."

The programme director for Wellbeing at the London School of Economics, Professor Lord Layard, who is spearheading the campaign, has stressed the economic as well as the humanitarian case for investing in treatment, suggesting that successful therapy can help many people return to the workplace.

"Mental illness is perhaps the greatest single cause of misery in our country," he said.

"The least we should offer is the same standard of care we would automatically provide if they had a physical illness."

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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By Jane Elliott
Health reporter, BBC News

When keen golfer Marlene Evans started to suffer excruciating pain in her hips she feared the worse.

"Even if I turned over slightly in the night, a shooting pain from my hip would wake me," she said.

"The final straw came when I was forced to take up to eight painkillers a day so that I could control the pain and get through a round of golf.

"Although the anti-inflammatory painkillers did take the edge off the pain, I started to feel dizzy and sick as a result. I knew that I had to find another way of dealing with it."

Wear and tear

Doctors initially thought Marlene, from Wrexham, had a deep vein thrombosis.

But tests revealed she had wear and tear of the hips and she was referred for treatment.

"Marlene had an excellent response, but the studies of it round the hip show these patients do very well"

Tony Spire

"I thought I would need a hip replacement," she said.

She was then referred to Dr Tony Smith at Spire Yale Hospital, Wrexham.

He diagnosed that she had trochanteric bursititis, a common disorder of the hip that results from a swelling of the bursa – a small fluid sac that releases fluid to prevent friction between bones.

And he said a relatively new treatment – extra-corporeal shock wave therapy – might work.

The therapy was first developed 20 years ago as a treatment for kidney stones but has only just been recognised as an orthopaedic treatment in the UK.

It uses high energy sound waves which are focused on the injury using a special pad.

A vibrating hand-held wand attached to a generator delivers the shockwaves in short bursts. Repeated applications have an analgesic effect which breaks down calcifications in the area and stimulates blood supply and the formation of new bone tissue.

Speedy treatment

Dr Smith explained that the treatment, which takes a matter of minutes to carry out over the course of three weeks, had been shown to have good results when used on the hip.

"Marlene had an excellent response, but the studies of it round the hip show these patients do very well.

"We do offer it to a variety of patients and the results are not remarkable in all areas, but you are dealing with a very difficult problem."

The treatment, which is carried out on joints like the hips, shoulder, ankle, is not widely available on the NHS and costs about £600 a course.

Jane Tadman from Arthritis Research UK said that there was currently little research evidence to show that extra-corporeal shock wave therapy was effective in the treatment of trochanteric bursitis.

"Trochanteric bursitis of the hip is quite common, and in most cases is self-limiting and normally clears up on its own with non-steroidal anti-inflammatory drugs and steroids, physiotherapy and exercise," she added.

But Marlene, who got her treatment on the NHS late last year, says she has no doubts recommending the treatment.

"It was not painful," she said.

"I had the three treatments and was starting to feel better very quickly, almost the same week.

"He has really ‘cured’ it because I have not been taking painkillers.

"I haven’t had a sleepless night for nine months. I am so relieved that I didn’t have to have surgery and will definitely recommend it to anyone else."

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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A sticking plaster approach to treating skin cancer has been unveiled at Ninewells Hospital in Dundee.

The light-emitting Ambulight PDT device has been developed in an attempt to make the treatment of skin cancer faster and more comfortable.

Clinicians said the plaster avoided scarring and reduced the amount of time patients need to spend in hospital.

Skin cancer is one of the most common cancers in the UK, with its incidence doubling every eight to ten years.

The new treatment, which is being rolled out to hospitals across the UK, would see skin cancer patients given a drug which makes the affected skin sensitive to light.

The disposable light-emitting plaster is then stuck over the top, allowing photodynamic therapy treatment (PDT) to be applied directly to the skin, destroying the cancerous cells.

For non-melanoma, the most common treatment in the past has involved applying a cream to the skin for several hours before the patient undergoes intensive light treatment.

"There was a nippy feeling but the pain threshold from nought to ten was only about a three and I have been told that the conventional method was about an eight"

Muriel Lowe
Skin cancer patient

But with the new device, the patient can be in and out of hospital within minutes, enabling them to continue with their normal daily routine while undergoing PDT treatment.

Pilot clinical trials have also indicated this new treatment method causes lower pain than conventional techniques while still achieving an equivalent outcome.

James Ferguson, a professor of dermatology at Ninewells, explained: "This new device can be taken away home with the patients.

"It is escaping from the hospital environment, making for a gentler approach to skin cancer treatment."

Muriel Lowe, one of the 50 patients who have so far been treated in Dundee, said: "I came in not knowing anything about the treatment.

"The nurse and the doctor explained the process really well, the plaster device was put on and I went home.

"There was a nippy feeling but the pain threshold from nought to ten was only about a three and I have been told that the conventional method was about an eight."

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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Scientists have developed a gene test which predicts how well chemotherapy will work in cancer patients.

Starting with 829 genes in breast cancer cells, the team whittled down the possibilities to six genes which had an impact on whether a drug worked.

They then showed that these genes could be used to predict the effectiveness of a drug called paclitaxel in patients.

It is hoped the approach, reported in The Lancet Oncology, can be replicated for other cancers and treatments.

The international project, including researchers from Cancer Research UK’s London Research Institute, opens the way for breast cancer treatment to be targeted to those who will benefit the most.

To find which genes, if missing or faulty, could prevent the drug from working, they deleted them one by one from cancer cells in the laboratory.

They eventually highlighted the six genes which if absent or not working prevent paclitaxel from properly killing breast cancer cells.

Spare treatment

More than 45,500 women are diagnosed with breast cancer in the UK each year – and it is estimated that around 15% of these women will be prescribed paclitaxel.

The researchers estimate they could potentially spare half of the patients currently receiving this drug from treatment which would not be effective.

Study leader, Dr Charles Swanton, head of translational cancer therapeutics at the Institute, said one of the great challenges in cancer medicine is determining which patients will benefit from particular cancer drugs, which are in themselves toxic and carry severe side effects.

"The challenge is to apply these methods to other drugs in cancer medicine"

Dr Charles Swanton, study leader

"Our research shows it is now possible to rapidly pinpoint genes which prevent cancer cells from being destroyed by anti-cancer drugs and use these same genes to predict which patients will benefit from specific types of treatment."

Further studies will now be done to see if the technique can be developed into a simple diagnostic test to be given to patients to help inform doctors about whether or not to prescribe paclitaxel.

He said the challenge will be to apply these methods to other drugs in cancer medicine.

"These could include treatments that are currently deemed too expensive to fund on the NHS – however, in the future, treating only the patients that will benefit from certain treatments will save the NHS money in the long term."

Dr Lesley Walker, Cancer Research UK’s director of cancer information, said: "New techniques such as these can enable drugs to be tailored to individual patients, and this could potentially improve cancer survival in the long term.

"Health professionals may in the future be able to use this information to direct treatment to patients most likely to benefit, and avoid giving treatment that is less likely to be effective to patients with drug resistant cancers."

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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