WA4D Question and Answer Session
held on the 12th April 2008 by Dr. Singh

Question. I have been going to the same opticians for 7 years now I have been told I must go to a different one why?

Answer. The diabetic team need to keep a check on your eyesight to do this accurately they need to keep a record of digital photographs of the back of your eyes. These special digital photographs are put onto specially connected computers. This system takes tens of thousands of pounds to set up. The optician must be specially trained and do at least 500 screenings. We only need 13-15 specialist opticians to do this so for screening the eyes of people with diabetes they have to go to one of these specialists. BUT you can visit your optician for other eye care like ordinary eye tests and new specs. People like spec savers have opted out because they employ opticians who move on so it is not worth there while training them. Question How often should this special test be done Answer. Once a year.

Question. What can you tell me about Exenatide (Byetta)

Answer. It is a drug made to mimic another hormone in the body, it helps to release insulin. It is no good to treat type 1 diabetics as they don’t produce insulin and not much use in longstanding type 2 diabetics because they have insufficient insulin to release. It has to be injected 3 times a day before meals. It has a number of side effects especially on the digestive tract 1 in 4 become queasy, but as long as not taken after meals no hypos and it can cause slight weight loss.

Question. A million pounds has been donated for pancreatic islet transplants why is this not offered to people.

Answer. There are centres for islet cell transplantation but this operation cannot be offered to everyone. If large doses of insulin are needed it will not work. The patient is screened using specific criteria weighing up the costs and benefits to get a balance of whether it is worth while for individuals, they must be suitable. There is not a high success rate and the patient must be on anti-rejection drugs for the rest of their life which in itself can be dangerous. Pancreas transplant is a better option. In 10 years or so it is foreseen there will be a technological solution like using a pacemaker in the heart.

Question. I have lumps of fat on my legs is this due to diabetes

Answer. Diabetes does cause changes in fat and skin but so does age.

Question. I have been told that anti-hypertensive drugs put on weight is this true?

Answer. The beta blockers are the only ones that do but it is minimal only about 5Kgs Some of the diabetic drugs such as Glicazide and Glimepiride can cause an average weight gain of 8Kgs.