Speakers - DEWC2025

Abstract

FORENSIC ADVOCACY IN HYPOGLYCAEMIA 2025

Call to Action presented by the WHO World Health Organisation and IDF International Diabetes Federation for World Diabetes Day 14 November 2024 identifies Public Health Concerns for Diabetes, Obesity, and Mental Health now a Global Challenge for 2025.  The concept that    Neuro Purkinje Cell Environmental Enrichment in Neurology and Physiology relates to Hypoglycaemia, Low BG Blood Glucose, and Hyperglycaemia, High BG Blood Glucose in theory links to the original Research Discovery of Insulin by Banting, Best, Macleod, Collip, in 1921/22 with the first Diabetes Patients Treated successfully in Toronto, Canada, with helpful input from JJR Macleod a Physiologist from Aberdeen, Scotland.  The Biochemistry and Clinical Pathology of how Insulin can be used as a lifesaver for Diabetes Patients when in T1D Diabetes Patients the Pancreas stops producing Insulin and in T2D Diabetes Patients we see a malfunctioning Pancreas requiring Hyperglycaemia lowering Medication for example Metformin and other T2D medication opportunities but often leading to need for Insulin Injection after several years. The discovery of Insulin has been a lifesaver for all T1D Patients for 104 years. However, how does it work in the Hypoglycaemia focus for patient welfare and success in prescribed Insulin medication treatment?

Clinical Science, Social Science, and Forensic Aspects of Hypoglycaemia and Hyperglycaemia in Law leave a serious challenge to Diabetes Patients to enjoy life and at the same time live a life knowing that each day, 100 additional decisions are required by the patient to achieve compliance with clinical guidance, but this leaves open the understanding of physiology.

Can Environmental Enrichment of Purkinje Nerve Cells in the Brain help identify the cause of Obesity with links to many Endocrinology Disorders especially when Rare Diseases such as Thyroid Disorders, Addison’s Disease, Dyslexia, Graves Disease, Hashimoto’s Disease, to name but a few of recognised 7,000 Rare Diseases.

Family issues are apparent with Mental Health and Emotional Challenge when a Daughter may rebel against her father with possible cause of Genetically Inherited Addison’s Disease leading to Fear, Paranoia, Agoraphobia, or genetically inherited Foetal Alcohol Spectrum Disorder linked to Dyslexia with learning difficulties and ignorance with risk of stigma and lack of respect when a Diabetes Patient understands the importance of daily Insulin injections and need for little stress when implementing such daily injections and at the same time understanding the importance of ensuring correct Dose, Insulin Type, frequency of injection.  Disruption when injecting Insulin can be alarming to the patient when knowing that overdose can easily lead to Hypoglycaemia which if not corrected can cause Diabetic Coma with Neuroglycopenia and sadly on occasion early preventable death.  Much is needed to improve knowledge and awareness of this importance.

Diabetes – 800 million patients are affected worldwide. India – 100 million.  UK – 5 million

Statistics suggest that 10% are T1D Diabetes Insulin Dependent Patients; 85% are T2D Diabetes; 5% are Gestational Diabetes during Pregnancy with complex Forensic Clinical Pathology to understand and identify the cause of death in tragic premature or newly born baby deaths.  Family Genetic History of Parents can be important to understand the cause of death eg Alcohol, Recreational Drugs, Smoking, and pre-existing family health such as Addison’s Disease previously known to have been caused by TB Tuberculosis infection of the mother at birth. T2D in Children has recently been identified with likely links to Obesity and child lifestyle.

2020 – 2025 Post Covid Challenge in Endocrinology - Patient Winning in the Endocrinology, Diabetes and Thyroid Challenge as Winning in Insulin Chicanes.

2025 - Warrior Challenge to improve Hypoglycemia Understanding in Clinical Science, Social Science & Law!  WHO and IDF Call to Action to address Mental Health in Diabetes, Endocrinology, Rare Diseases including Addison’s Disease.

• T1D Winning in Insulin Chicanes –
• The Book - In Progress – to be published in 2025
• Addison’s Disease – Fresh Evidence – Why Concealed?
• A 46-year Diabetes Journey by Derek Beatty, Edinburgh
• A 31-year Forensic Diabetes Research Investigation
• Guest Input from Associate Professor Dr Christina G Yap, Physiology, Monash University, Malaysia.

• Ref: Purkinje Brain Cell - Environmental enrichment preserves hippocampal neurons in diabetes and stressed rats. N. Pamidi1, C.G. Yap1 and S. Nayak2 1Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Kuala Lumpur, Malaysia
• Department of Anatomy, Melaka Manipal Medical College, Manipal University, Manipal, Karnataka, India
• Diet lifestyle issues in Keto Diet benefit in Diabetes.
• But Wait: In the UK Rare Conditions collectively affect 3.5 million people.
• It is estimated there are over 7,000 Rare Conditions.
• 8 out of 10 rare conditions are caused by a change to someone’s Genetic Code.

Ref: Genetic Alliance UK.

HYPOGLYCAEMIA affects patients with DIABETES and ADDISON’s DISEASE

Do we understand this concept and opportunity in Clinical Science, Social Science, and Law?  How do we educate patients, parents, children, families, teachers, and emergency services to better understand the social science of Hypoglycaemia?

Is it a burning question? Answers are needed to help understand Emergency Ambulance Services; Police Service at Emergency Events; and Council Social Services.

Hypoglycaemia with Low Blood Glucose associated with Neuroglycopenia and rapid lowering of Blood Glucose below 4.0mmol/l can be alarming.  It is a Red Alert Clinical Emergency when immediate witness attention and action are required to prevent Coma and if not corrected exposure to a fatal outcome.

In 2025 sadly we see a tragic return of Unexplained Death in Bed involving very young babies revisited after 30 years when /the problem was published in the late 1980’s.

I endorse the WHO and IDF ‘Call to Action’ and am honoured to be invited to share this concern at this important Global Diabetes Endocrinology and Obesity Conference.