BMJ  2008;336:1508 (28 June), doi:10.1136/bmj.a510

Views & Reviews

From the Frontline

A golden syrup

Des Spence

destwo@yahoo.co.uk

The first 150 words of the full text of this article appear below.

Much of my working life is spent listening to confessions. For example, someone with diabetes might say, "I have the occasional KitKat; I’m so sorry, doctor." Medicine’s denunciation of paternalism is but a sham, for we now attempt to micro-manage every detail of patients’ lives, through medications and health promotion diktats. But this clearly isn’t working.

People with type 2 diabetes fare the worst. Their diagnosis is now an absolute. The term "mild diabetes" has long been retired to the graveyard of defunct terminology, along with "nervous disability" and "rodent ulcer." Also, we have lowered the threshold for diagnosis, and the meaningless term "prediabetes" stalks some 54 million people in the United States. Diabetes is now a big problem—but an even bigger business.

Then start the horror stories of blindness, dialysis, amputations, and heart attacks—terror tactics used in the name of compliance. Next come the medications—statins, aspirin, and ACE inhibitors, . . . [Full text of this article]


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