British watchdog group The Healthcare Commission just gave diabetes care in the UK a lukewarm review. Its study of the facilities in which British diabetics receive care concludes that care levels overall are basic, at best. Most of the places (73%) surveyed in the study were rated "fair," meaning patients know what medications they are supposed to be on and when they should be taking them. They also know they should be getting annual checkups. Only five percent of facilities were rated "excellent by the Commission.

The system is lacking, however, when it comes to anything beyond those most basic of services. Just like here in the US, most British people with diabetes are not receiving help with diabetes management. Studies suggest that regular consultations with a health "coach" on an individual basis could really improve patient outcomes. One reason they are helpful is because they get patients to come up with a care plan tailored for each person, making it more likely he/she will be able to stick with it.

Diabetes UK head of healthcare policy, Bridget Turner, agrees with the Commission's conclusions: "The NHS [National Health Service] has to focus more on...self-care. For people with diabetes, 95% of diabetes management is self-care."

To read more, click here or visit the Healthcare Commission's own web summary of the report.

Any headline that features die is bound to grab your attention. The headline appeared in an article published by The Scotsman. What the title lacks in sensitivity it makes up for in reader feedback. Both, statistically eye-popping and universally alarming, I give you extracts from the article and a few passionate responses from readers. How does it make you feel?

Research from Edinburgh University reveals the number of people diagnosed with type-2 diabetes will soar by 60% within the next ten years. This is mainly due to the obesity crisis, with current estimates showing a quarter of the population is likely to be classed as obese by 2018. Doctors say they are treating an increasing number of teenagers for type-2 diabetes, which traditionally only develops in older people. Being overweight is a strong factor in becoming a type-2 diabetic, which can lead to complications of diabetes like blindness, amputations, cardiovascular disease and kidney failure. Diabetes and complications therein are estimated to costs the NHS nearly a tenth of its yearly budget. With future expectations of diagnosis -- the strain on the NHS will get worse. Andy Kerr, the health minister, admitted diabetes would prove to be a time bomb if the Executive's healthy eating initiatives failed. But he ruled out screening children for diabetes or rationing healthcare for people diagnosed with type-2 because of their unhealthy lifestyles.

And now for the comments:

Commenter #3 says I daresay the Scottish obesity/diabetes problems predates devolution.
Commenter #9 says, The statistical analysis regarding type 2 diabetes is flawed; the medical profession have been guilty in prescribing drugs and reissuing prescriptions for drugs that are only safe for short periods. One such drug has had its usage limited by the authorities within the past 3 years in Scotland and has only been reclassified in England and Wales in the past 6 months. This drug is now listed as causing type 2 diabetes, how many more are there out there? Hence the statistical analysis is being used to cover a grave error that is to be covered up.
Commenter #20 says, Perhaps we should take a closer look at why our kids are obese. They are marooned in the house for most their lives and when they actually do go out mum or dad are suckered into driving them everywhere. Tackle the fear which causes this situation and you are half way to solving the obesity problem of our youngsters.

All things considered, what if this headline was featured in the New York Times or more revealing - the 5 o'clock news? How would you react to it?

Prime Minister Tony Blair said in a speech that the so-called obesity epidemic is not an epidemic in the true sense of the word. In fact, he said, many of British society's health problems are not "strictly speaking, public health problems at all." Instead, Blair said, Britons need to get a dose of individual responsibility to get their health under control, starting with healthy nutrition and exercise. Mr. Blair also made it clear that he and his Labour government consider chronic health problems arising from unhealthy lifestyles to be self-inflicted. However, he acknowledged that the solution is through a community approach. "If millions of children are not eating the right food and not getting enough exercise," said Blair, "then it's not just a million individual problems, it's a collective problem that will require us all to work together, including government."

The biggest concern when it comes to "self-inflicted" diseases? Diabetes. "Ten percent of NHS [National Health Service] resources today are used to treat diabetes," said Blair. "By 2010 that estimate is that this could double. That's twenty percent of the entire resources of the NHS - and it's avoidable." Don't know about you, but I admire his frankness on this topic.

No matter what country you live in, you have to take the good with the bad. Nowhere does this impact your life more than in the area of health care, where your very physical and mental well-being may rely upon the type of system you live under. In the US, the system is privatized, leaving millions of people uninsured or under-insured. In the UK, the system is government-run and funded by taxpayers. There are disadvantages to this system also. For example, you may become accustomed to receiving certain services at no cost. Say, blood glucose monitors. Then one day you wake up to find that, in an effort to cut costs, that particular service has been axed by the National Health Service (NHS).

This is exactly what is happening in the UK at the moment. It looks likely that 2.1million diabetics will have to come up with the money to buy their own monitors in the future. The fear amongst health experts is that, for a variety of reasons, too many (especially those who are financially less-well-off) will end up going without altogether -- with disastrous consequences. It's possible, given the uproar over the decision, that the NHS will back down. It will be interesting to see what happens.