Maggie Watkinson on why young people need advice

Maggie Watkinson, lecturer practitioner in Diabetes Nursing at Oxford Brookes University, said it was inevitable in today's cultural climate that some young people with diabetes would dabble with illegal drugs.

She argued that instead of trying to stop young diabetics taking drugs, it would be more pragmatic to try to minimise the potential risks to their health.

Dr Watkinson makes her case in a paper in the Journal of Diabetic Nursing, published jointly with Julie Jenks, a nursing student at Oxford Brooks who is in regular contact with young drug users.

The authors warn that taking illegal drugs - especially amphetamine sulphate or "speed" - can have disastrous consequences for diabetics.

Taking speed could lead to coma

Taking speed increases the body's metabolic rate, rapidly decreasing blood sugar levels. In diabetics this can lead to a coma and, in extreme cases, death.

The authors say: "Recreational drug use is associated with more potential problems and dangers for young people with diabetes than for those without the disease.

"Information about how people with diabetes can remain as healthy as possible and control their diabetes while experimenting with recreational drugs should therefore be available.

"It is imperative that individuals who are going to take speed and go to a club know how to manage their diabetes in these circumstances, in order to avoid potentially dangerous hypoglycaemia."

The authors also advocate that nurses working with young people with diabetes should develop the kind of relationship in which they can easily relate the information on drug taking needed to avoid problems.

"Merely condemning illicit drug use is unlikely to result in young adults ceasing to indulge in risky behaviour," they argue.

'Counsel of despair'

"Supportive, open relationships that encourage disclosure and discussion about the dangers of illicit drug taking are more likely to result in increased safety and moderate usage."

Dr Adrian Rogers, director of the Conservative Family Institute, condemned the idea that young people should be given advice about drug taking as a "counsel of despair".

He said: "What is so sad is that we as a society are unable to take drugs off our streets and our dancefloors. The fact that they are coming up with this advice means that they have given up the struggle to protect young diabetics.

"If we assume that all young people are totally irresponsible and unable to control their appetite for drugs then we might as well pack up the human race and go home. It is just too tragic."

A spokesman for Department of Health said: "Health professionals need to give the best health advice they can to all their patients whatever the circumstances. This may well act as a way of stopping people taking illegal drugs."

Suzanne Lucas, director of care at the British Diabetic Association, said: "The BDA would recommend that people with diabetes need to be aware that the use of recreational drugs might interfere with their usual routine of medication and regular meals and would therefore be detrimental to their health."

Advance measures

Drugs are a part of nightclub culture

The authors warned that diabetics should take measures in advance to avoid this state, and also take a trusted friend with them who knows what to do in the event of a hypoglycaemic attack.

To avoid such an attack while taking speed, diabetics must have their usual insulin injection before going out, but they should also eat a meal rich in complex carbohydrates to ensure some slow release carbohydrate is available in the blood later in the evening.

It is also essential to monitor blood glucose levels frequently, and always to carry glucose or sugar for the treatment of hypoglycaemia.

"The increased metabolic rate, together with the heat generated by dancing , may result in excessive body fluid loss," the authors argue.

"Individuals should be encouraged to drink large amounts of non-glucose and non-alcoholic fluids to compensate for this.