Derek C Beatty
Edinburgh University, United Kingdom
Title: Diabetes hypoglycaemia and neuroglycopenia recovery emergency Covid-19 death link with insulin and diabetes
Biography
Abstract
The author Derek C Beatty on 23 February 1994 at 6.30pm in St Albans, Hertfordshire, England, in Dry Weather and Dark, experienced a very serious diabetic hypoglycaemia and neuroglycopenia event caused by incorrectly prescribed insulin by his medical team to treat Type 1 Diabetes for 9 years before hand. This led to many years of hypoglycaemia unawareness which went undiagnosed by his medical clinicians for many years. Following experience of this life changing event, and with detailed forensic investigation, he discovered he had been incorrectly treated with an estimated 20% overdose of the wrong insulin for 9 years beforehand having first been diagnosed in late 1978 and treated with porcine insulin for 6 years prior to being switched in 1985 to Human Insulin by his GP without access to blood glucose monitoring testing device and test strips and no dosage reduction as was advised by the Medicines Control Agency MCA at the time, nor suitable education from his NHS contracted clinicians on how to manage this new insulin regime with required support from his family. The experience in 1994 was life changing and devasting for the writer with family breakdown and massive financial loss caused by alleged medical negligence and wilful neglect at the time of the Hypoglycaemia incident along with suggested cover up. On switch back to porcine insulin at his personal insistence and supported by several professional friends his warning signs of hypoglycaemia returned and his health improved. He has experienced other complications of diabetes over the years but even in Pandemic Lockdown he has enjoyed reasonable health with positive motivation to research issues involving insulin used as a treatment for Diabetes to help others. His investigation has identified a possible Immunogenic link between insulin and Covid-19 in need of further research after statistical disclosure of suggestions that 25-30% of Covid-19 patient deaths are patients with Diabetes, both Type 1 and Type 2, many Type 2 patients being slightly or very obese and other lifestyle factors which may have contributed to premature death for many patients. To help research into understanding the increased infection risk of diabetes patients exposed to Covid-19 the author has decided to make available his findings to assist in research to prevent further loss of life and finding a cure for Covid-19 and to help others based on his 42 years experience with diabetes and medical device and diagnostics in his 48 year career in healthcare. The author believes ill health and death of many Covid-19 patients with diabetes whose lives might have been saved may have had patient experiences similar to his but such information has not been widely disclosed by patients to their clinicians possibly out of embarrassment and lack of patient knowledge of hypoglycaemia unawareness leaving society in many countries with a serious mental health issue likely to take decades to come to terms with. Had the issues been addressed correctly and immunogenic links between diabetes and insulin properly researched from late 1980’s/early 1990’s we may today be in a much stronger position to address and manage the Covid-19 Pandemic. Interestingly it is noted in late 2020 that Insulin, first discovered by Banrting, Best and Macleod and used in 1922 has been re-addressed by the charity Diabetes UK, Balance Winter 2020, Issue 289 P34 ‘To The Point’ - Insulin Types: Human Analogue; Human; Animal. It is recognised the medical profession worldwide when treating diabetes have remained focused on their own personal interests and research and protection of their professional career and at times been defocused to the care and welfare of patients, their families, and carers, and ignorant of the fact that treatment of a patient with the long term chronic health condition of diabetes requires care, support and education of the patient, his/her family, friends, and work colleagues. Since March 1994 has led me to investigate in detail what exactly happened to me which I was unaware of having placed my trust in my prescribing doctors, my ex-wife, my estranged daughter, and certain friends and extended family at the time all of whom betrayed me at a time of near death, negligently failed to summons an A1 Ambulance emergency at a time of temporary mental impairment caused by my being deliberately prescribed a 20% overdose of the wrong insulin for 9 years leading to my near death on 23 February 1994 caused by alleged criminal conduct of a GP, and on call GP (deceased); and others when my daughter aged 11 at the time the GP classified as Gilleck-competent when legal interpretation of Gillick-competence is around 14. Fear and paranoia associated with hypopituitarism, Addison’s Disease possible mistreatment, has also been investigated. The research has involved Endocrine Health Disorder; Mental and Temporary Mental Impairment associated with Hypopituitarism, Addison’s Disease, Diabetes, Insulin, Immunogenicity, and likely now Covid-19 infection link Pancreatic malfunction in patients with diabetes means the need for daily insulin injection into the patient bloodstream for patient survival in Type 1 Diabetes and also in many Type 2 patients.to prevent hyperglycaemia or ketoacidosis which if uncorrected can cause death and at the same time prevent hypoglycaemia which in the event of such if uncorrected can cause death. This investigation was first suggested to me by a local Police Constable ex Metropolitan Police Drugs Squad and Hertfordshire Constabulary in 1994 (before Covid-19) on discovery of hypoglycaemia unawareness issues associated with Human Insulin v Animal Insulin, never acknowledged or taken seriously by certain English courts from 1994 leading to discovery of Fresh Published Evidence informed to me personally by Prof Vincent Marks, February 2018, a leading UK forensic scientist expert in Insulin with information about Hypoglycaemia, Hypoglycaemia Unawareness, Use of Insulin as a weapon, Low Blood Glucose in unexplained premature baby deaths, and published February 2019, leading on further investigation to likely immunogenic link to Covid-19 and statistical fact that 25-30% of sad Covid-19 deaths in England can be attributed to persons with Diabetes. Evidence review by Police Scotland March 2017 led to advice that matter be placed with the GMC General Medical Council for investigation, inquiry, implemented November 2017, and again in August 2020, following suspicious possible breach of the Data Protection Act by attempted illegal enforced subject access in January 2020. A. A public immunity argument now exists to place my findings in the public domain to prevent further loss of life and public suffering in Pandemic times with associated link between Diabetes and 25 – 30% Covid-19 deaths in England. B. The investigation to prevent and detect crime has at relevant times been informed to the Police having been registered as a disabled person on 8 October 2004 by Hertfordshire Adult Care Services and since 2017 informed to Police Scotland. C. The insulin link with diabetes and immunogenicity was first presented in Edinburgh in 1988 G Scharnthaner ‘Is Human Insulin Better than Animal Insulin in the Treatment of Insulin-Dependent Diabetes Mellitus?’ with much research at the time. When licences were granted in the UK, EU and USA, to market human insulin much of this research work was put aside and the focus became to concentrate on preventing diabetes complications, retinopathy leading to impaired vision and blindness; neuropathy; kidney disease; heart disease; lower limb amputations; many people have suffered including in some instances premature unexplained death. D. Statistical analysis has identified that in England persons with diabetes, obesity, reduced infection protection probably caused by viral infection risk to patients when in state of hypo or hyper glycaemia and not norm glycaemia leading to paper published The Lancet October 2020 that 25-30% of Covid-19 deaths in England in 1 March – 11 May 2020. Of 23,698 Covid-19 related hospital deaths in England in the period 7,867 were patients with diabetes. I am not aware at this stage what the equivalent statistics are for Scotland. This is a tragedy. On the balance of probability if information placed contained in the Low Task Force Report, December 1992, had been placed in full in the public domain and at the time further research into immunogenicity and insulin undertaken and how best to treat diabetes, insulin type, dose, exercise, diet, alcohol and tobacco leading to health complications, many of these lives might have been saved, and recovery of others possible. E. Vitamin D deficiency has been identified in ethnic minority patients including Windrush Immigrants and ethnic minority NHS employee patients who have sadly died. F. Until we have prevention vaccine DNA (low temperature vaccine coming into the UK) or RNA (fridge temperature) with approvals granted DNA first vaccine, and RNA submissions ongoing, then life remains challenging. G. We must continue to social distance and minimise social contact. H. We will get through this if we are all, and I mean all, sensible and careful. We can celebrate later but we are in this together and we all have a personal duty of care to help one another. If we do not the consequences are major risk to many along with exposure to criminal neglect especially as persons with diabetes, Type 1 and Type 2 are vulnerable persons as identified in law and at risk of temporary mental impairment when exposed to or experiencing hypoglycaemia which can lead to neuroglycopenia and hyperglycaemia with tiredness and cognitive mental health issues which is affecting many as reported in Lockdown Surveys conducted by Generation Scotland and Healthwatch Hertfordshire. 1. A Covid-19 Care Home Death Investigation in Scotland and England I believe will justify the requirement of a Multi-Agency approach with disclosure of sensible patient record information possibly by family agreement and subject to Data Protection Compliance with NHS Scotland (or NHS England); Social Services (City/County Councils); The Police; The GMC, General Medical Council. 2. My incident of 23 February 1994 was in the first instance investigated by Hertfordshire Social Services and Hertfordshire Constabulary and later by Trafford Social Services and Greater Manchester Police; and by the GMC General Medical Council following judiciary advice in court hearings that conduct of a GP and her medical colleagues be referred to the GMC for investigation of alleged Medical Negligence and Gross Misconduct in Public Office. No co-ordination of these inquiries was ever undertaken at the time and should have been to address Temporary Mental Impairment, Neuroglycopenia, Hypoglycaemia Emergency under the legal jurisdiction of the Mental Health Act which as an alleged victim of wilful neglect crime effected against me I am legally entitled to protective jurisdiction of this Act. Ref: Northampton Crown Court, November 1999 R v Proprietor Oathurst House Elderly Care and Services. 3. Failure to place the Low Task Force Report 1992 full interpretation in the public domain it is reasonable to understand why at the time the police constables and others were unaware of hypoglycaemia unawareness and neuroglycopenia discovered after the event and partly investigated at the time with a sensible conclusion involving Police Constables in attendance based on available evidence at the time. Fresh evidence raises further questions to be answered and placed in the public domain. 4. I address that in respect of any allegations of harassment conduct suggested since 24 February 1994 such has been pursued in this matter for the purpose of preventing and detecting crime and that in all particular circumstances course of conduct was reasonable but questioned at times by the Police due to lack of available knowledge of diabetes and on the balance of probability causing serious miscarriage of justice for many over 26 years. 5. I am in no doubt that had the condition of Temporary Mental Impairment involving Diabetic Hypoglycaemia Unawareness and Neuroglycopenia often leading to Alzheimer’s Disease been fully investigated in 1994/5 on observations of the Solicitor and advisor to the Legal Aid Board, England, that the ongoing issues of Mental Impairment in Diabetes now identified by NHS Diabetes Scotland, Diabetes UK, IDDT, and others, on the balance of probability the NHS could have been better prepared to understand the Immunogenic Issues with insulin treatment of diabetes and probable link to infection exposure risk which may have prevented, or at least provided a better opportunity of recovery, of 7,867 deaths of Covid-19 patients who have sadly died in England from Covid-19 Pandemic in the period 1 March to 11 May 2020, published 13 August 2020. 6. My motivation to investigate this matter has been to create improved awareness of the issues involving diabetic hypoglycaemia to the public through charities the Independent Diabetes Trust and Diabetes UK and especially through these charities to assist in DVLA awareness of the problem and prevent car accidents and awareness in schools and colleges with the significant increase of incidence of diabetes with schoolchildren and students since 1994. 7. The witness experience of my daughter to life threatening neuroglycopenia and hypoglycaemia event on 23 February 1994 appears to have been deliberately suppressed by abuse and alleged cover up conspiracy which justified my contact with this witness on occasions detailed in NHS, Police, and Social Services Records which at the time were ordered to be referred to a Child Psychiatrist in 1995 at the RCJ, London, and the Official Solicitor to the Supreme Court. This did not happen and was prevented by conduct of several persons. A public immunity argument now justifies disclosure. 8. Protection from Harassment does not apply to an investigation of detecting or preventing crime. (3)Subsection (1) does not apply to a course of conduct if the person who pursued it shows— (a)that it was pursued for the purpose of preventing or detecting crime, (c)that in the particular circumstances the pursuit of the course of conduct was reasonable. Fresh Published Evidence not previously disclosed as evidence in many Diabetes Legal Cases includes: 1. Role and prevalence of impaired awareness of hypoglycaemia in ambulance service attendances to people who have had a severe hypoglycaemic emergency: a mixed-methods study; Duncan EAS BMJ 2017 2. R v Proprietor Oathurst House Care Home, Northampton Crown Court, November 1999. Resident diagnosed Alzheimer disease, died. Agency collaboration Police, Social Services, NHS 3. Two patients with neuroglycopenia – Dizon; Danese; Hoogwerf; CNS Symptoms and spells; Cleveland Clinic Journal; February 1998 4. A Case Report of Neuroglycopenic Coma with Diffuse Cortical Involvement – Kumar; Latha; Ramadevi; Bhaskar; Hypoglycaemia, Neuroglycopenia, Death. Austin Journal of Clinical Neurology, 2017 5. Forensic Aspects of Hypoglycaemia – Derek Beatty, World Diabetes 2020, Journal of Diabetes and Metabolism, Extended Abstract, Longdom, August 2020 6. Diabetes and Covid-19 Pandemic – A T1 Patient Perspective – Derek Beatty Journal of Diabetes and Metabolism, Longdom, August 2020 7. Associations of type 1 and type 2 diabetes with COVID-19- related mortality in England: a whole population study – Barron; Bakhai; Partha Kar; Weaver; Bradley; Ismal; Knighton;; Halman; Khunti; Sattar; Wareham; Young; Valabhji; The Lancet October 2020 8. Immunogenic Issues in Diabetes and Implications for Covid-19 Research, Report to Scottish Parliament, Derek Beatty, October 2020 9. Is Human Insulin Better than Animal Insulin in the Treatment of Insulin-Dependent Diabetes Mellitus? G Schernthaner, Edinburgh 1988 10. R v Sheppard [1981] A.C. 394 is precedent case law confirming Wilful Neglect by the alleged offender Heather R Beatty and others 11. National Diabetes Inpatient Audit England, 2019 England Published 13 November 2020 Full Report The occurrence of some important and life-threatening harms remain unchanged: Severe hypoglycaemic episodes in inpatients with type 1 diabetes 12. Immunogenic Issues in Diabetes and Implications for Covid-19 Research Update Report as an unpaid volunteer to assist Diabetes Research Groups and Covid-19 Research submitted to the Scottish Government by my MSP. I write this report as a person with Type 1 Diabetes diagnosed 43 years ago, treated with insulin for over 42 years, and with a 48 year career in healthcare involving experience in diagnostic laboratory testing, radiology and MRI, respiratory and diabetes. My investigations into insulin therapy commenced over 26 years ago after experience of a life threatening neuroglycopenia event in 1994 caused by alleged medical and professional negligence in the public domain. Publication of ‘Forensic Aspects of Hypoglycaemia’ V Marks 2019; ‘Insulin A Voice for Choice’ A Teuscher 2007; and identification of potential clinical links between insulin and infection exposure has led to renewed review of published clinical studies from 1993 and the possible immunological link to Covid-19 infection exposure leaving many sad deaths of patients with long term diabetes overcome by Covid-19. My hope is that these findings will assist clinical science in research to produce a vaccine to prevent Covid-19 and find a cure to treat those affected and extended to other health conditions with immunological risk exposure. Introduction 1. Investigation of published evidence from 1993 into Immunological Issues associated with Insulin and Diabetes is relevant to the fact that in England an estimated 25-30% of Covid-19 patient deaths are patients with diabetes as informed in the public domain. This report is hereby submitted to the Scottish Parliament by my MSP, to Edinburgh University, and others interested. 2. Events in respect of this matter are similar to the Factor 8 Haemophilia Medical Issue leading to ongoing Public Inquiry with results awaited and delayed due to Covid-19. The ITV documentary 'In Cold blood' screened on TV in recent weeks is a good summary of patient and family experiences leading to the HIV pandemic. In many respects the human insulin debacle is similar with the GM medical treatment being the first use of GM technology to produce commercially GM Human Insulin following UK research into DNA and RNA by Watson and Crick and commercial link between Genetech and Eli Lilly then Novo Nordisk. Immunogenic Issues 1. Studies about human insulin were limited before 1980 as significant amounts of human insulin could not be obtained. Research understanding of DNA and RNA by Watson and Crick led to a flurry of research used to produce genetically engineered human insulin. Drug company clinical trials approval was granted by licencing authorities in August 1982 to launch Human Insulin in the UK to treat diabetes patients and subsequently in October 1982 in Germany and the USA. Today Genetically Engineered GM Human Insulin with many combinations is prescribed every day throughout the world to treat diabetes. The pharmaceutical industry successfully purified human and animal insulin with safety advice available to prescribing clinicians and licensing bodies and accepted by prescribing clinicians worldwide. 2. In 2020 it is estimated that around 25 - 30% of the sad Covid-19 deaths are people who have an underlying health condition, often diabetes. NHS England statistics appear to endorse this. Today in 2020 immunological questions arise as to why patients with diabetes are more at risk of contracting Covid-19 often with tragic results. In 1988 presented in Edinburgh by G Schernthaner (Austria) was: Is Human insulin better than Animal Insulin in the Treatment of Insulin-Dependent Diabetes Mellitus? 3. Is the Diabetes Covid-19 link immunological? Scientific published information reviewed many years ago now suggests there may be a link between type of insulin and why some very ill Covid-19 patients treated with insulin for diabetes may be at more risk. 4. In the mid 1990’s published content was reviewed by a UK barrister (deceased) who was involved with the ‘Legal Opinion about Human Insulin’, Forrest & Evans, 26 January 1993. This advice reviewed a sample of 900 diabetes patient experiences with legal opinion addressing issues raised from the Low Task Force Draft Report, Posner, December 1992 from an estimated sample of 3,000 letters sent to the BDA. The Human Insulin Solicitors Group had been set up with a steering committee elected at a Law Society Meeting in London of over 200 firms who had been contacted by over 1,000 diabetic patients considering legal action against the drug companies by diabetic patients who believed they had suffered damage as a result of their insulin prescription having been changed to Human Insulin. The evidence was collated up to and including the summer of 1992 funded by the Legal Aid Board, England. 5. The Chairman of the Steering Group wrote to me on 9 October 1997 in detail. He advised counsel were unable to consider individual medical negligence cases and advice was to the Legal Aid Board. In order to prove that any GP could have been negligent in their prescribing by change of insulin from animal to human insulin it would be necessary to prove that the medication itself could in fact cause harm. 6. A key advisor Professor T was very clearly of the view that human insulin, while having benefits for those who had never been treated with animal insulin, did have potential side effects in those diabetics who had previously been used to animal insulin. 7. It had already been established that in multi-party cases involving medication the Department of Health was an inappropriate defendant. The choice was available between animal and human insulin. All the marketing suggested that human insulin was best, which was logical, however the insulin was not from human beings but a genetically engineered version of porcine insulin (Novo) or yeast (Lilly). Human insulin was the nearest one could get without taking insulin cadavers. The pharmaceutical industry had decided that the future of the insulin market was in Human insulin, invested in the opportunity, and achieved global licence safety approval. 8. Side effects – The steering committee trawled around 800 articles produced under the headings of diabetes, hypoglycaemia and insulin, in the 10 years prior to when the investigation started. Side effects – 2 classes were identified: a) Neurological – tremor and confusion b) Physical – sweating and shaking 9. Forensic case law in hypoglycaemia unawareness beyond reasonable doubt identifies alleged violence complaints and abnormal aggressive behaviour when treatment of acute hypoglycaemia and neuroglycopenia is deliberately denied of the diabetes patient as was personal experience, 23 February 1994, when witnesses and on call GP deliberately refused to summons ambulatory/paramedic help. 10. The difference between human and animal insulin was not the actual side effects but the order in which they came. Animal insulin caused the physical effects which enabled the brain to react while the general view was that with human insulin the neurological effects happened first and prevented the brain to act in a way which did not allow the diabetic patient to recognise the physical causes leading to loss of warnings of hypoglycaemia. At the time this was not backed up by any of the published studies but subsequently detailed by Teuscher in his published papers, and in his book ‘Insulin, A Voice for Choice’ published October 2007, Karger. The diabetic community around the world at the time tried to rubbish Professor Teuscher. I personally witnessed this at an International Diabetes Conference in Helsinki, 1997. 11. It had been hoped a further large randomised statistical clinical trial would be implemented. The pharmaceutical industry at the time had no reason to financially support such research as human insulin clinical approval and safety had been successfully achieved worldwide. 12. Res ipsa loquitur usually applies in medical negligence but in human insulin the scientific evidence was not there at the time. It is now. 13. Plaintiffs must set out their grievances in detail for a court to consider to which Defendants would have to answer. 14. Peter Stott remained convinced that one day there will be evidence which will prove that human insulin has a detrimental effect on those previously on animal insulin. 15. The key question now arises from the reported statistical facts that in patients who have died from Covid-19 in England 25-30% have been identified as having a previous health condition of diabetes, probably both Type 1 and Type 2, and on the balance of probability this suggests the need in any Covid-19 Public Inquiry to address the diabetes link in detail with further research in the immunological issues involved. 16. The American Diabetes Association, 3 December 1993 published in Diabetes Care, Supplement 3, ‘Human Insulin – A Decade of Experience and Future Developments’. This includes Human Insulin after 10 years, J S Skyler. This suggested along with G Schernthaner that human insulin has favourable immunogenicity and should be used to treat T2 diabetes patients. Hypoglycaemia unawareness is referred to along with the hypothesis could human insulin prevent T2 diabetes? Can the immunogenicity mediate β cell damage? Does human insulin metabolically cause dawn regulation of anti β cell immune response? 17. The History of Insulin – M Bliss, In 1889 insulin was named by Minkowski and Mering in reference to Pancreatectomy. In diabetes insulin was described as a mysterious substance responsible for metabolic control. Research in animals by Banting and Best, Collip and Macleod identified a dog experiencing a hypoglycaemic attack which later died. On 11 January 1922 in Toronto Leonard Thompson, aged 14, was injected with insulin from pig extract produced by Collip and treated by Banting and Best. On 23 January 1922 success was announced. Eli Lilly started to manufacture insulin in the USA and in 1923 Novo took to Denmark and the wife of Krogh was treated. 18. Gestational Diabetes GDM – DR Coustan stated 25% of GDM patients need insulin and 20 years later 40& of GDM women develop overt diabetes. 19. New Directions – Mixtures, Analogues, Modelling- JA Galloway. Focus is to reduce complications of diabetes. Peak effects of insulin occur 3-4 hours after injection and up to 8 hours. Remaining insulin after injection can remain in the body up to 24 hours and often up to 36 hours and further injections can lead to a build up of insulin action hence the need for glucose stabilisation in conjunction with daily lifestyle. GM human insulin has a changed molecule on the alanine chain at Lys (β28) Pro (β29). C-peptide can be normal or elevated in NIDDM but deficient in IDDM. In 1993 this was regarded as of no consequence in respect of quality of life issues. Could this be relevant to immunogenicity in Covid-19? 20. Insulin Regimes and strategies for IDDM – B Zinman. Insulin injection can cause death, ambient temperature, exercise, food intake, intra subject variation is considerable. Human insulin peak action leads to hypo risk especially during sleep. In 1993 55% long term patients on beef slow acting insulin, switch to porcine or human insulin could cause problems. In 2020 variations occur in hospitalised patients, insulin time, dose change. In forensic analysis of Covid-19 diabetes patient deaths what are the treatment regimes in place before hospital transfer and at home? 21. Insulin therapy in T2 diabetes – VA Koivistyo. Insulin therapy can have an anti-atherogenic effects on serum lipid profile. It stimulates glucose uptake and enhances glucose oxidation and storage in muscle tissue leading to T1 mortality to macrovascular complications up to 2-4 times normal. Data on T2 hypo insulin event was scant. Infection risk? 22. Hypoglycaemia Unawareness in IDDM – PE Cryer. Patients suffered 1-2 hypo events per week reducing symptoms and defences against hypo unawareness. Potential infection risk? Life goes on but insulin reactions change over time and circumstance. Infection risk? 23. Hyperinsulinemia – how innocent a bystander? PZ Zimmet, Caulfield, Australia. Nauajo Indians, Prima Indians, Asian Indians, Chinese, weight gain issues. Insulin resistance. Insulin is a survival hormone. Papua New Guinea. Cardiovascular studies plus NIDDM lifestyle leading to T2 diabetes. A powerful moral dilemma faces public health workers while molecular biologists and clinical research scientists attempt to understand the role of hyperinsulinemia in the etiology in these noncommunicable diseases. 24. Noctural Blood Glucose Control in Pregnancy – Bolli et al, Italy. Somogyi Phenomenon 1938, Hypo and hyper popular in 1950’s during sleep. Human insulin absorbed faster. One ammino acid molecule different on the alanine chain. Daily dose of insulin reduced 10 – 25% when switching from animal to human insulin. 25. Sweet Success with Diabetes – Pregnancy- JL Kitzmiller -Insulin therapy for glycaemic control – USA special diabetes and pregnancy clinics to reduce high levels of mortality, diagnosis, surveillance, nocturnal hypoglycaemia for balance and near normoglycaemia as outpatient. Tight glycaemic control prevents foetal macrosomia, birth trauma, respiratory distress, congenital malformation. Dietary therapy is crucial to success, estrogen protects uterus arteries. Insulin resistance in pregnancy, more insulin is needed for glycaemic control therefore more hypos. Pump therapy, Farquar, 1969, Edinburgh, reviewed 210 children of T1D mothers. 26. Further developments – Insulin Delivery.CD Saudek. DCCT improved BG reduces diabetes complications. Insulin absorption, injection site, depth of skin, infusion pumps, implanted pumps, nasal therapy, 1935 and 1993. 27. R & D Safety of Biosynthetic Insulin-Chance, Frank. R- DNA origin and insulin first genetically engineered treatment. Yeast used by Lilly, porcine used by Novo. Humalin 1982, RNA and DNA technology, Watson and Crick. Much PR activity, May 1976 Lilly Symposium, first approval August 1982, 1980 first volunteers, Erol Wood, Surrey, Lilly. 28. Insulin therapy in last decade, Paediatric perspective – JV Santiago. 1970’s 30% of children previously on beef or pork insulin, reddening, itching, inflammation, lipoatrophy at injection site. Insulin resistance 20-30% noted in puberty. 29. Immunogenicity and allergenic potential of animal and human insulins- G Schernthaner. From 1922 insulins were impure, anti-insulin antibodies identified as IgG and IgE. Human insulin is not totally immunogenic. Irregular administration can lead to higher risk and allergy reaction. Intermittent insulin therapy may be a patient stimulus for immunogenicity. Conclusion Public Involvement 1. 26 years of diabetes research since 1994 and now discovery that 25-30% of Covid-19 deaths in England are patients with diabetes any Covid-19 Public inquiry should address the following background statistical patient information and review immunogenic risk: 2. Is patient Type 1 or Type 2 diabetes? 3. If treated with insulin for how long? What type of insulin and dose? 4. Patient weight and BMI? Height? Diet/ Alcohol intake? 5. Complications of diabetes details, Vascular disease, Hypertension, Neuropathy, Retinopathy, Mental Health state? 6. Link to Diabetes and death from Covid-19 within 28 days of positive Covid-19 test. 7. Update from Indian study presented 12 November 2020 at World Diabetes 2020. Covid-19 deaths linked to Hypertension. Vitamin D deficiency identified along with Zinc and Magnesium. Generally 80% of the Indian population are deficient in Vitamin D. 1. Fresh evidence investigation followed invitation by the author Dr Duncan to Derek Beatty to submit details of personal hypoglycaemia experience of incident with paramedic ambulatory attendance required following hypo episode shortly after hospital discharge at time of recovery from hospitalised treatment to correct Otitis Externa and Osteomyelitis with catheter delivered antibiotics to treat MRI diagnosed infection associated as a complication of long term T1 diabetes condition. On this occasion low blood glucose was clearly caused by catheter delivery of IV antibiotic treatment at the time. A neighbour summonsed an ambulance (sadly deceased); an off-duty nurse witness attended and administered a glucagon injection; the paramedic in attendance along with my wife organised glucose snack to uplift blood glucose level and ensured BG level was stable before paramedic departure. 2. This event led to clinical investigation involving research at University of Edinburgh with colleagues informed to Lothian Health Board, Diabetes UK and others and update web publication ‘A Listening Ear’ by Derek Beatty©. 3. The work of Dr Duncan has assisted in my investigation into ‘Forensic Aspects of Hypoglycaemia’ which I had presented at World Diabetes 2020, Sydney, January 2020, on my behalf and published in the Journal of Diabetes and Metabolism August 2020; along with ‘Diabetes and Covid-19 Pandemic – A T1 Patient Perspective’. 4. ‘Immunogenic Issues in Diabetes and Implications for Covid-19 Research’ October 2020 has been submitted as a Report to the Scottish Government following MSP review to assist in any Public Inquiry into Covid-19 deaths and support for immunogenic vaccine development to prevent and or treat Covid-19 with vaccine preparation. 5. Hypothyroidism - Prof S M Shallet 15/6/2000 NHS Christie Hospital, Manchester; Commissioned Expert Witness Report, Hypopituitarism, Addison’s Disease, causes Genetic, Inheritance Hormone – Deficiencies – treatment in children, GH replacement. 6. Coping with Thyroid Problems – Dr Joan Gomez, 1994 7. The Assessment and Management of Thyroid Dysfunction – John O. Godden; Robert Volpe, Toronto 1975 8. ‘The Legal Aspects of Child Health Care’ Bridgit C Dimond 1996. A child is classified as Gillick-competent when aged over 14. 9. Why did the GP deem my daughter when aged 11 Gillick-competent at the age of 11 – 12 and able to make a decision as to whether to allow her medical records to be disclosed to her father and the Court when her father had her best interests, health and welfare at heart? 10. It is with sadness that after over 26 years I am left with no choice other than to allege that as a registered disabled person by Hertfordshire Adult Care Services on 8 October 2004 I believe alleged criminal conduct against me since 23 February 1994 amounts to wilful neglect causing me to suffer harm and deliberate criminal conduct has been engineered against me for over 26 years. A public immunity argument exists in time of Covid-19 Pandemic to question the believed to be misguided potential mental deficiency in Thyroid Health of the believed alleged offenders suspected of exercising conduct of wilful neglect on 23/2/1994, in Bricket Wood, St Albans; in Trafford circa 22/11/2000; as suggested in Harpenden 23/11/2017; to cause nuisance, ill health, legal confusion by deliberate victim target of an innocent father who at all times wanted like all fathers the best for his only natural child and for 26 years has been prevented from providing such in a normal despite estranged family environment in clear breach of family safety and wellbeing as promoted by the Prime Minister, the first Minister of Scotland, and their scientists advising HM Governments in this Pandemic. 11. It is identified that this criminal investigation now justifies full medical investigation to be ordered by the Court of the mental health and wellbeing of the Complainants and whether such was conducted before claims by the perpetrators were placed with the Administration of Justice Unit, Hatfield, and further questions the previous conduct of others in matters associated with this Mental Health Thyroid issue and to assist with any public inquiry ordered to investigate deaths of Covid-19 patients who were diagnosed and treated for Diabetes and who have sadly died prematurely likely with stated Covid-19 on death certificates. 12. Published clinical research identifies that on the balance of probability any off-spring of my daughter may also genetically inherit thyroid disorder leading to possibly to mental health deficiency in future generations. 13. The seriousness of fresh evidence discovery justifies a public immunity argument that findings be included in any forthcoming Covid-19 Public Inquiry as previously announced by the Prime Minister with independent administration possibly recommended by the Police Watchdog in England or alternative Government proposed Inquiry Team advised by the Scottish Parliament and Westminster Parliament. 14. It is proposed that contribution input to any inquiry would benefit from contributions from the Mental Health Foundation; the Pituitary Foundation; LAPPS; the Independent Diabetes Trust; Diabetes UK; along with Social Care Services Hertfordshire and Trafford Social Services; and the Official Solicitor to the Supreme Court who acted as Guardian ad Litem to my daughter and when informed in the High Court by the Official Solicitor High Court Judges Lady Butler-Schloss and Lord Wall were very disappointed that my daughter had not been referred by her GP to be seen by a consultant Child Psychiatrist to investigate medical reasons for the fear and paranoia exhibited by her towards her father and others along with abnormal hatred and subsequently possible revenge by underhand misguided conduct. 15. Prima facie evidence suggests my ex-wife and the GP to be in breach of such High Court order. 16. It is alleged subsequent to this event in 1994 the GP and others engineered a web of deception, false allegations, narcism and hatred against me and influenced my daughter to believe these beliefs and many false allegations against me of misguided events to cause me harm and emotional and financial loss and deliberately used others to conduct questionable hate crime, harassment and exposure to financial loss. 17. Extreme measures took place to avoid disclosure of medical records of my ex-wife and daughter showing abnormal emotional mental tendencies of ‘fear’ and ‘paranoia’ often exhibited as behaviour signs in patients diagnosed with Hypopituitarism, Addison’s Disease, endocrine disorder, which can be genetically inherited in families thus creating a spread in future generations similar to scientific statistically presented for Covid-19 pandemic. 18. Those responsible and believed to be alive are: 19. In 1994 also involved was the Vicar (known to have moved to Cambridgeshire and now possibly Nottingham) in the use of the Church of England premises at the Parish Church, Bricket Wood, where in the presence of my ex-wife it is alleged my daughter was influenced never to see her father ever again to assist in the alleged cover up by alleged conspiracy to pervert justice professional medical and professional negligence of Dr Anderson when in public office and along with others influenced the Vicar to ask me NOT to attend Sunday morning Church Services at the Parish Church at a time when I was initially very seriously ill having been prescribed a 20% overdose of the wrong insulin for 7 years by the GP and her colleagues and recovering from PTSD injury with recurrent flashbacks in certain circumstances and detrimental to my diabetes care and welfare. Recent flashbacks were 2,3,4 January 2020 in receipt of phone call from Diabetes UK, and 21 November 2020 on receipt of communication from Hertfordshire Chief Constable and at a time when I had put aside previous events including those in 2020 involving my ex-wife and daughter and was pursuing voluntary work to help others and in relationship of Immunogenic effects associated with Covid-19 and Diabetes submitted to the University of Edinburgh with interest and peer reviewed by Longdom Publishing for publication 20. 23.2.1994 My ex-wife claimed to be a State Registered Nurse, to whom I was married for 14 years, should have known better, or was she in a temporary mental imbalanced state of hypoglycemia associated with Hypopituitarism, Addison’s Disease at the time, exhibited wilful neglect to me in her failure to summons an ambulance and to inform witnesses present that an ambulance was required. Why was an ambulance not called? 21. My daughter aged 11 at the time knew I treated myself with insulin for diabetes. She could have called an ambulance but did not. Why not? 22. My Criminal Investigation since 1994 into detection of alleged crime has involved detection of ‘Forensic Aspects of Hypoglycaemia’ associated with unexplained death and death in bed of diabetes patients treated with insulin, murder associated with temporary mental impairment of the offender when in a state diabetic hypoglycemia and neuroglycopenia caused often by insulin overdose or imbalance of carbohydrate diet, excess exercise, excess alcohol, or other mitigating factors associated with hypoglycaemia unawareness often miss diagnosed by lack of knowledge and low standards of education of the innocent diabetic patient by certain clinicians and GP’s in the medical profession, and open to more detailed investigation. 23. My Criminal Investigation started on 19 May 1994 on disclosure to me of ‘Report from Low Task Force for 1992’ containing ‘Draft Report to BDA Low Task Force on Letters about the Change Over to Human Insulin’ Dr. T R Posner Medical Socialist, December 1992; Research Grants to Dr Stephanie Amiel, Guy’s Hospital, London; Dr. Simon Heller, Northern General Hospital, Sheffield; with Focus on Hypoglycaemia, Human Insulin, Analysis of Patient Letters Received by the BDA carried out by Dr. Natasha Posner (estimated 3,000 letters from patients, careers, friends, families Chaired by JD Ward. 24. The BDA owed a duty of care to diabetes patients to publish this report and create public awareness of insulin issues. They did not publish and announced on BBC2 News night TV on 28 June 1994 the reason was the report was ‘Too Alarmist’. 25. It is alleged this conduct by the BDA was Willful Neglect and placed patients with diabetes, their carers and friends and others in danger of patients with hypoglycaemia and neuroglycopenia which if uncorrected could lead to seizure, violence and death. While the BDA did publish extracts and edited versions of the report in Balance Magazine the full impact seemed watered down and furthermore many members of the medical profession did not listen to patients and it is suspected were negligent at the time in failing to keep up to date with media reports and reports about insulin change and human insulin in the BMJ, Lancet, Practical Diabetes and other journals. 26. 3 May 1994 – Attendance at BDA Diabetes Meeting, St Albans – Disclosure of Diabetes Care ADA ‘Human Insulin - A Decade of Experience and Future Developments’ including Immunogenicity and Allergenic Potential of Animal and Human Insulin’s - Guntram Schernthaner 27. 10 May 1994, 10.00am Meeting with Vicar, Parish Church, Bricket Wood, requested by him at his home. Sorrow shown for event of 23-24 February 1994, formal request by Vicar that I Do Not Attend Sunday Morning Church Service at Parish Church. At the time I was not a regular church visitor but respected the Christian faith and attended occasionally. The reason was given he did not want me to have contact or meet my daughter at the church where she attended Sunday School. The Church housed the GP Surgery and the NHS paid rent to the church for its use. Evidence suggests my ex-wife took my daughter aged 11 on 25 February 1994 to the GP at the Church Hall where she saw GP and where my daughter’s description of neuroglycopenia was recorded in her medical notes. It is suspected when aged 11 my daughter was emotionally abused by GP to cover up her professional negligence on 8 February 1994, 10.40am consultation when she failed to diagnose diabetic hypoglycaemia unawareness in the presence of my ex-wife and stated she could do nothing and the best thing would be for my ex-wife and I to divorce one another, a statement she subsequently lied to her NHS employer having made. Around this time I was removed from the GP patient list of the GP Practice and for several days left without a GP and at the same time period I demanded at Watford General Hospital to have my insulin switched back to porcine insulin when a few weeks later my warning signs of hypoglycaemia unawareness returned as observed by friends, family in Edinburgh, and others including clinicians. 28. In May 1994 I met with local PC responsible for Bricket Wood and surrounds. He had previously worked in the Metropolitan Police Drugs Squad. I informed him about my hypoglycaemia neuroglycopenia experience and subsequent findings which he found distressing and was passionate and understanding. He advised me based on his Drugs Squad experience to investigate the formulary of Human Insulin and obtain details of the history of Human Insulin genetic engineering with one molecule different on the alanine chain between Human and Porcine Insulin and in particular formulation at the time of approval by the MCA Medicines Control Agency and the FDA at time of first injections 15 July 1980, Lilly, Surrey, England, then approval 26 August 1982, UK; 13 October 1982, Germany; 28 October 1982, FDA approval in USA. 29. This forensic investigation is relevant to immunogenic issues associated with insulin and diabetes was first presented Edinburgh ‘Is Human Insulin Better than Animal Insulin in the Treatment of Insulin Dependent Diabetes’ G Schernthaner 1988. 30. Diabetes Care – Human Insulin – A Decade of Experience and Future Developments December 1993 had been sent to me by Eli Lilly. I took this to Edinburgh Easter 1994 and studied the content in detail. I concluded without doubt I had been prescribed a 20% overdose of the wrong insulin for 9 years which almost had cost me my life. I demanded insulin switch back to porcine insulin at Watford General Hospital at a consultation with Dr MC, Diabetologist; the hospital complaints manager, several diabetes nurses 25 May 1994 from diary entry. All were amazed at my disclosure. My health improved significantly in the next few weeks and warning signs of impending hypoglycaemia returned. I was then invited to appear on BBC2 Newsnight and comment on my experience. Friends and family noted I was back to being my own self again. Even the receptionist at the solicitor commented and contacted me separately as her husband had diabetes and was experiencing similar problems with personality change. 31. The trauma of the event caused me to suffer PTSD injury and I do sometimes still have flashbacks. I am indebted to Dr MK, J H, MBE, Dr L G, all of whom I have no doubt saved my life. In my prayers as a Christian I received a message from my God, there is a problem with Insulin treatment for patients with Diabetes. Go and fix it. My life since this event in 1994 has been dedicated to helping others when required to live improved and better life quality when managing diabetes. 32. My ‘Investigation Diabetes and Covid-19 Immunogenic Issues’ conducted during lockdown pandemic has been placed through my MSP with the Scottish Government for consideration and detailed response, awaited. NHS England have acknowledged receipt with observations to address to Public Health England and has been passed to NHS Regional GP contract and performance teams to address. The work is relevant to immunogenic issues associated with insulin and diabetes first presented Edinburgh ‘Is Human Insulin Better than Animal Insulin in the Treatment of Insulin Dependent Diabetes’ G Schernthaner 1988. 33. Associations of type 1 and type 2 diabetes with COVID-19 related mortality in England: a whole-population study, BMJ October 2020 identifies statistically that 25-30% patient Covid-19 deaths in England are patients with diabetes. Why is this. An insulin immunogenic link seems likely. 34. Channel 5 documentary on NHS workers, clinicians and nurses, deaths from Covid-19. Dr Subhasrea Ray, India, statistical analysis. Many deaths from Covid-19 due to hypertension. On Indian sub-continent 80& of population have Vitamin D deficiency along with Zinc and Magnesium. 35. Is this related to Covid-19 deaths of NHS staff. The NHS employs many ethnic minority staff. I believe this needs further statistical analysis and in Scotland? 36. My investigation remains ongoing at this time and will address the legal issue of wilful neglect in public office in situations of hypoglycaemia, neuroglycopenia, asthma attack, and in family home, schools, colleges for public benefit and human welfare. 37. Criminal Investigation: 26 years ‘T1D Winning in Insulin Chicanes’ by Derek C Beatty – in progress 38. There is a legal focus. In the event of a diabetic hypoglycaemia or neuroglycopenia requiring immediate paramedic 999 A1 Emergency Ambulance attendance and transfer to hospital, or an asthma attack of a child or adult, prima facia evidence suggests it is ‘Wilful Neglect’ if a witness, parent, teacher, friend, husband, wife, public servant eg Police, Fireman, deliberately do not make a 999 call for an ambulance. 39. On 23/2/1994 when I found myself in a state of temporary mental impairment with neuroglycopenia caused by 7-9 years prescribed insulin overdose of the wrong insulin by NHS contracted clinicians and GP’s and witnessed by a family member adult, an 11-year-old child, a neighbour witness, two police constables, informed to an on-call GP who refused to attend the diabetic emergency. Were the adult family member and 11-year-old child guilty of willful neglect who knew the patient was treated with insulin for diabetes? 40. Was my daughter psychologically abused at home when in the care of her mother out with my presence and was this alleged abuse extended to involve the GP and others, I wonder? Prima facie evidence suggests they were. 41. Subsequently the GP suggested an 11-year-old child was old enough to give consent as to whether the child medical notes of the event taken by the GP should not be allowed to be disclosed to the court to cover up alleged medical and professional negligence in public office. I believe this to have been emotional child abuse of my daughter and that she was not Gillick-competent at the time. I believe the GP should be ordered to answer this allegation. 42. On Police England and Police Scotland advice requests have been made to the GMC to investigate and especially recently in 2017 and 2020. The GMC have declined to investigate new evidence, and this raises serious questions about their role to protect the public of medical wrongdoing when it happens. 43. The immunogenic link between diabetes and insulin originally clinically investigated in 1988 and presented in Edinburgh, G Schernthaner, suggests a link leaving patients treated with insulin more prone to genetic and viral infection and likely the reason why 25-30% of Covid-19 deaths in England are patients with diabetes. 44. On advice by Police Scotland this criminal investigation commenced in 1994 remains ongoing with preliminary report submitted at this stage to the Scottish Government. Further ongoing research is needed. 45. I personally have lost around £274,000+ caused by the negligence at this diabetes hypoglycaemia and neuroglycopenia event in 1994 with fresh evidence ‘Forensic Aspects of Hypoglycaemia’ Marks 2019 confirming the above. For 26 years certain misconceived persons in society in England with whom I have had contact have completely misunderstood issues involving diabetes treatment, care and management, and their conduct has caused me personally loss of around £274,000+ following my near-death recovery in 1994. Sadly, many are less lucky and have died, many unnecessarily. 46. On receipt of a communication sent to me on 19/11/2020 with immediate effect and without notice I am placing this 26 year Criminal Investigation I have conducted voluntarily to clear my name of a salvo of false allegations made against me over 26 years with the Independent Police Complaints Commission, England, and Hertfordshire Police Complaints Commission, and in due course Police Scotland, and probably my MSP to raise with the Scottish Parliament and my MP to raise in the House of Commons, Westminster, with the observation previously suggested to me and with which I agree by a barrister and previously the diabetes link by a High Court Judge in Scotland that this investigation justifies placement with any Covid-19 Public Inquiry and while respecting and having high esteem and regard for the difficult task the Police have to perform in the UK in these Pandemic uncertain times as an organisation I am unsure as to whether they are a suitable organisation to investigate complex medical unexplained death issues and complex mental health issues involving not only Diabetes, relevant to the fact that 25-30% of patient deaths of Covid-19 patients who it is discovered have diabetes, ‘ Associations of type 1 and type 2 diabetes with COVID-19-related mortality in England: a whole -population study’ in England: a whole-population study’ but also other common health disorders where temporary mental impairment can cause behaviour change and sometimes death. 47. In 2020 the UK Prime Minister asks the public to stay safe, comply with distancing to avoid infection spread, eat sensibly, exercise, support family units. My previous personal family unit was destroyed 26 years ago with the cover up of my near death caused by medical and other alleged negligence by other persons, some in public office. I have to live with this bereavement every day of my life. There can be little doubt my investigation and support for others who have approached me in the last 26 years concerning this investigation may not be acknowledged today but in years to come I know will help others to understand living with diabetes issues and I am delighted to have been invited to assist in webcam discussion by Diabetes Scotland to assist others in Mental Health care work an understanding associated with diabetes often caused by blood glucose imbalance with fluctuation between hypo/hyper and normoglycaemia, along with unnecessary stress. My work has also been presented by webcam to World Diabetes 2020.