Practical Diabetes International via MedWorm.com

Spironolactone

Practical Diabetes International — Wed, 03 Mar 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Diabetes and cardiovascular risk in severe mental illness: a missed opportunity and challenge for the future

Practical Diabetes International — Wed, 03 Mar 2010 00:00:00 +0100

Schizophrenia and bipolar illness are severe mental illnesses that affect around 1-2% of the population. They are associated with premature mortality with a reduced life-expectancy of 10-20 years. Although suicide and trauma contribute the highest relative risk of mortality, physical illness accounts for around three-quarters of all deaths, with cardiovascular disease being the most common cause of death. Traditional cardiovascular risk factors including diabetes, dyslipidaemia, obesity and smoking are all more common in people with severe mental illness (SMI).Although there has been an increasing awareness of physical health issues in people with SMI, the level of screening for and management of cardiovascular risk factors has remained low. A number of national and international bodies ha...

Encephalopathy following diabetic ketoacidosis in a type 1 diabetes patient

Practical Diabetes International — Wed, 03 Mar 2010 00:00:00 +0100

A 44-year-old gentleman with type 1 diabetes mellitus was found collapsed with diabetic ketoacidosis. Following correction of the metabolic derangements his level of consciousness improved but he became encephalopathic, exhibiting unprecedented aggression with non-specific neurological signs. This profound neurological state persisted for one month. Reversible causes of encephalopathy were investigated and excluded. The patient made a slow and almost complete recovery over a period of six months.Encephalopathy is an unusual complication of hyperglycaemic emergencies with poorly understood underlying mechanisms. This case demonstrates the importance of considering and treating the numerous reversible causes of an encephalopathic state before attributing altered levels of consciousness to th...

ABCD position statement on continuous glucose monitoring: use of glucose sensing in outpatient clinical diabetes care

Practical Diabetes International — Wed, 03 Mar 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Artifactual hypoglycaemia secondary to leukaemoid reaction

Practical Diabetes International — Wed, 03 Mar 2010 00:00:00 +0100

Artifactual hypoglycaemia presents clinically as asymptomatic hypoglycaemia, and may be associated with an increased white blood cell count. The authors report a case of artifactual hypoglycaemia secondary to leukaemoid reaction in a patient with endometrial adenocarcinoma. Following thorough investigation and exclusion of true hypoglycaemia, this phenomenon was eventually diagnosed. The importance of awareness in the clinically asymptomatic patient of this phenomenon, taking measures to reduce erroneous laboratory glucose results, and confirmatory testing with a glucometer is emphasised. Copyright © 2010 John Wiley & Sons. (Source: Practical Diabetes International)

Cutaneous sarcoid at the site of insulin injections

Practical Diabetes International — Wed, 03 Mar 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

News

Practical Diabetes International — Wed, 03 Mar 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Screening and diagnosing diabetes in optometrists' practices: an evaluation of perceptions, attitudes and beliefs

Practical Diabetes International — Wed, 03 Mar 2010 00:00:00 +0100

In conclusion, optometrists are willing to carry out capillary blood glucose tests, provided that the scheme is simple, is supported by other health care professionals and is properly funded. There is a clear advantage in identifying undiagnosed diabetes in people attending optometry practices who are not accessing other health care providers. Copyright © 2010 John Wiley & Sons. (Source: Practical Diabetes International)

Glycaemic outcomes following discharge from an intermediate care diabetes clinic

Practical Diabetes International — Wed, 03 Mar 2010 00:00:00 +0100

This report examines the glycaemic outcomes over the following 18 months of those individuals who were discharged back to primary care.Between June 2007 and May 2008, the service saw 166 new and 238 follow-up patients with 91 discharges back to the primary care team. The referral HbA1c was 10.1%, and on discharge was 8.7%. Patients were discharged with a management plan. At 12 months post discharge the HbA1c was 8.6% and at 18 months 8.8%.These results are encouraging in the sense that robust management plans produce sustainable improvements in glycaemic control. However, it is clear that following discharge, further improvements in glycaemic control cannot be expected. It is therefore suggested that follow up should be continued until the individual glycaemic target is reached. Copyright ...

Lowering/maintaining HbA1c - room for improvement?

Practical Diabetes International — Wed, 03 Mar 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

NICE guidance and insulin pumps: has it made a difference?

Practical Diabetes International — Mon, 01 Mar 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Omacor (omega-3-acid ethyl esters)

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Elective admissions: the journey for the person with diabetes

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Cerebral venous sinus thrombosis in a patient with type 1 diabetes in the absence of ketoacidosis

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

We report a case of CVST in a patient with type 1 diabetes but without DKA, in whom we speculate that chronic poor glycaemic control was a contributory factor. Copyright © 2010 John Wiley & Sons. (Source: Practical Diabetes International)

Oral quinine-induced hypoglycaemic seizures

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

A patient with type 1 diabetes mellitus was admitted for investigation of hypoglycaemic seizures. His past medical history included a combined pancreas and kidney transplant, but by the time of admission both organs had failed. As his renal function deteriorated leg cramps were problematic, and so oral quinine had been prescribed. Despite reducing his insulin doses, his glycaemic control became more erratic. His plasma quinine concentration was typical of that expected in high dose intravenous treatment of malaria. On ceasing oral quinine therapy his hypoglycaemic seizures stopped.This case highlights that in cases of unexplained hypoglycaemic attacks, in patients with some residual endogenous insulin secretion, oral quinine must be excluded as a possible cause. Copyright © 2010 John Wile...

The RCT: a very beautiful technique

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

(Source: Practical Diabetes International)

Measuring psychological morbidity for diabetes commissioning

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

This study has demonstrated a high prevalence of psychological morbidity in the local secondary care population of people with diabetes, with as many as half of those surveyed (52%) reporting some level of psychological disturbance. After controlling for age, gender and diabetes type, few differences in levels of psychological dysfunction were identified between the T1DM and T2DM cohorts. The exception to this was disinhibited eating behaviours: 22% of people with T2DM had severe levels of disinhibited eating, twice that recorded in the T1DM population. Overall, 36% (n=76) of study participants had moderate-severe levels of depression, anxiety or both, and 9.5% (16 of 168) had scores suggestive of borderline personality disorder. Copyright © 2010 John Wiley & Sons. (Source: Practical Diab...

Transient neonatal diabetes re-presenting with type 2 diabetes at 12 years: responds well to sulphonylureas

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Combination of exenatide and insulin in type 2 diabetes: a retrospective case series observation

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

E-health: forward strides on a path with hurdles towards an uncertain destination

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Telehealth as adjunctive therapy in insulin pump treated patients: a pilot study

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

New National Institute for Health and Clinical Excellence guidance is likely to increase the use of insulin pump therapy, and the challenge for diabetes teams is to maintain the initial improvement in HbA1c without extra resources. A telehealth system has been developed where both health professionals and patients can view downloaded pump and blood glucose data.A pilot study in patients with HbA1c >8%, using pump therapy for more than a year, demonstrated a mean reduction from 9.3% to 8.2% at 12 months after using the telehealth system. Patient satisfaction with the system reported more understanding, insight and control by viewing the data, as well as easy access to the health professional. This pilot study has demonstrated that, for some people, using a telehealth approach has resulted i...

All clinical diabetes services need the support of health psychologists

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

News

Practical Diabetes International — Thu, 04 Feb 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

The addition of insulin to metformin and sulphonylureas: results of the 4-T study

Practical Diabetes International — Fri, 01 Jan 2010 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Sibutramine

Practical Diabetes International — Fri, 11 Dec 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Scleredema diabeticorum: an under recognised complication?

Practical Diabetes International — Fri, 11 Dec 2009 00:00:00 +0100

We report the case of a 41-year-old man with type 1 diabetes who presented with scleredema diabeticorum.Scleredema diabeticorum is an uncommon skin condition. It is a poorly known (recognised) complication of diabetes.The aetiopathogenesis of the clinical condition is not well understood. No single form of treatment has been proven to be consistently beneficial. In most cases it is a self-limiting, benign disease. Optimisation of metabolic control and physiotherapy are recommended for all cases. Copyright © 2009 John Wiley & Sons. (Source: Practical Diabetes International)

The DAFNE Collaborative. Experiences of developing a nationally delivered evidence-based, quality-assured programme for people with type 1 diabetes

Practical Diabetes International — Fri, 11 Dec 2009 00:00:00 +0100

This article describes the process by which the DAFNE (Dose Adjustment For Normal Eating) Collaborative developed and maintained the integrity of the programme during the national roll-out across diabetes services. The costs of maintaining the integrity and quality of the programme account for a significant proportion of the cost of DAFNE; however, the cost per patient is now almost half that of previously quoted figures. Copyright © 2009 John Wiley & Sons. (Source: Practical Diabetes International)

Efficacy of insulin lispro in pregnancies complicated with pregestational diabetes mellitus

Practical Diabetes International — Fri, 11 Dec 2009 00:00:00 +0100

Insulin is the mainstay in the management of pregnancies complicated by pregestational diabetes. Insulin analogues are useful in the non-pregnant state, leading to better glycaemic control. Our study tested the hypothesis that using insulin lispro in such pregnancies would lead to better feto-maternal outcome when compared to human insulin.The study was conducted as a retrospective case-control study, and was undertaken in the antenatal clinic of Lancashire Teaching Hospitals NHS Trust between 1997 and 2001. The study involved 153 consecutive women with pregestational diabetes, 83 of whom were treated with insulin lispro and the rest with human insulin. Details of their management and outcome were derived from their medical, obstetric and paediatric notes. The main outcome measures were: m...

News

Practical Diabetes International — Fri, 11 Dec 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

A funny thing happened on the way to the forum

Practical Diabetes International — Fri, 11 Dec 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Blood glucose meters: old and new

Practical Diabetes International — Fri, 11 Dec 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

News

Practical Diabetes International — Fri, 11 Dec 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Bariatric surgery: a cure for diabetes?

Practical Diabetes International — Fri, 11 Dec 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Orlistat

Practical Diabetes International — Mon, 26 Oct 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Delivery of U-500 insulin by CSII in a patient with type 2 diabetes and extreme insulin resistance

Practical Diabetes International — Mon, 26 Oct 2009 00:00:00 +0100

We present a case of extreme insulin resistance in a female patient whose glycaemic control improved remarkably using insulin pump. She also reported subjective improvement in her quality of life. Copyright © 2009 John Wiley & Sons. (Source: Practical Diabetes International)

News

Practical Diabetes International — Mon, 26 Oct 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

The Diabetes Foot Care Master Class

Practical Diabetes International — Mon, 26 Oct 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Severe reversible chorea complicating non-ketotic hyperglycaemia

Practical Diabetes International — Mon, 26 Oct 2009 00:00:00 +0100

We report the case of an 87-year-old lady who presented with chorea complicating non-ketotic hyperglycaemia, and this was confirmed with MRI brain imaging demonstrating the classical feature of this condition. A high T1-weighted signal in the putamen is quite characteristic of this condition. Copyright © 2009 John Wiley & Sons. (Source: Practical Diabetes International)

Successful treatment of diabetic autonomic diarrhoea with monthly subcutaneous lanreotide

Practical Diabetes International — Mon, 26 Oct 2009 00:00:00 +0100

A 29-year-old woman, with 15 years of poorly controlled type 1 diabetes and established diabetic autonomic diarrhoea, presented with worsening diarrhoea and diabetic ketoacidosis. Frequency of bowel opening was up to 40 times per 24 hours. Octreotide was started, rapidly decreasing bowel motion frequency. Due to previous intolerable side effects of rotten odour breath and flatus, she converted to once-monthly subcutaneous lanreotide (Somatuline Autogel). Her diarrhoea remained controlled without any side effects, until her demise a year later from severe diabetic ketoacidosis.To our knowledge this is the first published report of the successful treatment of intractable diabetic autonomic diarrhoea by once-monthly subcutaneous lanreotide. Copyright © 2009 John Wiley & Sons. (Source: Practi...

The current state of general practicediabetes care in the West of Ireland

Practical Diabetes International — Mon, 26 Oct 2009 00:00:00 +0100

This study aimed to assess the care provided to patients with diabetes in general practices in the West of Ireland. A postal questionnaire was sent to all 103 general practices in County Galway. The questionnaire assessed diabetes prevalence and maintenance of a diabetes register, use of guidelines for the care of diabetes, appointments systems and the provision of specialised diabetes clinics in general practice, referrals to the hospital specialist team, and opportunities for developing diabetes care.The response rate was 76%. Mean estimated prevalence of diabetes was 2.7% (range 0.1-9.5%). A diabetes register was maintained by 33% of practices. Diabetes care guidelines were used by 56%. Thirty-five percent of practices had GP(s) and 33% had practice nurse(s) with a special interest in d...

Understanding, knowledge and attitudes towards current UK driving advice in insulin treated diabetic patients

Practical Diabetes International — Mon, 26 Oct 2009 00:00:00 +0100

UK driving licences are issued and controlled by a government body, the DVLA (Driver and Vehicle Licensing Agency). Diabetic drivers must inform the DVLA and their motor insurer about their condition. Current advice is to test the capillary blood glucose level before driving. If symptomatic hypoglycaemia occurs during driving, the driver should stop, take carbohydrate, and wait 45 minutes after euglycaemia to allow brain function to recover before driving on. Previous studies have shown that diabetic drivers are good at informing both the DVLA and their insurer, but not good at following advice regarding testing and hypoglycaemia treatment. In order to inform our current education process, this study aimed to explore why drivers do not seem to follow this advice by examining the attitudes ...

Principles of safe driving on insulin: the message is still not getting across

Practical Diabetes International — Mon, 26 Oct 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

What has QoF ever done for diabetes?

Practical Diabetes International — Mon, 26 Oct 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Insulin use to improve glycaemic control in critically ill patients: should the NICE-SUGAR study change our practice?

Practical Diabetes International — Thu, 01 Oct 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Swine flu and diabetes

Practical Diabetes International — Thu, 01 Oct 2009 00:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Ivabradine

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Preconception care in people with knowndiabetes and those at risk in primary care

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Forward to the past: quality and audit for diabetes in primary care for the 21st century

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Polypharmacy in diabetes and solutions for greater adherence

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Marked improvement in glycaemic control in a type 2 diabetes patient following a liver transplant for cirrhotic steatohepatitis

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

We present the case of a 58-year-old woman with poorly controlled, insulin-treated type 2 diabetes mellitus who underwent a liver transplant for cirrhosis due to non-alcoholic fatty liver disease complicated by encephalopathy and portal hypertension. Within four months of surgery she exhibited marked improvement in insulin sensitivity, as evidenced by reduced exogenous insulin requirement, with cessation of insulin therapy at 11 months and a consequent dramatic improvement in glycaemic control, eventually achieving an optimal glycosylated haemoglobin concentration on no specific diabetes treatment aside from dietary advice. This was despite a standard regimen of immunosuppressive treatments including prednisolone, tacrolimus and sirolimus which all have the propensity to induce insulin res...

Patients' preference for subsequent therapy following secondary failure of metformin and sulphonylurea

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

We surveyed 205 type 2 diabetic patients with glycated haemoglobin 7.5-10.0% on maximum metformin and sulphonylurea to determine their choice for further glycaemic therapy. In all, 54.6% of patients requested pioglitazone, 21.9% basal insulin, and 23.4% preferred exenatide. South Asians generally preferred non-injectables, and more overweight patients preferred exenatide.Despite physician preference for insulin, most patients prefer additional oral agents over injectables. Copyright © 2009 John Wiley & Sons, Ltd. (Source: Practical Diabetes International)

A tribute to Dr Ken MacLeod

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Is diabetes a disease for general practice?

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

JDRF News Column

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

News update

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Diabetes care in general practice 25 years on: key developments and the future

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Genetic testing clarifies diagnosis and treatment in a family with both HNF1A and type 1 diabetes

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

Confirming a diagnosis of diabetes may often be straightforward but identifying the actual type of diabetes may not always be obvious, particularly in those with a family history of diabetes. Use of non-genetic tests, such as pancreatic antibodies, may assist in the classification of diabetes but is not routine practice. The introduction of molecular genetic testing may confirm a diagnosis of monogenic diabetes but may be considered by some health care professionals to be expensive and unnecessary, particularly if treatment change is unlikely. However, a positive genetic result may lead to successful transfer from insulin to sulphonylurea treatment in many cases with improvements in glycaemic control and quality of life.This paper describes a family with diabetes diagnosed below the age of...

IFCC standardised HbA1c - a paradigm shift

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Metformin and anaemia: myth or reality?

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

This study set out to determine if there is an association between metformin treatment and anaemia in a large population with diabetes mellitus.A total of 520 consecutive patients with diabetes were studied. Anaemia was defined by World Health Organization criteria of Hb (Source: Practical Diabetes International)

Patients' understanding is the key to effective communication

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

ABCD response to possible link between risk of cancer and use of insulin glargine

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Shared practice: integrating diabetes care

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Insulin glargine and cancer: cause and effect unproven

Practical Diabetes International — Tue, 01 Sep 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Rimonabant

Practical Diabetes International — Mon, 03 Aug 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Glibenclamide controls ketosis-prone diabetes in a 38-year-old woman with Kir6.2 mutation

Practical Diabetes International — Mon, 03 Aug 2009 23:00:00 +0100

We report the case of a patient with KCNJ11 S3C mutation, who is the oldest patient with neonatal diabetes to have successfully transferred from insulin to sulphonylureas. She was diagnosed with diabetes at the age of four and was treated as having type 1 diabetes mellitus. Her glycaemic control was always sub-optimal; she had had several admissions with diabetic ketoacidosis. Her daughter who developed diabetes at six weeks was found to have neonatal diabetes, which led to her genetic testing. Our patient was also diagnosed with the same KCNJ11 mutation as her daughter. At 38 years of age, after outpatient assessment, she was started on glibenclamide and in three weeks came off insulin completely, achieving good glycaemic control with glibenclamide. Her HbA1c improved from 10% pre-transfe...

News

Practical Diabetes International — Mon, 03 Aug 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

What do women with diabetes know about pregnancy and contraception?

Practical Diabetes International — Mon, 03 Aug 2009 23:00:00 +0100

In conclusion, two-thirds of women of child bearing age were unable to recall having had a discussion regarding pregnancy or contraception. There was poor understanding of the risks associated with pregnancy. A previous pregnancy and antenatal care did not improve knowledge. New educational strategies for preconceptual care are needed for women with diabetes, regardless of parity. Copyright © 2009 John Wiley & Sons, Ltd. (Source: Practical Diabetes International)

Primary care, secondary care or both: is there a consensus on long term management of diabetes mellitus?

Practical Diabetes International — Mon, 03 Aug 2009 23:00:00 +0100

The aim of this study was to test the hypothesis that specific referral guidelines are unhelpful because of wide variations in individual clinical practice.A series of representative diabetes case studies were given to a group of primary care, general practice (GP) clinicians for comment. The same cases were given to a group of secondary care clinicians. The suggested management strategies were compared.Overall the results show very little agreement among either primary care or secondary care clinicians for a series of commonly presenting clinical cases. Approximately a third of GP responses for each group of cases suggested primary care management with a third each split between secondary or shared care. Long term follow up of the cases was also disputed but a greater proportion felt that...

Management of people with diabetes as emergency medical admissions to hospital

Practical Diabetes International — Mon, 03 Aug 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Mindfulness Based Stress Reduction: effect on emotional distress in diabetes

Practical Diabetes International — Mon, 03 Aug 2009 23:00:00 +0100

Psychological distress is common in patients with diabetes. Little is known about the impact of Mindfulness Based Stress Reduction (MBSR), a non-traditional, cognitive behavioural intervention designed to improve stress management skills, in patients with diabetes.The purpose of this retrospective analysis was to evaluate the impact of MBSR training on mood states in 25 individuals with diabetes. All participants completed the Profile of Mood States Short Form (POMS-SF) at baseline and following eight weeks of MBSR. Overall psychological distress measured by the total mood score (TMS) and six subscales - including tension/anxiety, depression/dejection, anger/hostility, fatigue/inertia, confusion/bewilderment and vigour/activity - were assessed.Overall mood, measured by the TMS, as well as ...

Is mindfulness based training a cognitive behaviour technique?

Practical Diabetes International — Mon, 03 Aug 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Sinus headache with diabetic ketoacidosis

Practical Diabetes International — Mon, 03 Aug 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Practice-based commissioning in type 2 diabetes management: a successful joint health care practice/industry working model

Practical Diabetes International — Mon, 03 Aug 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Clinical research in diabetes: a practical resource to assist with participant understanding and recruitment

Practical Diabetes International — Mon, 03 Aug 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Gabapentin

Practical Diabetes International — Sun, 05 Jul 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Olanzapine-induced hyperglycaemic, hyperchloraemic, hyperosmolar state

Practical Diabetes International — Sun, 05 Jul 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Community diabetes consultants: the case for additional training

Practical Diabetes International — Sun, 05 Jul 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Quality of diabetes care in India, China, Brazil, Mexico and Russia

Practical Diabetes International — Sun, 05 Jul 2009 23:00:00 +0100

Employing US national standards, baseline data for type 2 diabetes were collected in India, China, Brazil, Mexico and Russia prior to Staged Diabetes Management implementation.In all, 5507 patients (India 2778, China 489, Brazil 1106, Mexico 925, and Russia 209) were evaluated. No site sample met the US standard for HbA1c or blood pressure. China, India and Mexico achieved criteria for LDL [ge] 130 mg/dL. Post-programme data from Russian sites showed significant improvement in HbA1c (p < 0.00001). In Brazil a trend toward improvement in blood pressure and blood glucose was also noted.Assessing current diabetes care employing US national criteria can serve as a benchmark for interventions to improve diabetes care. Collecting follow-up data measures programme impact and identifies areas requ...

ABCD position statement on incretin mimetics and DPP-4 inhibitors -2009

Practical Diabetes International — Sun, 05 Jul 2009 23:00:00 +0100

The Association of British Clinical Diabetologists (ABCD) currently recommends a limited place for exenatide and the gliptins in obese type 2 diabetes. Exenatide requires careful patient selection and continued specialist support, particularly to avoid initiation in individuals at risk of pancreatitis or for those who are already on insulin therapy. Hypoglycaemic and weight reduction efficacy may vary depending on baseline levels of HbA1c and body mass index. Continuation of therapy beyond six months should be determined by changes in weight and/or HbA1c. Gliptins should be reserved for less obese, less hyperglycaemic cases than those considered for exenatide, assuming normal hepatorenal function, and where sulphonylureas and glitazones are inappropriate. Gliptin therapy should only contin...

News

Practical Diabetes International — Sun, 05 Jul 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

The role of incretin-based therapies in the management of type 2 diabetes

Practical Diabetes International — Sun, 05 Jul 2009 23:00:00 +0100

In patients with type 2 diabetes mellitus (T2DM), goals for blood glucose and other cardiovascular risk factors, such as blood pressure and body weight, can be difficult to achieve. Recent clinical trials indicate that incretin-based therapies - dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 (GLP-1) agonists - help to achieve glycaemic goals and are generally well tolerated, with a low prevalence of hypoglycaemia. GLP-1 agonists also improve weight, blood pressure and markers of [beta]-cell function. Addition of an incretin-based agent may be appropriate for selected patients with T2DM and unsatisfactory glycaemic control on conventional therapies. Copyright ©2009 John Wiley & Sons. (Source: Practical Diabetes International)

Treatment options for type 2 diabetes:introducing the incretin-based therapies

Practical Diabetes International — Sun, 05 Jul 2009 23:00:00 +0100

In type 2 diabetes mellitus (T2DM), glycaemic control is often difficult to maintain and current treatments can produce adverse effects. The incretin-based therapies - dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 (GLP-1) agonists - improve glycaemic control when added to conventional therapies and are well tolerated, with a low incidence of hypoglycaemia. In addition, the GLP-1 agonists reduce body weight and systolic blood pressure and improve surrogates of [beta]-cell function. Incretin-based therapies may be appropriate for selected patients with T2DM when first-line therapy does not maintain glycaemic control, particularly where weight gain or hypoglycaemia are a concern. Copyright ©2009 John Wiley & Sons. (Source: Practical Diabetes International)

The National Clinical Director for Diabetes: one year on

Practical Diabetes International — Sun, 05 Jul 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Twenty-five years on [hellip]

Practical Diabetes International — Tue, 30 Jun 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Patient involvement in clinical trials: promoting participation and recruitment

Practical Diabetes International — Tue, 30 Jun 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Abstracts from the Autumn 2008 Meeting

Practical Diabetes International — Wed, 17 Jun 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Autumn 2008 Meeting of the Association of British Clinical Diabetologists

Practical Diabetes International — Wed, 17 Jun 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Prolonged-release nicotinic acid

Practical Diabetes International — Wed, 17 Jun 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Hypoglycaemia followed by lactic acidosis in a diabetic patient on metformin

Practical Diabetes International — Wed, 17 Jun 2009 23:00:00 +0100

A 71-year-old woman with a nine-year history of type 2 diabetes was admitted with hypoglycaemia, acute renal failure, and lactic acidosis. She was treated with fluids and antibiotics for presumed infection, and metformin was discontinued.Metformin-associated lactic acidosis is a rare consequence of metformin therapy and, as in this case report, there are often other factors contributing to the lactic acidosis. Copyright ©2009 John Wiley & Sons. (Source: Practical Diabetes International)

Providing optimal service delivery for children and adolescents with type 1 diabetes: a systematic review

Practical Diabetes International — Wed, 17 Jun 2009 23:00:00 +0100

The purpose of this systematic review was (1) to perform a comprehensive examination of the literature to identify aspects of service delivery which are associated with improved glycaemic control in young people with type 1 diabetes, and (2) to identify gaps in the current literature and suggest areas for future research.The online medical databases Medline, Embase, Psycinfo and Cinahl were searched using a series of keywords. We reviewed randomised controlled trials and cross-sectional, comparison and retrospective audit studies from 1980 to December 2007 which involved children, adolescents and young adults with type 1 diabetes. In total, 540 studies were screened for inclusion, with 68 papers retrieved for further analysis 23 of which were retained for inclusion in the review.The servic...

Risk calculation of developing type 2 diabetes in Libyan adults

Practical Diabetes International — Wed, 17 Jun 2009 23:00:00 +0100

The aim of this study was to identify nationals at risk of developing type 2 diabetes within the next 10 years in some areas across Tripoli Health Authority in Libya.In this questionnaire-based survey, a total of 400 Libyan nationals of both genders were randomly selected from seven areas across the central area of Tripoli Health Authority (Soug El-Juma, Zawet Dahmani, Al-Furnaj, Ain Zara, Al-Madena Centre, Al-Dhahra Centre, and Noflean).All participants approached (400) completed the study and responded to the items of the survey. Based on a modified Finnish Type 2 Diabetes Risk Score test (FINDRISC), 129 (32.3%) were categorised as either at moderate or at high/very high risk of developing diabetes within the next 10 years of life. Among the 129 participants at risk, body mass index was ...

An international partnership to implement innovative systems of health care delivery for diabetes in a developing country

Practical Diabetes International — Wed, 17 Jun 2009 23:00:00 +0100

Sri Lanka currently faces a 'double burden' of non-communicable and communicable diseases. Public institutions geared primarily to care for communicable diseases struggled to meet demand for quality care in non-communicable diseases. The World Health Organization has developed tools for implementing appropriate health care for long-term problems.We piloted interventions in self-management support, delivery system design, decision support and clinical information systems at sites in urban and rural Sri Lanka. This undertaking confirmed that interventions through adaptation of Sri Lanka's primary care infrastructure and establishment of innovative partnerships enable the effective implementation of care with existing resources in the short term. We demonstrated that media can be used as a po...

'Introduction to Insulin' classes: flexible approach to insulin initiation

Practical Diabetes International — Wed, 17 Jun 2009 23:00:00 +0100

We describe an alternative flexible, hybrid model of education, combining initial 1:1 education in some patients with group classes ('Introduction to Insulin' classes), for initiation and stabilisation on insulin. This model was adopted primarily to ensure that insulin was commenced with minimal delay, once the decision to start it had been made.Following piloting and design of the 'Introduction to Insulin' classes, a prospective audit was undertaken of the first 50 patients participating in the classes. By one year, HbA1c had fallen from 9.8% to 7.8% and there was an associated 2.7 kg weight gain. This model of insulin education is therefore as effective as traditional 1:1 education, yet has the potential to utilise less overall educator time. Copyright ©2009 John Wiley & Sons. (Source: ...

Ten-year risks of diabetes in Libyan adults: the importance of UN Resolution 61/225

Practical Diabetes International — Wed, 17 Jun 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Management of insulin starts: shared experiences and lessons learnt

Practical Diabetes International — Wed, 17 Jun 2009 23:00:00 +0100

No abstract. (Source: Practical Diabetes International)

Couple dynamics and coping with diabetes

Practical Diabetes International — Wed, 17 Jun 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

New treatment options for glucose control in type 2 diabetes: an opportunity for individualised therapy is now possible

Practical Diabetes International — Sun, 31 May 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Tadalafil

Practical Diabetes International — Mon, 11 May 2009 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Guidelines on the current best practice for the management of type 1 diabetes, sport and exercise

Practical Diabetes International — Mon, 11 May 2009 04:00:00 +0100

This article aims to empower health care professionals working in clinical practice within the field of type 1 diabetes, sport and exercise. The first section of the article summarises the physiological challenges to glucose homeostasis anticipated from different types of exercise in an individual with type 1 diabetes. The second section considers the current evidence base and recognised strategies available to overcome these physiological challenges.Although this article does not cover 'every insulin regimen' or 'every eventuality' it provides health care professionals with the knowledge to predict the impact of different sports and exercises on glucose homeostasis in an individual with type 1 diabetes, and an awareness of the potential strategies available to allow safe and successful pa...

Post-prandial glucose levels following three methods of insulin bolusing A study in adolescent girls and in comparison with girls without diabetes

Practical Diabetes International — Mon, 11 May 2009 04:00:00 +0100

The aims of this study were to assess whether one method of insulin bolusing was superior to two others in managing two pasta meals, and to compare the glucose levels with those of females without diabetes.Fifteen continuous subcutaneous insulin infusion (CSII)-treated adolescent females and 10 adolescent females without diabetes consumed two pasta meals with different fat contents. The plasma glucose (p-glucose) values were followed using capillary measurement and continuous glucose monitoring (CGMS) until three hours after the meal. The CSII-treated females received the same insulin dose at every occasion as: (1) normal bolus; (2) dual-wave bolus - 60% of the dose as normal bolus and 40% over one hour; and (3) square-wave bolus - a prolonged dose over one hour.No differences were found i...

News update

Practical Diabetes International — Mon, 11 May 2009 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Risk factors for visual impairment registration due to diabetic retinopathy in Leeds, 2002-2005

Practical Diabetes International — Mon, 11 May 2009 04:00:00 +0100

We undertook a retrospective study of case notes of those patients registered blind or partially sighted due to diabetic retinopathy in the Leeds metropolitan area in the years 2002 and 2005.Both the incidence of visual impairment due to diabetic retinopathy and the relative contribution to total registrations are similar to those observed in other local and national studies. The main risk factors for registered visual impairment were poor glycaemic control prior to ophthalmic review, no prior retinopathy screening, late presentation with symptomatic visual loss, non-compliance with planned review and laser treatment failure. Most of these risk factors are avoidable. Nearly two-thirds of patients diagnosed with diabetes mellitus were being screened for diabetic retinopathy. These figures w...

News

Practical Diabetes International — Mon, 11 May 2009 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Intrapyloric botulinum toxin injection as treatment for diabetic gastroparesis

Practical Diabetes International — Mon, 11 May 2009 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Post-natal follow up of patients with gestational diabetes: one year onward

Practical Diabetes International — Mon, 11 May 2009 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Quality outcomes for a diabetes service

Practical Diabetes International — Mon, 11 May 2009 04:00:00 +0100

Current NHS policy is to move services for chronic disease out of the hospital sector into the community, with services managed by a variety of health care professionals. There are often no clinical outcome measures specified for such clinics, and we therefore describe results for one such service run by a consultant, a dietitian and a specialist nurse.The clinic is hosted by an urban GP practice, and reviews patients with a view to problem solving, management planning and discharge.During a representative period, between 1 April 2007 and 31 March 2008, 144 patients were seen in 285 visits with a new:follow-up ratio of 1:0.98. The non-attendance rate runs between 15 and 20%. In a 21-month period, 213 patients were referred with conditions requiring improvement in diabetes control. Baseline...

TOPDOC Diabetes: national study of trainee doctors' confidence in managing diabetes

Practical Diabetes International — Mon, 11 May 2009 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Optimising glycaemic control in adolescents using CGMS

Practical Diabetes International — Mon, 11 May 2009 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

HbA1c - new unit of measurement necessitates a new educational exercise

Practical Diabetes International — Thu, 30 Apr 2009 23:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

The role of CGMS in the management of pregnant women with diabetes

Practical Diabetes International — Wed, 01 Apr 2009 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Putting people centre stage

Practical Diabetes International — Mon, 02 Mar 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Aliskiren

Practical Diabetes International — Mon, 02 Mar 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Periodontal disease and general health: implications for cardiovascular disease and diabetes

Practical Diabetes International — Mon, 02 Mar 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

The epidemiology of diabetes mellitus. Edited by Jean-Marie Ekoé, Marian Rewers, Rhys Williams and Paul Zimmet, 2nd Edition, © 2008, John Wiley & Sons ISBN: 978 0 470 017272. website:

Practical Diabetes International — Mon, 02 Mar 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Embedding CSII therapy in the routine management of diabetes in children: a clinical audit of this service in Leeds

Practical Diabetes International — Mon, 02 Mar 2009 05:00:00 +0100

The aim of this study was to document the clinical and secondary care cost benefit of continuous subcutaneous insulin infusion (CSII) over a five-year period in the Leeds Paediatric Diabetes Service.Patients with type 1 diabetes treated using CSII therapy since 2002 who attended the paediatric diabetes clinics in Leeds, UK, were eligible for inclusion. Information on glycaemic control (HbA1c) and frequency/type of hospital admission was collected during the 12-month period before CSII was initiated and compared prospectively after the transition to pump therapy. Multi-level regression modelling was used to assess the change in HbA1c levels and the effect of patient characteristics.Data were included on 84 individuals ranging in age from 0 to 18 years, 54% of whom were female. Mean (SD) HbA...

Service redesign: the experience of Newcastle Diabetes Service 2001-2007

Practical Diabetes International — Mon, 02 Mar 2009 05:00:00 +0100

The prevalence of diabetes is projected to rise substantially. National policy has introduced drivers to promote service redesign around patient needs. This paper describes how we have developed an integrated local diabetes service based on the community delivery of diabetes care, supporting primary care and interfacing with specialist care.The diabetes service is located in the Primary Care Trust and is based at the Newcastle Diabetes Centre. There is a service delivery plan agreed with all stakeholders for people with type 2 diabetes. The service supports primary care to deliver high quality care, provides community care in close proximity to patients' homes and delivers specialist care.Pathways of care for people with type 2 diabetes are based on level 1 primary care, level 2 community ...

News update

Practical Diabetes International — Mon, 02 Mar 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Life for a Child Program film debut

Practical Diabetes International — Mon, 02 Mar 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Gastrointestinal upset following improvement of HbA1con initiation of pump therapy

Practical Diabetes International — Mon, 02 Mar 2009 05:00:00 +0100

Continuous subcutaneous insulin infusion therapy is being increasingly used across the world in our armamentarium to improve blood glucose control in type 1 diabetes. Significant and rapid declines in HbA1c can be achieved because of the potential to reduce hypoglycaemic episodes and, whilst this is one of our goals in diabetes management, we must be conscious of the possible adverse effects of this. Here we report a case of transient gastroparesis with small bowel bacterial overgrowth following initiation of insulin pump therapy and a rapid drop in HbA1c. Copyright © 2009 John Wiley & Sons. (Source: Practical Diabetes International)

Diabetes service redesign: useful lessons

Practical Diabetes International — Mon, 02 Mar 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Does Caesarean section increase the risk of type 1 diabetes?

Practical Diabetes International — Mon, 02 Mar 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Current problems in diabetic foot care: how to solve them

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Eplerenone

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

The new Johnson & Johnson Diabetes Institute in Paris

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Diagnosis of obesity and clinical implications

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Paediatric obesity and type 2 diabetes: strategies for prevention and treatment

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

The rising pandemic of obesity has caused an increase in the prevalence of type 2 diabetes in children and adolescents worldwide. Between 8% and 43% of children with newly-diagnosed diabetes have type 2 diabetes in the USA, while in Europe currently only 0.5% of the newly-diagnosed cases are classified as type 2. Ethnic factors, pubertal insulin resistance and female gender play a major role. Accelerated weight gain in infants may not only lead to type 2 diabetes later in life, but has also been implicated in the pathogenesis of type 1 diabetes. Therefore, preventive approaches against childhood obesity and type 2 diabetes need to start in the preschool age group. Age-appropriate education programmes for paediatric type 2 diabetes should include elements of programmes for paediatric diabet...

The prevalence of risk factors for foot ulceration in Egyptian diabetic patients

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

The effect of ethnicity on diabetic foot ulceration (DFU), neuropathy and peripheral arterial disease (PAD) remains controversial, with few previous studies from Egypt. The aim of this study was to examine the prevalence of DFU and its risk factors in a cohort of patients presented to the outpatient diabetes clinic at Mansoura University Specialized Medical Hospital.Over a period of 12 months, 1220 diabetic patients were screened for DFU, neuropathy, PAD, foot deformities, and skin and nail abnormalities.The mean age was 50.5 ± 10.9 years and 36.8% were male. Diabetes duration was 7.9 ± 5.9 years and BMI 34.5 ± 6.7. The prevalence of active or past foot ulceration was 1.2% and 5.7% respectively. Monofilament insensitivity was found in 124 patients (10.2%). Only 38 patients (3.1%) had ab...

Type 2 diabetes in pregnancy: more to come?

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

The objective of this study was to determine the rate of increase in pregnancies complicated by type 2 diabetes in the former UK Northern health region between 1996 and 2006.Since 1993, all data for women with pregnancies complicated by pre-existing type 1 and type 2 diabetes have been prospectively collected by the Northern Diabetes Pregnancy Survey. The annual incidence of women with type 2 diabetes was collected and further analysed for associations with age, body mass index and ethnicity, perinatal mortality and stillbirth rates.There was an approximate four-fold increase in type 2 diabetes in pregnancy (r2 = 0.85) during the 11 years. The majority (80.8%) of the women were white, although ethnic minorities were over-represented; 88.2% women were overweight or obese. Stillbirth and per...

Quetiapine induced hyperosmolar non-ketotic state and pancreatitis

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

JDRF News Column

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

News update

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

When it comes to managing diabetes, education is key

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Suspension of rimonabant by the EMEA

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Newer agents for blood glucose control in type 2 diabetes: the NICE draft proposals

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Children with diabetes in the developing world

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Straight to you: retinopathy results of the DIRECT studies

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Type 2 diabetes in pregnancy: primary care awareness is vital

Practical Diabetes International — Mon, 02 Feb 2009 05:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

What's new for the DPP-4 inhibitors?

Practical Diabetes International — Sat, 01 Nov 2008 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Spring 2008 Meeting of the Association of British Clinical Diabetologists

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Bisoprolol

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

An external evaluation of the work of the National Diabetes Support Team in England

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

The Young Diabetologists Forum (Diabetes UK)/ABCD trainee survey

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

The Young Diabetologists Forum (YDF) is a forum for diabetes trainees in the UK. With help from the Association of British Clinical Diabetologists (ABCD), the YDF set up an audit amongst diabetes trainees to understand their feelings about the changing structure of diabetes care, present training needs and future job situations.A 24-question e-questionnaire was set up. All diabetes trainees were sent invitations to participate in this e-based audit, via e-mail.There were 192 respondents (42% of current trainees). Of these, 63% were male, and 60% were UK graduates. Twenty-three percent intended to work, as a consultant, in a teaching hospital, 31% in a district general hospital; 65% would like to work full time as a consultant, 28% part time. Sixteen percent intended to work in the communit...

NICE guidance on insulin pump therapy: over to you!

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Taxed by obsession or obsessed with taxation: a reflection

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Taxed by obsession or obsessed with taxation?

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

Deterioration of diabetic retinopathy during growth hormone therapy in a pan-hypopituitary diabetic patient

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

Diabetic retinopathy remains the leading cause of blindness in the developed world, resulting in significant morbidity for the diabetes population subset and, as yet, the specific pathogenesis remains elusive. Endogenous growth hormone (GH) is believed to play a role in the development of retinal new vessels that characterise proliferative retinopathy. Both endogenous GH and its active protein insulin-like growth factor 1 (IGF-1) have been found to be at high levels in diabetes, especially in patients with suboptimal glycaemic control. Recombinant human GH (rhGH) was licensed for adult therapeutic use in 1996. Its role in retinopathy is inconclusive. There are reports of rhGH administration being associated with proliferative retinopathy in non-diabetic patients. In a case series of 85 non...

Professional development for podiatrists in diabetes using a work-based tool

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

In conclusion, work-based diabetes-related educational input for community podiatrists can improve confidence, self-perceived knowledge and lines of communication between hospital and community podiatrists. This may result in improved diabetes foot care in the community. Copyright ©2008 John Wiley & Sons, Ltd. (Source: Practical Diabetes International)

Inpatient diabetes management: education of junior doctors and nurses

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

News update for readers of Practical Diabetes International

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)

JDRF News Column

Practical Diabetes International — Fri, 17 Oct 2008 04:00:00 +0100

No Abstract. (Source: Practical Diabetes International)