0001), and waist circumference decreased from 120.2±9.6 to 105.6±11.5cm (p<0.0001). Simultaneously, blood pressure find more improved (systolic 148±17 to 133±15mmHg, p<0.005; and diastolic 91±8 to 83±11mmHg, p<0.05). Serum gamma-glutamyltransferase decreased from 75.2±54.7 to 40.6±29.2 U/L (p<0.005). Total
serum cholesterol decreased from 5.5±1.0 to 4.7±1.2mmol/L (p<0.01). This approach is easy to implement in general practice, and brings rapid weight loss and improvement in HbA1c. Copyright © 2014 John Wiley & Sons. Practical Diabetes 2014; 31(2): 76–79 "
“Experience of the management of patients with type 1 diabetes treated with insulin pumps tends to vary significantly among clinicians in training. The Young Diabetologists and Endocrinologists Forum (YDEF), a body representing diabetes registrars, undertook a web-based survey of doctors to assess their familiarity, confidence and experience in dealing with the various aspects of continuous subcutaneous insulin infusion (CSII) given its relative technical complexity and lack of formal training. A total of 101 this website trainees (24%) responded to this survey. One-third of trainees
(38%) had no formal CSII training. Of the 62% of trainees who had had some form of training, including attendance on an insulin pump course, only 45% were able to set up and prime an insulin pump; 55% and 67% of trainees were able to set up basal and bolus insulin doses respectively, and 77% understood the insulin pump sick day rules. Individual trainee experience with pump starts varied between zero and 14 patients with an average of two per trainee, which is arguably inadequate. We conclude that the provision
of CSII training varies considerably in the UK; training opportunities and exposure to pump therapy in practice vary greatly, which reflects a lack of formal detail or consideration of this in the UK curriculum. We propose a basic set of pump training competencies which diabetes registrars should be expected to work towards and fulfil prior to the completion of training. Copyright © 2013 John Wiley & Sons. “
“Insulin pump services have been widely available in the UK for over 10 years. Despite this, the recent national Insulin Pump Audit identified that only 6% of patients with type 1 diabetes are managed with insulin Non-specific serine/threonine protein kinase pump therapy, far lower than anticipated. A key reason for the UK continuing to lag behind other European countries in the provision of insulin pump services is the lack of trained health care professionals. This paper aims to provide diabetologists and diabetes specialist nurses with a basic understanding of the clinical approach to the patient with type 1 diabetes on insulin pump therapy. Copyright © 2014 John Wiley & Sons. “
“Hypoglycaemia unawareness can be a devastating complication in both types of diabetes. It is probably becoming more common as patients are urged to tighten their glycaemic control.