Diabetic ketoacidosis has been reported in patients with type 2 diabetes on a combination of a GLP-1 receptor agonist and insulin who had doses of concomitant insulin rapidly reduced or discontinued. GLP-1 receptor agonists are not substitutes for insulin, and any reduction of insulin should be done in a stepwise manner with careful glucose self-monitoring. Abrupt discontinuation or reduction in insulin doses can lead to poor glycaemic control, with a risk of diabetic ketoacidosis.
The most frequent reductions in pressure occurred when the anterior edge of the metatarsal bar was placed at 77% of the peak pressure values, and its effects were independent of the choice of EVA or Poron offloading material. In the flat insole, 61% of participants had one or more metatarsal head areas with pressure above the 200 KPa, reducing to 58% when adopting generic orthotic design rules and 51% when using the best orthotic insole of the nine tested. Our results confirm that plantar pressure relief is sensitive to orthotic insole design decisions and individual patient feet.
This literature review considers the personal and practice implications of managing type 1 diabetes in adolescence. The review is part of a wider postgraduate study and critically considers 25 largely qualitative articles. To read the full article, log in using your MPFT NHS OpenAthens details.
The aims of this study were to: a) determine if self‐efficacy mediates the relationship between perceived stress and diabetes self‐management in adolescents with type 1 diabetes; and b) explore whether perceived stress moderated the self‐efficacy and diabetes self‐management relationship.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
Despite the increase in the use of insulin pumps and continuous glucose monitors in recent years, the management of type 1 diabetes remains suboptimal in terms of glycaemic control and normal glycated haemoglobin (HbA1c) level. This article discusses the case of a child with type 1 diabetes who was successfully treated with a very low-carbohydrate diet, resulting in normal levels of HbA1c and normal blood glucose 95% of the time in a range of 70–180 mg/dL (4.0 mmol/L−10 mmol/L). Therefore, further studies are needed to verify how a very low carbohydrate diet impacts child development. To read the full article, log in using your MPFT NHS OpenAthens details.
A new campaign has begun that advises patients on what they can do to keep Type 2 diabetes at bay.
There are an increasing number of people being diagnosed with Type 2 diabetes in Staffordshire and Stoke-on-Trent, a picture that is reflected nationally.
The new awareness campaign, #BeInTheKnowType2, has three main audiences
The aim of this study was to determine the association between antidepressant (AD) classes, types and duration of use during pregnancy and the risk of gestational diabetes mellitus (GDM). Open Access Article
Early screening, diagnosis and management of gestational diabetes mellitus are important to prevent or reduce complications during and postpregnancy for both mother and child. A variety of guidelines exists, which assist nurses and midwives in the screening, diagnosis and management of gestational diabetes mellitus. Open Access Article
Health systems invest in diabetes quality improvement (QI) programmes to reduce the gap between research evidence of optimal care and current care.1 Examples of commonly used QI strategies in diabetes include programmes to measure and report quality of care (ie, audit and feedback initiatives), implementation of clinician and patient education, and reminder systems. A recent systematic review of randomised trials of QI programmes indicates that they can successfully improve quality of diabetes care and patient outcomes.2 Changes in surrogate markers such as blood glucose control, blood pressure or cholesterol levels are used to measure QI intervention effectiveness.2
However, investments in QI strategies are only worthwhile if the programmes that effectively improve care are sustained after trial completion.3. To read the full article, log in using your NHS OpenAthens details.
The innovative device, which is the size of a £2 coin and worn on the arm, means people with Type 1 do not have to carry out multiple painful finger-prick checks to monitor their blood sugar levels.
Instead, people with the condition can monitor their blood sugar levels in a much more convenient way, making it easier for people to manage their blood sugar levels.