At present there are no specific interventions known to improve these pathogenic mechanisms; however, there is evidence to suggest that the organisation
of care could have an impact on the onset of foot disease. These patients therefore should have regular foot surveillance, education, and support from appropriate specialists to manage their foot care. All professionals involved in the care of patients with diabetes and renal disease should be aware of the Protease Inhibitor Library extent to which the patient’s feet are at risk. Copyright © 2012 John Wiley & Sons. “
“There have been few studies investigating the use of GLP-1 agonists in patients with insulin-treated type 2 diabetes and none looking at the costing. We compared the efficacy and relative cost of adding exenatide treatment to patients with type 2 diabetes receiving either oral hypoglycaemic agents (OHAs) or insulin. Patients were recruited from West Suffolk Hospital Diabetes Centre. Data were acquired retrospectively from 207 patients completing six months of treatment. Of 207 patients, 188 demonstrated good clinical progress with a mean HbA1c reduction of 1.6% (p<0.0001) and weight loss of 6.9kg (p<0.0001). Nineteen patients discontinued exenatide as HbA1c reduction did not achieve the NICE target (0.4%; p=0.29), but they did achieve significant weight loss (5.6kg; p<0.0001). The 188 patients continuing
on exenatide were sub-divided check details into insulin-treated (n=88) or tablet-treated (n=100). At six months, tablet-treated patients achieved an HbA1c reduction of 1.6% (p<0.0001) and weight loss of 6.5kg (p<0.0001). Insulin-treated patients achieved similar results: HbA1c reduction 1.6% (p<0.0001), weight loss 7.3kg (p<0.0001). After six months of exenatide treatment, the mean reduction in daily insulin dose was 48 units/person in the insulin-treated group. In the tablet-treated group, the cost of diabetic medication (per person/month) after six months was £54.90 above baseline, whereas in the insulin-treated group this was only £36.20 above baseline, because the reduction 4��8C in insulin dose offset the cost of exenatide. It was concluded that exenatide is clinically
effective in both insulin-treated and tablet-treated type 2 diabetes, but is more cost effective in those originally treated with insulin. Copyright © 2011 John Wiley & Sons. “
“The aims of this study were to determine whether the introduction of a diabetes management e-module can increase junior doctors’ confidence in managing inpatients with diabetes and contribute to improvements in patient care. A diabetes e-module was introduced at Barnet and Chase Farm Hospitals NHS Trust in October 2010. Junior doctors completed it and undertook an online exam at the end. Junior doctors were surveyed once, six to eight months after completing the e-module, and retrospectively ranked their confidence and knowledge levels in managing inpatients with diabetes before and after completing the e-module.