Posts Tagged 'Diabetes'



Cohort study: Diabetes, metformin, and breast cancer incidence among postmenopausal women

Cohort study: Diabetes, metformin, and breast cancer incidence among postmenopausal women

Source: JCO

There is emerging evidence suggesting that metformin may reduce breast cancer incidence, but reports are mixed and few provide information on tumour characteristics. This study used data from the Women’s Health Initiative (WHI) clinical trials to examine relationships among diabetes, metformin use, and breast cancer in postmenopausal women.   The WHI clinical trials program involves more than 68,019 postmenopausal women who were observed prospectively; 11,290 had diabetes at study entry or developed it during follow-up, and 3,273 developed invasive breast cancer after study entry.   The researchers found that compared with that in women without diabetes, breast cancer incidence in women with diabetes differed by diabetes medication type (P = 0.04). Women with diabetes receiving medications other than metformin had a slightly higher but not statistically significant incidence of breast cancer (hazard ratio [HR], 1.16; 95% CI, 0.93 to 1.45), and women with …
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Clinical Evidence reports on Diabetes

The worldwide increase in diabetes is focusing more attention on all aspects of treatment, including associated hypertension. Untreated hypertension in people with diabetes is linked to high rates of cardiovascular and microvascular disease. Our update examines new evidence questioning the effectiveness of angiotensin II receptor antagonists for this co-morbidity. In addition, while the evidence supports the idea of aggressive blood pressure targets, we highlight the uncertainty surrounding the exact level of those targets.

Visit the Clinical Evidence website to see the full review.

Other useful links:

News from NHS Networks: Children with Diabetes

Every child and young person with diabetes in England can now expect an improvement in their level of care as a landmark funding agreement for paediatric diabetes services comes in to force.
 
The Health Education England transition team has launched its first bulletin to start providing regular updates on the development of the new organisation.

News from NHS Networks

Prime minister’s challenge on dementia

The prime minister has launched a programme of work which aims to deliver major improvements in dementia care and research by 2015.  Read more »

Self-management of diabetes in Hospital

These guidelines have been commissioned by the Joint British Diabetes Societies for Inpatient Care Group in collaboration with NHS Diabetes.

Read more »

Institute’s Productive series available as e-learning

The NHS Institute for Innovation and Improvement has published the first of several promised modules in its Productive series of improvement aids as an e-learning course.  Read more »

Allied health professionals (AHP) QIPP toolkits

NHS Networks

 The Department of Health has identified potential savings and the opportunity to provide better care by involving more AHPs in patient care. This series of online tools aims to help the NHS identify how therapists can intervene at different stages of a patient’s condition to improve patient care whilst saving on costs. This first set of toolkits covers how AHPs can help to improve care for stroke; oral nutritional support; musculoskeletal care; cancer; and diabetes.

King’s Fund: ‘Join us on our journey’: developing a new model of care for children and young people with type 1 diabetes

NHS Diabetes

NHS Diabetes commissioned Leeds Metropolitan University to undertake a 3-year research project called ‘Join Us On Our Journey’. The aims of the research were to develop a model of care that will deliver the aspirations of the policy document Making Every Young Person with Diabetes Matter and improve the care provision for children and young people with type 1 diabetes in England. The findings show that there are certain aspects of the care pathway that need to be addressed. In particular, diabetes care, resources, education, psychological support, school/college and transition were found to be the main areas of concern.

March news from BMJ

Editorial content from The BMJ
Kim Eva Dickson and Mickey Chopra
Dae Hyun Kim
Chris Ham
Mike Peters and Jenny King
Cathy James
Simon Eaton, Alf Collins, Angela Coulter, Glyn Elwyn, Natalie Grazin, and Sue Roberts
Adam Timmis

 

Bruce Neal

 

Andrew D Oxman

 

Featured article

Anne Gulland

Last reminder: Have you completed your Diabetes UK – elearning

If you prescribe, prepare or administer insulin make sure you complete the Diabetes UK e-learning programme available at http://nhsdiabetes.healthcareea.co.uk/

When you register you will need to quote your 8 digit ESR staff number (see payslip) plus the Trust prefix 209. Complete the Learner tutorial and Safe use of Insulin modules and deliver safe care.

Don’t forget your Diabetes UK – elearning

If you prescribe, prepare or administer insulin make sure you complete the Diabetes UK e-learning programme available at http://nhsdiabetes.healthcareea.co.uk/

When you register you will need to know your ESR staff number (see payslip) plus the Trust prefix 209. Complete the Learner tutorial and Safe use of Insulin modules and deliver safe care.

Don’t forget your Diabetes UK – elearning

If you prescribe, prepare or administer insulin make sure you complete the Diabetes UK e-learning programme available at http://nhsdiabetes.healthcareea.co.uk/

When you register you will need to know your ESR staff number (see payslip) plus the Trust prefix 209. Complete the Learner tutorial and Safe use of Insulin modules and deliver safe care.

Diabetes UK e-learning programme

Calling all Healthcare Staff

It is a requirement of the NPSA report that all healthcare staff who are expected to prescribe, prepare or administer insulin complete the Diabetes UK e-learning programme

Can you please cascade to all staff in your areas who this may apply to and ensure that they complete the e-learning programme before 31st March 2012

To register for the programme at www.diabetes.nhs.uk staff will need their 8 digit ESR staff number found their payslip and will need to prefix this with the Trust number 209

Please follow the 10 steps below to register and access the training:

See www.diabetes.nhs.uk with you ESR number and Trust code to hand

  • Select Safe Use of Insulin Module
  • Click on e-learning courses  link
  • Click on “The 111 e-learning module is now available click here to access” button
  • On Welcome Page selectEngland
  • Register for the programme (Login if already registered)
  • Accept terms and conditions box if registering for the first time
  • Input ESR staff number with  209 prefix
  • Complete Learner Tutorial
  • Complete Safe Use of Insulin Modules and deliver safe care

Staff will need 2 hours time to register for and complete the e-learning programme which can be completed using computers available within the Trust’s Staff Library. Further support in accessing the module will also be available if required.

Other elearning modules at this website include:

Online e-learning modules

R Zaidi, A Heald, P Wai, T Patani and S Westal: Diabetic Medicine 2011

An audit on insulin prescribing errors and a survey of junior doctors on insulin prescribing

Diabetic Medicine, March 2011, vol./is. 28/(87-88), 0742-3071 (March 2011)

Authors: R Zaidi, A Heald, P Wai, T Patani and S Westal – Diabetes and Endocrine Department, East CheshireNHS Trust, Macclesfield, UK

Aims: (1) To identify errors in prescribing insulin on medical and surgical wards and compare resultswith those of the National Inpatient Diabetes Audit (NIDA) 2009. (2) A survey assessed the confidence of junior doctors in prescribing insulin.

Methods: We conducted a prospective audit, analysing 31 insulin prescription charts on medical and surgical wards, over 2 weeks following the NPSA report on safe administration of insulin. ‘Units’ written, regimen type and legitimacy, timing and signatures were checked. 48 junior doctors were questioned. This included 19 specialist registrars, 16 F2/CT trainees and 13 F1 doctors.

Continue reading ‘R Zaidi, A Heald, P Wai, T Patani and S Westal: Diabetic Medicine 2011’

BMJ: Best Practice looks at Diabetes insipidus

Featured updated topic: Diabetes insipidus

Diabetes insipidus is characterised by polydipsia, polyuria, increased thirst, and formation of hypotonic urine. Two types exist: central DI, due to defective synthesis or release of arginine vasopressin (AVP) from the hypothalamo-pituitary axis; and nephrogenic DI, due to renal insensitivity to AVP. Both types of DI may be associated with hypernatremia, and this may present as a medical emergency. Treatment goals are correction of any pre-existing water deficits and reduction in ongoing excessive urinary water losses. In central DI, desmopressin is the treatment of choice. Nephrogenic DI is treated with an adequate fluid intake; salt restriction and diuretics may help reduce polyuria.

Read the full article here

NHS Networks: 11/11/11

Report published by NHS Diabetes calls for more investment in specialist diabetes care.
 
Six out of ten people with dementia in England go undiagnosed. This means almost 400,000 people could be going without the vital support the NHS and social care services can offer.

News from The King’s Fund: 4 November

NHS Diabetes

Inpatient care for people with diabetes: the economic case for change
This report calls for more investment in specialist diabetes care to reduce the estimated £600 million excess spend on treating diabetes in hospitals.

Diabetes on the increase

“The number of people diagnosed with diabetes in the UK has increased by nearly 130,000 to 2.9 million in the past year. This is nearly a 50 per cent rise since GPs first published diabetes data in 2005 (2m).”

Extract from Diabetes UK
See the full article at Diabetes rates in the UK soar to nearly 3m

News from NHS Networks: 30 Sept

Two new respiratory quick reference guides have been published to help support patients with asthma and COPD.
 
This research scan describes how junior doctors have been engaged in quality improvement and factors that help and hinder their involvement.
 
The NHS must address the significant variations in care experienced by the 170,000 patients who have major emergency abdominal surgery each year, says a new report published by the Royal College of Surgeons.
The NHS could have saved a total of £625 million if it had prescribed NICE-recommended drugs for the treatment of type 2 diabetes as opposed to other treatment options, according to a new study.

Global rise in diabetes

Extract from NHS Evidence: Issue 29 September 2011
Overview:  Diabetes is the most common endocrine disease affecting more than one million people in the UK and causing three million deaths globally each year. It  is defined by high blood glucose: fasting plasma glucose (FPG) below 5.6 millimoles per litre (mmol/L) is considered normal, above 7 mmol/L is diagnostic of diabetes and an FPG level between 5.6 and 7 is considered pre-diabetes.

Treating diabetes accounts for approximately 10% of NHS spend. This is largely due to its associated complications which include coronary, cerebrovascular, ophthalmological and renal disease.

New evidence: A global study into diabetes prevalence (Danaei, G et al, The Lancet, 378, (9785) 31-40) shows the number of cases has more than doubled over the past 3 decades, with an estimated 347 million people now living with the condition worldwide.

Continue reading ‘Global rise in diabetes’

Mcinnes A., Jeffcoate W., Vileikyte L., Game F., Lucas K., Church A., Scanlan J., et al: Diabetic Medicine

Foot care education in patients with diabetes at low risk of complications: A consensus statement published in Diabetic Medicine, February 2011, vol./is. 28/2(162-167), 0742-3071;1464-5491 (February 2011)


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