Alsaffar H.; Whitby T.; Chandrasekaran S. Hormone Research in Paediatrics, October 2013

The effect of automated bolus calculators on HbA1c in children with type 1 diabetes in Macclesfield

Hormone Research in Paediatrics, October 2013, vol./is. 80/(413), 1663-2818

diabetesBackground: Previous studies have shown that using Automated bolus calculators (ABC) in type1 diabetic children showed noticeable reduction in HbA1C(1). Furthermore, it showed reduction in post prandial blood glucose level(2) and glucose variability(3) for those children treated with insulin pumps. Data from adults has already shown improvement in HbA1C following usage of ABC(4).

Objective: To confirm the effect of ABC on HbA1C in children with type1 diabetes who are on multiple daily insulin injection regimes in our unit.

Methods: This is a cross-sectional study. We have collected the data via Accu-check software and by reviewing the case notes. HbA1C was measured
before and after ABC use. Some of the patients were started immediately on ABC following their diagnosis with diabetes and others were started later after they showed poor glycaemic control.

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Moult D.; Chandrasekaran S; Diabetic Medicine, March 2013,

Comparison of multiple daily injections (MDI) vs continuous subcutaneous insulin infusion (CSII) methods of insulin delivery in children with Type 1 diabetes in a small district general hospital

Citation: Diabetic Medicine, March 2013, vol./is. 30/(100-101), 0742-3071 (March 2013)

Author(s): Moult D.; Chandrasekaran S.

Language: English

Abstract: Objective: To compare the efficacies of two different methods of insulin delivery in diabetic children in a small district general hospital, with regard to their average HbA1c, their daily insulin requirements and the results on their body mass index (BMI), the average reported number of non-severe hypoglycaemic events a week, and the rate of both long-term and acute complications in these children.

Methods: Data were collected retrospectively between December 2010 and December 2011. A total of 80 patients were included in this audit (40 MDI vs 40 CSII). The patients were divided into thre e different age groups (below five, five to 12, over 12). Results: The average HbA1c was 8.8% for the MDI group compared with 8.4% for the CSII group. The average daily insulin requirement was 0.81u/kg/day for the MDI group compared with 0.74u/kg /day for the CSII group. The average BMI was  0.6kg/m<sup>2</sup> for the MDI group compared with 19.6kg/m<sup>2</sup> for the CSII group. The number of non-severe hypoglycaemic events was recorded at an average of 0.69 episodes per week for the MDI group compared with 1.84 episodes per week for the CSII group. The difference in HbA1c was most marked in under fives (8.4% vs 7.8%). There were no signs of nephropathy in either group among the over 12s. However, lipid abnormalities in the form of elevated cholesterol was more often seen in the CSII group compared with the MDI group in the over 12s (seven vs five). Conclusions: CSII was found to be the overall better treatment in younger age groups, but loses its effectiveness in over 12 year olds.

Publication Type: Journal: Conference Abstract

Source: EMBASE

This article is not available fulltext but can be ordered through our inter-library loan scheme.

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.

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.

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