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Pregnancy |
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Pregnancy poses additional risks for women with diabetes. Although the majority of mothers with pre-existing diabetes have type 1 diabetes,
the proportion of births to women with diabetes is rising due
to the rising numbers of young women with Type 2 diabetes.
Worryingly, some of the latter group are only diagnosed in
pregnancy. |
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Dr. Mark Freeman, January 2012 |
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Insulin analogues |
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Insulin analogues have been getting a bad press over the past 12 months and the
latest revamp of NICE guidelines is expected to outlaw their
routine use in type 2 diabetes. So why have insulin manufacturers
found their position so hard to defend? |
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Professor Steve
Bain, November 2011 |
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Insulin prescribing |
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The last few years have seen a significant rise in the number of patients requiring
insulin. Unfortunately, the increasing number of different
insulins and regimes available have been mirrored by a rapid
increase in prescribing errors to the point at which insulin
is the drug with the highest number of prescribing errors in
the NHS. |
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Dr. Mark Freeman, October 2011 |
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Pioglitazone & bladder cancer - what’s the story? |
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On June 9th, France suspended new prescriptions of pioglitazone due to concerns
over an increased risk of bladder cancer. Within hours the
Germans followed suit ... |
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Professor Steve Bain, September 2011 |
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Diabetes and Driving |
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Diabetes is a condition which impacts significantly on many aspects of a person’s
life. Its effect on driving is often the most profound. |
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Dr. Mark Freeman, August 2011 |
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|
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Triple therapy in diabetes, what’s the third line? |
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When the NICE updated the clinical guideline for management of hyperglycaemia
in 2009 (CG87) it reiterated the place of metformin and sulphonylureas
as first- and second-line treatments respectively. However,
what is recommended when dual therapy does not achieve HbA1c
targets? |
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Professor Steve Bain, July 2011 |
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Hypoglycaemia |
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Diabetes care is often a trade off between tighter glucose control on the one
hand and hypoglycaemia (blood glucose <4.0mmol/l) on the other. Whilst clinicians often appear to concentrate on the
former, hypoglycaemia is the one aspect of diabetes care that
concerns patients. |
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Dr. Mark Freeman, June 2011 |
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HbA1c - out with the old, in with the new |
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Glycated haemoglobin levels (HbA1c) has become one of the key targets in diabetes
care, understood by patients and their health care professional.
However, clinicians working in diabetes cannot fail to have
noticed that their local chemical pathology departments have
also been measuring HbA1c using a less familiar scale than
the well known percentage scale, mmol/mol. |
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Dr. Mark Freeman, May 2011 |
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NICE review of diabetes therapies from 2012 |
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The decision by NICE to bring forward its review of diabetes therapies from 2012
to later this year is clearly an attempt to impact on prescribing,
especially since the last review was only published 2 years
earlier in May 2009 (Clinical Guideline [CG] 87, an update
on CG 66 published twelve months before). So, what will be
the likely focus of this update? |
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Professor Steve Bain, April 2011 |
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The development of incretins |
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The development of incretins has not been a smooth path ... Are the newer diabetes
agents really more dangerous than the old ones or should we
now expect this kind of scare story for all new drugs as competing
agenda fight it out in the medical press? |
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Professor Steve Bain, March 2011 |
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Year of care & care planning |
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The process of Care planning offers people active involvement in deciding and
agreeing how their diabetes (piloted in year of care) will
be managed through a partnership approach with health professionals.
Lofty aims to be sure but what is the basis for the care planning
consultation and how can it be delivered? |
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Dr. Mark Freeman, February 2011 |
