Type 1 diabetes: Complications

Sanjay Kalra and Silver Bahendeka, East Africa Diabetes Study Group Chair, provide an overview of the latest insulin guidance developed to aid management in a challenging region, facing familiar struggles.

Modestly increasing glucagon levels when commencing physical activity could be an effective strategy for preventing exercise-induced hypoglycemia among patients with type 1 diabetes, results of a randomized crossover trial suggest.

Ambulance call-outs for episodes of severe hypoglycemia do not consistently result in reviews of patients’ care, despite guideline recommendations, shows a study of diabetes patients in England and Wales.

The first randomized trial of islet transplantation supports its use in patients with severe, unstable type 1 diabetes.

Zivkovic M, Petrovski G, Bitoska I. Acta Diabetol 2018; Advance online publication. doi: 10.1007/s00592-018-1147-6

Diabetes and endocrinology Consultant and Advisory Board member Terence Pang highlights the benefits that a structured approach to glycemic goal setting can bring to your practice and patients with type 1 diabetes.

The excess mortality risk associated with high or very low glycated hemoglobin values is modified by glycemic variability in diabetes patients aged 70 years or more, shows an analysis of The Health Improvement Network database.

As the utility and availability of devices surges, so too do patient expectations. Advisory Board member Katharine Barnard provides key consultation questions to help determine your patients’ greatest needs and obstacles.

With the 2017 NaDIA results showing some positive trends in inpatient diabetes care, medwireNews talks to national clinical lead Gerry Rayman about the tools and tactics to deliver the best patient outcomes.

Awareness and education about compassion fatigue can help to limit its incidence and severity. Sanjay Kalra outlines strategies to identify and manage the emotional exhaustion that often affects diabetes caregivers.

The HypoDE investigators have reported that use of continuous glucose monitoring results in large reductions in hypoglycemia among high-risk patients managing their type 1 diabetes with multiple daily injections.

This review takes a practical approach to the assessment, nursing care, and medical treatment of diabetes in the elderly, highlighting major challenges and suggesting solutions to common clinical problems.

Editorial board member John Wilding casts a critical eye over the positive buzz surrounding the potential uses of sodium-glucose cotransporter 2 inhibitors in type 1 diabetes treatment.

Ovsyannikova AK et al. Diabetes Ther 2018; 9: 413. doi: 10.1007/s13300-017-0350-8

Editorial Board member Lori Berard addresses 2017's World Diabetes Day theme, providing her insights on the key considerations for managing diabetes in women (9:51).

Advisory Board member and pharmacist, Josh Neumiller, presents a practical guide to support clinical decision-making in the initiation and titration of U300 insulin glargine and insulin degludec.

Using a patient-centered care approach, the authors detail how to work in partnership with a patient to prevent hypoglycemia through evidence-based management of the disease and appropriate education.

This review provides an overview of the diagnosis and management of hypoactive sexual desire disorder, aiming to provide a practical approach to an under-recognized complication in women with diabetes.

van Megen KM et al. Diabetologia 2017; 60: 2252. doi: 10.1007/s00125-017-4403-3