Category Archives: Diabetes

Glucose control in Type II diabetes

(As per BMJ module ‘Clinical pointers: Blood glucose control in Type 2 diabetes’) I’ve used sulfonylureas as second-line diabetic drugs for years on a ‘devil you know’ basis, but it now seems that’s out of date; one meta-analysis showed them … Continue reading

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Diabetes management

The alphabet mnemonic is useful for remembering all the things that need to be discussed with patients: Advice – smoking, diet, exercise, weight loss. See about referring to structured educational programmes. Blood pressure Cholesterol Diabetes control Eye checks Foot checks … Continue reading

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Diabetes update

Some key points: DPP-4 inhibitors are now second-line after metformin Aim for HbA1c target of 48 mmol/l at diagnosis, unless clinical reasons why inappropriate (metformin and DPP-4 inhibs don’t risk hypoglycaemia, so this is feasible to do safely). For patients … Continue reading

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Talking to people about their diabetes

Judith Handley, a health policy geek with Type I diabetes, has written an article for the ‘What your patient is thinking’ section of the BMJ, on alternatives to asking people with diabetes whether they’re well-controlled (to which she always feels … Continue reading

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When not to use HbA1c for maintenance

We’re hopefully all familiar with the list of situations in which HbA1c might give a false reading when used to diagnose diabetes (short version; any situation in which the glucose might have undergone rapid recent change), but it’s also important … Continue reading

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Flozins and COPD inhalers

That’s two separate subjects, not one, whose link here is that they were both the topics of useful papers in this week’s BMJ. The first was on possible adverse effects of flozins (sodium-glucose cotransporter-2 inhibitors). The paper was a very … Continue reading

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Second-line drugs in diabetes

I love studies that explore the practical questions we wrestle with in day-to-day work. So, I was pleased to see the BMJ study ‘Sulfonylureas for type 2 diabetes‘ (Douros et al). The presentation of the results in the written journal … Continue reading

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