The Joint British Diabetes Societies (JBDS) of which ABCD is an integral member, has informed us of the plans for Diabetic Medicine to devote the August issue to publish the in-patient guidelines and other important papers. This is to be welcomed and will make these very important guidelines to reach readers not only in UK but worldwide.
As you will be aware the Joint British Diabetes Society (JBDS) guideline for the use of Variable Rate Intravenous Insulin Infusion (VRIII) was published in late 2014 and we hope it has become firmly embedded in practice in acute trusts throughout the country.
Link to guideline HERE
During surgery or other procedures under sedation or anaesthesia, the aim is to maintain normal glycaemic control with optimal hydration while preventing hypoglycaemia. These guidelines are based on the International Society of Paediatric and Adolescent Diabetes (ISPAD) clinical practice consensus guidelines. Modifications have been made in the light of recently published adult guidelines and from the guidelines published in the anaesthetic literature. They aim to ensure quality of patient care is standardised but individual units may make adjustments to fit with local practice.
Norfolk and Norwich University Hospitals NHS Foundation Trust have produced a guideline for the management of insulin pump therapy for children with Type 1 diabetes that covers the following: the process by which suitability for CSII will be determined; the responsibilities of the diabetes team and families, to facilitate effective management of CSII; criteria for discontinuing CSII where its use has not been effective in improving diabetes control and/or quality of life; guidance on management of sick day rules for patients on CSII; insulin pump failure
Northumbria Diabetes Service have developed a care pathway to ensure that all patients considered for pump therapy receive a standardised and documented approach with their multi-disciplinary team through decision making, initiation and follow-up.
Key to this pathway is their selection process and pre-enrolment discussion and preparation of patients which must fulfill the trust’s referral criteria (including having undertaken a self management course) and be documented in their referral form.
East Lancashire Hospitals NHS Trust have developed a referral form and criteria for the use of Continuous Subcutaneous Insulin Infusion (CSII) for adult patients.
Published in Practical Diabetes Vol.31 No.2
A Practical Diabetes International publication which provides some practical guidance on the approach to the patient on CSII therapy.
As part of the ABCD Renal Association clinical specialty work programme we have now finalised our guidelines on managing hyperglycaemia in kidney disease . A summary of the full guidelines with audit standards and issues for future research will be appearing this month in the British Journal of Diabetes
• A recent systematic review of clinical trials for type 2 diabetes found that no single outcome was measured in all trials. HERE
• A new EU HORIZON 2020 funded study wants to find out what the most important results of treatment for Type 2 diabetes are, to establish a set of minimum core outcomes that should always be measured in Type 2 diabetes research.
