Diabetes clinics

The next big thing in diabetes clinical progress on DPP-IV inhibitors. Drug Development Research, 67, 627-642. 

Bradley KJ, Paton RC. Silent hypoglycaemia at the diabetic clinic. Diabet Med 2001 18(5) 425-6. 

Holmboe ES. Oral antihyperglycemic therapy for type 2 diabetes clinical applications. JAMA 2002 287(3) 373-6. 

Table 16.3 Attendance at a diabetes clinic following various additional reminders...

Mr SA is 185 cm tall, weighs 83 kg and has a 15-year history of type 2 diabetes mellitus and hypercholesterolaemia. He is under the care of the diabetes clinic at the hospital for management of Charcot s arthropathy of the foot and diabetic foot ulcer. He also has a 5-year history of ischaemic heart disease and underwent coronary artery bypass grafting one year ago. He drinks half-a-bottle of red wine per day and smokes a pipe. He is allergic to penicillin. His current medications are ... 

You are a supplementary prescriber working in a diabetes clinic when John Stephens comes in to see you. He is still overweight despite being on the maximum dose of metformin and gliclazide. His HbAlc is 9.0% and on examination he has neuropathy developing in his feet. He is also on ramipril 10 mg, simvastatin 40 mg and aspirin 75 mg daily. His blood pressure was 130/80 mmHg and his total cholesterol was 4.0 mmol/L (reading from three months ago). There is no microalbuminuria present. 

R155 Smith, L.A., McNaught, J. and Hutchinson, A.S. (1989). How well do nurses perform blood glucose analyses at the diabetic clinic An assessment using the Reflotron analyser. Ann. Clin. Biochem. 26, 554-555. 

Turner RC, Hattersley AT, Shaw JTE, etal. (1995) Type II diabetes clinical aspects of molecular biological studies. In Diabetes 44 1—10. 

Grieve R, Beech R, Vincent J, Mazurkiewicz J. Near patient testing in diabetes clinics appraising the costs and outcomes. Health Technol Ass 1999 3 1-74. 

Raehl et al. reviewed results of questionnaires that were sent to directors of pharmacy in one-half of acute-care general medical-surgical hospitals in the United States that had at least 50 licensed beds to determine the extent that pharmacists provide ambulatory clinical pharmacy services.Overall, pharmacists performed nondispensing activities in ambulatory clinics in 19% of responding hospitals. Pharmacist involvement in oncology clinics occurred in 9% of institutions, second only to diabetes clinics (10%), and was more common than in cardiology (6%) or geriatrics, infectious disease, or pain clinics (4%). 

Dewitt DE, Dugdale DC. Using new insulin strategies in the outpatient treatment of diabetes clinical applications. JAMA 2003 289 2265-2269. 

Instructor, Department of Medicine, Division of Diabetes, Clinical Assistant Professor of Pharmacy, University of Texas Health Science Center at San Antonio, Texas Chapter 72... 

Pozzilli P, Manfrini S, Monetini L (2001) Biochemical markers of type 1 diabetes clinical use. Scand J Clin Lab Invest, 61(Suppl 235) 38-44. 

Mortality rates have been steadily declining over the recent years [5], but remain close to 5% for DKA and between 10% and 15% for HH [1]. The decline in mortality may be a consequence of lower incidence of DKA and HH, earlier diagnosis, improved treatment or - more plausibly - all combined. It is likely that improved education schedules and self-monitoring (e.g. blood ketone testing), organisation of specialised diabetes clinics and the use of standardised low-dose insulin regimens [1,6] have contributed to this favourable trend. 

Marshall, S. M., Home, P. D., Taylor, R., and Alberti, K. G. M. M., 1987, Continuous subcutaneous insulin infusion versus injection therapy A randomised cross-over trial under usual diabetic clinic conditions. Diabetic Med. 4 521-525. 

Ahren B (2013) Incretin dysfunction in type 2 diabetes clinical impact and future perspectives. Diabetes Metab 39 195-201... 

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