Prone positioning is associated with increased insulin requirements in mechanically ventilated patients with COVID-19.

Stress hyperglycaemia is common in critical illness. We have previously observed that increasing severity of respiratory failure in patients with severe COVID-19 is associated with increased insulin demand. Given previously reported direct effects of hypoxia on insulin action, we reasoned that rapid improvements in oxygenation following prone positioning may improve insulin sensitivity and increase risk of hypoglycaemia.

Two microbiota subtypes identified in irritable bowel syndrome with distinct responses to the low FODMAP diet.

Objective: Reducing FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides and polyols) can be clinically beneficial in IBS but the mechanism is incompletely understood. We aimed to detect microbial signatures that might predict response to the low FODMAP diet and assess whether microbiota compositional and functional shifts could provide insights into its mode of action.

Design: We used metagenomics to determine high-resolution taxonomic and functional profiles of the stool microbiota from IBS cases and household controls (n=56 pairs) on their usual diet.

Oral nutritional support in hip fracture patients.

Hip fracture care hs changed significantly over the past 7 years, but poor nutritional intake remains in this patient group, both before and after their hospital admission. This article explores the importance of improving nutritional status as part of the multidisciplinary team's efforts to enhance recovery and improve outcomes after surgery, with a specific focus on the role and evidence for using oral nutritional supplements. Strategies to optimise status and dietary intake should start in the preoperative stage and continue post-operatively in the community.