A quality improvement project reducing adverse events and improving adherence to guidelines surrounding VRIII usage.

Variable rate intravenous insulin infusions (VRIII) are frequently used in hospitals and incorrect use can lead to electrolyte imbalance, hypoglycaemia and adverse outcomes. The Joint British Diabetes Societies (JDBS) published guidelines in 2014 and recommended the use of a balanced fluid as substrate. There was no published data to demonstrate the superiority of this fluid in reducing adverse events.

Understanding the principles of insulin use in type 1 and type 2 diabetes management.

The year 2021 marks 100 years since the Nobel Prize-winning discovery of insulin as a medical treatment for diabetes mellitus. Its discovery changed type 1 diabetes from a terminal condition with a short life expectancy to one of long-term management, with patients now often living long and fulfilling lives. Today, much of the advice, support and prescribing of insulin is undertaken by nurses, including general nurses and those specialising in diabetes.

Effective management of hypoglycaemia.

Hypoglycaemia is a potentially serious complication of diabetes mellitus in which an individual's blood glucose drops to dangerously low levels. This can cause signs and symptoms such as sweating, confusion and unusual behaviour and, if untreated, may lead to unconsciousness and death. Hypoglycaemia is a side effect of some treatments for diabetes, whereby injected insulin or oral medicines that stimulate insulin secretion cause an abnormally low blood glucose level.

Are they high on steroids? Tailored interventions help improve screening for steroid-induced hyperglycaemia in hospitalised patients.

Steroid-induced hyperglycaemia (SIH) is a common adverse effect in patients both with and without diabetes. This project aimed to improve the screening and diagnosis of SIH by improving the knowledge of healthcare professionals who contribute to the management of SIH in hospitalised patients. Monitoring and diagnosis of SIH were measured in areas of high steroid use in our hospital from May 2016 to January 2017.

Exubera inhaled insulin in patients with type 1 and type 2 diabetes: the first 12 months.

Background: Following National Institute for Clinical Excellence approval of inhaled insulin Exubera (Pfizer, New York, NY) in 2006, we established a dedicated clinic in January 2007 to monitor the efficacy and safety of Exubera. Between January and October 2007, eight patients started Exubera: six because of needle phobia (DSM-IV criteria) and two with injection site problems.

Methods: Data were collected at the clinic over a 12-month period from February 2007 at 3-, 6-, 9-, and 12-month intervals.

How to manage diabetes in advanced terminal illnesses.

Diabetes mellitus is increasing in incidence and is therefore being encountered more frequently during palliative care. Diabetes management in the early stages of terminal disease is normally the same as conventional care. However, in the later stages of terminal illness there are a number of problems that may arise due to diabetes treatment, including hypoglycaemia and hyperglycaemia, which may impair the patient's quality of life.

Perioperative fasting and the management of type 2 diabetes.

Type 2 diabetes is the most common form of diabetes, affecting approximately 90 per cent of people with the condition. The global incidence of diabetes is rising and the number of people affected is projected to exceed 300 million by the year 2025 (World Health Organization, 2003). Type 2 diabetes results from insulin resistance and/or a relative lack of insulin production.