ENDOCRINE

 Diabetes Type 2 Oral Agents Guideline http://www.pccj.eu/images/stories/CurrentIssuePdf/p149_151New_Therapies.pdf

Liraglutide http://www.pccj.eu/images/stories/CurrentIssuePdf/liraglutide.pdf

Bydureon  http://www.lillydiabetes.co.uk  and http://www.bydureonbyyourside.co.uk [Patient support site]

DIABETIC FOOT CLINIC

Emergency Number of Diabetic Hot Foot Clinic 07866 684362 BLACKBURN    07875 011972  BURNLEY

DIABETIC FOOT ULCER

SANOFI DIABETES  http://www.diabetesmatters.co.uk

LILLY DIABETES https://www.lillypro.co.uk/acl_users/credentials_cookie_auth/require_login?came_from=https%3A//www.lillypro.co.uk/diabetes/

PATIENT LEAFLETS ADULT LILLEY https://www.lillypro.co.uk/diabetes/patients/patient-materials/diabetes-leaflets/adults/

SELF MONITORING GLUCOSE GUIDELINE

GUIDELINE FOR DIAGNOSIS T2DM

GUIDELINE FOR IMPAIRED GLUCOSE REGULATION

MICROALBINURIA SCREEN  INCLUDES RENAL GUIDELINES 2007

HBA% to MMOL/MOL

SIGN GUIDELINE FOR MANAGING DIABETES DM2

LANTUS DOSING AND APIDRA http://www.lantus.com/hcp/dosing.aspx

STRIPS FOR GLUCOSE METERS

MEREC BULLETIN ON DM2 VOL  22.  No 5 MARCH 2012 http://www.npc.nhs.uk/merec/therap/other/merec_bulletin_vol22_no5.php

http://www.npc.nhs.uk/merec/therap/other/resources/pyramid.pdf

NEW FRONTIERS IN DIABETES MEDICONF 2011. CLASHES A BIT WITH NICE RE USE OF NEWER MEDICINES

DIABETES COMPLICATIONS PICTURE INTERNATIONAL DIABETES FEDERATION

REFERRAL CRITERIA BWD COMMUNITY DIABETIC CLINIC AND HOSPITAL CLINIC

http://www.diabetesandprimarycare.co.uk  FREE ON LINE JOURNAL

RAMADAN AND DIABETES PROF RAYAZ MALIK

DIABETES AND RAMADAN http://www.diabetesandprimarycare.co.uk/journal-content/view/managing-diabetes-in-people-fasting-during-ramadan

DOWNLOAD OF DIABETES AND RAMADAN

INSULIN IN DM2 PAUL DROMGOOLE MEDICONF APRIL 2012

ON INSULIN SICK DAY RULES FROM PAUL DROMGOOLE

HYPOGLYCAEMIA TREATMENTS FROM PAUL DROMGOOLE

WHOLE DM2 PPT PAUL DRUMGOOLE

TREND LEAFLET ON HYPOGLYCAEMIA

TREND DOCUMENT MANAGING HYPOGLYCAEMIA

TREND DOCUMENT DIABETES: SAFE DRIVING AND THE DVLA

DR BOB WILKINSON LINAGLIPTIN AND RENAL PROBS IN DM2

GLIPTINS DOSES IN CKD

POSTER DM AND CKD  microalbumin  hba1c  and ckd stages

NOTES BOB WILKINSON AND DM2

DIABETES UPDATE OMNIAMED MANCHESTER 13 12  12

DIABETES GUIDELINES ELMMB 2013

EXPERT PATIENTS DIABETES LEAFLET   from www.expertpatients.co.uk

DAPAGLIFLOZIN

NEW DIAGNOSTIC CRITERIA FOR  DIABETES 2011  http://diabetes.org.uk/About_us/Position-statements--recommendations/Care-recommendations/New_diagnostic_criteria_for_diabetes_/

PUTTING FEET FIRST DIABETES ORG UK http://diabetes.org.uk/About_us/Position-statements--recommendations/Position-statements/Putting-Feet-First-Diabetes-foot-care/

NICE CG 10   TYPE 2 DM PREVENTION AND MANAGEMENT OF FOOT PROBLEMS http://guidance.nice.org.uk/CG10

DIABETIC FOOT EXAM VERSION 1  PPTX

DIABETIC FOOT EXAM VERSION 2  PPTX

DIABETIC FOOT EXAM GUIDE SHEET

DIABETIC FOOT REFERRAL PATHWAYS

DIAB FOOT ULCER ANTIBIOTIC USE

DIAB FOOT SCREENING FORMS AND NOTES

DIAB FOOT PATIENT LEAFLETS

NOTES DR GERINT JONES 2 MAY 2013 ON DM FOOT

ELMMB DM2 GUIDE

HUMAN INSULIN IN TYPE 2 DIABETES

NOTES ON GLIPTINS AND GLP1S PAUL DROMGOOLE OCT 2013

DIABETES NOTES HAYA LANGERMAN MSD MAY 2013

DM FASTING DURING RAMADAN NEESHA PATEL MAY 2014

FASTING DURING RAMADAN http://www.nhs.uk/Livewell/healthyRamadan/Pages/Healthyramadanhome.aspx

http://www.slideshare.net/promotemedical/ramadan-and-diabetes

HUI FASTING IN RAMADAN BMJ 2010

FASTING IN RAMADAN SLIDESHOW MAY 2014 SANOFI

ASPECTS OF DIABETES DR WILKINSON

COMPLETE GUIDE FOR CONTROLLING HYPOGLYCEMIA http://www.diabetes.org.pk/Acrobat%20Docs/Hypo%20Broucher.pdf

DIABETES YOUR RISK  http://www.diabetes.org.uk/risk

HBA1C    42-47  Impaired Glucose Tolerance Lifestyle Management See Nurses Repeat 1 year

                  48 onwards Diabetes See Nurses Do 2 readings min 2 weeks apart

                  50-51 Diet 52 and over Metformin

RESOURCES FOR NURSES ON DIABETES 2

www.Nice.org.uk/guidance/cg87

www.Sign.ac.uk/guidelines/fulltext/116

www.Patient.co.uk/doctor/management-of-type-2-diabetes

CLASS HEALTH

Providing Diabetes Care in General Practice

Vital Diabetes Management

Vital Diabetes

FAST FACTS

Diabetes Mellitus

DIABETES TEMPLATE EMIS

LEICESTER DM2 GUIDE

DM RISK ALGORITHM

HBA1C  Normal 42 PreDiabetes 42-47 Diabetes 48 and over

Do 2 readings one if symptoms

Orlistat if BMI <30  Must lose 5% of weight in 3/12 with diet and exercise  Weigh every month  Do not place in Repeats

Side effects fatty stool some abdo cramps  Do not issue for over 12-18 months

If BMI 45 and over Bariatric Surgery

Prediabetes recheck every 3 years

Diabetes MF 1-2/day unless good at the diet and exercise

No BM machines If hypos  reduce dose

If slim DM2 use gliclazide BM machine for them   USE Caresens ones Issue strips and lancets

CVD Risk  Assess: BP Chol  Issue statin  if side effects [muscle pains] try a different one

Eyes, Feet [ Healthy legs referral]

HOT TOPIC 24 2 15 DM2 DRUGS

CKS CLINICAL KNOWLEDGE SUMMARIES http://www.cks.nice.org.uk/clinicalspeciality   Navigate to Diabetes 2

DIABETES 2  NICE  CKS   SUMMARY http://cks.nice.org.uk/diabetes-type-2

http://cks.nice.org.uk/diabetes-type-2

DIABETES MEDS DURING RAMADAN

DR MMs DIABETES 2 CRIB SHEET

BMJ DIABETES 2  2016  [chart]

BMJ DIABETES 2 2016 [ article]

Diabetes and Renal   22 2 17

Diabetes Notes Dunkenhalsh 29 4 17

NOS VIT D

DM FOOT PATHWAY

DM ANNUAL SCREEN

DM2 Paul Drumgoole  2018

MF+ Diet /Exercise

Then Gliptin then SGLT2

PG if not overweight and not HF

Patients reluctant to take also  default on diet  educ programs

DM2 is progressive needs more rx to stop vascular comps

SIGN Guidelines better then NICE

Also American Diabetic Association and  European Association for Study of Diabetes

Early treatment delays complications [Legacy Effect]

Hypos driving or operating machines  SU and Insulin

Retinopathy and Nephropathy  start ACE

SGLT2  not with diuretic  or BP will fall

[[email protected]]

 

DIABETES AND RF 2018

HT DIABETES 2018

DIABETES RAMADAN 2018

DIABETES MANAGEMENT 2018 IN OVER  65S

DIABETES AND THE HEART 2018

MICROALBUMINURIA SCREENING PLAN

Fab Course with Omniamed in Manchester
Learning Points:
Remission if 10% wt loss in Prediabetres and 15% in diabetes
Drugs that affect cvd risk are MF DPP4 GLP1 and SGL2 Only Saxagliptin in doubt
PGZ trial awaited not if HF
Hypos dangerous
SGL2 useful in HF and trial to see if useful in CKD
Breathless DM may be HF do BNP but BNP raiseed if on DPP4 or obese
eGFR more accurate the worse the k function so 60 or better = normal
consider transplant when egfr under 15 transplant better than dialysis
HF? do ecg and echo if abnormal ecf and echo loks dilatred = HF preserved EF [ untreatable]
Otherwie max ace add SGL2 GLP1
IF high bm and losing wt need Insulin
SGL2 stop if feverish illness in case ketosis occurs
Testosterone if low check pituitary and adrenal function with SHBG LH FSH TSH Prolactin UE Glucose then do MRI Pituitary
Testrosterone in Prediabetes
ED causes vascular neuropathic low testosterone
Add PD5 to Testosterone ARB better than ace and Nebivolol better than Bisoprolol
PREDICTER OF IHD3-5y
LUTS goes with ED and IHD
Tadalafil 5mg for LUTS and affects endotheium all over body poss treatment for IHD HF#
For ED daily tadalafil better than on demand
Advice for DM2
New Case Poss of remission Legacy Effect
Established case Retinopathy causes blindness Make more effort
Old Person Hypos dangerous reduce gliclazide and Insulin
If very thin or very fat the Cockcroft Gault egfr is more accurate
Spirololactone god for HF but cant be used in RF as K+ goes too high
Doses of hypoglycemics in RF need reduced best are GLP1 DPP4 trials on for SGL2 and MF to be allowed at lower egfr
c Peptide is a urine test can be used to determine if type 1 DM where there is hardly any Insulin
Diabetes increase still birth risk Gestational Diabetes does not
SGL2 not if PVD or leg ulder
GLP1 not if alchol xs as risk of pancreatitis
U symps with SGL2 may not be thrush try 1L water/day
Statin definite benefit in cvd or DM maybe benefit in primary prevention
The real damage is from the LDL not routinely measured by lab only estimated
Chol 7.5 may be genetic hyperlipidaemia