Case conferencing involves a local diabetes specialist visiting you at your practice and discussing any patients who meet the criteria or who you feel you would like to discuss. Practice time for case conferencing is well paid for by Medicare and can assist GPs to better manage patients with diabetes . This will result in better care for diabetic patients, enhance the management skills of the GP and improve diabetes management capacity of the practice.
Controversies continue over screening, management and follow up for women with GDM, with various professional organisations internationally and experts in the field suggesting different strategies or not making specific recommendations at all.
What is NOT controversial is the evidence that even mild increases in maternal blood sugar are associated with adverse pregnancy outcomes – both maternal and foetal and that reducing blood sugar improves outcomes. Whenever you have many different definitions of a disease and many different guidelines for its management internationally, it usually means our data is not complete and more studies are needed.
So, what’s so bad about a bit of pesticide? Pyrethroid may be one of the least toxic pesticides (Kaplan, 2014), but that doesn’t mean it’s not toxic at all. The effects of pyrethroid exposure range from nausea and fatigue, to blurred vision and seizures (Beasley and Temple, 2013).
The centres are run by experienced breast radiologists, some of whom have fellowships in breast imaging. We provide a professional service where women are treated sensitively by experienced, empathetic staff dedicated to the health and wellbeing of women
Acute RIF pain is a common clinical presentation to the general practitioner. Diagnosis and management promptly required in order to limit morbidity and mortality. Clinical and laboratory findings are non specific and early recourse to imaging is being used more frequently in order aid diagnosis. Even after imaging, in approximately one third of patients the cause is not apparent.
It is claimed with unquestioned certainty in the fitness industry that a combination of both strength/resistance training and cardio/aerobic training need to be included in any exercise regime in order to obtain optimum results. Fitness instructors and personal trainers are taught from the beginning that cardio increases heart rate, thus, increasing calorie burn – and, of course, that that strength training increases muscles tone hence causing the body to burn more energy during the day.
Have you notice that our patients never really behave like patients in clinical trials? In real life (i.e. patients in our practice), we have a mix match of patients with different motivation and different busy schedules. They have a real life to live and tablets are omitted for a number of reasons.
Diarrhoea is a common side effect of metformin in patients with diabetes. The exact mechanism is poorly understood. Starting at a lower dose and slowly titrating up may reduce the incidence of this side effect. Changing over to the extended release version may sometimes help. Some patients just can’t tolerate even the smallest dose of metformin extended version or not. What about patients with diabetes and suffers from frequent diarrhoea but not on metformin? In the absence of any other known causes, we often blame it on autonomic dysfunction. Are we missing other causes? What about pancreatic exocrine insufficiency?
The DELIGHT trial is arandomised, double-blinded, placebo controlled, parallel design study to evaluate the efficacy, safety and pharmacodynamics or dapagliflozin and dapagliflozin in combination with saxagliptin in CKD patients with Type 2 diabetes mellitus and albuminuria treated with ACEi or ARB.
The views expressed are views of the authors and do not necessarily represent the views of the board of SSW GP Link