However, the increasing use of insulin analogues poses a challenge because commercially available insulin assays detect these with varying accuracy and precision. Insulin analogues are increasingly used in diabetes management and the case outlined here highlights the variations in assay. Initially, the local assay (ELISA kit – Dako, Copenhagen) failed to detect a significant concentration of insulin (<6pmol/L; range 9.6–65.4pmol/L) which an external reference laboratory CDK inhibitor subsequently detected using the Mercodia Iso-insulin two-site
immunoassay (Uppsala, Sweden). The key analytical point is the recognition that different immunoassays detect insulin analogues to varying degrees. Clinical teams need to consider this if such cases are to be recognised. Following recent media reports where surreptitious insulin administration may be implicated in inpatient mortality, this knowledge is crucial to empower us to STA-9090 molecular weight accurately diagnose all cases of unexplained hypoglycaemia. Copyright © 2013 John Wiley & Sons. Practical Diabetes 2013; 30(3): 118–120 “
“The evolution of diabetes centres in the UK, with co-location of clinical
teams, has resulted in examples of success in improving clinical efficiency, communication and patient-centred care. “
“Erectile dysfunction (ED) is expected to affect 322 million men by 2025. A number of lifestyle factors such as smoking, obesity, alcohol consumption and lack of physical activity are linked with erectile dysfunction. We reviewed the evidence in
recent studies examining the impact of weight loss upon erectile function in obese men with and without diabetes. Esposito et al. showed that weight loss through diet and increased physical activity can improve sexual function in about one-third of obese non-diabetic men with ED. Subsequently, Dallal et al. reported that the amount of surgical weight loss after gastric bypass predicted the degree of improvement in sexual function independent of improvement in glycaemic control. Wing et al. reported Cepharanthine that weight loss in older obese diabetic subjects in the Look AHEAD trial may help in preventing the worsening of ED over time. Most recently in 2011, Khoo et al. have shown that rapid diet-induced weight loss improves sexual and endothelial function and systemic inflammation in obese diabetic men. In conclusion, the majority of recent studies show that weight loss can improve erectile function in obese men, though the beneficial effect is less profound in diabetic men. Copyright © 2012 John Wiley & Sons. “
“It is a myth that screening of type 2 diabetes is ‘a given’, that we provide adequate education for patients and that increasing physical activity by simply referring patients to a health trainer can prevent type 2 diabetes. Research in this area is often seen as an easy or soft option.