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We aimed to assess the utility and acceptability of outpatient glucose self‐monitoring in an adult cystic fibrosis (CF) population.

Perimenstrual changes in glycaemic control and insulin requirements have been reported in Type 1 diabetes. A population‐based sample of 124 women with Type 1 diabetes, aged 18 to 40 years, were questioned regarding perimenstrual changes in their self‐monitored capillary blood glucose and insulin regimen. Sixty‐one percent of women noted perimenstrual changes in capillary blood glucose. The commonest pattern was a premenstrual rise in glucose. Thirty‐six percent of all study participants were making adjustments to their insulin dose in response to these changes in capillary blood glucose. There was no statistical difference in the mean glycated haemoglobin of subjects making perimenstrual adjustments in insulin (79.1 mmol mol−1haem) compared to subjects who noted cyclical capillary glucose changes but did not adjust insulin (73.0 mmol mol−1haem). Sixty‐seven percent of subjects taking the fixed dose oestrogen/progesterone oral contraceptive pill (OCP) noted perimenstrual changes in glucose. In summary, a third of the women surveyed made perimenstrual adjustments to their insulin dose, but there was no evidence to suggest that this behaviour was associated with improved glycaemic control. Use of the fixed dose combined oral contraceptive pill did not eliminate perimenstrual changes in glucose.

There is an increasing demand by women with diabetes for information on health issues such as pre‐conception planning, contraceptive choices, hormone replacement therapy, and osteoporosis prevention. The risks and benefits of therapeutic approaches in these areas will be influenced by the presence of diabetes. Other health issues discussed in this article, which are unique to women with diabetes, include the effect of the menstrual cycle on glycaemic control and insulin requirements, and insulin omission in order to lose weight.

On the basis of data obtained from microscopic examination, melting observations, cooling curves, X-ray analyses, and resistance measurements, phase diagrams have been proposed for the Th-Cb and Th-Ti alloy systems. Both are simple eutectic systems and have no terminal solid solubility or intermediate phases. The eutectic between thorium and columbium occurs at a composition of about 8 wt pet Cb and a temperature of 1435°C. The Th-Ti eutectic occurs at 1190°C at the composition 12 wt pet Ti. No change was observed in the transformation temperature of thorium in either system or in the titanium transformation.

Objective:To assess the number of patients admitted with a diabetic foot complication to a regional teaching hospital over a 12-month period (July 2005 to June 2006) and determine the percentage that went though an optimal diabetes outpatient management pathway before and after this admission.Method:Diabetic inpatients with foot ulcers and infections were identified through the relevant International Classification of Diseases (ICD) codes. Both inpatient and outpatient data were obtained through the local electronic patient management system and review of clinical notes.Results:Forty-nine patients were admitted to hospital with diabetic foot ulcers or infections during the audit period. Median age was 66 years and 67% were male. The most common admitting speciality was vascular surgery. The main associated procedure was toe amputation. In the six month period before and after the index admission, 63% of patients were seen by a health professional at the diabetes centre before or after the admission. 45% of patients were seen at the diabetes centre before and after the admission; 33% were seen by a podiatrist before and after the admission. However, 37% had no contact with the diabetes Centre and 51% did not see a podiatrist from the diabetes centre at any time during the six months before and after their admission.Conclusion:Despite the availability of a multidisciplinary high risk foot clinic, only 45% of patients admitted to our regional hospital during the audit period followed an interdisciplinary pathway that included specialist diabetes input of some form and only 33% were assessed by a specialist diabetes podiatrist both before and after their hospital admission. A formalised patient pathway is likely to improve clinical management and may minimise further admissions. In this way it will help reduce morbidity and mortality in this high-risk patient group. In the future, this might best be achieved using an electronic referral and decision support system.