Case Studies

Type 2 diabetes is a serious, chronic and progressive disorder associated with significant morbidity and mortality. As beta-cell function declines, many people with Type 2 diabetes require insulin replacement therapy to achieve and maintain glycaemic control. In your own practice, you will find...

• Significant numbers of people who could benefit from starting insulin therapy
• Too many people using insulin who are suffering from
• Persisting hyperglycaemia
• Frequent hypoglycaemia
• Significant blood glucose swings
• Increasng weight gain

In this ‘case study’, Dr Stuart Bootle asks Dr Peter Hammond and Gillian Morrison some important questions to help us explore the challenges involved in helping people with Type 2 diabetes start insulin replacement therapy.

Dr. Peter Hammond
Consultant Physician, Harrogate

Gillian Morrison
Diabetes Specialist Nurse, Liverpool

Following the introduction of the Chronic Kidney Disease register to the quality and outcomes framework, GPs are getting more involved in the management of people with deteriorating renal function. Significant numbers of people on the CKD register also have diabetes and we are seeing more and more people with diabetes related nephropathy in our practice based clinics. Such patients often have other diabetes related complications and co-morbidities resulting in:

• Several healthcare professionals being involved in care provision
• The need for complex therapeutic decision making
• A significant impact on quality of life

In this ‘case study’, Dr Stuart Bootle asks Dr Indranil Dasgupta and Professor Tony Barnett some important questions to help us explore the challenges involved in the management of people with diabetes and deteriorating renal function.

Dr. Indranil Dasgupta
Consultant Physician and Nephrologist,
Honorary Senior Lecturer
Birmingham Heartlands Hospital
Bordesley Green East, Birmingham B9 5SS

Professor Anthony Barnett
Consultant Physician and Clinical Director of Diabetes and Endocrinology
Birmingham Heartlands Hospital
Bordesley Green East, Birmingham B9 5SS