Diabetes Newsletter – November 2018

www.berkshirewestdiabetes.org.uk November 2018
Monthly diabetes news for healthcare professionals and
others in Berkshire West

  Optimal insulin needle sizes  
The Berkshire West CCG Medicines Optimisation Team (MOT) is undertaking a review of prescribing of needles for diabetes patients. Correct needle length is very important for patients and is something we GPs don’t always think about. Berkshire West CCG Pharmaceutical Adviser, Beena Patel-Parker,  has written the article below and correct prescribing will feature in the PQS for 2019/20:

The Forum for Injection Technique (FIT) UK provides evidence-based best practice recommendations for people with diabetes who are using injectable therapies and for clinicians who care for people with diabetes using injectable therapies. Through these recommendations, people with diabetes can achieve the best possible health outcomes by ensuring that the correct dose of medication is delivered to the correct injection site, using the correct technique.

The whole document is easy to read with top tips to help manage the impact of injecting diabetes medications. Of particular note is the use of short needles which may be more acceptable to patients who are on insulin doses below 50 units. The 4 mm pen needle is reported by patients to be less painful than longer needles. If patients occasionally experience sharp pain on injection they should be reassured that the needle may have touched a nerve ending which happens randomly and will not cause any damage.

The FIT guidelines recommends the use needles of the shortest length (4mm) in patients with insulin doses less than 50 units, smallest diameter (highest gauge number), and the tip with the lowest penetration force to minimize pain. In readiness for the review of insulin needle formulary for next year’s Prescribing Quality Scheme patients on needles longer than 5mm should be reviewed and changed to a shorter needle length if their insulin dose is less than 50 units. Patients with insulin doses above 50 units may require insulin needles of 6mm. Advice regarding monitoring blood glucose levels following a change to a shorter needle should be given as well as using up any existing needles before changing to a shorter needle to reduce wastage.

1. Diabetes Care in the UK: FIT UK Forum for Injection Technique UK. The UK Infusion and Injection Technique Recommendations 4th Edition.
  Embedding diabetes education random controlled trial  
The Embedding Diabetes Education random controlled trial (RCT) is part of a 5 year National Institute for Health Research (NIHR) grant research project looking to increase attendance at Type 2 diabetes structured education (DSE). The study is not about testing a particular diabetes education programme. As you know, attendance nationally at diabetes education programmes is poor.

The RCT is aiming to recruit 1000 participants with Type 2 diabetes. These participants will be drawn from 66 GP practices, each recruiting approximately 20 patients. Recruitment will be supported by the research nurse team and led by Prof Melanie Davies and the Oxford University Hospitals Diabetes Team. A small amount of money is available to cover practice costs.

Please see the attached letter and study summary if you are interested.
Diabetes Specialist Nurse Hotline: 07879 814922 (Monday to Friday 10am – 4pm) Consultant Hotline: 07717 867448. Email: virtualdiabetes@royalberkshire.nhs.uk
Visit our website: www.berkshirewestdiabetes.org.uk
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