681-P: Survey of Medical Staff on Use of Glucagon Injection in the Event of Serious Hypoglycemia in Japanese Diabetic Patients—Reason for Poor Spread of Glucagon Use in Japan

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 681-P
Author(s):  
NOBUMICHI SAITO ◽  
MASAO TOYODA ◽  
MORITSUGU KIMURA ◽  
MASAFUMI FUKAGAWA
2019 ◽  
Vol 104 (7) ◽  
pp. e2.13-e2
Author(s):  
Emma Barbour

AimThe paediatric wards in two hospital sites within one Trust deal with the supply of newly diagnosed diabetic prescriptions differently and the aim of this project was to have uniformity throughout the Trust with regards the supply of these discharge items, with both hospital pharmacy sites supplying the discharge items. Having completed the Pharmacy Management Clinical Leadership in Pharmacy (CLIP) program I wanted to use new skills learned throughout CLIP to be able to lead on influencing a change of practice on one hospital site and have uniformity across the Trust. I wanted to be able to persuade one site to change their practice of over 20 years and start getting the items dispensed through the hospital pharmacy.MethodsUsing the GROW model I ensured I was clear on what my plan was and that my goals were SMARTER. I had to deal with a number of different professionals and was prepared for some conflict as was expecting resistance to change. I met with the key stakeholders with regards the change. I communicated with medical staff, nursing staff and dispensary manager in the relevant hospital, and used the Colours Model1 to help me with this. The Colours Model is a simple and effective way to analyse our own communication preference and also to understand the preference of others. Knowing this I was then able to flex my communication style accordingly to engage with all parties more effectively. I identified what ‘colour’ I classed each group as and used different styles of communication for each. I also reviewed the records of newly diagnosed diabetic patients discharged from the paediatric ward over a period of one year to determine what discharge letter was given to the patient, and what detail was on it.ResultsOf the patients discharged in 2017, only 44% had a discharge on the relevant electronic system with pharmacy items on it, with just one having all required items. I communicated the following way with the different staff, once I had identified their ‘colour’. Medical staff (GREEN - Amiables, who are task focused and have indirect style). I focused on whole team and explained the benefit for change across interface. Nursing staff (RED - Drivers, who are task focused and have a direct style). I got straight to the point, explained reasons and results. Dispensary manager (BLUE - Analyticals, who are task focused and have an indirect style). I emailed in advance. Got to the point and gave exact details.ConclusionAll Staff agreed to the change in process in the paediatric ward. All discharges for newly diagnosed diabetic children on both sites will be electronically written and dispensed within the hospital pharmacy. The outcome for patient care is a more seamless transition of care between interface. By undertaking the CLIP programme I acquired a number of important skills to enable me to successfully lead this change. I made my voice heard and led with impactful communication.ReferenceCLIP workbook Leading with Impactful Communication Chapter 5 The Colours ModelJanuary 2018.


Author(s):  
Bruce R. Pachter

Diabetes mellitus is one of the commonest causes of neuropathy. Diabetic neuropathy is a heterogeneous group of neuropathic disorders to which patients with diabetes mellitus are susceptible; more than one kind of neuropathy can frequently occur in the same individual. Abnormalities are also known to occur in nearly every anatomic subdivision of the eye in diabetic patients. Oculomotor palsy appears to be common in diabetes mellitus for their occurrence in isolation to suggest diabetes. Nerves to the external ocular muscles are most commonly affected, particularly the oculomotor or third cranial nerve. The third nerve palsy of diabetes is characteristic, being of sudden onset, accompanied by orbital and retro-orbital pain, often associated with complete involvement of the external ocular muscles innervated by the nerve. While the human and experimental animal literature is replete with studies on the peripheral nerves in diabetes mellitus, there is but a paucity of reported studies dealing with the oculomotor nerves and their associated extraocular muscles (EOMs).


Author(s):  
John M. Basgen ◽  
Eileen N. Ellis ◽  
S. Michael Mauer ◽  
Michael W. Steffes

To determine the efficiency of methods of quantitation of the volume density of components within kidney biopsies, techniques involving a semi-automatic digitizing tablet and stereological point counting were compared.Volume density (Vv) is a parameter reflecting the volume of a component to the volume that contains the component, e.g., the fraction of cell volume that is made up of mitochondrial volume. The units of Vv are μm3 /μm3.Kidney biopsies from 15 patients were used. Five were donor biopsies performed at the time of kidney transplantation (patients 1-5, TABLE 1) and were considered normal kidney tissue. The remaining biopsies were obtained from diabetic patients with a spectrum of diabetic kidney lesions. The biopsy specimens were fixed and embedded according to routine electron microscogy protocols. Three glomeruli from each patient were selected randomly for electron microscopy. An average of 12 unbiased and systematic micrographs were obtained from each glomerulus and printed at a final magnification of x18,000.


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