British Journal of Diabetes

Winning Abstracts from ABCD Diabetes Update 2026

Mon, 29 Jun 2026 00:00:00 +0000

Abstracts from ABCD Diabetes Update 2026

Mon, 29 Jun 2026 00:00:00 +0000

Both a person with type 1 diabetes and a doctor: what I have learnt

Graydon Thorpe — Mon, 29 Jun 2026 00:00:00 +0000

A reflective piece highlighting the most important learning points following diagnosis with type 1 diabetes (T1DM). You do not need to be severely unwell to have diabetic ketoacidosis (DKA); a T1DM diagnosis should be treated as breaking bad news; and the psychological aspects of T1DM should not be overlooked.

Postprandial hyperglycaemia and continuous glucose monitoring: a personal journey

Debjit Chatterjee — Mon, 29 Jun 2026 00:00:00 +0000

This article outlines my journey through the diagnosis and management of postprandial hyperglycaemia, highlighting the challenges, interventions, and insights gleaned along the way

Wernicke’s encephalopathy following tirzepatide therapy in a non-alcoholic patient with autoimmune hepatitis/primary biliary cholangitis and diabetes: a case report

Yasmin Zaidy — Mon, 29 Jun 2026 00:00:00 +0000

Familial partial lipodystrophy misdiagnosed as type 1 diabetes: ensuring accurate diagnosis: a case report

Mon, 29 Jun 2026 00:00:00 +0000

Familial partial lipodystrophy (FPLD) is a rare, inherited disorder characterised by selective loss of adipose tissue, often affecting the limbs and gluteal region, and concurrent fat accumulation in the face, neck and intra-abdominal areas. This redistribution leads to profound insulin resistance, dyslipidaemia and fatty liver disease. It may be misdiagnosed clinically as type 1 diabetes (T1DM), particularly in patients with lean body habitus, or type 2 diabetes (T2DM) due to insulin resistance. We report a case of a young woman who was initially treated for presumed T1DM but was ultimately diagnosed with FPLD.

Risk factors for premature mortality in patients with diabetic foot ulcers: a one-year retrospective study from a multidisciplinary clinic

Mon, 29 Jun 2026 00:00:00 +0000

Background: Diabetic foot ulcers (DFUs) are associated with high morbidity and mortality. This study examined factors associated with earlier death in patients managed within a multidisciplinary foot clinic.

Methods: We performed a retrospective study of 138 patients with DFUs who died in the year 2024. Cause of death assessed through Medical Certificate of Cause of Death (MCCD). Complementary multivariable linear and logistic regression analyses were used to identify factors associated with younger age at death and premature mortality (age < 70 years).

Results: Cardiovascular disease was the leading cause of death (28.3%). Smoking, poor glycaemic control, renal replacement therapy, and prior lower-limb amputation were independently associated with premature mortality, while prior revascularisation was associated with lower odds of early death.

Conclusion: Patients with DFUs who are actively smoking with adverse severity markers are at high risk of premature death. Multidisciplinary foot clinic should also include cardiovascular risk optimisation.

Recurrent diabetic ketoacidosis admissions: gaps in education, discharge safety-netting and psychosocial support

Kiran Rathi, Su Phyo, Saloni Shastri, Sowmya Gururaj Setty — Mon, 29 Jun 2026 00:00:00 +0000

Background: Diabetic ketoacidosis (DKA) remains a common cause of emergency admission in people with type 1 diabetes (T1DM) and is associated with significant morbidity and mortality. Recurrent DKA admissions may reflect unmet needs beyond acute metabolic management, including gaps in structured education, discharge safety-netting and psychosocial support. Understanding local patterns of recurrent DKA is essential to inform preventative strategies.

Methods: We conducted a retrospective service evaluation at a large teaching hospital between 1st July and 31st December 2024. This study was designed as a baseline evaluation informing the first stage of a multi-cycle quality improvement (QI) project, conducted in accordance with SQUIRE 2.0 guidelines. Routinely collected, clinically coded discharge data were used to identify adults with T1DM admitted with DKA. Recurrent DKA was defined as two or more admissions within a rolling 12-month period, assessing admissions during the study window. Lifetime admissions within the cohort were also studied. Electronic health records were reviewed to identify demographic characteristics, documented triggers, psychosocial factors and sick-day rule education documentation. A survey of resident doctors was conducted to assess training exposure and confidence in delivering DKA prevention education.

Results: The 210 DKA admissions during the evaluation period corresponded to 57 unique adult patients with T1DM, of whom 41 (72%) were identified as having recurrent DKA (59% female [n=24]; 73% White British [n=30], 17% Asian [n=7], 5% Black or African [n=2], 5% Mixed ethnicity [n=2]). Admissions were concentrated within a small number of individuals: 17 patients (41%) had 2-4 lifetime DKA admissions, 16 patients (39%) had 5-9 admissions, and 8 patients (20%) had 10 or more admissions. Documented sick-day rule education was present in 61% of patients (n=25), absent in 34% (n=14), and 5% (n=2) self-discharged prior to diabetes team review. Psychosocial triggers were identified in a subset of patients, with mental health conditions and substance misuse most frequently documented among those with the highest admission frequencies. Of 20 resident doctors surveyed, only 35% (n=7) reported receiving formal teaching on sick-day rules, and 85% (n=17) reported low confidence in delivering personalised written discharge advice.

Conclusion: Recurrent DKA admissions are concentrated within a small, high-risk cohort and are associated with deficiencies in inpatient education, discharge safety-netting and psychosocial support. These findings support recurrent DKA as a marker of psychological and social vulnerability. This baseline evaluation identifies clear targets for a multi-faceted preventative quality improvement approach, including standardised discharge documentation, clinician education and integrated psychosocial support.

The psychological impact of a diagnosis of diabetes: why the moment matters

Jamie Ross, Shoba Poduval, Kate Hardenberg — Mon, 29 Jun 2026 00:00:00 +0000

Management of type 2 diabetes in adults: NICE updates guidance

Clifford J Bailey — Mon, 29 Jun 2026 00:00:00 +0000

The importance of identifying a frailty metabolic phenotype in managing frail older people with type 2 diabetes

Alan Sinclair, Ahmed H Abdelhafiz — Mon, 29 Jun 2026 00:00:00 +0000

ABCD News

Ketan Dhatariya, Umesh Dashora, Rebecca Reeve, Amy Coulden, Geraldine Gallen — Mon, 29 Jun 2026 00:00:00 +0000