British Journal of Diabetes

ABCD 2025 winning posters

Ikechukwu Roland Chukwudi — 2025-12-18

Abstracts from ABCD Conference

Marie-France Kong — 2025-12-18

Abstracts from ABCD and EASE Regional Meeting

Marie-France Kong — 2025-12-18

Type 1 diabetes presenting initially as type 2 diabetes which remitted with lifestyle change: a case report

Ahmed Ali — 2025-12-18

We present a case of type 1 diabetes (T1DM) in a middle-aged Caucasian woman who initially presented with phenotypic characteristics of type 2 diabetes (T2DM) and whose type 2 phenotype contributed to accelerated progression of T1DM. This case illustrates the challenges in making a clinical diagnosis of T1DM in patients who also have phenotypic features of T2DM. Recognising such presentations is important in order to make the correct diagnosis and potentially to offer immunotherapy-based interventions while beta cell function is still relatively well preserved.

Type 1 diabetes through the challenges of dementia: a case series

Jonathan Golding — 2025-12-18

Medical advances continue to improve the life expectancy of people living with type 1 diabetes (T1DM). As this population grows older, they will increasingly encounter the challenges of ageing, including dementia. Many people living with T1DM are concerned about how their diabetes might impact their care needs, including their ability to self-manage. This case series aims to highlight some of the challenges that arise in the care of older adults with T1DM and dementia, including the transitioning of care to carers, community nursing teams or residential care. Since the population of older adults with T1DM is expected to continue to increase, researching ways to improve the care of older adults with T1DM should remain a key priority.

Paradoxical embolism: a hidden cause of acute lower limb ischaemia in a young adult with diabetes and an atrial septal defect: a case report

Harriet D Morgan — 2025-12-18

Paradoxical embolism is a rare but recognised cause of acute systemic arterial occlusion, particularly in the presence of intracardiac defects such as atrial septal defects (ASDs). We report the case of a 36-year-old female with type 2 diabetes (T2DM) who presented with acute right lower limb ischaemia. Initial investigations revealed extensive lower limb arterial occlusions without evidence of underlying atherosclerosis, thrombophilia or arrhythmia. A transoesophageal echo-cardiogram identified a previously undiagnosed secundum ASD with bi-directional shunting. The patient was diagnosed with paradoxical embolism and initially managed with anticoagulation. Despite medical therapy, she developed limb-threatening ischaemia and underwent bilateral iliac embolectomy and a kissing common aorto-iliac revascularisation procedure. Autoamputation of the second right toe eventually occurred. She underwent percutaneous ASD closure using an AmplatzerTM device.
This case highlights the diagnostic challenges of paradoxical embolism in young patients, particularly when confounded by co-morbid conditions such as diabetes. Clinicians should maintain a high index of suspicion for structural cardiac anomalies in patients with acute arterial occlusion and no clear embolic source. Prompt recognition and closure of ASDs can prevent recurrent embolic events and improve outcomes. Transcatheter ASD closure remains a safe and effective treatment strategy in such cases.

IgG4-related disease: an uncommon cause of type 3c diabetes: a case report

Hala Alsafadi — 2025-12-18

Transitioning the Knuston Diabetes Counselling and Empowerment Skills Course to an online format: an exploration of the experiences of educators

Ruth Tobin — 2025-12-18

Introduction: Since the coronavirus pandemic, the amount of healthcare education provided online has increased enormously. Research has generally focused on the effectiveness of online courses. Little attention has been given to the lived experiences of educators transitioning their courses to an online format. This paper explores the thoughts and feelings of a team of educators who recently experienced such a transition.

Methods: In this qualitative study, a team of healthcare educators participated in a focus group or individual interview to explore what they learned from transitioning a four-day residential course teaching counselling skills and empowerment philosophy to healthcare professionals to an online format. A reflexive thematic analysis was employed to identify the themes that emerged from the data.

Results: Six key themes emerged: 1) impact of COVID-19; 2) initial perspectives; 3) support; 4) disintegration to reintegration; 5) understanding the relationship between the old and the new; and 6) future planning.

Conclusions: Transitioning an educational course from an in-person to an online format can initially be difficult but, with appropriate support, it is achievable and worthwhile. The process of transitioning a much-cherished course online was both an intellectual and an emotional process.

Practice implications: It is hoped that this paper will help to guide those transitioning a course traditionally taught in-person to an online format.

Group consultations in diabetes care: qualitative insights from patients and practitioners to inform service redesign

Azhar Zafar — 2025-12-18

Aims: To identify the barriers and enablers influencing the uptake and delivery of diabetes group consultations, drawing insights from patients' and healthcare professionals’ perspectives.
Methods: Between September and May 2025, semi-structured interviews were conducted with patients and primary care healthcare professionals. Participants were interviewed to discuss facilitators and barriers to attending or referring patients to attend diabetes group consultations. Using thematic analysis, interviews were coded based on Braun and Clarke's six-phase framework.
Results: A total of 11 patients [eight attendees, three non-attendees] and 10 healthcare professionals [GPs, nurses, trainees] agreed to participate in this study. Key barriers identified include logistical challenges (such as scheduling and accessibility), difficulty relating to group dynamics, content relevance and unclear communication about session goals and benefits. Enablers to improve engagement, included structured education on medication management, diet and weight loss, patient segmentation and tailored group models. Peer support also emerged as a factor in reducing patient isolation and fostering shared learning.
Conclusions: Uptake of group consultations can be improved by enhancing communication strategies, implementing balanced structured education with facilitated peer sharing, and offering flexible attendance options such as virtual participation or rotational clinics. By addressing barriers and leveraging enablers, group consultations can become a more effective and accessible resource for supporting diabetes management, enhancing patient outcomes and reducing pressures on individual clinical appointments.

Influence of switching from dulaglutide to oral semaglutide on glycaemic control and clinical parameters in Japanese patients with well-controlled type 2 diabetes: a retrospective, observational study

Kentaro Watanabe — 2025-12-18

Aims: This study sought to evaluate retrospectively how switching from dulaglutide to oral semaglutide affected glycaemic control and clinical parameters in patients with well-controlled type 2 diabetes (T2DM).

Methods: The study included 18 patients with well-controlled T2DM (mean HbA_1c 6.99%) who were taking dulaglutide. HbA_1c levels and clinical parameters were measured at baseline and two, four and six months later. Changes in these parameters during the study period were assessed retrospectively.

Results: HbA_1c levels at two months from baseline were significantly higher than at baseline (7.43 ± 0.72 vs. 6.99 ± 0.39%, p = 0.003), whereas no significant change was observed at four or six months from baseline. Subjects with improved glycaemic control at six months from baseline (n = 5) had significantly lower gamma-glutamyl transferase levels at baseline compared to those who did not show improvement (n = 13) (13.8 ± 3.0 vs. 47.9 ± 53.6 IU/L, p = 0.026). Notably, high-density lipoprotein cholesterol levels at six months were significantly higher than at baseline (p = 0.006).

Conclusion: Glycaemic control worsened temporarily after switching from dulaglutide to oral semaglutide, but no significant difference was observed between baseline and six months later.

Changing pattern of GP referrals: experience from a community diabetes clinic

Jyoti Balani — 2025-12-18

The management of type 2 diabetes (T2DM) has undergone significant changes in recent years, with a shift away from the hospital setting towards community–based teams. This study aimed to investigate changes in clinical acuity and complexity of patients with T2DM referred to the Sutton Community Diabetes Service.

This retrospective audit of patients with T2DM compared the first hundred patients referred in 2017, when local guidelines for referral were first introduced, with the first hundred patients referred in 2023. Demographic data, treatment modalities, diabetic complications and co- morbidities were retrieved from our EMIS database.

Compared to the 2017 cohort, patients referred in 2023 were more ethnically diverse (35% South Asian vs. 18%; p<0.01), had higher mean (SD) HbA_1c levels (mmol/mol at referral 90.8 [20.6] vs. 81.5 [19.9, p <0.01), higher rates of microalbuminuria (47% vs. 28%, p=0.02),and were more likely to have three or more significant co-morbidities such as co-existent cancers or cardiovascular disease.

This study highlights the growing complexity of patients referred to the community diabetes service, which impacts on the entire multidisciplinary team. Commissioners and care planners need to consider the increasing complexity of patients managed in these settings.

ABCD News

Ketan Dhatariya — 2025-12-18

Community diabetes services: fit for the future?

Christopher Walton — 2025-12-18