Improved blood glucose control, cardiovascular health and empowerment in people attending X-PERT structured diabetes education

© 2021 John Wiley & Sons. This is the accepted manuscript version of an article which has been published in final form at https://doi.org/10.1002/pdi.2368The aim of the audit was to assess the change in key health markers in people with, or at risk of, diabetes who attended X-PERT structured diabetes education. Data from X-PERT programmes are entered into a central database. Twelve-month changes in anthropometric and clinical variables – and diabetes medication usage – are reported for programmes run between 1 January 2017 and 31 December 2018. Where appropriate, paired t-tests were performed. In total, 29,703 participants were registered to attend a programme during this period, of which 23,118 (78%) attended at least one session. Of those who attended at least one session18,039 (78%) completed a programme. Ninety-nine percent (3342) of participants with clinical data available had type 2 diabetes. Meaningful reductions in HbA1c were seen (-8.6mmol/mol,95% CI -9.2 to -8.0mmol/mol [-0.8%, 95% CI -0.8 to -0.7%]; n=2957; p<0.001); and there were statistically significant reductions in body weight, BMI, waist circumference, fasting blood glucose, total cholesterol, low-density lipoprotein cholesterol, triglycerides, total cholesterol to high-density lipoprotein cholesterol ratio, and triglycerides to high-density lipoprotein cholesterol ratio (all p<0.001). No change in high-density lipoprotein cholesterol was observed. Of the 1180 participants who were recorded as taking diabetes medication at baseline, 632(54%) were able to reduce the number of medications they were taking and 278 (24%) were able to omit them entirely. Participant empowerment score increased by 20%. Improvements in glycaemic control, weight management and cardiovascular disease risk, as well as reduced medication requirements and an increased feeling of empowerment, were observed in people who attended X-PERT structured diabetes education programmes.Peer reviewe

Polycystic Ovary Syndrome: From Contraception to Hormone Replacement Therapy

Polycystic ovary syndrome (PCOS) is a common disease based on a combination of various endocrine impairments. The use of hormonal treatments permits the aesthetic disturbances to be counteracted (acne, hirsutism, alopecia), but greater attention has to be given to insulin resistance, which may induce more severe diseases, such as diabetes. The use of oral contraceptives is helpful, but a lifestyle change is considered essential so as to improve the natural ability to resist disease affecting the circulation and metabolism. When the menopausal transition starts, greater attention is given to those PCOS patients who demonstrated insulin resistance during their fertile life. The use of hormone replacement therapy is often suggested as it has been proven to be beneficial