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ABCD now on N3

In April ABCD went live on N3, the national broadband network for the National Health Service (NHS). N3 is a secure network that connects sites where NHS services are delivered or managed such as acute hospitals and GP surgeries. It offers official secure storage of patient data and permits rapid transmission of communications from images to discharge letters. The establishment of ABCD on N3 offers particular potential for the performance of national audits (More information here).

ABCD nationwide exenatide QW audit now recruiting

Membership of ABCD is not a pre-requisite to contribute to the national exenatide QW (Bydureon) audit. This audit, which comes in the wake of the exenatide (Byetta®) and ongoing liraglutide (Victoza®) audits, aims to gain insights to the safety, tolerability, efficacy and clinical usage of exenatide QW in routine clinical practice (More information here). For more information on the audit and how to participate click here.

JBS3 report now online

The third report of the Joint British Societies (JBS) consensus recommendations for the prevention of cardiovascular (CV) disease is now available online (More information here). com/index.htm ) and contains specific guidance for the targeting of CV risk in people with diabetes (here). The online CV risk calculator has been designed for use by clinicians to communicate an individual’s 10 year CV risk and the benefits of interventions, thereby facilitating patient empowerment. The calculator also provides the clinician with an indicator of clinical and cost effectiveness of treatments as well as addressing the issues of “Why, When and How?“ to start treatment (Click here). However the calculator is not designed for use in people with established CV disease or high risk conditions such as diabetes in people >40 years of age.

Join national audit on DKA management

Following the publication of the new JBDS DKA guidelines, Ketan Dhatariya (Norwich) is co-ordinating the collection of data on the care of patients admitted to hospitals with DKA. Despite numerous meeting abstracts on the care of DKA patients – using local and JBDS guidelines – this is the first systematic attempt to assess how DKA is managed across the UK. This audit will be a snapshot of care in Spring 2014 (termination of data collection September 30th 2014) and will provide evidence to further inform the expert opinion of the guideline authors. For more information see ABCD website and letter inviting participation (More information here)

UK ‘best in class’ insulin chart

The Rowan Hillson insulin safety award is a nationwide competition held to identify the ‘best in class’ insulin prescription chart. The award aims to promote prescribing patterns which reduce the inherent risk of error in dose or mode of administration of insulin. ABCD is amongst the supporters of this award (More information here). The winners will be announced in August 2014.

Diabetes in BME

Over 500,000 people from black and minority ethnic (BME) backgrounds have diabetes in the UK and the rate of diagnosed diabetes in this group is much higher than in the white population. A recent report (Diabetes in BME communities: raising awareness, improving outcomes and sharing best practice) outlines the barriers to improving outcomes for people with type 2 diabetes in BME communities and identifies examples of best practice to support these people to better manage their diabetes (More information here).

The cost of diabetes

Diabetes UK’s recent report ‘The cost of diabetes’ (May 2014) highlights the spiralling cost of diabetes and the areas where interventions are urgently needed. Investments in in-patient diabetes teams, in-patient and out-patient podiatry supported by the multi- disciplinary team, education for type 1 and type 2 diabetes have been particularly highlighted with evidence of their cost-effectiveness. More information here.

Clinical Endocrinology online

Professor Stephen Judd, one of the senior editors of Clinical Endocrinology, has led the development of some new on-line educational modules. The modules constitute a short educational programme based on a paper in the journal, linked to established training curriculum, with clear learning objectives and formal recognition of completion. There are 5 new modules, with a further 7 to be live by the end of 2014. More information here.

Care home diabetes audit

The Institute of Diabetes for Older People (IDOP) in association with ABCD has led a national stakeholder audit of diabetes care in care homes. Responses from more than 2000 care homes in England revealed important gaps in screening for diabetes, hypoglycaemia care, and the training and education of care staff in the area of diabetes. The results of this audit have been passed to the Care Quality Commission to assist them in developing inspection processes for care homes. The report, launched in June, is available on the IDOP website (More information here).

Meet the Committee

The final composition of the new ABCD committee has been agreed. Dr Umesh Dashora has persuaded almost everyone to write a few words for the journal describing their responsibilities, achievements, and special interests. The committee will meet in September to agree the work programme for the next term. Members will be surveyed for their suggestions beforehand.

Emma BinghamEmma Bingham

Current Position: Consultant and Deputy CD for Medicine at Frimley Park Hospital in Camberley, Surrey

Interests and current work: I am a member of pituitary MDT and lead for several working groups to improve patient flow, data quality and implementation of IT in medicine.

Ali ChakeraAli Chakera

(SpR Representative)

Current Position: SpR, Exeter.

Interests and current work: I am doing my PhD supervised by Andrew Hattersley focussed on improving the treatment of patients with monogenic diabetes (MODY) in pregnancy and developing a test to supersede amniocentesis for diagnosis of foetal genotype.

Hamish CourtneyHamish Courtney (Northern

Ireland Representative)

Current Position: Consultant at the Belfast Trust.

Interests and current work: Inpatient, antenatal, foot care, DAFNE programme, pituitary, adrenal and thyroid conditions, co-clinical lead in the Northern Ireland Diabetes Clinical Research Network, diabetes SpR training and education.

Umesh DashoraUmesh Dashora (News editor, BJDVD)

Current Position: Consultant, Clinical Lead, Chairman (Medical Division), Senior Lecturer and Deputy Sub-Dean (BSMS) at Conquest Hospital, Hastings.

Interests and current work: I am the regional link fellow for the RCP (Edin) and am on the executive committee of south east regional council and southern region consultants and specialist committee of BMA. Having completed an MA in Medical Education from Brighton University, I am very keen to introduce some of the newly acquired skills in education and training. I have been working on a model diabetes prescription chart to reduce insulin errors nationally. I am also interested in developing national audits of the use of high strength insulin preparations.

Russell DrummondRussell Drummond

(Meeting Secretary)

Current Position: Lead consultant in endocrinology and diabetes at North Glasgow Diabetes and Endocrinology unit in Glasgow Royal Infirmary

Interests and current work: I have sub-specialty interests in continuous subcutaneous insulin infusion therapy, improving cardiovascular outcomes in patients with type 2 diabetes and genetic diabetes. I am medical school year director and Honorary Associate Clinical Professor at Glasgow University and lead for Endocrine and Diabetes teaching.

Kate FayersKate Fayers

Current Position: Lead consultant at the new West Hampshire Community Diabetes Service.

Interests and current work: Patient empowerment has been at the heart of my strategy for developing an intermediate community service which has relocated type 1 and type 2 diabetes care into the community and is supported by a portfolio of education for patients and healthcare professionals. My interests extend to the wider long term conditions strategy, population risk stratification and GP engagement as mechanisms to drive up standards of care and reduce inequity.

Jyothis GeorgeJyothis George

Current Position: Academic diabetologist at the Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM).

Interests and current work: My translational research, funded by the MRC amongst others, involves first-in-human studies of two novel peptides (kisspeptin-10, GnIH) and their translational applications. As clinical lead for EXSCEL - a large (14,000 patient) multinational (>30 countries) cardiovascular outcome study - I am learning 'mega-trial' skills under the mentorship of Prof. Rury Holman.

Stella GeorgeStella George

Current Position: Consultant at East and North Hertfordshire NHS Trust.

Interests and current work: I have become the lead for Inpatient Diabetes in our Trust. I am (via the Joint British Diabetes Societies) leading on the ‘Guideline for the Use of Variable Rate Intravenous Insulin Infusions in Medical Inpatients’ which is soon to be completed. I am also the lead for our diabetes retinopathy clinics and joint lead for our transition service. I am also the tutor for Cambridge Undergraduates that come to our trust.

Rob GregoryRob Gregory (Chairman)

Current Position: Consultant at the University Hospitals of Leicester NHS Trust

Interests and current work: My sub-specialty interests are diabetes and pregnancy, and management of patients with diabetes and chronic kidney disease. I am also the diabetologist on the Leicester Pancreatic Surgical team that is internationally-renowned for total pancreatectomy and islet autotransplantation. I have collaborated with Professor Joan Taylor of De Montfort University on the development of an implantable artificial pancreas.

Paul GrantPaul Grant (Editor BJDVD)

Current Position: Consultant at Guy's & St. Thomas' Hospitals in London.

Interests and current work: Following a management degree at Brighton Business School, my focus is increasingly on improving clinical systems and quality of care. I am also a Quality in Care (QiC) judge and new consultant representative on the Diabetes & Endocrinology Joint Specialist Societies Committee. I have a strong interest in clinical research, writing, editing and publishing. As well as being the deputy editor of Clinical Medicine, I am now an editor of the new ABCD journal - the British Journal of Diabetes & Vascular Disease (BJDVD).

T Hugh JonesT. Hugh Jones

Current Position: Consultant at Barnsley Hospital.

Interests and current work: I am also an Honorary Professor of Andrology in the Department of Human Metabolism the University of Sheffield Medical School, Sheffield, UK and Hon. Consultant Endocrinologist at the Royal Hallamshire Hospital, Sheffield. I am a clinical and laboratory researcher into the role of testosterone in the pathogenesis and treatment of type 2 diabetes and cardiovascular disease. I have also conducted research on the hypothalamic and paracrine control of anterior pituitary hormone secretion, among others. I was elected to the European Academy of Andrology and am a co-chair of the testosterone and metabolic disorders group as part of the International Consultation on Men’s Health and Infertility.

Andrew Macklin Andrew Macklin (Social Media – ABCD & BJDVD)

Current Position: Consultant at West Dorset.

Interests and current work: I enjoy the variety of challenges in DGH work and the close working relationship with primary care and patients that exists in the area. These have allowed a wide range of developments in diabetes and general medicine which have improved patient care.

John A. McKnightJohn A. McKnight (Scottish Representative)

Current Position: Honorary Professor at the University of Edinburgh.

Interests and current work: My research interests include preventing diabetes, epidemiology and remote monitoring of diabetes. I have an active interest in improving quality of care in NHS Scotland, Chairing the National Clinical Data Advisory Group of Healthcare Improvement Scotland.

Dinesh NagiDinesh Nagi (Manpower lead)

Current Position: Consultant at the Mid Yorkshire NHS Trust

Interests and current work: I am currently a member of the RCP Council representing Diabetes UK, Association of British Clinical Diabetologist (ABCD) and Society of Endocrinology. I am a past Secretary of the ABCD. I also lead the Diabetes Topic Specific Research Group at WYCLRN. I have a major interest in service development in diabetes, having led the development and implementation of the innovative redesign of diabetes service supporting primary care. I am Clinical Lead and Director of Wakefield and North Kirklees eye screening programme. I have edited a book on exercise and sports in diabetes.

Dipesh PatelDipesh Patel

Current Position: Consultant and Honorary Senior Lecturer at UCL

Interests and current work: General endocrinology and inpatient or complex diabetes management. My academic interests include lipid transport, cardiovascular disease, mechanisms in type 2 diabetes and renal disease and clinical trials involving novel therapies.

Ana PokrajacAna Pokrajac

Current Position: Consultant at the West Herts Hospital Trust.

Interests and current work: I set up the service for people with diabetes and chronic kidney disease (CKD). I also lead on Thyroid Eye Disease management for the trust. I am a core member of Thyroid Cancer MDT. I have received a grant to organise an interest group to improve the care of patients with diabetes and CKD nationally. I am also a member of the ABCD-RA national guidelines writing group. I am a core member of the organising board for Hertfordshire Diabetes Conference.

Hermione PriceHermione Price (Associate editor BJDVD)

Current Position: Consultant working in the community in West Hampshire and in the Bournemouth Diabetes and Endocrine Centre.

Interests and current work: I am passionate about improving diabetes care for the frail and vulnerable including those in care homes, secure units and prisons. I am currently working with local GPs, mental health professionals and the CCG to look at novel ways to improve care for people living in these environments. I have a research interest in diabetes and cardiovascular disease and also in evaluating patient experience with new technologies. I spent a year working as part of the diabetes policy team at the Department of Health so have seen first hand the leverage that ABCD has to influence diabetes policy in the UK and improve care for people living with diabetes.

Gerry RaymanGerry Rayman (National Inpatient Programme Lead)

Current Position: Consultant Physician and Head of Service at the Diabetes and Endocrine Centre and the Diabetic Foot Clinic, Ipswich Hospitals NHS Trust.

Interests and current work: I contribute to research into complications of diabetes, particularly foot complications. My interests include the application of new technologies to diabetes care including glucose sensing and methodologies in early detection of diabetic neuropathy. I have also been involved in developing group education programmes in diabetes including the DESMOND and the Families, Adolescents and Children’s Teamwork Study programmes (FACTS; group education for families). I have introduced and led a number of education initiatives for SpRs including the Foundation course and the ABCD SpR meeting. I have been the Clinical Lead for Diabetes Inpatient Care and foot disease at NHS Diabetes. I was the innovator and am the lead of the National Diabetes Inpatient Audit. I am currently Specialist Advisor to Diabetes UK and President of the Endocrine and Diabetes Section of the Royal Society of Medicine. I am the Clinical Lead for Diabetes UK’s ‘Putting Feet First’ campaign and have contributed to NICE guidelines on the diabetic foot, CG10 and CG119, and am a member of the current NICE clinical development guideline group on integrated foot care.

Rustam RaeRustam Rae

Current Position: Consultant at Oxford University Hospitals NHS Trust.

Interests and current work: I have spent the last 7 years in Derby developing new models of integrated diabetes care bringing together primary and secondary care. My other clinical interests include inpatient diabetes care and using insulin pump therapy to improve the outcomes of patients with diabetes.

Rustam RaeAled Roberts

(Welsh Representative)

Current Position: Consultant, Clinical Lead and Lecturer at University Hospital of Wales, Cardiff.

Interests and current work: My interests include the management of hospital inpatients with diabetes, and perinatal care of patients with diabetes and endocrine disease. I am a member of the JBDS Inpatient Guideline Group and a tutor on the Cardiff University Diabetes Diploma.

Anthony RobinsonAnthony Robinson (Treasurer)

Current Position: Consultant and clinical Lead at Royal United Hospital Bath.

Interests and current work: I am the departmental lead for retinal screening, antenatal care and research. I have been involved with developing our departmental database, and our own website. At present we are negotiating with our three local CCGs a new community diabetes service. Regionally I have helped to set up a South West Diabetes in Pregnancy forum and we are organising our third annual meeting at present. I am the Regional Specialty Advisor for Severn Deanery area and a mentor for the ABCD mentorship programme.

Susannah RowlesSusannah Rowles

(Transitional care)

Current Position: Consultant, Pennine Acute Hospitals NHS Trust, Greater Manchester.

Interests and current work: I have been intimately involved in the integration of hospital and community diabetes services. I am the clinical director for diabetes and endocrinology, cardiology and long term conditions. I am also the training programme director for general (internal) medicine in the North West Deanery and I find that this positions me well in the specialist vs generalist debate!

Bob RyderBob Ryder (ABCD Website and audit lead; Associate editor BJDVD)

Current Position: Consultant at City Hospital, Birmingham.

Interests and current work: Over the years special interests have included photographic screening for diabetic retinopathy – I undertook much of the groundwork behind the current national eye screening programme; diabetic hypoglycaemia unawareness; diabetic autonomic neuropathy; diabetic impotence; clinical use of IT; treating to target; relative risks and benefits of pioglitazone (especially its insufficiently recognised cardio-protective properties). I run the ABCD website and lead the ABCD nationwide audits of new therapies, most recently establishing for this purpose an ABCD presence on N3, the national broadband network of the NHS. Current and imminent audits include exenatide qw, dapagliflozin and degludec. Beyond diabetes I am best known for being principal author of the best-selling "An Aid to the MRCP Short Cases", the fourth edition of which is the three volume “An Aid to the MRCP PACES”.

Thozhukat SathyapalanThozhukat Sathyapalan

(Academic Consultant)

Current Position: Reader and Honorary Consultant at Hull.

Interests and current work: I lead the Academic Diabetes, Endocrinology and Metabolism research in Hull. My clinical interest in diabetes includes ‘diabesity’, which involves working closely with bariatric surgery services. In endocrinology, my subspecialty interests are neuroendocrine tumours and gynaecological endocrinology. I have developed the regional neuroendocrine tumour services in Hull.

Dr Patrick SharpDr Patrick Sharp

(General Secretary)

Current Position: Director for Diabetes Solent NHS Trust.

Interests and current work: My current research interest lies in screening modalities for diabetes in the community, and using modern technology to educate people with diabetes to ensure they have the nine care processes completed and have understood their results.

Alan SinclairAlan Sinclair (Lead for ACCEA nominations)

Current Position: Professor of Medicine at the University of Bedfordshire and Dean at the Bedfordshire & Hertfordshire Postgraduate Medical School.

Interests and current work: I have produced European guidelines on diabetes care for older people available on I am co-leading a major EU-funded project on diabetes and frailty (MID-Frail Project) and leading an NIHR-funded study on medication errors in care home residents with diabetes. I am the lead for the Older Peoples Diabetes Network which I jointly established in 2012 with NHS Diabetes. I am currently leading a global initiative for the IAGG and have co-chaired an International Working Group to produce global diabetes guidance for older people with the IDF. I founded the Institute of Diabetes for Older People (IDOP) which is now nationally recognised for its significant outputs in the area of diabetes in older people. (

Jonathan ValabhjiJonathan Valabhji

(NHS England)

Current Position: National Clinical Director for Obesity and Diabetes at NHS England and Consultant and adjunct Professor Imperial College Healthcare NHS Trust.

Interests and current work: I was a member of the expert group that informed the Healthcare for London diabetes work-stream. From 2011 to 2013, I provided leadership for the diabetes work-stream of the North West London Integrated Care Pilot, an ambitious and complex clinical change process to integrate diabetes and frail elderly care across the sector. I have also represented the Royal College of Physicians on the Joint Specialty Committee for Endocrinology and Diabetes.

Peter WinocourPeter Winocour

Current Position: Consultant and CD East and North Hertfordshire NHS Trust

Interests and current work: Currently I am co-ordinating joint ABCD-Renal Association guidelines on diabetic nephropathy. I was the diabetes lead in the published JBS3 guidelines on CVD prevention. I am also RCPL Secretary of the Joint Speciality Committee in Diabetes and Endocrinology and ABCD Lead on Transitional Diabetes Care.

Chris Walton (Ex Officio chairman; Associate editor BJDVD)

Current Position: Consultant at Hull

Interests and current work: I work mostly on the community interface and I chair the local diabetes network board. I recently gave up my local role in the retinal screening service and replaced it with the role of the Yorkshire/Humber strategic clinical network (SCN) clinical lead for diabetes. For the past 8 years I have been an officer of ABCD initially as Treasurer and over the past three years as Chair. Much of my time recently has been taken up with the process of taking over the British Journal of Diabetes & Vascular Disease (BJDVD) from SAGE. I intend to continue to be active in the work of the Association and developing BJDVD. I believe that the journal can help further the role of UK diabetologists in developing clinical research and provide a platform for a host of educational opportunities.


Obituary: David Robert Hadden

David Robert HaddenProfessor David Hadden was an internationally recognised expert on growth, nutrition and diabetes. Anticipating the impact of the westernised lifestyle on the epidemic of type 2 diabetes, in 1972 he set up the Belfast Diet Study, which confirmed that strict adherence to diet alters the natural history of the disease. Subsequently his collaboration in the UK Prospective Diabetes Study demonstrated for the first time the importance of good control of blood glucose in preventing complications of type 2 diabetes.

His other great contribution was in the management of diabetic pregnancy. The joint diabetes obstetric service he built up was an example copied nationally. He led the involvement of Belfast as major centre and main laboratory in the Hyperglycaemia and Adverse Pregnancy Outcome Study, which highlighted the potentially harmful effects of small increases in blood sugar on the non-diabetic mother – findings that continue to challenge and change practice.

David Hadden came from a well known Irish medical family. His great grandfather was a doctor in Skibbereen, Co Cork, where he treated victims of the Irish potato famine. His grandfather became ship’s doctor on an ocean liner bound for Liverpool from New York. The chance event of the ship running aground on the North Antrim coast led to him settling in Northern Ireland and setting up practice in Portadown, where his grandson was born. David Hadden grew up across the road from the practice run by his grandfather, father and aunt. After primary school in the war years, he attended Campbell College, and then medical school at Queen’s University, Belfast. Fellow students remember a tendency to be late for lectures often finishing breakfast at the back of the hall, wearing a deerstalker hat in cold weather. Despite this he graduated with honours in 1959, winning the Thomson Medal for top marks in the final examination in medicine.

His training through the early 1960s, in his chosen specialty of endocrinology and diabetes, began in the Royal Victoria Hospital, Belfast. After a Clinical Research Fellowship using the new technique of radioimmunoassay to measure growth hormone, he travelled as Fulbright Fellow to the Johns Hopkins Hospital, Baltimore, USA . His report in the journal Nature of a growth hormone binding protein, although dismissed by conventional thinking at the time, is now recognised as one of the first descriptions of that important regulatory protein. He brought this interest back to Belfast, as the first children with short stature and growth hormone deficiency were treated using growth hormone extracted from human pituitary glands. His own children also remember being lined up in his study each year to have height and weight measured and plotted on a centile growth chart, a tradition later extended to his seven grandchildren.

Continuing his interest in growth and nutrition as MRC Fellow at the Infantile Malnutrition Research Unit in Kampala, Uganda, and then the Department of Experimental Medicine in Cambridge, he was asked to explore the cause of hypoglycaemia in babies with kwashiorkor. He was able to show that these children were in fact insulin resistant, with abnormally high blood glucose and insulin levels, differing from the more striking cases of total starvation (marasmus). This experience in malnutrition was also carried back to Belfast as he developed his ideas on the treatment of Type 2 diabetes, at least in part a disease of excessive nutrition.

Returning to the Metabolic Unit at the Royal Victoria Hospital as Consultant Physician in 1967, he worked there until his retirement in 2001. He was an extraordinarily caring physician, who regarded himself as permanently on-call. The pressure experienced by colleagues from his attention to detail and determination to get things right was balanced by his friendly manner as well as clear personal commitment and example. His clinical work and research covered the full range of endocrinology and diabetes and extended well past formal retirement.

His work and qualities were marked by an Honorary Chair at Queen’s University Belfast and by lectureships including the 1998 Jorgen Pedersen Lecture of the Diabetes Pregnancy Study Group of the European Association for the Study of Diabetes, the 2006 Norbert Freinkel Lecture of the American Diabetes Association and, in 2012, the first Lifetime Achievement Award of the Irish Endocrine Society. These recognised scientific excellence in the true sense of knowing and sharing work with colleagues.

Locally he is remembered by generations of Belfast medical students who, for over 25 years, attended his Saturday morning case demonstrations in endocrinology and diabetes. Ever approachable, open to new ideas and encouraging, this commitment summed up his desire to help and support colleagues.

Of many interests outside medicine, the most memorable was the project to produce Irish linen, possibly inspired by his mother’s family, who had been involved in the linen industry in its heyday. Starting with growing flax in a field at their country cottage in Co Down, he and his wife Diana succeeded, with some difficulty, in arranging for the whole process including retting, spinning and weaving to be done in Northern Ireland. As foreign competition had undermined this once thriving industry, authentic Irish linen had not been manufactured locally for many years.

He is survived by his wife Diana, an accident and emergency doctor and artist, son Robert, neurologist, and daughters Katharine and Emily, engineer and landscape architect respectively.

Professor David Robert Hadden
born May 24th 1936, died February 26th 2014


Twitter @BJDVD_Editor News editor: Dr Umesh Dashora