The Diabetes Special Interest Group (SIG) was founded in 1992 by a small group of committed geriatricians with expertise in diabetes and endocrinology.

One of its main aims was to highlight the importance of delivering high quality diabetes care to vulnerable older adults by providing first class postgraduate educational events. With this in mind, the SIG meeting in Aberdeen, attended by more than 200 delegates, met this aim and provided a session which was not only stimulating, but highly educational.

Dr Simon Croxson, a consultant physician in Bristol (Chair, SIG-Diabetes), delivered a short, practical, unique but occasionally eccentric review of insulin treatment in older people. His messages were clear: insulin treatment should not be delayed; most older patients can manage insulin pens; all insulin preparations should be available to older ‘folk’; and consider the newer insulin analogues which have some theoretical and practical advantages.

The background and methodology of the GIST (Glucose Insulin in Stroke Trial) was then discussed eloquently by Dr Jon Scott, a specialist registrar from South Shields. Jon had previously been a Northern region Research Fellow at the University of Newcastle, one of those prized appointments that seem only to be available in the North East! His review of the area of cerebrovascular disease and diabetes was fascinating and pointed out that in acute stroke, a glucose level of > 5mmol/l at presentation in subjects without a previous diagnosis of diabetes, may have adverse consequences in terms of mortality. About 800 subjects so far have been recruited to this RCT which is investigating the benefits of tight glucose control versus usual care in the first 24 hours of admission on three monthly outcomes.

Dr Geraldine Brennan, a consultant physician with a special responsibility for diabetes in Tayside, completed the session by providing a splendid overview of the DARTS/Memo project. This has given us a tremendous insight into the burden of diabetes on a population basis, and led to the first effective diabetes register being developed. This project appears to have four facets: a Register; an Audit tool; a Data Management Tool; and Research. Her presentation was enlightening and provided delegates with the information to go away and set up their own audit tools for their diabetes practice, and gave helpful tips on how to improve the integration of diabetes care into their geriatric medical practice.

At a time when the NSF for Diabetes is in its early stages of implementation, and when our own discipline is re-examining our roles in intermediate care, community care including care homes, there is a clear opportunity for exploring how we can manage older people with diabetes in new environments. Many thanks to Simon Croxson for organising this enjoyable event.

Professor Alan Sinclair
University of Warwick
Executive Officer of BGS Diabetes SIG

To join the British Geriatrics Diabetes SIG, contact the Chairman:

Prof A Sinclair
Geriatric Medicine/Gerontology
Health Services Studies
University of Warwick
Coventry CV4 7AL

Email: Sinclair.5@btinternet.com or
chssasai@wbs.warwick.ac.uk