Diabetes Management Journal is produced by The Tangello Group on behalf of Diabetes Australia.

This publication is mailed to Australian GPs, Endocrinologists and Diabetes Australia Health Professionals. The digital publication is also sent to Diabetes Nurse Educators (ADEA), Pharmacy Guild of Australia members and Australian Practice Nurses Australia (APNA). The journal is a clinical publication accessed via a password.

If you have not been provided with a password by your professional association please send a request for the password to dmj@tangello.com.au with your full name and AHPRA number. Dietitians, please include a copy of your Dietitians Australia certificate with your request.

SURVEY:  Please let us know what you enjoy in the DMJ, and what you would like to read more of  TAKE THE 3 MIN SURVEY HERE >>

Please click the button under the cover to read the journal edition and references

• T1D / T2D / LADA -A harmonised guide

  for the classification & treatment with pull out flow charts

• Aboriginal & Torres Strait Islander people - diabetes care
• RACGP Extract: Management of type 2 diabetes: A handbook for general practice
• Sarcopenic obesity - What it is, why it is important and how we manage it
• The role of AI in the advancement of diabetes management
• Ultra-processed foods and diabetes
• PLUS: Ed's view: sport & diabetes, Are we a step closer to insulin-free T1D management?, T1D reversed with stem cell transplantation, Smart insulin

• The LGBTQIA+ Community - the unique and complex relationship with diabetes explained.
• Diabetes & cancer - the risks and implications for clinical management.
• ADS, ADEA, RACGP consensus statement: The use of Diabetes Specific Nutritional Formulas in T2D.
• Is HIIT all it's cracked up to be? An evidence review.
• Complementary medicine - clinical considerations for people with diabetes.
• Empathy over judgement - A call to address stigma in diabetes care.
• Obesity Pharmacotherapy - The nutritional support required to avoid nutrient deficiencies.
• PLUS: HbA1c may be inaccurate in South Asian people, GDM and inter-generational MAFLD, Fathers' diet influences sons' metabolic health through sperm RNA, Exercise timing may be important in glycaemic management.

• Bariatric surgery Pre-operative assessment and post-operative care - a multidisciplinary approach for success
• Diabetes & frailty - when and how to review medications
• Exercise for T2D without leaving the house
• Drivers with diabetes what GPs need to know
• Managing diabetes sustainably - issues to consider when providing care to people with diabetes
• Nutrition after bariatric surgery - important nutritional considerations
• PLUS: From the Ed's warm car, Apple cider vinegar may help with weight management,

  Fasting glucose may be an adequate screen for GDM

• Diabetes, CV & CKD in the era of SGLT-2 inhibitors & GLP-1RAs
• Alternative diabetes models of care can provide significant benefits for people with diabetes and their clinical team
• Exercise physiology and its role in the management of T2D
• Prescribing exercise for someone with T2D and comorbidities - a case study
• Plan for emergencies - helping people with diabetes prepare

  Popular weight loss diets compared

• PLUS: Climate change and diabetes, Metformin may reduce the risk of developing long COVID, The latest on statins & diabetes risk.

• Diabetic kidney disease - an update on the pharmacological management of DKD and the role of newer agents
  
• Obesity & pregnancy: the risks and care of people with obesity during and after pregnancy
  
• Exercise - as part of DKD management
• Diabetes emergencies - identifying & managing HHS & DKA
• PCOS - nutrition & lifestyle recommendations
• Dietary Modifications - in diabetic kidney disease
• PLUS: Hookworm infection reduces insulin resistance (Australian research); Aspartame update; Liraglutide and associative learning in people with obesity; Semaglutide shows promise in T1D study; The effects of weight stigma

• Beyond type 1 and type 2 - the less familiar types of diabetes
• PULL OUT: Living guidelines for manaing T2D in adults
• Type 1 diabetes - a shift in understanding and focus on prevention
• PCOS - an overview of the updated international evidence based guideline
• Patient point of view: Diagnosing LADA - my GP asked the right questions
• The Mediterranean diet - exploring its benefits and practical tips for adoption
• PLUS: Endometriosis may increase the risk of gestational diabetes, Exercise and T2D prevention, Embryonic vitamin D deficiency programs haematopoietic stem cells to induce T2D, First cellular therapy to treat T1D, New plant-based pro-insulin – hope for oral T1D therapy

• Sustainable weight loss for T2D management and remission
• Insulin delivery systems - what you need to know about this  evolving technology
• Steroids and glucose control - identifying and managing hyperglycaemia
• COVID-19 and diabetes - the bi-directional relationship
• PULL OUT CHECKLIST: a systematic screening process for T2D complications
• Improving outcomes - gestational diabetes and nutrition
• PLUS: coffee consumption & T2D risk; GDM and the gut microbiome; Sex differences and T2D; Sleep duration, timing and insulin resistance in late adolescence; Verapamil may preserve pancreatic β-cell function in T1D

• The ocular complications of diabetes: risks, prevention, management & treatment
• B12 deficiency caused by metformin - how best to monitor and treat
• Is Menopause a risk for diabetes? Evidence review and symptom management
• End-of-life care - a different approach to diabetes management
• Ramadan - how to care for people with diabetes considering a month of fasting
• Food Stuff - red meat and diabetes
• PLUS: SGLT2-I as first-line treatment for diabetes with CKD; Bionic pancreas shows promise; Gestational diabetes & cardiovascular disease; T1D with CKD or AGEs increases fracture risk; Disease modifying therapy may prevent T1D.

• Pregnancy & metformin use
• Pregnancy planning with diabetes
• Hospital specialists join the GP team
• Disability in people with diabetes
• Students fill the health service gap
• Advanced glycation end-products and metabolic health: delicious but dangerous
• PLUS: Metformin reduces COVID severity in prediabetes, SGLT2-i for heart failure and kidney disease, Diabetes rates in Australia tripled in the past 20 years, Dulaglutide injections for youth with T2D, Do not to start patients on semaglutide or dulaglutide, Weight loss with semaglutide in East Asian people
• 
  

• Diabetic Autonomic Neuropathy of the heart and gut
• Young-onset diabetes - the unique challenges and management recommendations
• Self-managing diabetes - an app can help with that
• SGLT-2 Inhibitor management in acute situations
• Reality Check: 'Deep end' diabetes care - what to look out for and how to help
• Food Stuff: Benefits of a plant-based diet
• PLUS: Sleep disorders in people with diabetes and venous insufficiency, The cost of hybrid closed loop therapy for youth, The story of an unloved app, DPP-4 Inhibitors & GLP-1 RAs impact on cholecystitis, Could some T1D be preventable?

• Non-insulin Medications
• Diabetes & hearing loss -implications for general practice
• Bolus Calculator Apps - simplify dosing & reduce errors
• Reality Check: De-prescribing medication for T2D
• Patient Point of View: Well meant - but a harmful influence
• PULL OUT FOR PEOPLE WITH T2D: All you need to know about carbs
• PLUS: An end to pricks?, New-onset COVID diabetes remission, SGLT2 inhibitors increase DKA risk, Sleep deprivation increases abdominal fat, Remote management of people – within hospital, Psoriatic arthritis associated with diabetes, Ultrasound treatment of diabetes, Inadequate diabetes management – trending harm
• 
  

• Continuous Glucose Monitoring - a review
• COVID-19 & Diabetes - a practical guide to management
• Exercise is Medicine - the latest evidence & a framework to incorporate in a management plan
• Faecal Microbiota Transplantation - Paradigm shift or a load of crap?
• Reality Check - a GP discovers there's nothing like experiential learning to grow compassion and understanding
• Food Stuff: OzDAFNE - the dose adjustment education program with evidence for improved biomedical and psychosocial outcomes.
• PLUS: TGA approves pills for COVID-19, A century of insulin, Statins may aggravate diabetes, Children and youth risk diabetes after COVID-19, Contradictions in Galectin-1, People with T2D less likely to perceive Atrial Fibrillation, First Nations youth with T2D in the Hot North

• Risky Business: managing unsafe behaviour & mental health in young people with T1D
• Pull Out - Advice for young people with T1D
• The Liver Disease Link - and the consequences for clinical management
• Polypill puzzle - evidence-based review of how fixed-dose combinations fit in the diabetes armamentarium
• Monogenic Diabetes - how to diagnose and treat these clinically significant types of diabetes
• Reality Check - Dr Gary Deed discusses the changes to they care and support people need with the onset of complications
• Patient Point of View: Scarlett describes how she breaks the rules to optimise her T1D management
• Food Stuff: Disordered eating in T2D - how to identify, assess and provide appropriate referals
• PLUS:DKA in T2D: pandemic increase, Hook worms may not be all bad, The dangers of sitting, Grim Figures - diabetes and COVID19

• Diabetes Remission - an evidence-based review
• GLP-1 Receptor Agonists - the benefits and challenges for the management of T2D
• Oral health and diabetes - the bi-directional link
• Diabetic Ketoacidosis in children with new T1D - don't miss it!
• Reality Check: Chasing unicorns in general practice
• Food Stuff: Caring for people with T1D and eating disorders or disordered eating
• PLUS: Sever hypos in T1D & mid-life cognitive impairment, PPIs reduce HbA1c - maybe - a little, Tai Chi for people with central obesity, Are SGLT2 inhibitors renoprotective? Lower bone density in youth with T1D, Lethal mucormycosis upsurge in India associated with COVID - look out - we might just start seeing it in Australia.

• Diabetes and vascular dementia - prevention & management
• COVID-related distress & diabetes - practical tips, resources, when to manage and when to refer
• Stepping out with apps - evidence-based guide to recommending physical activity apps
• How to help people with diabetes and schizophrenia
• Reality Check: T2D and obesity - a psychologist's perspective
• Patient Point of View: Sometimes diabetes isn't caused by overeating and lack of exercise
• Food Stuff: Are low-carb diets really the holy grail? An evidence-based review
• PLUS: Inflammation reduced after 5% weight loss, CVA risk higher in COVID-19, Diabetic foot ulcer hospitalisations accelerating in younger people, Testosterone and diabetes remission, ß-cells work together for islet resilience

• Avoiding Amputations - most of the 4,000 amputations each year are preventable
• An evidence-based medical weight loss plan for T2D and prediabetes
• Clinic pull-outs: Diabetes foot risk stratification and Triage; Active foot disease pathway
• Diabetes and Rheumatology - the musculoskeletal diseases
• Using new T2D therapies in general practice
• Reality Check: A remote diabetes educator & healing through Dadirri
• Patient Point of View: On GP's approach 'saved her life'
• Food Stuff: Meal replacement options for weight loss
• PLUS: LADA exposed by COVID-19 infection, Meta-analysis of low-carb for T2D, $38m for new research centres, Maybe the mitochondria - Japanese men with T2D, COVID-19: Metformin associated with lower mortality.

• The Heart's Performance When Diabetes Is The Puppeteer
• Research Breakthroughs - the projects seeking to understand, prevent and treat diabetes
• Gut Microbiome - can changes predict diabetes?
• Patient Point of View: The motivation to take control of prediabetes
• Reality Check: Tackling it together - Indigenous Australians with T2D
• Food Stuff: Pancreatic Exocrine Insufficiency etiology and dietary management
• PLUS: Metformin in Pregnancy, One Hundred and Ninety-six Hour Insulin,
  Sleeve Gastrectomy vs Roux-En-Y

• Diabetic Cheiroarthropathy - important clinical clues to help diagnosis and management
• Medication Review - the common medicines that affect glycaemic stability
• Pancreatic Islet Transplantation. What you need to know.
• Sustained Diabetes Self-Management. The role of peer support.
• Reality Check: Beyond the gym - exercise options for (almost) every diabetes limitation
• Food Stuff:  Malnutrition in obesity. Yes! it seems counterintuitive.
• PLUS: COVID-19 linked to new-onset diabetes, Diabetes Living Evidence - call to provide feedback, new Diabetes Australia/RACGP diabetes handbook, Gestational diabetes - the intergenerational epidemic

• Bone Fragility Fractures -The etiology & medication effects
  on bone health in T1D & T2D
• Complementary Medicines - what you need to ask and how
• Haemochromatosis - how to diagnose and manage the silent killer
• Diabetic Gastroparesis: dietary management
• Managing diabetes and other chronic diseases during a pandemic
• Point of view -a journey to finding support
• PLUS: Diabetes & COVID-19: burning questions, the psychological impact, ACE-I’s and ARBs, GDM ante- & postnatal testing advice; Diabetes Living Evidence update

• Skin Deep - dermatologists discuss T1D and T2D
• Diabetes of the exocrine pancreas - what you need to know
• Too much medicine - polypharmacy and deprescribing
• Long-term doctoring - the emotional challenges
• Coeliac disease & diabetes - gluten-free options
• Slow exercise: why tai chi?
• Point of view - diabetes remission at last
• PLUS: Editor's final reflections, Novel insulin compound, Quit the cigs and gain the weight

• Gestational Diabetes - diagnosing, testing & managing
• Living Evidence - overcoming outdated diabetes guidelines
• PULL OUT GUIDE for T2D glucose medication decisions
• Free Exercise Programs - no gym fees required
• Residential Aged Care - translating guidelines into practice
• Reality Check: Managing T2D in group homes
• Food Stuff: Diabetes & The Gut Microbiome
• PLUS: The DIRECT trial & diabetes remission, Diabetes inventor paid his dues, Fatty Liver marker not so useful, Intensive glucose management: outcomes 5, 10 and 15 years later.

• Diabetic Kidney Disease - a practical approach
• How Depression and Anxiety Interact with Diabetes
• PULL OUT TABLE - The New Injectables for Diabetes
• Injection Perfection - technique matters for optimal diabetes management
• Late-onset T1D - more common than you think
• Reality Check: Why this GP doesn't like Glucose Tolerance Tests
• Patient Point-of-View: T1D couldn't stop my father Prof. Geoff Harcourt, AC
• Food Stuff: Non-hungry eating
• PLUS: Diagnosing diabetes in Australian general practice, Proteinuria or retinopathy? Worry about amputation, An extraordinary legal precedent.

• The Older Person - diabetes management tips
• Continuous Glucose Monitoring - what you need to know
• DIY Pancreas - staying one loop ahead of the regulators
• High-Intensity Interval Training - rethinking an old idea
• Blood Pressure - new evidence, new targets
• Patient Point of View: The GP with T1D who built his own loop
• Food Stuff:  A peek inside our dietitian's toolkit
• PLUS: Proactive diabetes hospital admissions,
  Is vitamin C a hypoglycaemic?, Insulin - pump or injections in kids?

• Obesity Management - a quintessentially GP issue.
• Diabetes on Steroids - why corticosteroids are bad and what do do about it.
• Annual Diabetes Checks - a (very) practical guide.
• Self Monitoring in T2D - it seems obvious - but it's not.
• Managing Sick Days - a pull-out guide to managing diabetes during illness
• Ketogenic Diets - where's the evidence in diabetes?
• Reality Check - an island, a rural town and a mega-city
• PLUS: Addison's disease in T1D, Gestational diabetes threshold questioned,
  Reducing diabetes-related vision loss, Patient point-of-view

• Cardiovascular screening - can we look too hard?
• Preventing heart attacks - the list of interventions that actually work.
• Polycystic Ovaries - authors of the new guideline talk diabetes management.
• New diabetes medications - which T2D agents prevent cardiovascular deaths?
• Fit for it - the 'HANDI' guide to exercising with cardiovascular disease.
• Making 'adherence' irrelevant - why won't we take our medicine?
• Reality Check - overweight Aussie kids.
• 'I had a baby one week, a heart attack the next'.
• Plus: Sugar wars - more tax anyone?, The hot water balloon 'diabetes cure', Diabulimia: withholding insulin to lose weight, Are chairs making us sick?

• Starting Insulin - How to prescribe those first few doses
• Managing Hypoglycaemia - get out of trouble fast
• Exercising safely on Insulin
• Chaos! A GP's approach to helping vulnerable people
• Poverty & Diabetes - Tailoring medical management to human circumstance
• Fear the Lows - How fear of hypos changed one mother's life
• It's Artificial - Are sugar substitutes healthy?
• Plus: TGA Warning - SGLT2s & euglycaemic ketoacidosis, Supplements - oils ain't oils!, Deep brain stimulation improves diabetes, Preserve Sight Program

• Surgical Weight Loss - Expensive, risky...but probably worth it.
• T2D Medication Overview - the independent evidence behind every medication
• PULL OUT (PRINT OFF) chart - Hypoglycaemics at a glance
• Cheap Eats - nutritious meals on a shoestring budget
• Unashamedly Metformin - 60 years old and still kicking goals
• Diabetes in the Immigrant Population - A GP reflects
• It's Complicated - Exercise doesn't stop when diabetes complications start
• The Day My Stomach Shrank - being on the receiving end of bariatric surgery is no picnic
• Plus: GLP-1 and SGLT-2 are A-OK, The artificial pancreas - still room for improvement, Diabetes group support on Facebook, A night owl's lament

• Practical Management of Diabetic Retinopathy
• Sleep Apnoea & Diabetes -the association is more than just obesity
• Smart Meters - what makes some smarter than others?
• The 5:2 Question - Do fasting diets help diabetes?
• My Brush with Blindness - a patient's point of view
• A GP's approach to diabetes in Aboriginal and Torres Strait Islander people
• Pre-Pregnancy Planning - preparation makes all the difference
• Getting Off the Couch - how to move the hard-to-motivate
• Plus: Remarkable results from GP-led diet, Cataracts twice as common with diabetes, Shakeup for diabetes tests, Too many big babies? Psychological glucose treatment?

• The Facts Behind the Artificial Pancreas
• Diabetes and Emotional Health - an extract from the new NDSS handbook
• Plant-Based Diets - the evidence supporting the benefits of weight loss
• Sarcopenia - The relationship between diabetes and muscle mass, strength and performance
• How To Incorporate a Diabetes Educator into a GP Practice
• Living with a Smart Pump - a patient's point of view
• Plus: The impact of hypos, Imatinib may slow new-onset T1D, Risk of diabetic ketoacidosis after initiation of an SGLT2 inhibitor, Glycaemic control and weight loss with semaglutide in T2D, The NADC support for GPs explained

• Managing Diabetic Foot Syndrome
• Continuous Glucose Monitoring - the technology and NDSS eligibility criteria explained
• Bread & Weight Loss - A dietetic review
• Ramadan: Fasting & Feasting - Diabetes implications and clinical management
• A GP's perspective - wholistic diabetes care
• Tech & Apps - help for silver surfers managing their diabetes
• Too busy for diabetes - a patient's point of view
• Running on Empty - T2D exercise is not a one size fits all