Diabetes

Glucose is a paradox, best personified as a soccer hooligan. He arrives late for the important match with his mates after the ground is full and is not able to get through the turnstiles. Had he been more punctual, his exuberant energy would have been expended to drive his team over the line. Now this energy is released in other areas, creating havoc in the form of black eyes in pubs, overturned tables in cafes and broken windows. This analogy will become obvious as this article unfolds.

Women with pre-gestational diabetes represent a high-risk pregnancy group for obstetricians. How can this be improved? Technology has changed the care of diabetes significantly in the last decade. Have you heard of insulin pumps, continuous glucose sensors and flash monitors? Obstetricians need to become aware of what is available to help women, especially those pregnant with type 1 diabetes.

Women with diabetes during pregnancy make up between seven and 14 per cent of the pregnant population. These women and their infants are at increased risk of complications during pregnancy. After the birth, the babies are at higher risk of hypoglycaemia than babies of women who do not have diabetes in pregnancy. The purpose of expressing before the birth is to have an adequate volume of breastmilk available for supplementary feeding to treat neonatal hypoglycaemia, hopefully keep mother and baby together, promote earlier onset of lactogenesis II, and, possibly, increase women’s breastfeeding confidence.

The evolving concept that type 1 diabetes in many children has developmental origins has directed research questions in search of prevention back to pregnancy and early life. To this end, the world’s first pregnancy to early childhood cohort study in at-risk children, the Australian Environmental Determinants of Islet Autoimmunity (ENDIA) Study, has been established in Australia.

Have you ever captured a patient image on your smartphone? Digital technology is ubiquitous in hospitals and medical care, with readily available devices for capturing, sending and reproducing patient images. However, digital dissemination of patient information has significant implications for privacy, security, ethics and the law.

The Pacific Medical Students Association (PMSA) is a relatively new organisation based in Fiji, representing medical students from a variety of South Pacific nations. In December 2017, PMSA organised an inaugural medical camp on the island of Malolo, in a tribal area distant from the tourist destinations.