The significant glucose-lowering and weight-loss benefits achieved with tirzepatide, the first “twincretin” (long-acting dual GIP/GLP-1 receptor agonist) therapy, could challenge and change current type 2 diabetes management strategies, resulting in tighter glycaemic control and in earlier use of tirzepatide, according to this recently published review by Australian authors. In randomised controlled and open-label studies in the SURPASS clinical programme in people with type 2 diabetes, tirzepatide achieved greater glucose-lowering, weight loss and other metabolic benefits compared with placebo, semaglutide and basal insulins across a broad range of populations, with low rates of hypoglycaemia and with comparable adverse event and safety profiles to GLP-1 receptor agonists. Overall, 43–62% of people treated once weekly with the highest tirzepatide dose (15 mg) achieved normoglycaemia, defined as HbA1c <5.7% (<39 mmol/mol), the lower end of the prediabetes/non-diabetic hyperglycaemia range used in the USA. Up to half achieved normoglycaemia and weight loss of ≥5%, without hypoglycaemia. A separate review brings together the results of the patient-reported outcome measures used in the SURPASS programme studies, exploring the impact of tirzepatide treatment on overall quality of life, ability to perform physical activities of daily living and treatment satisfaction. Significant quality of life benefits were demonstrated with tirzepatide compared to placebo or active comparators.

Pam Brown GP in Swansea

Citation: Brown P (2023) “Twincretin” tirzepatide significantly SURPASSes comparator effects on glucose, weight and quality of life. Diabetes & Primary Care 25: 209–11

This report outlines the proceedings of an industry-sponsored symposium (held at the European Wound Management Association 2023 Conference) during which an international panel of scientific and clinical experts shared research data relating to the mechanism of action of negative pressure wound therapy (NPWT) and its clinical relevance. The speakers also shared their clinical experiences of using a canister-based, singleuse NPWT system in the management of both open wounds and closed surgical incision sites.

Speakers: (Clockwise from top left) Marino Ciliberti (chair), Amit Gefen , Anette Svensson Henriksson and Sanna Kouhia

Marino Ciliberti is MD Surgeon, Director of the Wound Care Centre, Rete Aziendale Di Riparazione Tissutale, Aslnapoli3sud, Gragnano, Campania, Italy;

Amit Gefen is Professor of Biomedical Engineering Herbert J Berman Chair in Vascular Bioengineering, Department of Biomedical Engineering, Tel Aviv University, Tel Aviv, Israel; Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Mathematics and Statistics, Faculty of Sciences, Hasselt University, Hasselt, Belgium;

Anette Svensson Henriksson is Senior Scientist, Research & Development, Mölnlycke Healthcare, Gothenburg, Sweden;

Sanna Kouhia is Consultant in Vascular Surgery, Consultant in General Surgery, Specialist in Wound Care, Espoo, Finland

Our companion article outlines how metformin use can lead to a clinically significant deficiency in vitamin B12, and describes the problems this can cause. In this comment, we outline a project conducted in four primary care practices that aimed to improve metformin-related vitamin B12 deficiency detection rates in people with diabetes.

Shafali Khanom

Medical Student, University of Sofia, Bulgaria

Mosammath Monira Khatun

Medical Student, Imperial College London

Reshma Rasheed

GP, Chapel Street Surgery, Billericay

Citation:

Khanom S, Khatun MM, Rasheed R (2023) Improving detection rates of vitamin B12 deficiency caused by metformin. Journal of Diabetes Nursing

[Early view publication]

Melanie Burcham

While it is rare for both a parent and their child to have type 1 diabetes, paediatric diabetes teams may come across this situation. This article explores the experiences and opinions of four such parents following their child’s diagnosis, and how diabetes teams can meet the needs of these families. The themes discussed include the emotional impact of a child’s type 1 diagnosis on the parent, and how their experience and knowledge of the condition can benefit their child, as well as providing challenges resulting from the parent’s own trauma of living with diabetes. Strategies for supporting and educating families following a child’s diagnosis, which include acknowledging the personal experiences that a parent with type 1 diabetes can bring and discussing emotional health routinely, are explored.

Citation: Burcham M (2023)

When your child is diagnosed with type 1 diabetes: Experiences of parents who also have the condition. Journal of Diabetes Nursing 27: JDN288

Article points

1. When a parent with type 1 diabetes has a child diagnosed with the same condition, the paediatric diabetes team must consider how to meet the particular needs of that family.

2. The parent’s experience of type 1 diabetes may bring feelings of guilt and grief, and other emotional challenges, as well as potential benefits arising from their knowledge of the condition. Paediatric diabetes teams need to acknowledge the additional pressures that such parents face, identify their specific needs and evaluate how to support the family.

Key words

- Children with type 1 diabetes

- Diabetes distress

- Emotional support

- Parents with type 1 diabetes

Authors

Melanie Burcham, Paediatric Diabetes Clinical Nurse Specialist, Royal Free Hospital, London.