Medical Education - Research Publications
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ItemNo Preview AvailableInsulin icodec use in hospital settings: Considerations for once-weekly basal insulin therapy in hospital glycaemic management practice(Elsevier, 2024-05)Diabetes management has benefitted greatly from novel insulin analogues with action profiles that better match individual’s requirements. However, the increased complexity of hospital insulin administration involving multiple practitioners, rapidly changing clinical situations, and therapies causing hyperglycaemia, demands specific consideration for their use. Insulin icodec has an extended duration of action and is beginning to be used in the ambulatory setting. A reassuring early trial experience observed no substantial dysglycaemia in 135 hospitalised participants [ 1 ]. However, the limited glucose measurements informing this observation under intensive clinical trial conditions warrants further consideration of insulin icodec’s implications for real-world hospital settings.
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ItemThe role of medical students in humanitarian responses to armed conflict(Elsevier, 2024-01-03)The Russia–Ukraine and Israel–Palestine armed conflicts have been widely covered by the media in 2023. However, on a global scale, humanity is no stranger to violence with many countries currently experiencing armed conflict, terrorism, political unrest, or ethnic violence. 1 There is great demand for medical professional expertise to assist with these humanitarian crises. Compounding the pre-conflict medical workforce shortages often present, conflict can often displace health-care workers internally and across borders, interrupts medical education, and causes disproportionate loss of life among working-age individuals who could form future health workforces. 2 , 3 One potential approach to addressing this shortage lies in unlocking the latent potential of medical students, which in our opinion are a predominantly young, energetic, and altruistic group with developing medical expertise, uniquely placed to assist in this context.
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ItemThe Synergism of Virtual and In-Person Inpatient Diabetes Consultations(SAGE Publications, 2023)
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ItemNo Preview Available165-OR: Early Electronic Consultation Reduces Glucose and Health Care–Associated Infection in Hospital—The STOIC-D Surgery Randomised Controlled Trial(American Diabetes Association, 2023)Aims: To assess the effect of early intervention with electronic-based proactive specialist diabetes care in surgical inpatients on glycaemia and clinical outcomes. Methods: The Specialist Treatment of Inpatients: Caring for Diabetes (STOIC-D) Surgery randomised controlled trial (RCT) recruited consecutive adults admitted to surgical units of the Royal Melbourne Hospital (Australia) in 2021 with diabetes or blood glucose ≥200 mg/dL and length of stay (LOS) ≥24 hours. Intervention arm patients received remote proactive consultation by the inpatient diabetes service (IDS) in the electronic medical record (Epic®) within 24 hours of admission and, if escalation criteria were met, received a bedside consultation. Patients receiving standard care were reviewed by the IDS at the bedside only following referral. Insulin and non-insulin agents were used to target glucose 90-180 mg/dL. Outcomes included glucometrics, healthcare-associated infection (HAI), and mortality. Registration: ACTRN12620001303932. Results: 1,383 admissions met inclusion criteria; 689 received the intervention. The primary outcome of mean patient-day mean glucose was lower in the active (158.4 mg/dL, standard deviation [SD] 48.6) vs. control arm (162.0 mg/dL, SD 46.8, p<0.001). HAI (most commonly pneumonia) was lower in the active vs. control arm (11% vs. 16%, p=0.02). Mortality (2.4% vs. 4.2%, p=0.08) and LOS (10.7 vs. 10.0 days, p=0.26) were no different. The number needed to treat for HAI prevention was 22. Hypoglycaemia <72 mg/dL was not increased (1.0% active vs. 0.9% control, p=0.23). The IDS performed a bedside consultation in 333 (49%) of the active vs. 93 (14%) of the control arm. Conclusion: The STOIC-D Surgery trial is the largest RCT of a diabetes model-of-care intervention in non-critical care. Early, electronic-based specialist diabetes intervention significantly reduced patient-day mean glucose and HAIs in a surgical population.
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ItemNo Preview AvailableCOVID-19 and hyperglycaemia: a bidirectional relationship(Tangello Group on behalf of Diabetes Australia, 2023)
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ItemNo Preview AvailablePregnancy planning in a woman with diabetes secondary to familial partial lipodystrophy due to a rare PPAR gamma gene variant(International Association of the Diabetes and Pregnancy Study Groups, 2022)
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ItemNo Preview AvailableDiabetes Digital Phenotyping to Improve Documentation of Diabetes in Hospital Inpatients(Australian Diabetes Society, 2022)
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