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Weight loss drugs could at least double the risk of diabetic patients developing age-related macular degeneration, a large-scale study has found. Originally developed for diabetes patients, glucagon-like peptide-1 receptor agonist (GLP-1 RA) medicines have transformed how obesity is treated and there is growing evidence of wider health benefits. They help reduce blood sugar levels, slow digestion and reduce appetite. But a study by Canadian scientists published in Jama Ophthalmology has found that after six months of use GLP-1 RAs are associated with double the risk of older people with diabetes developing neovascular age-related macular degeneration compared with similar patients not taking the drugs. Academics at the University of Toronto examined medical data for more than 1 million Ontario residents with a diagnosis of diabetes and identified 46,334 patients with an average age of 66 who were prescribed GLP-1 RAs. Nearly all (97.5%) were taking semaglutide, while 2.5% were on lixisenatide. The study did not exclude any specific brand of drugs, but since Wegovy was only approved in Canada in November 2021, primarily for weight loss, it is likely the bulk of semaglutide users in the study were taking Ozempic, which is prescribed for diabetes. The study found that those who had been taking semaglutide or lixisenatide for at least six months had twice the risk of developing macular degeneration, compared with similar patients who were not taking the drugs. Patients who had been taking GLP-1 RAs for more than 30 months had more than three times the risk. Marko Popovic, a co-author of the study and physician in the department of ophthalmology and vision sciences at the University of Toronto, said: “GLP-1 receptor agonists appear to have multiple effects on the eye, and in the case of neovascular age-related macular degeneration, the overall impact may be harmful. “Based on our data, I would advise exercising particular caution when prescribing GLP-1 RAs to older [diabetic] patients or those with a history of stroke, as both groups were found to have an even higher risk of developing [the condition].” Read full story Source: The Guardian, 5 June 2025

Patients in A&E are being put in potentially life-threatening situations due to missed doses of prescription medicines, according to a new report. The Royal College of Emergency Medicine (RCEM) found people in A&E were not getting their medications on time and were missing doses needed to manage their illnesses – putting them at risk of getting worse. Insulin for diabetes, Parkinson's drugs, epilepsy medicines and tablets for preventing blood clots are all time critical medicines (TCM). If these drugs are delayed or missed, the patient can deteriorate and is at greater risk of complications or death. While patients are advised to remember to bring their medications to A&E and to take them, there is also a responsibility on NHS staff to make sure this happens. Despite the recognised risk of harm, the delivery of TCM is not consistent across emergency departments with long waiting times often contributing to this. The study, which was part of the College's clinical Quality Improvement Programme (QIP) which aims to improve the care of A&E patients, found more than half of these patients were not identified as being on TCM within 30 minutes of their arrival in an emergency department. In addition, 68% of doses were not administered within 30 minutes of the expected time. "The findings contained in this report should serve as a call to action for both emergency medicine staff, as well as patients reliant on time critical medications, to ensure no dose is ever missed in A&E," said Dr Jonny Acheson, an emergency medicine consultant in Leicester who has Parkinson's, led the study. Read full story Source: The Independent, 7 April 2025 Further reading on the hub: Time-critical Parkinson’s medication: the human cost of delays and mistakes HSSIB investigation report: Medication not given: administration of time critical medication in the emergency department Parkinson's UK: Time critical medication guides for health professionals Improving safety for diabetic inpatients: 4 key steps D1abasics: Equipping staff to care safely for inpatients with diabetes

Popular glucose monitors used to take regular blood sugar readings could be driving poor diets and food restrictions due to inaccurate measurements, according to a new study. Continuous Glucose Monitors (CGMs) take blood sugar readings every five minutes and were originally designed for people with diabetes to assess how their body responds to different foods. But they are growing in popularity and in recent years have increasingly been used by the health-conscious to track their diet and avoid glucose spikes. Carried out in healthy, non-diabetic volunteers, the research compared results from a CGM to the gold standard finger-prick test for blood sugar levels. Scientists found that the CGMs consistently reported higher levels than the finger-prick test. The monitors overestimated the time spent above the Diabetes UK’s recommended blood sugar level threshold by nearly 400 per cent, causing unnecessary concern for people whose blood sugar was actually well-controlled. Professor Javier Gonzalez, from the university’s department of health, warned people should stick with the finger-prick test if they are looking for accurate readings. “Continuous glucose monitors (CGMs) are fantastic tools for people with diabetes because even if a measurement isn’t perfectly accurate, it’s still better than not having a measurement at all,” he said. “However, for someone with good glucose control, they can be misleading based on their current performance." Read full story Source: The Independent, 26 February 2025

Pregnant women in prison in England are three times more likely to be ­diagnosed with gestational ­diabetes than those on the outside, according to “alarming” new data. Figures obtained through freedom of information (FOI) requests to NHS trusts providing healthcare to women’s prisons in England found 12% of women receiving care relating to pregnancy in 2023 were diagnosed with the condition, triple the national figure of 4%. Laura Abbott, associate ­professor in midwifery at Hertfordshire University, said these figures were “alarming but not surprising”. “We have known for many years that preterm birth is more common among ­incarcerated pregnant women, and this ­further highlights the severe health risks they face,” she said. “Gestational diabetes increases the risk of high blood pressure and pre-eclampsia, serious conditions that require early detection, good nutrition and careful obstetric management, which is extremely difficult in a prison setting. It can also increase the risk of stillbirth.” There were 215 pregnant women in prison in England between April 2023 and March 2024, according to figures published by the Ministry of Justice. There were 52 births while in custody, 98% of which took place in hospital. The NHS and Prison Ombudsman categorise all pregnancies in prison as high risk. Pregnant women in prison are seven times more likely to have a stillbirth and twice as likely to go into premature labour, according to data from FOI requests in 2022. In 2019, newborn Aisha Cleary died at HMP Bronzefield after her mother, who was in prison on remand, was left to give birth alone in her cell. Read full story Source: The Guardian, 23 February 2025

The Food and Drug Administration released an alert notifying patients of a safety concern using diabetes devices such as continuous glucose monitors, insulin pumps and automated insulin dosing systems that rely on a smartphone for delivering alerts. The agency said it received medical device reports in which users reported alerts were not being delivered or heard in situations where the users thought they configured the alerts to be delivered. Some instances may have contributed to serious harm, including severe hypoglycaemia, severe hyperglycaemia, diabetic ketoacidosis and death. The FDA issued recommendations for users and said it is working with diabetes-related medical device manufacturers to ensure that smartphone alert configurations are evaluated prior to use. It is also working with manufacturers to ensure settings for smartphones and mobile medical applications are continuously tested and that updates are communicated quickly and clearly to users. Read full story Source: US Food and Drug Administration, 5 February 2025

One in five UK adults are living with diabetes or pre-diabetes as diagnoses have reached an all-time high, new data shows. Charity Diabetes UK called this a “hidden health crisis” and urged the government to act immediately. Some 4.6 million people are now diagnosed with the condition, compared to 4.4 million a year ago. This includes about 8% with type 1 diabetes, which happens when a person cannot produce insulin, a hormone that helps the body turn glucose into energy. Some 90% have type 2 diabetes, which happens when the body does not use insulin properly, while 2% have different and rarer forms of the condition. A further 1.3 million are estimated to be living with undiagnosed type 2 diabetes. The chief executive of the charity, Colette Marshall, said: “These latest figures highlight the hidden health crisis we’re facing in the UK and underline why the government must act now. “There must be better care for the millions of people living with all types of diabetes, to support them to live well and fend off the risk of developing devastating complications. “With more people developing pre-diabetes and type 2 diabetes at a younger age, it’s also critical that much more is done to find the missing millions who either have type 2 diabetes or pre-diabetes but are completely unaware of it. The sooner we can find and get them the care they need, the more harm we can prevent.” Read full story Source: The Independent, 6 February 2025

Hundreds of patients are being contacted over potentially incorrect results at a second NHS trust, as more laboratories report concerns over diabetes tests, HSJ understands. Bedfordshire Hospitals Foundation Trust was the first to report an issue over blood tests earlier this year, saying up to 11,000 patients may have received the wrong results – including a misdiagnosis of diabetes. But the Medicines and Healthcare Products Regulatory Agency has confirmed to HSJ that other laboratories across the country have reported concerns over the same device, which measure glucose control. The Hb1AC blood test is used to diagnose diabetes and prediabetes, as well as manage existing conditions. A spokeswoman said clinical care was unlikely to have been affected, but doctors were reviewing individual circumstances and patients would be contacted if they needed a new test. Several field safety notices have now been published for the Premier Hb9210 HbA1c analyser device, manufactured by Trinity Biotech. Dr Janine Jolly from MHRA said the regulator was working closely with the manufacturer to ensure corrective actions were being put in place. Read full story (paywalled) Source: HSJ, 27 November 2024

Hundreds of patients are being contacted over potentially incorrect results at a second NHS trust, as more laboratories report concerns over diabetes tests, HSJ understands. Bedfordshire Hospitals Foundation Trust was the first to report an issue over blood tests earlier this year, saying up to 11,000 patients may have received the wrong results – including a misdiagnosis of diabetes. But the Medicines and Healthcare Products Regulatory Agency has confirmed to HSJ that other laboratories across the country have reported concerns over the same device, which measure glucose control. The Hb1AC blood test is used to diagnose diabetes and prediabetes, as well as manage existing conditions. One affected trust is Maidstone and Tunbridge Wells FT, which said around 1,500 patients had been identified for a retest following a technical issue affecting results in July. A spokesman said the problem was escalated to the supplier as soon as possible, and that affected patients would be contacted by GPs. Read full story (paywalled) Source: HSJ, 27 November 2024

The number of people with diabetes has doubled over the past 30 years to more than 800 million worldwide, according to a groundbreaking international study. Global analysis published in the Lancet found that rates of diabetes in adults doubled from about 7% to about 14% between 1990 to 2022, with the largest increase in low and middle-income countries. The study is the first global analysis of diabetes rates and treatment in all countries. Scientists at NCD-RisC in collaboration with the World Health Organization used data from more than 140 million people aged 18 or older from more than 1,000 studies in different countries. They applied statistical tools to enable accurate comparisons of prevalence and treatment between countries and regions. The study highlighted growing health inequalities. More than half of global diabetes cases were concentrated in four countries. Of those with diabetes in 2022, more than a quarter (212 million) lived in India, 148 million were in China, 42 million were in the US and 36 million in Pakistan. Indonesia and Brazil accounted for a further 25 million and 22 million cases, respectively. Dr Ranjit Mohan Anjana, the joint first author and president of the Madras Diabetes Research Foundation in India, said: “Given the disabling and potentially fatal consequences of diabetes, preventing diabetes through healthy diet and exercise is essential for better health throughout the world. “Our findings highlight the need to see more ambitious policies, especially in lower-income regions of the world, that restrict unhealthy foods, make healthy foods affordable and improve opportunities to exercise, through measures such as subsidies for healthy foods and free healthy school meals as well as promoting safe places for walking and exercising including free entrance to public parks and fitness centres.” Read full story Source: The Guardian, 13 November 2024

The UK's drug safety regulator is asking doctors to be alert for patients who may be misusing obesity injections, such as Wegovy. It follows reports of some people who are not obese becoming sick, after using the jabs for weight loss. The Medicines and Healthcare products Regulatory Agency (MHRA) stresses that the drugs are only meant for treating obesity and diabetes. Health Secretary Wes Streeting has backed the call, saying the drugs are "serious medicines" and not "for people to get a body beautiful picture for Instagram". While most side-effects are mild, some can be serious, says the MHRA. It adds that the drugs should only be prescribed by a registered healthcare professional. When appropriately used, in line with the product licence, the benefits of these medications outweigh the risks for patients, says the regulator. But this benefit-risk balance is positive only for those patients within the approved indications for weight management or type 2 diabetes, as described in the product information. Dr Alison Cave, MHRA Chief Safety Officer, said all medicines carry a risk of potential side-effects: “We encourage healthcare professionals to ensure patients being treated with these medicines are aware of the common side-effects and how to minimise risk." Read full story Source: BBC News, 24 October 2024

These comments were made by people with diabetes in response to a Twitter thread asking "Why is a hospital stay scary if you have diabetes?" If you have diabetes, or care for someone who does, please share your experience with us by adding a comment to this community thread, “I was in ICU after a car accident—none of the staff knew how to work my CGM and/or my insulin pump. I had to manage my own care” “For me it was when I went into hospital for surgery and the nurse said 'Type 1... so do you take insulin for that?'... that's not a reassuring thing to hear minutes before you're taken into the theatre!” “Lucky to get out alive.” “DKA 10 years ago, once back in normal range the consultant insisted I didn't need anymore insulin & refused to let me have any. Obvs within 3 hours I was back in DKA, he wouldn't come see me but had a convo with my husband on the ward phone where hubs explained how T1 works.” “I've been given a full day's bolus, through my iv and then told I was wrong when I said that I only bolused when I ate. Massive hypo followed quickly. I was then told it was my fault and I should have said something.” “After being admitted as an emergency, my own insulin ran out. I was given 2 (2!) of the wrong types of insulin and told that 'it would be okay'.” “They were often confused about T2 versus T1 - lots of emphasis about low fat foods and only being allowed a low fat yoghurt for puddings even though I was on a pump! I had a bag of snacks though as it was a planned hospital stay” “After a major medical issue I was denied insulin in the ICU for over 24 hours but was told I could have some pills to treat my type 1 diabetes” “Last time I went to the hospital, they took my pump (forcefully) and refused to give it back. When I protested, they sedated me. I was in and out of sedation having a panic attack bc I couldn’t breathe. They sedated me again and put me on DKA protocol, even tho I wasn’t in DKA.” “it’s so scary right like you know that you’re the expert on your condition and your needs but that power gets totally taken away” “Handing over your care over to a group of nurses who have no idea what they are doing. It’s super scary. I hate it when they lock it all away and you can’t get to it.” “I didn’t feel safe either. Told them on a few occasions I felt ‘low’. Finally Lucozade got wheeled out but it was almost an inconvenience” “Totally understand why they don’t know much about it if it’s not their specialism BUT some are so arrogant that what they were told one afternoon 10yrs ago is the absolutely way to deal with, and that the person living with it doesn’t know what they’re talking about!” Sarcastic responses “You seem to know a lot about it!” “The neurologist told me I am a terrible diabetic.” “I never feel safe because they don’t allow me to dose my own insulin and last time dropped me from 600 to 40 in three hours and then shot me back up so fast when i specifically told them that i would go low and high from that much insulin” Report of being diagnosed with type 1 diabetes while in hospital, despite telling every healthcare professional she had T1. “I smuggled in my own tester and meds and took care of myself.” “I think the biggest thing for me is them not understanding insulin dose when they’re writing up your chart and how you don’t really have a “typical” insulin dose that fits neatly into their charts because of carb counting or correction doses/reduction dose. It’s strange, when I’ve had DKA admissions and I’m on the sliding scale IV it’s fine because there’s clear guidelines but for just day to day injection management it’s soooo difficult.” "Daughter had food and insulin withheld in a mental hospital." “the ward nurses didn’t even know I had T1 until the more mobile lady opposite me went and fetched a nurse who had been ignoring my call button. I was hypo and couldn’t reach my treatment.” "Taken off insulin for two days as no doctor to prescribe." “Particularly bad experience when a nurse left the glucose drip on but turned off the insulin. It terrifies me to think how bad this could have been.”