Renal and diabetes care are both highly specialised areas with high standards; a lack of synchronisation between the two can result in unstructured care for the person with renal failure and diabetes. In this article, the author reports the experience of implementing a DSN service within a renal transplant clinic to provide multidisciplinary care for renal transplant recipients with diabetes. After a period of 1 year, this scheme resulted in improved glycaemic control, improved renal staff awareness of diabetes and earlier diabetes diagnosis and treatment initiation. ...

Enabling patients to have a say in the design and delivery of local health services is a key priority in the NHS. The St Helens and Knowsley Teaching Hospitals NHS Trust diabetes team aimed to set up a peer support group for people with type 1 diabetes to aid in carbohydrate counting while on multiple daily injections (MDI) or insulin pump therapy (continuous subcutaneous insulin infusion [CSII]) and to collaborate with them to improve their CSII service. Most of the CSII users had completed the Insulin and Carbohydrate Education (ICE) course, for intensive management of type 1 diabetes, prior to commencing CSII therapy and these individuals suggested that a similar course based around CSII would improve their self-management skills. In response to this feedback, the team established the Pump Advanced Carbohydrate Education (PACE) programme for the CSII users, which has now been incorporated into routine care. PACE has proved extremely popular and has been associated with much participant satisfaction. ...