Improving and standardizing metabolic screening for people prescribed antipsychotic medication who are at risk of developing metabolic syndrome within the community mental health setting.

Aim and objective of the audit. The purpose of this audit was to identify the number of people prescribed antipsychotic medication who are at risk of developing metabolic syndrome in a community mental health service area with the aim of improving and standardising metabolic screening practices within this setting. Community mental health services are secondary care services in which individuals are referred from Primary Care (General Practitioners). The catchment area of this audit is within the South East Region of Ireland and offers adults community mental health services to a population of approximately 57 000. For the purpose of this audit we focused on one community mental health team within the service.

Use of continuous glucose monitoring for sport in type 1 diabetes.

BACKGROUND: The benefits of exercise for patients with type 1 diabetes (T1D) are difficult to balance with associated glycaemic excursions. The aim of this cohort study was to show that continuous glucose monitoring (CGM) could reduce glycaemic excursions in patients with T1D already using insulin pumps, exercising at moderate to high intensity. METHODS: Questionnaires were used to identify patients with T1D using insulin pumps and naive to CGM use, who reported regular exercise. Six were enrolled and trained on Enlite sensor use with Medtronic Minimed Paradigm Veo system and given activity trackers and written advice on adjustment of insulin or carbohydrate intake for exercise. Resting heart rate (HR) and age were used to determine HR surrogates of moderate and high-intensity exercise. They were to exercise as usual for 3 weeks (run-in week, week 1 and week 2) using the activity trackers and heart rate monitors. Problem areas in Diabetes, Hypoglycaemia fear survey II, Diabetes Technology Questionnaire and Gold scores were completed prior to run-in and at the end. The downloaded sensor glucose data were used to compare the change in time in range (glucose 3.9-10.0 mmol/L) from week 1 to week 2. RESULTS: For the duration of exercise, this time in glucose range increased from 72±20 to 88%±16 %, p=0.05. The time in hypoglycaemia range (glucose < 3.9 mmol/L) went from 3.9±7.9 to 2.4%±4.8 %, p=0.39. The time in hyperglycaemia range (> 10 mmol/L) reduced from 24±19 to 10%±17%, p=0.04. CONCLUSION: These results demonstrate the benefit of CGM use for patients with T1DM doing moderate-intensity to high-intensity exercise.