The various diabetes service frameworks have now been launched in England, Scotland and Wales, and are being developed
in Northern Ireland.

The Heart Foundation has released a new nutrition position statement: "Position statement on the relationship between carbohydrate, dietary fibre and
glycaemic index/load and cardiovascular disease". The Statement, Executive Summary and Health Professional Q & As are
available at http://www.heartfoundation.com.au/index.cfm?page=41

Report of the findings of the working group set up in 2005. The report sets out the current problems, provides guidance and
makes recommendations in a number of areas including commissioning, organisation of care, provision of services and workforce.
See the Department of Health website for a copy of the report.

http://www.diabetes.nhs.uk/
NHS Diabetes is a national organisation supporting improvement in diabetes services

Many of the new Infopoints were featured in the recent Department of Health publication 'The Way Ahead: The Local Challenge',
charting the progress of diabetes care nationally four years on from the Diabetes National Service Framework (NSF) Delivery Strategy.

Beyond Boundaries: A Guide to Diabetes Networks. The 31-page document
looks at all aspects of networks, including, roles, requirements and structures, and has lots of advice an analysis which
can be applied to networks in any area, not just diabetes.

The NDST has also published a factsheet examining how the forthcoming PCT
reconfiguration will affect (or not) diabetes networks; again, this is a potentially useful document for any network.

Diabetes networks in the NHS Networks Register

According to the findings of a survey we published recently, the majority of people with diabetes say they receive annual check-ups
to assess whether their condition is under control. However, the findings also show that people with diabetes need to be offered
more help by local services to manage their diabetes themselves, particularly through access to education courses and while in
hospital.
The survey, carried out last autumn, is the largest ever of people with diabetes - over 68,500 people responded from across England.
It also involved the participation of 1,500 general practices and all 152 primary care trusts (PCTs). The national report of this
survey will be published in the summer.
For more information see the Health Commission website.

The Health Foundation has launched a £5 million, three-year initiative which aims to transform healthcare by making self-management
an integral part of the NHS. Co-creating Health is designed to improve the health and healthcare of people with long-term
conditions. Up to eight awards are on offer worth in the region of £600,000 each.
For further details see the Health Foundation website.

- Obesity
"Obesity: the prevention, identification, assessment and management of overweight and obesity in adults and children"
- Diabetes (type 1 and 2) - inhaled insulin
"Inhaled insulin for the treatment of type 1 and type 2 diabetes"
For full details see the NICE website.

Prevalence of obesity in the United Kingdom is among the highest in Europe; in England in 2003, prevalence was highest in the
West Midlands for women and in Yorkshire and the Humber for men.
Click here for a copy of the report.

The Food Standards Agency Board has agreed its recommendation for a consistent approach to front of pack labelling that will
help make it easier for people to choose a healthier diet.
The Agency's recommendations are based on four core principles. These have been developed as a result of extensive consumer
research and feedback from supermarkets, manufacturers, consumer and public health groups.
For further information visit the FSA website.

The department of Health have published the Diabetes Commissioning Toolkit, which
could prove invaluable to all health professionals involved in commissioning diabetes
services.

The world's top 25 food companies appear not to be taking the new global diet and health agenda seriously enough, says
report from The City University released on Wednesday, 5th April 2006.
Researchers Prof Tim Lang, Dr Geof Rayner and Elizabeth Kaelin, at City's Centre for Food Policy studied the annual
reports, accounts and HQ websites (to Autumn 2005) of the top 10 food manufacturers, top 10 food retailers and top 5
foodservice companies (top 3 fast food and top 2 contract caterers). They were rated for whether the companies were doing
anything about the health agenda agreed by the world's governments at the World Health Organisation.

'The NHS Improvement Plan"' has identified long term conditions as one of the 3 top priorities
for the NHS in the period up to 2008. A handbook has been developed detailing consultation techniques that improve
quality of life for patients and clinicians.

Visit the Department of Health website.

Journal Articles
Cochrane review - low G.I. diets and weight loss
The results of the Cochrane review of the evidence for low GI diets and weight loss have just been published.
Visit the Cochrane Library.
Michael L. Dansinger, MD, MS; Athina Tatsioni, MD; John B. Wong, MD; Mei Chung, MPH; and Ethan M. Balk, MD, MPH (2007)
Meta-analysis: The Effect of Dietary Counseling for Weight Loss. Annals of Internal Medicine, 147(1): 41-50.
Rakiciogolu N, Samur G, Topcu A & TopcuOPÇU A A (2006)
The effect of Ramadan on maternal nutrition and composition of breast milk. Paediatrics International, 48: 278-283.
American Diabetes Association (2006) Nutrition Recommendations and Interventions for Diabetes 2006: A position statement
of the American Diabetes Association. Diabetes Care 29:2140-2157.
American Diabetes Association (2006) Physical Activity/exercise and Type 2 diabetes: A consensus statement from the American Diabetes
Association. Diabetes Care, 29(6):1433-1438
Sales CH and de Fatima Campos Pedrosa L (2006) Magnesium and diabetes mellitus: Their relation. Clinical Nutrition,
25: 554-562.
Donnelly JE and Smith BK (2005) Is exercise effective for weight loss with ad libitum diet? Energy balance, compensation and
gender differences. Exercise and Sport Sciences Reviews, 33(4):169-74.
Coker RH etal.(2006) Exercise induced changes in insulin action and glycogen metabolism in elderly adults. Medicine & Science
in Sports & Exercise.
Kuo-Chin Huang, Kormas etal (2004) Obesity Research 12(5).
Severely obese (BMI >35) patients withT2 DM have a higher metabolic rate than those without DM. The best predictive
equation for calculating RMR in these patients is:
RMR = 71.767 - 2.337 x age + 257.293 x gender (women = 0 and men = 1) +9.996 x weight (in kg) + 4.132 X height (cm) +
145.959 x DM (non-diabetic = 0) and diabetic = 1)
American Diabetes Association, 2002: Evidence-Based Nutrition Principles and Recommendations for the
Treatment and Prevention of Diabetes and Related Complications. Diabetes Care. 25, S50-S60.
Foster-Powell K, Holt S and Brand-Miller J, 2002. International table of glycemic index and glycemic load values:
2002. The American Journal of Clinical Nutrition, Vol. 76, No. 1, 5-56, July.
Augustin LS, Franceschi S, Jenkins DJA, Kendall CWC and La Vecchia C, 2002. Review: Glycaemic index
in chronic disease: a review. European Journal of Clinical Nutrition. 56, 1049-1071.
Bell S, Sears B, 2003. Low-glycaemic-load diets: Impact on obesity and chronic diseases. Critical reviews
in food science and nutrition. Boca Raton. Vol. 43, Iss 4; pr 357.
Berger M, Mühlhauser I, 1995. Implementation of intensified insulin therapy: a European perspective.
Diabetic Medicine 12: 201-208
DAFNE Study Group, 2002. Training in flexible insulin management to enable dietary freedom in people with
type 1 diabetes: dose adjustment for normal eating (DAFNE) randomised control trial. British Medical Journal 325:746-756
Diabetes UK, 2003. The implementation of nutritional advice for people with diabetes. Diabetic Medicine, 20: 786-807.
Food and Agriculture Organisation and World Health Organisation, 1997. Carbohydrates in Human Nutrition
- a summary of the joint FAO/WHO expert consultation. www.sugar.ca/FAOPrt.htm
Frost G, Dornhorst A, Moses R (Eds), 2003. Nutritional Management of Diabetes Mellitus. Wiley, England
ISBN 0 471 49751 7
Frost G. & Dornhorst A, 2000. The relevance of the glycaemic index to our
understanding of dietary carbohydrate. Diabetic Medicine, 17:336-345
Ha, TKK and Lean, MEJ, 1998. Technical Review: Recommendations for the nutritional management of patients
with diabetes mellitus. European Journal of Clinical Nutrition. 52, 467-481.
UKPDS 45, 2000. Effects of three months of diet after diagnosis of type II
diabetes on plasma lipid and lipoproteins. Diabetic Medicine, 17:518-523
Mühlhauser I, Bruckner I, Berger M et al., 1987. Evaluation of an intensified insulin treatment and
teaching programme as routine management of Type 1 (insulin-dependent) diabetes. The Bucharest-Düsseldorf
Study. Diabetologia 30: 681-690
Nelson M. et.al, 2000. Survey of dietetic provision for patients with diabetes. Diabetic Medicine, 17:565-571
Nutrition Subcommittee of the Diabetes Care Advisory Committee of Diabetes UK, 2003. The implementation of
nutritional advice for people with diabetes. Diabetic Medicine, 20(10): 786-807.
The DCCT Research Group, 1993. Nutrition interventions for intensive therapy in the Diabetes Control and
Complications Trial. Journal of the American Dietetic Association. 93 (7), 768-772.
Willet W, Manson J and Liu S, 2002. Glycaemic index, glycaemic load, and risk of type 2 diabetes. American
Journal clinical Nutrition. 76 (suppl):274S-80S.
Alpha-glucosidase inhibitors for type 2 diabetes mellitus
Group based training for self-management strategies in people with type 2 diabetes mellitus
Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus
Long-term non-pharmacologic weight loss interventions for adults with type 2 diabetes
Long-term non-pharmacological weight loss interventions for adults with prediabetes
Self-monitoring of blood glucose in patients with type 2 diabetes who are not using insulin
Nagi D. (Ed) (2005) Exercise and Sport in Diabetes. 2nd ed. Wiley, England. ISBN-13 978-0-470-02206-X