Aims: The aim of this study was to report on the practicality, feasibility and impact of implementing the National Institute for Health and Care Excellence (NICE) guidelines for the control of diabetes in women during labour and birth. Methods: We analysed case records of pregnant women with diabetes who delivered in the period between July 2014 and June 2015. The data were collected in relation to the availability of a plan in the notes, capillary blood glucose (CBG) monitoring, use of variable rate intravenous insulin infusion (VRIII), maintenance of CBG targets within 4-7 mmol/L, maternal hypoglycaemia during labour and neonatal hypoglycaemia. Results: Fifty-one women with diabetes delivered during this period. Only 45% of women were monitored by complete hourly CBGs until delivery. 27.4% of women had CBG ≥7 mmol/L but only 17.6% were started on VRIII. The VRIII group had a 22.2% incidence of minor maternal hypoglycaemia. Neonatal hypoglycaemia occurred in 47% of the babies. Conclusion: A CBG target of 4-7 mmol/L during labour and initiation of VRIII when levels are above this target in pregnant women with diabetes is difficult to achieve and is associated with some maternal hypoglycaemia. Repeat CBG measurements within half an hour and strict adherence to clear guidelines and protocols supported by more education and adequate staffing may improve results.Br J Diabetes 2017;17:ONLINE AHEAD OF PUBLICATION

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presented at the Phillippine Nurses UK World Cafe Convention, 24 October 2020

Aim Radiological localisation imaging may achieve gland localisation in primary hyperparathyroidism, thereby allowing minimally invasive surgery. However, initial imaging sometimes fails to identify the abnormal gland. This study explored the outcomes of patients undergoing repeated imaging at our institution, after a negative initial set of scans. Method Data was retrospectively collected and analysed for patients undergoing repeated imaging between 2015 and 2020 at an institution providing parathyroid endocrinology services. Results 45 patients who had repeated localising scans after a first localising scan that was negative, were identified. Of these, 39 did not undergo surgery. 11 out of these 39 patients (28%) had subsequent positive localisation scans, but no particular patient factors were predictive of gland localisation success. A large proportion of patients were managed conservatively, despite repeated sets of negative scans being done. Patients undergoing three or four sets of scans did not have imaging or surgical success. Conclusion A dedicated, streamlined parathyroid pathway should be followed whereby patients should be triaged for suitability for surgery prior to repeated imaging. A second set of scans should be offered when patients are unsuitable for conservative management and are willing and fit to undergo surgery. There is no merit to repeating scans more than twice.

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