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Foot ulceration in diabetic patients is a serious complication, with the potentially devastating possibility of lower limb amputation. We describe six patients with type 2 diabetes who all developed significant neuropathic foot ulceration during holidays, mostly in hot countries abroad. All were male, aged 52–62, and one patient developed three ulcers on the same foot on three consecutive holidays, the last one resulting in a below knee amputation. The specific causes of ulceration were often related to walking barefoot (on sand, shingle or hot flagstones), or wearing inadvisable beach footwear. The association of poor educational compliance and a high‐risk environment may lead to this specific ‘diabetic holiday foot syndrome’. Intensive warning education prior to at‐risk patients going on holiday may help prevent this serious complication. Copyright © 2001 John Wiley & Sons, Ltd.

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Objective. To describe a patient with unilateral exudative pleural effusion that developed after commencement of carbimazole. Methods. We describe the presentation and clinical journey of an elderly woman who presented to the chest physicians initially with pleural effusion but was followed up by the endocrinology team. Result. The patient was a 77-year-old Caucasian woman who presented with symptoms of breathlessness and a confirmed unilateral pleural effusion while being on treatment for thyrotoxicosis. Her symptoms needed recurrent hospital admission for investigations and drainage, but no potential cause was identified after extensive investigations. A drug-induced exudative effusion consequent to carbimazole intake was diagnosed as discontinuation of the drug lead to complete resolution of the effusion with no recurrence. Conclusion. Physicians and Endocrinologist must bear in mind that this potentially rare complication of carbimazole while treating patients of thyrotoxicosis as appearance of similar features in their patients while being on carbimazole should lead to the discontinuation of the drug, and alternative treatment strategy should be considered.

Clinical trials have demonstrated that treatment of hypertension in patients with diabetes can reduce microvascular and macrovascular complications. The aim of this study was to measure the prevalence of normotension, untreated and treated hypertension and to assess whether targets based on current recommended guidelines had been achieved. We undertook a cross‐sectional, analytic prospective study of consecutive patients attending a diabetes clinic in a district general hospital in the UK (n =1631; 86% participation). Blood pressure (BP) was measured using the average of two clinic readings and the type and frequency of use of antihypertensive agents were recorded using a questionnaire. In 220 patients with type 1 diabetes, the mean BP was 129/77mmHg. Twenty‐six per cent were hypertensive, with BP greater than 140/90mmHg, 95% of the hypertensive patients were prescribed treatment and 76% had reached a target BP of 140/80mmHg. In 1411 patients with type 2 diabetes, the mean BP was 147/82mmHg, 51% were hypertensive with 90% prescribed treatment but only 52% reaching target BP recommendations. The results of the study show that hypertensive diabetic patients are being identified and the majority are being prescribed treatment, but in patients with type 2 diabetes, the target BP recommendations are not being achieved. The study underlines the need for more aggressive antihypertensive therapy in hypertensive patients with diabetes. Copyright © 2003 John Wiley & Sons, Ltd.