There was little variation between practitioners in the procedure of converting patients to insulin therapy. This procedure forms an important part of a diabetes nurse's workload. The nurses adapted their approach to individual patients depending on their needs although some common themes emerged during the interviews.

This study confirms, in a new UK population with over 121,002 eligible patients, that there is a statistically significant drop in patients with diabetes taking up cardiac rehabilitation. This study is unique in looking at all four key diagnosis and treatment groups and comparing them to those taking up cardiac rehabilitation. To achieve the target of 65% uptake set by NHS England, improvements in identifying and targeting complex patients, such as those with diabetes, need to be adopted.

With one person dying from diabetes-related preventable complications, including foot complications, every 7 seconds across the world, it is clear this is a major health challenge. Foot ulceration in diabetes remains the commonest reason for hospital admission in Western countries. From neuropathy to peripheral vascular disease, the challenges are significant and can result in premature death, but early diagnosis by aware health-care professionals, combined with supporting people in self-care, can help reduce the problems of diabetes to manageable proportions.

The following literature review will focus on sexual dysfunction in women living with diabetes, drawing on international studies in this specialist field. The key aim of this paper is generate a greater understanding and recognition of the issues facing these women and to determine a more proactive approach to identification, consultation and potential treatment options. The main findings highlight the unique role practitioners have with women with diabetes and how to facilitate partnership working. Nurses have the most frequent contact with people living with diabetes in any healthcare system. Nurses' knowledge about sexuality in relation to diabetes should improve patient education, recognition and could signal undiagnosed or increased risk of sexual dysfunction to enable treatment so care can be optimised accordingly (Sivrikaya et al, 2014).

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