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Background: Perioperative diabetes management has become increasingly complex; management is often inconsistent resulting in dysglycaemia and associated morbidity. Aim:To evaluate a structured pre-admission perioperative diabetes management plan (PDMP) for safe and appropriate recommendation, prescription and administration of diabetes medications in the perioperative period for people with diabetes undergoing elective, non-cardiac surgery.Methods: A multidisciplinary team developed the intervention, a structured PDMP (including diabetes medication reconciliation, management guide, individualised plan) to standardise optimal perioperative diabetes management. A single centre prospective pre-and post-intervention pilot study was performed, including all individuals with diabetes medications attending the pre-admissions clinic during two 4-month periods (February to May) in 2016 (control period) and 2017 (intervention period). The primary outcome was appropriate recommendation, prescription and administration of diabetes medications (including insulin), according to the PDMP, in the perioperative period. Secondary outcomes measures were glycaemia. Analysis was by intention to treat.Results: Control and intervention groups included 131 and 133 participants, respectively; they were well matched in clinical characteristics. The PDMP was completed correctly in 100 (75%) individuals in the intervention group. The appropriate use of diabetes medications increased from 30% in the control group to 71% in the intervention group (p < 0.001). Following the PDMP implementations, glycaemia improved in the overall perioperative period (8.7 ± 2.9 vs. 9.8 ± 3.3 mmol/L, p = 0.005) and at all time points (from admission and over entire hospital stay).

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A new inquiry into the archaeology of north-eastern Anatolia was initiated in the summer of 1990 at Büyüktepe Höyük, alternatively called İkiztepe. Located about 1·8 km. north of the village of Çiftetaş, in the mountain-girdled Bayburt plain, some 1500 m. above the level of the Black Sea, the site comprises layers of human occupation stretched across two distinct natural hills joined by a saddle (Figs 1–3). Orientated along a northwest–southeast axis, Büyüktepe rises impressively some 20 m. above the floor of the Beşpınar valley. In a direct line from Bayburt, Büyüktepe is only 30 km. to the southwest, although, if one follows the Bayburt to Demirözü road, the distance is increased to about 35 km. From the village of Çiftetaş, a track leads to Büyüktepe and bifurcates roughly 350 m. from its southern end. One branch skirts its eastern base on its way to Çayıryolu; the other runs toward the spurs of Baltakaya Tepesi which were also settled in antiquity.