Cancer rates are increased in people with diabetes. There is also recent evidence that outcomes from cancer treatment are worse in those with diabetes. There is a need to assess the prevalence of diabetes in cancer patients in order to tailor resources and improve clinical outcomes. This study examined the prevalence of diabetes and hyperglycaemia and specific referrals amongst hospitalised patients in a specialist cancer hospital. In a cancer hospital 11% of in-patients had either identified diabetes or hyperglycaemia (random blood glucose >11mmol/l.) Consecutive referrals to a diabetes consultant confirmed that over half of patients had gastro-intestinal tract primary cancers, over 20% had poor glycaemic control whilst on steroids, and 18% had poor glycaemic control during artificial nutrition. Referrals came from both medical and surgical teams. Thus diabetes and hyperglycaemia are common problems amongst in-patients with cancer, and these patients have complex diabetes requirement. Patients with cancer and diabetes need access to specialist diabetes care.

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Schizophrenia is one of the most wide-spread mental brain disorders with complex and largely unknown etiology. To characterize the impact of schizophrenia at a cellular level, we performed single nucleus RNA sequencing of >190,000 neurons from the dorsolateral prefrontal cortex of patients with schizophrenia and matched controls (7 vs 11, respectively). In addition, to correlate data with cortical anatomy, >100,000 neurons were analyzed topographically by immunohistochemistry in an extended cohort of cases with schizophrenia and controls (10 vs 10). Compositional analysis of RNA sequencing data revealed reduction in relative abundance across all families of GABAergic neurons and a concomitant increase in principal neurons, which was most pronounced for supragranular subtypes (layers 2-3). Moreover, supragranular subtypes of GABAergic interneurons showed most dramatic transcriptomic changes. These results were substantiated by histological analysis, which revealed a reduction in the density of calretinin, calbindin and parvalbumin GABAergic interneurons particularly in layer 2. Common effect of schizophrenia on supragranular neuronal networks was underlined by downregulation of protein processing genes and upregulation of neuronal development/plasticity genes across supragranular subtypes of principal neurons and GABAergic interneurons. In situ hybridization and spatial transcriptomics further confirmed supragranular layer neuron vulnerability, revealing complexity of schizophrenia-affected cortical circuits. These point towards general network impairment within supragranular layers being a core substrate associated with schizophrenia symptomatology.

The principal cause of death in post-menopausal women with diabetes is cardiovascular disease. Women who use hormone replacement therapy (HRT) have been shown to have a 50% reduction in their risk of coronary heart disease (CHD). The aim of this study was to determine if general practitioners prescribed HRTas frequently to women with diabetes as to other women of the same age. A prevalence study of HRTprescribing was carried out using a GP database. There were 788,933 women aged 45-79 years on the database, of whom 77% were prescribed HRT. The overall age-standardised rate ratio for HRT use in women with diabetes compared with women without diabetes was 0.71 (95% CI 0.64-0.78). Within the diabetic group, insulin-treated patients compared with those treated with hypoglycaemic agents were more likely to be prescribed HRT, with an age-standardised rate ratio of 7.37 (95% CI 7.06-7.62). The studyshows that general practitioners are less likely to prescribe HRT to women with diabetes despite the potential major benefits of a reduced incidence of CHD. Practical Diabetes Int 1 998; 15(3): 71 -72 Key words diabetes mellitus; hormone replacement therapy (HRT); prescribing ratesKey points 0 HRT use is associated with a 50% reduction in CHD. 0 Postmenopausal women with diabetes are at increased risk of CHD, so 0 Postmenopausal women with diabetes were found to be 30% less likely to HRTmay be an important therapeutic option. be prescribed HRT, compared with non-diabetic women. 2. Grodstein F, Stampfer MJ, Manson J, el ul. Postmenopausal estrogen and progestin use and the risk of cardiovascular disease. N Engl J Med 1996; 335(7): 4 5 3 6 1 3. Beard CM,KottkeTE,AnnegersJF,BallardDJ. The Rochester Coronary Heart Disease Project: effect of cigarette smoking, hypertension, diabetes, and steroidal estrogen use on coronary heart disease among 40-to 59year-old women, 1960 through 1982.

The rising incidence of type 2 diabetes in the developed world is already well established. There are, however, specific populations in the occident where there is an increase in type 2 diabetes, but unrelated to obesity. One such group is the HIV infected population. Associated with this increase in diabetes, there has been a similar rise in cardiovascular disease. This review article aims to outline the aetiological factors that may precipitate diabetes and cardiovascular disease in this group, and establishes the role of a specialist diabetes and HIV clinic in the management of these individuals. Copyright © 2005 John Wiley & Sons, Ltd.