In subjects with severe hypoglycemia suitable for islet transplantation, CSII decreased hypoglycemia frequency and glycemic variability compared with MDI whereas islet transplantation resolved hypoglycemia and further improved glycemic variability regardless of insulin independence.

Findings can be used by health professionals to inform people embarking on insulin pump therapy and prepare them with regard to expectations of the treatment. Further research is required to explore the role of diabetes health professional in providing psychosocial support to people with type 1 diabetes on insulin pump therapy.

Aims and objectives: To identify innovative new strategies to maintain optimal care for patients with diabetes while in hospital. Background: The ongoing escalation in the incidence of diabetes is contributing to a growing burden associated with diabetes management. Design: Mixed methods underpinned by Appreciative Inquiry. Methods: Online survey (n=173) and focus group interviews with nurses and midwives (n=40), and individual interviews with recently discharged hospital patients (n=6). Results: Suggest a need for further education and knowledge on diabetes management for nursing, midwifery, medical and ancillary staff. This, together with improved communication and team work, is required to prevent delays in prescribing and reviewing insulin requirements, along with timely access to appropriate food for people with diabetes. Conclusions: In seeking solutions to the challenges in caring for hospitalised patients with diabetes there is a need to work across the entire hospital workforce and to develop effective and efficient methods for ensuring appropriate skills and knowledge of diabetes management for staff across complex and rapidly changing hospital systems.

The significance of this paper lies in the uncovering of ontological understandings and tacit knowledge of how consultant nurses and midwives optimise patient care delivery in challenging situations. The findings indicate, however, that the value of these internationally established roles is yet to be fully realised. The paper concludes by recommending strategies to assist newly appointed clinical nurse/midwifery consultants transition into these demanding autonomous roles.