When is diabetes not T1D, T2D or monogenic diabetes? When it’s a completely new diabetes identified in Africa.

Doctors have a responsibility to lead change in healthcare to make it more sustainable, we have a responsibility to the people we care for now and those that come after us.

I’ve been leading a switch to reusable insulin pens in Devon. It’s a small change with massive impact.

If you’re interested in switching to reusables locally, DM me.

We’re happy to share the data, pathway, and lessons. Let’s scale this together. ♻️

#GreenerNHS #SustainableHealthcare #DiabetesCare #ClimateHealth #PenSwitch #EPCA2025

Winning this was a massive surprise the other finalists were national and global leaders.

But it reminded me:
🧢 Sometimes you just have to put your hat in the ring.

Huge thanks to @deepthilavu.bsky.social academic GP and co-lead to PenSwitch’s success.

And to @uhpnhs.bsky.social research team for supporting me to attend and represent our region on an international stage. 🌍

We piloted this (on a shoe string) across diabetes services in Devon. What started as a sustainability idea quickly became a better way to deliver care.

It’s greener, cheaper, less wasteful and still great for people living with diabetes.

PenSwitch is our project switching from disposable to reusable insulin pens.
It’s simple. But the results speak for themselves 👇

✅ 90% less plastic
✅ 40% lower carbon footprint
✅ 1–5% of the cost
✅ 4x fewer sharps bins
✅ Fridge space saved!
✅ 86% of people living with diabetes switch when offered

🚨 We won the @rcphysicians.bsky.social #EPCA2025 award for Sustainability in Patient Care!
Absolutely thrilled and honestly surprised. Here’s the story of #PenSwitch and why it matters. 🧵

Purple graphic featuring cuts from the summer issue of The Endocrinologist and the Society for Endocrinology logo. Text reads "Discover the latest hot topics from The Endocrinologist!"

Have you read the summer issue of The #Endocrinologist yet? 📰

Here are our editorial board’s picks of the ‘hot’ papers from the Society's journals and beyond. @joendocrinology.bsky.social @endocancer.bsky.social @natmetabolism.nature.com

Dive into the latest hot topics here 👉 bit.ly/3TTIn6f

Finalists | RCP Medical Care

Reusable insulin pens =
🌍 40% fewer carbon emissions
♻️ 90% less plastic
💷 5% lower prescription costs

Proud our project “Pen Switch” is a finalist for @rcphysicians.bsky.social #EPCA2025 in Sustainability!

Greener care starts with smarter prescribing.
More: medicalcare.rcp.ac.uk/excellence-i...

The NHS is responsible for 4% of England’s carbon footprint, 30-40% of which comes from pharmaceuticals.

If we are to avert global temperature increases of 2 Celsius then we have to change our behaviour.

One easy switch in diabetes care is moving to a reusable insulin pen.

5-drug precision prescribing for people with type 2 diabetes is here

Our model for optimising glucose lowering therapy using low-cost routine clinical features published in the Lancet today

Paper: thelancet.com/journals/lan...

Try the web tool here: diabetesgenes.org/t2-treatment/

Interested in sustainable diabetes care?

Come to my talk at #DUKPC25 tomorrow 11:00-12:00 in the exhibition hall.

Interested in a PhD & have strong computational skills ? Study diabetes & heart disease using peta bytes of human genetic & medical record data. In a lovely central European location and as part of a cohort of Genomics and Digital Health students : lifesciencesphd.unige.ch/jobs

If we are to reach net zero by 2040 then we have to start changing the way we work.

One easy thing you can do as a Diabetologist, DSN or GP is to switch individuals on insulin to reusable cartridge pens.

By switching you can ⬇️ plastic waste by 89% and CO2 by 40%

It’s International Day of Women and Girls in Science! Thank you to all the amazingly talented and hard working women in science who are helping us to better understand the world.
#WomenInScience

If you’re treating DKA remember to use a fixed rate insulin infusion to bring down the ketones, don’t stop the insulin if the glucose drops below 14 mmol/L.

Instead add IV glucose!

If you’re checking a serum cortisol (i.e. total cortisol) be mindful that oral oestrogen can increase CBG making free cortisol (i.e the active component) lower.

Don’t be falsely reassured, if in doubt repeat off oral oestrogen!