Over the past ten years there have been guidelines that have been produced regarding the management of individuals with diabetes undergoing a surgical procedure. This clinical audit will be focusing on the area of orthopaedics and the standards of care received by individuals with diabetes. The audit examined retrospectively; the care received in a large acute NHS trust with a sample of 78 adult individuals with diabetes. Ten audit criteria were reviewed and evaluated and compared to the guidance that is currently available nationally. Both emergency and elective procedures were assessed to see if there were any variances in the management of individuals with diabetes. On review of the results, a number of recommendations will be put forward to the trust with regards to changes that should be implemented to enhance patient care.

Albuminuria is the most characteristic marker of diabetic nephropathy (DN), which is a diabetic complication associated with DN progression. However, renal functions decreased by about one-third of diabetic patients before the occurrence of albuminuria. We study the role of telomere length (TL) of blood leukocytes, some inflammatory markers in the progression of DN in patients with type 1 diabetes (T1D). Volunteers were selected and distributed into four groups: group 1 included 20 healthy subjects as control, group 2: 20 T1D patients with albumin excretion rate (AER) < 30 mg/gm creatinine, group 3: 15 T1D patients with (300 > AER > 30 mg/gm creatinine), group 4: 15 T1D patients with (AER > 300 mg/gm creatinine) and group 5 (DN group), which is a collective group between group 3 and group 4. Glycated haemoglobin (HbA1c), serum urea, creatinine, malondialdehyde (MDA), 8-OHdG, and TL in leukocytes were measured. Results showed a significant increase in HbA1c, creatinine, urea, 8-OHdG, transforming growth factor β1 (TGF-β1), MDA and decrease in TL in G2, G3, G4, and G5 compared with control with a p-value < 0.05.