News in brief: Endocrinologists recognised in College awards; One in seven surgical patients risk DKA with SGLT2i therapy; Rethink your imaging requests to cut carbon footprint

17 May 2022

Endocrinologists recognised in College awards

Two endocrinologists have been recognised for their contributions to the speciality at the RACP congress in Melbourne.

Professor Alicia Jenkins was granted the RACP International Medal, an award recognising members who have provided outstanding service in developing countries.

A clinical endocrinologist and lipidologist based in Sydney, Professor Jenkins had dedicated much of her life to improving the plight of some of the world’s poorest patients in disadvantaged regions, the RACP said.

Her work included more than two decades on the board of Insulin for Life (IFL), an NGO providing in-date unopened diabetes supplies from nine affluent countries to clinics in over 30 third world nations.

It also supported locally-led clinics for young patients along with community education and diabetes screening, the college said.

Besides her charitable work, she was also director of diabetes and vascular medicine at the NHMRC Clinical Trials Centre (CTC), a flagship research organisation at the University of Sydney.

The prestigious 2022 College Medal went to Professor Susan Davis AO, an NHMRC Senior Principal Research Fellow and head of Monash University Women’s Health Research Program.

Professor Davis also heads the Specialist Women’s Health Clinic at Alfred Hospital Melbourne and is past president of the Australian and International Menopause Societies.

“Her research spans basic science to clinical trials and has been pivotal in our understanding of sex hormones in women, notably in relation to menopause and testosterone,” the RACP said.

“She has over 435 peer-reviewed publications and has received numerous national and international prestigious awards.”

“She provides a voice for women and physicians to influence government policy.”

Both award recipients received free registration plus travel and accommodation to attend the RACP congress, held last week.

One in seven surgical patients risk DKA with SGLT2i therapy

Vigilance is needed in identifying SGLT2i use in cardiac surgery patients, according to WA clinicians who found that one in seven of their diabetes patients taking the agents experienced perioperative diabetic ketoacidosis (DKA).

A review of outcomes for 685 patients with diabetes who underwent cardiac surgery identified 55 patients as taking a SGLT2i in the perioperative period. Of the 39 patients who were still taking SGLT2is at the time of the operation, 15% developed DKA post-operatively in the ICU, compared to a DKA rate of 0.5% in non-SGLT2i-treated patients.

Reporting their findings in the Internal Medicine Journal, Dr Michael McCann and colleagues noted that intravenous insulin in the first 24 hours after surgery was associated with a significantly lower risk of DKA in SGLT2i patients.

They drew attention to current guidelines which advise that elective cardiac surgery patients should cease SGLT2i medications at least 48 hours before the day of surgery.

“In patients who are critically ill and unable to cease these medications due to urgent surgery, routine prophylactic insulin administration should be considered to reduce the risk of DKA,” they advised.

Rethink your imaging requests to cut carbon footprint

Clinicians are being urged to reduce the healthcare carbon footprint by adopting a three-pronged strategy to make more efficient use of diagnostic imaging.

Diagnostic imaging and pathology testing account for almost 10% of the hospital carbon footprint, with MRI and CT scans accounting for a high proportion of it, a Melbourne University study has shown.

The carbon emissions from an MRI were equivalent to driving a car for 145 km, while a CT scan carbon emission was equal to driving 76 km, the findings in Lancet Regional Health showed.

Much of the large carbon footprint was due to electricity use by scanners, and in particular, their standby power use, said the researchers, who recommended that clinicians and administrators make efforts to reduce unnecessary imaging and/or switch imaging to a lower carbon modality such as X-rays.

Other carbon footprint reduction tips include turning scanners off when they are not required rather than leaving them on standby and ensuring existing scanners have high utilisation rates, the researchers suggested.

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