A 34-year-old man was referred to the diabetes outpatient clinic with impaired glucose tolerance. He had a family history of diabetes mellitus and had a body mass index of 34.6 kg/m2 (18–25).

On examination, his blood pressure was 140/82 mmHg.

He wished to delay the onset of frank diabetes mellitus.

What is the most effective way of achieving this outcome?

A 26-year-old woman with type 1 diabetes mellitus was seen in the antenatal diabetes clinic and was 8 weeks pregnant. The father of her child also had type 1 diabetes mellitus. They were concerned that their child might develop type 1 diabetes mellitus.

What is the likelihood of the child developing type 1 diabetes mellitus?

A 33-year-old woman was reviewed in the insulin pump clinic. She had had type 1 diabetes mellitus for 10 years. She had been treated with a continuous subcutaneous insulin infusion 3 years previously, because of frequent hypoglycaemic episodes. She had recently undergone continuous glucose monitoring (see image).

Investigations:

haemoglobin A1c43 mmol/mol (20–42)

What is the most likely cause of the blood glucose trace seen between 08.00 h and 10.00 h?