A 76-year-old man with a 17-year history of type 2 diabetes mellitus attended for his annual review. Comparison of his retinal screening report with the previous year’s report showed that his visual acuity was unchanged at 6/9 in both eyes. The previous year’s right eye retinal image had been reported as ‘pre-proliferative retinopathy’, whereas this year’s was reported as ‘pre-proliferative retinopathy with maculopathy’.

What is the most appropriate next step?

A 73-year-old man with type 2 diabetes mellitus was reviewed because of deteriorating blood glucose control. He was taking metformin 850 mg twice daily.

On examination, his body mass index was 29 kg/m2 (18–25).

Investigations:

serum creatinine102 µmol/L (60–110)

haemoglobin A1c66 mmol/mol (20–42)

According to the NICE guidelines (CG87, May 2009), what would be the most appropriate additional treatment?

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?