Sharps Bins disposal

Cornwall Council: sharps bins collections information or 0300 1234 141

Isles of Scilly Council: For advice and disposal arrangements please contact St Mary's Hospital on 01720 422392

• NICE NG28 Type 2 diabetes in adults: management
• NICE NG17 Type 1 diabetes in adults: diagnosis and management
• NG18 Diabetes (type 1 and type 2) in children and young people: diagnosis and management
• Semaglutide (Ozempic) setting pre-set quantities in GP practice systems to prevent overprescribing
• Guidelines for Blood Glucose Monitoring in Adults 2024
• Lancet factsheet V4 (2024)
• Needles for Pen Injectors factsheet V4 (2024)

Hormone replacement therapy

Adapted from Drug Safety Update Sep 2007

HRT effectively relieves vasomotor symptoms. In most cases, 2 - 3 years’ therapy is sufficient, but some women may need longer - this judgement should be made on a case-by-case basis with regular attempts to discontinue. Symptoms may recur for a short time after stopping HRT.

For all women, the lowest effective dose should be used for the shortest time.

Information on the risks and benefits associated with HRT can be found in the BNF, Chapter 6.4.

Osteoporosis

HRT is effective for prevention and treatment of osteoporosis, but its beneficial effect on bone diminishes after stopping treatment.

Because of the risks associated with long-term use, HRT should be used for prevention of osteoporosis only in women who are unable to use other medicines that are authorised for this purpose, or have troublesome symptoms.

Maintenance of bone density will be achieved with all currently available regimes / doses (although not all oestrogen preparations are licensed for osteoporosis prophylaxis). Doses of 2 mg estradiol valerate, 2 mg micronised estradiol, 625 micrograms conjugated oestrogen, or 50 micrograms transdermal oestrogen will increase bone density in osteopaenic and osteoporotic women.

Hence before prescribing HRT:

• The decision to prescribe HRT should be based on a thorough evaluation of the potential benefits and potential risks of treatment
• Healthcare professionals should assess every woman’s overall risk, including cardiovascular risk, particularly in those older than 60 years who have increased baseline risk of serious adverse events
• Evidence for the risks of HRT in women who had premature menopause is limited. However, the baseline risk of adverse events in these younger women is low, and the balance of benefits and risks may be more favourable than in older women.