Clin Med
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An increasing number of people with type 1 diabetes mellitus are using insulin pump therapy, also known as continuous subcutaneous insulin infusion therapy (CSII). Most patients using pumps are safest remaining on CSII if admitted to hospital, unless incapacitated. This review provides the generalist physician with a framework to guide the management of such patients, although one should always seek specialist diabetes advice where available.
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One percent of laboratory samples are rejected as 'unsuitable for analysis’. Although this may be due to incorrect handling, a proportion are attributable to underlying pathology affecting serum, contamination or artefact. In this Lesson of the month we present two case reports. ⋯ In both cases, the laboratory comments had important diagnostic implications. Early identification of lipaemic serum from hypertriglyceridaemic pancreatitis in the first case allowed directed therapy with insulin, and hyperviscous serum from lymphoma in the second allowed directed therapy with plasma exchange and chemotherapy. Other causes of analyser artefact are tabulated to serve as a useful template for hospital doctors in considering underlying causes and practical solutions.