The main side effect of SGLT-2 inhibitors appears to be an increase in genital infections, although concerns remain about the potential adverse effects of dehydration and electrolyte imbalance. Dapagliflozin is the SGLT-2 inhibitor that is the AZD6738 furthest along in development, and is currently in phase III clinical trials. In this review article we consider the role of the kidney in glucose homeostasis

in normal and diabetic subjects. We also review the history and concept of SGLT-2 inhibition, and discuss the future potential clinical utility of this promising new class of drugs. Copyright © 2010 John Wiley & Sons. “
“Malta is a small Mediterranean island with particularly distinct population and culture. It also has one of the highest rates of type 2 diabetes in the world. As a result it provides a unique microcosm of problems in diabetes care common across Europe. This study explores the effects of culture, religion and government organisation on the management of patients with diabetes. The cultures of patients, health care professionals and the Maltese government were examined in terms of their influence on the potential to deliver culturally relevant competent care. The results of this research indicate that national culture and local practices may have a detrimental influence on the management of diabetes in Malta. The findings

highlight the need for change if effective diabetes care is to be offered to the Maltese population.

These changes are related to a highly buy Selumetinib complex, poorly understood health care system, and to the way in which it is structured and the way health care processes are managed in this highly specific national and ethnic culture. Copyright © 2011 John Wiley & Sons. The number of people living Tacrolimus (FK506) with diabetes is increasing exponentially worldwide1 and Malta, a small island in the Mediterranean with a population of 400 000 inhabitants, is no exception. Currently, 10% of the Maltese population is living with diabetes, compared with 2–5% of its European neighbours.2 The increase in prevalence may be due to a combination of factors including changes in lifestyle, aging populations and genetic factors.3 Nevertheless, the increasing number of people living with diabetes is affecting the diabetes services, putting it under considerable strain and prompting the need for a major reorganisation of services.4 There is only one public hospital in Malta which serves the whole island. It is estimated that an average of 1100 patients living with diabetes visit the Diabetes Out-Patients’ Clinic at Mater Dei Hospital and to date the waiting time for a new case to be seen by a consultant inside this clinic is approximately 12 months.5 Health care in Malta is provided both publically and privately,6 and patients have the right to choose their preferred service.