We've changed the way you complete courses

In response to user feedback we have simplified the way courses can be completed.

Until now you needed to complete the topics and modules in order, from start to finish. But from today you can complete them in any order you wish.

Just visit any topic that interests you, and when you are ready mark it as completed by clicking the green 'Mark complete' button at the bottom of the page.

Once you have completed all of the topics in a module an assessment will be provided for you.

Complete all the assessments to finish the course.

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Play the video to watch Professor Chantal Mathieu describe the findings
An interesting study is the REMOVAL study, where they wanted to see whether adding metformin to intensive insulin therapy in people with type 1 diabetes could remove atherosclerotic lesions in the carotid arteries, by measuring intima-media thickness. Now, the study was negative - metformin did not improve intima-media thickness, but it was an interesting study because it allowed us to see what metformin could do on haemoglobin A1c levels, weight, and also insulin dose, when added to intensive insulin therapy in people with type 1 diabetes. Metformin lowered haemoglobin A1c in the first months of treatment, but then progressively, haemoglobin A1c levels caught up with those seen in placebo treated patients. There was a difference in weight, and there was also a reduction in insulin dose but these reductions were quite small. Also there was a price to pay - there was an increase in people who were deficient in vitamin B12.

The REMOVAL study showed some interesting findings regarding what metformin could do on HbA1c levels, weight and insulin dose.

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Petrie JR, Chaturvedi N, Ford I, Brouwers MCGJ, Greenlaw N, Tillin T, Hramiak I, Hughes AD, Jenkins AJ, Klein BEK, Klein R, Ooi TC, Rossing P, Stehouwer CDA, Sattar N, Colhoun HM; REMOVAL Study Group. Cardiovascular and metabolic effects of metformin in patients with type 1 diabetes (REMOVAL): a double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol. 2017 Aug;5(8):597-609