Saturday 29 December 2012

Self-learning stations for CPR

This Belgian study looked at whether sophisticated self-learning stations for CPR were as good as instructor-led stations. [1]

They used a Resusci Anne Skills Station which was installed in a small room. 235 nurses were then randomized to Self-Learning or Instructor-led training and they were assessed at 1 and 7 months for depth of compression, compression rate, release, and mean ventilation volume.

It seems that the traditional instructor-led groups did better than the self-learning groups for this particular type of practical skill. I wonder if they integrated the self-learning more closely to the workplace and work activities they may have got a better outcome. Worth investigating further and no doubt the Resusci Anne automated instruction system will improve.

1. Monsieurs KG, De Regge M, Schelfout S, D’Hondt F, Mpotos N, Valcke M, Calle PA. Efficacy of a self-learning station for basic life support refresher training in a hospital: a randomized controlled trial. Eur J Emerg Med 2012 Aug;19(4):214–219.

Friday 9 November 2012

Liverpool Care Pathway

Good talk at the departmental meeting today on the integrated care pathway for the dying patient (aka. Liverpool Care Pathway for the Dying Patient (LCP)) which covered a lot of the recent media coverage.

Cancer expert who treated Mo Mowlam brands Liverpool Care Pathway 'the most corrupt practice in British medicine'
Mo Mowlam's doctor condemns Liverpool Care Pathway
The Liverpool Care Pathway leads away from pain
Liverpool Care Pathway: minister orders report into cash rewards
'A dog would have been treated better': Daughter's heartbreak over father's death after he was put on Liverpool Care Pathway without family's permission
Liverpool Care Pathway: Relatives 'must be informed'
Hospitals bribed to put patients on pathway to death: Cash incentive for NHS trusts that meet targets on Liverpool Care Pathway
Doctors defend Liverpool Care Pathway as 'dignified' way to die

A figure came up (in our discussion) that someone had read a report in the newspapers that the average time on the pathway is 33 days but that must have been a mistake - more like 33 hours.

The LCP was developed by a team led by John Ellershaw Consultant (now Professor) in palliative care from Marie Curie Centre, Speke Road Woolton, Liverpool [1] and has been demonstrated to be useful in other specialties [2].

When it won NHS Beacon status in 2000 it was referred to as the LCPDP. I think its name should have always been used in full 'Liverpool Care Pathway of care for the Dying Patient LCPDP' to prevent suspicion of some euphemistic cover for some other agenda. However, it's probably now too late as everyone has heard the term. There's a lot to be said for a name that is clear and clinical. Perhaps it was inevitable that the 'for the Dying Patient' was dropped when non-clinical staff were trumpeting its uptake.

The general mood in our meeting was one of incredulity that politicians and the media simply didn't understand the practicalities of caring for people who die.

1. Ellershaw et al. (1997) Developing an integrated care pathway for the dying patient. Eur.J Pall Care. 4 (6): 203-207
2. Jack C, Jones L, Jack BA, Gambles M, Murphy D, Ellershaw JE. Towards a good death: the impact of the care of the dying pathway in an acute stroke unit. Age Ageing 2004 Nov;33(6):625–626.

Monday 22 October 2012

Pancreatic extracts in the treatment of diabetes mellitus - classic paper

We've been having a 'extra-curricular' discussion on historical aspects of diabetes on the Postgraduate Diploma course.

I just found this open access copy of the full text of the classic paper from 1922 and thought I'd share it.

It describes the very first cases (seven to the date of the article) of the use of insulin in the treatment of people with Type 1 Diabetes. Reading it makes you relive the palpable excitement of the discovery. Classic.
"Patients report a complete relief from the subjective symptoms of the disease. The sugar excretion shows marked decrease or, if dosage be adequate, disappears. Ketonuria is abolished, thus confirming a similar observation by Collip in diabetic animals (results as yet unpublished)."
Banting FG, Best CH, Collip JB, Campell WR, Fletcher AA (1922). Pancreatic extracts in the treatment of diabetes mellitus. Canadian Medical Association Journal 12: 141 - 146.

iGel supraglottic airway for resuscitation

I had mandatory training at my NHS Trust last week and got to play with quite marvellous device - the iGel supraglottic airway.

OK it probably shows how little acute medicine I do but this was a much better experience than the usual 'tooth cracking' struggle with an ET tube.

On the manikin at least it seemed quite straight forward to get a secure airway sufficient for CPR.

The device is used as an initial airway choice in resuscitation and a case series from Gloucester of 100 resuscitations gives some evidence of its effectiveness in practice [1]. This is the practice in our hospital and the anaesthetist then makes the decision on what to use for airways management when they arrive at the crash call.

I wouldn't be confident about its ability to prevent aspiration but it is clearly more useful for airway control by novices until someone experienced at endotracheal intubation arrives.


1. Larkin C, King B, D’Agapeyeff A, Gabbott D. iGel supraglottic airway use during hospital cardiopulmonary resuscitation. Resuscitation 2012 Jun;83(6):e141. Available from: http://www.resuscitationjournal.com/article/S0300-9572(12)00124-4/fulltext

Saturday 13 October 2012

Do you want a reprint with that? My 'bad pharma Friday'.

"Yes", I said, vaguely remembering the debate on aldosterone antagonists from a couple of years ago but not being able to recall exactly what it was all about.

We had a presentation in the hospital from a Pfizer rep on their drug eplerenone (Inspra) and it went through the results of the EMPHASIS-HF trial [1] talking about how that  has affected the European Society of Cardiology guidelines for heart failure and how the local cardiologists apparently 'use it anyway'.

A reprint of the EMPHASIS-HF trial was offered and I then saw that, yes, it was a Pfizer-sponsored trial of eplerenone against placebo. Also, it did not include the accompanying editorial in the same issue of the NEJM by Paul Amstrong.

There are two issues here:
  • Selective reporting of evidence. It was not made clear that the major change to the guidelines was in the placement of mineralocorticoid antagonists (spironolactone AND eplerenone) ahead of ARBs which state: "ARBs are no longer the first choice recommendation in patients with HF and an EF ≤40% who remain symptomatic despite optimal treatment with an ACE inhibitor and beta-blocker. This is because in EMPHASIS-HF, eplerenone led to a larger reduction in morbidity–mortality than seen in the ARB ‘add-on’ trials discussed below, and because in both the Randomized Aldactone Evaluation Study (RALES) and EMPHASIS-HF, MRA treatment reduced all-cause mortality, whereas ARB 'add-on' treatment did not.". The RALES trial showed the benefits of spironolactone in a similar group of patients [2].
  • Selective reporting of opinion. The editorial commentary which suggested that the more expensive eplerenone should be reserved for those who do not tolerate spironolactone was not addressed. Notice also how the Pfizer-sponsored trial is freely available on NEJM but the accompanying editorial is not. Shame on you NEJM. Freely available copies of the editorial are available here, and here. Other commentators agree. As our National Prescribing Centre (NICE) points out "the results are consistent with those seen with spironolactone in the RALES study".
Now I'm no cardiologist and I haven't ever prescribed eplerenone but, to me, my 'bad pharma Friday' looked like a bit of a demonstration of nice outcomes data of a slightly better tolerated but patented expensive drug versus placebo whilst hiding the real debate about its position in the treatment algorithms compared with another effective, off-patent, much cheaper drug.

Time to read my Kindle copy of Ben Goldacre's new book 'Bad Pharma' I think.

1. Zannad F, McMurray JJV, Krum H, van Veldhuisen DJ, Swedberg K, Shi H, Vincent J, Pocock SJ, Pitt B. Eplerenone in patients with systolic heart failure and mild symptoms. N. Engl. J. Med. 2011 Jan;364(1):11–21.

2. Pitt B, Zannad F, Remme WJ, Cody R, Castaigne A, Perez A, Palensky J, Wittes J. The effect of spironolactone on morbidity and mortality in patients with severe heart failure. Randomized Aldactone Evaluation Study Investigators. N. Engl. J. Med. 1999 Sep;341(10):709–717.

Sunday 23 September 2012

Start of diabetes term!

The Diabetes Qualifications and Courses website http://online.qualificationsandcourses.bmj.com/ has been taking up a lot of my time this last week. We've been working hard on it to ensure that it is ready for the launch of the new 'term' tomorrow.

There are three simultaneous modules running with over 300 students, and more than 20 tutors showing how quickly the course has grown since its launch in May 2011. The technical team have done wonders with the new Moodle cloud-based platform and the designers have reworked the new logo.

The course is a collaboration between BMJ Learning and University of Leicester and is a very rewarding, social learning environment looking at Masters level study in diabetes for healthcare professionals. Whilst the majority of students are currently doctors last year saw an entire intake of Diabetes Nurse Educators from the Middle East.

Being the digital steward for this course is really enjoyable and we are looking to bring in many new ideas for supporting the programme.

Saturday 22 September 2012

Follow-up costs of bariatric surgery

There's an article in JAMA about the costs of care in those who have bariatric surgery. This Swedish cohort looked at 20 years' of follow-up after obesity surgery.

It seems that the costs for the first 6 years are higher in those that are surgically treated - more days spent in hospital, more outpatient visits - but after that the costs of care were in fact lower in the surgically treated group.

The authors conclude - "surgically treated patients used more inpatient and nonprimary outpatient care during the first 6-year period after undergoing bariatric surgery but not thereafter. Drug costs from years 7 through 20 were lower for surgery patients than for control patients."

Although the procedure used in these patients was different to that used now this data helps with the planning of ongoing care of people undergoing obesity surgery.

1. Neovius M, Narbro K, Keating C, Peltonen M, Sjöholm K, Agren G, Sjöström L, Carlsson L. Health care use during 20 years following bariatric surgery. JAMA 2012 Sep;308(11):1132–1141.

Friday 7 September 2012

Medical Education & Social Media

New opportunities to connect people will improve learning

This is a short review I wrote for the IDEACON conference brochure souvenir that ran in India in July. I've included it here with some corrections. Comments and flames welcomed! :-)

Medical education could benefit from new forms of communication between health professionals made possible through social media - a collection of technologies that use the Internet to connect people. These technologies will be familiar to many and include Twitter, Facebook, LinkedIn and Google+. These social media create connections between individuals and form networks within which information is shared. In this short review I will outline some of the opportunities and challenges facing the use of social media and medical education. I will not focus on any particular form of medical education so the discussion includes undergraduate and postgraduate.

Although there have always been networks and communities of physicians it has not been on a scale and immediacy that is now possible with social media. In the past the size of communities was restricted by geography and slower modes of communication. This has broadened in recent decades. For example, the use of Twitter at conferences has increased and can be "successfully used by physicians ... to engage in clinical discussions" even if the author is not present at the event [1]. Scientists see social media as a critical form of communication [2], especially with the public, but also with colleagues and experts within and outside their disciplines. Some academics have called for the career recognition of the open, digital and networked exchange of information [3]. They argue that publishing should not be seen as a restricted, academic activity within journals but as part of a more open discourse and discovery.

The adoption of social media technologies has been rapid. The telephone took 100 years to be used by 50% of UK households. Facebook has taken just 5 years to reach 50% of the UK population and the most rapidly adopting group is now those aged over 50 [4]. However, social media can blur the distinction between professional and personal lives making professionalism and social media an uneasy mix [5]. There have been many reports of inadvertent disclosure of confidential information and public displays of unprofessional behaviour which have led many to look in horror at what social media could do to the profession. Doctors associations [6] have published - and regulators are drafting [7] - guidance on the use of social media.

However, I'd argue that social media and other new technologies are here to stay and we should become familiar with them. How can they be used in medical education? How should they be used to increase our knowledge and the reach of our profession?

Behaviourist, Cognitive and Social Theories of Learning have helped shape the design of medical education with lectures, small group and clinical attachments being familiar to most. Over the past decade the educational use of technology has become mainstream in medical education [8]. These various types of "e-learning [are] neither inherently superior nor inferior to traditional instruction; rather they are different and complementary" [9]. When tested against traditional teaching they often achieve the same levels of educational outcomes. What they do offer, by their very nature, is the opportunity for broader involvement, asynchronous communication, and more convenience for busy clinical schedules.

Recent theories of learning can be viewed as frameworks explaining how a particular type of learning takes place. Two of these learning theories I will describe further with reference to how social media can be successfully used in medical education.

Communities of Practice

Lave and Wenger's work on situated (workplace) learning has been extended to describe communities in the digital habitats [10] within which modern practitioners share the passion and expertise of their work. A Community of Practice has three dimensions of domain, practice and community. The domain is the area that participants have in common. The practice is the shared expertise that they have within that domain and the community consists of the social links between members of the Community of Practice.

The Facebook group "Key Opinion Leaders (KOL) blog on Diabetes and Endocrinology" [11] is an example of a Community of Practice of doctors, academics and the pharmaceutical industry based mainly in India. The domain is the scientific evidence in the field of diabetes and endocrinology. The practice is the critical appraisal skills and aggregation of information in the medical literature. The community is the social links between the members many of whom are based in India and discuss football and conferences alongside the discussions of new scientific findings. Facebook acts as the communication technology between members of the group allowing them to interact with each other at times that are convenient to each individual. The group has been set up and is monitored by some core individuals who perform the duties of digital stewardship - continually experimenting with and evaluating the usefulness of the technology to the needs of the group.

You are probably part of a community of practice already. Some communities have used the digital ecologies including social media but this is only useful if the community of practice finds it of value.

Connectivism

George Siemens has proposed a learning theory called Connectivism which at its core is the concept of amplification where "learning, knowledge and understanding [can be amplified] through the extension of a personal network" [12]. This is extension is, in part, through the digital, networked world. Learning takes place in a complex and changing environment where individuals have increasing levels of specialisation. By connecting these specialist 'nodes' to each other there is the ability to enact new domains of knowledge. For example, the SARS virus was discovered through a distributed research network which led to the collection and analysis of samples from researchers in seven countries [13]. Different experts and points of view, knowledge, understanding and skill were brought together to focus on a particular task. Whilst each of the countries could have solved the problem themselves - given time - a more efficient solution was developed through the connections they made with each other.

Connectivism describes the use of the technology available to learners today. Learners create blogs (weblogs - short public articles published on the web), post discussions on discussion boards, and stream thoughts through social media. They use tags to classify information such as #diabetes or #meded on Twitter and then others can use search engines to find postings from the network of learners interested in the same topic. The learner, in the world of connectivism, is not simply the student with inferior knowledge but everyone involved in the topic. Learners and the expertise is maintained in the network and not necessarily within the individuals.

An example of connectivism would be the use of the tag #CMEchat which involves an ongoing discussion of Continuing Medical Education (CME) by an international audience with varying levels of expertise. It ran, until recently, each week on a Wednesday at 11am EST, there is a Twitter chat where the community comes together for an hour to discuss an agenda on CME. In between the discussions individuals post to Twitter, on their own websites, in blogs, on YouTube and social bookmarking sites such as delicious.com, items of interest and insights that they tag with #CMEchat for others to find. Individuals involved learn from each other and from the collected expertise of the group. Others can engage with the topic by searching and finding the resources identified by #CMEchat or through  the central hub of the group on its website (www.cmeadvocate.com). Over time the expertise in CME is increased and artefacts are developed by the participants that are available to others.

An important aspect of connectivism is its openness and, in particular, the looseness of its definition of membership or engagement.

To many this technological world of medical education and social media can be seen as challenging. Adoption of these new tools may require a digital literacy that many do not possess and they may be perceived to involve a disruption to the boundaries of professional and private life. As Siemens says "When knowledge ... is needed, but not known, the ability to plug into sources to meet the requirements becomes a vital skill." [12]

How should a novice in this area get started? What simple steps can be suggested to 'plug in' to this new world of medical education? Some suggestions have been made by others [14,15] and I have summarised an approach below.
  • Start by 'lurking'. This means just listening and reading the social media that others produce. Join some social media sites, search for your areas of interest, and follow people to see what they are talking about. You don't need to post straight away so don't feel obliged to. It is generally good advice when joining any community to listen first to understand the culture and norms before talking yourself.
  • Listen to a few medical Twitter chats such as #TwitJC Twitter Journal Club (http://www.twitjc.com/) and #phtwitjc Public Health Twitter Journal Club (http://phtwitjc.wordpress.com/).
  • Rewrite your CV into a short biography of about 100 words and get a photograph of yourself so that you can use it as your profile in the social media sites that you join.
  • Talk to your colleagues at your institution and see what they feel about social media. Is it available on your computer network and what would be the implications if it were. Read your own specialist society's advice on social media.
  • When you are ready start posting - we look forward to hearing from you.


1. Chaudhry A, Glodé LM, Gillman M, Miller RS. Trends in Twitter Use by Physicians at the American Society of Clinical Oncology Annual Meeting, 2010 and 2011. JOP 2012 Apr; Available from: http://jop.ascopubs.org/content/early/2012/04/17/JOP.2011.000483

2. Van Eperen L, Marincola FM. How scientists use social media to communicate their research. J Transl Med 2011;9:199. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22085450

3. Weller M. The Digital Scholar: How Technology Is Transforming Scholarly Practice. London: Bloomsbury Academic; 2011.

4. Cunningham A-M. Doctors’ use of social media. General Medical Council Review of Good Medical Practice 2012; Available from: http://www.gmc-uk.org/guidance/10900.asp Accessed 27th April 2012

5. McCartney M. How much of a social media profile can doctors have? BMJ 2012 Jan;344(jan23 1):e440-e440. Available from: http://www.bmj.com/content/344/bmj.e440

6. British Medial Association. Using social media: practical and ethical guidance for doctors and medical students. Available at http://www.bma.org.uk/press_centre/video_social_media/socialmediaguidance2011.jsp Accessed 14th April 2012.

7. General Medical Council. GMC seeks views on doctors' use of social media. Available at http://www.gmc-uk.org/news/12922.asp Accessed 23rd April 2012.

8. Ellaway R, Masters K. AMEE Guide 32: e-Learning in medical education Part 1: Learning, teaching and assessment. Med Teach 2008 Jun;30(5):455–473. Available from: http://www.ncbi.nlm.nih.gov/pubmed/18576185

9. Cook DA. The failure of e-learning research to inform educational practice, and what we can do about it. Med Teach 2009 Feb;31(2):158–162. Available from: http://www.ncbi.nlm.nih.gov/pubmed/19330674

10. Wenger E, White N, Smith JD. Digital Habitats: stewarding technology for communities. Portland: CPsquare; 2009. Available from: http://technologyforcommunities.com/

11. Key Opinion Leaders (KOL) blog on Diabetes and Endocrinology. Internet resource Available from http://www.facebook.com/groups/204310799599696/ Accessed 23rd April 2012.

12. Siemens G. (2004) Connectivism: A Learning Theory for the Digital Age. Available from http://www.elearnspace.org/Articles/connectivism.htm

13. Ksiazek TG, Erdman D, Goldsmith CS, Zaki SR, Peret T, Emery S, Tong S, Urbani C, Comer JA, Lim W, Rollin PE, Dowell SF, Ling A-E, Humphrey CD, Shieh W-J, Guarner J, Paddock CD, Rota P, Fields B, DeRisi J, Yang J-Y, Cox N, Hughes JM, LeDuc JW, Bellini WJ, Anderson LJ. A novel coronavirus associated with severe acute respiratory syndrome. N. Engl. J. Med. 2003 May;348(20):1953–1966. Available from http://www.ncbi.nlm.nih.gov/pubmed/12690092

14. George DR. 'Friending Facebook?' A minicourse on the use of social media by health professionals. J Contin Educ Health Prof 2011;31(3):215-219. Available from: http://www.ncbi.nlm.nih.gov/pubmed/21953663

15. Fisher WG. What Social Media Can Bring to the Physician Skeptic. Dr Wes Blog. Available from http://drwes.blogspot.co.uk/2012/04/what-social-media-can-bring-to.html Accessed 17th April 2012

Friday 6 July 2012

Adding to the Super Six of Diabetes?

The Super Six of Diabetes recently won a Health Service Journal - Integrated Care Award for Diabetes Care where the caseload in diabetes is split between specialists (covering the so-called super six) and primary care covering the rest. Importantly there was a stronger link to the specialist diabetes teams allowing support for grey cases. It involved redefining the job plans of the consultants and, in the words of Partha Kar from Portsmouth:

"As a specialist body, we could either continue to wish for what could happen, or we could pick up the gauntlet and join up with primary care to create a way of working which just might suit all."

The Super Six was defined in the same paper as:

"In general, there was broad agreement on the 'super six': antenatal diabetes, diabetic foot care, renal (estimated glomerular filtration rate <30), insulin pumps, type 1 / adolescent diabetes (unstable control), and inpatient diabetes."

http://www.practicaldiabetes.com/SpringboardWebApp/userfiles/espdi/file/September%202011/MoC%20Kar2.pdf

I negotiated a similar division of labour between my NHS Trust and the Local Health Board in South Wales in 2004-5 (but admittedly without the agreed change in job plans).

Caterham 7 Supersport, 1.6 K series 140 bhp
Being a driver of a Caterham Seven Supersport I'd be an advocate for adding at least one super service to the six - which we were developing at the time. The older person with diabetes. A geriatrician with an interest in, and training in diabetes, should lead the service for the frail elderly and liaise closely with primary care colleagues. A key advantage would be to reduce harm from over-medication and reduce admissions to hospital.

I'm catching up with the innovative Dr Kar next week so I shall press my case.

Saturday 9 June 2012

Avoiding inappropriate medication in the elderly

Lesson #1 of being a geriatrician? Stop hazardous drugs.

The Beers criteria (named after the late Dr Mark Beers) is used by the American Geriatrics Society to compile a list of Potentially Inappropriate Medication use in the Elderly.

Scott Gavura of Science Based Medicine has blogged a useful summary of the latest version of Beers criteria. He goes on to call for wider use of something from the geriatrician's therapeutic tool box - stopping medication.

"Some physicians and geriatricians call for more efforts at deprescribing or “drugectomies” as a means of reducing drug-related harms in the elderly: Ruthlessly discontinuing drug therapies if the expected clinical benefits are small. The approach involves a careful consideration of each drug, confirming that it’s still medically appropriate and necessary, while considering patient preferences and overall quality of life. As data emerges suggesting these approaches look promising, we may see more standardized approaches to deprescribing in the future."

Rating GP practices out of 10 - why so complex?

The NHS Choices website is offering ratings of GP surgeries out of 10 based on the results of a nationwide survey looking at how easy it is to get an appointment and have explanations about diseases.

http://www.bbc.co.uk/news/health-18343060

Why not just make it simpler and use a Facebook-style 'like' button for GP practices?

The more 'likes' you have obviously the better the GP practice. (sarcasm)

See also:

Hospital Doctor: GPs attach plan to rate practices out of 10

Wednesday 16 May 2012

The mathematics of obesity

Based on a mathematical model of lifestyle and body weight this 'Body Weight Simulator' from the National Institute of Diabetes and Digestive and Kidney Diseases has been built by Dr Carson Chow.

It is discussed in this recent NY Times article after he presented the model at the American Association for the Advancement of Science. Illuminating the Obesity Epidemic with Mathematics.

By selecting your current weight, height, age, and levels of calorie intake and activity it can give estimates of the change in calorie or activity that is required to gain certain weight targets.

Have a go!

We all know that people respond differently to this lifestyle advice but using this tool perhaps we can give better and more specific advice to patients.

What is interesting is the small size of change that is required and the indefinite nature of that change to maintain a particular target.

Tuesday 15 May 2012

Lancet degludec papers April 2012

I recently blogged about Insulin Degludec. A few more papers have been published since then.

The Lancet has published some open label, phase 3, funded-by-the-manufacturer (Novo Nordisk) papers on the use of insulin degludec in Type 1 and Type 2 diabetes [1,2].

Both were 1 year trials randomised to degludec or glargine. In type 2 diabetes the rates of mild to moderate, daytime or nocturnal hypoglycaemia seemed to be lower in the degludec patients but not the rate of severe hypoglycaemia. [2]

In Type 1 diabetes there results were similar for both glargine or degludec but there was reduction in 'confirmed nocturnal hypoglycaemia'. Again there were no differences in severe hypoglycaemia. [1]



1. Heller S, Buse J, Fisher M, Garg S, Marre M, Merker L, Renard E, Russell-Jones D, Philotheou A, Francisco AMO, Pei H, Bode B. Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 1 diabetes (BEGIN Basal-Bolus Type 1): a phase 3, randomised, open-label, treat-to-target non-inferiority trial. Lancet 2012 Apr;379(9825):1489–1497. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22521071

2. Garber AJ, King AB, Del Prato S, Sreenan S, Balci MK, Muñoz-Torres M, Rosenstock J, Endahl LA, Francisco AMO, Hollander P. Insulin degludec, an ultra-longacting basal insulin, versus insulin glargine in basal-bolus treatment with mealtime insulin aspart in type 2 diabetes (BEGIN Basal-Bolus Type 2): a phase 3, randomised, open-label, treat-to-target non-inferiority trial. Lancet 2012 Apr;379(9825):1498–1507. Available from: http://www.ncbi.nlm.nih.gov/pubmed/22521072

Sunday 13 May 2012

Carten100 ... great weekend cycling for JDRF diabetes

Thanks to the organisers of the Cardiff to Tenby 100 mile cycle ride (#carten100) this weekend.

Involved ...


Top resources ...
http://twitter.com/mattdavey19/status/201197418929340416/photo/1
http://www.bbc.co.uk/weather/2634894
http://twitter.com/trueman3295/status/198776536726372352/photo/1
http://twitter.com/katetrueman24/status/201377590408261632/photo/1
http://www.justgiving.com/Chris-Trueman0
http://twitter.com/huwlock/status/201234694988247040/photo/1
http://twitter.com/dean_jenkins/status/201355562573766656/photo/1
http://twitter.com/huwlock/status/201317552163528704/photo/1
http://twitter.com/dean_jenkins/status/201261756453105665/photo/1
http://twitter.com/huwlock/status/201199618678194177/photo/1

Related tags ...
#cycling #jdrf #wales #nervous #carbten100

See Twitter for more tweets, people, videos and photos for #carten100

@Official_StoneyThis time last week i was have way through a 6000 mile journey on a Boeing 777-300 today i have just cycled 54. #Whatadifference #carten100
(Sat, 05 May 2012 13:01:02 +0100)
@trueman3295Nice 40 mile bike ride to fresh west this morning with Dusty. Check out the pic - Awesome! #Carten100 http://t.co/SnQUVaKo
(Sat, 05 May 2012 15:09:54 +0100)
@katetrueman24RT @trueman3295 : Nice 40 mile bike ride to fresh west this morning with Dusty. Check out the pic - Awesome! #Carten100 http://t.co/SnQUVaKo
(Sat, 05 May 2012 15:11:44 +0100)
@emmaburgoyneRT @trueman3295 : Nice 40 mile bike ride to fresh west this morning with Dusty. Check out the pic - Awesome! #Carten100 http://t.co/SnQUVaKo
(Sat, 05 May 2012 16:03:38 +0100)
@huwlockOff for a ride with @pippa81 and the @dragoncrossfit riders around the vale! Hope it stays dry! #carten100 only 6 days away!
(Sun, 06 May 2012 06:58:52 +0100)
@meribelmanThis bike won't ride itself. Let's do this thing. #carten100 training almost done.
(Sun, 06 May 2012 08:52:07 +0100)
@huwlockwent for a 53.6 mile road ride. Check it out on @Strava http://t.co/OK4qZMQY #carten100 #cycling
(Sun, 06 May 2012 12:25:46 +0100)
@CardiffPlacesMap: http://t.co/LOrkKqYc - RT @huwlock went for a 53.6 mile road ride. Check it out on @Strava http://t.co/95bSVZZv #carten100 #cy ...
(Sun, 06 May 2012 12:48:03 +0100)
@meribelmanPlease let the weather be just like this next Saturday #carten100 . Very excited
(Sun, 06 May 2012 18:05:17 +0100)
@meribelmanAfter #carten100 I need a new project. #cardiffhalf in Oct, but what to keep me busy during the balmy summer months?
(Sun, 06 May 2012 18:15:20 +0100)
@Jemma222RT @meribelman : Please let the weather be just like this next Saturday #carten100 . Very excited
(Sun, 06 May 2012 19:34:19 +0100)
@trueman3295Just cycled 50mile to Preseli's / Rosebush and back in the rain! #knackered #soaked #Carten100 ????
(Mon, 07 May 2012 18:54:18 +0100)
@katetrueman24RT @trueman3295 : Just cycled 50mile to Preseli's / Rosebush and back in the rain! #knackered #soaked #Carten100 ????
(Mon, 07 May 2012 19:06:51 +0100)
@trueman3295@gregmurds yeah, coming up Friday pal. Staying at the Hilton. No where near ready, but gonna give it my best! U ready mate? #Carten100
(Mon, 07 May 2012 20:15:26 +0100)
@Official_Stoney@LeahJean14 thanks for the sponsorship. Very much appreciated. #sokind #carten100 #4daystogo
(Tue, 08 May 2012 19:38:51 +0100)
@huwlockfingers x the weather Sat looks fine for the #carten100 BBC #weather #Wales http://t.co/EVjCmCiS #cycling
(Tue, 08 May 2012 22:34:44 +0100)
@trueman3295She's arrived! Gonna look the business for #Carten100 on Saturday! #Nervous #Excited #JDRF http://t.co/rWVlXDvy http://t.co/umB8bzq1
(Wed, 09 May 2012 11:06:34 +0100)
@KateMadleyLooking forward to a weekend in Tenby for #carten100 There will be 600 cyclists on the road this Saturday #watchout
(Wed, 09 May 2012 11:40:31 +0100)
@Official_Stoney@WelshGigs modelling #carten100 shirt. @TWright919 @Madley3 @Collins_Luke @jamoharvey #lastonetherebuysthebeers http://t.co/yd7fXmhi
(Wed, 09 May 2012 12:04:12 +0100)
@Official_Stoney@Collins_Luke wat name you get on your shirt? #carten100
(Wed, 09 May 2012 22:41:16 +0100)
@justineswainsonhttp://t.co/fZhZlsLu Can you spare �2 to sponsor my 12 year old daughter cycling 100 miles for charity this Saturday? #carten100
(Thu, 10 May 2012 06:56:33 +0100)
@coastalcottagesOur boss is doing the #Carten100 on Saturday! 100 miles from Cardiff to Tenby, on a bike, in a day! Good luck Matt @CaptainCymru ? #cycling
(Thu, 10 May 2012 08:24:50 +0100)
@emmetttherapistRT @coastalcottages : Our boss is doing the #Carten100 on Saturday! 100 miles from Cardiff to Tenby, on a bike, in a day! Good luck Matt @CaptainCymru ? #cycling
(Thu, 10 May 2012 09:42:34 +0100)
@NewToCardiffRT @coastalcottages : Our boss is doing the #Carten100 on Saturday! 100 miles from Cardiff to Tenby, on a bike, in a day! Good luck Matt @CaptainCymru ? #cycling
(Thu, 10 May 2012 10:27:51 +0100)
@Official_Stoney@jay_bombadil thanks for the sponsorship. #carten100
(Thu, 10 May 2012 10:30:45 +0100)
@giggleCardiffgood luck to Mr Giggle, his mates and everyone doing the #carten100 cycle ride from Cardiff to Tenby on Saturday.
(Thu, 10 May 2012 13:36:35 +0100)
@trueman3295@emmaburgoyne thanks to u & Elton 4 your incredible donation 4 my #Carten100 challenge!! Extremely generous! Diolch! ? http://t.co/rWVlXDvy
(Thu, 10 May 2012 17:05:07 +0100)
@AWilkes7bikes all ready for the #carten100 lets hope i am! #cardifftotenby
(Thu, 10 May 2012 17:12:04 +0100)
@Suburban10bRT @AWilkes7 : bikes all ready for the #carten100 lets hope i am! #cardifftotenby
(Thu, 10 May 2012 17:19:09 +0100)
@Cardiffian79#carten100 in under 36hrs now! Beer and curry not best preparation! Thank god the weather is looking settled! BBQ /beers in kiln park after!
(Thu, 10 May 2012 21:19:25 +0100)
@KateMadley@jamoharvey Have a fun day carb loading #carten100 !!!!!!
(Fri, 11 May 2012 10:52:52 +0100)
@jamoharvey@KateMadley carbs carbs carbs ready for the big day #carten100 @Official_Stoney
(Fri, 11 May 2012 11:03:34 +0100)
@Official_Stoneyadvice from @jamoharvey is 2 get the carbs on board take note @Collins_Luke @TWright919 @Madley3 @WelshGigs #CARBTEN100 #Carten100 #shitting
(Fri, 11 May 2012 11:16:42 +0100)
@4ledjLooking forward to the #carten100 tomorrow. Hope the weather is as predicted and those winds don't pick up. 100 miles on the bike in a day.
(Fri, 11 May 2012 12:14:00 +0100)
@justineswainson@GeraintThomas86 @LauraTrott31 please can you shout out to my 12 yr old daughter Georgia, cycling 100 miles for charity 2moro #carten100
(Fri, 11 May 2012 13:08:39 +0100)
@justineswainson@jasonmbbc please can you shout out to my 12 yr old daughter Georgia who is cycling 100 miles Cardiff - Tenby for charity 2moro #carten100
(Fri, 11 May 2012 13:10:06 +0100)
@justineswainson@chrishoy please can you shout out to my 12 yr old daughter Georgia who is cycling 100 miles Cardiff to Tenby for charity 2moro #carten100
(Fri, 11 May 2012 13:15:40 +0100)
@huwlockHappy Dayz @johnnyevs2011 @nippa81 @mattdavey19 BBC Weather : Wales http://t.co/EVjCmCiS #carten100 #wales #cycling
(Fri, 11 May 2012 13:26:53 +0100)
@nickwatkins01Let's hope the weather stays like this for tomorrow #Carten100
(Fri, 11 May 2012 13:41:34 +0100)
@huwlock@ChristianFerri2 great news, looking forward to a top day! #carten100 #cycling #wales
(Fri, 11 May 2012 13:44:36 +0100)
@justineswainson@DerekTheWeather please can you shout out to all the riders in the #CarTen100 , cycling 100 miles Cardiff to Tenby 2moro. Will the sun shine?
(Fri, 11 May 2012 13:46:59 +0100)
@huwlock@nippa81 @johnnyevs2011 @mattdavey19 @ChristianFerri2 tom looks even better! u can get your guns out! #carten100
(Fri, 11 May 2012 13:47:39 +0100)
@justineswainsonRT @KateMadley : Looking forward to a weekend in Tenby for #carten100 There will be 600 cyclists on the road this Saturday #watchout
(Fri, 11 May 2012 13:47:53 +0100)
@huwlock@nippa81 @johnnyevs2011 @mattdavey19 @christianferri2 sorry, thought i was replying to ferris.....haha #carten100
(Fri, 11 May 2012 13:51:49 +0100)
@mattdavey19@fadger carb loading for ???? #carten100 http://t.co/KXU7Cw4E
(Fri, 11 May 2012 14:41:25 +0100)
@gardavies13@mattdavey19 @fadger #carten100 new cover model for @HeavyRepCF ?
(Fri, 11 May 2012 14:51:47 +0100)
@jmwroe@KeithEdwardsCIH @Tregolwyn It will just be a blur of spokes, pedals and flapjack crumbs... #CarTen100
(Fri, 11 May 2012 14:55:08 +0100)
@scrivsxx@trueman3295 Good luck for your super bike ride tomorrow, hope the sun is shining for you! #nottoohotthough #Carten100
(Fri, 11 May 2012 16:37:51 +0100)
@WelshGigsOne day until #carten100 . @Official_Stoney , @Collins_Luke and I are pedaling 100 miles. Please give what you can at https://t.co/DaHVqbYl xx
(Fri, 11 May 2012 17:20:27 +0100)
@mattdavey19RT @huwlock : Happy Dayz @johnnyevs2011 @nippa81 @mattdavey19 BBC Weather : Wales http://t.co/EVjCmCiS #carten100 #wales #cycling
(Fri, 11 May 2012 17:43:17 +0100)
@Official_StoneyGetting the carbs in with @Madley3 @KateMadley @madley01 and @jamoharvey #carbten100 #carten100
(Fri, 11 May 2012 19:14:02 +0100)
@trueman3295Thanks for all the good luck messages and sponsors for tmw! All Carbed up now & ready to go! #Carten100 #Nervous #JDRF
(Fri, 11 May 2012 19:55:55 +0100)
@AndrewBrockway@TonPentre @r0513_ Thanks Ton Everyone else:pls donate here.We're cycling 100 miles Cardiff-Tenby, tomrw! http://t.co/LaR3JkMp #CarTen100
(Fri, 11 May 2012 20:36:35 +0100)
@R0513_@ir_emery nah not really, but have eaten enough today to mean there's no backing out of #carten100 . Bring it on!
(Fri, 11 May 2012 20:59:49 +0100)
@meribelmanBedtime ahead of the big cycle ride. Very excited. #carten100
(Fri, 11 May 2012 21:31:54 +0100)
@jmwroe@DerekTheWeather Give us a wave as we cycle past on #CarTen100 on Saturday!!
(Fri, 11 May 2012 22:31:27 +0100)
@dean_jenkinsLooking forward to the #carten100 tomorrow raising money for @JDRF diabetes. http://t.co/oKT49khD
(Fri, 11 May 2012 23:18:43 +0100)
@dean_jenkins. @AndrewBrockway @TonPentre @R0513_ good to see we'll have an orthopaedic surgeon on hand at #carten100 tomorrow.
(Fri, 11 May 2012 23:22:29 +0100)
@RhysapWilliam#Carten100 fory gwely!!!!!!
(Sat, 12 May 2012 00:30:04 +0100)
@emmaburgoyneRT @trueman3295 : Thanks for all the good luck messages and sponsors for tmw! All Carbed up now & ready to go! #Carten100 #Nervous #JDRF
(Sat, 12 May 2012 01:00:01 +0100)
@AWilkes7up and ready for the bus to cardiff! #carten100
(Sat, 12 May 2012 04:27:21 +0100)
@Tony810Today's the day...Cardiff to Tenby by bike. And the sun is shining at last #carten100
(Sat, 12 May 2012 05:23:43 +0100)
@Cardiffian79100 mile bike ride now! Last thing in the world i feel like getting out of bed for!!! #carten100
(Sat, 12 May 2012 06:07:14 +0100)
@huwlockIts #carten100 time and the sun is shining! Bring it on! #wales #cycling
(Sat, 12 May 2012 06:18:12 +0100)
@nickwatkins01Lovely day for cycling #Carten100 with @Chrissy_Dav , Steff king and the beaut!
(Sat, 12 May 2012 06:27:25 +0100)
@MrsKGreensGood luck to my hubby @nippa81 today 100 cycle from Cardiff 2 Tenby #carten100
(Sat, 12 May 2012 06:32:18 +0100)
@Chrissy_DavRT @nickwatkins01 : Lovely day for cycling #Carten100 with @Chrissy_Dav , Steff king and the beaut!
(Sat, 12 May 2012 06:46:45 +0100)
@dean_jenkins#carten100 today http://t.co/IGIHpkh6
(Sat, 12 May 2012 06:51:05 +0100)
@EffectiveHRMA lovely morning for the bike riders on #carten100
(Sat, 12 May 2012 06:52:39 +0100)
@mattdavey19?????? @Fadger #carten100
(Sat, 12 May 2012 07:08:07 +0100)
@AlyciaZaraEvans" @MrsKGreens : Good luck to my hubby @nippa81 today 100 cycle from Cardiff 2 Tenby #carten100 " massive good luck too mate!! X
(Sat, 12 May 2012 07:21:20 +0100)
@Gethyn_HudsonGood luck to @RhysapWilliam and boys with the #carten100 today. All respect goes to @ARESm #toughjob #goodwingman
(Sat, 12 May 2012 07:22:10 +0100)
@mattdavey19#carten100 @fadger @GLYNN1010 http://t.co/EJaJgtlU
(Sat, 12 May 2012 07:29:39 +0100)
@Dragon_CrossFit? @mattdavey19 : #carten100 @fadger @GLYNN1010 http://t.co/oRmfqboH? good luck boys
(Sat, 12 May 2012 07:35:02 +0100)
@huwlockAnd wer off #carten100 @johnnyevs http://t.co/mPeFi93m
(Sat, 12 May 2012 07:38:25 +0100)
@katetrueman24@andipeters my husband is on his bike today..... Cycling 100 miles from Cardiff to Tenby in the #Carten100 You should have joined them!!!!
(Sat, 12 May 2012 07:48:32 +0100)
@katetrueman24So glad the sun is shining in Cardiff for @trueman3295 @gregmurds and everyone else taking part in the #Carten100 #goodlucktrues ????
(Sat, 12 May 2012 07:51:18 +0100)
@daih1010@mattdavey19 good luck gravy!! Looking fab in the lycra pal! Great effort, @huwlock #carten100 #hopeyouhaveyourpuncturekit
(Sat, 12 May 2012 07:52:26 +0100)
@katetrueman24@hughhanley my husband @trueman3295 was up early this morning for a 100 mile bike ride from Cardiff to Tenby in the #Carten100
(Sat, 12 May 2012 07:58:09 +0100)
@katetrueman24@ShaneWilliams11 can I get a good luck for my husband @trueman3295 who is doing the #Carten100 today!!!???
(Sat, 12 May 2012 07:59:11 +0100)
@IamChris_JohnsGood luck to all doing #carten100 and #tourofpembbrokeshire
(Sat, 12 May 2012 08:02:50 +0100)
@Lenny0009RT @Dragon_CrossFit : ? @mattdavey19 : #carten100 @fadger @GLYNN1010 http://t.co/oRmfqboH? good luck boys
(Sat, 12 May 2012 08:32:07 +0100)
@Benhooper98Wooo go my dad , 100 mile bike ride from Cardiff to Tenby #carten100
(Sat, 12 May 2012 08:51:24 +0100)
@coastalcottagesGood luck to everyone taking part in the Tour of #Pembrokeshire and the #Carten100 today! The suns out for you ?? http://t.co/x8aV90CD
(Sat, 12 May 2012 08:56:26 +0100)
@GilesParryGood luck to @Ieuan_Cactus , Rob, Marc and everyone else cycling from Cardiff to Tenby today supporting #JDRF #carten100
(Sat, 12 May 2012 09:48:08 +0100)
@huwlock@johnnyevs 1/3 the way there in margam! #carten100 now for a bacon butty and a cup of tea! #wales #cycling http://t.co/uRtTuM2T
(Sat, 12 May 2012 09:57:45 +0100)
@dean_jenkinsMargam for breakfast on #carten100 http://t.co/uYaEKydZ
(Sat, 12 May 2012 10:02:00 +0100)
@dean_jenkins. @diabetesdiploma @K2Rum ooh just stopped for breakfast at 29 miles on #carten100
(Sat, 12 May 2012 10:03:08 +0100)
@NAGabriel30 miles done. 70 to go! Bacon sandwich time #Carten100 http://t.co/6UgLn60n
(Sat, 12 May 2012 10:10:38 +0100)
@Leepy_LeeGood luck today @dean_jenkins with the #carten100 today cardiff to tenby cycle ride
(Sat, 12 May 2012 10:32:34 +0100)
@dean_jenkinsSwansea on #carten100 http://t.co/QAaPthUY
(Sat, 12 May 2012 11:45:17 +0100)
@HelenAnneDaviesRT @dean_jenkins : Swansea on #carten100 http://t.co/QAaPthUY
(Sat, 12 May 2012 11:46:48 +0100)
@HelenAnneDaviesRT @Leepy_Lee : Good luck today @dean_jenkins with the #carten100 today cardiff to tenby cycle ride
(Sat, 12 May 2012 11:47:39 +0100)
@coopsie74gimme a peloton update @AndrewBrockway @dancaunt #CarTen100
(Sat, 12 May 2012 11:52:13 +0100)
@LeilaAnneHughesRT @Dragon_CrossFit : ? @mattdavey19 : #carten100 @fadger @GLYNN1010 http://t.co/oRmfqboH? good luck boys
(Sat, 12 May 2012 12:25:42 +0100)
@huwlockIn pembrey! Time for lunch! #carten100 #cycling with @johnyevs http://t.co/32LB6FD9
(Sat, 12 May 2012 12:34:55 +0100)
@dancaunt@coopsie74 @AndrewBrockway having Lunch in sun at burry port. Feeling strong #Lycra #CarTen100
(Sat, 12 May 2012 13:12:41 +0100)
@nickwatkins0175 down...25 to go. #Carten100
(Sat, 12 May 2012 13:46:10 +0100)
@Chrissy_Dav25 to go #Carten100 with @nickwatkins01 and kingy. The beaut has gone
(Sat, 12 May 2012 13:48:17 +0100)
@huwlock10 miles from Tenby! The sporting chance pub is last stop! Pint and quavers time! #carten100 http://t.co/vkbuIiyw
(Sat, 12 May 2012 15:27:00 +0100)
@dean_jenkins10 miles from Tenby and the finish line. #carten100 http://t.co/TOTp3Ril
(Sat, 12 May 2012 16:11:21 +0100)
@huwlock@johnnyevs2011 89 done, 12 to go! #welldeserved #sportingchance #carten100 http://t.co/He5yxVs3
(Sat, 12 May 2012 17:12:36 +0100)
@dean_jenkinsFinished #carten100 lovely ladies at the @jdrf tent found my bank card and somehow found me. Spooky.
(Sat, 12 May 2012 17:18:34 +0100)
@ir_emeryHa ha ha! #Carten100 RT @R0513_ Quote from JPR on finishing "I'd rather play the All Blacks than that".
(Sat, 12 May 2012 17:24:28 +0100)
@DuncanLaw7RT @Dragon_CrossFit : ? @mattdavey19 : #carten100 @fadger @GLYNN1010 http://t.co/oRmfqboH? good luck boys
(Sat, 12 May 2012 17:25:26 +0100)
@ChrisSmithAVFC@ir_emery @R0513_ #Carten100 just don't ask him for medical advice. #trusthimhesadoctor
(Sat, 12 May 2012 17:32:19 +0100)
@dean_jenkinsJDRF tent at the finishing line of #carten100 raising funds for diabetes. http://t.co/KK9ZOxGn
(Sat, 12 May 2012 17:58:03 +0100)
@dragonrun1027@Fadger Hope it's gone well today!!! #Carten100 #RideFadgerRide !
(Sat, 12 May 2012 17:59:45 +0100)
@ninjabetic1RT @dean_jenkins : JDRF tent at the finishing line of #carten100 raising funds for diabetes. http://t.co/KK9ZOxGn
(Sat, 12 May 2012 18:02:49 +0100)
@dancaunt@coopsie74 @AndrewBrockway arrived at finish at 5pm, 9.5 hours. We had first two girls home on our team #CarTen100 #confused .com #missedyou
(Sat, 12 May 2012 18:04:35 +0100)
@ir_emeryCongratulations and bloody well done to @R0513_ and @AndrewBrockway on completing the 100 mile #carten100 charity bike ride today #coldbeers
(Sat, 12 May 2012 18:13:39 +0100)
@dancaunt@alexhiggs82 #CarTen100 next year Higgsy
(Sat, 12 May 2012 18:22:21 +0100)
@meribelman#carten100 . Bucket list tick! Great day. Loved it. Thanks everyone. This ones for you Cal #jdrf
(Sat, 12 May 2012 18:35:50 +0100)
@Fadger@dragonrun1027 hey arry. 6hrs 20mins excluding stops. Well chuffed. #carten100 #FadgerDidRide
(Sat, 12 May 2012 18:39:06 +0100)
@katetrueman24Huge well done to @trueman3295 , @gregmurds and everyone else who completed the #carten100 today! Fantastic effort!!! http://t.co/KUwCHE0X
(Sat, 12 May 2012 18:49:44 +0100)
@R0513_Colin Charis just dropped his bag in front of u. Ah bless #carten100 #starspotting
(Sat, 12 May 2012 18:52:32 +0100)
@Rhi_EdwardsJust returned from Tenby as support vehicle for @mattdavey19 @Fadger and fellow dragons. Amazing effort dragons!! ? #carten100
(Sat, 12 May 2012 19:03:59 +0100)
@R0513_Still no Dani #Carten100
(Sat, 12 May 2012 19:06:06 +0100)
@alexhiggs82@dancaunt 12 miles today and i was pretty shattered, so a bit of training to go! Congrats on the #CarTen100 #dc #alawyerandawarrior
(Sat, 12 May 2012 19:11:08 +0100)
@katetrueman24@trueman3295 and his girls at the finish #carten100 http://t.co/QwDVksNe
(Sat, 12 May 2012 19:25:37 +0100)
@trueman3295Great day doing #Carten100 with @gregmurds @garoberts83 @jonlloydjones & Dusty! Thanks 4 the support tweeps! #JDRF #Carten100 #goodtimes
(Sat, 12 May 2012 19:33:03 +0100)
@trueman3295? @katetrueman24 : well done to @trueman3295 , @gregmurds @jonlloydjones @garoberts83 who completed the #carten100 today! http://t.co/MF7uuwI5?
(Sat, 12 May 2012 19:40:46 +0100)
@Jemma222RT @meribelman : #carten100 . Bucket list tick! Great day. Loved it. Thanks everyone. This ones for you Cal #jdrf
(Sat, 12 May 2012 19:41:02 +0100)
@trueman3295Oi @scrivs73 my challenge is done. All Ive got 2 do now is get fatter lol. Pressure's on you now ha ha ? #wales3000 #Carten100 ???
(Sat, 12 May 2012 19:55:32 +0100)
@jmwroeCompleted #CarTen100 - excellent event, brilliantly organised! @Carten100 http://t.co/isgHtxtK
(Sat, 12 May 2012 20:15:06 +0100)
@KateMadley@SarahThomas92 they made it!! #carten100 http://t.co/LKTQS9Ja
(Sat, 12 May 2012 20:38:50 +0100)
@R0513_Charvis!! RT @R0513_ Colin Charis just dropped his bag in front of u. Ah bless #carten100 #starspotting
(Sat, 12 May 2012 20:52:56 +0100)
@welshcoles? @jmwroe : Completed #CarTen100 - excellent event, brilliantly organised! @Carten100 http://t.co/NZVShf8N? Well done - fab day for it
(Sat, 12 May 2012 20:53:22 +0100)
@trueman3295RT @katetrueman24 : @trueman3295 and his girls at the finish #carten100 http://t.co/QwDVksNe
(Sat, 12 May 2012 21:34:29 +0100)
@scrivsxxRT @katetrueman24 : @trueman3295 and his girls at the finish #carten100 http://t.co/QwDVksNe
(Sat, 12 May 2012 21:43:24 +0100)
@scrivsxx@trueman3295 a big fat well done!! Seen a few on bikes on the bridge when I was on m4, I gave a wave in case it was you!! #Carten100
(Sat, 12 May 2012 21:45:52 +0100)
@Ieuan_Cactus#carten100 done! 6.2hr ride, NW head wind. #bg good. Thank you for the RTs esp @IHphoto and the sponsorship from every1 Really appreciated.
(Sat, 12 May 2012 22:12:55 +0100)
@meribelmanStill walking and feeling remarkably OK. It's gonna start hurting soon surely #carten100
(Sun, 13 May 2012 08:38:57 +0100)
@mattdavey19RT @daih1010 : @mattdavey19 good luck gravy!! Looking fab in the lycra pal! Great effort, @huwlock #carten100 #hopeyouhaveyourpuncturekit
(Sun, 13 May 2012 09:19:54 +0100)
@dean_jenkins@drpaulmorgan yes well spotted from the Giltar Hotel. Recovering from the #carten100 yesterday
(Sun, 13 May 2012 09:24:17 +0100)
@AndrewBrockway3hrs and 50 miles in. Jacket sleeve unfurls out of jersey pocket, has argument with derailleur. Argh! #CarTen100 http://t.co/3mvpbU7g
(Sun, 13 May 2012 09:56:58 +0100)
@AndrewBrockwaySat by roadside for hr, clapping the riders..glad no harm done to me or others but gutted my ride is over. #CarTen100 http://t.co/gQAwnrIJ
(Sun, 13 May 2012 09:59:55 +0100)
@AndrewBrockwayRescued by support van.Over to http://t.co/V2dDbIFo who get me back on the rd! #CarTen100 #HobbsCycles http://t.co/9QR0Un2y
(Sun, 13 May 2012 10:06:40 +0100)
@NAGabrielYesterday I cycled 100 miles. Today I will look like Elvis but walk like John Wayne. #StiffLegs #Carten100 #ElvisForBrendan
(Sun, 13 May 2012 10:25:23 +0100)
@coopsie74@AndrewBrockway how's the bike Brockers? #CarTen100 #backdoorblast @dancaunt
(Sun, 13 May 2012 10:28:22 +0100)
@P__TheLetterRT @NAGabriel : Yesterday I cycled 100 miles. Today I will look like Elvis but walk like John Wayne. #StiffLegs #Carten100 #ElvisForBrendan
(Sun, 13 May 2012 10:53:30 +0100)
@R0513_Swim, sauna, jaquzzi followed by protein shake (thanks #cardiffinternationalpool ). Feel much more human now #carten100
(Sun, 13 May 2012 13:41:56 +0100)
@R0513_@ir_emery @tonpentre what Ian said. You should sign up for next year! #carten100
(Sun, 13 May 2012 13:43:41 +0100)
@johnnyevs2011RT @huwlock : And wer off #carten100 @johnnyevs http://t.co/mPeFi93m
(Sun, 13 May 2012 14:00:18 +0100)
@johnnyevs2011RT @huwlock : @johnnyevs 1/3 the way there in margam! #carten100 now for a bacon butty and a cup of tea! #wales #cycling http://t.co/uRtTuM2T
(Sun, 13 May 2012 14:00:39 +0100)
@johnnyevs2011RT @huwlock : 10 miles from Tenby! The sporting chance pub is last stop! Pint and quavers time! #carten100 http://t.co/vkbuIiyw
(Sun, 13 May 2012 14:00:52 +0100)
@huwlockNice relaxing day on south beach #tenby b4 lubch at #mullberry in #saundersfoot ! Nice way 2 recover after #carten100 http://t.co/sqE3Xev1
(Sun, 13 May 2012 14:06:24 +0100)
@RhysapWilliamwedi blino ar ol #carten100 a 20 pints
(Sun, 13 May 2012 14:25:15 +0100)
@Fadger@LeilaAnneHughes @Rhi_Edwards @mattdavey19 cheers Leila #carten100
(Sun, 13 May 2012 14:42:02 +0100)
@SionAron@RhysapWilliam : wedi blino ar ol #carten100 a 20 pints D.y.Pysgod??? Sut ath hi? Es i allan bore ma #stryglo #parchatochyncwblhaucanmilltir
(Sun, 13 May 2012 18:05:53 +0100)
@KK_OTTOWell the weekend is over already! Had a day recovering from the #carten100 not looking forward to 2nd day ache tomorrow :(
(Sun, 13 May 2012 21:56:28 +0100)
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