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Patients on such medications require careful blood glucose monitoring and possible dose adjustments, in line with BNF guidance

Applying a warm compress for two minutes before injection dilates blood vessels slightly, then applying ice afterward constricts them to slow bleeding

Its defining structural feature is the gamma-glutamyl linkage: the glutamate residue is joined through its side-chain carboxyl rather than the usual alpha-peptide bond, which makes the molecule resistant to most intracellular peptidases and means it is cleaved almost exclusively by gamma-glutamyl transpeptidase at the outer cell surface (Zhang, Forman and Choi, Methods in Enzymology, 2005)

A genuine NHS scandal

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