A number of guidelines have emerged from recognition of these potential risks but it is worth emphasizing that these have been arrived at by consensus and few, if any, have been tested within the context of a clinical trial. Even the admirable structured education programme for individuals on oral therapy cited by the author has been subject to an observational evaluation only and did not apply to patients taking insulin. Nevertheless, I agree with the author that clinicians should ensure that patients at risk receive practical advice even if these are not evidenced based. This might include: