Dr Niki Margari

I am a Consultant in Diabetes & Endocrinology at University College London Hospitals (UCLH) NHS Foundation Trust, a busy central London academic tertiary centre, and Lead for Inpatient Diabetes. I manage high-risk people with obesity, type 1 and type 2 diabetes and complex cardiometabolic disease across inpatient, outpatient and community settings. My practice combines intensive patient-facing clinical work, digital and telephone-based models of care, and trust-wide guideline development in peri-operative and maternity diabetes.

I have particular expertise in obesity and weight-related metabolic disease (with or without type 2 diabetes), diabetes in pregnancy, cardiometabolic risk reduction and lipid disorders. I enjoy working in multi-disciplinary clinical forums with dieticians, psychologists, nurses and other specialists, and I am passionate about translating evidence into pragmatic, supportive, patient-centred care plans that improve health, confidence and quality of life.

GMC License Number: 7067496

GMC Specialist Register:

• Diabetes and Endocrinology
• General Internal Medicine

GMC Recognition:

• Clinical Supervisor
• Educational Supervisor
• Lead Coordinator of Undergraduate Training

• Obesity, diabetes & weight management
  Extensive experience managing people with obesity, pre-diabetes and type 2 diabetes in a large tertiary centre, including those with complex multimorbidity and high cardiovascular risk.
  Weekly lipid clinic focusing on cardiometabolic risk assessment, familial hypercholesterolaemia and access to advanced lipid-lowering therapies.
  Strong background in lifestyle, behavioural and pharmacological approaches to weight and risk-factor modification.
• Digital & remote care
  Active involvement in maternity diabetes services where the majority of consultations are delivered via telephone and virtual clinics, supported by app-based blood pressure and glucose monitoring and Zoom-based education sessions.
  Confident using electronic health records and digital tools to monitor outcomes, track engagement and coordinate multidisciplinary care.
• Pharmacotherapy & safety (including GLP-1 pathways)
  Daily practice in initiating and optimising complex diabetes therapies, including insulin, SGLT2 inhibitors and GLP-1 receptor agonists, in line with NICE and JBDS guidance.
  Named diabetes consultant within trust-wide guidelines for peri-operative diabetes and maternity diabetes, ensuring safe medicines management in high-risk settings.
• Leadership, guidelines & service improvement
  Lead for Inpatient Diabetes at UCLH with responsibility for standards of care and pathway development across multiple hospital sites.
  Contributor and owner/sponsor of several hospital-wide guidelines that standardise care for surgical patients with diabetes and for women with diabetes in pregnancy.
• Multi-disciplinary teamwork & clinical forums
  Convenor of twice-monthly MDT meetings with community diabetes teams in Camden and Islington, providing case-based advice and shared decision-making on complex patients.
  Highly experienced working with dietitians, psychologists, diabetes specialist nurses, obstetricians, anaesthetists and surgeons to deliver integrated care.
• Teaching, supervision & research
  Educational supervisor for trainees; lead organiser of diabetes and endocrinology teaching for UCL medical undergraduates.
  Former diabetes research fellow with experience in study design, data analysis and evidence translation into clinical practice.

Consultant in Diabetes & Endocrinology / Lead for Inpatient Diabetes
University College London Hospitals NHS Foundation Trust, London
Dec 2020 – present

• Lead the inpatient diabetes service across UCLH, a major central London teaching and tertiary referral centre, responsible for clinical governance, safety and service development for all adult inpatients with diabetes.
• Deliver high-volume outpatient clinics for people with type 1 and type 2 diabetes, many with co-existing obesity, insulin resistance, hypertension and other cardiometabolic risk factors.
• Run a weekly lipid clinic receiving referrals from primary and secondary care, focused on detailed cardiometabolic risk stratification, diagnosis of familial hypercholesterolaemia and delivery of advanced lipid-lowering therapies in line with guideline-mandated pathways.
• Provide specialist care for women with pre-existing diabetes and gestational diabetes, working closely with obstetricians, midwives and diabetes specialist nurses to optimise outcomes for mother and baby.
• Play a key role in UCLH's outpatient and inpatient maternity diabetes services, which combine telephone and face-to-face consultations, app-based self-monitoring and virtual education to support women through pregnancy and postpartum.
• Manage complex endocrine and diabetes cases referred from across the Trust and regional networks, including atypical phenotypes (e.g. MODY, LADA, mitochondrial diabetes) and technology-intensive type 1 diabetes care (insulin pumps, closed-loop systems, CGM).
• Lead or contribute to multi-disciplinary care plans for high-risk surgical patients with diabetes, ensuring safe peri-operative glycaemic management and clear communication between anaesthesia, surgery and ward teams.

• Peri-operative Management of the Adult Surgical Patient with Diabetes – UCLH Trust-wide guideline
  Named Diabetes Consultant within the stakeholder group for guideline that standardises peri-operative diabetes care across anaesthesia, surgery, pre-assessment, wards and day-case units, incorporating national CPOC and JBDS recommendations.
• Diabetes Outpatient Maternity Guideline (Local, UCLH) – Diabetes Consultant / guideline owner
  Co-authored and sponsored a comprehensive maternity diabetes guideline that defines screening, diagnosis and management of gestational and pre-existing diabetes, integrating telephone-based reviews, app-supported monitoring and multidisciplinary clinics.
• Diabetes Inpatient Maternity Guideline (Local, UCLH) – Diabetes Consultant & guideline development group member
  Contributed to trust-wide standards for inpatient management of women with diabetes during pregnancy, labour, delivery and the postnatal period, including VRIII protocols, pump management and neonatal handover.
• Ongoing involvement in audit and quality improvement projects in inpatient diabetes safety, peri-operative care and maternity diabetes outcomes.