The onset of type 1 diabetes is usually rapid, taking patients and their relatives and friends, and even healthcare professionals by surprise. Diagnosis can involve some degree of diabetic ketoacidosis (commonly referred to as DKA). It is estimated that approximately 30% of newly diagnosed children seen by a healthcare professional have problems related to their diabetes before diagnosis, which suggests that practitioners are missing opportunities to diagnose type 1 diabetes at an earlier stage and possibly avoiding DKA. In this article, we explore how primary care staff can achieve earlier diagnosis of type 1 diabetes.
Preventing delayed diagnosis of type 1 diabetes: time to act
Explaining the concept of absolute cardiovascular risk to patients
Putting Prevention First – the national strategy for assessing cardiovascular risk in everyone between the ages of 40 and 74 years – is here to stay, regardless of any changes in the NHS. This strategy is based on assessing a patient’s individual risk of cardiovascular disease and, where this risk is significant, offering them measures to reduce this risk. In this article, we look at how to achieve a key step in this process: explaining the complex concept of absolute cardiovascular risk to patients so they understand what’s at stake when deciding whether or not to take their statin or antihypertensive.
Editorial – Going back to basics in cardiovascular disease
There are 28 cardiac and stroke networks in the country. They play an important part in implementation of national strategies, enabling high-quality services to be planned and delivered to patients within the framework of primary and community care. One of the most useful contributions of the networks is provision of education and training for primary care staff. The “Back to Basics” material in this supplement forms the backbone of what is presented at study days. The articles cover some of the most common cardiovascular conditions that are seen in primary care, showing clearly what causes the symptoms, how best to assess and manage patients, and how the treatments actually work. They help healthcare workers both to understand these conditions and to explain them to patients, and therefore really improve patient care.
Editorial
This educational supplement is brought to you by the Cardiac and Stroke Network. What is this Network, and how can it further support your education and development?
Editorial
Chronic kidney disease (CKD) has shot up the primary care agenda over the last few years, and is now well recognised as an independent risk factor for cardiovascular disease (CVD). At the same time, CVD is a risk factor for progression of CKD. The close links between CKD and CVD mean we have to get to grips with assessing patients’ kidney function and ensuring those with CKD receive the treatment needed to prevent progression. This special issue devoted to CKD is full of step-by-step guides and illustrated articles to help you get to grips with this important condition.
Editorial
The effective management of long-term conditions such as chronic kidney disease (CKD) is probably the single greatest challenge faced by the NHS. The population is growing and people are living longer. Every week, the life expectancy for a newborn baby in the UK increases by more than 24 hours. While this is, in part, testament to the success of our health services, it also places steadily increasing demands upon them. As the population ages, the number of people living with long-term conditions is predicted to triple by 2050.
Understanding end-of-life care in advanced kidney disease
People with advanced kidney disease are required to make many choices about their treatment throughout the journey of this disease. Opting not to have dialysis or to withdraw from treatment is a difficult decision and there are many factors that influence patients’ decisions. For those who choose not to have dialysis, the implications need to be understood by the patient, their family and carers and healthcare professionals involved in their care. This article provides an update on this important issue to equip primary care professionals with a clear understanding of end-of-life care for patients with advanced kidney disease.
Making sense of chronic kidney disease
What exactly is chronic kidney disease (CKD), what causes it and how is it diagnosed? In this article we get down to the basics of defining what CKD is, and explore the stages of CKD. We review CKD progression and the assessment and management recommendations for each stage of CKD.
Kidney damage and what it means to you
Proteinuria: should it replace cholesterol as a marker for people at high risk of CVD?
We have all seen paintings of early physicians looking at flasks of urine to give an indication of a person’s health. And most of us can remember days of rows of urine pots lined up to test for new patients in primary care and in hospital outpatient clinics. We may assume that those days have gone in the era of blood testing and CT scans. So why are we suggesting that urine testing has a central role in finding patients with previously undiagnosed cardiovascular disease?
Editorial
The Department of Health certainly gave us all something to think about over the Christmas break and well into the New Year. In the middle of last December, Secretary of State Andrew Lansley confirmed that the Coalition Government is pressing ahead with its radical structural changes to the NHS in England.1 This was despite concerns by professional and patient organisations, and indeed the House of Commons Select Committee,2 about the feasibility of introducing major reforms when the NHS is under increasing financial pressures.
