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Diabetes

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Diabetes

More than 4.9 million people in the UK have diagnosed diabetes and by 2030 Diabetes UK estimate there will be 5.5 million people with diabetes.

The care of patients with diabetes – particularly type 2 diabetes which counts for about 90% of patients seen in primary care – is a significant challenge.

Our resources focus on:

Detection of pre-diabetes conditions frequently associated with obesity and metabolic disorders

Early diagnosis of type 2 diabetes

Interventions to reduce the risks of cardiovascular and renal disease (the cardio-renal syndrome)

Glycaemic control with established therapies including metformin

The roles for newer agents including SGLT2 inhibitors and DDP-4 inhibitors

Importance of lipid (cholesterol) management and antihypertensive therapy

Additional contributions discuss:

The initiation and intensification of insulin in people with type 2 diabetes

Diagnosis and management of people with type 1 diabetes

Prevention of hypoglycaemia

Diabetes Specialist Nurses: Making the Most of their Expertise in Primary Care

Diabetes specialist nurses (DSNs) are usually experienced registered nurses who specialise in all aspects of diabetes care. They work in hospitals and in the community, fulfilling many different roles. As their work focuses on diabetes care they become very knowledgeable in their subject area and are potentially a valuable resource. This article looks at the role of the DSN and how practice nurses can make use of their expertise to improve both patient care and their own diabetes management skills.

Glitazones: All That Glitters…

Glitazones were rapidly incorporated into the management of patients with type 2 diabetes after their introduction. How do they work and when should we consider using them? And what should we make of recent discussions about the possibility of an increased risk of myocardial infarction with rosiglitazone?

Diabetes Control During Ramadan: How to Advise our Patients

Fasting is obligatory for all Muslim men and boys over the age of 12 and for Muslim women and girls who have passed puberty. It requires that no food or drink pass the lips during the hours of daylight, including medication – oral or inhaled. Not eating or being unable to take medication during the daytime obviously has major implications for people with diabetes. In this article we review how we should advise our patients – how can they maintain control of their diabetes at the same time as honouring their religious obligations?

Diabetes In The Elderly

As the world population continues to age and the proportion of the elderly suffering from diabetes increases compared to other age groups, the health burden of diabetes in the elderly is set to continue to rise. Practices need to be prepared to cope with a near doubling of the number of elderly people with diabetes over the next twenty years. In this article, we review the particular challenges of managing diabetes in the older patient.

Making the Most of Insulins in Primary Care

Insulin therapy has, historically, been initiated and managed by specialist services in secondary care. However, the recent shift in focus from secondary to primary care services, together with the fact that insulin therapy in type 2 diabetes is becoming more common, means that many GPs and practice nurses are becoming increasingly involved in insulin management. This article reviews the different types of insulin now available and how to use them, with the aim of unravelling some of the mysteries surrounding insulin management.

Finger Pricking Good: Optimising Self-Testing of Blood Glucose in Diabetes

Finger pricking or self-monitoring of blood glucose (SMBG) – which patients with diabetes can regularly use to check their own blood sugar levels – is not cheap. Most practices spend 40% more on blood testing strips than on oral hypoglycaemic drugs. Dr Karet carefully reviews the evidence for which patients we should be advising to selfmonitor, how often they should test their blood glucose and – most importantly – how they should act on the results.

What’s on the Menu? Eating Out with Diabetes and Heart Disease

Learning to accept and live with a chronic condition such as diabetes or coronary heart disease (CHD) is as crucial a part of treatment as medications. As eating outside the home is increasingly a feature of today’s society, it is important that patients with diabetes or CHD feel able to enjoy meals out without any feelings of guilt. In this article, we suggest practical tips for helping patients with diabetes and heart disease to eat out healthily.

Organising Care For The Person Newly Diagnosed With Diabetes

The focus of diabetes care is well established in general practice, with practice nurses taking on much of the responsibility for diabetes management. The white paper Our Health, Our Care, Our Say talks about high quality care being delivered to patients close to where they live. So, in the future, general practice can expect to take on more responsibility for conditions such as diabetes. This article discusses the priorities for the newly diagnosed patient, and the importance of sound advice and guidance in the early stages.

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