Back to Basics: Blood glucose-lowering therapy
New drugs and where they fit in the treatment algorithm
In May 2009, NICE published recommendations on the use of newer agents for the control of blood glucose in type 2 diabetes. This guideline provides a partial update for NICE Clinical Guideline 66 on the management of type 2 diabetes that was published last year. These newer agents include the dipeptidyl peptidase-4 (DPP-4) inhibitors, thiazolidinediones (TZDs), the glucagon-like peptide-1 (GLP-1) mimetic exenatide and the long-acting insulin analogues (insulin detemir and insulin glargine).
Understanding the Potential of New Oral Anticoagulant Drugs
Although there are other oral anticoagulation agents available, warfarin is the drug used predominantly in the UK. Warfarin has been in clinical use for over 50 years. It is still referred to by patients as ‘rat poison’ and,indeed, warfarin derivatives are still used as rodenticides.In this article, we take a look at some of the new oral anticoagulants coming along.
A practical guide to starting patients with type 2 diabetes on insulin
The prevalence of type 2 diabetes is rising and people are developing the condition at an earlier age. Type 2 diabetes becomes progressively more difficult to control over time, so many people need to start on insulin therapy as the pancreas is no longer able to meet the body’s insulin requirements on its own. In this article,we look at the practical issues involved in helping a patient to start on insulin therapy for their diabetes.
Tracing the history of insulin
We often take modern medicine for granted,but a review of the history of a disease and its treatment can help us put the whole thing in perspective.In this article,we trace the development of understanding about the nature and cause of diabetes and the use of insulin as a key treatment.
Learning to live with insulin: helping patients to do well
Starting on insulin injections represents a major change for most people with diabetes. Many aspects of everyday life will need to be considered more carefully,which can be quite daunting.With adequate support and education from the practice nurse,patients can be encouraged to be proactive and positive towards this new stage in their lives. This article looks at people with type 2 diabetes or those with stable type 1 diabetes,who are likely to be managed in general practice.We discuss everyday concerns about using insulin,why people on insulin are prone to put on weight,how exercise affects blood glucose levels,how to manage illness in those with diabetes and how to adequately prepare for holidays.
Insulin in type 2 diabetes: getting the balancing act right
How much insulin does a patient with type 2 diabetes need for optimal glucose control? It can sometimes be a tricky balancing act to get the dose just right – too much increases the risk of hypoglycaemic episodes and too little risks poor glucose control and the associated long-term complications.In this article we review what the research and guidelines recommend in how to ensure each patient gets the best dose of insulin.
Starting on insulin for type 2 diabetes
Hitting the spot: injection technique using an insulin pen
This article provides a simple guide to the do’s and don’ts of insulin injection technique, taking you through the steps that patients need to go through to inject their insulin correctly.
Helping patients on insulin to travel safely
People with diabetes need to plan carefully for holidays, especially if they are treated with insulin. Although much of the advice will be the same as for the general population, these patients are more vulnerable and will need to take particular care in looking after themselves to avoid any ill health while away from home.
Starting On Nateglinide Or Repaglinide
Tredaptive: a new option in lipid management
Blood cholesterol levels play an important role in the development of atherosclerosis and cardiovascular disease (CVD), and the incidence of CVD is closely related to the concentration of the specific lipoproteins in the blood. In this article, we review the role of different lipoproteins and the mechanism of action and potential role of a new agent for lipid modification – Tredaptive.
