Type 1 Diabetes

Primary care has traditionally managed people with type 2 diabetes, and people with type 1 diabetes have largely been the responsibility of secondary care. However, as blood glucose targets have become tighter and growing numbers of people with type 2 diabetes have started to require insulin, many in primary care have gradually taken on insulin management. As primary care professionals become more confident in the management of patients on insulin, many practices will be keen to take on the challenge of type 1 patients. This article looks at how type 1 differs from type 2 diabetes, which type 1 patients might be managed appropriately in primary care, and recaps on insulin regimens and dose adjustment.

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.

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.