Making Best Practice, Every Day Practice
*The British Journal of Primary Care Nursing approached Abbott Healthcare Products Limited to fund the production of this supplement. The company was not involved in its development, although it was asked to review it for technical accuracy just prior to printing. Editorial control has remained with the British Journal of Primary Care Nursing at all times.
Glucose monitoring has revolutionised the management of diabetes by providing the means for patients to check their blood glucose level in real time. This review provides an update on continuous glucose monitoring, looks at the devices available and analyses what the strategy adds to diabetes management.
Glycated haemoglobin – HbA1C, or A1C as it is now being called – should be used to diagnose diabetes, according to a recent recommendation from an international expert committee appointed by the American Diabetes Association, the International Diabetes Federation and the European Association for the Study of Diabetes. We explore the basis for this recommendation, and look at why HbA1C would provide a more accurate measure for diagnosing diabetes than glucose tests and what the change would mean in clinical practice.
Diabetes affects approximately 3-4% of the British population but is thought to be significantly under-diagnosed. How can we improve the number of patients who are diagnosed early and so improve their risk of long-term complications?
The new NICE guideline enables us to individualise care bearing in mind the needs of the person in front of us. It is concerned with clinical efficacy, and – for once – the cost of care has not noticeably influenced its recommendations. In contrast, QOF does the exact opposite, demanding that we drive our patients’ HbA1c down to low […]
Many people with type 2 diabetes are overweight or obese at diagnosis and continue to struggle to control their weight. This article looks at why people with diabetes find weight control more of a challenge than the rest of us and how practice nurses can help patients to remain positive, particularly when starting insulin to optimise blood glucose control.
The new national strategy for vascular risk assessment, now being referred to as NHS Health Check, will include testing for diabetes and impaired glucose tolerance (IGT). This follows a major evaluation of the evidence showing that it is more cost-effective to screen individuals for IGT than screening for diabetes alone, but only as part of the broader vascular risk assessment. This article examines the concepts of IGT and impaired fasting glucose (IFG) and offers practical advice as to how these conditions can be managed in primary care.
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.
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.
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