Type 2 Diabetes

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.

The year of care for diabetes: what can it achieve?

The Year of Care for diabetes project has its roots in the recent movement to put patient empowerment at the top of the health agenda.It reflects recent government publications,including Choosing Health: Making healthy choices easier and Our health, Our care, Our say. In this article we look at the development of the project, its aims and what it will mean in practice.

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.

Optimising insulin treatment in primary care

Everyone with diabetes deserves the highest standards of personalised diabetes care, no matter where, when or by whom this care is delivered.

The UK Prospective Diabetes Study (UKPDS): Its legacy for type 2 diabetes management

Get Your Socks Off: Diabetic Foot Care In The Community

All of us delivering care to people with diabetes know that it’s increasingly common, affecting two million people in the UK,according to figures for 2007.It is also expensive,taking up about 10% of NHS costs and 5% of social costs. We also know it’s the commonest cause of non-traumatic lower limb amputations and that’s just one of the reasons that we spend so much time in clinics optimising care and detecting complications.But how well do we understand the impact of foot disease and how organised are we in assessing and treating it?

Working In Partnership With Patients: Developing A Diabetes Pathway With Local Service Users

This article looks at how a group of patients worked in partnership with North Lancashire Teaching Primary Care Trust (PCT) to produce a patient information leaflet for people newly diagnosed with diabetes (see page 32).The leaflet is intended to act as a guide, giving the new diabetic information and facts to help them,as well as encouraging them to find out more for themselves and enabling them to ask the appropriate questions.

How to prevent and manage lipohypertrophy at injection sites

Lipohypertrophy is surprisingly common in people using insulin to control their diabetes. As more and more people with diabetes are managed in primary care, practice nurses take on a greater role in the management and education of these patients. This article considers what lipohypertrophy is, how it can be prevented and how it should be managed once it has been identified.

Cardiovascular disease and type 2 diabetes

Herbal Medicines and the Clinical Management of Cardiovascular Disease and Diabetes

Many people use herbal medication of some sort, but several commonly used herbs have been shown to interact with prescribed medication. Studies show that many patients either do not realise that the herbs could interact (and anyway do not class the herbs as medicines) or do not want to tell their practitioner that they are using them. With many more nurse prescribers taking control of management of patients with longterm conditions such as diabetes and ischaemic heart disease, it is vital that we consider that the patient may be taking non-prescribed medication including herbs and supplements.

Making Sense of FINDRISC: the Finnish Diabetes Risk Score and How to Use it

In this article, we look at what FINDRISC is and how this tool can be used to effectively prevent and slow down the development of diabetes. We also discuss the correlation between blood glucose and cardiovascular risk before a diagnosis of diabetes has been made, and how to manage risk factors to significantly reduce morbidity and mortality.

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