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?
What are the health benefits of walking,and how much should we walk and how often? In this article,we review the evidence on the impact of walking on health, the latest recommendations on walking,how to overcome barriers to walking,how to motivate our patients to start walking and how to keep it going.
How do you recognise a transient ischaemic attack (TIA) and how does this differ from a full stroke? In this article, we explore the ABCD2 score, which can be used to identify high- and low-risk TIAs, and the best course of action if a TIA is suspected. A TIA is very often the herald of a more serious and permanent stroke, underlining why it should be acted on as a matter of urgency, and there is an update on the current guidance from NICE and the Royal College of Physicians.
Most women think they are at greatest risk of dying from cancer, especially breast cancer, but in fact, women are nine times more likely to die from cardiovascular disease (CVD) than from breast cancer. The menopause has particular significance in CVD risk. In this article we look at what happens to cardiovascular risk at the menopause and opportunities for CVD prevention.
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.
Dietary fibre is a frequently neglected nutrient, with eight out of ten UK adults eating less than is needed for good health. Most people think of fibre simply as roughage or bran and know that it helps with constipation and bowel disorders, but fibre is far more than this, with a wide range of health benefits. Evidence indicates that eating a fibre-rich diet will not only improve digestive health, but also aid weight loss, help to reduce cholesterol levels, and reduce the risk of certain cancers (including bowel and breast cancer) and type 2 diabetes. It will also boost intake of vitamins, minerals and antioxidants. This review explores the major role of fibre in health and wellbeing and gives practical tips for dietary advice.
Hypertension is a silent, malevolent factor in both cardiovascular and renal disease. Raised blood pressure (BP) rarely causes any symptoms – in fact the presenting symptom of hypertension is too often the heart attack or stroke that is the end result. Diagnosis of prolonged abnormal blood pressure is therefore key in the prevention of a range of long-term conditions. In this article, we will examine the importance of measuring blood pressure correctly before making the diagnosis of hypertension. We will also look at the different levels of blood pressure that constitute a diagnosis of hypertension according to the variety of guidelines that exist.
The prevalence of atrial fibrillation (AF) is increasing with the ageing population. It is well worth detecting and treating as it carries a significant risk of debilitating disease, including stroke and heart failure. This article explains some of the health risks and describes simple actions that can play an important part in both the prevention and management of AF and its consequences.