NICE have recently updated the guidance in a number of sections of the type 2 diabetes guidelines (NG28). New information on sodium–glucose cotransporter 2 (SGLT-2) inhibitors has been added to the section on initial drug treatment when metformin is contraindicated or not tolerated.
The National Institute for Health and Clinical Excellence (NICE) recommends that all people with diabetes should receive nine key tests at their annual diabetes review. These important markers ensure diabetes is well controlled and are designed to prevent longterm complications. The nine key tests are: weight, blood pressure, smoking status, HbA1c, urinary albumin, serum creatinine, cholesterol, eye examinations and foot examinations. This review discusses the importance of each marker of improved long-term care of patients.
A new wound care system using nitric oxide has been shown to heal diabetic foot ulcers faster and more effectively than standard care in UK treatment centres.
Two new studies highlight the ongoing gap in life expectancy between people living with type 1 diabetes (T1D) and the general population.
The number of people diagnosed with diabetes in the UK has more than doubled in the last twenty years, according to new analysis released today by Diabetes UK. The new figures show that there are now almost 3.7 million people living with a diagnosis of the condition in the UK, an increase of 1.9 million since 1998.
*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.
Volume 6, Special Issue 1, Jan-Feb-Mar 2009
Primary care nurses play a central role in the management of type 2 diabetes in the community. This includes helping patients to use their drug treatment correctly. Although many patients with type 2 diabetes initially respond well to weight loss and exercise, most require oral hypoglycaemics and half of all patients eventually require insulin to control their glucose levels in order to prevent the devastating long-term complications of inadequately controlled diabetes. Linda Goldie gives an up-to-date review of the newer insulins – including the insulin analogues, insulin lispro, insulin aspart and insulin glargine – that have been introduced.
There is good evidence that tight glycaemic control significantly improves outcomes in patients with type 2 diabetes. All practice nurses will be looking to achieve the new General Medical Services contract (GMS2) targets for HbA1c reduction in diabetes (see box). Practices will be developing prescribing strategies to achieve this reduction, in accordance with good clinical practice. Metformin offers an important first-line therapy for type 2 diabetes. The introduction of a new, sustained-release formulation – Glucophage SR – should improve patient compliance with metformin and so improve glycaemic control.