Foot complications are very common in patients with diabetes. At least one in six diabetics develop foot ulcers at some point in their lives. This article reviews why foot complications occur in diabetes, how you can detect foot problems early, and treatment and prevention strategies. The National Service Framework for Diabetes suggests that targeted foot care for people at high risk could save hundreds of amputations a year. By detecting complications earlier, we can make a real difference to patients' lives, reducing morbidity, improving quality of life and even saving limbs.
A Scottish study shows that the overall incidence of type 2 diabetes has stabilised over the past 12 years while mortality has declined. The study authors suggest that the increasing prevalence of the disease, from 3.2% in 2004 to 5.1% in 2013 is due to longer survival of patients and not increasing numbers.
In 2008, NICE published a comprehensive guideline on the management of type 2 diabetes which took a patient-centred approach to care and updated recommendations on the management of blood glucose, blood pressure, lipids, thrombosis, renal function and retinopathy. A number of new and emerging therapies for blood glucose management were not included at the time and the recent publication of NICE Clinical Guideline 87 provides valuable recommendations on when and where these drugs should be used in the care pathway. They give more options for healthcare professionals and their patients with type 2 diabetes at a time of ongoing change in management of the condition.
In the UK, an estimated 1 million people with diabetes use injectable therapies, and these patients are increasingly being managed in primary care. As a result, more primary care nurses are taking responsibility for the initiation and continuing management of injectable therapies, including advising on and reviewing an individual patient's injection technique.
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.
Intensified and multifaceted treatment of patients with type 2 diabetes and poor prognosis due to microalbuminuria extends median lifetime by 8 years compared with conventional therapy, according to a new long-term Danish follow-up study of the Steno-2 trial.
Type 2 diabetes can be reversed with intensive medical treatment using medications and lifestyle therapies, according to a new study. Up to 40% of study participants were able to stay in remission three months after stopping diabetes medications.
A new study suggests that a ‘Sit Less’ intervention ‒ breaking sitting with standing and light-intensity walking ‒ may be an alternative to structured exercise to promote blood sugar control in patients with type 2 diabetes, giving improved 24-hour glucose levels and improved insulin sensitivity.
Dapagliflozin (Forxiga) is the first in a new class of oral antidiabetic drug that has been given the go-ahead for marketing in Europe, including the UK. Described as a sodium glucose cotransporter 2 (SGLT2) inhibitor, this new preparation works on the kidneys to lower blood glucose. What does this new drug have to offer and how can it potentially help our patients with type 2 diabetes?