What are the practicalities of supporting people with diabetes who fast during Ramadan? Practice nurses can make a real difference by educating patients before Ramadan starts and advising them on what they need to consider before starting their fast. Patients need to be involved in the whole process so that they are well aware of the importance of managing their diabetes to ensure good control of their glucose levels throughout Ramadan. We review how to assess patients before Ramadan, what adjustments to make to medication and how to follow up.
There are several blood tests available to measure blood glucose levels. Some require the patient to fast while others do not. Understanding and interpreting the results accurately are essential in optimising the management of our patients with diabetes. This article looks specifically at the HbA1c test and its significance. We define what it is and when we should carry out this test, as well as helping you to understand what the results mean and the targets we are aiming for.
Primary care has traditionally managed people with type 2 diabetes, and people with type 1 diabetes have largely been the responsibility of secondary care. However, as blood glucose targets have become tighter and growing numbers of people with type 2 diabetes have started to require insulin, many in primary care have gradually taken on insulin management. As primary care professionals become more confident in the management of patients on insulin, many practices will be keen to take on the challenge of type 1 patients. This article looks at how type 1 differs from type 2 diabetes, which type 1 patients might be managed appropriately in primary care, and recaps on insulin regimens and dose adjustment.
Insulin therapy has, historically, been initiated and managed by specialist services in secondary care. However, the recent shift in focus from secondary to primary care services, together with the fact that insulin therapy in type 2 diabetes is becoming more common, means that many GPs and practice nurses are becoming increasingly involved in insulin management. This article reviews the different types of insulin now available and how to use them, with the aim of unravelling some of the mysteries surrounding insulin management.
MODY (maturity onset diabetes of the young) is a rare, genetic form of diabetes characterised by three main features: a young age of onset (
Primary care nurses can target efforts to prevent type 2 diabetes by measuring patients' waist circumference, according to a new definition of metabolic syndrome announced recently by the International Diabetes Federation. The definition focuses on excess abdominal fat – which results in people being 'apple' shaped – as a key contributor to the development of the dangerous mix of impaired glucose control, hypertension and hyperlipidaemia that sets people on the road to type 2 diabetes. Just looking at people's body shape as they come into the surgery, measuring their waist size and taking steps to reduce it where indicated, can help in the ongoing fight against the disease.
As the use of insulin therapy becomes more common in the ever-growing population of people with diabetes, practice nurses need to be aware of the range of insulins now available and how they work as they take on more responsibility for the management of these patients. In this article, we look at the production and role of insulin in the body and how type 1 and type 2 diabetes affects this. Moving on to newer insulins, we review how longer-acting insulins are used to mimic the characteristics of natural background insulin, the role of shorteracting insulins available for mealtime bolus doses, and the use of insulin mixtures in practice.
A new NHS service to provide a non-surgical reversible weight loss device for people who have both poorly controlled type 2 diabetes and obesity is safe and effective and should be rolled out across the NHS, according to new research presented at the recent EASD annual meeting in Lisbon, Portugal.