Obesity is estimated to be responsible for more than 30,000 deaths each year, reducing lifespan by an average of nine years. The links between obesity, diabetes and cardiovascular disease are well documented, but overweight and obesity also causes 6% of cancers in the UK. These figures have resulted in warnings that obesity is the new smoking when it comes to risks to health and longevity. So the problem is clear. The challenge is to put into action what works.
More and more is being expected of practices in improving the management of diabetes – with initiatives such as the National Service Framework (NSF) for Diabetes and NICE guidance setting increasingly ambitious targets. The National Diabetes Support Team (NDST) has been set up to help support local services throughout the NHS and in meeting these challenges. In this issue, they share latest advice for practices and patients on disposing of used syringes and other sharps.
The onset of type 1 diabetes is usually rapid, taking patients and their relatives and friends, and even healthcare professionals by surprise. Diagnosis can involve some degree of diabetic ketoacidosis (commonly referred to as DKA). It is estimated that approximately 30% of newly diagnosed children seen by a healthcare professional have problems related to their diabetes before diagnosis, which suggests that practitioners are missing opportunities to diagnose type 1 diabetes at an earlier stage and possibly avoiding DKA. In this article, we explore how primary care staff can achieve earlier diagnosis of type 1 diabetes.
Exenatide (Byetta) is the first glucagon-like peptide-1 analogue (GLP-1 analogue) to be approved for the treatment of type 2 diabetes. It is a twice-daily injection, currently prescribable only by consultants, given before breakfast and before the evening meal. The early signs are that this new and different medicine has the potential to be very exciting for both patients and healthcare professionals. Studies show a reduction in HbA1c as well as steady weight loss – every diabetic's dream! In this article, we look at how exenatide works, where it fits into current practice and the pros and cons of this new preparation.
Finger pricking or self-monitoring of blood glucose (SMBG) – which patients with diabetes can regularly use to check their own blood sugar levels – is not cheap. Most practices spend 40% more on blood testing strips than on oral hypoglycaemic drugs. Dr Karet carefully reviews the evidence for which patients we should be advising to selfmonitor, how often they should test their blood glucose and – most importantly – how they should act on the results.
Spring has sprung with lambs in the fields and Easter eggs in the shops. We also have lots happening on the cardiovascular and diabetes front!
New research from a large national database shows an increased risk of adverse outcomes in babies born to mothers with gestational diabetes when compared with non-diabetic mothers. The database of all 797,346 deliveries in France in 2012 included 57,629 (7.24%) mothers with gestational diabetes. There was an increased risk of a number of complications for mothers with gestational diabetes compared with non-diabetic mothers.