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.
Putting Prevention First - the national strategy for assessing cardiovascular risk in everyone between the ages of 40 and 74 years - is here to stay, regardless of any changes in the NHS. This strategy is based on assessing a patient's individual risk of cardiovascular disease and, where this risk is significant, offering them measures to reduce this risk. In this article, we look at how to achieve a key step in this process: explaining the complex concept of absolute cardiovascular risk to patients so they understand what's at stake when deciding whether or not to take their statin or antihypertensive.
The UK faces an epidemic of heart failure (HF). NICE guidelines emphasise the importance of multidisciplinary assessment and care by HF specialists, evidence-based prescribing, and careful discharge planning after hospitalisation. This article highlights areas where improvements can be made in the management of HF including taking lessons from the latest National Heart Failure Audit.
People with diabetes need to plan carefully for holidays, especially if they are treated with insulin. Although much of the advice will be the same as for the general population, these patients are more vulnerable and will need to take particular care in looking after themselves to avoid any ill health while away from home.
Many people use herbal medication of some sort, but several commonly used herbs have been shown to interact with prescribed medication. Studies show that many patients either do not realise that the herbs could interact (and anyway do not class the herbs as medicines) or do not want to tell their practitioner that they are using them. With many more nurse prescribers taking control of management of patients with longterm conditions such as diabetes and ischaemic heart disease, it is vital that we consider that the patient may be taking non-prescribed medication including herbs and supplements.
This article provides a simple guide to the do's and don'ts of insulin injection technique, taking you through the steps that patients need to go through to inject their insulin correctly.