A happy and productive 2009 to all our readers! We hope that as we all face the challenges – and, we hope, joys – that this year will bring, BJPCN can provide the practical and reliable information and advice that you tell us you find so useful.
Editorial
Triglycerides: Making Sense Of The Sometimes Forgotten Lipid Fraction
The importance of lowering total and LDL cholesterol (LDL-C) in the prevention of cardiovascular disease (CVD) is so firmly established that it has,in only a short time, become part of everyday practice for all primary care health professionals.Lipids,of course,come in multiple forms,which include fatty acids,the different forms of cholesterol and triglycerides.Most practitioners have only a sketchy idea of what triglycerides are,what they do and how important they are.Few understand the intricacies of measurement, diagnosis and interpretation,and when – and how – to manage them.The story is complex and involves difficult biochemical and metabolic concepts,so we should begin at the beginning.
Working In Partnership With Patients: Developing A Diabetes Pathway With Local Service Users
This article looks at how a group of patients worked in partnership with North Lancashire Teaching Primary Care Trust (PCT) to produce a patient information leaflet for people newly diagnosed with diabetes (see page 32).The leaflet is intended to act as a guide, giving the new diabetic information and facts to help them,as well as encouraging them to find out more for themselves and enabling them to ask the appropriate questions.
Get Your Socks Off: Diabetic Foot Care In The Community
All of us delivering care to people with diabetes know that it’s increasingly common, affecting two million people in the UK,according to figures for 2007.It is also expensive,taking up about 10% of NHS costs and 5% of social costs. We also know it’s the commonest cause of non-traumatic lower limb amputations and that’s just one of the reasons that we spend so much time in clinics optimising care and detecting complications.But how well do we understand the impact of foot disease and how organised are we in assessing and treating it?
Starting On Nateglinide Or Repaglinide
Cardiac Resynchronisation: A New Approach To Managing Chronic Heart Failure
About 40% of patients with heart failure die within one year of diagnosis,underlining the need for more effective management.Nearly one-third of patients with heart failure may have an abnormality in the electrical conducting system of the heart.In this article,we review cardiac resynchronisation and its role in managing chronic heart failure.
Walking your way to good health
What are the health benefits of walking,and how much should we walk and how often? In this article,we review the evidence on the impact of walking on health, the latest recommendations on walking,how to overcome barriers to walking,how to motivate our patients to start walking and how to keep it going.
Tredaptive: a new option in lipid management
Blood cholesterol levels play an important role in the development of atherosclerosis and cardiovascular disease (CVD), and the incidence of CVD is closely related to the concentration of the specific lipoproteins in the blood. In this article, we review the role of different lipoproteins and the mechanism of action and potential role of a new agent for lipid modification – Tredaptive.
How to prevent and manage lipohypertrophy at injection sites
Lipohypertrophy is surprisingly common in people using insulin to control their diabetes. As more and more people with diabetes are managed in primary care, practice nurses take on a greater role in the management and education of these patients. This article considers what lipohypertrophy is, how it can be prevented and how it should be managed once it has been identified.
Diagnosing hypertension: getting the numbers right
Hypertension is a silent, malevolent factor in both cardiovascular and renal disease. Raised blood pressure (BP) rarely causes any symptoms – in fact the presenting symptom of hypertension is too often the heart attack or stroke that is the end result. Diagnosis of prolonged abnormal blood pressure is therefore key in the prevention of a range of long-term conditions. In this article, we will examine the importance of measuring blood pressure correctly before making the diagnosis of hypertension. We will also look at the different levels of blood pressure that constitute a diagnosis of hypertension according to the variety of guidelines that exist.
Dietary fibre – more than just roughage
Dietary fibre is a frequently neglected nutrient, with eight out of ten UK adults eating less than is needed for good health. Most people think of fibre simply as roughage or bran and know that it helps with constipation and bowel disorders, but fibre is far more than this, with a wide range of health benefits. Evidence indicates that eating a fibre-rich diet will not only improve digestive health, but also aid weight loss, help to reduce cholesterol levels, and reduce the risk of certain cancers (including bowel and breast cancer) and type 2 diabetes. It will also boost intake of vitamins, minerals and antioxidants. This review explores the major role of fibre in health and wellbeing and gives practical tips for dietary advice.
