Diabetes specialist nurses (DSNs) are usually experienced registered nurses who specialise in all aspects of diabetes care. They work in hospitals and in the community, fulfilling many different roles. As their work focuses on diabetes care they become very knowledgeable in their subject area and are potentially a valuable resource. This article looks at the role of the DSN and how practice nurses can make use of their expertise to improve both patient care and their own diabetes management skills.
You and your Treatment: Starting on Ezetimibe (Ezetrol)
Glitazones: All That Glitters…
Glitazones were rapidly incorporated into the management of patients with type 2 diabetes after their introduction. How do they work and when should we consider using them? And what should we make of recent discussions about the possibility of an increased risk of myocardial infarction with rosiglitazone?
Hands on Hypertension: Getting to Targets in Practice
Hypertension affects one in five people in the UK and is poorly managed despite a range of drug and lifestyle interventions known to be useful and effective. We are constantly reminded about the importance of getting people to target with blood pressure (BP) treatments but this can be easier said than done. In this article, we will look at the challenge of getting blood pressure readings down to target levels and we will work through some case studies to explore possible solutions to achieving the targets in practice.
Monitoring kidney function with eGFR
Around 2.9 million people in the UK have moderate-to-severe kidney disease. Estimated glomerular filtration rate (eGFR) can help to identify patients at high risk of cardiovascular disease (CVD) and improve the prevention and management of chronic kidney disease (CKD). In this article, we explain why it is important to detect CKD early, how eGFR is calculated and how to reduce risk in patients found to have impaired kidney function.
Editorial
“It is no use saying ‘We are doing our best.’ You have got to succeed in doing what is necessary.” So said Winston Churchill. His approach helped win the Second World War, and applies just as well to the war we fight every day against cardiovascular disease.
Diabetes Control During Ramadan: How to Advise our Patients
Fasting is obligatory for all Muslim men and boys over the age of 12 and for Muslim women and girls who have passed puberty. It requires that no food or drink pass the lips during the hours of daylight, including medication – oral or inhaled. Not eating or being unable to take medication during the daytime obviously has major implications for people with diabetes. In this article we review how we should advise our patients – how can they maintain control of their diabetes at the same time as honouring their religious obligations?
Blood Clotting: How do Drugs Affect it?
Haemostasis is essentially the fine balance between activators and inhibitors that control the production of the protein tangle that makes up a blood clot. A range of drugs can interfere with this fine balance. In this article we guide you through the latest theories of how blood clotting occurs and explain how various drugs used as anticoagulants interfere with this normal haemostatic mechanism.
You and Your Treatment: Starting on Metformin
Polycystic Ovary Syndrome (PCOSs): Where Metabolic Syndrome Meets Gynaecology
Polycystic ovary syndrome (PCOS) is a complex and distressing life-long condition. It is the commonest endocrine disorder among women of reproductive age, affecting 5-15% of women. PCOS causes short-term effects due to hormonal imbalance as well as longterm effects relating to underlying insulin resistance and consequent hyperinsulinaemia, a form of metabolic syndrome. How can we achieve effective reduction of risk factors in these women to prevent premature cardiovascular disease?
Portfolio Diet
The consistency and magnitude of cholesterol lowering achieved following the introduction of statins has resulted in less importance being given to long-term diet-based interventions over the past few years. Nevertheless, lifestyle changes are, and will remain, the preferred option before resorting to long-term drug therapy. They are also essential in people below the cut-off cholesterol level for drug treatment or where side-effects limit drug use. This article reviews the portfolio diet and its role in cholesterol management.
Stable Angina: Making the Most of Cardiac Function
Stable angina is very common. Just under two million people in the UK – over one million men and 840,000 women – have, or have had, angina. In this article we review how new-onset stable angina is assessed, including an update on new investigations, and the latest treatment options including drugs and interventions, based on the most up-to-date guidelines and current practice.
