Primary care nurses play a central role in the management of type 2 diabetes in the community. This includes helping patients to use their drug treatment correctly. Although many patients with type 2 diabetes initially respond well to weight loss and exercise, most require oral hypoglycaemics and half of all patients eventually require insulin to control their glucose levels in order to prevent the devastating long-term complications of inadequately controlled diabetes. Linda Goldie gives an up-to-date review of the newer insulins – including the insulin analogues, insulin lispro, insulin aspart and insulin glargine – that have been introduced.
The Primary Care Training Centre (PCTC) was set up eight years ago with the aim of providing practical, evidence-based training for primary care health professionals. It was started in response to requests from primary care professionals who were concerned that there was no training specifically for them, particularly on the important subjects of diabetes and coronary heart disease prevention. Existing courses sometimes failed to fully understand the primary care situation.
Angina is a common problem in primary care, affecting around one in every six patients aged 65 years and over. It ispredominantly chest pain due to transient myocardial ischaemia caused by coronary artery disease. Episodes of angina are typically caused by exertion or emotion, and are relieved by rest. Treatment with drugs and/or surgery that improves blood flow to the heart and lifestyle changes can significantly improve patients’ quality of life and survival.
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 very good audit data for this practice has led to its winning awards. So how does the practice do it? This ‘day in the life of’ photo diary gives a step-by-step guide to the key elements of running a successful cardiovascular clinic in general practice.