Volume 5, Number 5, September-October 2008
BACK TO BASICSMaking Sense of Peripheral Arterial Disease (PAD)
POPULAR
TOPICCHANGING BEHAVIOURWhy do People with Diabetes Fall Off the Rails?
Philippa Ward Why is it that some patients with diabetes are able to stick to the ‘straight and narrow’
while others fall off the rails? I decided to look at my client group to see if I could
pick up on any particular issues that made people either forget that they have
diabetes, or struggle to continue to control their blood glucose levels as they had
previously been doing. This article reviews what I found and offers some suggestions on how to
help patients get back in control.
POPULAR
TOPICDIABETES MANAGEMENTPutting the NICE Guideline on Type 2 Diabetes into Practice
Linda Goldie At last, the updated NICE (National Institute for Health and Clinical Excellence) guideline
for the management of type 2 diabetes has been published. It includes an update on the
management of blood glucose, blood pressure, lipids, renal function and retinopathy,
but the key priorities for implementation are based on taking a patient-centred
approach to care. In this article, we will focus on the important areas of patient education,
dietary assessment, setting targets for HbA1c, self-monitoring and starting insulin therapy.
DID YOU KNOW?Herbal Medicines and the Clinical Management of Cardiovascular Disease and Diabetes
Catherine Strowbridge 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. EDITORIALEditorial
Jan Procter-King ‘Raindrops keep falling on my head’ might have been the theme tune for
most of this summer. Hopefully, we might have a drier winter to make up for
the downpours we have had over the last few months. But we hope this
issue of BJPCN will provide a handy ‘umbrella’ to keep you dry under the
storm clouds you might have to face in the day-to-day management of the
wide range of patients with cardiovascular disease (CVD) and diabetes. EVIDENCE IN PRACTICEEvidence in Practice
There are just not enough hours in the day to read all the research journals, even if you wanted to. This section of BJPCN –
Evidence in Practice – will keep you on top of relevant research without having to spend hours in the library.
Each review gives you a bite-size summary of new research, pulling out key points for primary care and recommending the action
that you might consider taking. HAVE YOU HEARD?Have you Heard?
POPULAR
TOPICMONITORINGMaking Sense of FINDRISC: the Finnish Diabetes Risk Score and How to Use it
Sandra Waddingham In this article, we look at what FINDRISC is and how this tool can be used to effectively
prevent and slow down the development of diabetes. We also discuss the correlation
between blood glucose and cardiovascular risk before a diagnosis of diabetes has been
made, and how to manage risk factors to significantly reduce morbidity and mortality.
PREVENTION IN PRACTICEThe Penis as a Barometer of Cardiovascular Risk
Mike Kirby The arteries that supply the penis are very small and may be more prone to
atherosclerosis than larger vessels. This means that the penis may be the first area
in a man’s body to suffer from a reduction in blood flow and so signal
cardiovascular disease. POPULAR
TOPICQUALITY MATTERSHeart Failure Specialist Nurses: Feeling the Impact
Jill Pattenden Heart Failure Specialist Nurses (HFSNs) now work in the community alongside their
general practice colleagues. They can act as a valuable resource to support the primary
care team in the management of heart failure patients. They carry out home visits and
run community clinics to stabilise patients after discharge from hospital following an
acute event. The aim is to educate patients and their family carers how to manage living with
heart failure, up-titrate medications to optimal levels, stabilise the patient and then hand them
back to the care of the primary care team, knowing that they will be referred back to the HFSN
should their condition deteriorate. However, some complex patients with advanced heart failure
(NYHA III or IV) and at high risk of re-hospitalisation are retained in the specialist nurse caseload. POPULAR
TOPICTHERAPEUTICS REVIEWLipid Modification in Primary Prevention – Treatment not Target
Jan Procter-King The NICE lipid modification guideline, published in May this year, covered both primary and
secondary prevention of CVD. This article will look briefly at the principles of this guideline
in relation to primary prevention and then go further to highlight the key issues regarding
statin prescribing for people established to be at high cardiovascular risk.
PATIENT INFORMATIONStarting on a Gliptin – Sitagliptin or Vildagliptin
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