Volume 6, Special Issue 1, Jan-Feb-Mar 2009

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TOPICBACK TO BASICSGlucose metabolism
Jan-Procter King

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TOPICCHANGING BEHAVIOURThe year of care for diabetes: what can it achieve?
Bev Cox, Linda Goldie

The Year of Care for diabetes project has its roots in the recent movement to put patient empowerment at the top of the health agenda.It reflects recent government publications,including Choosing Health: Making healthy choices easier and Our health, Our care, Our say. In this article we look at the development of the project, its aims and what it will mean in practice.

EDITORIALEditorial
Dr Rowan Hillson

Everyone with diabetes deserves the highest standards of personalised diabetes care,no matter where,when or by whom this care is delivered.

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TOPICEVIDENCE 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 – summarises recent research in diabetes. 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?

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TOPICHOW TOHitting the spot: injection technique using an insulin pen
Bev Cox

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.

MONITORINGBlood glucose monitoring for people on insulin
Sharon Preston

This article will examine the issues surrounding blood glucose monitoring for people treated with insulin.It will look at the practical skills required for patients to test accurately,the roles of the individual patient and the healthcare professional in successful monitoring,and the equipment required.The aim of the article is to ensure that monitoring justifies the expense and time involved by achieving good glycaemic control.

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TOPICQUALITY MATTERSInsulin in type 2 diabetes: getting the balancing act right
Brian Karet

How much insulin does a patient with type 2 diabetes need for optimal glucose control? It can sometimes be a tricky balancing act to get the dose just right – too much increases the risk of hypoglycaemic episodes and too little risks poor glucose control and the associated long-term complications.In this article we review what the research and guidelines recommend in how to ensure each patient gets the best dose of insulin.

THERAPEUTICS REVIEWTracing the history of insulin
Professor Mike Kirby

We often take modern medicine for granted,but a review of the history of a disease and its treatment can help us put the whole thing in perspective.In this article,we trace the development of understanding about the nature and cause of diabetes and the use of insulin as a key treatment.

PATIENT INFORMATIONStarting on insulin for type 2 diabetes

PATIENTS AS PARTNERSLearning to live with insulin: helping patients to do well
Sandra Waddingham

Starting on insulin injections represents a major change for most people with diabetes. Many aspects of everyday life will need to be considered more carefully,which can be quite daunting.With adequate support and education from the practice nurse,patients can be encouraged to be proactive and positive towards this new stage in their lives. This article looks at people with type 2 diabetes or those with stable type 1 diabetes,who are likely to be managed in general practice.We discuss everyday concerns about using insulin,why people on insulin are prone to put on weight,how exercise affects blood glucose levels,how to manage illness in those with diabetes and how to adequately prepare for holidays.

PATIENTS AS PARTNERSHelping patients on insulin to travel safely
Sandra Waddingham

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.

HANDS ONA practical guide to starting patients with type 2 diabetes on insulin
Bev Cox

The prevalence of type 2 diabetes is rising and people are developing the condition at an earlier age. Type 2 diabetes becomes progressively more difficult to control over time, so many people need to start on insulin therapy as the pancreas is no longer able to meet the body’s insulin requirements on its own. In this article,we look at the practical issues involved in helping a patient to start on insulin therapy for their diabetes.