Volume 3, Number 3, May-June 2006

BACK TO BASICSGlitazones: how they work

POPULAR
TOPICDIABETES MANAGEMENTKeep taking the tablets: achieving adherence in type 2 diabetes
Linda Goldie

Most patients with type 2 diabetes require many tablets to control their diabetes and prevent cardiovascular complications. Patients are often prescribed two or three antidiabetic agents, two or three antihypertensives, one or more lipid-lowering tablets and low-dose aspirin. Research has warned that fewer than 50% of patients take their prescribed diabetes medication adequately. The consequence of this poor adherence is increased risk of cardiovascular complications. How do we help patients to take their tablets and so improve their health and long-term outcomes?

POPULAR
TOPICDISEASE FOCUSAcute coronary syndromes
Alun Roebuck, Martyn Farrer

Acute coronary syndromes (ACS) include common and high-risk conditions such as unstable angina, which can be difficult to diagnose, particularly in women, the elderly and diabetics. Early identification and appropriate management can significantly reduce the risk of death, morbidity and subsequent hospital admissions. This article aims to clarify what happens in ACS, how they present and how they should be managed.

EDITORIALEditorial
Jan Procter-King

Welcome to the latest issue of the British Journal of Primary Care Nursing (BJPCN). The NHS is currently in meltdown around the ears of primary care teams, with new mergers and reshuffles. There is great uncertainty about who will lead the new PCTs and the structures that will support the delivery of CHD and diabetes care. But, like many of you, I have been around long enough to know that things ‘go in circles’.

FOOD FOR THOUGHTThe role of dietary fibre in optimising health
Karen Allan

The gastrointestinal tract plays a vital – and sometimes overlooked – role in maintaining overall health. Dietary fibre, eaten as part of a balanced diet, helps to ensure effective functioning of the intestines and can offer benefit in terms of the prevention and treatment of a number of health problems. As levels of obesity in the population continue to escalate, research has shown that dietary fibre has an important role in satisfying appetite and in weight management, in addition to playing a potential role in controlling insulin levels.

POPULAR
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 the BJPCN – Evidence in Practice – will keep you on top of relevant research without having to spend hours in the library. Each journal 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.

POPULAR
TOPICPOINTS MEAN PRIZESValidating and maintaining your CHD register
Adele Graham

Disease registers are essential for practices to optimise the diagnosis, management and follow-up of patients with a particular condition, in addition to being an important feature of the Quality and Outcomes Framework. Practices are responsible for demonstrating that they have systems in place to maintain a high-quality register. In this article, we look at a ‘recipe’ for validating a coronary heart disease (CHD) register – but the same method used for validating and maintaining the register can apply to any disease, using appropriate diagnostic and treatment information.

MONITORINGMonitoring kidney function in the surgery
Sandra Waddingham

The most common cause of chronic kidney failure is diabetes, which accounts for between 30 and 40% of all cases. Chronic kidney disease is a long-term condition usually taking between fifteen and twenty years to reach the final stages. Although 30% of all people with type 2 diabetes will develop some degree of kidney disease, only a minority go on to develop end-stage renal failure. In this article, we look at the benefits of early detection and treatment in slowing the progression of renal impairment.

PREVENTION IN PRACTICEType 2 diabetes in south Asian communities in the UK
Brian Karet

People from ethnic minorities may not get the diabetes care they need because of issues associated with language, literacy and culture, warned a recent Audit Commission report on diabetes – Testing Times. This article explores these issues and gives some insight into the challenges of looking after South Asians – Bangladeshis, Pakistanis, Indians and Sri Lankans – with diabetes, as well as offering some pointers to improve their care and treatment.