Optimising glycaemic control for patients starting insulin therapy.
The incidence of diabetes is set to rise dramatically in the next five years so there is a growing focus on 'shared care' for people with diabetes, involving healthcare professionals from primary and secondary care in patient management. Insulin initiation and dose adjustment in patients with type 2 diabetes are increasingly being carried out in the primary care. This article discusses the important role of practice nurses in managing the care of patients with type 2 diabetes and the specific challenges presented by patient fears and resistance to insulin treatment. Current recommended targets for glycaemic control are identified and treatment plans discussed with a focus on transferring patients from oral hypoglycaemic drugs to insulin treatment.
Gartnavel Diabetes Centre, Glasgow. Brenda.capaldi@northglasgow.scot.nhs.uk
Brenda
B
Capaldi
D000284:Administration, Oral; D000465:Algorithms; D001786:Blood Glucose / Q000378:metabolism; D003663:Decision Trees; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000451:nursing; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008019:Life Style; D009722:Nurse Practitioners / Q000458:organization & administration*; D024802:Nurse's Role; D010347:Patient Care Planning; D010353:Patient Education as Topic; D018579:Patient Selection; D011320:Primary Health Care / Q000458:organization & administration; D012307:Risk Factors; D012648:Self Care / Q000379:methods; D012944:Social Support
D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin