Randomised controlled trial of near-patient testing for glycated haemoglobin in people with type 2 diabetes mellitus.

Background: Tight glycaemic control in people with type 2 diabetes can lead to a reduction in microvascular and possibly macrovascular complications. The use of near-patient (rapid) testing offers a potential method to improve glycaemic control.

Aim: To assess the effect and costs of rapid testing for glycated haemoglobin (HbA1c) in people with type 2 diabetes.

Setting up a fast-track insulin start clinic for type 2 diabetes.

When people with established type 2 diabetes first need insulin therapy there is often a delay in accessing services. Since the report of the UK Prospective Diabetes Study was published it has been recognised that people with type 2 diabetes have a progressive disease and a need for increasing treatment. The authors set up a fast-track service to enable GPs and practice nurses to refer to a nurse-led service at the diabetes centre.

An RCT into calculating insulin start dose in type 2 diabetes.

Aims: This trial compares to methods used to find the insulin dose when starting insulin in people with type 2 diabetes in whom maximal tolerated oral hypoglycaemic agents have failed to control glycaemia. One method of initiating insulin (based on height, weight, and fasting blood plasma glucose and insulin resistance) was compared with a conventional method of initiating 10 units of isophane insulin twice daily.

Method: Sixty subjects were randomised to calculated (CALC) or conventional (C).

Diabetes: new treatments and guidance.

It is recommended today that care for people with diabetes should be given in the community. New initiatives are being set up to deliver that care, and new treatments are constantly being developed, such as insulin analogues that provide an opportunity for patients to adjust their insulin regimen to suit their lifestyle. National initiatives in diabetes care are aiming to reduce inequalities in care.

Diabetes: treatment and complications--the nurse's role.

Diabetes is treated by insulin (type 1), and by diet and exercise alone or in combination with insulin (type 2). The long-term complications of diabetes can be devastating in their effects, therefore good glycaemic control must be a target for all patients. Nurses have a role in diabetes care as specialists or as part of general care.

Diabetes: signs, symptoms and making a diagnosis.

There are two principal classes of diabetes-type 1 and type 2. Type 1 is an autoimmune disease and is treated with insulin. Type 2 can often be controlled by diet initially, but hypoglycaemic agents and insulin may be needed at some stage in order to maintain satisfactory glycaemic control.

Resolution of diabetic autonomic neuropathy.

Many consider diabetic autonomic neuropathy to be an irreversible complication of diabetes of long duration. Three patients developed symptoms of autonomic neuropathy which subsequently resolved. Their autonomic neuropathy was not associated with long duration of diabetes, but with weight loss.