Diabetes

The SGLT2 inhibitors - where are we now? (2017)

Posted on by

Type of publication:
Journal article

Author(s):
*Morris, David

Citation:
Journal of Diabetes Nursing; Jun 2017; vol. 21 (no. 5); p. 162-167

Abstract:
Sodium–glucose cotransporter 2 (SGLT2) inhibitors are once-daily oral agents effective in treating hyperglycaemia in people with type 2 diabetes, with additional benefits including weight loss and a low risk of hypoglycaemia. This review provides a basic guide to the SGLT2 inhibitors licensed in the UK, including their mechanism of action, benefits, adverse effects and limitations, and place in treatment. Advice on avoiding the rare but serious adverse effect of diabetic ketoacidosis is also provided.

Link to full-text: http://www.thejournalofdiabetesnursing.co.uk/media/content/_master/4984/files/pdf/jdn_21-5_162-7.pdf

Managing problems with medications for type 2 diabetes (2017)

Posted on by

Type of publication:
Journal article

Author(s):
*Morris, David

Citation:
Practice Nursing; Apr 2017; vol. 28 (no. 4); p. 148-152

Abstract:
The most recent National Institue for Health and Care Excellence (NICE) and European Association for the Study of Diabetes guidelines on management of type 2 diabetes (NICE, 2015; Inzucchi et al, 2015) emphasise the need to individualise glycemic targets and treatments, and highlight that working in partnership with the person concerned should be central to decision making. In addition to assessing the likely efficacy of a treatment, consideration should be given to tolerability and safety. The possibility of medication problems and side- effects needs to be anticipated and if a medication is chosen then a means for identifying and dealing with these should be considered in advance. Most adverse drug reactions are predictable and dose- dependent, the exception being allergic reactions. This article will consider problems arising with medications used for type 2 diabetes, excluding insulin.

Overview of diabetes... This reflective account is based on NS852 Mayo P (2016) An overview of diabetes (2017)

Posted on by

Type of publication:
Journal article

Author(s):
*Ponomarenko-Jones, Rosalind

Citation:
Nursing Standard; May 2017; vol. 31 (no. 36); p. 64-65

Abstract:
The article presents a reflective account of how a continuing professional development (CPD) article improved Rosalind Ponomarenko-Jones's knowledge of the pathophysiology, symptoms and diagnosis of diabetes. Topics discussed include the nature of the CPD activity, lesson learned from the CPD activity and how she changed or improved her practice.

Best practice in management of type 2 diabetes (2016)

Posted on by

Type of publication:
Journal article

Author(s):
*Morris, David Stuart

Citation:
Nurse Prescribing, 2016, vol./is. 14/Sup10(0-5)

Abstract:
This article will highlight best practice in managing type 2 diabetes in adults. HbA1c is the preferred diagnostic test for type 2 diabetes, the threshold for diagnosis being 48 mmol/ mol. Structured education is the cornerstone of management of type 2 diabetes with a focus on diet, exercise and weight loss. Multiple risk factors for complications need to be addressed including hypertension, dyslipidaemia and smoking (the most important factors in targeting macrovascular disease) and hyperglycaemia (more important in targeting microvascular disease). It is important to recognise that HbA1c targets need to be individualised. Metformin remains the first-line drug for hyperglycaemia in type 2 diabetes. Sulphonylureas, pioglitazone, DPP-4 inhibitors and SGLT-2 inhibitors are all recommended as possible add-on therapies to metformin, the choice again depending on individual circumstances. GLP-1 agonists and insulin can be considered in more intractable cases of hyperglycaemia.