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Targets for glycaemic control in type 2 diabetes

Increasingly, day-to-day management of people with type 2 diabetes falls to general practice nurses (GPNs).1 It is therefore important that they are familiar with the latest guidelines, and understand how to apply the recommendations to their individual patients. This includes recognising how to determine appropriate targets (for example, for blood glucose control) in each individual case.

This module will help improve awareness of the role of adequate blood glucose control in the prevention of the complications of diabetes

Renal considerations in patients with type 2 diabetes

Renal impairment frequently co-exists with diabetes.1 As many agents used to control blood glucose are metabolised by the kidneys, reduced renal function has important implications for the choice and dose of oral hypoglycaemic agents.

This module aims to raise awareness of how chronic kidney disease impacts on the management of hyperglycaemia, including the need for dose reduction for many agents used in the management of type 2 diabetes.

Tailoring therapy to the individual patient

The goals of therapy for type 2 diabetes are to prevent or delay complications and maintain quality of life. This requires control of glycaemia, management of cardiovascular risk factors, regular follow-up and importantly a patient centred approach.1 This is in line with the Nursing and Midwifery Council (NMC) Code, which says that nurses should ‘prioritise people, practise effectively, preserve safety and promote professionalism and trust’.2 In addition, National Institute for Health and Care Excellence (NICE) guidelines emphasise the importance of taking into account individual needs and preferences.3

Short-term complications of type 2 diabetes

This module is intended to develop the general practice nurse’s understanding of the short-term complications of type 2 diabetes – ‘hypos and hypers’ – and their implications for morbidity and mortality.

The module covers:

  • Diabetic ketoacidosis (DKA): definition, diagnosis, causes and management
  • Hyperosmolar hyperglycaemic state (HHS): definition, diagnosis, causes and management
  • Hypoglycaemia (hypos): definition, diagnosis, causes and management
  • Sick day rules

Cardiovascular considerations in patients with type 2 diabetes

The goals of treatment for type 2 diabetes are to prevent or delay complications and maintain quality of life.1 According to international guidelines, this requires control not only of blood glucose levels, but also cardiovascular risk factor management.1

This module looks at the increased risk of cardiovascular disease (CVD) associated with type 2 diabetes, and the role of pharmacotherapy in managing the condition in line with current guidelines.