Contents -- About the author -- Foreword -- Acknowledgements -- Introduction -- Part I Diabetes: an overview -- 1 Diabetes mellitus in the United Kingdom -- Prevalence and incidence -- The consequences of diabetes: microvascular complications -- The consequences of diabetes: macrovascular complications -- Life expectancy and mortality rates -- The cost of diabetes -- Impact of diabetes on the individual -- Effectiveness of treatment for people with diabetes -- The aims of diabetes care -- How is diabetes care organised in the UK? -- The role of the specialist team -- Diabetes UK -- SUMMARY -- References -- Further reading -- 2 Responsibilities of those involved in the provision of diabetes care -- The general practitioner -- The practice nurse and community (district) nurse -- The team approach to integrated diabetes care -- New ways of working in primary care diabetes -- SUMMARY -- References -- Further reading -- 3 The General Medical Services contract and practice-based commissioning -- The QOF framework -- How to gain points and improve diabetes care -- QOF points explained -- Nurses in the GMS contract -- Practice-based commissioning -- References -- Further reading -- 4 The educational needs of the team -- Diabetes education for the primary care team - what is available? -- Diabetes education for the primary healthcare team - what is needed? -- References -- Further reading -- Part II Providing diabetes care -- 5 The diabetes service in general practice -- How to set up a system of care -- The General Medical Services contract -- Planning the service -- Organisation of the service -- Who might be offered the practice diabetes service? -- Who will be involved in the provision of the practice diabetes service? -- Frequency of clinics -- Shared (integrated) care -- Ideal facilities for the diabetes service -- Essential equipment: general.

Essential equipment: screening and monitoring -- For emergency use: for the treatment of hypoglycaemia -- Resources for diabetes education -- Materials for organising and recording information -- References -- Further reading -- 6 The practice diabetes register and links with specialist services -- Advertising the practice diabetes service -- Diabetes registers -- Links with specialist services -- 7 The diagnosis and symptoms of diabetes mellitus -- Public awareness of diabetes -- Who should we screen? -- Diagnosis of diabetes mellitus -- Identification of people with diabetes mellitus -- References -- 8 Providing the service -- Initial explanation of diabetes and provision of psychological support -- Clinical examination and investigations -- Initial treatment and care -- Example of criteria for specialist referral -- Sample protocol for performing a routine review -- Sample protocol for performing an annual review -- Recall and follow-up -- Screening for microalbuminuria -- References -- 9 Nurse prescribing in diabetes -- The background -- Types of nurse prescriber -- Supplementary prescribing -- Training -- Patient group directions -- References -- Further reading -- Websites -- 10 Non-medical treatment of diabetes -- Aims of treatment -- Preventing and reducing the risk of diabetes complications (types 1 and 2 diabetes) -- Starting treatment (type 2 diabetes) -- Dietary recommendations for people with diabetes -- Activity for health -- Glycaemic index -- References -- Further reading -- 11 Drug and insulin therapy -- Oral medication -- Insulin therapy -- References -- Further reading -- 12 Monitoring and control -- The benefits of monitoring -- Blood glucose control -- Sick day rules -- High blood glucose levels (hyperglycaemia) -- Low blood glucose levels (hypoglycaemia, 'hypo') -- Self-monitoring of blood glucose -- References.

Further reading -- 13 Eye care and screening -- Features of an acceptable national programme: an integrated pattern of care -- Organisation of diabetic eye screening in primary care -- The role of the primary care team -- Visual acuity -- Opticians/optometrists -- Cataracts -- Age-related macular degeneration -- Chronic glaucoma -- Laser treatment/therapy -- References -- Further reading -- 14 Foot care and surveillance -- What foot care should be provided by the primary care team? -- The diabetic foot -- Examination of the feet -- Identification of people at risk of diabetic foot problems -- Treatment -- References -- Further reading -- 15 Aspects of culture relating to diabetes care -- Diabetes prevalence and complications -- The effect of diabetes in ethnic communities -- Barriers to effective communication -- Religions -- African/Caribbean populations -- Providing diabetes care -- SUMMARY -- References -- Further resources -- Further reading -- 16 Structured patient education -- Key criteria -- Living with diabetes -- References -- Further reading -- 17 Personal diabetes records and care plans -- What is a care plan? -- References -- 18 Living with diabetes -- After confirmation of diagnosis -- References -- Further reading -- 19 Auditing care -- DiabetesE -- The National Diabetes Audit -- References -- Further reading -- Part III About diabetes -- 20 Diabetes mellitus: a history of the condition -- Classification and types -- History -- References -- Further reading -- 21 Type 1 diabetes mellitus -- Diagnosis -- The causes of type 1 diabetes -- SUMMARY -- Further reading -- 22 Type 2 diabetes mellitus -- Diagnosis -- Treatment -- References -- Further reading -- 23 Other categories of diabetes -- Impaired glucose tolerance (Unwin et al, 2002) -- Impaired fasting glycaemia -- Gestational diabetes mellitus -- References -- Further reading.

24 Complications of diabetes -- Macrovascular complications -- Microvascular complications -- Chronic kidney disease -- Association with other conditions -- References -- Further reading -- 25 New insights -- Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance -- DCCT: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus -- UK Prospective Diabetes Study -- Primary Care Diabetes - a National Survey -- Multifactorial intervention and cardiovascular disease in patients with type 2 diabetes -- A review of diabetes self-management interventions in disadvantaged populations -- The Hypertension Optimal Treatment study -- The DECODE Study Group -- Collaborative Atorvastatin Diabetes Study -- Anglo-Scandinavian Cardiac Outcomes Trial -- Heart Protection Study -- Appendices -- Appendix 1 What diabetes care to expect (2006) -- What you should expect from the National Health Service (NHS) -- What care you should expect from your diabetes care team -- What you should do if you have a complaint -- Annual review checklist -- Appendix 2 Groups working in diabetes in primary care -- Primary Care Diabetes Society (www.pcdsociety.org) -- Diabetes UK -- The Diabetes Industry Group (www.diabetesindustrygroup.com) -- Diabetes Research and Wellness Foundation (www.drwf.org.uk) -- Patient UK (www.patient.co.uk) -- Insulin Dependent Diabetes Trust (www.iddtinternational.org) -- Appendix 3 Recommendations for the provision of services in primary care for people with diabetes -- Aims of diabetes care -- Provision of diabetes care -- Skills required to provide care for people with diabetes in primary care -- Planning mechanisms across the nations -- Diabetes UK -- Appendix 4 Resources for the provision of diabetes care.

Education -- Practical, useful and interesting books for people with diabetes -- Useful books for the primary care team -- Useful reports/papers -- Useful websites -- Diabetes UK publications -- Journals -- Companies -- Diabetes-focused organisations for professionals -- Patient support organisations -- Appendix 5 Diabetic emergencies: guidelines for health professionals -- Hypoglycaemia -- Diabetic ketoacidosis -- Hyperglycaemic hyperosmolar non-ketotic coma -- Lactic acidosis -- General advice ('sick day rules') -- Glossary -- Index.