Type 2 diabetes: prevention and cure?

Abstract

General practice in the UK has been very successful in meeting the challenges raised by increasing prevalence of diabetes. Most diabetes is now managed in general practice and disease registers, evidencebased care, diabetes clinics, and diabetes trained practice nurses are now routine.As a consequence of the obesity epidemic, and the ageing population, diabetes rates are rising, and diabetes can remain undiagnosed for many years. GPs have made progress in recent years in identifying previously undiagnosed cases. Recent population-based reports suggest that only 3% of men and 1% of women over 50 years have undiagnosed diabetes.

Incretin-Based Drugs and the Incidence of Prostate Cancer Among Patients With Type 2 Diabetes

“…Furthermore, while the CPRD records prescriptions written by general practitioners and not specialists, general practitioners are primarily responsible for the long-term care of patients with type 2 diabetes and renewing medications in the United Kingdom. 33,34 Finally, while prostate cancer is well-recorded in the CPRD, 18,35 it was not possible to stratify the analyses on tumor grade or stage as this information is not available in the database. Future studies should investigate whether incretin-based drugs have impact on these important disease parameters.…”

Diabetes is on the rise, so why are we not bothered?

“…First, Dr Leach disagrees with the 2-week interval for repeating HbA1c to confirm new diagnosis of diabetes in asymptomatic people with HbA1c ≥6.5% (≥48 mmol/ mol). 1 Dr Leach suggests instead a longer interval of 6-8 weeks for the test is more appropriate. However we disagree with Dr Leach's suggestion.…”

“…1 Mary Pierce explains that HbA1c testing compared to the glucose-based test would be a more practical scheme as suggested by the Leicester Group and that 'People identified as being in the top 50% of diabetes risk using a computer-based risk assessment tool, can be opportunistically offered a HbA1c test to identify those with diabetes and those at high risk who require intensive structured lifestyle intervention and annual HbA1c monitoring'. 1 She further states that 'The Vascular Screening Programme with the diabetes addendum will improve the health of the population ...' ' 1 ; a statement with which I agree and hence the search for a method to improve patient compliance in HbA1c testing. For these reasons we can relate our audit that was carried out at The Royal Docks Medical Practice in 2012, in the Borough of Newham, London.…”