Diabetes
Over 36,000 people in Somerset are diagnosed with diabetes, which is more than 6% of the population.
Prescribing Guidelines by Clinical Area
Type 1 diabetes (0.5%) and Type 2 diabetes (5.7%). 10% of the annual NHS budget is spent on treatment. On this page you will find useful information and resources to optimise treatment of your patients and improve outcomes for this complicated long term condition.
Measuring annually the 8 care processes is key to determining the treatment regimes, and achieving the three treatment targets of HbA1c, blood pressure and cholesterol.
- Blood glucose level measurement (HbA1c)
Optimum level between 48 mmol/mol and 53mmol/mol. Targets are individual to patient. - Blood pressure measurement
<140/80 mmHg with no kidney, eye or cerebrovascular damage; <130/80 mmHg with evidence of kidney, eye or CV damage - Cholesterol
National Diabetes Audit calls for total cholesterol of 5.0 millimoles per litre (mmol/L) or lower. NHSE calls for a reduction of 40% from baseline. NHSE lipid pathway calls for:
Primary prevention – aim for a reduction in NON-HDL of 40% from baseline
Secondary Prevention - secondary prevention LDL <1.8mmol/l and / or NON-HDL <2.5mmol/l - Kidney function testing (Urinary albumin)
<2.5 mg/mmol for men;
<3.5 mg/mmol for women. Ideal ACR < 3 for both - Kidney function testing (Serum creatinine) to calculate eGFR
- Weight check
Aim for a healthy weight between a BMI of 18.5 and 24.9 kg/m2 - Smoking status
Check smoking status at annual review - Foot examinations
Screening at least annually
Chronic Kidney Disease is often linked to diabetes, and fortunately we now have evidence to support outcomes in SGLT-2 inhibitors (gliflozins) which we hope will transform the treatment of type 2 diabetics with CKD, existing CVD and high CVD risk.
For any diabetes related medication queries please contact your ICB pharmacist.
