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Diabetes mellitus, usually classified
as either type 1 (T1DM) or type 2 (T2DM), is a long-term metabolic disorder,
characterised by a chronically elevated blood glucose level (hyperglycaemia),
which results from defects in insulin secretion, insulin action, or both
(Kumar et al, 2003). The number of people with diabetes has quadrupled since
1980, to 422 million (World Health Organization, 2016), and the condition is
now one of the biggest threats to human health in the 21st century (Zimmet et
al, 2005). Over the past two decades, there has been an explosive increase in
the number of people diagnosed with diabetes worldwide (International
Diabetes Federation, 2015). Changes in the human environment and a tendency
towards an obesogenic lifestyle, together with globalisation, have resulted
in alarming rises in the rates of both obesity and diabetes. It is estimated
that the NHS spends 10% of its budget on diabetes (Hex, 2012); the total cost
(direct care and indirect costs) associated with diabetes in the UK currently
stands at £23.7 billion, and this figure is predicted to rise to £39.8
billion by 2035/6 (Hex, 2016). In December 2015, the National Institute for
Health and Care Excellence (NICE) published a new guideline, NG28, Type 2
diabetes in adults: Management, which gives recommendations for managing the
condition, with a focus on patient education, dietary advice, managing
cardiovascular risk, managing blood glucose levels, and identifying and
managing long-term complications. This article gives a critical overview of
the new guideline.
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Diabetes, a chronic progressive
life-long metabolic disorder, is characterised by hyperglycaemia, which is
due mainly to absolute (type 1 diabetes) or relative (type 2 diabetes)
insulin deficiency. The disease is fast-emerging as one of the world’s biggest
health catastrophes. In the UK, as elsewhere in the world, the prevalence of
this long-term disorder is escalating in an uncontrollable manner. A more
concerted, strategic and multi-sectorial policy approach, underpinned by
solid research, is essential to improving human behaviour and lifestyle to
reverse the negative trends in the global incidence of this condition. The
management of this condition is becoming a significant health-care challenge
to health professionals. Various pharmacological options, such as oral
hypoglycaemic agents and subcutaneous insulin, are now available for
glycaemic control. Health professionals should always give serious
consideration to structured education to help people with diabetes to adhere
to their regimen. In turn, this education will improve people’s quality of
life by minimising and/or slowing the development of diabetes-related
complications.
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