Book review: Providing Diabetes Care in General Practice

Julie Tomlinson, Advanced Nurse Practitioner, Cornwall:

This book is a practical guide for diabetes care designed specifically for those working in primary care. It seemed appropriate that in order to review a book of this nature, rather than read it straight through from beginning to end, I would use it as it is intended – as a source of practical guidance in a diabetes clinic. I therefore decided to use it as a reference book for issues that have arisen recently in my own diabetes clinics and topics that I feel are relevant to diabetes nursing in primary care.

What struck me straight away was how well laid out the chapters are, enabling the user to flick through the pages quickly to find answers to questions. This makes it appropriate for use in a clinical setting where we often don’t have the time to wade through reams of pages. Of particular use is the comprehensive table that lists types of insulin with their onset, peak and duration of action. The information is even more comprehensive that the standard MIMS table as it advises exactly when the different varieties of insulin should be taken – before, with or just after a meal. Guidelines in the book are simple to follow with detailed instruction on areas such as how to teach someone to administer their insulin, how to perform a foot check and the ABC treatment algorithm for hypertension. A really novel idea is chapter 25, which covers the main findings of various major studies relating to diabetes. This could be extremely helpful when explaining to people why it might be necessary to treat to tight targets in glucose control, lipid level or hypertension for example.

The author does not claim to be writing an all-encompassing text book on every aspect of diabetes and this may explain why some of the rarer causes of diabetes (for example, pancreatitis, Cushing’s syndrome or genetic reasons such as MODY) are not covered here. Nor would it answer some of the associated medical aspects of diabetes management; for example, fatty liver disease. I believe it is nevertheless the most comprehensive, practical guide for diabetes management in primary care that I have read and, for this reason, I will be keeping my copy close at hand when I run my diabetic clinics.

Eugene Hughes, Chairman of Primary Care Diabetes Europe:

I first became interested in diabetes in 1993, when an audit of diabetes in my practice showed that care was, shall we say, ‘suboptimal’. It was at this time that Mary MacKinnon’s book first appeared on the bookshelves. Providing Diabetes Care in General Practice rapidly became reference, resource, tool, bible.

Some years later, I had the good fortune to work with Mary on a number of projects, even spouting Shakespeare at her inaugural Mary MacKinnon lecture! I found that her lucid writing style was underpinned by an immensely practical approach, a touching compassion and an unnerving sense of humour.

The task of updating, and bringing to an eager public, the fifth edition of her book is unenviable. How can you preserve the underlying structure and principles of a classic text, whilst making it relevant and appealing to a new audience? Thankfully, the task fell to Gwen Hall, who although understandably daunted, responded with enthusiasm, dedication and that rare brand of common sense for which she is famed.

Diabetes care is changing. The epidemic that threatens to engulf healthcare systems has led to new therapies, new approaches and inevitably new political initiatives. These are all met head on in this edition, which is bang up to date and intensely relevant.

There is a helpful glossary, an incisive overview and clear sections on management. I personally found the chapter on ‘Aspects of Culture’ especially informative. The evolving field of therapeutic education is sensitively handled, and the chapter on ‘New Insights’ carefully guides the reader through the maze of new, and often confusing, research. The whole book is also peppered with useful patient information and is very thoroughly referenced.

All in all, there is something for everyone involved in diabetes care in this book, from the new practice nurse struggling to get to grips with a diabetes clinic, to the seasoned, world-weary GP.

Gwen Hall is to be congratulated in retaining the spirit of the original but imbuing it with her own personality. The best just got better. Treasure it.

Providing Diabetes Care in General Practice
Author: Gwen Hall
Publisher: Class Publishing, London
ISBN-13: 9781859591543