Statin use in young people
Q I work in a young persons’ clinic and recently there has been an increase in the number of prescriptions for statins. Does anyone have any evidence-based guidelines for statin therapy in young people with diabetes?
Margaret Daley, DSN, Aintree
OHAs in pregnancy
Q I am a practice nurse and was wondering how soon I should be referring women with diabetes who are pregnant or who plan to become pregnant. What should be done if they are on OHAs, statins or other agents, and when should medication be stopped, if at all?
Name and address witheld
A All women of childbearing age (starting at adolescence) should be informed of the risks of an unplanned pregnancy. Women with diabetes planning to conceive should be offered pre-conception care and advice before discontinuing whatever contraception they are using as per the recently published NICE guidelines (NICE, 2008). Before, or as soon as, pregnancy is confirmed cease all OHAs except metformin. Statin therapy and ACE inhibitors should also be halted as suggested in the NICE `guideline, particularly as there is evidence suggesting that there is an increased risk of foetal malformation in women who are taking ACE inhibitors and conceive (Cooper et al, 2006).
Anne Rayman, Diabetes Research Nurse, Ipswich
Education for housebound individuals
Q We are looking at developing diabetes education for our increasing housebound population with diabetes, and are interested to know how and what education is provided in other areas of the country.
Trish Noble, DSN, Liverpool PCT
A At Wandsworth PCT we have a ‘Housebound Pack’. This was developed by a subgroup of our local network group – the WIG (Wandsworth Implementation Group). A number of healthcare professionals from various disciplines developed this pack with, and for, the district nurses. The pack is held at district nursing centres so it can be referred to by any member of the team. The pack can be downloaded from our website http://thewig.eu/pageID_3486388.html.
Jo Butler, Nurse Consultant, London
Residential homes
Q Around 10% of the population of residential care homes have diabetes. How should we effectively monitor these individuals given that the staff in residential homes are mainly unqualified or untrained in diabetes care? Does anybody have any ideas or schemes that have worked?
Name and address witheld
A tool to help advocate for well-resourced inpatient diabetes services.
19 Nov 2024