By Kurtis Moffatt

As the incidence of diabetes continues to grow, pharmacist Kurtis Moffatt assesses the enhanced role for the pharmacist in reducing the cost to the NHS.

Given the ever-growing burden that diabetes places on our nation’s health and the financial pressures it places on the NHS, it is of no surprise that there are increased efforts to improve the clinical management of – and to re-evaluate the efficacy and safety of treatments available – to those affected by the condition.

Diabetes mellitus is a condition caused by a lack of insulin or resistance to its action. The diagnosis is confirmed by the measurement of fasting or random blood glucose concentration, and in some cases by an oral glucose tolerance test. While many different subtypes of the condition exist, the two principle classes of diabetes of concern are Type 1 and Type 2 diabetes. Type 1 (previously referred to insulin-dependent diabetes mellitus (IDDM)), is caused as a result of insulin deficiency following auto-immune destruction of pancreatic beta cells, thus Type 1 patients requires the administration of insulin for survival. Type 2 diabetes (previously termed non-insulin-dependent diabetes (NIDDM)) is caused by a reduced secretion of insulin or to peripheral resistance of its action (in some rare cases a combination of the two). While Type 2 patients can be controlled by diet alone, the majority require oral antidiabetic drugs or insulin (or both) to maintain adequate control. In patients who are overweight, Type 2 diabetes may be prevented by reducing their weight or increasing physical activity, and, in some circumstances, the use of Orlistat (anti-obesity drug) may also be permitted in obese patients. Within the UK it is estimated that nine out of ten adults currently diagnosed with diabetes suffer from Type 2 subtype, which is equivalent to around three million people. Type 2 is also more common in people of African, African Caribbean and South Asian family origin.

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