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HEALTH DIABETES
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as they add that “a person may have some or no symptoms upon diagnosis”. “Pathology for the diagnosis of type 2
diabetes is usually a result of an elevated fasting blood screen, an elevated random blood glucose level, suspicious symptoms, an optometrist noting retinal changes, or when a person is considered high risk of type 2 diabetes,” they
said, adding that the process towards diagnosis also includes an “oral glucose tolerance test or a HbA1c [blood test]”.
Management of diabetes
Most experts agree that one of the keys to managing type 2 diabetes is a healthy lifestyle.
“Addressing lifestyle factors such as maintaining healthy eating and daily regular activity is a lasting foundation for managing type 2 diabetes,” Ms Itzstein and Ms Crow said. “Achieving a
healthy weight and waistline reduces insulin resistance.”
According to Mr Quigley, losing 10kg will change your “blood glucose levels completely”.
Ms Itzstein and Ms Crow add that along with regular monitoring and screening, the management of type 2 diabetes also includes smoking cessation and blood pressure and cholesterol level checks.
They say the annual cycle of diabetes care also involves regular “screening of eyes, feet, kidneys and mood”, which “reduces the impact of complications”.
RETAIL PHARMACY ASSISTANTS • JUL 2020
“Medications to reduce hyperglycaemia may be employed strategically according to comorbidities and in a stepwise manner according to needs,” they said. “Medication should be reviewed at least annually with major health changes.”
Mr Quigley says that when addressing a patient’s weight, referring to a dietitian and an exercise specialist for the prescription of appropriate exercise should be among considerations.
“I think there’s an awful gap between education about living with diabetes and keeping your diabetes well under control, therefore minimising your reliance on medication,” he said.
“The fact is, today we see people whose blood glucose levels aren’t being appropriately controlled because they actually haven’t been educated correctly.”
Mr Quigley adds that education is
a fundamental role of the pharmacist, an opportunity to assist in the management of the condition.
“There’s a huge gap between the patient with diabetes and the educational aspects that should be
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Ms Itzstein and Ms Crow suggest these strategies “to prevent or further damage (especially to the feet)”:
• Optimising blood glucose control to prevent or slow the progression of DPN.
• Wearing appropriately fitting footwear.
• Regular visits to the podiatrist.
• Referral to a doctor or podiatrist
for any signs of food problems, including broken skin, blisters and maceration.
• Applying Zostrix HP, a topical analgesic cream used to help provide relief and manage DPN or neuralgia.
• Recommending any good moisturiser to apply to the feet to keep the skin in good condition.
• Applying an antiseptic such as Betadine to any injury or crack, covering with a sterile dressing and seeing a doctor if it doesn’t improve within 24 hours.
• Using toenail clippers to trim toenails straight and nail files to remove any sharp edges.