Independent Prescriber: The UKPDS Study

When making the decision to prescribe there are a number of influence you have to consider. It is important to have an awareness of these influences and take them into consideration when issuing a prescription. It is importance to have knowledge of the DOH (2006) Medicines Matters this give guidance on the mechanisms available for prescribing and administration and supply of products. Team trends and external company’s and there representatives promoting their products have a big influence on your prescribing practice Bradley (2006) found that these influences were of concern to some nurses feeling that their colleague may ask them to prescribe for patients they haven’t seen. Thomas (2008)

Diabetes can be treated in three basic ways: by diet, by diet in conjunction with tablets, or diet in conjunction with insulin. Diet serves as an initial control for non-urgent patients. If a person’s diet will have a major effect on glycaemic control, it does so reasonably quickly, within a few weeks of changing

For nurses extending their role to include prescribing there is much to consider. Revelay (1999) states that, accountability involves an individual giving an account of their actions with the rationale and explanation given for these actions. The decisions regarding boundaries of practice are firmly placed in the hands of the individual practitioner (Carlisle 1992). Accountability means being able to justify any actions and accepting responsibility for them, and is an integral part of nursing practice (Rowe 2000) The NMC Code of Professional Conduct (2004) states that a nurse is personally accountable for her practice, has a duty of care to patients and must work within the laws of the country.

“Non-medical prescribing is prescribing which is taken by a health professional who is not a doctor” (Non-medical prescribing 2012).To become a non-medical prescriber the relevant training must be undertaken to ensure the patients’ safety is most important. The health care professional who is the non-medical prescribers is only legally allowed to prescribe within their area of expertise and they must remain competent within that area, through maintenance of various continuing education and training programmes.

The American Diabetes Association (2004) defines diabetes as a subset of metabolic diseases associated with hyperglycemia secondary to insulin failing to release, act, or both. Complications related to chronic diabetes can be detrimental to one’s health including but not limited to: heart disease, stroke, kidney disease, amputations, blindness, and other optical diseases. Furthermore, the prevalence of diabetes is rising at an astronomical rate within the United States as well as internationally. According to the Center for Disease Control and Prevention (CDC) (2016) an estimated 29 million people suffer with diabetes and 86 million are prediabetic within the United States (US). Without major interventions from the healthcare community,

The study had an overall total of 1150 participants. Although there were many participants to begin with, they did not provide all of the feedback the researchers had requested.  This resulted in the expulsion of their participation, so their results were not included in the final reports of the study. The number of patients that did provide the essential information added up to a total of 901. The profile for a participant was a patients diagnosed with Type 2 diabetes in the last 6 months, but has been diagnosed no more than 10 years ago. They had to be between 35-70 years of age. Their BMI had to be more or less than 24 kg/m2 and have an HbA1c more or less than 6.5%. They also had to have treatment with a diet or oral glucose lowering medication. Those needing insulin shots, had been diagnosed with chronic diseases, or had a change in diet or lifestyle 3 months prior to the study were not included in the overall

Everybody knows that obesity is a big factor in developing type-2 diabetes, and that part of coping with this metabolic disorder is lifestyle change. If blood glucose does not go down, then medicines are introduced. Some type-2 diabetics even have to administer insulin in order to keep their blood glucose levels

In the UK, nurse prescribing was born out of the need to increase efficiency in the NHS by making best use of its resources. Nurse-led services are one means of improving healthcare provision and a string of legislative change has gradually broadened the scope of nurse prescribing in the UK. (Courtenay et al 2007).

The purpose of this study is to minimize the risk of hypoglycemia among the elderly. As people with diabetis age, the physiological changes affect the diabetic. The purpose of this study is to consider whether HbA1 goals can be attained without undue treatment burden and decrease the risk of severe hypoglycemia. Though client teaching and minimizing the risk factors of hypoglycemia can prevent further exacerbation of catastrophic events that could have potential lethal outcomes to an older patient with diabetes. The one patient’s case, Mr. J., an 86 year old man who has had type 2 diabetes for 15 years is a quantitative study that focuses on prevention of hypoglycemia in older adults. Interventions include diet, meal planning, medication, glucose

Medication should only be prescribed after careful consideration of the patient's best interests. The prescriber should have access to the most up to date version of the British National Formulary (BNF). Dispensing must also be appropriately trained, follow safe systems of work and understand the side effects of various drugs; be able to access appropriate information and understand when to access advice or further information (the dispenser may not necessarily be a trained pharmacist but should be working alongside one). By supporting medication

Nurse prescribing in the UK is well established with over 54,000 nurses and 19,000 independent nurses.

It must be emphasized that lifestyle modifications should be the initial step in achieving adequate blood glucose control and that medication should only be discussed when lifestyle modifications has failed.

There is growing concern that intense glucose lowering or the use of certain agents may be associated with adverse cardiovascular outcomes.

There have a lot of precautions before to take sitagliptin. Since sitagliptin was only treat type 2 diabetes, which is relative by lack of insulin. Type 1 diabetes is incapable of producing insulin in patient’s body. And Patients with diabetic ketoacidosis have extremely high blood sugar that requires emergency medical attention. Therefore, patients with type 1 diabetes or with diabetic ketoacidosis should not be used sitagliptin. Also, this drug is not very suitable used to patient with chronic kidneys disease in stage 3 to 5 that because of sitagliptin would be through of kidney to excrete. So this type of patient need to decrease the dosage intake.

To examine the efficacy and safety of insulin and other pharmacological interventions for lowering glucose-lowering levels in patients with diabetics and Chronic Kidney Disease (CKD).