'Diabetes in focus', by Anjana Patel. Pp ix+142. Price £24.95. London: Pharmaceutical Press, 1999. ISBN 0 85369 401 X.
The care of patients with diabetes mellitus will present considerable challenges to health professionals in the years ahead. This is especially the case in the management of type 2 diabetes (formerly termed "non insulin dependent diabetes") as the incidence of this condition is projected to increase dramatically over the next decade. Although appropriate management of diabetes has a major pharmaceutical care element, pharmacists have frequently felt their contribution to be somewhat peripheral. Pharmaceutical care of the patient with diabetes has primarily been delivered by specialist nurses. At last a book is available which has been written for pharmacists wishing to become more intimately involved with diabetes care.
'Diabetes in focus' is a concise text which contains a surprising amount of detail about most topics of interest to pharmacists providing a service to patients with diabetes. The first few chapters represent a good overview of the disease and its classifications, followed by descriptions of cardiovascular and neurological complications of sustained hyperglycaemia. However, the major achievement of this book is to give practical guidance to pharmacists wishing to extend their involvement in diabetes care. Appropriate treatment of diabetes within the context of managing other cardiovascular risk factors such as hypertension and hyperlipidaemia is a recurring theme running through the text. The rationale and guidance for using oral agents is discussed in detail, as are insulin regimens. An excellent pharmaceutical care checklist is included in the final chapter to help define particular interventions pharmacists can make in the care of their patients.
If I have any criticisms, they are that there is only brief mention of the management of diabetic ketoacidosis and no reference to the management of diabetes in surgery. These are two areas of particular relevance to hospital practice. However, as the book is aimed primarily at the general reader, these topics may have been considered too specialised for inclusion in detail. That being said, I would recommend 'Diabetes in focus' to every general hospital pharmacy and to community pharmacists who have an interest in diabetes care.
Reviewer - Adrian Brown
Adrian Brown is chief pharmacist at Southport and Ormskirk Hospital NHS trust.