- Age
- Gender
- Ethnicity
- Family history
- Past medical history of CVA or MI
- High total cholesterol or LDL
- Low HDL levels
- Hypertension
- Sedentary lifestyle
- Obesity
- Diabetes mellitus
- Excessive alcohol consumption
Tag Archives: health promotion
Risk Factors for CHD
Treating Mild Hypoglycaemia
To raise blood glucose, take one of the following:
- 100ml Lucozade
- 150ml non-diet fizzy drink
- 200ml smooth orange juice
- 5-6 dextrose tablets
- 4 jelly babies
- 7 jelly beans
- 2 tubes glucose gel
If blood glucose is still below 4mmol/l after 10 mins, or if patient doesn’t feel better, repeat one of the above treatments.
When feeling better, eat some starchy food such as a sandwich or a banana, monitoring blood glucose afterwards.
ABCD2 Scoring tool for calculating risk of CVA
| Age | >60 years | 1 point |
| Blood pressure | >140/90mmHg | 1 point |
| Clinical signs | Unilateral weaknessSpeech disturbance | 2 points1 point |
| Duration of symptoms | 0-59 mins60 mins or more | 1 point2 points |
| Diabetes | Diabetes | 1 point |
Score 4 or more indicates significant risk of CVA
Thanks to Practice Nurse 41 8 for this.
Type I Diabetes
Type I diabetes occurs when there is a loss of insulin secretion ability due to automimmune destruction of the beta cells in pancreatic tissue. Patients generally present with the symptoms of hyperglycaemia including ketoacidosis.
Type I diabetes is the most common form in young people (affecting aout 0.5% of the population); bringing with it the potential for problems such as retinopathy, neuropathy, nephropathy and vascular disease.
Small amounts of insulin are produced by the pancreas throughout the day to ensure cells have access to glucose, and suppress the release of stored glucose from the liver. During fasting periods, glucagon is released to ensure glucose supplies for brain function.
Carbohydrates are digested in order to provide glucose, which results in the release of insulin titrated to the supply of glucose to use and store glucose in suitable quantities.
Insulin needs to be replaced in type I diabetes patients to ensure 24 hour cover. Boluses may also need to be prescribd to match carbohydrate intake at mealtimes. Often this can be suitably treated with a twice daily insulin if the patient’s daily routine is predictable, for patients whose lifestyle is more varied, titrated insulin may be required perhaps involving a pump or more frequent injections.
Carbohydrate awareness is important for those with type I diabetes because it is carbohydrates that affect blood glucose levels, and therefore patients need to be aware of the carbohydrate values of the foods they consume. This is particularly important for those titrating their insulin.
One of the ways insulin titration is done is through ‘dose adjustment for normal eating’ (DAFNE) which was designed for those with type I diabetes and can contribute to an improved quality of life and satisfaction for patients. Research shows that patients on DAFNE treatment are less likely to be admitted to hospital with ketoacidosis or hypoglycaemia, and also the treatment can make huge cost savings for providers. It consists of a 38 hour training course delivered in a group session based around competency skills. The scheme is successful in promoting understanding of diabetes, awareness of implications regarding diet, and the skills and knowledge required to count carbohydrates and titrate insulin accordingly with the use of DAFNE algorithms.
Cutting salt intake improves survival in patients with heart failure
Limiting intake fo sodium to less than 3g prolongs the survival of patients living with heart failure according to Korean study. J Clin Nursing 2011;20;3029-3038
Breast Cancer – Signs and Symptoms
- Dimpling/puckering of skin (like orange peel)
- Changes to either or both nipples, changes in size or shape of breast
- Lumps in breast tissue or axilla, pain in one or both breasts or axillae
- Inflammation, erythema, eczema to breast
Vegetarian and high fibre diets can reduce risk of diverticular disease
An Oxford study found that vegetarians were 31% less likely to suffer diverticular diease compared with adults who consumed a healthy diet containing meat and fish. Those who consumed a high intake of fibre were 41% less likely to suffer from diverticular disease.
Crowe FL et al (2011) Diet and risk of diverticular disease in Oxford cohort of European Prospective Investigation into Cancer and Nutrition (EPIC): prospective study of British vegetarians and non-vegetarians BMJ 343:d4131 doi:10.1136/bmj.d4131.
Varenicline in Smoking Cessation
Using varenicline before planning to quit smoking can improve 12 week success rates, by alleviating withdrawal discomfort and reducing pleasure gained from smoking.
Hajek P. et al (2011) Use of varenicline for four weeks before quitting smoking. Archives of Internal medicine. 171, 8, 770-777.
UK Guidance on Diet could save around 33,000 Lives annually
A study has found if people adhered to the recommended 5 portions of fruit and vegetables each day and reduced their daily intake of salt to 3.5g as well as their saturated fat intake to 3% of their daily energy intake, this could prevent around 33,000 deaths each year. It was calculated that 20,800 coronoary artery disease deaths, 5,876 stroke deaths, amd 6,481 cancer deaths could be prevented each year by following such guidance. Around 12,500 deaths would be in the 75 years and under category.
Scarborough P et al (2010) Modelling the impact of a healthy diet on cardiovascular disease and cancer mortality Journal of Epidemiology and Community Health. Doi:10.1136/jech.2010.114520
Prostate Cancer Progression slowed by Brisk Walking
A study by University of California, San Francisco and published in the Cancer Research journal has found that men with localised prostate cancer who walk briskly for three or more hours per week can halve the rate at which the cancer grows and metastasises. Men who exercised more had fewer instances of bone mets, disease recurrence and death (although those with healthier lifestyles tended also not to smoke and were often younger).
