Diabetes for healthcare providers

Best practice diabetes toolbox(external link) BPAC, NZ, 2021
Type 2 diabetes management guidance(external link) NZ Society for the Study of Diabetes and Ministry of Health, NZ, 2021
A rising tide of type 2 diabetes in younger people – what can primary care do?(external link) BPAC, NZ, 2020
COVID-19 and diabetes Research Review, NZ, 2020
How do we support walking prescriptions for type 2 diabetes management? Facilitators and barriers following a 3-month prescription(external link) The Royal NZ College of General Practitioners, 2020
Slowing progression of renal dysfunction in patients with diabetes(external link) BPAC, NZ, 2019
Dialling back treatment intensity for older people with type 2 diabetes(external link) BPAC, NZ, 2019
Optimising pharmacological management of HbA1c levels in patients with type 2 diabetes – from metformin to insulin(external link) BPAC, NZ, 2019
Type 2 diabetes and the management of hyperglycaemia(external link) Research Review, NZ, 2019
Type 2 diabetes and overcoming clinical inertia(external link) Research Review, NZ, 2018
Guidance on the use of insulin in the management of type 2 diabetes in primary care Research Review, NZ, 2017
Management of type 2 diabetes(external link) NZ Primary Care Handbook, pages 45–64, including:

• glycaemic control
• management of blood pressure
• preventing complications
• starting insulin.

Primary care-led weight management for remission of type 2 diabetes (DiRECT) – an open-label, cluster-randomised trial(external link) The Lancet, UK, 2017
A rising tide of type 2 diabetes in younger people – what can primary care do?(external link) BPAC, NZ, 2018
Managing patients with type 2 diabetes – from lifestyle to insulin(external link) BPAC, NZ, 2015
Improving glycaemic control in people with type 2 diabetes(external link) BPAC, NZ, 2013
The new role of HbA1c in diagnosing type 2 diabetes(external link) BPAC, NZ, 2012

Diabetic nephropathy 

Renal disease screening in diabetes(external link) Auckland Regional HealthPathways, NZ
Type 2 diabetes management guidelines – management of diabetic renal disease(external link) NZSSD and Ministry of Health, NZ, 2020
CKD management in general practice – summary guide(external link) Kidney Health NZ 
CVD risk assessment for people with type 2 diabetes in NZ(external link) NZSSD 
Diabetic nephropathy(external link) PatientInfo Professional, UK, 2016
Chronic kidney disease in adults – assessment and management(external link) NICE Guideline, UK, 2015

General practice has an important role to distinguish between the majority of patients who have stable CKD (who require management of their cardiovascular risk factors) and the minority with or at high risk of progressive CKD (who need to be closely monitored in collaboration with nephrology services).

The following is taken from Type 2 diabetes management guidelines – complications of diabetes(external link) NZSSD and Ministry of Health, NZ, 2020

Those at high risk of diabetic complications include both vulnerable populations and those with associated risk factors:

• Populations vulnerable to the development of diabetic complications:
  • Onset of diabetes at a young age
  • Advancing age
  • People of Māori or a Pacific ethnicity
  • People of other non-European ethnicities
  • Lower socioeconomic status
• Risk factors for the development of diabetic complications:
  • Long duration of diabetes
  • Suboptimal glycaemic control
  • Pre-existing complications or comorbidities e.g. established cardiovascular disease, microalbuminura and/or reduced eGFR
  • Hypertension
  • Dyslipidaemia
  • Smoking
  • Obesity
  • Reduced engagement with health services and adherence to therapy

The following information is taken from The detection and management of patients with chronic kidney disease in primary care(external link) BPAC, NZ, 2015

Māori and Pacific peoples with diabetes are 3-4 times more likely to have renal failure than non-Māori with diabetes.

Be aware of increased cardiovascular risk: The risk of a person experiencing a cardiovascular event increases as their renal function declines. Between 40–50% of people with kidney failure die of cardiovascular disease. 

Type 2 diabetes

From 1 February 2021, empagliflozin, a SGLT2 inhibitor, is subsidised for patients with type 2 diabetes who are at high risk of heart and kidney complications.

• Empagliflozin(external link) is fully subsidised for those patients who meet the special authority criteria(external link).
• It is available as a once daily tablet either alone (Jardiance(external link)) or in combination with metformin (Jardiamet(external link)).

Read more about:

• type 2 diabetes management guidelines: non-insulin medications(external link) Ministry of Health, NZ & New Zealand Society for the Study of Diabetes, 2020

• Empagliflozin and dulaglutide: Your questions answered(external link) Dr Ryan Paul, He Ako Hiringa, NZ, 2021

Medsafe data sheets

Use the link below to search for the medication you want information about. In the 'Medicine' field enter the generic name or brand name.
Prescriber data sheet and Consumer medicine information(external link)

Blood glucose meters and test strips

A guide to the availability of CareSens meters and test strips for newly diagnosed patients.(external link) Pharmaco diabetes, NZ.

Webinar: The diabetic foot(external link) Presenter: Rebecca Aburn – Nurse Practitioner & Emil Schmidt – Wound Care Specialist

Part 1 of 2: This presentation covers:

• Incidence and Prevalence
• History of Diabetes
• Disease Guidelines
• DF Classification and Documentation
• Introduction to Multi-Disciplinary Team

You can watch the video, answer questions and claim hours with a certificate. 

Part 2 of 2:  Topic: Surgical Intervention
Presenter: Mr. Fraser Harrold – Consultant Orthopaedic Surgeon & Senior Lecturer & Rebecca Aburn – Nurse Practitioner

Topic: Podiatry and Orthotics – an Overview
Presenter: Jacqui Journeaux – Podiatrist & Brent Fisher – Orthotist

You can watch the video, answer questions and claim hours with a certificate. 

Goodfellow Unit Webinar: New diabetes medications - guidelines and best practice

(Goodfellow Unit Webinar, NZ, 2021)

Overview of diabetes – Lisa Sparks

(Mobile Health, NZ, 2020)

Primary care – PHARMAC Seminar Series

Sick day management for type 1 and type 2 diabetes in primary care. Presented by Dr Elaine Barrington-Ward (30 minutes).

(Dr Elaine Barrington-Ward, PHARMAC, Wellington, NZ, 2016)

Goodfellow Unit Webinar

Type II diabetes in young people(external link), 17 April 2018, Dr Steven Miller

New medications in type 2 diabetes by Dr Zaven Panossian

(The Goodfellow Unit, NZ, 2018)

Starting insulin with type 2 diabetes by diabetes nurse specialist Kate Smallman

(The Goodfellow Unit, NZ, 2018)

PHARMAC Seminar series 

Diabetes Diagnosis – Tim Kenealy(external link) Goodfellow Unit, NZ, 2017
"Dr Timothy Kenealy talks about diagnosing diabetes in primary care. Tim was a GP in South Auckland for 25 years and is an associate professor of integrated care at the University of Auckland. One of his main research interests is in diabetes in primary care."

Nutrition – type two diabetics, Jennifer Crowley(external link) Goodfellow Unit, NZ, 2017
Dr Jennifer Crowley talks about nutrition and advice to give type 2 diabetics. Jennifer's doctorate in health sciences thesis topic was 'New Zealand GPs and nutrition care – perceptions, perceived competence and barriers to provision'. Jennifer is a registered dietitian, registered sports dietitian and secondary teacher with extensive experience in teaching nutrition education.

Pacific patients and T2D – how can we do better?(external link) Goodfellow MedCases, 2019

Diabetes topics