Home' Australian Pharmacist : Australian Pharmacist March 2013 Contents 70
Australian Pharmacist March 2013 I ©Pharmaceutical Society of Australia Ltd.
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1. SNAP guidelines (smoking,
nutrition, alcohol and physical
activity) should be discussed with
people with type 2 diabetes:
a) every three months.
b) twice per year.
c) once per year.
2. What is the target HbA1C for a person
who was diagnosed with diabetes
2 years ago and is taking both
metformin and a sulfonylurea?
a) 42 mmol/mol.
b) 48 mmol/mol.
c) 53 mmol/mol.
d) 64 mmol/mol.
3. A 68 year-old man who has type
2 diabetes and no history of
a) does not require aspirin therapy to
reduce his risk of a cardiovascular
b) may benefit from aspirin therapy if he
has high blood pressure.
c) should take aspirin therapy to reduce
his risk of a cardiovascular event
regardless of whether he has high
4. A non-smoking 70-year-old man
is taking metformin, ramipril and
atorvastatin. He has type 2 diabetes,
renal failure, a blood pressure
of 130/80mmHg and an LDL
cholesterol level of 2.5mmol/L. What
recommendation should you give
a) He should be reminded about SNAP
guidelines to ensure he is following
a balanced diet, not consuming too
much alcohol and being physically
b) He needs to see his doctor about
trying to reduce his blood pressure
c) He should visit his doctor about ways
to lower his LDL cholesterol further.
It is important for pharmacists and GPs
to keep up dated with alterations to the
recommended targets. Also, remember
that any movement towards these targets
will provide a benefit for the patient and
reduce their risk of CVD.
1. Diabetes Australia, Royal Australian College of General
Practitioners. Diabetes management in general practice:
Guidelines for type 2 diabetes. 17th edn, 2011/2012 Canberra,
snapguide2004.pdf (Accessed 25th Oct 2012)
guide-adult (accessed 23 Nov 2012)
CD004097.pub4/pdf (accessed 24 Nov 2012)
5. www.ncbi.nlm.nih.gov/pubmed/21540423 (accessed 24 Nov
news/current/type_2 _diabetes_priorities_targets (Accessed
26 Oct 2012)
7. Gerstein HC, Miller ME, Byington RP, et al. Effects of
intensive glucose lowering in type 2 diabetes. N Engl J Med
8. Patel A, MacMahon S, Chalmers J, et al. Intensive blood
glucose control and vascular outcomes in patients with type 2
diabetes. N Engl J Med 2008;358:2560–72.
9. Holman RR, Paul SK, Bethel MA, et al. 10-year follow-up of
intensive glucose control in type 2 diabetes. N Engl J Med
10. Turnbull FM, Abraira C, Anderson RJ, et al. Intensive glucose
control and macrovascular outcomes in type 2 diabetes.
11. Yudkin JS, Richter B, Gale EA. Intensified glucose lowering
in type 2 diabetes: time for a reappraisal. Diabetologia
12. National Prescribing Service. Type 2 Diabetes: Priorities and
Targets. Background Materials. Jun 2012.
13. Law MR, Morris JK, Wald NJ. Use of blood pressure lowering
drugs in the prevention of cardiovascular disease: meta-
analysis of 147 randomised trials in the context of expectations
from prospective epidemiological studies. BMJ 2009;
14. MRC/BHF Heart Protection Study of cholesterol lowering
with simvastatin in 20,536 high-risk individuals: a randomised
placebo-controlled trial. Lancet 2002;360:7–22.
(accessed 26 Nov 2012)
hypertension_0910.pdf (Accessed 25th Oct 2012).
17. National Vascular Disease Prevention Alliance. Guidelines for
the management of absolute cardiovascular disease risk, 2012.
18. Baigent C, Blackwell L, Collins R, et al. Aspirin in the primary
and secondary prevention of vascular disease: collaborative
meta-analysis of individual participant data from randomised
trials. Lancet 2009;373:1849–60 .
19. Seshasai SR, Wijesurya S, Sivakumaran R, et al. Effect of Aspirin
on Vascular and Nonvascular Outcomes: Meta-analysis of
Randomized Controlled Trials. Arch Intern Med 2012;172:209–
prescribing_practice_review/current/type_2 _diabetes_- _
priorities_and_targets (Accessed 26 Nov 2012).
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