Alphabet Strategy for diabetes care: A multi-professional, evidence-based, outcome-directed approach to management

With the rising global prevalence in diabetes, healthcare systems are facing a growing challenge to provide efficient and effective diabetes care management in the face of spiralling treatment costs. Diabetes is a major cause of premature mortality and associated with devastating complications especially if managed poorly. Although diabetes care is improving in England and Wales, recent audit data suggests care remains imperfect with wide geographical variations in quality. Diabetes care is expensive with a sizeable amount of available expenditure used for treating the complications of diabetes. A target driven, long-term, multifactorial intervention in patients with type 2 diabetes has been shown to reduce mortality and morbidity. The alphabet strategy is a novel approach to effective diabetes care provision, aiming to address patient education and empowerment, provide consistent comprehensive care delivered in a timely fashion, and allowing multidisciplinary team work.

维生素B12缺乏症

一名44岁女性,因嗜睡2年到全科门诊就诊,嗜睡导致其无法继续小学教师的工作。数年前患者曾有贫血史,但除混合避孕药外,未规律服用治疗贫血的相关药物。患者母亲患有甲状腺功能减退症并服用左旋甲状腺素;家庭其他成员病史不详。体格检查无特殊。近期血液生化检查显示,血红蛋白110g/L(参考范围115~160g/L),平均红细胞容积102fL(80~100fL)。