2 September 2008

The August edition of Australian Prescriber includes articles on:

• Under treatment of rural people with cardiovascular disease
• Restless legs syndrome
• Preventing foot ulcers

We must do better on rural cardiovascular disease

Death rates for cardiovascular disease are higher in country areas than in cities, and this could be caused by under prescribing of drugs for heart disease.

An editorial in the August edition of Australian Prescriber cites the lack of doctors as a major problem. Rural people see their GPs less and have less access to specialists, writes Professor Dawn DeWitt, head of the University of Melbourne School of Rural Health in Shepparton, Victoria.

Further work needed on new drugs for type 2 diabetes

Also in the August issue are reviews of exenatide and sitagliptin, recently approved for type 2 diabetes. The drugs can be added to treatment when diabetes is not controlled by other drugs.

The role of these incretin mimetics and enhancers is uncertain and requires further research, write Dr Anne Reutens and Associate Professor Jonathan Shaw from the Baker IDI Heart and Diabetes Institute in Melbourne.

'Exenatide mainly affects postprandial glucose, but it also lowers fasting glucose', say the authors. When it was compared with insulin, both drugs improved glycaemic control but the patients injecting exenatide lost weight.

Sitagliptin also improves glycaemic control but does not cause significant weight change, say Dr Reutens and Professor Shaw.

The new drugs are not without adverse effects. The article is accompanied by a review of the mechanisms of action of these drugs.

For the full August edition go to www.australianprescriber.com

ENDS

Australian Prescriber is an independent peer-reviewed journal providing critical commentary on therapeutic topics for health professionals, particularly doctors in general practice. It is published by the National Prescribing Service Limited (NPS), an independent, non-profit organisation for Quality Use of Medicines funded by the Australian Government Department of Health and Ageing.