Figures suggested that patients with diabetes in the Medway Clinical Commissioning Group area were 88.6% more likely to have a heart attack and 85.7% more likely to have a stroke than the general population. Also, targets for blood pressure and cholesterol were below the NHS England average. These findings prompted a service re-evaluation. Glycaemic support is inadequate to manage macrovascular complications, but a multifactorial management approach can reduce cardiovascular mortality by about 50%. A pharmacist prescriber ran a pilot service for eight months, using a cardiometabolic approach to review glycaemic control, blood pressure and chronic kidney disease in five practices.
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