Abstract
How would you rate this book? (5 star means excellent book useful for all GPs in training—a must have item; 1 star means poor book that you would not buy yourself)
What is good about this book?
This book is an excellent and informative resource tool for trainee GPs studying for the Membership of the Royal College of General Practitioners (MRCGP) exam and for qualified GPs wishing to revise or update their knowledge at a time when diabetes management is being shifted into the community. It predominantly focuses on diabetes mellitus but does have chapters on thyroid disorders and rarer endocrine problems such as hypopituitarism, Addison's and Cushing's. Written by Dr Roger Gadsby, a GP and academic involved in writing the National Institute for Health and Clinical Excellence (NICE) guideline for type 2 diabetes in 2008, it expands on the MRCGP curriculum statement 15.6 ‘Metabolic problems’.
It is written in a logical and easy-to-digest style. Divided into chapters dealing with all aspects of diabetic care including diagnosis, complications, glycaemic control, ethnic and cultural aspects and pregnancy, each chapter opens with a patient-based case study. The latest relevant knowledge, evidence and guidelines are then outlined to enable the reader to best manage the patient example. The initial scenario is then revisited and management options outlined, before referring back to the six domains of core essential competences of being a GP as outlined in the MRCGP curriculum.
Each subject is discussed clinically, focusing on management in primary care at individual and population level, and targeted to Quality and Outcomes Framework (QOF), while also including financial and epidemiological data. In doing so, it covers more than just the theory required to pass the MRCGP exam.
There is an invaluable chapter on the structure of diabetic care highlighting the shift of diabetes from secondary to primary care, the QOF targets and recent changes in clinical indicators and useful advice for running diabetic clinics in practice. It highlights potential changes in service provision through GPs with specialist interests (GPwSIs) and community diabetic clinics and through redesign by practice-based commissioning (PBC) groups.
What is bad about this book?
This book is primarily focused on diabetes and while this is covered comprehensively, there is more limited information regarding thyroid disease and rarer endocrine disorders. While covered at a sufficient level for most primary care physicians, those with a specialist interest or more complex cases may need to further their knowledge by other means.
Each of the glucose-lowering agents is explained in terms of mechanism, efficacy and evidence and a clear ladder of treatment is outlined. Although not the aim of the book, it would be necessary to obtain further training in order to be confident in initiating the incretins (glucagon-like peptide-1 [GLP-1] mimetics such as exenatide and dipeptidyl peptidase IV [DPP-4] inhibitors such as sitagliptin) and insulin.
Overall, this book is thorough and concise and delivers relevant up-to-date information, based on commonly encountered case scenarios, allowing GPs hands on advice to enable them to update their clinical practice and revise their diabetic care structure.