Evidence Update: Preventing type 2 diabetes at the population and community level

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With the rate at which new evidence is published, it’s impossible for guidelines or even systematic reviews to keep pace.  That’s why NICE Evidence Updates are so, err, nice!  They summarise what’s new in relation to existing NICE guidelines since they were published. The NICE guidance This Evidence Update relates to NICE guideline 35 on [read the full story…]

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More evidence needed for direct telephone support in diabetes care

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There’s lots of interest in how we can use the increasingly ubiquitous telephone to improve diabetes care.  It’s important that we apply the same rigorous tests to these interventions as we do to others, and don’t just assume that “new” means “better“. In resource-poor settings this is all the more important, as we have to [read the full story…]

NHS England: Action for Diabetes

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NHS England has announced a new strategy document for diabetes care, called Action for Diabetes.  The document is for Clinical Commissioning Groups (CCGs), to serve as a reference on the work that is going on across NHS England. It will also be of interest to the wider community interested in diabetes care to see what [read the full story…]

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Diabetes education is more effective if it’s culturally sensitive

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Another one to file under “stating the obvious”, you might think. Sadly, it’s not that obvious, as many patients would attest. This is also evidenced by the recent randomised controlled trial (RCT) on giving diet and lifestyle advice to try to prevent diabetes.  The paper in the Lancet reported a reduction in body weight in [read the full story…]

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Collaborative Care improves outcomes for people with diabetes and depression

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Today, our cousin the Mental Elf has posted an important blog about the management of people with diabetes and depression. Around 20% of patients with diabetes meet diagnostic criteria for depression.  NICE guidelines state that Collaborative Care (CC) should form part of a well-developed stepped-care programme for people with moderate to severe depression and a [read the full story…]

National Diabetes Audit highlights the need to focus on prevention and treatment of heart failure

Missing the target

In answering the question “Are we ‘doing things right’ in Diabetes care?”, a good place to start is to look at all the data we have about patients in the NHS.    The National Diabetes Audit does just that for NHS services in England and Wales. Over two million people have diabetes in England and [read the full story…]

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Intensive glycaemic control does not reduce mortality in type 2 diabetes

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More isn’t necessarily better.  This seems true in respect of glycaemic control in type 2 diabetes. More intensive control risks additional hypoglycaemia, where less intensive control risks long term complications. An updated Cochrane systematic review looked at the impact of tighter or intensive glycaemic control on overall mortality. Methods The reviewers searched bibliographic databases, the [read the full story…]

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Evidence of improved cardiovascular risk for people with diabetes in England between 1994 and 2009

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This study evaluated trends in cardiovascular risk factors among people with diabetes. Data obtained as part of the Health Survey for England (HSE) between 1994 and 2009 were examined with particular focus on the differences between men and women and between social classes. It was important to investigate possible trends so that the impact of [read the full story…]

The Finnish Diabetes Risk Score did not perform well as a screening tool for type 2 diabetes

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A recent UK Health Technology Assessment pointed out the problems with screening for type 2 diabetes.  However, research continues into the performance of tools to detect type 2.  On the basis of this paper, we won’t be changing that advice any time soon. Methods This community screening study was undertaken in urban settings in the [read the full story…]

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A diet containing low fat dairy may reduce the risk of type 2 diabetes

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It has been suggested that dairy products might have a preventive effect against type 2 diabetes.  However, the results of observational studies looking at the correlation between the consumption of dairy and incidence of type 2 have been inconclusive. A new systematic review set out to combine the evidence from these different studies into an [read the full story…]