Source Amgen Switzerland AG, Zählerweg 6, 6301, Zug (Zug), Switzerland. reto.kessler@amgen.com Abstract PRINCIPLES: Current evidence indicates that chronic kidney disease (CKD) can be detected by simple laboratory tests. This study aimed to evaluate the cost-effectiveness of microalbuminuria screening and subsequent treatment in different populations. METHODS: Cost-effectiveness of microalbuminuria screening in a cohort of simulated [read the full story...]
Screening diabetic patients for microalbuminurea every 2 years was cost-effective in a Swiss setting
May 152012
May 142012
A recent systematic review looked at whether hyaluronic acid derivatives can be effective in dressings to promote wound healing. Clinical question: In people with burns or surgical or chronic wounds, do hyaluronic acid derivatives improve healing? The outcomes of interest were the percentage of patients whose wounds healed completely and the reduction in wound size. [read the full story...]
May 112012
Previous research has shown that structured diabetes education improves outcomes, and that education that is particularised to an individual patient’s cultural background is more effective than education that is not. This systematic review set out to identify what factors constitute “culturally competent” education, and what their long-term effects are. Clinical question: In ethnic minority patients [read the full story...]
A number of recent studies have found that bariatric surgery can improve diabetes or even reverse it. This meta-analysis looked at its use in people with type 2 diabetes who are obese but not severely obese. Clinical question: In obese type 2 diabetics with BMI < 35, does bariatric surgery reduce improve glycaemic control? The [read the full story...]
The Centre for Reviews and Dissemination (CRD) published an appraisal of a systematic review of drug interventions to prevent type 2 diabetes. Clinical question: In high risk patients do oral antidiabetic drugs prevent progression to type 2 diabetes? The scope included thiazolidinediones, biguanides, alpha-glucosidase inhibitors, sulphonylureas, glinides and dipeptidyl peptidase-4 inhibitors. The evidence: The reviewers [read the full story...]
We report on a critical appraisal by the Centre for Reviews and Dissemination (CRD) of a systematic review of insulin regimens in type 2 diabetes. Clinical question: In type 2 diabetes inadequately controlled with oral agents, does biphasic insulin, compared with basal insulin, lead to better glycaemic control? The review defined the proportion of patients [read the full story...]
May 042012
DPP-4 inhibitors, or “gliptins”, are a new oral therapy for type 2 diabetes. This review set out to find evidence for their safety in long term use. Clinical question: In type 2 diabetes, do DPP-4 inhibitors have any adverse effects? The evidence: The reviewers found 67 randomised controlled trials that evaluated alogliptin, linagliptin, saxagliptin, sitagliptin, [read the full story...]
We recently reported on a review of GLP-1 analogues as a second line of treatment in type 2 diabetes. A new systematic review reports on a direct comparison with insulin therapy in poorly controlled type 2 diabetes. Clinical question: In type 2 diabetes poorly controlled on oral therapy, do GLP-1 analogues as compared with insulin, [read the full story...]
Several recent studies have suggested unexpected benefits of metformin. This prompted a slew of meta-analyses looking for evidence of benefit in preventing cancer. This evidence needs to be interpreted with caution; this latest review, looking at liver cancer, is a case in point. Clinical question: In type 2 diabetes, does metformin prevent liver cancer? The [read the full story...]
Apr 302012
This systematic review looked at observational studies of a link between treatment with insulin, whether type 1 or type 2 diabetes, and the incidence of cancer of any type. Clinical question: In people with diabetes, is treatment with insulin, as compared to other treatment, associated with an increased risk of cancer? The evidence The reviewers [read the full story...]
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