Diabetes education is more effective if it’s culturally sensitive

Asian couple

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

Vitruvian data man

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

A pen ticking off a checklist

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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HTA recommends against screening for type 2 diabetes in the UK

Asian man

Following on from our report of the ADDITION trial last week, we can add that the UK Health Technology Assessment programme has updated its recommendation against screening for type 2 diabetes. Their recommendation to the National Screening Committee contains an analysis of new evidence published between 2009 and January 2012. Elves everywhere – coniferous, deciduous [read the full story…]

RCT finds that screening for type 2 diabetes in primary care did not improve clinical outcomes

singled out

If we pick up a disease early, we can treat it early.  So screening tests must be a good thing, right? Not necessarily. Testing is only beneficial if it enables us to provide better care.  There are many examples from clinical practice that demonstrate how earlier is not necessarily better.  Sometimes “lead-time bias” can mislead [read the full story…]

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More evidence needed on the benefits of CGM in children with type 1 and adults with type 2

SMBG

Previous systematic reviews and meta-analyses have failed to turn up clear evidence on the benefits and harms of continuous glucose monitoring (CGM) in children with type 1 diabetes and insulin-using patients with type 2 diabetes. This systematic review set out to update this state of affairs in the light of recent studies. In children with [read the full story…]

Pre-pregnancy care for diabetic women substantially reduces the risk of foetal malformations or death

Testing positive

Maternal diabetes can be a cause of congenital malformations and death in infants.  Diabetic mothers planning pregnancy need to be able to minimise these risks through good information, advice and care.  What forms of care are most effective? This systematic review set out to examine the evidence on giving specific pre-pregnancy care (PPC) in preventing [read the full story…]

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NHS Evidence Update on Diabetic Foot Problems

Foot examination

NHS Evidence is a service provided by NICE, the National Institute for Health and Clinical Excellence.  As part of this service, they publish regular updates of recent evidence that fits under the main sections of NICE guidance. In March, NHS Evidence produced an Evidence Update on Diabetic Foot Problems.  This is the first Evidence Update [read the full story…]

Emerging evidence about the impact of different statins on the risk of diabetes

A pill

Recent evidence has shown that statins can increase the incidence of new-onset diabetes, leading to an official warning by the FDA.  This has huge implications for practice, as these drugs are widely used to reduce the risk of cardiovascular disease in patients with and without diabetes.  Selecting the right treatment and balancing the proven benefits [read the full story…]