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…]

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…]

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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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…]

ACE inhibitors significantly reduce the risk of diabetic kidney disease

Kidney

Kidney disease is one of the most serious complications of diabetes.  Reducing its incidence can greatly enhance survival, quality of life and reduce costs of care.  Keeping blood pressure under control is essential to this effort.  NICE guidance recommends ACE inhibitors as a first-line therapy for patients with diabetes and high blood pressure. However, a [read the full story…]

Increased risk of acute pancreatitis in people with diabetes

A pancreas

We already know that pancreatitis can lead to diabetes.  This systematic review of observational studies looked at whether people with diabetes can subsequently develop pancreatitis. Clinical question: In people with diabetes, what is the risk of developing acute pancreatitis? The reviewers were interested in studies that report new (incident) cases of pancreatitis rather than existing [read the full story…]

Metformin may reduce the risk of cancer, but more research is needed

cancer_blood

This systematic review looked at the relationship between oral antidiabetic drugs and the risk of cancer. Clinical question: In type 2 diabetes, does treatment with metformin or sulphonylurea affect the risk of cancer? The evidence: The reviewers found 17 observational studies reporting 37,632 cases of cancer.  When they pooled the data from these studies they [read the full story…]

Greater whole grain intake is associated with a lower risk of type 2 diabetes

Whole Grain

This systematic review set out to establish whether whole grains specifically contribute to a reduction in the risk of developing type 2 diabetes. Clinical question: In healthy indivduals, is consumption of whole grains associated with a reduced risk of type 2 diabetes. The reviewers were also interested in the effects on cardiovascular disease and weight. [read the full story…]