More evidence needed for direct telephone support in diabetes care

An asian woman on the phone

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…]

Collaborative Care improves outcomes for people with diabetes and depression

Unhappy woman

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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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…]

Systematic review finds that vitamin D intake in early life may be associated with a reduced risk of type 1 diabetes

Cod liver oil

Vitamin D is suspected of having a role in the development of type 1 diabetes.  Previous studies have been small-scale and inconclusive. Now we have a systematic review of the observational evidence about the relationship between consumption of Vitamin D in early life (or during pregnancy) and the risk of developing type 1 diabetes later [read the full story…]

The National Pregnancy in Diabetes Audit aims to improve pregnancy outcomes for women with diabetes

Pregnant woman holding a syring

We already know that women with diabetes have a substantially increased risk of adverse pregnancy outcomes.  We also know that improved glycaemic control can reduce these risks.  But are these messages being adequately addressed in current clinical practice? The NHS in England has recently started the National Pregnancy in Diabetes Audit, with the aim of [read the full story…]

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Metformin appears to be safe in diabetic patients with heart failure

ECG readout

Heart failure is more prevalent in diabetes than in the general population.  All too often, patients with such serious co-morbidities are excluded from clinical trials.  As a result, there remains uncertainty around the benefits of diabetes medications in these sub-groups of patients.  Often, we need to look at observational data to get the best available [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…]

Ethnicity, parenting, stress and self-efficacy are all associated with glycaemic control in young people with diabetes

Child with a megaphone

This review was motivated by the need to understand the barriers to achieving and maintaining good metabolic control among children and adolescents. From insulin pump (CSII) therapy to carbohydrate counting, technology has advanced rapidly since the Diabetes Control & Complications Trial.  However, this has not been matched with efforts to understand the impact of human [read the full story…]

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Review of the role of podiatrists in diabetes care highlights the need for further research

Smiley feet

Foot care is a cornerstone of diabetes care.  However, there is very little evidence about the impact of specialist foot care by podiatrists or chiropodists on the risk of amputation.  Current guidance recommends that podiatrists should be part of the multidisciplinary foot care team.  However, this recommendation is based on observational studies.  For this reason, [read the full story…]