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…]

Intensive glycaemic control does not reduce mortality in type 2 diabetes

Lots of different pills

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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From our Dental Elf: evidence of improved metabolic control in type 2 diabetes after treating periodontal disease

Dental examination

Clinical question: In type 2 diabetes, does non-surgical treatment of periodontal disease lead to improved glycaemic control? Methods: An updated systematic review of randomised trials. Results: The review concluded there was evidence of a small reduction in HbA1c after treatment for gum disease.  However, the studies were of poor quality with some evidence of publication [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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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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Telehealth did not improve quality of life, anxiety and depressive symptoms in patients with diabetes

A stethoscope on a keyboard

As pressure increases on an over-burdened healthcare system, focusing on self-care has potential. Advances in technology have improved many aspects of healthcare: now its uses may be harnessed to reduce utilisation of health services by those with long term conditions. “Telehealth” is an assistive technology that allows individuals to exchange information with their healthcare professional [read the full story…]

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…]

More evidence needed for ADP-antagonists to prevent CVD in type 2 diabetes

ECG readout

This Cochrane systematic review looked at whether adenosine-diphosphate (ADP) receptor antagonists such as clopidogrel and ticlopidine,  can prevent cardiovascular disease (CVD) in type 2 diabetes mellitus. These drugs have been shown to reduce the risk of cardiovascular outcomes in non-diabetic patients.  However, few studies have looked at the diabetic population.  As people with type 2 [read the full story…]

Repost from The Mental Elf: Depression increases risk of all cause mortality in diabetes

Today the Mental Elf reports on a systematic review and meta-analysis looking at whether depression in people with diabetes is associated withan increased risk of mortality. The reviewers combined the results of sixteen longitudinal studies comprising 109,046 individuals with diabetes.  They found a statistically significant increase in the risk of mortality amongst people with depression [read the full story…]

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