NHS England: Action for Diabetes

Stethoscope on a keyboard

NHS England has announced a new strategy document for diabetes care, called Action for Diabetes.  The document is for Clinical Commissioning Groups (CCGs), to serve as a reference on the work that is going on across NHS England. It will also be of interest to the wider community interested in diabetes care to see what [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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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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Review finds no evidence for topiramate in treating neuropathic pain

Unhappy woman

Diabetic neuropathy is a common complication of diabetes.  This condition is very painful and substantially compromises quality of life.  Its progressive nature places a further burden on patients and their carers. Current guidance recommends a range of possible drug treatments, including the antidepressant drugs amitriptyline or duloxetine and the anti-convulsant pregabalin.  A recent Cochrane review [read the full story…]

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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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…]

Weak evidence for radix astragali in treating diabetic retinopathy

Radix astragali

Radix astragali is a traditional Chinese medicine made from dried roots of  that has been widely used for the treatment of diabetes.  This systematic review set out to establish if there is any clinical evidence to support its use in treating diabetic retinopathy. Clinical question In people with diabetic retinopathy (DR), does radix astragali, compared [read the full story…]

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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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High-dose atorvastatin did not cause diabetes in low-risk patients with existing cardiovascular disease

Atorvastatin molecule

The Diabetes Elf once overheard a respected senior colleague: “The only treatments that don’t have any side-effects are the ones that don’t work.” So it turned out with statins, which were recently found to have increased the risk of developing type 2 diabetes.  The questions, of course, is “Are the benefits worth the harms?”  In [read the full story…]