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…]

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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A diet containing low fat dairy may reduce the risk of type 2 diabetes

A cow

It has been suggested that dairy products might have a preventive effect against type 2 diabetes.  However, the results of observational studies looking at the correlation between the consumption of dairy and incidence of type 2 have been inconclusive. A new systematic review set out to combine the evidence from these different studies into an [read the full story…]

The views of black and ethnic minority patients on self-management of type 2 diabetes

Asian couple

People in black and minority ethnic (BME) groups have a higher risk of type 2 diabetes than the population as a whole and often experience difficulty in managing their condition. A recent systematic review looked at their experiences of self-management of type 2.  This information will be extremely valuable to those running services for BME [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…]

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…]

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…]

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…]

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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