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…]

New guideline for bariatric surgery in type 2 diabetes

A gastric band

Bariatric surgery is increasingly seen as an effective and cost-effective treatment for obesity.  There is even some evidence that it can reverse type 2 diabetes. The American Association of Clinical Endocrinologists (AACE) have co-produced a guideline for bariatric surgery that includes within its scope, its use in patients with type 2 diabetes. The guideline covers: [read the full story…]

Share this post: Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+ Share via email

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…]

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…]

Share this post: Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+ Share via email

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…]

Share this post: Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+ Share via email

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…]

Share this post: Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+ Share via email

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…]