NHS Evidence Update on Diabetic Foot Problems

Foot examination

NHS Evidence is a service provided by NICE, the National Institute for Health and Clinical Excellence.  As part of this service, they publish regular updates of recent evidence that fits under the main sections of NICE guidance. In March, NHS Evidence produced an Evidence Update on Diabetic Foot Problems.  This is the first Evidence Update [read the full story…]

E-health may help to improve self-care in diabetes, but more research is still needed

Keyboard with health icons on the keys

E-health offers tremendous potential to improve self-management of diabetes.  The Centre for Reviews and Dissemination (CRD) has recently published an appraisal of a systematic review into the use of e-health in diabetes and other chronic conditions. Clinical question: In people with diabetes, do e-health interventions improve self-management? The reviewers looked at the use of interactive [read the full story…]

TZDs may prevent type 2 diabetes

A colourful selection of pills

The Centre for Reviews and Dissemination (CRD) published an appraisal of a systematic review of drug interventions to prevent type 2 diabetes. Clinical question: In high risk patients do oral antidiabetic drugs prevent progression to type 2 diabetes? The scope included thiazolidinediones, biguanides, alpha-glucosidase inhibitors, sulphonylureas, glinides and dipeptidyl peptidase-4 inhibitors. The evidence: The reviewers [read the full story…]

Review: biphasic insulin was better than basal insulin in type 2 diabetes

Adjusting the dose

We report on a critical appraisal by the Centre for Reviews and Dissemination (CRD) of a systematic review of insulin regimens in type 2 diabetes. Clinical question: In type 2 diabetes inadequately controlled with oral agents, does biphasic insulin, compared with basal insulin, lead to better glycaemic control? The review defined the proportion of patients [read the full story…]

DVLA monitoring requirements for diabetic drivers

A lorry driver

The NPC published this evidence summary to clarify the position regarding driving and diabetes.  In addition to existing publications, the summary was based on direct correspondence between the NPC and the UK Driver and Vehicle Licencing Agency (DVLA).  It includes a summary of the position and Q&A section for health professionals. Clinical question: In drivers [read the full story…]

Bariatric surgery may be cost-effective for obesity with type 2 diabetes

A gastric band

An economic evaluation reported by the Centre for Reviews and Dissemination concludes that bariatric surgery, whether gastric bypass or gastric band, is cost-effective in a US payor setting. Clinical question In severely obese people with type 2 diabetes, is bariatric surgery cost-effective compared with usual care? The evidence This is a critical appraisal of a [read the full story…]