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…]

Evidence of improved cardiovascular risk for people with diabetes in England between 1994 and 2009

Vitruvian data man

This study evaluated trends in cardiovascular risk factors among people with diabetes. Data obtained as part of the Health Survey for England (HSE) between 1994 and 2009 were examined with particular focus on the differences between men and women and between social classes. It was important to investigate possible trends so that the impact of [read the full story…]

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…]

Pre-pregnancy care for diabetic women substantially reduces the risk of foetal malformations or death

Testing positive

Maternal diabetes can be a cause of congenital malformations and death in infants.  Diabetic mothers planning pregnancy need to be able to minimise these risks through good information, advice and care.  What forms of care are most effective? This systematic review set out to examine the evidence on giving specific pre-pregnancy care (PPC) in preventing [read the full story…]

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Review: experiences of stigma associated with diabetes

Singled out

People with diabetes often experience stigma in association with the disease.  However, this is an under-researched area compared with stigma associated with other conditions.  Therefore this narrative review is particularly welcome. The review encompasses stigma enacted by others, stigma that is perceived by people with diabetes, and internalized stigma or “self-stigma”. Causes of stigma Often, [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…]

Effective treatments for non-healing diabetic ulcers

Diabetic foot ulcer

Non-healing leg ulcers are a major burden for people with diabetes and for the health service.  This evidence review by the US Department of Veterans’ Affairs focuses on treatments approved by the US Food and Drug Administration but contains important findings that could be applicable in any setting. Clinical question The review addresses the following [read the full story…]