The All Wales Medicines Strategy Group has published a recommendation regarding saxagliptin, the DPP-4 inhibitor (Onglyza®) Saxagliptin is recommended as an option for use within NHS Wales for the treatment of adult patients aged 18 years and older with type 2 diabetes mellitus to improve glycaemic control in combination with insulin (with or without metformin) [read the full story...]
Linagliptin rejected by the NHS in Wales for use in type 2 diabetes due to lack of evidence of efficacy
We previously reported systematic reviews of DPP-4 inhibitors. Recently, the All Wales Medicines Strategy Group, the government agency charged with assessing the effectiveness of medicines and making recommendations about their use in the NHS in Wales, issued an evaluation of linagliptin, a DPP-4 inhibitor marketed under the brand name Trajenta. Clinical question: In patients with [read the full story...]
American Diabetes Association: Standards of Care 2012
The latest edition of Diabetes Care contains the most recent guidance from the American Diabetes Association. These standards of care are intended to provide clinicians, patients, researchers, payers, and other interested individuals with the components of diabetes care, general treatment goals, and tools to evaluate the quality of care. The guidelines address: Classification and diagnosis [read the full story...]
DVLA monitoring requirements for diabetic drivers
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...]
Exenatide should be an option for triple therapy in type 2 not on insulin
Exenatide is an injectable drug that promotes the production of insulin and inhibits production of glucagon. The National Institute for Health and Clinical Excellence (NICE) has just published a guideline stating that prolonged-release (weekly) exenatide injections should be used as third line of therapy in type 2 diabetes. Clinical question: In type 2 diabetes inadequately [read the full story...]
Facilitating the transition from paediatric to adult care services.
Children may gradually shift gradually from diabetes care supervised by parents and other adults to self-care management. The actual change from paediatric to adult health care providers can be more abrupt. Clinical question: In children with diabetes, how should the transition to adult care be managed by care systems? This consensus statement provides a framework [read the full story...]
Quality of care for people with diabetes in England and Wales, 2009-10
The National Diabetes Audit reports on the quality of care for people with diabetes. Clinical question: What is the standard of diabetes care delivered by the NHS in England and Wales? The report looked at patient registrations, care processes, treatment targets and rates of complications. Data were derived by surveying GP practices and health authorities. [read the full story...]
Guidance on improving staff safety in injecting insulin.
This new guidance has been developed by the European Medical Association to assist health care staff in minimising risk from injecting insulin for diabetes patients, principally through blood exposure. Clinical question: In health staff administering insulin to people with diabetes, what precautions should be taken to minimise their risk of needle injuries? The evidence This [read the full story...]
Drug treatment of type 2 diabetes: new guidance from the American College of Physicians
This new publication provides guidance for clinicians on the comparative effectiveness and safety of type 2 diabetes medications. The guidance applies to adults over 18 years of age and does not cover combinations of more than two drugs. Main recommendations: The ACP recommends that clinicians add oral pharmacologic therapy in patients diagnosed with type 2 [read the full story...]
NICE guidance on ranibizumab for diabetic macular oedema
In a technology appraisal, the National Institute for Health and Clinical Excellence (NICE) has concluded that ranibizumab is not recommended for the treatment of visual impairment due to diabetic macular oedema. This conclusion is based on data about cost and effectiveness provided by the manufacturer. NICE’s review team noted important limitations of this data, including [read the full story...]