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…]

Ethnicity, parenting, stress and self-efficacy are all associated with glycaemic control in young people with diabetes

Child with a megaphone

This review was motivated by the need to understand the barriers to achieving and maintaining good metabolic control among children and adolescents. From insulin pump (CSII) therapy to carbohydrate counting, technology has advanced rapidly since the Diabetes Control & Complications Trial.  However, this has not been matched with efforts to understand the impact of human [read the full story…]

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

Review: the effect of exercise on HbA1c in type 1 diabetes is still uncertain

Runners

Existing recommendations for exercise in diabetes are based largely on evidence from the general population or from people with type 2 diabetes.  This systematic review set out to look specifically at the effect of exercise on glycaemic control among people with type 1 diabetes. Clinical question In people with type 1 diabetes, does exercise improve [read the full story…]

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

DAFNE improved quality of life whilst reducing costs in type 1 diabetes in the UK and Ireland

Two people eating

Dose adjustment for normal eating (DAFNE) is a structured education programme for adults with type 1 diabetes for insulin adjustment on a meal-by-meal basis. It is based on carbohydrate estimation and is suitable for patients who can read or speak English. DAFNE is delivered by specially trained educators (diabetes specialist nurses and diabetes specialist dietitians) [read the full story…]

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

Review finds little evidence of benefit for insulin analogs over NPH insulin

Picture of a syringe

A systematic review comparing insulin analogues (glargine and detemir) with NPH insulin was published at the end of 2011. Clinical question: In type 1 diabetes, are insulin analogues better than NPH insulin? It is not clear what outcomes were specified in advance of the study. The evidence: The reviewers found 8 randomised trials comparing glargine [read the full story…]

American Diabetes Association: Standards of Care 2012

Logo of the American Diabetes Association

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…]

Review: unclear evidence about education for type 1 diabetes using pump therapy

Insulin Pump with sensor

This systematic review set out to establish the effectiveness and optimal delivery of educational interventions to help adults with type 1 diabetes who are using insulin pump therapy. Clinical question: In adults with type 1 diabetes using or starting insulin pump therapy, what is the effectiveness of educational interventions? The review included both patients starting [read the full story…]

Better evidence needed for psychological interventions in young people with diabetes

A young girl

Clinical question In children and young people with diabetes, do psychological interventions improve care? This review had a broad scope and included many different types of intervention for different disease areas.  The common factor was children with chronic diseases.  It is not clear which outcomes were set out in advance as being of interest to [read the full story…]

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

Continuous glucose monitoring may be effective and safe in type 1 diabetes compared with SMBG

CGM monitor

Clinical question In patients with type 1 diabetes, does Continuous glucose monitoring (CGM) compared with self-management of blood glucose (SMBG) lead to an improvement in glycaemic control or a reduction in hypoglycemia? Methods Systematic review of randomised trials.  14 trials were found, comprising 1,268 participants. Bottom line Real-time CGM was associated with a 0.26% (95% [read the full story…]

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

5mm needles may be as good as 8mm for obese patients with type 1 diabetes or type 2 on insulin

Picture of a syringe

Clinical question: In obese people (BMI ≥30kg/m2) with diabetes who inject insulin, are 5mm needles, as compared to 8mm, effective at maintaining glycaemic control and acceptable to patients? Methods: Randomised crossover trial with six months duration, N=130.    Glycaemic control was measured by HbA1c, fructosamine and 1,5-anhydroglucitol.  Patient preferences were measured with a visual analog pain [read the full story…]