Diabetes education is more effective if it’s culturally sensitive

Asian couple

Another one to file under “stating the obvious”, you might think. Sadly, it’s not that obvious, as many patients would attest. This is also evidenced by the recent randomised controlled trial (RCT) on giving diet and lifestyle advice to try to prevent diabetes.  The paper in the Lancet reported a reduction in body weight in [read the full story…]

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Intensive glycaemic control does not reduce mortality in type 2 diabetes

Lots of different pills

More isn’t necessarily better.  This seems true in respect of glycaemic control in type 2 diabetes. More intensive control risks additional hypoglycaemia, where less intensive control risks long term complications. An updated Cochrane systematic review looked at the impact of tighter or intensive glycaemic control on overall mortality. Methods The reviewers searched bibliographic databases, the [read the full story…]

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The Finnish Diabetes Risk Score did not perform well as a screening tool for type 2 diabetes

A pen ticking off a checklist

A recent UK Health Technology Assessment pointed out the problems with screening for type 2 diabetes.  However, research continues into the performance of tools to detect type 2.  On the basis of this paper, we won’t be changing that advice any time soon. Methods This community screening study was undertaken in urban settings in the [read the full story…]

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A diet containing low fat dairy may reduce the risk of type 2 diabetes

A cow

It has been suggested that dairy products might have a preventive effect against type 2 diabetes.  However, the results of observational studies looking at the correlation between the consumption of dairy and incidence of type 2 have been inconclusive. A new systematic review set out to combine the evidence from these different studies into an [read the full story…]

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…]

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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…]

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More evidence needed for ADP-antagonists to prevent CVD in type 2 diabetes

ECG readout

This Cochrane systematic review looked at whether adenosine-diphosphate (ADP) receptor antagonists such as clopidogrel and ticlopidine,  can prevent cardiovascular disease (CVD) in type 2 diabetes mellitus. These drugs have been shown to reduce the risk of cardiovascular outcomes in non-diabetic patients.  However, few studies have looked at the diabetic population.  As people with type 2 [read the full story…]