Search Results for: randomised

No difference between TZDs and DPP-4 inhibitors or sulphonylureas added to metformin in type 2 diabetes

No difference between TZDs and DPP-4 inhibitors or sulphonylureas added to metformin in type 2 diabetes

Research question: In people with type 2 diabetes inadequately controlled with metformin, which additional oral therapy offers the greatest improvement in HbA1c? The reviewers just looked at glycaemic control in patients whose starting HbA1c was 7% or higher at 12 weeks or longer follow-up. The evidence: Eight randomised trials were found, which looked at various …

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Lack of clear evidence for metformin in type 2 diabetes on insulin therapy

Lack of clear evidence for metformin in type 2 diabetes on insulin therapy

Metformin is widely used as a first line treatment for type 2 diabetes and it is usually continued when treatment is intensified, such as with other oral agents or by insulin therapy. This systematic review looked at whether metformin is actually beneficial to patients who are using insulin. Clinical question: In people with type 2 …

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Bevacizumab did not improve diabetic macular oedema at 12 weeks

Bevacizumab did not improve diabetic macular oedema at 12 weeks

We recently reported on new guidance from NICE about the treatment of diabetic macular oedema with ranibizumab.  Another systematic review recently looked at another injectable drug with a similar role: bevacizumab, or Avastin. Clinical question: In patients with diabetic macular oedema (DMO), does intravitral injection of bevacizumab (IVB) improve visual acuity? The review focused on …

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Unclear evidence for chronic disease

Unclear evidence for chronic disease management interventions

Chronic diseases such as diabetes inflict a huge burden of suffering on patients and costs on health systems worldwide. Increasingly, health systems are being encouraged to take an integrated approach to their management.  This systematic rewiew looked at what sorts of interventions work best in these chronic disease management models. Clinical question: In the delivery …

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Hyaluric acid derivatives

Hyaluric acid derivatives may promote healing of diabetic foot ulcers

A recent systematic review looked at whether hyaluronic acid derivatives can be effective in dressings to promote wound healing. Clinical question: In people with burns or surgical or chronic wounds, do hyaluronic acid derivatives improve healing? The outcomes of interest were the percentage of patients whose wounds healed completely and the reduction in wound size. …

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