Badenoch

Badenoch
I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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Weak evidence for radix astragali in treating diabetic retinopathy

Radix astragali

Radix astragali is a traditional Chinese medicine made from dried roots of  that has been widely used for the treatment of diabetes.  This systematic review set out to establish if there is any clinical evidence to support its use in treating diabetic retinopathy. Clinical question In people with diabetic retinopathy (DR), does radix astragali, compared [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…]

Repost from The Mental Elf: Depression increases risk of all cause mortality in diabetes

Today the Mental Elf reports on a systematic review and meta-analysis looking at whether depression in people with diabetes is associated withan increased risk of mortality. The reviewers combined the results of sixteen longitudinal studies comprising 109,046 individuals with diabetes.  They found a statistically significant increase in the risk of mortality amongst people with depression [read the full story…]

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Diabetes care involving pharmacists to prevent CHD: a win-win?

A pharmacist

Previous research has shown that pharmacist involvement in the management of type 2 diabetes can improve HbA1c as well as blood pressure and cholesterol. These models of care may be more costly to deliver, however, compared with conventional primary care. This economic evaluation looked at the cost-effectiveness of pharmacist management in preventing cardiovascular disease in [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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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…]

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Mediterranean diet may improve glycaemic control in type 2 diabetes

The oft-cited “Mediterranean diet” – rich in olive oil, fruit and vegetables, enlivened with dairy, fish and, of course, a little wine – is held up as a paragon of virtue.  But there is no lack of dietary advice out there.  Low-GI, low-carb, high-protein?  American Diabetes Association (ADA) or European Association for the Study of Diabetes [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…]