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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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…]

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NHS Evidence Update on Diabetic Foot Problems

Foot examination

NHS Evidence is a service provided by NICE, the National Institute for Health and Clinical Excellence.  As part of this service, they publish regular updates of recent evidence that fits under the main sections of NICE guidance. In March, NHS Evidence produced an Evidence Update on Diabetic Foot Problems.  This is the first Evidence Update [read the full story…]

Emerging evidence about the impact of different statins on the risk of diabetes

A pill

Recent evidence has shown that statins can increase the incidence of new-onset diabetes, leading to an official warning by the FDA.  This has huge implications for practice, as these drugs are widely used to reduce the risk of cardiovascular disease in patients with and without diabetes.  Selecting the right treatment and balancing the proven benefits [read the full story…]

ACE inhibitors significantly reduce the risk of diabetic kidney disease


Kidney disease is one of the most serious complications of diabetes.  Reducing its incidence can greatly enhance survival, quality of life and reduce costs of care.  Keeping blood pressure under control is essential to this effort.  NICE guidance recommends ACE inhibitors as a first-line therapy for patients with diabetes and high blood pressure. However, a [read the full story…]

Insufficient evidence of benefit for colesevelam in glycemic control in type 2 diabetes

Another drug for type 2

Colesevelam is a bile acid sequestrant drug that was originally approved in the US for the treatment of hyperlipidaemia.  It was subsequently found to help improve glycaemic control in type 2 diabetes.  This dual benefit offers significant potential in reducing the risk of complications in T2.  This Cochrane systematic review set out to summarise all [read the full story…]

The Diabetes Elf is coming out of hibernation

Lock up your goblins!  The snow may still be on the ground, but it’s time for the Diabetes Elf to come out of his hibernation and get busy with the evidence. Thanks for your patience! What is The Diabetes Elf? The Diabetes Elf highlights important new evidence in diabetes care as it arises in journals, [read the full story…]

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Lack of evidence on whether cognitive behavioural therapy can improve glycaemic control

When we are looking to change our behaviour, we often turn to cognitive behavioural therapy, or CBT.  It has been proven effective in a number of settings, such as the management of pain or treatment of depression or schizophrenia. Could CBT help people with diabetes to improve their health? Clinical question: In people with diabetes, [read the full story…]

Welsh NHS recommends saxagliptin as an option in type 2 diabetes

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…]

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Review: children and adolescents with type 1 diabetes can have the same quality of life as those without it

A child tests her blood sugar

A new systematic review summarises a number of studies that examined how diabetes affects the quality of life of children and adolescents. Clinical question: In children with type 1 diabetes, is quality of life worse compared with the general population? The evidence: Is it not clear exactly how the reviewers calculated the “effect size” on [read the full story…]

Eating disorders are common and problematic in adolescents with type 1 diabetes.

Young people with diabetes often struggle with diet in their teens.  A new systematic review looks at how common problems with eating are in adolescents with type 1 diabetes, in comparison with their non-diabetic peers. Clinical question: In young adults with type 1 diabetes, what is the prevalence of eating problems? The review differentiated between [read the full story…]

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