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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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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ACE inhibitors significantly reduce the risk of diabetic kidney disease

Kidney

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…]

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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Intensive blood pressure control prevents strokes in diabetic patients with hypertension

Sphygmomanometer

What target, if any, should we aim for in treating hypertension in patients with type 2 diabetes? Clinical question: In type 2 diabetes with hypertension, is intensive treatment, compared with less intensive treatment, effective at reducing the risk of stroke, death or other cardiovascular events? Intensive treatment was defined as a target maximum of 130 [read the full story…]

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New guidelines for the management of diabetic retinopathy

Retinopathy

The Canadian Ophthalmological Society has published new guidance for the management of diabetic retinopathy. The guideline provides explicit account of the methods used to identify and evaluate the evidence and arrive at consensus.  Recommendations for clinical practice are set apart from the text that describes the evidence. The guideline covers: Definitions of disease Epidemiologyof diabetes [read the full story…]

Moderate physical activity is associated with lower mortality in people with diabetes

Physical exercise is beneficial to everyone, with or without diabetes. But how much actual benefit accrues from it?  A recent paper  measured the association between physical activity and mortality in diabetes. Clinical question: In people with diabetes, does physical activity reduce the risk of premature death? The evidence This paper reports the findings of a [read the full story…]

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