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…]

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…]

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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Diabetes accounted for 8.9% of prescribing costs in NHS England in 2011/12

The NHS Information Centre has released audit data for prescriptions for diabetes medications in England in the financial year 2011/12. Along with an executive summary and full text PDF of the report, the NHS has released the source data stratified by PCT and a data quality statement to assist interpretation. The prescribing data covers insulins, [read the full story…]

Canadian guidelines for managing diabetic retinopathy


The Canadian Journal of Opthalmology has recently published guidelines for managing diabetic retinopathy by the Canadian Ophthalmological Society. Coverage: Methodology Definitions Epidemiology Screening Telehealth and Teleophthalmology Risk Factors For And Prevention Of Progression Of Diabetic Retinopathy Treatment Modalities Pregnancy Neovascularization of The Iris Economic Considerations Support Appraisal hints: Does this guidance conform to AGREE principles? [read the full story…]

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Ranibizumab may be cost-effective for diabetic macular oedema


Blindness is one of the most serious microvascular complications of diabetes.  The most common cause is diabetic macular oedema (DME).  Current treatment with lasers is often unsuccessful. The new injectable drug ranibizumab, which works by selectively inhibiting vascular enothelial growth factor A, has been seen in the RESTORE trial to improve visual acuity and quality [read the full story…]

Possible benefits of insulin pumps compared with multiple daily injections

Insulin Pump with sensor

An appraisal of a 2010 systematic review of continuous subcutaneous insulin infusion (CSII, or insulin pumps) has been published in DARE. Research question: In diabetes, does CSII as compared with multiple daily injections (MDI), improve the clinical or cost-effectiveness of care? The review included both adults and children with type 1 or type 2 diabetes.  [read the full story…]

More evidence needed on the cost-effectiveness of peer support in type 2 diabetes

Tug of war

A recently study looked at the cost-effectiveness of a peer support intervention in type 2 diabetes. Study question: In type 2 diabetes in primary care, are peer-support programmes cost effective? Quality of life outcomes were assessed in a randomised trial while long term costs were derived from analysis of the UKPDS model. The evidence: The [read the full story…]