More evidence needed for direct telephone support in diabetes care

An asian woman on the phone

There’s lots of interest in how we can use the increasingly ubiquitous telephone to improve diabetes care.  It’s important that we apply the same rigorous tests to these interventions as we do to others, and don’t just assume that “new” means “better“. In resource-poor settings this is all the more important, as we have to [read the full story…]

A diet containing low fat dairy may reduce the risk of type 2 diabetes

A cow

It has been suggested that dairy products might have a preventive effect against type 2 diabetes.  However, the results of observational studies looking at the correlation between the consumption of dairy and incidence of type 2 have been inconclusive. A new systematic review set out to combine the evidence from these different studies into an [read the full story…]

Metformin appears to be safe in diabetic patients with heart failure

ECG readout

Heart failure is more prevalent in diabetes than in the general population.  All too often, patients with such serious co-morbidities are excluded from clinical trials.  As a result, there remains uncertainty around the benefits of diabetes medications in these sub-groups of patients.  Often, we need to look at observational data to get the best available [read the full story…]

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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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Tight glycaemic control may prevent neuropathy in type 1 but not type 2

A foot with ants on it

There remains considerable uncertainty around the exact benefits and harms of tighter control of blood sugars.  This Cochrane systematic review looked at the evidence on neuropathy. Clinical question: In diabetes care, does tight glycaemic control prevent neuropathy? “Tight control” was defined as any intervention to enhance glucose control compared with standard care.  The review’s primary [read the full story…]

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

Some pills

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 [read the full story…]

Greater whole grain intake is associated with a lower risk of type 2 diabetes

Whole Grain

This systematic review set out to establish whether whole grains specifically contribute to a reduction in the risk of developing type 2 diabetes. Clinical question: In healthy indivduals, is consumption of whole grains associated with a reduced risk of type 2 diabetes. The reviewers were also interested in the effects on cardiovascular disease and weight. [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…]