Review finds no evidence for topiramate in treating neuropathic pain

Unhappy woman

Diabetic neuropathy is a common complication of diabetes.  This condition is very painful and substantially compromises quality of life.  Its progressive nature places a further burden on patients and their carers. Current guidance recommends a range of possible drug treatments, including the antidepressant drugs amitriptyline or duloxetine and the anti-convulsant pregabalin.  A recent Cochrane review [read the full story…]

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…]

From our Dental Elf: evidence of improved metabolic control in type 2 diabetes after treating periodontal disease

Dental examination

Clinical question: In type 2 diabetes, does non-surgical treatment of periodontal disease lead to improved glycaemic control? Methods: An updated systematic review of randomised trials. Results: The review concluded there was evidence of a small reduction in HbA1c after treatment for gum disease.  However, the studies were of poor quality with some evidence of publication [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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Telehealth did not improve quality of life, anxiety and depressive symptoms in patients with diabetes

A stethoscope on a keyboard

As pressure increases on an over-burdened healthcare system, focusing on self-care has potential. Advances in technology have improved many aspects of healthcare: now its uses may be harnessed to reduce utilisation of health services by those with long term conditions. “Telehealth” is an assistive technology that allows individuals to exchange information with their healthcare professional [read the full story…]

Ethnicity, parenting, stress and self-efficacy are all associated with glycaemic control in young people with diabetes

Child with a megaphone

This review was motivated by the need to understand the barriers to achieving and maintaining good metabolic control among children and adolescents. From insulin pump (CSII) therapy to carbohydrate counting, technology has advanced rapidly since the Diabetes Control & Complications Trial.  However, this has not been matched with efforts to understand the impact of human [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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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…]