Review: the effect of exercise on HbA1c in type 1 diabetes is still uncertain

Runners

Existing recommendations for exercise in diabetes are based largely on evidence from the general population or from people with type 2 diabetes.  This systematic review set out to look specifically at the effect of exercise on glycaemic control among people with type 1 diabetes. Clinical question In people with type 1 diabetes, does exercise improve [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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High-dose atorvastatin did not cause diabetes in low-risk patients with existing cardiovascular disease

Atorvastatin molecule

The Diabetes Elf once overheard a respected senior colleague: “The only treatments that don’t have any side-effects are the ones that don’t work.” So it turned out with statins, which were recently found to have increased the risk of developing type 2 diabetes.  The questions, of course, is “Are the benefits worth the harms?”  In [read the full story…]

Effective treatments for non-healing diabetic ulcers

Diabetic foot ulcer

Non-healing leg ulcers are a major burden for people with diabetes and for the health service.  This evidence review by the US Department of Veterans’ Affairs focuses on treatments approved by the US Food and Drug Administration but contains important findings that could be applicable in any setting. Clinical question The review addresses the following [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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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…]

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…]

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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