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…]

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…]

Review: insulin pumps may improve quality of life and glycaemic control in adults with type 1 diabetes

What are the benefits of insulin pumps compared with multiple daily injections of insulin?  This report by the US Agency for Healthcare Quality and Research summarises what the evidence says. Clinical question: In diabetics using insulin, does continuous subcutaneous insulin infusion (CSII), compared with multiple daily injections (MDI), improve quality of life or glycaemic control? The [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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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…]

Bevacizumab did not improve diabetic macular oedema at 12 weeks

Macular_oedema

We recently reported on new guidance from NICE about the treatment of diabetic macular oedema with ranibizumab.  Another systematic review recently looked at another injectable drug with a similar role: bevacizumab, or Avastin. Clinical question: In patients with diabetic macular oedema (DMO), does intravitral injection of bevacizumab (IVB) improve visual acuity? The review focused on [read the full story…]

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Increased risk of acute pancreatitis in people with diabetes

A pancreas

We already know that pancreatitis can lead to diabetes.  This systematic review of observational studies looked at whether people with diabetes can subsequently develop pancreatitis. Clinical question: In people with diabetes, what is the risk of developing acute pancreatitis? The reviewers were interested in studies that report new (incident) cases of pancreatitis rather than existing [read the full story…]

Lack of evidence of a link between health literacy and medication adherence

A doctor and patient discuss medicines

A lot of effort these days goes into educating people about good health.  Are people more likely to adhere to recommended treatments as a result? Clinical question In people with diabetes or cardiovascular disease, are people who have high health literacy more likely to adhere to treatment? The review used a broad definition of health [read the full story…]