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…]

NHS Atlas of Variation in Diabetes in England

The NHS Atlas of Variation series is intended to support local decision making to increase the value which a population receives from the resources spent on their healthcare. The aim of the Diabetes Atlas is to identify and quantify the extent of ‘unwarranted’ variation that may be due to unjustified geographical differences in medical practice [read the full story…]

Share this post: Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+ Share via email

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…]

Disease management programmes may improve glycaemic control

A female doctor talking to a patient

Disease management programmes are multi-faceted interventions to improve standards of care.  Diabetes disease management often comprises a combination of patient education, psychological support, lifestyle support, self-monitoring and telemedicine.  This review looked at how effective they are at controlling blood sugar levels. Clinical question: In diabetes care, do disease management programmes lead to better glycaemic control? [read the full story…]

E-health may help to improve self-care in diabetes, but more research is still needed

Keyboard with health icons on the keys

E-health offers tremendous potential to improve self-management of diabetes.  The Centre for Reviews and Dissemination (CRD) has recently published an appraisal of a systematic review into the use of e-health in diabetes and other chronic conditions. Clinical question: In people with diabetes, do e-health interventions improve self-management? The reviewers looked at the use of interactive [read the full story…]

What is “culturally competent” diabetes education and is it effective?

Asian couple

Previous research has shown that structured diabetes education improves outcomes, and that education that is particularised to an individual patient’s cultural background is more effective than education that is not. This systematic review set out to identify what factors constitute “culturally competent” education, and what their long-term effects are. Clinical question: In ethnic minority patients [read the full story…]

Insulin treatment may be associated with an increased risk of cancer

This systematic review looked at observational studies of a link between treatment with insulin, whether type 1 or type 2 diabetes, and the incidence of cancer of any type. Clinical question: In people with diabetes, is treatment with insulin, as compared to other treatment, associated with an increased risk of cancer? The evidence The reviewers [read the full story…]

Share this post: Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+ Share via email

DVLA monitoring requirements for diabetic drivers

A lorry driver

The NPC published this evidence summary to clarify the position regarding driving and diabetes.  In addition to existing publications, the summary was based on direct correspondence between the NPC and the UK Driver and Vehicle Licencing Agency (DVLA).  It includes a summary of the position and Q&A section for health professionals. Clinical question: In drivers [read the full story…]

Mobile phones can help self-management of diabetes

A recent systematic review looked at the evidence for mobile phone interventions in helping to manage diabetes. Clinical question: In diabetes, do interventions delivered by mobile phone as compared with usual care improve glycaemic control? The evidence: The review identified twenty-two trials with 1,657 participants.  They included non-randomised trials. When they combined the results of [read the full story…]

Diabetic patients undergoing heart bypass have more complications.

On the operating table

This systematic review looked at how diabetes affects the outcomes of coronary artery bypass.  A higher risk of complications should influence clinical thinking about perioperative and postoperative management. Clinical question: In patients undergoing coronary artery bypass surgery, is diabetes associated with a higher risk of complications? The review also looked for evidence on resource use, [read the full story…]