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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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…]

Better evidence needed on the effectiveness of tailored interventions on self-management type 2 diabetes

A doctor and patient discuss medicines

This systematic review set out to establish whether treatment interventions that systematically tailor care according to an individual patient’s characteristics and objectives are more effective than usual care at influencing self-management behaviour. Clinical question: In type 2 diabetes, do tailored interventions improve self-management? The reviewers also looked at tailored interventions on self-management of hypertension and [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…]

More evidence needed on the cost-effectiveness of peer support in type 2 diabetes

Tug of war

A recently study looked at the cost-effectiveness of a peer support intervention in type 2 diabetes. Study question: In type 2 diabetes in primary care, are peer-support programmes cost effective? Quality of life outcomes were assessed in a randomised trial while long term costs were derived from analysis of the UKPDS model. The evidence: The [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…]

Review: some evidence that lifestyle education can help diabetics with schizophrenia

Fruit slices

For many different reasons, people with schizophrenia and schizoaffective disorders have a greater risk of type 2 diabetes.  This review looked for evidence of the efficacy of interventions to help them manage their diabetes. Clinical question: In people with type 2 diabetse and schizophrenia or schizo-affective disorder, what lifestyle interventions improve self-management? The scope included [read the full story…]

How cultural and social norms affect the uptake of diabetes prevention messages.

Asian couple

Diabetes has a higher prevalence among some ethnic groups, particularly people of South Asian origin.  This systematic review looked for  qualitative evidence on the implementation of community based lifestyle behaviour interventions to reduce the risk of diabetes in black and minority ethnic (BME) groups in the UK. Clinical question: In ethnic minority populations, what cultural [read the full story…]

Web-based tools for diabetes need better interactivity

Keyboard with health icons on the keys

A systematic review of trials of web-based and computerised tools to help manage diabetes has found mixed evidence of their effectiveness. Clinical question In diabetes care, do computerised tools for patients, carers or clinicians improve psychological, behavioural or clinical outcomes? As well as reviewing the published evaluations, each tool was assessed by experts for its [read the full story…]

Unclear evidence on the type and frequency of education for type 1 starting insulin pumps

A female doctor talking to a patient

Clinical question In adults with type 1 diabetes starting insulin pump therapy, what is the best approach to education? The evidence The reviewers searched for published research between 1998 and 2008.  They found five studies, with widely varying methods and outcome measures.  No overall conclusion could be drawn from the findings. Appraisal hints Users of [read the full story…]