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…]

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…]

Review: children and adolescents with type 1 diabetes can have the same quality of life as those without it

A child tests her blood sugar

A new systematic review summarises a number of studies that examined how diabetes affects the quality of life of children and adolescents. Clinical question: In children with type 1 diabetes, is quality of life worse compared with the general population? The evidence: Is it not clear exactly how the reviewers calculated the “effect size” on [read the full story…]

Eating disorders are common and problematic in adolescents with type 1 diabetes.

Young people with diabetes often struggle with diet in their teens.  A new systematic review looks at how common problems with eating are in adolescents with type 1 diabetes, in comparison with their non-diabetic peers. Clinical question: In young adults with type 1 diabetes, what is the prevalence of eating problems? The review differentiated between [read the full story…]

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Intensive blood pressure control prevents strokes in diabetic patients with hypertension

Sphygmomanometer

What target, if any, should we aim for in treating hypertension in patients with type 2 diabetes? Clinical question: In type 2 diabetes with hypertension, is intensive treatment, compared with less intensive treatment, effective at reducing the risk of stroke, death or other cardiovascular events? Intensive treatment was defined as a target maximum of 130 [read the full story…]

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Review finds weak evidence favouring moderate blood sugar targets in diabetic women during pregnancy

Taking a blood test during pregnancy

Women with diabetes are known to have a higher risk of adverse pregnancy outcomes, including birth defects and pre-eclampsia, compared with non-diabetic women. NICE recommends that pregnant diabetic women aim for a fasting blood glucose between 3.5 and 5.9 mmol/litre and 1-hour postprandial blood glucose below 7.8 mmol/litre. However, this guidance was issued in 2008 and is [read the full story…]

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Review: more evidence needed for metformin in children with type 2 diabetes

A child tests her blood sugar

Metformin is usually the first line of active treatment for type 2 diabetes in adults. However, like many drugs its safety and effectiveness has not be adequately studied in children.  With more children being diagnosed as type 2, should metformin also be the first port of call for them? Clinical question: In children and adolescents [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…]