Systematic review

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

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

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

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 …

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Possible benefits of insulin pumps compared with multiple daily injections

Possible benefits of insulin pumps compared with multiple daily injections

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.  …

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The 50g glucose challenge test does not diagnose gestational diabetes

The 50g glucose challenge test does not diagnose gestational diabetes

This systematic review found that the 50g test is not accurate enough to diagnose gestational diabetes on its own. Clinical question In pregnant women <32 weeks gestation, what is the sensitivity and specificity of the 50g glucose challenge test? The conventional test for diabetes is the oral glucose tolerance test (OGTT), in which a woman …

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Unclear evidence for chronic disease

Unclear evidence for chronic disease management interventions

Chronic diseases such as diabetes inflict a huge burden of suffering on patients and costs on health systems worldwide. Increasingly, health systems are being encouraged to take an integrated approach to their management.  This systematic rewiew looked at what sorts of interventions work best in these chronic disease management models. Clinical question: In the delivery …

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