High levels of patient satisfaction with incretin-based therapies in type 2 diabetes.

A syringe

A new systematic review looked at patient-reported outcomes associated with GLP-1 receptor agonists for managing type 2 diabetes. Clinical question: In type 2 diabetes not on insulin, do incretin-based therapies compared to usual care improve patient satisfaction or quality of life? The main outcome measures were the Diabetes Treatment Satisfaction Questionnaire (DTSQ) and/or Impact of [read the full story…]

Review: efficacy of DPP-4 inhibitors is similar to other second line treatments for type 2 diabetes.

Some pills

This systematic review set out to assess the effectiveness of dipeptidyl peptidase-4 (DPP-4) inhibitors compared with other treatments at reducing HbA1c in type 2 diabetes. Clinical question: In type 2 diabetes not on insulin, do DPP-4 inhibitors, as compared with alternative treatments, reduce Hba1c? The comparators included metformin alone and in combination with other oral [read the full story…]

In type 2 diabetes not on insulin, SMBG does not significantly reduce HbA1c

Self testing of blood glucose

This meta-analysis of individual patient data looked at whether self-monitoring of blood glucose improved glycaemic control in people with type 2 diabetes not on insulin. Clinical question: In type 2 diabetes not on insulin, does SMBG as compared to usual care, improve glycaemic control? The review also looked for improvements in blood pressure and cholesterol. [read the full story…]

Linagliptin improves glycemic control in type 2 diabetes.

Diagram showing how DPP 4 inhibitors work

Linagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor that can increase insulin production and reduce blood glucose in type 2 diabetes.  A new systematic review looked for effects on glycemic control, biomarkers and incidence of adverse events. Clinical question: In type 2 diabetes, does linagliptin, compared with placebo, improve glycemic control or cause adverse events? The [read the full story…]

Exenatide should be an option for triple therapy in type 2 not on insulin

Picture of a laptop with a stethoscope around it

Exenatide is an injectable drug that promotes the production of insulin and inhibits production of glucagon. The National Institute for Health and Clinical Excellence (NICE) has just published a guideline stating that prolonged-release (weekly) exenatide injections should be used as third line of therapy in type 2 diabetes. Clinical question: In type 2 diabetes inadequately [read the full story…]

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Drug treatment of type 2 diabetes: new guidance from the American College of Physicians

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This new publication provides guidance for clinicians on the comparative effectiveness and safety of type 2 diabetes medications. The guidance applies to adults over 18 years of age and does not cover combinations of more than two drugs. Main recommendations: The ACP recommends that clinicians add oral pharmacologic therapy in patients diagnosed with type 2 [read the full story…]

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Self monitoring of blood glucose may reduce HbA1c in type 2 diabetes not on insulin

Self testing of blood glucose

An updated Cochrane systematic review found inconsistent evidence of benefit for self-monitoring of blood glucose (SMBG) in people with type 2 diabetes who do not use insulin. Clinical question: In type 2 diabetes not on insulin, does SMBG, as compared with usual care, reduce HbA1c? The reviewers also looked at adverse events (including hypoglycemia), quality [read the full story…]

Evidence for under-reporting of adverse drug events by health care providers

A doctor and patient discuss medicines

Clinical question In type 2 diabetes on oral antidiabetic drug treatment, do patients report more side-effects than health care providers? This systematic review set out to compare patient-reported adverse drug events (such as abdominal pain, dyspepsia or constipation) with provider-reported adverse drug events to see if they are consistent. The evidence The reviewers searched Medline [read the full story…]

What people with type 2 diabetes think about starting insulin therapy

Picture of a syringe

Clinical question In type 2 diabetes starting insulin or poorly controlled on oral therapy, what psychological barriers do people experience around initiating insulin therapy? Making the transition to insulin therapy in type 2 diabetes can be very difficult.  This review set out to identify the psychological barriers people experience when faced with the challenge. The [read the full story…]

Liraglutide may be safe in type 2 diabetes with mild renal impairment

A doctor and patient discuss medicines

Clinical question In patients with type 2 diabetes and mild renal impairment, is liraglutide safe and effective? Liraglutide is a long-acting glucagon-like peptide-1 (GLP-1) analog sometimes used in type 2 diabetes to help the body produce more insulin.  This review looked at whether it is safe in people who also have renal impairment. The evidence [read the full story…]