Diabetes care involving pharmacists to prevent CHD: a win-win?

A pharmacist

Previous research has shown that pharmacist involvement in the management of type 2 diabetes can improve HbA1c as well as blood pressure and cholesterol. These models of care may be more costly to deliver, however, compared with conventional primary care. This economic evaluation looked at the cost-effectiveness of pharmacist management in preventing cardiovascular disease in [read the full story…]

Mediterranean diet may improve glycaemic control in type 2 diabetes

The oft-cited “Mediterranean diet” – rich in olive oil, fruit and vegetables, enlivened with dairy, fish and, of course, a little wine – is held up as a paragon of virtue.  But there is no lack of dietary advice out there.  Low-GI, low-carb, high-protein?  American Diabetes Association (ADA) or European Association for the Study of Diabetes [read the full story…]

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High-dose atorvastatin did not cause diabetes in low-risk patients with existing cardiovascular disease

Atorvastatin molecule

The Diabetes Elf once overheard a respected senior colleague: “The only treatments that don’t have any side-effects are the ones that don’t work.” So it turned out with statins, which were recently found to have increased the risk of developing type 2 diabetes.  The questions, of course, is “Are the benefits worth the harms?”  In [read the full story…]

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…]

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…]

New NICE guidance on preventing type 2 diabetes in high risk individuals

Photograph of a bowl of fruit

The National Institute for Health and Clinical Excellence (NICE) has just published important guidance for everyone who is involved identifying people at high risk of type 2 diabetes and in preventing or delaying its onset. This includes GPs, nurses and other health professionals, as well as commissioners and managers within the NHS, local authorities and [read the full story…]

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Greater whole grain intake is associated with a lower risk of type 2 diabetes

Whole Grain

This systematic review set out to establish whether whole grains specifically contribute to a reduction in the risk of developing type 2 diabetes. Clinical question: In healthy indivduals, is consumption of whole grains associated with a reduced risk of type 2 diabetes. The reviewers were also interested in the effects on cardiovascular disease and weight. [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…]

Bariatric surgery improved HbA1c in obese type 2 diabetes with BMI < 35

A gastric band

A number of recent studies have found that bariatric surgery can improve diabetes or even reverse it.  This meta-analysis looked at its use in people with type 2 diabetes who are obese but not severely obese. Clinical question: In obese type 2 diabetics with BMI < 35, does bariatric surgery reduce improve glycaemic control? The [read the full story…]

TZDs may prevent type 2 diabetes

A colourful selection of pills

The Centre for Reviews and Dissemination (CRD) published an appraisal of a systematic review of drug interventions to prevent type 2 diabetes. Clinical question: In high risk patients do oral antidiabetic drugs prevent progression to type 2 diabetes? The scope included thiazolidinediones, biguanides, alpha-glucosidase inhibitors, sulphonylureas, glinides and dipeptidyl peptidase-4 inhibitors. The evidence: The reviewers [read the full story…]