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Diabetes Evidence Update 

 

Produced by the UHL Clinical Librarian Service 

APRIL 2014 Summary


1.     NICE Guidance
There were no new NICE guidelines published this issue.
 
2.     New and Updated Cochrane Systematic Reviews

 

  1. Reminder systems for women with previous gestational diabetes mellitus to increase uptake of testing for type 2 diabetes or impaired glucose tolerance 

    Authors’ conclusions:  Results from the only trial that fulfilled our inclusion criteria showed low-quality evidence for a marked increase in the uptake of testing for type 2 diabetes in women with previous GDM following the issue of postal reminders. The effects of other forms of reminder systems need to be assessed to see whether test uptake also increases when email and telephone reminders are deployed. We also need a better understanding of why some women fail to take opportunities to be screened postpartum. As the ultimate aim of increasing postpartum testing is to prevent the subsequent development of type 2 diabetes, it is important to determine whether increased test uptake rates also increase women's use of preventive strategies such as lifestyle modifications.
     
  2.  Reminder systems for women with previous gestational diabetes mellitus to increase uptake of testing for type 2 diabetes or impaired glucose tolerance 

    Authors’ conclusions: Results from the only trial that fulfilled our inclusion criteria showed low-quality evidence for a marked increase in the uptake of testing for type 2 diabetes in women with previous GDM following the issue of postal reminders. The effects of other forms of reminder systems need to be assessed to see whether test uptake also increases when email and telephone reminders are deployed. We also need a better understanding of why some women fail to take opportunities to be screened postpartum. As the ultimate aim of increasing postpartum testing is to prevent the subsequent development of type 2 diabetes, it is important to determine whether increased test uptake rates also increase women's use of preventive strategies such as lifestyle modifications.
  3. Intensive glucose control versus conventional glucose control for type 1 diabetes mellitus 

    Authors’ conclusions: Tight blood sugar control reduces the risk of developing microvascular diabetes complications. The evidence of benefit is mainly from studies in younger patients at early stages of the disease. Benefits need to be weighed against risks including severe hypoglycaemia, and patient training is an important aspect in practice. The effects of tight blood sugar control seem to become weaker once complications have been manifested. However, further research is needed on this issue. Furthermore, there is a lack of evidence from RCTs on the effects of tight blood sugar control in older patient populations or patients with macrovascular disease. There is no firm evidence for specific blood glucose targets and treatment goals need to be individualised taking into account age, disease progression, macrovascular risk, as well as the patient's lifestyle and disease management capabilities.
     
  4. Probiotics for preventing gestational diabetes 

    Authors’ conclusions: One trial has shown a reduction in the rate of GDM when women are randomised to probiotics early in pregnancy but more uncertain evidence of any effect on miscarriage/IUFD/stillbirth/neonatal death. There are no data on macrosomia. At this time, there are insufficient studies to perform a quantitative meta-analysis. Further results are awaited from four ongoing studies.

 
3.     Good Quality Systematic Reviews
 

  1. Metformin is associated with survival benefit in cancer patients with concurrent type 2 diabetes: a systematic review and meta‐analysis 
     
  2. Physical activity during pregnancy and the risk of gestational diabetes mellitus: a systematic review and meta‐analysis of randomised controlled trials 
     
  3.  Vitamin D intake and risk of type 1 diabetes: a meta‐analysis of observational studies 
     
  4. The effect of chinese herbal medicine on albuminuria levels in patients with diabetic nephropathy: a systematic review and meta‐analysis
     
  5. Collaborative care for patients with depression and diabetes mellitus: a systematic review and meta‐analysis 
     
  6. Dapagliflozin treatment for type 2 diabetes: a systematic review and meta‐analysis of randomized controlled trials 

     
  7. Liuwei Dihuang pills enhance the effect of Western medicine in treating type 2 diabetes: a meta‐analysis of randomized controlled trials 
     
  8. Effect of antioxidant vitamin supplementation on endothelial function in type 2 diabetes mellitus: a systematic review and meta‐analysis of randomized controlled trials
     
  9. Meta analysis of the efficacy and safety of combined treatment with ARB and ACEI on diabetic kidney disease 
     
  10. Ruboxistaurin for the treatment of diabetic peripheral neuropathy: a systematic review of randomized clinical trials 


4.     Economic Evaluations
 

  1. Real world outcomes of adding rapid‐acting insulin versus switching to analog premix insulin among US patients with type 2 diabetes treated with insulin glargine 
     
  2. Improving quality of care in people with Type 2 diabetes through the Associazione Medici Diabetologi‐annals initiative: a long‐term cost‐effectiveness analysis 
     
  3. Real‐world outcomes of initiating insulin glargine‐based treatment versus premixed analog insulins among US patients with type 2 diabetes failing oral antidiabetic drugs 
     
  4. Cost‐utility analysis of pharmaceutical care intervention versus usual care in management of Nigerian patients with type 2 diabetes 
     
  5. Differences in rates of hypoglycemia and health care costs in patients treated with insulin aspart in pens versus vials 

     
  6. Stratified patient‐centered care in type 2 diabetes: a cluster‐randomized, controlled clinical trial of effectiveness and cost‐effectiveness 
  7. A model‐based economic evaluation of improved primary care management of patients with type 2 diabetes in Australia 
  8. Evaluation of two screening methods for undiagnosed diabetes in China: a cost‐effectiveness study 
     
  9. Adding pregabalin or gabapentin for the management of community‐treated patients with painful diabetic peripheral neuropathy: a comparative cost analysis
     
  10. Economic evaluation of continuous subcutaneous insulin infusion for children with diabetes ‐ a pilot study: CSII application for children ‐ economic evaluation 


5.     Practice changing research, sourced from Dynamed
 

  1. Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists
    Updated 2014 Apr 07 03:07:00 PM: liraglutide associated with greater weight loss and glycemic control than insulin aspart in adults with type 2 diabetes receiving insulin degludec plus metformin (Diabetes Obes Metab 2014 Jan 20 early online) view update 
     
  2. Gestational diabetes mellitus (GDM)
    Updated 2014 Apr 07 05:03:00 AM: addition of probiotics (Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12) to dietary counselling decreases risk of gestational diabetes mellitus in pregnant women (Cochrane Database Syst Rev 2014 Feb 27) view update 
     
  3. Diabetic nephropathy
    Updated 2014 Mar 31 04:52:00 AM: bardoxolone methyl does not decrease risk of end-stage renal disease or cardiovascular death and increases risk of heart failure in adults with type 2 diabetes and advanced chronic kidney disease (N Engl J Med 2013 Dec 26) view update 
     
  4. Diabetes mellitus type 2 prevention
    Updated 2014 Mar 31 04:49:00 AM: Mediterranean diet enriched with extra-virgin olive oil associated with reduced risk of type 2 diabetes in adults at high risk for cardiovascular disease (Ann Intern Med 2014 Jan 7) view update 
     
  5. Diabetes mellitus type 2
    Updated 2014 Mar 26 09:50:00 AM: review of pathophysiology and treatment of type 2 diabetes (Lancet 2014 Mar 22) view update
     
  6. Gestational diabetes mellitus (GDM)
    Updated 2014 Apr 07 05:03:00 AM: addition of probiotics (Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12) to dietary counselling decreases risk of gestational diabetes mellitus in pregnant women (Cochrane Database Syst Rev 2014 Feb 27) view update 
     
  7. Glucose lowering medications for type 2 diabetes
    Updated 2014 Mar 17 05:17:00 AM: early combination therapy with metformin may reduce HbA1c and fasting plasma glucose compared to metformin monotherapy with increased risk of hypoglycemia (Diabetes Obes Metab 2013 Nov 9 early online) view update
  8. Dipeptidyl peptidase IV (DPP-4) inhibitors (gliptins)
     
  9. Updated 2014 Mar 03 02:57:00 PM: DPP-4 inhibitor monotherapy associated with reduced risk of hypoglycemia and gastrointestinal events compared to metformin monotherapy in patients with type 2 diabetes (Diabetes Obes Metab 2014 Jan) view update 

 
6.     NHS Behind the Headlines

  1. Diabetes claim for low-fat yoghurt not proven


7. Latest Journal Table of Contents

If you would like full text of any of the articles listed in the below journals then please contact us to request a copy. This is a free service but you will need to complete our Article Request Form <http://www.uhl-library.nhs.uk/directpages/uhlarticles.html> . Or you may email us <mailto:sarah.sutton@uhl-tr.nhs.uk> directly quoting the number(s) of the articles you would like.



34)   The British Journal of Diabetes & Vascular Disease <http://dvd.sagepub.com/content/current>

35)   Clinical Diabetes <http://clinical.diabetesjournals.org/content/current>

36)   Diabetes <http://diabetes.diabetesjournals.org/content/current>

37)   Diabetes Care <http://care.diabetesjournals.org/content/current>

38)   Diabetes Educator <http://tde.sagepub.com/content/current>

39)   Diabetes, Obesity & Metabolism <http://onlinelibrary.wiley.com/doi/10.1111/dom.2014.16.issue-4/issuetoc>

40)   European Diabetes Nursing <http://onlinelibrary.wiley.com/doi/10.1002/edn.v11.1/issuetoc>

41)  Experimental Diabetes Research <http://www.hindawi.com/journals/edr/contents/>

42)The Lancet Diabetes and Endocrinology <http://www.thelancet.com/journals/landia/issue/current?elsca1=ETOC-TLDE&elsca2=email&elsca3=R3S1K8F>

43)   Pediatric Diabetes <http://onlinelibrary.wiley.com/doi/10.1111/pedi.2014.15.issue-2/issuetoc>

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Email: sarah.sutton@uhl-tr.nhs.uk
 

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