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UHL Clinical Librarian Service

Diabetes Evidence Update

8th August 2016

NICE  National Institute for Health and Care Excellence

Updated July 2016:
Type 1 diabetes in adults: diagnosis and management

Type 2 diabetes in adults: management

Diabetes in children and young people

Updated August 2016: 
Obesity: clinical assessment and management


NICE Shared learning - Implementing an active foot disease pathway for people with diabetes in South Tees
New and Updated Cochrane Systematic Reviews

Continuous subcutaneous insulin infusion versus multiple daily injections of insulin for pregnant women with diabetes
Authors' conclusions: There is no evidence to support the use of one particular form of insulin administration over another for pregnant women with diabetes. There are only a small number of trials appropriate for meta-analysis, a small number of women included and questionable generalisability of the trial population.

Pump technology has progressed since these trials were undertaken. Well-designed randomised trials are required to evaluate comparisons such as patch pumps against MDI and more conventional CSII against MDI. These trials should be adequately powered to assess the effect of interventions, and report the core set of outcomes used in Cochrane reviews of diabetes in pregnancy. Trials to assess the effects of pumps on birthweight and macrosomia rates are needed. It would be beneficial for future trials to undertake longer-term follow-up of participants and their infants, assess women's preferences, and conduct an economic evaluation.


Did you know that you now have free access to Cochrane Clinical Answers?
It provides brief evidence based summaries of information on popular clinical questions and links to the evidence from Cochrane Reviews on those questions. Here is a link to the Cochrane Clinical Answers on Diabetes, to give you an idea of what is available:
Cochrane Clinical Answers on Diabetes

Dynamed  Point-of- Care Clinical Reference Tool

Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists
  • Liraglutide slightly reduces cardiovascular adverse events and mortality within 3-5 years in patients with type 2 diabetes (N Engl J Med 2016 Jul 28) 
  • Insulin degludec/liraglutide may reduce HbA1c and hypoglycemic episodes compared to insulin glargine in patients with inadequately controlled type 2 diabetes receiving metformin (JAMA 2016 Mar 1)
  • Liraglutide may improve glycemic control in patients with inadequately controlled type 2 diabetes receiving high-dose insulin therapy (JAMA Intern Med 2016 Jul)
Leicester Publications

Management of type 2 diabetes: the current situation and key opportunities to improve care in the UK. Bain SC, Feher M, Russell-Jones D, Khunti K.

Assessment of response rates and yields for Two opportunistic Tools for Early detection of Non-diabetic hyperglycaemia and Diabetes (ATTEND). A randomised controlled trial and cost-effectiveness analysis. Khunti K, Gillies CL, Dallosso H, Brady EM, Gray LJ, Kilgallen G, Willis A, Zafar A, Davies MJ.

Rationale and design of the randomised controlled trial to assess the impact of liraglutide on cardiac function and structure in young adults with type 2 diabetes (the LYDIA study). Htike ZZ, Yates T, Brady EM, Webb D, Gray LJ, Swarbrick D, McCann GP, Khunti K, Davies MJ.

Cost Effectiveness of IDegLira vs. Alternative Basal Insulin Intensification Therapies in Patients with Type 2 Diabetes Mellitus Uncontrolled on Basal Insulin in a UK Setting. Davies MJ, Glah D, Chubb B, Konidaris G, McEwan P.

Engagement, Retention, and Progression to Type 2 Diabetes: A Retrospective Analysis of the Cluster-Randomised "Let's Prevent Diabetes" Trial. Gray LJ, Yates T, Troughton J, Khunti K, Davies MJ

The treatment of type 2 diabetes in the presence of renal impairment: what we should know about newer therapies. Davies M, Chatterjee S, Khunti K.

Basal insulin peglispro vs insulin glargine in insulin-naïve type 2 diabetes: IMAGINE 2 randomized trial. Davies MJ, Russell-Jones D, Selam JL, Bailey TS, Kerényi Z, Luo J, Bue-Valleskey J, Iványi T, Hartman ML, Jacobson JG, Jacober SJ

To access full text you may have to log in to your NHS Athens account (click here to register for free). If full text is not available then please email us to request a copy.

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Selected High Quality Research
Metformin use improves survival of diabetic liver cancer patients: systematic review and meta-analysis.

Epidemiological characteristics and methodological quality of meta-analyses on diabetes mellitus treatment: a systematic review.

Prevention of microalbuminuria using early intervention with renin-angiotensin system inhibitors in patients with type 2 diabetes: A systematic review.

An evaluation of the effectiveness of self-management interventions for people with type 2 diabetesafter an acute coronary syndrome: a systematic review.

Physical activity and the risk of gestational diabetes mellitus: a systematic review and dose-response meta-analysis of epidemiological studies.

MANAGEMENT OF ENDOCRINE DISEASE: The effect of vitamin D supplementation on glycaemic control in patients with Type 2 Diabetes Mellitus: a systematic review and meta-analysis.

Effectiveness of percutaneous flexor tenotomies for the management and prevention of recurrence of diabetic toe ulcers: a systematic review.

The Effect of Metformin on Adolescents with Type 1 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Continuous subcutaneous insulin infusion versus multiple daily injections in individuals with type 1 diabetes: a systematic review and meta-analysis.

Antigen-based immunotherapies do not prevent progression of recent-onset autoimmune diabetes: a systematic review and meta-analysis.

Cardiometabolic Risk Factor Changes Observed in Diabetes Prevention Programs in US Settings: A Systematic Review and Meta-analysis.

Metabolic Effects of Monounsaturated Fatty Acid-Enriched Diets Compared With Carbohydrate or Polyunsaturated Fatty Acid-Enriched Diets in Patients With Type 2 Diabetes: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

The Effectiveness of Health Literacy Oriented Programs on Physical Activity Behaviour in Middle Aged and Older Adults with Type 2 Diabetes: A Systematic Review.
Other Sources
 
Diabetes UK - State of the Nation 2016: time to take control of diabetes.  Bringing together evidence from recent national diabetes audit reports covering care processes and treatment targets, inpatient care, pregnancy and foot care.
 
Public Health England - Pathway Standards for NHS Diabetic Eye Screening Programme. This document presents the revised national standards for the NHS Diabetic Eye Screening Programme, which will come into effect in April 2017. It should be read in conjunction with the service specifications for the NHS providers. The document was originally published in August 2014.

Statistics
Prescribing for diabetes in England - 2005/06 to 2015/16
NHS Behind The Headlines - Media stories explained

Pasta-rich diet may 'prevent pounds from piling on', says study'

Stop demonising butter,' say researchers


Diabetes drugs may be useful for Alzheimer's, mice research finds
Table of Contents

Clinical Diabetes
Diabetes
Diabetes Care
Diabetes Educator
Diabetes, Obesity & Metabolism
Journal of Diabetes Research
The Lancet Diabetes and Endocrinology
Pediatric Diabetes
Our mailing address is: sarah.sutton@uhl-tr.nhs.uk
 
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