Updated: August 2019 (NHS England Diabetes Programme Team and Data Sharing and Privacy Unit, NHS England & NHS Improvement)
Diabetes News
Category: Management
Severe Hypoglycemia Attributable to Intensive Glucose-Lowering Therapy Among US Adults With Diabetes
Intensive glucose-lowering therapy, particularly among vulnerable clinically complex adults, is strongly discouraged because it may lead to hypoglycemia. However, intensive treatment was equally prevalent among US adults, irrespective of clinical complexity (Mayo)
Changes in behaviors after diagnosis of type 2 diabetes and 10-year incidence of cardiovascular disease and mortality
In the year following diabetes diagnosis, small reductions in alcohol use were associated with lower hazard of CVD and small reductions in calorie intake were associated with lower hazard of all-cause mortality in a population-based sample (Cardiovascular Diabetology)
The Association Between Polypharmacy and Adverse health Consequences in Elderly Type 2 Diabetes Mellitus Patients
Pooled risk estimates reveal that polypharmacy is associated with increased all-cause mortality, macrovacular complications and hospitalization using categorical definitions. These findings assert the need for interventions that optimize the balance of benefits and harms in medicines prescribing (Diabetes Research and Clinical Practice)
Protocol: investigating the effectiveness and cost benefit of a lifestyle intervention targeting type 2 diabetes in Australia
The outcomes of this study have the potential to inform decisions about patient treatment and potentially provide incentive for the provision of funded lifestyle-based preventive and restorative programs for patients diagnosed with T2DM (BMC Endocrine Disorders)
Type 2 diabetes in adults: management
It focuses on patient education, dietary advice, managing cardiovascular risk, managing blood glucose levels, and identifying and managing long-term complications (NICE)
Type 1 diabetes in adults: diagnosis and management
This guideline covers the care and treatment of adults (aged 18 and over) with type 1 diabetes (NICE)
Diabetic foot problems: prevention and management
This guideline covers preventing and managing foot problems in children, young people and adults with diabetes. The guideline aims to reduce variation in practice (NICE)
Cross-sectional study about the use of telemedicine for type 2 diabetes mellitus management in Spain: patient’s perspective. The EnREDa2 Study
In Spain, nearly 10% of patients with T2DM have experience with TM and it is well accepted, especially one based on glucometers. Nevertheless, in order to promote TM use, easier and time-saving programmes for patient-physician interaction should be optimised (BMJ)
Lack of Durable Improvements in β-Cell Function Following Withdrawal of Pharmacological Interventions in Adults With Impaired Glucose Tolerance or Recently Diagnosed Type 2 Diabetes
In adults with IGT or recently diagnosed type 2 diabetes, interventions that improved β-cell function during active treatment failed to produce persistent benefits after treatment withdrawal. These observations suggest that continued intervention may be required to alter the progressive β-cell dysfunction in IGT or early type 2 diabetes (Diabetes Care)
Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients
This review covers recommendations for acute management of diabetic ketoacidosis and HHS, the complications associated with these disorders, and methods for preventing recurrence. It also discusses why many patients who present with these disorders are at high risk for hospital readmissions, early morbidity, and mortality well beyond the acute presentation (BMJ)
A randomized trial comparing the efficacy and safety of treating patients with very elevated hba1c levels with basal‐bolus insulin or a glp‐1 receptor agonist plus basal insulin
In patients with HbA1c≥10% treatment with GLP1RA plus basal insulin, compared with basal‐bolus insulin, resulted in better glycemic control and weight, lower insulin dosage and hypoglycemia, and improved quality of life. This treatment strategy is an effective and safe alternative to basal‐bolus insulin regimen (Diabetes, Obesity and Metabolism)
Recruitment, retention, and training of people with type 2 diabetes as diabetes prevention mentors (DPM) to support a healthcare professional-delivered diabetes prevention program: the Norfolk Diabetes Prevention Study (NDPS)
Individuals with type 2 diabetes can be recruited, trained and retained as DPM in large numbers to support a group-based diabetes prevention program delivered by healthcare professionals. This volunteer model is low cost, and accesses the large type 2 diabetes population that shares a lifestyle experience with the target population. This is an attractive model for supporting diabetes prevention efforts (BMJ)
Deintensification in older patients with type 2 diabetes: a systematic review of approaches, rates and outcomes
Available but limited evidence suggests that the benefits of deintensification outweighs the harms in older people with type 2 diabetes with or without comorbidities (Diabetes, Obesity and Metabolism)
Fully closed-loop insulin delivery in inpatients receiving nutritional support: a two-centre, open-label, randomised controlled trial
Closed-loop insulin delivery is an effective treatment option to improve glycaemic control in patients receiving nutritional support in hospital (The Lancet Diabetes & Endocrinology)
A Practical Guide to Delivering Nutritional Advice to People with Diabetes
Adopting new skills and changing their own behaviour is challenging for many healthcare professionals, and there are few education programmes available that specifically address effective consultation skills rather then increasing clinical expertise. Despite these challenges, there are practical strategies that can be incorporated into general practice and most of these strategies are not more time-consuming than standard approaches and are more effective if used appropriately (Diabetes Therapy)
The Role and Effectiveness of Telephone Peer Coaching for Adult Patients with Type 2 Diabetes
This pilot found that a pragmatic low-cost telephone peer-coaching intervention assisted patients with type 2 diabetes to better self-manage their diabetes (Canadian Journal of Diabetes)
Meeting the needs of multimorbid patients with Type 2 diabetes mellitus
Additional care management did not influence HRQoL over and above standard disease management. Improving diabetes patients’ self-care behavior in the context of structured disease management programs may be difficult to achieve. Women might benefit from additional care management, but this finding needs to be confirmed in future research (Diabetes Research and Clinical Practice)
Perioperative Management of Diabetes Mellitus: Novel Approaches
Implementation of a perioperative diabetes program that systematically identifies and treats patients with poor glycemic control early in the preoperative period is feasible and improves clinical care of patients undergoing elective surgery (Current Diabetes Reports)
Automated insulin dosing guidance to optimise insulin management in patients with type 2 diabetes: a multicentre, randomised controlled trial
The combination of automated insulin titration guidance with support from health-care professionals offers superior glycaemic control compared with support from health-care professionals alone (The Lancet)
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