Open access. People with type 1 diabetes who attend structured education training in self-management using flexible intensive therapy achieve improved blood glucose control and experience fewer episodes of severe hypoglycaemia. However, many struggle to sustain these improvements over time. To inform the design of more effective follow-up support we undertook a review of qualitative studies which have identified factors that influence and inform participants’ self-management behaviours after attending structured education and their need for support to sustain improvements in glycaemic control.
Failsafe processes minimise risks of anything going wrong in the screening pathway.
These publications explain the failsafe procedures in place for the diabetic eye screening programme.
This document states the minimum audits each local diabetic eye screening service must complete on a regular basis.
It identifies audits required in national guidance, service specification or quality assurance pathway standards. Where no national guidance on frequency is available, a suggested frequency is provided. Audits that are part of routine programme management and failsafe are not included. Where applicable, data for audits can be extracted using fields available in programme performance reports (PPRs) which can be presented at clinical commissioning group (CCG) and service level.
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Self-management support aims to give people with chronic disease confidence to actively manage their disease, in partnership with their healthcare provider. A meta-review can inform policy-makers and healthcare managers about the effectiveness of self-management support strategies for people with type 2 diabetes, and which interventions work best and for whom. Open Access Article
Objective: To examine the experiences of patients with diabetic foot ulcers (DFUs). To read the full article, log in using your MPFT NHS OpenAthens details.
The Medicines and Healthcare products Regulatory Agency (MHRA) is aware some users of the FreeStyle Libre flash glucose monitoring system are experiencing skin reactions to the sensor adhesive.
Users may have been applying creams, sprays or patches under their sensor to reduce symptoms of skin reactions caused by the sensor adhesive. This is not advised as it may affect the performance of the device.
Insulin therapy is most effective if dosage titrations are done regularly and frequently, which is seldom practical for most clinicians, resulting in an insulin titration gap. The d-Nav Insulin Guidance System (Hygieia, Livonia, MI, USA) is a handheld device that is used to measure glucose, determine glucose patterns, and automatically determine the appropriate next insulin dose. We aimed to determine whether the combination of the d-Nav device and health-care professional support is superior to health-care professional support alone.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
Effective management of diabetes mellitus requires lifelong adherence to a plan that incorporates lifestyle changes, exercise and diet. Following a dietary plan is a fundamental component of diabetes management because this can regulate the body’s supply of glucose and lipids, resulting in weight reduction, an improved response to pharmacotherapies, and optimal control of the patient’s glycaemic status and lipid profile. This article examines the components of nutrition therapy recommended for people with diabetes. To read the full article, log in using your MPFT NHS OpenAthens details.
The recent publication of the American Diabetes Association and European Association for the Study of Diabetes position statement points to greater individulisation of care focused on an individual's comorbidities and their preferences for treatment. The changes are most pronounced in patients living with established atherosclerotic cardiovascular disease, heart failure and chronic kidney disease. To read the full article, log in using your MPFT NHS OpenAthens details.
This study examined (a) psychosocial health care needs of people with type 2 diabetes from the perspective of patients and diabetes health care providers in primary care, in terms of topics, attention in diabetes care and preferences and (b) factors associated with a positive attitude towards specialised psychosocial health care.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
To investigate the frequency of coeliac disease (CD)-specific human leucocyte antigen (HLA) genotypes in paediatric patients with type 1 diabetes (T1D), who are known to have a higher prevalence of CD than the general population, and to evaluate whether HLA genotyping is a suitable first-line screening method for CD.. To read the full article, log in using your NHS OpenAthens details.
To identify diabetes specific patient safety domains that need to be addressed to improve home care of older people; to assess research from primary studies to review evidence on patient safety in home care services for older people with diabetes.. To read the full article, log in using your NHS Athens details. To access full-text: click “Log in/Register” (top right hand side). Click ‘Institutional Login’ then select 'OpenAthens Federation', then ‘NHS England’. Enter your Athens details to view the article.
The study generally shows that lifestyle weight management programmes can help obese people lose weight and improve their diabetes control. However, it highlights a "real world" problem of how many people would be willing to stick to the rules of the programme. In this study less than 10% of people referred successfully completed it and experienced benefits over the 3 years.
Open access. The combination of eating disorders and diabetes is associated with increased risk of morbidity and mortality. The aim of this study is to compare the prevalence of disordered eating behaviour (DEB) in young adults with type 1 diabetes mellitus to a sample of non-diabetic controls, and to examine the relationship of DEB to glycaemic control.
This study adds to evidence that keeping healthy during pregnancy, with a good diet and plenty of exercise, can give the baby a head start when it comes to its own health.
There's a pervasive myth that women need to "eat for 2" while pregnant, but that's not true.
Humans are not mice, and these early findings can't be applied to us. And as metformin is only licensed as a diabetes treatment, we don't know whether it would be safe or appropriate to use it for nicotine withdrawal symptoms.
Also, this study provided no evidence that metformin would be any better than the many well-established treatments to help people quit smoking, such as nicotine replacement therapy.
Objectives To assess the long-term cost-effectiveness of insulin pumps and Dose Adjustment for Normal Eating (pumps+DAFNE) compared with multiple daily insulin injections and DAFNE (MDI+DAFNE) for adults with type 1 diabetes mellitus (T1DM) in the UK. Open Access Article
Type 2 diabetes (T2D) is a leading health priority worldwide. Multimorbidity (MM) is a term describing the co-occurrence of two or more chronic diseases or conditions. The majority of people living with T2D have MM. The relationship between MM and mortality and glycaemia in people with T2D is not clear. Open Access Article
Open access. To investigate associations between takeaway meal consumption and risk markers for coronary heart disease, type 2 diabetes and obesity risk markers in children.
Objective To determine ethnic differences in the progression of chronic kidney disease (CKD) and risk of end-stage renal failure (ESRF) and death in adults with type 2 diabetes mellitus (T2DM), and to identify predictors of rapid renal decline. Open Access Article
People with severe mental illnesses (SMI) such as schizophrenia and bipolar disorder have an increased risk of developing type 2 diabetes and have poorer health outcomes than those with diabetes alone. To maintain good diabetes control, people with diabetes are advised to engage in several self-management behaviours. The aim of this study was to identify barriers or enablers of diabetes self-management experienced by people with SMI.
Free access. To determine the cross‐sectional and longitudinal associations between diabetes treatment type and cognitive outcomes among type II diabetics.
To test the hypothesis that fluid adherence in patients on hemodialysis can be improved through nurses′ solution‐focused communication with patients on issues of adherence.. To read the full article, log in using your MPFT NHS OpenAthens details. SSOTP (legacy account) - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
The NHS Diabetic Eye Screening Programme produced this guidance in response to queries from local screening providers.
Providers should use this guidance to inform local policy on dealing with patients who drive to their screening appointment.
In an unadjusted analysis each 2000-step increment in the average number of daily steps, up to 10 000, was associated with a 5.5% lower risk of progression to diabetes. Open Access Article
This article describes a study of the phenomenon of supporting patients who are learning to live with diabetes, from a diabetes specialist nurse (DSN) perspective. To read the full article, log in using your NHS OpenAthens details.
To examine the relationships of health literacy to diabetes self‐care behaviors (diet, physical exercise, foot care and blood glucose monitoring) through empowerment controlling for diabetes education.. To read the full article, log in using your MPFT NHS OpenAthens details. SSOTP (legacy account) - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
While these findings warrant further study, they are not proof that titanium dioxide causes diabetes. With so few samples tested, any differences between samples with and without diabetes could be due to chance.
Even if it is confirmed that levels of titanium dioxide are higher in people with diabetes, this doesn't necessarily mean titanium dioxide caused the condition.
And even if future evidence suggests titanium dioxide may be a risk factor for diabetes, there is no evidence that toothpaste is to blame.
There is a growing body of evidence to support the use of telehealth in monitoring HbA1c levels in people living with type 2 diabetes. However, the overall magnitude of effect is yet unclear due to variable results reported in existing systematic reviews. The objective of this study is to conduct a systematic review and meta-analysis of systematic reviews of randomised controlled trials to create an evidence-base for the effectiveness of telehealth interventions on glycemic control in adults with type 2 diabetes.
Type 1 diabetes is a chronic autoimmune disease characterised by insulin deficiency and resultant hyperglycaemia. Knowledge of type 1 diabetes has rapidly increased over the past 25 years, resulting in a broad understanding about many aspects of the disease, including its genetics, epidemiology, immune and β-cell phenotypes, and disease burden.. Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
NHS advice will be offered online to people with type 2 diabetes to help them manage their condition via a first of its kind service.
The new offer, will mean people with type 2 diabetes have evidence-based information and support available at the touch of a button, via an online portal, giving them convenient and quick help to deal with the physical and mental challenges of diabetes.
The resource will make the right advice available from home, work or on the move, helping people manage their health and wellbeing independently, potentially preventing the need for extra medical attention or the condition becoming worse.
In chronic kidney disease (CKD), hypertension is associated with poor outcomes at ages <70 years. At older ages, this association is unclear. We tested 10-year mortality and cardiovascular outcomes by clinical systolic blood pressure (SBP) in older CKD Stages 3 and 4 patients without diabetes or proteinuria.. Please contact the library to request a copy of this article - http://bit.ly/2HjNDf3
‘Diabetic foot’ is a term used to describe a group of syndromes in which neuropathy and/or ischaemia lead to tissue breakdown and reduced resistance to infection in a patient with diabetes mellitus. Foot ulceration is a serious and potentially limb-threatening complication of diabetes that can lead to pain, tissue necrosis and amputation, and may significantly affect an individual’s well-being and mobility. To read the full article, log in using your MPFT NHS OpenAthens details.
Among patients with diabetes, the lifetime risk of acquiring a foot ulcer is 25%. To read the full article, log in using your MPFT NHS OpenAthens details.
Health systems invest in diabetes quality improvement (QI) programmes to reduce the gap between research evidence of optimal care and current care.1 Examples of commonly used QI strategies in diabetes include programmes to measure and report quality of care (ie, audit and feedback initiatives), implementation of clinician and patient education, and reminder systems. A recent systematic review of randomised trials of QI programmes indicates that they can successfully improve quality of diabetes care and patient outcomes.2 Changes in surrogate markers such as blood glucose control, blood pressure or cholesterol levels are used to measure QI intervention effectiveness.2
However, investments in QI strategies are only worthwhile if the programmes that effectively improve care are sustained after trial completion.3. To read the full article, log in using your NHS OpenAthens details.
'What this study adds A substantial positive association was seen between use of warfarin with glipizide/glimepiride and hospital admission/emergency department visits for hypoglycemia and related diagnoses, particularly in patients starting warfarin. The findings suggest the possibility of a significant drug interaction between these medications.'
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This study explored the annual occurrence/incidence of bacterial infections, and their association with chronic hyperglycemia and diabetic nephropathy, in patients with type 1 diabetes. Open Access Article
The UK National Institute for Health and Care Excellence (NICE) guideline on diabetes recommends at least annual monitoring of patients with type 2 diabetes mellitus (T2DM) for proteinuria. To date, little has been published on the frequency of proteinuria monitoring in T2DM, and its association with risk factors for renal complications. We aimed to describe proteinuria monitoring in patients with T2DM. Open Access Article
Objective Type I and II diabetes are associated with a greater relative risk of cardiovascular diseases (CVD) in women than in men. Sex differences in adiposity storage may explain these findings. Open Access Article
Our aim was to assess the impact of an educational initiative for non-specialist, healthcare professionals in the community on the process and quality measures of diabetes care delivered, and changes in their learning experiences and clinical management behaviour in the short and long term. Open Access Article
Evidence shows the longer between appointments the higher the chance of a young person developing psychosocial issues such as anxiety and depression and increased HbA1c. Diabetes is also linked to higher rates of eating disorders.
The Diabetes Transition Service Specification is designed to inform commissioners’ development of a clear specification based on local context.
Commentary on:
Malanda UL, Bot SD, Kostense PJ, et al. Effects of self-monitoring of glucose on distress and self-efficacy in people with non-insulin-treated type 2 diabetes: a randomized controlled trial. Diabet Med 2015. Published Online First.
Context
While it is generally accepted that blood glucose monitoring is an important component of treatment in the management of insulin-treated diabetes (both type 1 and type 2 diabetes), the role of blood glucose monitoring in those with type 2 diabetes treated by oral agents remains uncertain. Systematic reviews of randomised controlled trials have persistently failed to find benefits on blood glucose control or hypoglycaemia in people with type 1 diabetes.1 ,2 This emphasises the methodological challenges of establishing the value of self-monitoring of blood glucose in individuals with type 2 diabetes on oral agents, who are at … To read the full article, log in using your NHS Athens
Commentary on:
Balk EM, Earley A, Raman G, et al. Combined diet and physical activity promotion programs to prevent type 2 diabetes among persons at increased risk: a systematic review for the community preventive services task force. Ann Intern Med 2015;163:437–51.
Context
Type 2 diabetes mellitus (T2DM) is a significant and growing medical problem affecting close to 400 million people worldwide1 and almost 10% of the US population2 while imposing a major financial burden on society.3 Furthermore, an estimated 37% of the US adult population is at risk of T2DM, making primary prevention of T2DM a critical public health objective. Large clinical trials have shown that combined diet and physical activity promotion programmes … To read the full article, log in using your NHS Athens
Musculoskeletal symptoms limit adherence to exercise interventions for individuals with type 2 diabetes. People with diabetes may be susceptible to tendinopathy due to chronically elevated blood glucose levels. Therefore, we aimed to investigate this potential association by systematically reviewing and meta-analysing case–control, cross-sectional, and studies that considered both of these conditions. To read the full article, log in using your NHS Athens
The UK National Screening Committee (UK NSC) has published a number of recommendations today (15 January 2015) following its meeting on 19 November 2015.
The independent expert committee made 11 recommendations in total, which included improvements to existing screening programmes for Down’s syndrome and other related conditions, cervical cancer, bowel cancer and eye screening for people with diabetes.
Difficulty in sleeping is associated with an increased risk of developing type 2 diabetes, a study published in Diabetologia has found. To read the full article, log in using your NHS Athens
A parliamentary report identifies weaknesses in the current national approach to diabetes prevention, resulting in the continued increase in the cost of diabetes to the NHS.
NICE – the National Institute for Health and Care Excellence – is consulting on potential new indicators for the NICE indicator menu. Indicators encourage health professionals to assess patients on a range of key health issues where diagnosis and treatment is supported by evidence-based guidelines. The aim is to tackle widespread public health challenges one patient at a time. Areas where indicators are being suggested include diabetes and stroke.
Implications for practice and research
Large-scale acceptance of telemonitoring of patient self-administered tests (eg, glucose, blood pressure) will require attention to how additional workload will be integrated into the workflow of the clinic.
Additional research is required to fine tune telemonitoring interventions, including content, intervention dose, intervention length and appropriate targeting to subpopulations with chronic illness. To read the full article, log in using your NHS OpenAthens details
Continuous glucose monitoring can improve glycaemic control in patients with type 1 diabetes who use insulin injections, two studies published in JAMA have found.12
This consists of a sensor under the skin with a transmitter attached that reports glucose levels continuously to the patient on a handheld monitor. Most patients whose continuous glucose monitoring has been compared with self monitored blood glucose have used insulin pumps, whereas the two new studies were carried out in patients with type 1 diabetes who injected insulin. To read the full article, log in using your NHS OpenAthens details
Policies to ‘screen and treat’ people to prevent type 2 diabetes are unlikely to have a substantial effect on the growing diabetes epidemic, say researchers from the University of Oxford. To read the full article, log in using your NHS OpenAthens details
Microvascular complications (retinopathy, nephropathy, and neuropathy) affect hundreds of millions of patients with type 2 diabetes. They usually affect people with longstanding or uncontrolled disease, but they can also be present at diagnosis or in those yet to have a diagnosis made. The presentation and progression of these complications can lead to loss of visual, renal, and neurologic functions, impaired mobility and cognition, poor quality of life, limitations for employment and productivity, and increased costs for the patient and society. If left uncontrolled or untreated, they lead to irreversible damage and even death. This review focuses on the primary and secondary prevention of diabetic microvascular complications in patients with type 2 diabetes, beyond glycemic control. To read the full article, log in using your NHS OpenAthens details
Increasing levels of physical activity decreases the risk of premature mortality associated with chronic diseases e.g., coronary heart disease, type 2 diabetes, stroke. Despite this, most adults in England do not meet physical activity guidelines. Physical activity advice and signposting offered to at-risk patients by primary care providers is recommended. However, exercise medicine education is sparse, leading to poor practitioner knowledge of the risk reduction evidence and strategies to implement effective patient behaviour change. The ‘Generation Games’ intervention seeks physical activity increase in the 50+ population of Oxfordshire. It offers a Health Professional Education Programme (HPEP) providing exercise medicine education, and promotion of Generation Games to which health professionals can signpost patients. There is a poor evidence base concerning how such education translates into patient exercise behaviour change.
Conclusions: Individuals with type 2 diabetes improved their glycemic control and lost more weight after being randomized to a very low-carbohydrate ketogenic diet and lifestyle online program rather than a conventional, low-fat diabetes diet online program. Thus, the online delivery of these very low-carbohydrate ketogenic diet and lifestyle recommendations may allow them to have a wider reach in the successful self-management of type 2 diabetes.
This document summarises the evidence-base on type 2 diabetes mellitus: medicines optimisation priorities. It is a key therapeutic topic which has been identified to support medicines optimisation. It is not formal NICE guidance.
Public health strategies aiming to prevent adult weight gain in the whole population could be twice as effective in reducing the incidence of type 2 diabetes as weight loss strategies targeting only obese people, analysis of a large population based follow-up study has found. To read the full article, log in using your NHS OpenAthens details
This document summarises the evidence-base on safer insulin prescribing. It is a key therapeutic topic which has been identified to support medicines optimisation. It is not formal NICE guidance.
However, it's important to put these findings in context. Diabetes has previously been linked with pancreatic cancer, though it is unclear why. It could be that diabetes increases the risk of pancreatic cancer. What is probably more likely is that rapid onset or progression of diabetes could be a symptom of the cancer itself.
Diabetes is fairly common in the UK, with around 4 million cases, while pancreatic cancer remains very rare. Just because you have diabetes does not mean you will go on to get pancreatic cancer.
Objective We aimed to describe patterns of weight change in insulin-naive patients with type 2 diabetes mellitus (T2DM) starting basal insulin (BI) treatment.
Conclusions Though BI therapy leads to modest weight gain over the subsequent year, this may be limited by BI initiation at an early stage of the disease. As such, delaying the start of insulin therapy based on fears of weight gain appears counter-productive, and should be reconsidered. Open Access Article
Globally, diabetes is increasing with concerns about the impact on outcomes, including premature death and the costs associated with managing the condition. Research indicates that adults with intellectual disabilities (ID) are two to three times more likely to develop diabetes; however, there has been limited focus on diabetes service utilisation in this population. The aim of this study is to explore the perceptions and experiences of diabetes and ID practitioners. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Open access. To describe how diabetes nurses in primary care experience the process of learning to practise the person-centred counselling approach Guided Self-Determination among adults with type 2 diabetes.
It has been the generally held viewpoint of clinicians, as well as the recommended positioning of consensus guideline groups (e.g., American Diabetic Association), that diabetes education is an essential component of any comprehensive plan to manage diabetes, predicated on the belief that educational investment results in improved control of diabetes and better outcomes.
Based on 4 studies in 632 participants, individual patient education did not improve glycemic control over a 12 to 18 month period compared with usual care (mean difference −0.08%, 95% CI −0.25% to 0.08%).
Objective To compare the effectiveness of a novel model of care (“Stepping Up”) with usual primary care in normalising insulin initiation for type 2 diabetes, leading to improved glycated haemoglobin (HbA1c) levels. To read the full article, log in using your NHS OpenAthens details
The study reported in this article aimed to analyse factors associated with the risk of ulceration in the feet of patients with diabetes using a conceptual hierarchic model. It was a cross-sectional study carried out with 1515 people with diabetes mellitus aged 40 years and older. To read the full article, log in using your NHS OpenAthens details
The promotion of a healthy diet, physical activity and measurement of blood glucose levels are essential components in the care for women with gestational diabetes mellitus (GDM). Smartphones offer a new way to promote health behaviour. The main aim is to investigate if the use of the Pregnant+ app, in addition to standard care, results in better blood glucose levels compared with current standard care only, for women with GDM. Open Access Article
To determine accuracy, safety and acceptability of the FreeStyle Libre Flash Glucose Monitoring System in the paediatric population. To read the full article, log in using your NHS OpenAthens details.
We have launched a new publication showcasing examples of where clinically led commissioning is changing the way diabetes care is commissioned and improving people’s lives. The document draws out lessons from those involved in the projects to share and embed for the future.
Telemedicine, such as text messaging or internet support systems used to communicate with patients, improves long-term blood sugar control in adults with type 1 or type 2 diabetes.
In people at high risk of type 2 diabetes, the educational programme ‘Let’s prevent’ had minimal impact on blood sugar control, and cholesterol. Overall it did not prevent people developing diabetes, though the risk was reduced for the 29% of people who attended all three sessions.
Unfortunately SSOTP do not plan to take library services from the SSSFT library services during 2017/18. Sadly this means that we will be discontinuing this weekly bulletin. If you are an SSSFT member of staff subscribed to this bulletin, please reply to this email letting us know what areas of the update you are interested in and we can discuss the best way of keeping you updated in this area.
Unfortunately SSOTP do not plan to take library services from the SSSFT library services during 2017/18. Sadly this means that we will be discontinuing this weekly bulletin. If you are an SSSFT member of staff subscribed to this bulletin, please reply to this email letting us know what areas of the update you are interested in and we can discuss the best way of keeping you updated in this area.
To validate the European Health Literacy Survey Questionnaire (HLS-EU-Q47) in people with type 2 diabetes mellitus. Login using your SSSFT NHS OpenAthens for full text. SSOTP - You can request a copy of this article by replying to this email. Please ensure you are clear which article you are requesting.
Conclusions: While telehealth-mediated self-management was not consistently superior to usual care, none of the reviews reported any negative effects, suggesting that telehealth is a safe option for delivery of self-management support, particularly in conditions such as heart failure and type 2 diabetes, where the evidence base is more developed.
The study found that people who said they'd experienced workplace bullying or violence had an increased risk of developing type 2 diabetes compared with those who didn't report any bullying or violence.
Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management within routine primary care would achieve remission of type 2 diabetes. . Please contact the library to request a copy of this article - http://bit.ly/1Xyazai
As part of World Diabetes Day which takes place on November 14, the area’s Clinical Commissioning Groups (CCGs) for Staffordshire have announced there will be a number of education sessions available in the New Year for newly diagnosed or existing patients who have type 2 diabetes.
Long-term regular physical activity training was found to be helpful in improving glycemic control, body composition and cardiovascular fitness among patients with T2DM.
Open Access Article
Conclusions The relative effect of DPP-4 inhibitors on the risk of heart failure in patients with type 2 diabetes is uncertain, given the relatively short follow-up and low quality of evidence. Both randomised controlled trials and observational studies, however, suggest that these drugs may increase the risk of hospital admission for heart failure in those patients with existing cardiovascular diseases or multiple risk factors for vascular diseases, compared with no use.
Pioglitazone was incorrectly described as a PPAR-gamma inhibitor in this News story (BMJ 2016;352:i1029, doi:10.1136/bmj.i1029) when it is an agonist. To read the full article, log in using your NHS Athens
Skin grafts and tissue replacement products can help heal diabetic foot ulcers in some cases, and may also slightly reduce the numbers of future amputations. Foot ulcers are common and can be hard to treat, but failure to heal them carries high risk for amputation and mortality