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NIHR Signal ‘Artificial pancreas’ improves glucose control in hospital patients with type 2 diabetes
Closed-loop insulin pumps, which continuously monitor blood glucose and administer insulin accordingly, can improve blood glucose control among patients with type 2 diabetes admitted to hospital for non-critical care. Those using the system spent about six hours longer in the target range, and this could hasten their recovery and reduce staff workload. The number of hospitalised patients with type 2 diabetes is increasing. Glucose control often worsens during illness. Closed-loop pumps have bee...
NIHR Signal Self-monitoring of blood glucose provides no important benefit for most people with type 2 diabetes
Patients with type 2 diabetes who monitor their blood glucose themselves may see small, short-term improvements in blood sugar control. This is not enough to be clinically important or outweigh the costs and personal inconvenience of long-term self-testing. Self-monitoring is a well-established strategy for type 1 diabetes and for people with type 2 who need insulin. The benefit for all people with type 2 is debatable. This review pooled 24 randomised controlled trials comparing self-monitoring...
NIHR Signal Text messages improve diabetes self-management and blood sugar control
In adults with poorly controlled diabetes, text messages offering advice and support can improve self-management and blood sugar control. This trial included 366 adults with type 1 or type 2 diabetes in New Zealand. An automated system delivered individually tailored text messages to participants over a nine-month period to support self-management of blood sugar. The control group received usual care, comparable to that in the UK. The text message group had a small reduction in blood sugar lev...
NIHR Signal Outpatient video consultations are feasible but challenging for the NHS
Video consultations may be a useful substitute for face-to-face consultations for some hospital outpatient appointments. This NIHR funded study provided insights into the conditions which made them better. When these practical and clinical conditions are met, video consultations can be safe and effective and are liked by staff and patients. But there are challenges in embedding new technology in routine practice, and these challenges may have been under-estimated. This high-quality implementati...
NIHR Signal Hospital admission rates and costs increase in line with BMI
Each 2kg/m2 rise in body mass index (BMI) above the normal-weight threshold in women aged 55-79 leads to a 5% rise in annual hospital admissions and 7% rise in healthcare costs. In England, £662 million of the annual hospital admission costs in 2013 could be attributed to overweight or obesity in women of this age group. This large study, partly funded by the NIHR, looked at over one million women participating in the NHS breast cancer screening programme. Five-year data on hospital admis...
NIHR Signal Diet and exercise programmes can prevent diabetes in high-risk individuals
Lifestyle changes can reduce the risk of diabetes by about 40% and overall prevents about four high-risk individuals in 100 developing type 2 diabetes each year. The risk remained low for an average of about seven years after the intervention, but effects did decline over time. Medications including the weight-loss drug orlistat and diabetes drug metformin also reduced risk. But in contrast, there was no evidence of sustained effect after stopping treatment. Type 2 diabetes accounts for a large...
NIHR Signal Diabetes drug aids fertility in women with polycystic ovaries
The diabetes drug metformin may help women with polycystic ovarian syndrome who are having problems getting pregnant, but it is unclear whether it works better than an alternative fertility drug that stimulates the ovaries. This study updates a previous review of trials that compare metformin with placebo, no treatment or with the fertility drug clomifene. It summarised results of 48 studies, including 4,451 women. The study found that metformin may work better than placebo or no treatment and ...
NIHR Signal Type 2 diabetes can be reversed with a low-calorie diet
Nearly half of people given a formula replacement diet of 830 calories per day for three to five months, followed by food reintroduction, went into remission from type 2 diabetes. They were supported to achieve and maintain weight reduction by primary care nurses or dieticians. This trial involved 298 adults who had been diagnosed with type 2 diabetes within six years. Those that stuck with the program were more likely to lose weight (average 10kg was lost) and to go into remission compared to ...
NIHR Signal Takeaways linked to increased cardiovascular risk factors and obesity in children
Children who eat takeaways once or more each week have more body fat and higher low-density lipoprotein (LDL) “bad” cholesterol levels than those who never or hardly ever eat them. Their diets were also higher in fat and lower in protein and calcium. This cross-sectional study looked in depth at eating habits and risk markers for coronary heart disease, obesity and diabetes in 2,529 children in England. Though this type of study can only show an association between takeaways and ris...
NIHR Signal Being overweight or having diabetes are both linked to cancer
For western high-income countries such as the UK, an estimated 15% to 16% of cancers could be avoided by preventing diabetes, obesity or excess weight (defined as a Body Mass Index [BMI] greater than 25). A high BMI was responsible for almost twice as many cancers as diabetes. Around 5.6% of cancers globally in 2012 were attributable to diabetes or high BMI. Because obesity is increasing globally, this number may rise by 25% by 2035. Although the links between high BMI, diabetes and cancer hav...
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