Losing weight following type 2 diabetes diagnosis boosts chance of remission
People who lose at least 10% of their body weight in the first year after being diagnosed with type 2 diabetes increase their chances of being in remission after five years, compared with those whose weight remains stable. Losing this achievable amount of weight over the next four years also makes remission more likely.
In this study of 867 people, 257 (30%) achieved remission at five-year follow-up. The participants had been taking part in a trial but had not received intensive lifestyle inter...
Boosting omega-3 fatty acid intake is unlikely to prevent type 2 diabetes
Increasing the intake of polyunsaturated fats in the diet with supplements of omega-3 fatty acids, for example, is unlikely to affect people’s risk of developing type 2 diabetes. However, this review only looked at the effect of supplements on diabetes, not wider health.
This large systematic review included 83 long-term trials comparing higher and lower intake of omega-3 and omega-6 fatty acids and total polyunsaturated fats in healthy adults and those with existing diabetes. It found no...
Smartphones may help people with diabetes manage their condition better
People with type 2 diabetes using smartphone apps or message services feel more confident about their ability to manage their condition, are more likely to engage in self-care activities and have a better quality of life.
Smartphone self-management technologies can be split into two main types: applications where users can record data and view information, and SMS text messages which can act as prompts or reminders. A review of 22 international studies found that smartphones could aid diabetes ...
Diet and exercise can reduce the risk of developing diabetes during pregnancy
Diet and exercise are effective ways of preventing the development of diabetes during pregnancy, known as gestational diabetes.
Gestational diabetes is becoming more common and is associated with poorer outcomes for mother and baby. Diet, physical activity and weight are modifiable risk factors, but trials published to date have shown inconsistent results.
This systematic review pooled 47 trials and found that any form of lifestyle intervention reduced the risk of gestational diabetes by 23%, ...
The best dose of aspirin for cardiovascular protection may depend on body weight
Low dose aspirin only appears to be effective at preventing stroke or heart attack for people weighing less than 70kg, while higher doses are better for people who weigh over 70kg.
Researchers analysed data from 13 trials of aspirin for primary or secondary prevention of cardiovascular events, totalling over 115,000 participants. They found that 75 to 100mg aspirin only benefitted people who weighed less than 70kg, while only those who weighed 70kg or more benefited from doses of 325mg or above...
The benefits and harms of aspirin for people with type 2 diabetes are finely balanced
Daily aspirin reduced the risk of serious vascular events among people with diabetes, while increasing the risk of major bleeding to a similar extent. Aspirin prevented one person in every 100 from having a heart attack or stroke over seven years, but an additional person per 100 experienced a major bleed.
The ASCEND study is one of three large placebo-controlled trials investigating the effects of 100mg daily aspirin for primary prevention in people without established cardiovascular disease. ...
Fish oil supplements do not reduce cardiovascular deaths in people with diabetes without existing vascular disease
Omega-3 fatty acid supplements make no difference to cardiovascular outcomes in people with diabetes but without established cardiovascular disease. Serious vascular events like heart attack, stroke or deaths from these occurred in about 10% of people regardless of whether they took daily omega-3 or placebo capsules for seven years.
The ASCEND studyis a large UK trial assessing primary cardiovascular prevention for people with any type of diabetes. A companion publication assesses the use of as...
Insulin pumps offer little value over multiple injections for children at the onset of diabetes
Young people newly diagnosed with type 1 diabetes achieve similar blood glucose control by 12 months if they are treated with multiple daily insulin injections or continuously via an insulin pump. Adverse events are rare and occurat similar rates. Pumps are more expensive with no clear benefit to quality of life.
Both regimens are used in the management of type 1 diabetes, and the number of children using insulin pumps is rising. This NIHR-funded trial suggests that at an additional cost of &po...
‘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...
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...