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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 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 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 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...
NIHR Signal New screening pathway could help to identify a rare, single-gene form of diabetes
A screening pathway using blood and urine tests followed by two genetic (DNA) tests identified all people with a rare subtype of diabetes called monogenic diabetes. The screening pathway performed better than current practice based on age at diagnosis and family history which misses 63%. It is, therefore, a useful approach for ruling out this form of diabetes and probably cheaper overall than offering every young person with diabetes DNA testing. Monogenic diabetes, caused by a mutation in a si...
NIHR Signal Fewer large babies are born to pregnant woman with type 1 diabetes if their glucose was monitored continuously
Pregnant women with type 1 diabetes who used a continuous glucose monitoring system were half as likely to have a large baby compared with those using standard finger prick blood glucose measurements. Only 15% of infants needed intensive care admissions due to low blood glucose in the continuous glucose monitoring group, compared with 28% born to mothers in the standard finger prick control group. Pregnant women using continuous monitoring spent 7% more time in the target glucose range than tho...
NIHR Signal Heel casts do not improve heel ulcers in diabetes
Fibreglass casts moulded to the heel did not improve heel ulcers in people with diabetes when added to usual ulcer care. Ulcers healed within six months in 44% of people using casts compared with 37% without which was not a statistically significant difference. Foot ulcers are a common complication of diabetes, and heel ulcers are particularly difficult to treat. Based on the success of casts for treating ulcers elsewhere on the foot this trial was designed to test the effect and cost-effective...
NIHR Signal Type 2 diabetes is becoming more common in children
The number of children being diagnosed with both type 1 and type 2 diabetes is rising, but new cases of type 2 diabetes, the form associated with being overweight, has risen five-fold in about five years. New analysis in this NIHR-supported study suggest that type 2 diabetes now accounts for up to a third of diabetes diagnoses in children. Amongst 100,000 school age children about six new cases of type 2 diabetes a year could be expected in the 1990s. This increased to about 33 new cases per ye...
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