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NIHR Signal NHS health check attendance improves with changes to the invitation letter
Invitation letters improve uptake when they address common concerns and reasons for not attending the free NHS Health Checks. People are invited to attend a check every five years between 40 and 74 years, but uptake has been low. This trial of 6,313 patients from six general practices in Northamptonfound that presenting reasons for non-attendance countered by a GP responseincreased uptake of NHS Health Checks by 5.5%. The ‘counterarguments’ included the reduced longer-term cost to ...
NIHR Signal Pedometers can help people get more active as part of an exercise programme
Pedometers and accelerometers helped people with diabetes or cardiovascular diseases to increase their physical activity by a moderate amount, though pedometers were more successful. Programmes that involved face-to-face consultations with a facilitator were more effective than those where devices were used in isolation to track progress. This NIHR-funded systematic review included 36 trials which objectively measured the activity of people with cardiac or metabolic conditions, and in which wea...
NIHR Signal GLP-1 drug for diabetes gives modest cardiovascular benefits compared with placebo
Taking a glucagon-like peptide-1 receptor (GLP-1) agonist drug lowers the likelihood of having a stroke, heart attack or dying due to cardiovascular causes by 12%. The drugs give a similar 12% reduction in overall mortality. They do not increase the risk of heart failure, very low blood sugar levels or pancreatic disease. Diabetes causes one in five strokes along with other cardiovascular complications. Clinicians aim to reduce these risks and lower blood sugar levels. This meta-analysis is the...
NIHR Signal 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...
NIHR Signal 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...
NIHR Signal 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 ...
NIHR Signal 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...
NIHR Signal 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%, ...
NIHR Signal 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. ...
NIHR Signal 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...
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