ELHT Evidence Hub
  • Home
  • Meet the Team
  • Library Facilities
  • Library News
  • FAQS
  • Evidence Search Request
Picture

There is no dose response relationship between the amount of exercise and improvement in HbA1c in interventions over 12 weeks in patients with type 2 diabetes: a meta-analysis and meta-regression.

15/8/2022

0 Comments

 
​Authors: Wrench E;  Rattley K;  Lambert JE; 
Source:Acta diabetologica [Acta Diabetol] 2022 Aug 05. Date of Electronic Publication: 2022 Aug 05.
Publication Model: Ahead of Print
Abstract:
Aims: Aerobic exercise is well recognised as an effective treatment for people with type 2 diabetes but the optimal amount of aerobic exercise to improve glycaemic control remains to be determined. Thus, the aim of this meta-analysis and meta-regression was to assess the impact of volume and intensity of aerobic exercise on glycaemic control.
Methods: Medline, Cochrane, Embase, and Web of Science databases were searched up until 15 December 2020 for the terms "aerobic exercise AND glycaemic control", "type 2 diabetes AND exercise", and "exercise AND glycaemic control AND Type 2 diabetes AND randomised control trial". We included (i) randomised control trials of ≥ 12 weeks, (ii) trials where participants had type 2 diabetes and were aged 18 or over, and (iii) the trial reported HbA1c concentrations pre- and post-intervention. Two reviewers selected studies and extracted data. Data are reported as standardised mean difference (SMD) and publication bias was assessed using funnel plots.
Results: A total of 5364 original titles were identified. Sixteen studies were included in the meta-analysis. Aerobic exercise reduced HbA1c versus control (SMD = 0.56 (95% CI 0.3-0.82), p < 0.001). There were also significant reductions in BMI (SMD = 0.76 (95% CI 0.25-1.27), p < 0.05). There was no dose-response relationship between improvement in HbA1c and the intensity and volume of the intervention (p > 0.05).
Conclusions: Twelve-week or longer aerobic exercise programmes improve glycaemic control and BMI in adults with type 2 diabetes. Longer or more intense interventions appear to confer no additional benefit on HbA1c.

​Full text available here
0 Comments

The Place and Value of Sodium-Glucose Cotransporter 2 Inhibitors in the Evolving Treatment Paradigm for Type 2 Diabetes Mellitus: A Narrative Review.

5/7/2022

0 Comments

 
Authors: Wilding JPH;  Evans M;  Fernando K; 
Source: Diabetes therapy : research, treatment and education of diabetes and related disorders [Diabetes Ther] 2022 May; Vol. 13 (5), pp. 847-872. Date of Electronic Publication: 2022 Mar 20.
Abstract:
Over recent years, the expanding evidence base for sodium-glucose cotransporter-2 inhibitor (SGLT2i) therapies has revealed benefits beyond their glucose-lowering efficacy in the treatment of Type 2 diabetes mellitus (T2DM), resulting in their recognition as cardiorenal medicines. While SGLT2is continue to be recommended among the second-line therapies for the treatment of hyperglycaemia, their true value now extends to the prevention of debilitating and costly cardiovascular and renal events for high-risk individuals, with particular benefit shown in reducing major adverse cardiac events and heart failure (HF) and slowing the progression of chronic kidney disease. However, SGLT2i usage is still suboptimal among groups considered to be at greatest risk of cardiorenal complications. The ongoing coronavirus disease 2019 (COVID-19) pandemic has intensified financial pressures on healthcare systems, which may hamper further investment in newer effective medicines. Emerging evidence indicates that glycaemic control should be prioritised for people with T2DM in the era of COVID-19 and practical advice on the use of T2DM medications during periods of acute illness remains important, particularly for healthcare professionals working in primary care who face multiple competing priorities. This article provides the latest update from the Improving Diabetes Steering Committee, including perspectives on the value of SGLT2is as cost-effective therapies within the T2DM treatment paradigm, with particular focus on the latest published evidence relating to the prevention or slowing of cardiorenal complications. The implications for ongoing and future approaches to diabetes care are considered in the light of the continuing coronavirus pandemic, and relevant aspects of international treatment guidelines are highlighted with practical advice on the appropriate use of SGLT2is in commonly occurring T2DM clinical scenarios. The 'SGLT2i Prescribing Tool for T2DM Management', previously published by the Steering Committee, has been updated to reflect the latest evidence and is provided in the Supplementary Materials to help support clinicians delivering T2DM care.

Full text available here
0 Comments

Health professionals interface with cultural conflict in the delivery of type 2 diabetes care

6/9/2021

0 Comments

 
Author(s) Patel T.; Umeh K.; Poole H.; Vaja I.; Newson L. et al.
Source Psychology & health; Aug 2021 ; p. 1-19
OBJECTIVE: This study explored the knowledge and experiences of health professionals (HPs) caring for South Asian patients with type 2 diabetes (T2D). DESIGN: Fourteen HPs, who supported patients with T2D, were interviewed. The recruitment strategy employed purposeful and theoretical sampling methods to recruit HPs who worked across primary and secondary care settings. MAIN OUTCOME MEASURES: Grounded Theory (GT) methodology and analysis generated a theoretical framework that explored HP's perceptions and experiences of providing diabetes care for South Asian patients. RESULT(S): A GT, presenting a core category of Cultural Conflict in T2D care, explores the influences of HP's interactions and delivery of care for South Asian patients. This analysis is informed by four categories: (1) Patient Comparisons: South Asian vs White; (2) Recognising the Heterogeneous Nature of South Asian Patients; (3) Language and Communication; (4) HPs' Training and Experience. CONCLUSION(S): The findings consider how the role of social comparison, social norms, and diminished responsibility in patient self-management behaviours influence HPs' perceptions, implicit and explicit bias towards the delivery of care for South Asian patients. There was a clear call for further support and training to help HPs recognise the cultural-ethnic needs of their patients.
0 Comments

Association of diabetes with outcomes in patients undergoing contemporary percutaneous coronary intervention: Pre-specified subgroup analysis from the randomized GLOBAL LEADERS study

27/2/2020

0 Comments

 
​Author(s) Chichareon P.; Modolo R.; Kogame N.; Takahashi K.; Wykrzykowska J.J. et al.
Source Atherosclerosis; Feb 2020; vol. 295 ; p. 45-53
Background and aims: Diabetes has been well recognized as a strong predictor for adverse outcomes after percutaneous coronary intervention (PCI), however, studies in the era of drug-eluting stent and potent P2Y12 inhibitors have shown conflicting results. We aimed to assess ischemic and bleeding outcomes after contemporary PCI according to diabetic status. 
  • Available in full text at Atherosclerosis from Unpaywall
0 Comments

TCT-636 Impact of Diabetes on the Outcomes in Patients Undergoing Contemporary Percutaneous Coronary Intervention: Analysis From the GLOBAL LEADERS Study

25/10/2019

0 Comments

 
Author(s) Chichareon P.; Modolo R.; Kogame N.; Takahashi K.; Wykrzykowska J. et al.
Source Journal of the American College of Cardiology; Oct 2019; vol. 74 (no. 13)
DOI 10.1016/j.jacc.2019.08.754
Background: Diabetes has been well recognized as a strong predictor of adverse outcomes after percutaneous coronary intervention (PCI), but studies in the era of drug-eluting stents and potent P2Y12 inhibitors have shown conflicting results. We assessed ischemic and bleeding outcomes after contemporary PCI according to diabetic status.

Method(s): We studied 15,957 patients in the GLOBAL LEADERS study with known baseline diabetic status. The primary endpoint was all-cause death or new Q-wave myocardial infarction at 2 years. The secondary safety endpoint was major bleeding defined as Bleeding Academic Research Consortium (BARC) type 3 or 5.

Result(s): A quarter of the study cohort had diabetes (4,038 of 15,957), and these patients had a significantly higher risk for the primary endpoint at 2 years compared with those without diabetes (adjusted hazard ratio [HR]: 1.36; 95% confidence interval [CI]: 1.14 to 1.61). The difference was driven by a significantly higher risk for all-cause mortality at 2 years in patients with diabetes (adjusted HR: 1.44; 95% CI: 1.18 to 1.75). The risk for BARC type 3 or 5 bleeding was comparable between the 2 groups (adjusted HR: 1.18; 95% CI: 0.92 to 1.50). The antiplatelet strategy (experimental vs. reference strategy) had no significant effect on the rates of the primary endpoint and secondary safety endpoint at 2 years in patients with and without diabetes.

​Conclusion(s): Patients with diabetes had a higher risk for ischemic events after PCI than those without diabetes, while bleeding risk was comparable. The outcomes of patients with diabetes following PCI were not affected by the 2 different antiplatelet strategies. Categories: CORONARY: Pharmacology/PharmacotherapyCopyright © 2019
  • Available in full text at Journal of the American College of Cardiology from Unpaywall
0 Comments
    The following databases were searched:
    EMBASE,  MEDLINE, PsycINFO, BNI, CINAHL, 
    to find  ELHT staff publications

    Specialties

    All
    ANAESTHETICS
    CAMHS
    CARDIOLOGY
    COVID 19
    DEMENTIA
    DERMATOLOGY
    DIABETES
    DIETETICS
    EMERGENCY CARE
    ENDOCRINOLOGY
    EVIDENCE BASED MEDICINE
    GASTROENTEROLOGY
    GYNAECOLOGY
    HAEMATOLOGY
    MATERNITY
    MAXILLOFACIAL
    NEONATOLOGY
    NEUROLOGY
    NURSING
    OBSTETRICS
    ONCOLOGY
    ORTHOPAEDICS
    PAEDIATRICS
    PHARMACY
    PHYSIOTHERAPY
    RADIOLOGY
    RESPIRATORY
    RHEUMATOLOGY
    STROKE
    SURGERY
    UROLOGY
    VASCULAR SURGERY

    RSS Feed

    Archives

    August 2022
    July 2022
    May 2022
    April 2022
    March 2022
    December 2021
    November 2021
    October 2021
    September 2021
    August 2021
    July 2021
    June 2021
    May 2021
    April 2021
    March 2021
    February 2021
    December 2020
    November 2020
    October 2020
    September 2020
    August 2020
    July 2020
    June 2020
    May 2020
    April 2020
    March 2020
    February 2020
    January 2020
    December 2019
    November 2019
    October 2019

Learning Centre Library
Royal Blackburn Teaching Hospital
01254 734312 or Ext 84312
library.blackburn@elht.nhs.uk
​Find us
​​Mackenzie Library
Burnley General Teaching Hospital
01282 803114 or Ext. 13114
library.burnley@elht.nhs.uk

Find us
​Staffed Opening Hours
Mon     08:30-16:30
Tue      08:30-16:30
Wed     08:30-16:30
Thu      08:30-16:30
Fri        08:30-16:00
24/7 access to both libraries is available - please see library staff
View our Quality Standards and Performance
Picture
Picture
  • Home
  • Meet the Team
  • Library Facilities
  • Library News
  • FAQS
  • Evidence Search Request