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BMJ Clin Evid. 2008 Jul 30;2008. pii: 0607.

Diabetes: glycaemic control in type 1.

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Department of Diabetes and Endocrinology, University Hospitals of Leicester NHS Trust, Leicester, UK.



Type 1 diabetes occurs when destruction of the pancreatic islet beta cells, usually attributable to an autoimmune process, causes the pancreas to produces too little insulin or none at all.


We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of intensive treatment programmes and educational interventions in adults and adolescents with type 1 diabetes? What are the effects of different insulin regimens on glycaemic control in adults and adolescents with type 1 diabetes? We searched: Medline, Embase, The Cochrane Library, and other important databases up to December 2006 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA).


We found 16 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions.


In this systematic review, we present information relating to the effectiveness and safety of the following interventions: different frequencies of insulin administration (continuous subcutaneous insulin infusion compared with multiple daily subcutaneous insulin injections); different frequencies of blood glucose self-monitoring; educational interventions; and intensive treatment programmes.

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