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Experts have reached international agreement on the blood sugar thresholds for diagnosing diabetes.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 29, 2017

Sweet potato (Ipomoea batatas) is a plant found in the tropical and subtropical belts and is one of the most nutritious tropical and subtropical vegetables. As well as being popular in cooking in countries in Asia‐Pacific, Africa and North America, sweet potato is also used in traditional medicine for the treatment of diabetes mellitus. We decided to investigate whether there is enough evidence from medical trials to show whether sweet potato works as a treatment for diabetes. This review of randomised controlled trials found only three studies (with a total of 140 participants) that evaluated the effects of sweet potato for type 2 diabetes mellitus compared with a fake medicine (placebo). All these trials were of very low quality. Two studies with 122 participants showed improved long‐term metabolic control of blood sugar levels as measured by glycosylated haemoglobin A1c (HbA1c) which was moderately lowered by 0.3% in participants who were given 4 g sweet potato tablets a day for three to five months. The duration of treatment ranged from six weeks to five months. No study investigated diabetic complications, death from any cause, health‐related quality of life, well‐being, functional outcomes or costs. Adverse effects were mostly mild, and included abdominal distension and pain. There are many varieties of sweet potatoes and sweet potato preparations. More trials are needed to assess the quality of the various sweet potato preparations as well as to evaluate further the use of different varieties of sweet potato in the diet of diabetic people.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

People with diabetes need to adjust their diet in order to control their blood sugar levels and avoid complications. Healthcare professionals often take dietary histories from patients to help them monitor their dietary intake and provide them with advice. Patient histories may be recorded manually by using oral‐and‐written methods or via a computer‐assisted history taking system. Computer‐assisted history taking systems can be used by healthcare professionals, or directly by patients, as in the case of, for example, pre‐consultation interviews. They can be used remotely, for example via the Internet, telephone  or on‐site. They draw on a range of technologies such as personal computers, personal digital assistants, mobile phones and electronic kiosks; data input can be mediated via, amongst others, keyboards, touch screens and voice‐recognition software. Although computer‐assisted history taking methods were first used in the 1960s we are still not certain about their effects on dietary history taking in people with diabetes. Therefore, we reviewed the literature to find studies that compare the effects of oral‐and‐written to those of computer‐assisted dietary history taking on the quality of collected data as well as on the quality of patients' lives. We found only one publication with 38 study participants that compared the two methods of history taking over a total of eight weeks. This study found that computer‐assisted diet history taking would be as accurate as the oral‐and‐written method and may potentially allow doctors to spend more time with their patients to discuss as opposed to taking measurements. However, it is not possible to draw reliable conclusions of which of the two methods is more effective from a single small study. We therefore suggest that more primary research is required in this area to allow an informed decision to be made by physicians, patients and policymakers.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Colesevelam was originally approved for the treatment of hyperlipidaemia (high blood lipids) in the 2000s but has been shown to improve blood sugar as well. Therefore, we investigated its role in the management of type 2 diabetes mellitus. A total of 1450 patients took part in six studies investigating colesevelam. These studies lasted 8 to 26 weeks. Only one small study compared colesevelam directly to placebo, the other five studies investigated a combination of colesevelam with other antidiabetic agents versus a combination of placebo with other antidiabetic agents. There were no two studies with the same intervention and comparison group. When added to other antidiabetic agents colesevelam showed improvements in the control of blood glucose and blood lipids. However, it is difficult to disentangle the effects of colesevelam from the other antidiabetic agents used because only one study compared colesevelam to placebo. The same is true for adverse effects: three studies reported on just a few non‐severe hypoglycaemic episodes, no other serious side effects were observed. No study investigated mortality; complications of type 2 diabetes such as eye disease, kidney disease, heart attack and stroke; health‐related quality of life; functional outcomes and costs of treatment. Therefore, long‐term data on the efficacy and safety of colesevelam are necessary.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

The SGLT 2 inhibitors (such as canagliflozin, dapagliflozin and empagliflozin) are glucose‐lowering drugs that reduce blood glucose levels by increasing the secretion of glucose from the kidneys to the urine. SGLT 2 inhibitors were recently approved for the treatment of diabetes in people with type 2 diabetes mellitus. It is currently not known whether SGLT 2 inhibitors should be prescribed for people with raised blood glucose levels who do not meet the criteria for having type 2 diabetes. We wanted to find out whether these drugs would prevent or only delay the development of type 2 diabetes. Furthermore, we wanted to analyse the effects of SGLT 2 inhibitors on patient‐important outcomes such as complications of diabetes (for example kidney and eye disease, heart attacks, strokes), death from any cause, health‐related quality of life and side effects of the medications.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Glucagon‐like peptide analogues or agonists are a new kind of drug in the treatment of type 2 diabetes that are given by injection under the skin. They regulate glucose levels by stimulating glucose‐dependent insulin secretion and biosynthesis, and by suppressing glucagon secretion, delaying gastric emptying and promoting satiety.  Various glucagon‐like peptide‐1 agonists are in use or in the licensing process, including exenatide, liraglutide, albiglutide, taspoglutide, lixisenatide and LY2189265.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Nutritional factors affect blood glucose levels, however there is currently no universal approach to the optimal dietary strategy for diabetes. Different carbohydrate foods have different effects on blood glucose and can be ranked by the overall effect on the blood glucose levels using the so‐called glycaemic index. By contributing a gradual supply of glucose to the bloodstream and hence stimulating lower insulin release, low glycaemic index foods, such as lentils, beans and oats, may contribute to improved glycaemic control, compared to high glycaemic index foods, such as white bread. The so‐called glycaemic load represents the overall glycaemic effect of the diet and is calculated by multiplying the glycaemic index by the grammes of carbohydrates.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Short acting insulin analogues (Lispro, Aspart, Glulisine) act more quickly than regular human insulin. It can be injected immediately before meals and leads to lower blood sugar levels after food intake. Our analysis showed that short acting insulin analogues were almost identically effective to regular human insulin in long term glycaemic control and were associated with similar episodes of low blood sugar (hypoglycaemia). No information on late complications such as problems with the eyes, kidneys or feet are existing. Until long term safety data are available we suggest a cautious response to the vigorous promotion of insulin analogues.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Diabetes mellitus type 1 is a chronic disease with short and long term complications. The treatment for this disease is insulin administration, with basal and bolus insulin preparations being its main stay. Neutral Protamine Hagedorn (NPH) insulin had previously been considered the standard of care for basal insulin replacement in blood glucose lowering for people with type 1 diabetes mellitus. Over the years, newer and longer acting insulins with a more physiological action profile became available: insulin ultralente, and later insulin glargine and insulin detemir. Their theoretical advantages lead to the thought of a beneficial effect on glucose level and rate of complications, such as very low levels of glucose or long term complications. The aim of this review was to assess whether this theoretical advantage is translated into real‐life benefits, by comparing the effect of long acting insulins to intermediate acting insulins on diabetes control.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Nine studies involving 1359 participants met the inclusion criteria. Six studies compared individual education to usual care and three compared individual education to group education (361 participants). There were no long‐term studies and overall the quality of the studies was not high. Individual face‐to‐face patient education for type 2 diabetes over a six to twelve month period did not significantly improve glycaemic control, body mass index (BMI ‐ measure of overweight; body weight in kilogram divided through squared height in meters, kg/m2), blood pressure or total cholesterol in the short or medium term compared with usual care. However, there did appear to be a significant benefit of individual education on glycaemic control in a subgroup analysis of studies involving participants with a higher baseline HbA1c greater than 8% (that is, too high blood sugar levels over a couple of months or inadequate 'metabolic control'). In the studies comparing individual education to group education, there was no significant difference between individual or group education at 12 to 18 months nor a significant difference in the impact of individual education versus group education on BMI, systolic or diastolic blood pressure.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Diabetes mellitus is a chronic metabolic disorder. People with diabetes are known to be at greater risk of cardiovascular disease (including heart attack, stroke, and peripheral vascular disease such as acute or chronic ischaemia of a leg resulting in severe pain when walking short distances). There is also an increased risk of eye disease, kidney failure, nerve damage and sexual dysfunction when compared to the general population. Improvements in the regulation of blood sugar levels may help to reduce the risk of these complications.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2014

Pregnant women with diabetes need to keep their blood glucose levels stable, using diet, exercise, insulin or other drugs, clinic visits and monitoring. This review looked at the best blood glucose target for pregnant women with diabetes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Exercise, dietary changes and medications are frequently used in the management of type 2 diabetes. However, it is difficult to determine the independent effect of exercise from some trials because exercise has been combined with dietary modifications or medications, or compared with a control which includes another form of intervention. The review authors aimed to determine the effect of exercise on blood sugar control in type 2 diabetes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Cardiovascular disease is the name given to any disease, such as heart attack or stroke, that affects the heart and circulatory system (which moves blood around the body). Risk factors for cardiovascular diseases include high blood pressure, and high levels in the blood of glucose and cholesterol. People with cardiovascular risk factors are more likely to have a heart attack or stroke than people without them.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Type 1 diabetes is a disease in which the pancreas has lost its ability to make insulin. A deficit in insulin leads to increases in blood glucose levels, these elevated blood glucose levels can lead to complications which may affect the eyes, kidneys, nerves and the heart and blood vessels. Since there is no cure for type 1 diabetes, patients need to check their blood glucose levels often by fingerprick and use these blood glucose values to decide on their insulin dosages. Fingerpricks are often regarded as cumbersome and uncomfortable by patients. In addition, fingerprick measurements only provide information about a single point in time, so it is difficult to discern trends in decline of rises in blood glucose levels.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

The two long‐acting insulin analogues (artificial insulins), insulin detemir or insulin glargine differ in their mechanism of attaining protracted action, leading to possible differences in glycaemic control and safety outcomes. Several studies have compared either insulin detemir or insulin glargine to NPH (Neutral Protamin Hagedorn) insulin. Research directly comparing both long‐acting insulin analogues is limited.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Kidney transplantation is often complicated by worsening or new‐onset diabetes. The safety and effectiveness of drugs used to lower glucose in this setting is largely not known.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: February 27, 2017

The aim of this Cochrane review was to find out if giving women with diabetes specialised care before they become pregnant has an impact on their health, and on the health of their future babies. We collected and analysed all relevant studies to answer this question (date of search: January 2017).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

LADA is a condition that at diagnosis looks like type 2 diabetes (non‐insulin requiring diabetes mellitus) but actually is a type 1 diabetes, where the patient will become insulin requiring. In the UK approximately 3.6% of people who look like they have type 2 diabetes actually have type 1 diabetes, while other studies suggest the prevalence is higher and treatment for these patients may need to be different from that used in type 2 diabetes.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Diabetes is one of the commonest long‐term medical conditions, affecting around 347 million adults worldwide. Around 90% of them have type 2 diabetes and are at significant risk of developing diabetes related complications such as strokes or heart attacks. Patient education programmes can reduce the risk of diabetes‐related complications, but many people with type 2 diabetes have never attended structured education programmes to learn how to look after themselves (self‐management). Better use of computers might be one way of helping more people learn about self‐management.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

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