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Bibliographic details: Santaguida P L, Balion C, Hunt D, Morrison K, Gerstein H, Raina P, Booker L, Yazdi H.  Diagnosis, prognosis, and treatment of impaired glucose tolerance and impaired fasting glucose: diagnosis. Rockville, MD, USA: Agency for Healthcare Research and Quality. Evidence Report/Technology Assessment; 128. 200516194123

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2005

The aim of the present investigation is the benefit assessment of measures with the goal of long-term adjustment of BG to near-normal levels compared to measures with no goal or a less intensive goal of BG adjustment in patients with type 2 diabetes mellitus in respect of patient-relevant outcomes.

Institute for Quality and Efficiency in Health Care: Executive Summaries [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 6, 2011

Swedish Council on Health Technology Assessment (SBU).

Version: October 22, 2013

The purpose of this report is to retrieve and review the existing clinical effectiveness evidence for various frequencies of SMBG with test strips for patients with type 1 DM and hypoglycemia unawareness. Additionally, this report aims to retrieve and review evidence-based guidelines regarding the optimal frequency of SMBG with test strips for this patient population.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: April 5, 2017

This report reviews the scientific evidence for intensive therapy aimed at lowering blood glucose levels to near normal in patients with type 1 and type 2 diabetes. In diabetes, risks for diabetic complications are associated with high average blood glucose levels as measured by HbA1c. Hence, in treating diabetes it is natural to aim at lowering HbA1c to normal or near normal levels. In type 1 diabetes, we refer to this as intensive insulin therapy. Since several different types of drugs are used to treat type 2 diabetes we refer to this as intensive glucose-lowering therapy. The report was commissioned by the Swedish National Board of Health and Welfare (NBHW) to provide a foundation for their national guidelines for diabetes care. Within the framework of the NBHW guidelines program, SBU is producing three additional reports addressing patient education in managing diabetes, self-monitoring of blood glucose in noninsulin-treated diabetes, and dietary treatment of diabetes.

Swedish Council on Health Technology Assessment (SBU).

Version: December 2009

Sodium-glucose co-transport 2 (SGLT-2) inhibitors are a new class of drugs used to treat type-2 diabetes (T2DM). They exert antihyperglycemic action by blocking the renal reabsorption of glucose, leading to increased urinary glucose excretion. In healthy individuals, the kidney filters up to 180g of glucose every day, which is almost entirely reabsorbed into the blood in the proximal convoluted tubule through the mediation of SGLT-1 and SGLT-2, with the latter reabsorbing the majority (80% to 90%). Based on their mechanism of action and observations from clinical trials, the SGLT-2 inhibitors have demonstrated the potential to reduce the risk of cardiovascular events in addition to reducing blood glucose levels. By inhibiting renal reabsorption of glucose, they lower blood glucose to clinically significant levels, increase the potential for weight loss through calorie reduction, and increase water content of urine by osmotic diuresis to potentially reduce blood pressure.

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: November 5, 2015

Diabetes is a prevalent and costly disease in Veterans. Control of blood glucose is an important VA objective. Self-monitoring of blood glucose (SMBG) is advocated as a method to better achieve control. The Key Questions were: Key Question 1. Is regular SMBG effective in achieving target A1c levels for patients with type 2 diabetes? Key Question 2. Is regular SMBG effective in maintaining target A1c levels for patients with type 2 diabetes? Key Question 3. Does regular SMBG reduce the frequency of hypoglycemia in patients with type 2 diabetes? Key Question 4. Is there evidence that different frequencies of testing result in differences in improvements in A1c?

Evidence-based Synthesis Program - Department of Veterans Affairs (US).

Version: September 2007

Diabetes is a chronic medical condition in which the body impairs to the responding to or production of insulin, leading to the abnormal metabolism of sugar and increase in blood sugar level. Over the seven-year period (2004/2005 to 2010/2011), the rate of type 1 diabetes in pregnant women remained unchanged (about 2.9 per 1,000 deliveries), the rate of type 2 diabetes in pregnant women increased from 2.9 to 4.3 per 1,000 deliveries, and the rate of gestational diabetes increased from 40.8 to 54.5 per 1,000 deliveries. The rate of type 2 and gestational diabetes also increased with age. Pre-gestational (pre-existing type 1 or type 2) and gestational diabetes in pregnant women can have significant impact to pregnancy outcomes.– Poor glycemic control in pre-gestational maternal diabetes and in gestational diabetes may be associated with pregnancy complications, such as preeclampsia, neonatal jaundice, and respiratory distress.–

Rapid Response Report: Summary with Critical Appraisal - Canadian Agency for Drugs and Technologies in Health.

Version: April 4, 2017

The prevalence of type 2 diabetes mellitus (T2DM) is increasing in the UK and worldwide. Before the onset of T2DM, there are two conditions characterised by blood glucose levels that are above normal but below the threshold for diabetes. If screening for T2DM in introduced, many people with impaired glucose tolerance (IGT) will be found and it is necessary to consider how they should be treated. The number would depend on what screening test was used and what cut-offs were chosen.

Health Technology Assessment - NIHR Journals Library.

Version: August 2012

The study found evidence to suggest that integrated continuous glucose monitoring insulin pump therapy systems are more clinically effective in patients with type 1 diabetes than stand-alone treatments. However, based on the evidence available, these integrated systems are unlikely to be cost-effective in comparison with stand-alone insulin delivery and monitoring. Further research on the clinical effectiveness and cost-effectiveness of these integrated systems in different populations is warranted.

Health Technology Assessment - NIHR Journals Library.

Version: February 2016

This study finds that the routine identification of pregnant women for treatment of hyperglycaemia cannot be considered cost-effective given the absence of evidence of longer-term benefit.

Health Technology Assessment - NIHR Journals Library.

Version: November 2016

Type 2 diabetes mellitus (DM) is the leading cause of kidney failure, nontraumatic lower-limb amputations, and new cases of blindness; a major cause of heart disease and stroke; and the seventh leading cause of death in adults in the United States. Screening could lead to earlier detection and earlier or more intensive treatment of persons with asymptomatic DM, impaired fasting glucose (IFG), or impaired glucose tolerance (IGT), potentially resulting in improved clinical outcomes.

Evidence Syntheses - Agency for Healthcare Research and Quality (US).

Version: April 2015

Surgical site infections are caused by bacteria that get in through incisions made during surgery. They threaten the lives of millions of patients each year and contribute to the spread of antibiotic resistance. In low- and middle-income countries, 11% of patients who undergo surgery are infected in the process. In Africa, up to 20% of women who have a caesarean section contract a wound infection, compromising their own health and their ability to care for their babies. But surgical site infections are not just a problem for poor countries. In the United States, they contribute to patients spending more than 400 000 extra days in hospital at a cost of an additional US$ 10 billion per year.

World Health Organization.

Version: 2016

Although dapagliflozin, canagliflozin and empagliflozin improve glycaemic control, as monotherapy they are not cost-effective compared with gliclazide or pioglitazone, but may be against sitagliptin.

Health Technology Assessment - NIHR Journals Library.

Version: January 2017

Type 1 diabetes affects over 370,000 adults in the UK, representing approximately 10% of adults diagnosed with diabetes. Given the complexity of its treatment regimens, successful outcomes depend, perhaps more than with any other long-term condition, on full engagement of the adult with type 1 diabetes in life-long day-by-day self-management. In order to support this, the health service needs to provide informed, expert support, education and training as well as a range of other more conventional biomedical services and interventionsfor the prevention and management of long term complications and disability.

NICE Guideline - National Clinical Guideline Centre (UK).

Version: August 2015

Report finds that the case for universal screening for type 2 diabetes mellitus in people aged > 40 years is not proven, although there is a case for selective screening as part of overall vascular risk assessment.

Health Technology Assessment - NIHR Journals Library.

Version: August 2013

Background Diabetes mellitus (DM) has become one of the most common public health problems world-wide. According to the 2014 Norwegian Public Health report, diabetes affects an estimated 4.3% of the Norwegian population. Diabetes is a metabolic disorder resulting from a defect in insulin production, secretion, action, or all. Type 1 and 2 are the two main types, with the prevalence of type 2 accounting for the majority (>85%) of diabetes. This assessment will focus on FreeStyle Libre, flash glucose monitor for insulin treated individuals with type 1 and 2 diabetes (“Type 1 and 2 DM”).

Knowledge Centre for the Health Services at The Norwegian Institute of Public Health (NIPH).

Version: August 21, 2017

Bibliographic details: Wang Q, Han P.  Intensive glucose control compared with standard therapy in type 2 diabetes: a systematic review. Chinese Journal of Evidence-Based Medicine 2009; 9(7): 774-782

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet] - Centre for Reviews and Dissemination (UK).

Version: 2009

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

Gestational diabetes mellitus (GDM) is a glucose intolerance leading to high concentrations of glucose (sugar) in the blood (hyperglycaemia) that begins or is first recognised during pregnancy. Monitoring of blood glucose levels is an important way to maintain control of sugar concentrations in the blood. There are several different methods for monitoring blood glucose which can be carried out in different settings (e.g. at home or hospital), however it is not clear which is best for limiting health complications for women and their babies.

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

Version: 2017

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