Benefits and black holes in the latest Cochrane evidence

If you read my last blog, you’ll know I’ve been getting hot under the collar about evidence gaps and I’m not about to quieten down about those any time soon, as you’ll see if you read to the end of the blog. There are not just gaps but some enormous black holes, this time not because no evidence was found but because so much of it was unusable. But at least there’s good news too; some reviewers find what they’re looking for and can give us evidence which shows benefits from particular interventions. So, if you logged on thinking you’d like to read about teeth, pain (from several causes), schizophrenia treatments, gut bacteria and jellyfish (really!), you’ve come to the right place. Continue reading

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Managing diabetes: new evidence on targets for blood pressure and blood glucose

Key messages:

1. Current evidence does not support blood pressure targets lower than the standard targets for people with raised blood pressure and diabetes

2. Better evidence is needed to guide the choice between targeting intensive or conventional glycaemic control in people with type 2 diabetes but intensive control increases the risk of both mild and severe low blood sugar

Today is World Diabetes Day and there’s a big emphasis on knowing the complications of diabetes and trying to avoid them. Maintaining healthy blood pressure levels and blood sugar levels are important ways to reduce the risk of damage to the heart and blood vessels, kidneys, nerves and eyes. We have new evidence from Cochrane systematic reviews which helps shed some light on which approaches might be best when it comes to setting targets for blood pressure and blood glucose levels. Continue reading

Babies, bright lights, blood-thinners and more: Cochrane evidence round-up

It’s probably best to draw a veil over many of the things done in English boarding schools by past generations and some in the name of health. The boys of Dickens’ fictional Dotheboys Hall were given brimstone and treacle from “a common wooden spoon, which might have been originally manufactured for some gigantic top, and which widened every young gentleman’s mouth considerably: they being obliged, under heavy corporal penalties, to take in the whole of the bowl at a gasp.” Continue reading

Non-removable casts are better than dressings or removable casts for helping diabetes-related foot ulcers heal

Key message: Non-removable, pressure-relieving casts are more effective in healing diabetes-related plantar foot ulcers than removable casts, or dressings alone

Diabetes is a serious chronic disease that’s on the rise, thanks to ever more sedentary lifestyles, changes in our diet and people living longer. Since the mid-1990s, the number of people with diabetes in the UK has risen from 1.4 million to 2.9 million and it’s estimated that 4 million of us will be diabetic by 2025. Continue reading