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

A wake-up call on children’s well-being: do more, do it now

It’s official – the Chief Medical Officer is ‘profoundly ashamed’. In her report on child health, Professor Dame Sally Davies highlights appalling inequalities in the UK, with three times as many child deaths in the poorest areas compared with wealthier regions, and shows us to be a nation lagging behind our European neighbours too. Much more needs to be done to improve the health of Britain’s children and it needs to be done sooner, she says. Early, preventive action rather than reaction will benefit both the health and the wealth of the nation. I thought I’d take a look at where Cochrane evidence might fit into her vision of what needs to be done. Continue reading

Alive, able and at home: stroke unit care offers better outcomes than alternatives

Key message: people who have a stroke are more likely to be alive, be at home and be independent after a year if they are cared for in a stroke unit

We probably all know someone who’s had a stroke, which is now the second leading cause of death and the third most common cause of disability worldwide. Many of us have followed broadcaster Andrew Marr’s progress in the wake of the stroke he had, aged 53, earlier this year and his wife, Jackie Ashley, caught the attention of many with her recent Guardian blog on their experience of this devastating event. She deemed the NHS to be “wonderful, wonderful, wonderful” and paid tribute to the health professionals who helped get her husband back on his feet, but pointed to the void in support offered by community services after intensive and generally excellent care in hospital. Not all hospital care is equal either, of course, and the type of care offered in hospital after acute stroke can make all the difference to whether, and how well, the person recovers. Continue reading