Effective Healthcare
Bulletin on the effectiveness of health service interventions for decision makers
Source: Centre for Reviews and Dissemination, University of York
- Over a million people in the United Kingdom have Type 2 (non-insulin dependent) diabetes.
- The urine of people with Type 2 diabetes should be tested regularly (at least annually) for proteinuria and, if this is negative, for microalbuminuria. Two or more measurements should be carried out.
- The blood pressure of people with diabetes should be checked at regular intervals and treatment offered if it is found to be consistently higher than 140/90.
- In people with above-normal levels of protein in their urine, treatment with ACE inhibitors is appropriate, even if blood pressure is within the normal range. Treatment of other cardiovascular risk factors should also be considered.
- Blood glucose levels should be kept as near to normal as is consistent with an acceptable quality of life.
- People with Type 2 diabetes should be actively encouraged to be involved in their own care.
- Further research is necessary to determine whether interventions to promote self-management have positive significant long-term effects on outcomes such as weight and HbA1c levels.
- All future research should consider clinically relevant outcomes such as morbidity, mortality, and quality of life.
The Effective Health Care bulletins are based on systematic review and synthesis of research on clinical effectiveness, cost effectiveness and acceptability of health service interventions. This is carried out by a research team using established methodological guidelines, with advice from expert consultants for each topic. Great care is taken to ensure that the work, and the conclusions reached, fairly and accurately summarise the research findings. The University of York accepts no responsibility for any consequent damage arising from the use of Effective Health Care.
Note: The contents of the bulletins should be considered in relation to the time of original publication. Significant new research evidence is likely to have become available since then.
The bulletins are also available free of charge via the World Wide Web. The address is: www.york.ac.uk/inst/crd/ehcb.htm
Enquiries concerning the bulletins should be addressed to:
Centre for Reviews and Dissemination, University of York, York, YO10 5DD. Telephone: +44 (0) 1904 321040; Fax: +44 (0) 1904 321041; email: crd@york.ac.uk
Complications of diabetes: Renal disease and promotion of self-management, Effective Health Care, March 2000, Volume 6, Number 1. ISSN: 0965-0288
