Expert reaction to study looking at drinking alcohol and risk of diabetes

In new research published in Diabetologia scientists report that alcohol drinking frequency is associated with a reduced risk of diabetes and that consumption of alcohol over 3-4 days per week is associated with the lowest risk of diabetes | Science Media Centre

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Dr Graham Wheeler, Bayesian Medical Statistician, UCL, said:

“Whilst this large study has found an association between moderate weekly alcohol consumption and a reduced risk of diabetes, this alone does not prove a causal link.

“Establishing a biological mechanism for how this protective effect might work is key to understanding the findings of these types of study.

“In the Danish study, participants were asked to recall drinking habits only once.  So participants may under- or over-report their true alcohol consumption.  We also don’t know how their drinking habits changed as they were followed up.

“Researchers looked at the association between diabetes onset and lots of different categories of drinking behaviour, which increases the chance of claiming at least one association is statistically significant, when actually it isn’t.

“Whilst drinkers may want to raise a glass upon hearing this news, alcohol has been linked to the increased risk of alcoholic hepatitis, liver cirrhosis and several cancers.  Further research will help us piece together the complex relationship between alcohol consumption and diabetes.”

Read the full analysis here

Expert reaction from to two studies looking at coffee consumption and risk of death

Two studies publishing in the Annals of Internal Medicine assess the association between higher coffee consumption and reduced risk of death | Science Media Centre

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Dr Tim Chico, Reader in Cardiovascular Medicine / consultant cardiologist, University of Sheffield, said:

“These two studies followed many thousands of people for 16 years and compared death rates in coffee drinkers with non-coffee drinkers.  In keeping with previous studies, death rates were slightly lower in coffee drinkers than in non-coffee drinkers.

“The studies were well conducted and have the advantage of having observed thousands of people from many different countries and ethnic backgrounds, and the association between coffee drinking and mortality seems to be the same across all these populations.

“The authors of both studies are commendably cautious about whether or not coffee drinking is the cause of the reduced mortality in coffee drinkers, or whether there are other unknown differences between coffee drinkers and non-coffee drinkers that are the real cause for the differences observed.  Neither study seems to take into account the income of the people involved (although they do adjust for educational level) and since coffee isn’t cheap it is possible that non-coffee drinkers are less well off, which would be a potential explanation for some of the differences seen.

“What can we conclude from these studies?  The authors of both papers sensibly go no further than concluding that their results show that coffee drinking is not harmful.  I’m occasionally asked by patients whether they should drink coffee and these studies will help in advising them that coffee drinking is safe.

“The only way to be certain whether or not coffee might make people live longer is to force many thousands of people to drink it regularly, while preventing many thousands of otherwise similar people to never drink coffee.  A study like this is never going to take place, so we may never know the answer to this question.

“I don’t think this study should lead anyone to drink more coffee in search of a health benefit that might not actually exist.  It is useful to compare this to the proven benefits of physical activity.  A 20-min walk to a local coffee shop will definitely provide many health benefits, even if you don’t actually go in and buy anything.”

Why gluten-free food is not the healthy option and could increase your risk of diabetes

New research from Harvard University has found a link between gluten-free diets and an increased risk of developing type 2 diabetes | Brown, J. for The Conversation

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Image source: Whatsername? – Flickr // CC BY-SA 2.0

There is evidence that the popularity of gluten-free diets has surged, even though the incidence of coeliac disease has remained stable. This is potentially due to increasing numbers of people with non-coeliac gluten sensitivity. In these cases, people exhibit some of the symptoms of coelaic disease but without having an immune response. In either case, avoiding gluten in foods is the only reliable way to control symptoms, which may include diarrhoea, abdominal pain and bloating.

Without any evidence for beneficial effects, many people without coeliac disease or gluten sensitivity are now turning to gluten-free diets as a “healthy” alternative to a normal diet. Supermarkets have reacted to meet this need by stocking ever growing “free from” ranges. The findings of this recent study, however, suggest that there could be a significant drawback to adopting a gluten-free diet that was not previously known.

Read the full blog post here

Read the original research abstract here

National Diabetes inpatient audit

The Healthcare Quality Improvement Partnership has published National Diabetes Inpatient Audit, England and Wales 2016.

The report finds that the prevalence of all hypoglycaemic episodes in hospital, both mild and severe, has decreased from 26 per cent in 2011 to 20 per cent in 2016. It also highlights that there has been an overall reduction in the prevalence of the most severe, life-threatening hypoglycaemia which requires injectable rescue treatment for inpatients with diabetes. This has fallen from 2.2 per cent in 2011 to 1.7 per cent in 2016.

Full report and findings available here

Transformation fund call to bid

To support the implementation of the Five Year Forward View vision of better health, better patient care and improved NHS efficiency, NHS England has created a transformation fund | NHS England

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The interventions for which transformation funding are available are:

Sustainability and Transformation Plans (STPs) are central to this process and all bids should be explicitly linked to the relevant local STP plans. This process is open to any STP, although individual organisations or alliances may bid on behalf of an STP for this funding; submission of applications must be via STPs.

Read the full overview here

Diabetes UK nursing survey

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Diabetes UK has published Diabetes specialist nursing 2016 workforce survey: a workforce in crisis.   This survey found that nearly four out of five Diabetes Specialist Nurses (78%) voiced concerns that their workload is having an impact on patient care and/or safety and almost four in ten respondents (39%) said they considered their current caseload ‘unmanageable’.

Additional link: Royal College of Nursing

Treatment adherence, thresholds for intervention and disparities in treatment in people with type 2 diabetes

McGovern, A. et al. (2016) BMJ Open. 6:e012801

Purpose: The University of Surrey-Lilly Real World Evidence (RWE) diabetes cohort has been established to provide insights into the management of type 2 diabetes mellitus (T2DM). There are 3 areas of study due to be conducted to provide insights into T2DM management: exploration of medication adherence, thresholds for changing diabetes therapies, and ethnicity-related or socioeconomic-related disparities in management. This paper describes the identification of a cohort of people with T2DM which will be used for these analyses, through a case finding algorithm, and describes the characteristics of the identified cohort.

Findings to date: A cohort (N=58 717) of adults with T2DM was identified from the RCGP RSC population (N=1 260 761), a crude prevalence of diabetes of 5.8% in the adult population. High data quality within the practice network and an ontological approach to classification resulted in a high level of data completeness in the T2DM cohort; ethnicity identification (82.1%), smoking status (99.3%), alcohol use (93.3%), glycated haemoglobin (HbA1c; 97.9%), body mass index (98.0%), blood pressure (99.4%), cholesterol (87.4%) and renal function (97.8%). Data completeness compares favourably to other, similarly large, observational cohorts. The cohort comprises a distribution of ages, socioeconomic and ethnic backgrounds, diabetes complications, and comorbidities, enabling the planned analyses.

Read the full abstract and article here