Postgraduate medicine
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Postgraduate medicine · Nov 2020
Scientific independence and objectivity: many questions linger about treatment of type 2 diabetes, such as scientific study design, optimal glucose control and the safety of injecting exogenous insulin.
Whilst clinical guidelines exist for the treatment of people with type 2 diabetes, many underlying assumptions are still not qualified by convincing evidence. In this commentary, it is argued that fundamental issues still cloud clinical practice, such as biases in the design of clinical studies, the association between glucose control & clinical outcomes, and the safety of exposure to exogenous insulin and other glucose-lowering drugs. Relevant scientific evidence and alternative opinions about important issues continue to be largely ignored, and no effort has been made to resolve these questions. This may have had serious consequences, such as stifling innovation because there are no further benefits to be achieved in relation to glucose control.
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Chronic pain is a significant and costly problem all over the world. Despite significant progress in identifying the best treatment approaches, there are still significant obstacles that must be overcome in order for the treatment to be truly beneficial. ⋯ Creating an interdisciplinary service is not easy and certainly is much more complicated than simply placing different services in one clinic. However, when such interdisciplinary programs are instituted, they increase the effectiveness of chronic pain management significantly; bring satisfaction to doctors and are economically attractive (interdisciplinary treatment programs for patients suffering from pain not only provide the best clinical treatment, but are also the most cost-effective in the long run).
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Postgraduate medicine · Nov 2020
Evaluation of the value of diabetes risk scores in screening for undiagnosed diabetes and prediabetes: a community-based study in southwestern China.
To evaluate the performance and cost-effectiveness of existing diabetes risk scores (DRSs) to screen for undiagnosed diabetes mellitus (UDM) and prediabetes (PD) in a community-based southwestern Chinese population. ⋯ The NCDRS represents a valid and cost-effective tool for use in southwestern China to identify high-risk patients with UDM or PD who need a diagnostic test.