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    1. Correspondence to: Helen Noble
      Queens University Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK; helen.noble{at}

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    Drug and Therapeutics Bulletin (DTB) April, May, June 2013 issues

    HbA1c targets in type 2 diabetes: guidelines and evidence

    • Aims of treatment for type-2 diabetes include minimising long-term complications (eg, cardiovascular disease, blindness, chronic kidney disease, premature mortality) and avoiding the unwanted effects of treatment (eg, severe hypoglycaemia, weight gain).

    • Publication of the UK Prospective Diabetes Study (UKPDS) 33 in 1998 suggested that ‘intensive blood glucose control’ to lower the glycated haemoglobin (HbA1c) in people with type 2 diabetes reduced microvascular disease but not macrovascular complications.

    • The UKPDS 34 study in overweight patients found that metformin produced less of a reduction in HbA1c but reduced cardiovascular complications and death. Recently, further trials have examined the impact of intensive glycaemic control and have produced conflicting results.

    • In this article we examine the evidence and guideline recommendations for HbA1c targets; glycaemic control for acutely unwell patients and targets in pregnancy will not be covered (DTB;51:42–5).

    What place for racecadotril?

    In this article, we review the evidence for racecadotril and its place in the management of acute diarrhoea (DTB 2013;51:54–7).

    Glycopyrronium for COPD

    In this article, we review the evidence for glycopyrronium and assess its place in the management of chronic obstructive pulmonary disease (DTB 2013;51:66–8).

    Prevention of recurrent urinary tract infections in women

    • Recurrent urinary tract infections (UTIs; usually defined as three episodes in the last 12 months or two episodes in the last 6 months) can have a considerable impact …

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