Complications resources
Here are links to evidence-based resources on complications in diabetes. You may also want to refer to information about the national service frameworks and strategies across the UK.
Some of the resources on this page are in PDF format - see how to access PDF files.
Guidelines and guidance
Clinical Resource Efficiency and Support Team (2008) Guidelines on the management of neuropathic pain (PDF 357.79KB)
This guideline from Crest in Northern Ireland covers diagnosis, initial treatment options, treatment options available in specialist pain clinics. Crest , along with a number of related bodies became the Guidelines and Audit Implementation Network and the guideline is made available as part of the Gain website.
Department of Health (2001) National Service Framework for Diabetes: Detection and management of long-term conditions
The NSF sets standards for preventing long term complications , minimising their impact and for providing care for those with complications arising from their diabetes.
JBS 2 (2005) Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice (PDF 848.16KB)
These guidelines have been developed jointly by a number of societies to promote a consistent multidisciplinary approach to the management of people with established atherosclerotic cardiovascular disease (CVD) and those at high risk of developing symptomatic atherosclerotic disease which includes people with diabetes. The guideline is made available as a supplement of the journal 'Heart'.
National Institute for Health and Clinical Excellence (2010) Neuropathic pain: the pharmacological management of neuropathic pain in adults in non-specialist settings (CG96)
This clinical guideline updates and replaces recommendations made in previous Nice clinical guidelines for type one and type two diabetes.
Nice: Clinical guidelines and guidance on diabetes
This page on the Nice website links to all the clinical guidelines and guidance from Nice relevant to diabetes. This includes completed and in development clinical guidelines, interventional procedures and technology appraisals.
Systematic reviews and evidence summaries
Bandolier: Duloxetine: painful diabetic neuropathy and fibromyalgia
The trials show a reasonable level of efficacy for daily doses of 60 or 120 mg of duloxetine helping some people with painful diabetic neuropathy or fibromyalgia.
For more information about Cochrane Systematic Reviews, examples of which appear below, visit the page within this resource on the Cochrane Library.
Cochrane Review: Antihypertensive agents for preventing diabetic kidney disease
Twenty to 60 per cent of diabetic patients are affected by hypertension and antihypertensive agents are used to treat this condition. These agents are also used to prevent the onset of kidney disease both in normotensive and hypertensive diabetics. This study was undertaken to determine the benefits and harms of antihypertensive treatment in patients with diabetes but who do not show signs of kidney disease.
Cochrane Review: Systematic administration of local anaesthetic agents to relieve neuropathic pain
The aim of this study was to evaluate pain relief and adverse effect rates between systemic local anaesthetic-type drugs and other control interventions.
Cochrane Review: Aldose reductase inhibitors for the treatment of diabetic polyneuropathy
The aim of this review was to assess the effects of aldose reductase inhibitors on the progression of symptoms, signs or functional disability in diabetic polyneuropathy which causes pain and sensory and motor deficits in the limbs.
Cochrane Review: Opioids for neuropathic pain
This review aimed to assess the efficacy and safety of opioid agonists for the treatment of neuropathic pain.
Cochrane Review: Vitamin B for treating peripheral neuropathy
This review sought to assess the effects of vitamin B for treating generalised peripheral neuropathy.
Cochrane Review: HAAM Hormonal versus non-hormonal contraceptives in women with diabetes mellitus type one and two
Hormonal contraceptives might influence carbohydrate and lipid metabolism and increase micro and macrovascular complications in women with diabetes, so caution in selecting a contraceptive method is required. This study investigated whether progestogen-only, combined estrogen/progestogen or non-hormonal contraceptives differ in terms of effectiveness in preventing pregnancy, in their side effects on carbohydrate and lipid metabolism and in long-term complications such as micro and macrovascular disease, when used in women with diabetes mellitus.
NHS Clinical Knowledge Summaries (CKS) Diabetes Type Two – management
Includes a range of scenario which cover management of foot problems, eye problems, renal problems, and neuropathy. As from mid 2011 the CKS programme is no longer actively updating content so please see the CKS homepage for information on how to establish topic currency.
Nice: Foot care services for people with diabetes
This area of the Nice website links to a commissioning guide for foot care services and related guidance.
Other resources
BMC Endocrine Disorders (2008) The Edinburgh Type Two Diabetes Study: study protocol
BMC Endocrine Disorders is one of the open access journals made available on the BioMed Central website. This artcile describes the Edinburgh Type 2 Diabetes Study which was established in 2006 in order to investigate the role of potential risk factors in certain complications, as well as to further investigate mechanisms underlying the development and progression of micro and macrovascular disease in type two diabetes. "This study will provide a wealth of epidemiological and biomarker data that should be invaluable in the identification of potentially modifiable, causal risk factors for diabetes-related cognitive impairment, liver dysfunction and vascular disease, which can be targeted for the development of preventive and therapeutic interventions".
Diabetes UK: complications
This section within the Diabetes UK website describes both short term and long term complications, what might cause them, and how to reduce the risk of these complications occurring.
Diabetes UK: Your care review checklist
Outlines what needs to be checked and what topics should form part of the discussions at the annual review.
NHS Diabetes (2011) Diabetes with kidney disease: key facts 2011 (PDF 691.46KB)
This booklet from NHS Diabetes provides key information about the impact of kidney disease in diabetes, in particular what puts people at risk of developing kidney disease and what can be done about it.
Open University Open Learn learning space: Diabetes Care Chapter Five: Diabetes complications
This chapter, made available by the Open University from their course on Diabetes Care, describes various monitoring processes that people with diabetes and the healthcare practitioners caring for them are likely to be involved in order to identify possible risk factors for complications.