Finding information for diabetes care

The diabetes resource signposts key evidence-based guidelines, guidance and recommendations for a range of different situations and aspects of diabetes and its care, but is not intended to be comprehensive in coverage.

This section of the resource therefore aims to guide you to important sources of information which you can use to search for further resources and information to support your practice and learning.

Improving your searching skills

An RCN Learning Zone area ‘How trustworthy is your information’ can help you in researching topics in support of your day-to-day work or studies. The learning is arranged around the RCN competences for information literacy and guides you through some of the issues and activities involved, including using information legally, inclusively and ethically and applying and communicating the results of your information search appropriately.
Visit How trustworthy is your information (you will need your RCN membership number to access).

The RCN information literacy competences are intended to support the individual and the nursing team’s thinking about information required to inform activities of varying complexity. They are mapped to the Knowledge and Skills Framework – see Finding, using and managing information (PDF 1.4MB) - see how to access PDF files.

Pages for each of the information literacy competences also guide you to learning resources which will help you develop the skills relevant to each competence- see the left hand menu at information literacy competences. 

Sources of information on diabetes care

Some of the sources signposted have been referred to throughout the resource but are here described in more detail.

The sources are arranged in the following categories:

UK organisations / special collections

Included here are key organisations which provide different types of information and activities to support diabetes care.

Diabetes UK 
Diabetes UK is the largest organisation in the UK working for people with diabetes and providing practical support and information to help people manage their diabetes. There is a dedicated area for professionals which includes guidance and reports, areas for sharing practice, resources for patients, news and updates.

National Clinic Audit Support Programme (NCASP): Diabetes
NCASP is part of the NHS Information Centre for health and social care and is commissioned by the Healthcare Quality Improvement Partnership (HQIP) to deliver the National Diabetes Audit which is considered to be the largest clinical audit in the world. The audit covers England and Wales and reports and data from 2003-2004 onwards are available. See also the National Diabetes Information Service below.

National Diabetes Information Service
The National Diabetes Information Service (NDIS), working in partnership with other key organisations, provides “streamlined access to a comprehensive suite of diabetes information products, datasets and tools”. You need to register and log in to access some of the products and tools.

NHS Diabetes
The role of the NHS Diabetes team is to support health care professionals, organisations and people with diabetes to achieve delivery of the Diabetes National Service Framework in England. There are a number of work programmes which aim to explore ways to improve specific aspects of diabetes care. The website describes these programmes and brings together news, guidance and tools and includes areas for discussion and the sharing of experiences and practice examples.

NHS Evidence
NHS Evidence is a freely available service that enables access to clinical and non-clinical evidence and best practice for health and social care through a web-based portal. It also includes an area of specialist topics which bring together resources under the following headings: guidance; commissioning; information for the public; ongoing research; medicines. The topics are type 1 diabetes and type 2 diabetes.

NHS Education for Scotland: The Knowledge Network
The Knowledge Network in Scotland provides evidence, information, e-learning and community tools. You can limit your search to evidence and guidelines. The search results are categorised acording to different types of material or information from specific sources.
The Knowledge Network includes a number of specialist portals, for example:

Yorkshire and Humber Public Health Observatory: Diabetes health intelligence
The Yorkshire and Humber Public Health Observatory (YHPHO) is one of a network of 12 public health observatories working across the UK countries and the Republic of Ireland. The observatories produce information, data and intelligence on people’s health and health care for practitioners, policy makers and the wider community with an expertise in “turning information and data into meaningful health intelligence”. Each of the English Public Health Observatories has a lead role in a key policy area and the YHPHO is the lead PHO in diabetes. The overarching organisation is the Association of Public Health Observatories (APHO).

Clinical guidelines

Clinical guidelines are systematically developed statements which make recommendations on the appropriate treatment and care of people with specific diseases and conditions. They should support health care practitioners and patients in good decision-making and reduce unacceptable or undesirable variations in practice (Broughton and Rathbone 2001; Royal College of Nursing n.d.).

National clinical guidelines
For information about the national agencies developing guidelines in each of the four UK countries  – NICE (England and Wales), SIGN (Scotland) and GAIN (Northern Ireland) see  the separate section in this resource on clinical guidelines.

RCN clinical guidelines
Information about the clinical guidelines developed by the RCN in collaboration with other stakeholders. Each guideline is described and there are links to the relevant documents and related online resources.

Guidelines International Network
G-I-N is an international association of organisations and individuals involved in the development and use of clinical practice guidelines. It seeks “to improve the quality of health care by promoting systematic development of clinical practice guidelines and their application into practice, through supporting international collaboration”. The Network has the largest International Guideline Library.

Systematic reviews and evidence digests

A systematic review uses a predefined, explicit methodology. High quality systematic reviews seek to: Identify all relevant published and unpublished evidence; select studies of reports for inclusion; assess the quality of each study or report; synthesise the findings in an unbiased way; interpret the findings and present a balanced and impartial summary. (Cochrane 2009; Hemingway and Brereton 2009).

This section also points to other initiatives which aim to support health care practitioners in using evidence-based practice by providing overviews, summaries and digests of evidence-based information and best practice.

Bandolier
Bandolier aims to find information about evidence of effectiveness (or lack of it) using information from systematic reviews, meta-analyses, randomised trials and from high quality observational studies. Reviews and studies are summarised and a comments section is included. Relevant content within Bandolier is brought together in a section on diabetes.

Cochrane Library
The Cochrane Library database is an essential resource for finding reliable evidence on interventions such as diagnosis, treatments, aspects of health promotion and the organisation of care. Particularly useful is the Cochrane Database of Systematic Reviews which is now updated monthly. For further information see the section within this resource on the Cochrane Library.

Cochrane Primary Health Care Field: P.E.A.R.L.S. Practical Evidence About Real Life Situations
PEARLS are succinct summaries of Cochrane Systematic Reviews for primary care practitioners. PEARLS from earlier years are available. You can search for specific topics within each year. This page lists P.E.A.R.L.S up to 2009, use the left hand menu to access subsequent years.

Prodigy
Prodigy, formerly known as Clinical Knowledge Summaries (CKS), is aimed at health care professionals working in primary and first-contact care. It provides summaries of evidence-based information and practical ‘know how’ about common conditions managed in primary care. There are sections for diagnosis and management of type 1 diabetes and type 2 diabetes.

NHS Evidence – UK Database of Uncertainties about the Effects of Treatments (DUETs)
UK DUETS has been set up to publish uncertainties about the effects of treatment which cannot currently be answered by referring to reliable up-to-date systematic reviews of existing research evidence. The aim is to help those prioritising research in the UK and to give priority to the information needs of patients, carers and clinicians. Currently there are over 100 identified uncertainties about the effects of treatment for diabetes. UK DUETs does not include unanswered questions about the frequency, causes and diagnosis of health problems.

E-libraries

E-libraries usually enable access to a range of bibliographic databases, which can be used to find journal articles, collections of full text journals and increasingly include e-books. The following are key national e-libraries which can be accessed according to membership and country location.

Royal College of Nursing e-library
Databases include British Nursing Index and CINAHL. Over 700 full text journals and over 300 e-books are available. 

NHS e-libraries
This page within the RCN website describes the NHS e-libraries in the four UK countries.

Databases and clinical queries

You can access databases which will help you find articles relevant to your search via the e-libraries above. For databases available via the RCN e-library see Databases to search.

NHS Education for Scotland: CLEAR: clinical enquiry and response service
CLEAR is part of The Knowledge Network in Scotland. It aims to provide clinicians with summarised evidence relating to aetiology, diagnosis, prognosis and treatment queries about patient care. The service is currently being piloted until October 2011. To ask a question you need to log-in via an NHS Scotland Athens username and password. However questions and answers can be viewed without logging in. To find relevant questions and answers there is a search facility and answers are also arranged according to categories, for example Endocrine, nutritional and metabolic.

Trip (Turning Research into Practice) Database
This is a clinical search tool designed to help health professionals identify high quality clinical practice. See the search tips for guidance on how best to search and note that within your results you are able to filter your search according to different types of resource e.g. evidence based synopses, systematic reviews and guidelines. The Frequently Asked Questions sections tells you more about how content is selected. Other databases related to this are:

Patient information

This is a selection of UK-based websites providing information for people with diabetes.

BBC Health: Diabetes
This site presents information under the following headings: about diabetes; living with diabetes; treating diabetes, research into diabetes.

Diabetes UK
The largest organisation in the UK working for people with diabetes, campaigning and helping people to live with the condition and also funding research. Diabetes UK provides a wide range of information on diabetes both online and in printed format. It also runs the Careline telephone information service.

Equip (Electronic Quality Information for the Public): Diabetes
The Equip website was set up by NHS West Midlands Strategic Health Authority in 2000 in response to Government requirements for improvements in information available to patients. Resources included fulfil certain quality and accessibility criteria, are accredited by NHS West Midlands staff and are regularly checked.

NHS Choices: Diabetes
Information arranged under the following headings: Understanding diabetes; avoiding diabetes; knowing the symptoms of diabetes; being diagnosed with diabetes; treating diabetes; living with diabetes.

Keeping up to date

Diabetes UK: News, updates and alerts
Updates are intended to provide health care professionals with the latest information. Medical alerts include warning and product recalls and the Diabetes Bulletin acts as a news service. These can all be accessed online.

NHS Diabetes membership/forum
Membership is free and is via registration on the website. Members will be consulted on key developments and will be sent information relative to their field as well as the monthly news email briefing and quarterly membership newsletter. A discussion forum is also available to members.

NHS Evidence bulletin - Eyes on Evidence
A monthly e-bulletin which provides updates on new and important evidence and key developments on the NHS Evidence portal. You can subscribe to the Eyes on Evidence e-bulletin.

Royal College of Nursing: Diabetes Nursing Forum Community
Membership of the Forum is available to RCN members and includes regular e-newsletters from the forum to help keep you up to date on practice topics. Each forum also has access to an area on the RCN Discussion Network for exchange of ideas.

The Diabetes Elf
This resource aims to keep users up-to-date with "important  and reliable diabetes research, policy and guidance".  It is managed by an information scientist who has been searching for, appraising and summarising diabetes research evidence as part of his work since 2006. You can sign up to receive regular updates.

References

The items in this reference list are available online and were last accessed on 9 February 2011. Some of them are in PDF format - see how to access PDF files.

Broughton R and Rahtbone B(2001) What makes a good clinical guideline (PDF 406.37KB). London: Hayward Medical Communications (made available on the Bandolier website).

Cochrane Library (2010) About Cochrane systematic reviews and protocols. The Cochrane Library website.

Hemingway P and Brereton N (2009) What is a systematic review? Second edition. Available on the What is...? series website.

Royal College of Nursing (n.d.) More about clinical guidelines. RCN website.