Minerva

Baize doors, and other stories . . .

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2325 (Published 17 April 2013) Cite this as: BMJ 2013;346:f2325

Before long, one in 10 human beings will carry the label of “diabetes,” and the world badly needs new ways of reducing the long term risks of this condition, such as coronary heart disease, peripheral vascular disease, blindness, and renal failure. Minerva considers that the human race should have learnt by now that unless an intervention for diabetes can be shown to reduce such events, then it has no place in the arsenal of treatment—and this will inevitably require large, long trials in typical populations. So she reads with dismay in Diabetologia that the majority of current trials in diabetes registered on ClinicalTrials.gov exclude older people, are of short duration, involve drug therapy rather than preventive or non-drug interventions, and do not focus on important cardiovascular outcomes (2013, doi:10.1007/s00125-013-2890-4).

The chief medical officer for England recently warned us about the dangers of a return to the pre-antibiotic era owing to growing resistance to antibiotics, and the lack of any new ones in the development pipeline. …

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