No abstract

A controlled trial of pen injection of insulin was performed in 78 patients, with assessment of metabolic control and lifestyle. After a 6-week run-in period, during which control was optimized, the patients were randomized, either to stay on a twice daily insulin regimen (n = 37), or to change to a three times daily pen regimen with human ultralente at night (n = 41). Over the 20 weeks, there was no significant change in mean glycosylated haemoglobin (syringe, mean +/- SD, 11.1 +/- 2.5% to 10.9 +/- 2.0%; pen, 11.3 +/- 2.6% to 11.2 +/- 2.0%), in blood glucose profiles or in frequency of hypoglycaemic attacks in either group. A self-completed questionnaire demonstrated high patient satisfaction with the pen injector (NovoPen), 78% for effect on lifestyle and 81% for increased flexibility. Ninety-five percent preferred the pen injector regimen to conventional treatment and stayed on it.

Although the health benefits of greater fruit and vegetable (FV) consumption are well known (1) , a large proportion of the UK population fails to meet the recommended intake of at least 5 portions per day (2) . Personalised (or tailored), web-based nutritional interventions are becoming a popular strategy for improving FV intake but the effectiveness of such web-based interventions in increasing FV intake remains unclear. The objective of the present study was to conduct a systematic review and meta-analysis of randomised controlled trials (RCTs) which tested the effect of personalised, web-based nutritional interventions on FV intake.Seven databases (ASSIA, CAB Abstracts, IBSS, Medline, Psych Info, Scopus and Embase) were searched using the following criteria: 1) RCTs; 2) tailored versus non-tailored advice; 3) web-based interventions; 4) dietary-related outcomes; 5) adult participants ≥ 18 years. Data were pooled as weighted mean difference (WMD) and analysed using a random effects model.Nine studies were conducted in United States and the remaining studies in the Netherlands, Australia and Belgium. The mean age of participants in the studies ranged from 27·4-61·2 years. Pooled analysis of 13 studies (n = 5,465 participants) showed that webbased personalised interventions were more effective in increasing FV consumption (Fig 1. WMD: 0·41 serving portion per day [95% CI: 0·22 to 0·61]; p < 0·0001) than non-personalised advice.These results suggest that the use of web-based, personalised interventions could be a more effective strategy for increasing FV consumption in the adult population, than non-personalised advice.