bluuebunny/crossref_metadata_2025_split huggingface dataset:
Placebo‐controlled trial of guar in poorly controlled Type II diabetes
Authors: Baker Paul 
Published: March 2007

AbstractThis study assessed the acceptability and efficacy of guar mini‐tablets in poorly controlled Type II diabetes. Thirty patients were allocated in a random and single‐blind manner to two months of treatment with placebo or guar, 5 gms three times daily. No patient found guar unpalatable or difficult to take. Gastrointestinal side effects were more frequent in the guar group and were minor and temporary apart from in two patients who had to withdraw from the trial. Fasting plasma glucose and glycosylated haemoglobin (HbA1) were measured and glycosuria assessed semi‐quantitatively by urine testing strips. No significant difference was found between guar and placebo groups, although there was a trend for patients treated with diet alone to improve glycaemic control better than patients taking oral hypoglycaemic drugs in addition. The evidence of this and other trials is discussed.
Diabetic camps for children — effects on control and hypoglycaemia
Authors: Kerr David , Kerr Sara 
Published: March 2007

AbstractEducational holidays provide an opportunity to assess the advice given to parents and diabetic children and provide insight into the difficulties that they face in everyday life. We describe our experience of camping with 43 diabetic children for two weeks. Hypoglycaemia was common but severe nocturnal episodes may be avoided by assessing the blood glucose in the evening and providing extra carbohydrate if the glucose value is less than 4.5 mmol/l at that time. Children describe hypoglycaemic symptoms which may differ from those described in standard textbooks and are predominantly neuroglycopaenic. It was impossible to improve diabetic control using only twice daily blood glucose monitoring. In conclusion, children should be encouraged to increase the frequency of daily blood glucose testing and parents should be provided with alternative methods of assessing diabetic control such as the results of glycosylated haemoglobin measurements.
Clinic screening for peripheral vascular disease in diabetes mellitus: Reliability of history, palpation of pulses and doppler ultrasound examination
Authors: Duarte P M , Young R J , Clarke B F 
Published: March 2007

AbstractA sample of 142 (60 male, 82 female) randomly selected outpatients (94 non‐insulin‐dependent diabetics, 48 insulin‐dependent diabetics) routinely attending a diabetic clinic were carefully assessed for evidence of peripheral vascular disease by history of intermittent claudication, palpation of lower limb arterial pulses and Doppler ultrasound examination of the posterior tibial artery. Palpation of the pulses was as reliable (92.5%) as Doppler examination (90.6%) in establishing the diagnosis. A history of intermittent claudication was found in only 60.4% of patients with clear clinical evidence of peripheral vascular disease. Palpation of foot pulses may be the most efficient way of screening for peripheral vascular disease in the busy diabetic clinic.
Colour vision and blood glucose self‐monitoring in diabetics
Authors: Allwood M C , Tyler Rachel 
Published: March 2007

AbstractThe aim of this study was to assess the ability of diabetic patients to interpret visually‐read blood glucose strips and to assess the value of a simple test to identify patients with colour vision defects who may be unable to correctly interpret these strips. The simplified Colour Vision Test identified patients suffering from red‐green, blue yellow or mixed colour vision defects. Some patients who exhibited red‐green colour vision deficiency were unable to interpret Glucostix correctly, whereas many patients exhibiting a mixed deficiency had difficulty in interpreting both Glucostix and BM‐Test‐Glycemie 1–44 strips. Patients with either no detectable colour vision defect or blue‐yellow colour vision deficiency had no clinically significant difficulty in interpreting either set of strips. Therefore, the use of the Simplified Colour Vision Test has been shown to identify groups of patients with colour vision defects who may be unable to use blood glucose strips. Glucostix should not be given to patients who are found to be red‐green colour blind, and the use of visually‐read blood glucose strips should be avoided altogether in patients with a mixed colour vision deficiency.
Liver function tests after hypoglycaemia in insulin‐dependent‐diabetic patients
Authors: Patrick A W , Fisher B M , Collier A , Howie A F , Frier B M 
Published: March 2007

AbstractLiver function tests were measure in 16 patients with insulin‐dependent diabetes mellitus following controlled insulin‐induced hypoglycaemia (Group A) and in 12 patients admitted to an Accident And Emergency Department in hypoglycaemic coma (Group B). Bilirubin, alanine aminotransferase and aspartate aminotransferase were normal in all patients. Gamma‐glutamyl transferase was elevated in three patients in Group B, of whom two were receiving phenytoin therapy and the third had a history of excessive alcohol consumption. It appears that significant abnormalities of liver function tests are not a common sequel of hypoglycaemia in diabetic patients in the absence of predisposing liver disease.
Lipoatrophy with highly purified insulins and treatment with recombinant human insulin
Authors: Jowett N I , McNally P G 
Published: March 2007

AbstractLipoatrophy at insulin injection sites is a distressing local complication of therapy with conventional insulin preparations. The introduction of highly purified insulins has markedly reduced its occurrence, and intra‐lesional injection of monocomponent porcine insulin is a widely utilised stratagem for reversing these cutaneous changes. We describe a patient who developed insulin‐induced lipoatrophy following treatment with purified bovine insulin (“Neulente”), which actually became worse when treated conventionally with monocomponent porcine insulin (“Mixtard”). This is the first description of successful reversal of insulin‐induced lipoatrophy with biphasic recombinant human insulin (“Humulin M2“).
Documentation of complications of diabetes in a primary care centre
Authors: Hempel R J , Deeb L C 
Published: March 2007

AbstractDiabetes mellitus is a common problem with profound health consequences. Much attention has been directed towards the patient's role in the prevention of the complications of diabetes. The authors reviewed the clinical records of 46 diabetic patients in a Family Practice Residency Program with emphasis on the prevention of diabetic complications from the standpoint of the physician's responsibility. Eye, lower extremity, and renal care were evaluated, along with hypertension since it is an important exacerbating factor in diabetes. Clinic attrition rates were also assessed. Retinal history was recorded for 24% of patients while only 22% were referred to ophthamologists. A urinalysis was obtained in 57% of patients with approximately 25% of those examined having proteinuria. Blood pressure measurements were uniformly recorded although adequate blood pressure control was achieved in only 41% of the study group. Twenty‐eight per cent of patients had recorded evidence of significant lower extremity pathology, yet just 37% had any documentation of a lower extremity examination. The median clinic attendance time was 2.94 months with 43% of patients lost to follow‐up after the first visit. While these data suggest inadequate documentation of the performance of routine measures in the case of diabetes mellitus, they provide a strong incentive for improvement.
Patient evaluation of a pen‐sized glucose meter
Authors: Spivey Rosemary S , Davies Glenys , Matthews D R 
Published: March 2007

AbstractA pensized glucose meter has been developed which uses electrochemistry to give a digital glucose read out 30 seconds after the application of whole blood. We describe here an evaluation of its use among 51 diabetic patients who used the meter at home for two weeks and made duplicate recordings from a finger prick test. The coefficient of variation was 9.2% between duplicate values. The response to a questionnaire suggested that most patients were enthusiastic about this fast and portable method of home blood glucose monitoring.
Some eating habits of Scottish children: Implicaths for the diabetic child
Authors: Johnston Alison , Massie Wendy , Ross Kathleen , Young Eileen , Craig J O 
Published: March 2007

AbstractThe diet of Scottish children is surveyed in terms of the particular foods eaten. There is evidence of improvement in eating habits and some old beliefs seem out‐dated. In the teenage years, however, a deterioration in eating habits occurs. The full implementation of a national dietary policy, as in Norway, is mentioned and reference is made to the education of the individual in dietetics. Recent signs of improvement in the national diet suggest that the diet of the diabetic child is not as far from “normal” as it once was.
Experience with Penject: Comparison of two and four daily insulin injection regimens
Authors: Lakhdar A A , McLellan I , McLaren E H , Neilson J McE 
Published: March 2007

AbstractEighteen insulin‐dependent diabetics, aged 20–45 years, participated in a study comparing twice and four‐times‐daily insulin injection regimens while using Penject, an insulin injection device. After a two month run‐in period on twice‐daily insulin given with conventional syringes they were randomised into either four injections of short‐acting insulin or two injections of mixed short and intermediate‐acting insulins for a six months period using Penject in a crossover fashion.HbAIc, fell over the run‐in period from 7.3 ± 1.9% to 6.7 ± 1.5% HbAIc was lower during the four‐injection regimen at 6.2 ± 1.3%, compared with 7 ± 1.6% during the two‐injection regimen. There was a trend towards lower mean blood glucose values during the four‐injections regimen, reaching statistical significance pre‐dinner (P <0.05) and pre‐lunch (P <0.05). There was no significant change in HbAIc, between the twice‐daily injections regimen and the run‐in period.All patients except one found Penject easy and convenient to use. Four daily injections offered flexibility and better diabetic control, with only four patients needing a longer‐acting insulin at night.
Simple screening tests for detection of microalbuminuria
Authors: Stamp R J , Simpson R D 
Published: March 2007

AbstractTwo screening tests, Albuscreen (Cambridge Life Sciences plc, Cambridge, UK) and Microalbutest (Ames Division, Miles Ltd, Slough, UK), designed for the detection of raised urine albumin concentration in the microalbuminuria range, were evaluated and compared. Both tests detected albumin concentrations greater than 24 mg/I as determined by a quantitative immunonephelometric assay, the Albuscreen test yielding slightly fewer false positive and false negative results and being easier to use. In a preliminary study of 55 diabetic patients, two patients (3.7%) had Albustix (Ames Division, Miles Ltd) positive proteinuria. In patients whose urine samples were Albustix negative and who successfully fulfilled the protocol requirements, four of 51 patients (7.8%) had microalbuminuria with albumin exretion rates greater than 30 μg/min, and a further seven patients (13.7%) had albumin excretion rates within the range 12–30 μglmin, indicating possible early diabetic nephropathy. Those patients with overnight albumin excretion rates greater than 30 μg/min had albumin: creatinine ratios (albumin mg/I creatinine mmo/I) greater than 3.5 and random urine albumin concentrations greater than 24 mg/I, suggesting that these findings might predict microalbuminuria. A further study on a larger diabetic population is needed to determine the reliability of simple screening tests applied to random and first morning urine samples for predicting raised overnight albumin exretion.
Improvement of recurrent diabetic ketoacidosis due to danazol
Authors: Davis S N , Stephenson P 
Published: March 2007

AbstractRecurrent diabetic ketoacidosis (DKA) is a serious problem for the patient and the attending health care team. We report the first ease of Danazol (Winthrop Laboratories, Guildford, UK), a synthetic derivative of ethisterone to improve this condition.
The Stoke Mandeville diabetes record system ‐effective management and teamwork without a computer
Authors: Brown L A , Brown R S , Chiverton N A , Green J E , Hull R P , Knight A H , List M E , Mayon‐White V A , McGough N I , Stratford J , Thackray J , Turner E V 
Published: March 2007

AbstractA complete purpose‐designed diabetes record system was introduced for the hospital‐based diabetes service at Stoke Mandeville in 1982. It seeks to overcome many of the deficiencies inherent in hospital records and has proved effective, easy to use, and inexpensive. Even in its original form it has been flexible enough to accommodate new ideas and alterations in working practice, but further refinements were made for its second edition (January 1988). The record system itself has provided a valuable infrastructure for coordinating the activities of the multidisciplinary team working in the continually changing situation of our developing District Diabetes Centre (Ref 1). This system, with minimal local modification, has now been successfully introduced into three other NHS districts.
Assessment of glycaemic control in the diabetic clinic
Authors: Gill G V , Huddle K R 
Published: March 2007

AbstractWe assessed the value of home urine glucose monitoring, home blood glucose monitoring, and clinic random blood glucose (RBG) level in measuring overall glycaemic control in a group of 66 Type 1 diabetic patients. Each parameter was compared with the glycosylated haemoglobin (HbA1) level for each patient.Both home urine and blood testing measurements showed no relationship with HbA1. RBG levels reflected HbA1 only at the lowest (0‐5.0 mmoyl/l) and highest (>30.0 mmoyl/l) levels of RBG (mean HbA1 for these groups 7.9±1.8% and l2.0±2.2% respectively, p<0.00l). Home monitoring results, and clinic RBG levels, may be useful in individual cases; but they must be used with caution to assess average glycaemic control.
Self monitoring of capillary blood glucose in diabetic pregnancy
Authors: McCance D R , Hadden D R , Traub Ai , Harley J M G 
Published: March 2007

AbstractHome monitoring of capillary blood glucose is now a well‐established feature of pregnancy in the diabetic woman. We have analysed the data from 48 pregnancies to determine if reasons could be found why some mothers achieved better blood glucose control than others.A mean weekly pre‐prandial blood glucose was calculated for each week from the date of first booking (from the estimated date of conception in some).No difference in age, weight, age at onset of diabetes or duration of diabetes was found between those diabetic mothers who achieved excellent (all weekly means <6 mmol/l), intermediate, or only fair blood glucose control (weekly mean blood glucose >6 mmol/l on more than six of the weeks monitored). The blood HbA1 values related best to mean capillary blood glucose in the third trimester but were always lowest in those with excellent mean blood glucose values. Insulin resistance is increased during both normal and diabetic pregnancy: a calculated “insulin‐resistance” factor (ratio of mean total insulin dose to mean capillary blood glucose) showed this to be higher in the less well controlled patients. This may represent the effect of further insulin resistance due to food intake in excess of requirement, or to the efkfect of the persistent hyperglycaemia itself. Optimum control of blood glucose will not always guarantee a normal fetal outcome, but frequent self‐monitoring has provided the means to assess factors influencing hyperglycaemia in pregnancy.
The use of a multiple injection insulin regimen for diabetic adolescents
Authors: Challener Jill , Barnes N D 
Published: March 2007

AbstractThe treatment of 20 adolescent diabetics (M:F 9:11, age range 10‐18 years) was changed from twice daily injection of short and intermediate acting insulin to a multiple injection regimen of a long acting insulin to a multiple injection regimen of a long acting insulin zinc suspension (Ultratard, Novo Laboratories, Basingstoke, Hants) once daily, with soluble insulin (Actrapid, Novo) preprandially two or three times daily using a multiple injection device (NovoPen, Novo). The effiects on insulin dose, diabetic control as assessed by glycosylated haemoglobin values and growth were studied after one year. Total insulin dosage was unchanged but the flexibility of the regimen was welcomed and no patients requested to return to a regimen with fewer injections. Symptomatic improvement occurred especially in those who had frequent or severe hypoglycaemic reactions on a twice daily regimen. Mean glycosylated haemoglobin values increased sharply at three months and slightly at six months, but then fell and at one year the mean value was significantly lower than the control value (p<0.0l). Growth rates showed no significant change.The best results were achieved and the injection regimen remained acceptable when the Ultratard was given as a separate injection at bedtime.
Barriers to comprehensive diabetic care in the Northern Region
Authors: Whitford D L , Avery Alison J 
Published: March 2007

AbstractIn mid 1986 a questionnaire on diabetic care was sent to a 50% random sample of general practitioners in the Northern Region of England; 78% responded.A similar questionnaire was sent to consultant diabetologists in the region; 95% responded. There was a high level of support for the concept of shared diabetic care among both general practitioners and consultants, but less evidence of its actual presence.Further development of the diabetes team, district and practice facilities, postgraduate education in diabetes and the concept of shared care is necessary to work towards a system of comprehensive diabetic care in the Northern Region.
Comparison of well‐controlled and poorly‐controlled IDDs in central Liverpool: Are knowledge and attitude to diabetes important?
Authors: Casson I F , Kent Linda , Spibey Peta 
Published: March 2007

AbstractKnowledge of diabetes and attitude to diabetes in well‐controlled (HbA1c<9.0%) and poorly‐controlled (HbA1c >12.1%) insulin dependent diabetics attending the main diabetic clinic at the Royal Liverpool Hospital, were assessed by means of questionnaires. Eighty‐two questionnaires were completed (50 poorly‐controlled). No differences were found between well‐controlled and poorly‐controlled diabetics. Basic clinical data were also collected and it was found that although the two groups had similar age, weight and duration of diabetes, the daily dose of insulin was significantly greater in the poorly‐controlled group (p<0.005).
Influence of shaking vials on insulin mixture concentrations
Authors: Mather H M , Lockwood Diana , Jakobsen Grethe , Kurtz A B 
Published: March 2007

AbstractPatients using insulin mixtures (eg Mixtard 30/70 Nordisk/Wellcome, Epsom, Surrey, England), are taught to shake the vial before withdrawing insulin. It is not known whether inadequate mixing of the soluble and isophane components is a problem in clinical practice. We collected partially‐used Mixtard vials from 79 outpatients, asked them whether, and how, they shook their vials, and measured insulin concentrations in the residual insulin. Values were between 90 and 110 IU/ml in all vials with over 1 ml residual insulin, with a median value of 99.2 IU/ml. Concentrations were not influenced by shaking the vials. Values in vials from four patients who never shook them were >92 lU/ml. However, values in five out of six vials with less than 1 ml residual insulin were markedly lower (42.7 to 77.1 lU/ml). Inadequate mixing is probably not a problem in clinical practice, except when there is less than 1 ml residual insulin.
Accuracy of home blood glucose monitoring in children with insulin‐dependent diabetes mellitus
Authors: Clarke Caroline F , Warren Sheila 
Published: March 2007

AbstractThe accuracy of home blood glucose monitoring was assessed in a group of children with insulin‐dependent diabetes mellitus. Seventy six children each provided a blood sugar profile on filter paper treated with 5% boric acid. Only 42 (55%) of the patients estimated more than half of their readings accurately. Patients using reflectance meters were no more accurate than those using visually read strips. Of the 34 patients in whom the initial results were inaccurate, 15 (44%) showed some degree of improvement after further teaching, but only seven of these patients (21 %) improved to greater than 50% accuracy. This study confirms that diabetic children as a group are not particularly accurate in blood sugar monitoring at home and suggests that a significant number do not improve even with intensive education.
Serum fructosamine and glycosylated haemoglobin in the monitoring of glycaemic control in insulin‐dependent diabetic outpatients
Authors: Watts G F , Morris R W , Goodland F C , Kubal C , Shaw K M 
Published: March 2007

AbstractThis longitudinal study compares serum fructosamine (SF) and glycosylated haemoglobin (HbA1) in assessing glycaemic control in 172 insulin‐dependent diabetic outpatients over a 21 month period. Seven simultaneous measurements of SF and HbA1 were performed in sequential order at intervals of 10 to 12 weeks, during which patients received standard diabetic care. In common with other studies, the between‐subject correlation of SF and HbA1 was confirmed to be satisfactory (r = 0.68, p<0.001). However, the within‐subject correlation between these indices of glycaemic control was found to be of lower order (r = 0.21, p<0.05). This finding reflected the larger percentage variance due within‐subject variance of SF (47%) compared with HbA1 (17%), and was consistent with the shorter biological half‐life of serum albumin compared with haemoglobin. At the end of the study, there was a significant reduction in the SF concentration (mean difference 0.55 mmol/l, SEM 0.04, p<0.001), but not in the HbA1. There was no significant between‐or within‐subject correlation of SF and immunologically determined serum albumin concentration (range 30‐ 54 g/l). We conclude that when monitoring metabolic control in individual insulin‐dependent diabetic patients, SF and HbA1 provide different information on glycaemic status. Since this information may influence patient management, clinical trials should be undertaken to assess the merits conferred by use of either test. For the present we recommend that the measurement of SF and HbA1 be employed additively and not interchangeably in the routine care of the diabetic patient; correction of SF for serum albumin concentration is rarely required.
Diabetes care team treatment improves glycaemic control in dysregulated insulin‐treated diabetic subjects admitted to a diabetes day care unit
Authors: Sundkvist G , Jerntorp P , Ekberg G , Jeppsson J‐O 
Published: March 2007

AbstractThe education and treatment programme of the diabetes day care unit in Malmo, Sweden, was evaluated with regard to metabolic control in 34 poorly controlled insulin‐treated diabetic patients. Three to 12 months before admission and on admission, mean HbA1c was 9.09 ± 0.41% and 9.28 ± 0.35%, respectively, compared to 8.31 ± 0.38% and 8.41 ± 0.36%, respectively, p < 0.05, in 29 out‐patient diabetic controls (reference value:4.00‐5.20%). Despite unchanged mean insulin doses in the patients, glycaemic control improved significantly during the education period, and mean blood glucose decreased significantly (p < 0.001) from 12.8 ± 0.6 mmol/l on the day after admission to 9.2 ± 0.5 mmol/l on the last day before discharge. Six months after discharge from the unit, metabolic control was still improved and mean HbA1c values had been reduced to the level of the diabetic controls (8.11 ± 0.40 and 8.36 ± 0.39%, respectively).An education and treatment programme promoted metabolic control in poorly regulated diabetic patients. An intense education programme, insulin dose adjustments and self‐monitoring of blood glucose contributed to this result.