bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of home urine sugar tests: Sensitivity, frequency of use and effect on diabetes control
Authors: Dolan M , Clarke H , Heffernan A , McKenna T J 
Published: March 2007

AbstractThe present study was designed to examine methods of urine sugar testing by comparing the traditional 'tablet' test requiring urine collection and water availability (Clinitest) with a 'dipstick' method (Diabur‐Test 5000). Seventy‐nine patients participated in the study. The patients used each test for three months and the order in which the tests were used was randomly assigned. There was no evidence that either method was used more frequently, or was associated with increased sensitivity for detection of glycosuria, or with improved diabetic control. However, 53 of the 79 patients expressed a preference for use of Diabur‐Test 5000 in the future. The frequent surveillance employed in this study may have obscured a possible benefit of the dipstick method which may operate under routine conditions.
Benefits of BDA educational holidays — chance or design?
Authors: Walker Rosemary , Sharland Virginia 
Published: March 2007

AbstractThe British Diabetic Association (BDA) organises annual educational holidays in the summer for some 800 children with diabetes. The holidays take place mainly in schools and in all parts of the country. They are staffed by volunteers, both medical and non‐medical.This paper was prompted by our experiences as nurses on two holidays, which have proved in no uncertain way what enormous potential there is for serious problems to arise when dealing with a large number of children and staff in unfamiliar surroundings.The intention of the paper is fourfold: firstly to place emphasis on the need for careful forward planning and preparation if the holidays are to achieve their aims; secondly to encourage more people whose work is concerned with diabetes to attend a holiday; thirdly to highlight the greater contribution which could be made to the holidays by the diabetes nurse specialist, since the majority of staff on the holidays know little or nothing about the condition of diabetes; and lastly to invite response from readers who have experience of the holidays, so that this feedback may be used constructively by the BDA in its efforts to ensure that the holidays are of optimum value to all who attend.
Performance of the Reflocheck system used outside the laboratory by trained non‐laboratory personnel
Authors: Burrin J M , Newton‐Adair I , Fyffe J A 
Published: March 2007

AbstractWe have tested the performance of the Reflocheck glucose monitor in both the laboratory and in hospital wards. The Reflocheck performed well in the laboratory (r=0.94, y=0.92 x + 0.64, n = 113). Results from the wards were compared by taking replicate samples onto filter paper for subsequent analysis in the laboratory. However, despite the use of trained nursing staff, 55% of results were outside the ± 20% limits of analytical acceptability. The question is raised as to the robustness and suitability of the Reflocheck system for the measurement of blood glucose outside the laboratory.
Comparison of two new ward‐based glucose meters
Authors: Brodrick J M , Colloby P S , Legg E F 
Published: March 2007

AbstractThe Ames Glucometer II and Boehringer Reflolux II glucose meters were evaluated from the point of view of precision of results, correlation with a reference method, susceptibility to interferences from other monosaccharides and anticoagulants and ease of use. The Boehringer Reflolux II is recommended as the meter of choice.
The role of anticonvulsants, antidepressants and phenothiazines in the management of painful diabetic neuropathy
Authors: Cantrill Judith 
Published: March 2007

AbstractPeripheral neuropathy is often severely disabling and may be the most common complication of diabetes mellitus. It results in a large variety of sensory symptoms, including hypoaesthesia, paraesthesia and severe spontaneous pain. Improved control of hyperglycaemia may be associated with improvement of such symptoms; impaired motor nerve conduction velocity has been improved in newly diagnosed diabetics by the institution of insulin therapy. Specific therapy directed at the presumed pathophysiological basis of neuropathy with aldose reductase inhibitors, is currently being studied. Meanwhile, relief of pain in diabetic neuropathy may require large doses of potent analgesics but even these are not universally effective. Other forms of neurological pain, eg trigeminal neuralgia, have been successfully treated with anticonvulsants, phenothiazines and antidepressants. This article reviews all three classes of drugs in the symptomatic treatment of painful diabetic neuropathy. Although the number and quality of the studies does not permit firm conclusions to be drawn, the currently available evidence suggests that severely affected patients may benefit from a trial of an antidepressant with some patients requiring the addition of a phenothiazine.
Anorexia nervosa and bulimia in diabetics
Authors: Perkins Jane E 
Published: March 2007

AbstractThe percentage of diabetics who suffer from anorexia nervosa or bulimia is not currently known. Two patients with a combination of the conditions are reported. Anorexia nervosa and diabetes mellitus are defined. Similarities between the diseases are discussed and the potentially lethal consequences of the co‐existing diseases are emphasised. The available literature is reviewed. It is postulated that, due to under‐reporting, the incidence of the conditions is greater than is known and that it may not always be recognised.
Intravenous fluid therapy and heart failure in uncontrolled diabetes of the elderly
Authors: Horrocks P M , Wright A D , Nattrass M , Fitzgerald M G 
Published: March 2007

AbstractFluid balance and the prevalence of heart failure have been analysed in a group of patients over 75 years of age, and a group of patients under 40 years of age presenting with severely uncontrolled diabetes. Though the total volume of fluid given was significantly lower in the elderly, the net retention of fluid was similar in the two groups, implying a smaller urine output in the elderly. Despite the lower volume of fluid given, signs of heart failure were detected in 17 of 44 episodes (39%) in the elderly compared to only 1 of 50 episodes in the young. Even greater caution is required with fluid replacement in elderly patients with uncontrolled diabetes.
Community diabetic clinics and the diabetes specialist nurse
Authors: Honey Teresa , Mather H M 
Published: March 2007

AbstractCommunity clinics run entirely by a diabetes specialist nurse have been established in Southall, in response to the high prevalence of diabetes within the Asian community. These have proved popular with patients and general practitioners. In an audit of 102 patients, the treatment had been altered by the nurse in 51 patients (11 on insulin and 40 on oral hypoglycaemic therapy), 13 had been referred for antihypertensive treatment, eight for chiropody, and six with abnormal fundi for further assessment. Two of the latter patients had severe maculopathy and were referred for consideration of laser therapy. Suitably trained diabetes specialist nurses may play an increasingly important role in diabetes care within the community.
Pyoderma gangrenosum and finger‐tip ulceration in a diabetic patient
Authors: Cox N H , Dufton P A 
Published: March 2007

AbstractWe report details of a diabetic patient who developed pyoderma gangrenosum following cholecystectomy, and subsequently developed ulceration of the thumb at the site of finger‐prick for capillary glucose monitoring. Although the latter was thought to be due to viral infection, pyoderma gangrenosum may also have been involved as it is associated with impaired immunological function and abnormal cutaneous response to minor trauma. The possible relationship between pyoderma gangrenosum and diabetes is discussed, and also the implications for therapy of the two disorders. The pyoderma gangrenosum resolved with steroid therapy.
Investigation of impotence with particular reference to the diabetic
Authors: Gingell J C , Desai K M 
Published: March 2007

AbstractIt is recognised that the commonest organic cause for impotence is diabetes. It must be appreciated however, that the aetiology of impotence in diabetes can be due to a variety of factors that cover the whole spectrum of impotence. The problem may be primarily neurogenic, vasculogenic or a combination of these factors. In addition, impotence in the diabetic may be contributed to or caused by diuretic or antihypertensive medication, a penile abnormality such as Peyronie's disease or be purely psychogenic. Whatever the possible organic basis for the problem, an additional psychogenic overlay is likely. It is apparent therefore that a comprehensive medical history and specific detailed psychosexual history are required, together with a relevant clinical examination and screening before a likely cause or causes can be identified and appropriate treatment instituted. This cannot readily be undertaken in a busy outpatient department and time must be made available for the impotent patient to be comprehensively counselled in a specially designated clinic.
Assessment of diet adherence in relation to long‐term follow up of non‐insulin‐dependent diabetics
Authors: Holmes J , Atkinson A B , Hadden D R , Kennedy A L , Wilson E A 
Published: March 2007

AbstractA group of 223 newly diagnosed diabetic patients, onset age 40‐69 years, was enrolled in a prospective study of instensive dietary management of diabetes. During a six year period the patients were reviewed by doctor and dietitian at three‐monthly intervals. At each clinic visit the dietitian graded each patient according to dietary adherence. For a subgroup of 172 patients who were managed on diet only for the six year period, dietary compliance is considered in relation to diabetic control. Measurements of weights, insulin, glucose and serum lipids were made at each visit. Among the patients with poor dietary compliance the plasma glucose, insulin, triglyceride and cholesterol levels were significantly higher.
A cheap microcomputer network for diabetic clinic management
Authors: Higgins Elisabeth , Oakley N 
Published: March 2007

AbstractA computer system has been developed for use in a teaching hospital diabetic I clinic. It concentrates on management functions, although the contents of the database can be used in conventional statistical analyses for research purposes.The priorities identified when drawing up the functional specification were: avoidance of extra secretarial demands; multiuser on‐line data entry, elegant letter generation; and a powerful appointments module, operative at the clinic desk. Collection of more than minimal serial data was sacrificed to the interests of simplicity and economy. Over 500 patients have so for been entered into the system. Untrained medical staff have quickly learned to master the clinic entry technique and secretaries check and make appointments without difficulty Questionnaires were completed by patients attending the clinic to evaluate the on‐line data entry arrangements; by local GPs to assess their response to computer‐generated clinic letters; and by medical records officers throughout the country to find out what they felt about an independent clinic appointments system operated by doctors. Replies indicated that the system is well liked by both patients and GPs, and that fears as to the patient acceptability of on‐line systems are groundless. GPs were universally delighted by the speed and precision of communication Medical records officers generally favoured a computerised clinic appointments system but opinions were divided on the question of whether a clinic system could, or should, be independent from the main hospital patient appointment system (PAS) The on‐line appointments system is universally appreciated and it is suggested that this facility should be mandatory in the functional specification for any clinic contemplating computerisation, even if global PAS‐linked appointments systems are promised for future hospital installation.
Quality assessment of visual test strips for home blood glucose monitoring
Authors: Watts G F , Quiney J , Morris R W , Thaker P , Craddock S , Shaw K M 
Published: March 2007

AbstractA quality control filter‐paper method was applied to the assessment of two glucose enzyme reagent strips — Type A and Type B — in the home environment. Forty insulin‐dependent diabetics, experienced in home blood glucose monitoring, took part in a randomised, cross‐over trial. Marked variation was observed in the accuracy of readings with both strips over a wide range of glucose concentrations. Overall, Type B was found to read consistently higher than the reference filter‐paper method, whereas Type A read consistently higher for reference glucose concentrations < 10 mmol/l, but lower for concentrations ≥10 mmol/l. In particular, both strips were equally poor at detecting filter‐paper concentrations in the hypoglycaemic range. Although both strips have been modified since the study was initiated, the principle of quality control is equally applicable to all other currently used and visually read strips. Recommendations are provided for the quality assessment of all reagent strips employed by patients for home blood glucose monitoring.
The use of an algorithm as a simple, practical guide to detect errors in the use of a Glucometer
Authors: Tsang W M , Levitt P E , Howell M J , Griffin H , Miller A L 
Published: March 2007

AbstractBlood glucose meters are now in common use in many hospital wards, in casualty and emergency departments, and also for home‐monitoring of diabetic patients.Recurring problems in blood glucose measurements have been reported, and we present here a simple algorithm to solve the most common errors encountered in the use of the Glucometer II (Ames, Slough UK), with explanations of the expected effects. Some of the checks, eg reagent strips and light window checks, will also be applicable to other blood glucose meters.
General characteristics of a community‐based diabetic population
Authors: Gatling Wendy , Mullee M , Hill R 
Published: March 2007

AbstractAll the known diabetics (917) registered with 40 general practitioners in the Poole area were identified. 842 (92%) attended a review examination conducted by a single observer. 202 (24%) were classified as insulin dependent diabetics (IDDs) and 640 (76%) as non‐insulin dependent diabetics (NIDDs). Mean age at review was 40.8 years for the IDDs and 67.3 pars for the NIDDs. Mean age at diagnosis of diabetes was 25.4 years for the IDDs and 58.9 years for the NIDDs. 333 (39.5%) diabetics were treated with insulin, 340 (40.4%) with oral hypoglycaemic agents and 169 (20.1%) with diet alone. The mean blood glucose and HbA1c for the IDDs were 9.5 mmol/l and 9.5% respectively and for the NIDDs, 9.0 mmol/l and 8.8% respectively (HbAlc normal range 5–9%). Serious retinopathy was found in 8.6% of the diabetics, proteinuria in 6.8% and 18.5% had a history of ischaemic heart disease. This information will be useful to those organising diabetic care services.
Screening for diabetes mellitus using a self‐administered blood spottest mailed for analysis
Authors: Falkenberg M , Schenck H Von 
Published: March 2007

AbstractUsing self‐administered blood sampling on filter paper mailed for analysis of glucose, we evaluated the feasibility of home screening for diabetes mellitus (DM) and impaired glucose tolerance (IGT) in a specific target group, ie all people in a community aged 50–59. Of the 967 subjects we excluded 23 with known DM (2.4%), four with IGT, four having moved and four having died. Of the remaining 932, 688 participated. Fifty‐two people had a postprandial homeblood glucose value exceeding 7.1 mmol/l. Subjecting these to repeated oral glucose tolerance (OGTT) according to WHO 1985 we diagnosed DM in 12 and IGT in five more cases. Thus, for each known diabetic patient there may be another one undiagnosed in the age group studied.
Audit of an education programme for recently diagnosed Type II diabetic patients
Authors: Hampton K K , Bodansky H J , Stickland M , Wales J K 
Published: March 2007

AbstractA structured two session education programme (2 × 2 hours) was introduced for newly diagnosed Type II diabetic patients who were invited to attend within one month of diagnosis. To assess its value, 59 consecutive new patients were divided into attenders (n = 49) and non‐attenders (n=10). At diagnosis, HbA1c was similar in the two groups (median, range); (attenders 12.3% (6.1–15.8) non‐attenders 13.1% (8.9–16.4)) and was significantly reduced in both groups six months after diagnosis; (attenders 7.9% (5.6–12.9), non‐attenders 8.5% (5.7–13.2)). Attenders lost weight during this period, while non‐attenders gained weight (attenders −3 kg (−12‐+3.5), non‐attenders +0.75 kg (−7.9‐+7) p=0.03). Although the initial therapy was diet alone in all 59 patients, at six months significantly fewer attenders required the addition of oral therapy than non‐attenders (20% v 60% p=0.01). All patients were tested after six months with a 17 point questionnaire of knowledge and compliance. Attenders scored higher than non‐attenders (median 85% v 65%, p=0.0003).There was an inverse correlation between age and test score (rs= −0.28, p=0.03) in the whole patient group.It is concluded that attendance at the education sessions improved patients' knowledge about diabetes and led to a reduced dependence on oral hypoglycaemic therapy.
Malignant otitis externa — a serious complication of diabetes mellitus
Authors: Vernham G A , Robinson D , Resouly A , Shaw K M 
Published: March 2007

AbstractThis paper reviews five cases of malignant otitis externa treated in Portsmouth between 1979 and 1986. These five patients constitute all the cases seen in the Portsmouth, South East Hampshire, Chichester and South West Sussex area during the period, indicating the condition to be rare. All cases showed a number of features in common: all were elderly (over 55 years); diabetic; the majority (4:1) being male. In all cases Pseudomonus aeruginosa was cultured from pus exuding from the external auditory canal. Each of the five cases was resident in the Chichester and South West Sussex part of the catchment area. Every case presented with otorrhoea and otalgia and all were treated with a combination of topical and intravenous antibiotics plus intensified diabetic control. Two cases followed ear syringing.Neurological complications seen in this series of patients included facial palsy (three cases), fifth nerve palsy, dysphagia, vocal cord palsy, ataxia and Argyll‐Robertson pupil.
Effect of the NovoPen on glycaemic control and patient independence in diabetics with visual impairment
Authors: Hyer S L , Froyd H E , Kohner E M 
Published: March 2007

AbstractTwelve patients with insulin‐dependent diabetes and visual acuity of 6/12 or worse in the best eye were transferred to three preprandial injections of human Actrapid insulin daily using the NovoPen (Novo Laboratories Ltd, Basingstoke, Hants, England) and a bedtime injection of human Ultratard insulin by syringe. There was a small but significant fall in mean HbAl (%) over the study period (11.4±3.14 at entry: 10.1±2.83 after six months: p<0.05). The NovoPen proved popular with the patients: flexibility in mealtimes was appreciated by all patients, and seven patients felt they were more relaxed about their diabetes. Half the patients felt they were now more active whilst the others were little changed or worse because of further visual deterioration (four patients) or other complications such as neuropathy (two patients). There were no technical problems with the NovoPen but four patients were not sure of getting the correct insulin dose when the cartridge was nearly empty. The NovoPen may be of particular value in visually impaired diabetic patients in whom it may increase patient independence.
Insulin resistance and insulin antibodies: Fact or hallowed fiction?
Authors: Armitage Marry , McCaughey E , Brooks A , Cove D , Betts P , Casey C , Wilkin T J 
Published: March 2007

AbstractIt is commonly stated that insulin antibodies (IA) cause insulin resistance. This is illogical as once insulin binding has reached equilibrium, the daily dose will circulate as free hormone. In order to pursue this question we studied three groups of patients: 30 patients treated with ‘dirty’ beef insulins over many years (Group l), 50 young patients who had received only porcine insulin (Group 2) and 12 patients with clinical ‘insulin resistance’ — requiring more than 150 units of insulin per day (Group 3). Insulin antibody binding was measured in a direct binding IgG class specific ELISA, and plotted against both the total daily insulin dose and the daily dose/kg body weight. Metabolic control did not differ significantly between the first two groups, but mean IA titre was significantly higher (p<0.001), and mean insulin dose significantly lower (p<0.001) in group 1 than group 2. There was no correlation between IA titre and either total daily insulin dose or dose/kg body weight. IA titre in the group with clinical insulin resistance was significantly less than in group 1 (p<0.05). We conclude that insulin antibodies do not cause insulin resistance.
Early warning symptoms of hypoglycaemia in ambulant diabetics
Authors: McLaren E H , Somerville J M 
Published: March 2007

AbstractOne hundred and twenty five insulin‐taking patients and their relatives were asked to list the symptoms which they found most useful in the early recognition of hypoglycaemia. Those reported dared from those mentioned in thirteen text books and patient information books. Early warning symptoms varied with the duration of diabetes. Within the first five years automatic symptoms predominated but thereafter early symptoms were mainly neuroglycopaenic.
Diabetes in school: A study of teachers' knowledge and information sources
Authors: Warne Jennifer 
Published: March 2007

AbstractThis study was designed to investigate teachers' knowledge and sources of information about diabetes and the benefits of diabetes nurse specialists to teaching staff. Of a sample of secondary school teachers in Birmingham, only one third were found to have an adequate overall knowledge of diabetes. Just over one quarter were unaware that a pupil with whom they had contact had diabetes. The report offers suggestions for improvements using a multi‐team approach.
Diabetes mellitus in pregnancy: Implication in developmental abnormalities
Authors: Moley K H , DeCherney Ah , Diamond M P 
Published: March 2007

AbstractAn uncontrolled diabetic state during pregnancy results in serious medical complications to the fetus, occurring both in late gestation (ie hyaline membrane disease, hypoglycaemia) and in early gestation (ie abnormal organogenesis leading to malformations). Whether there are also deleterious effects of diabetes mellitus seen preconceptually, such as anovulation, or in early pregnancy, such as an increased rate of early fetal loss, is controversial. This report examines evidence that the diabetes may contribute to abnormalities in development beginning at these earlier stages of the developmental process.
A study of metabolic control and patient acceptability in adolescent diabetics using the NovoPen
Authors: Jenkins H R , Hinton J L , Williams H , Ansari B M 
Published: March 2007

AbstractA regimen of three injections per day involving the NovoPen (Novo Laboratories Ltd, Basingstoke, Hants, UK) was assessed in eight adolescent diabetics (median age l3.5 years). Six months after the institution of this regimen there was an improvement in metabolic control (assessed by HbA1c measurements) and patient acceptability (assessed by questionnaire). This improvement was maintained for a further six‐month period.