bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimating the prevalence of diagnosed diabetes in a health district of Wales: the importance of using primary and secondary care sources of ascertainment with adjustment for death and migration
Authors: Morgan C. LL. , Currie C. J. , Stott N. C. H. , Smithers M. , Butler C. C. , Peters J. R. 
Published: March 2003

Summary Aims To determine diagnosed diabetic prevalence within our district (population 434 398) in 1996 using data from two sources. Methods A general practice audit comprising data on patients with diabetes from 61 (82%) of 74 general practices was linked to a record linkage‐derived patient index in which data from secondary care and other sources underwent a process of probability matching to identify records relating to the same patient and to flag those with diabetes. By linking this dataset to a mortality dataset, patients known to have died before 1996 could be excluded. Age and sex‐stratified emigration rates were applied to those identified by the hospital dataset for each year from 1991 onwards. Results A total of 386 988 residents (89.1%) were listed with a general practitioner participating in the audit, of whom 6050 patients were identified as having diabetes in 1996; a prevalence rate of 1.56%. From the hospital‐based source, 7639 patients were identified who were alive in 1996, a period prevalence of 1.76%. By combining the two sources, and extrapolating the general practice audit to the population as a whole, a total of 10 530 patients were identified of whom 8735 were confirmed as still resident within South Glamorgan during 1996. This represented a period prevalence of between 2.01% to 2.42%. By applying age and sex‐stratified migration rates to the diabetic population identified by hospital sources, a diagnosed diabetic population of 10,004 was identified, a prevalence of 2.3%. Conclusions This study demonstrates that to calculate the true prevalence of diagnosed diabetes from health sources, it is necessary to use both primary and secondary care sources.
Clinical profile of diabetic foot infections in south India – a retrospective study
Authors: Vijay V. , Narasimham D. V. L. , Seena R. , Snehalatha C. , Ramachandran A. 
Published: March 2003

Summary Aims The aim of the study was to determine the profile of diabetes foot infections in south Indian diabetic subjects. The causative factors for delayed wound healing and the recurrence of infection were also studied. Methods During a period of 6 months, 374 patients who had undergone some surgical procedure for foot infection were available for follow‐up (M : F 227 : 147, mean age 54.9 ± 9.4 years, diabetes duration 10.9 ± 7.7 years). All of them had records of clinical and treatment details, laboratory data including biothesiometry, Doppler tests and electrocardiogram (ECG) records. Foot ulcers were classified according to Wagner's classification. Results Majority of the patients had grade II and III ulcers (50% and 26.5%, respectively), grade IV was seen in another 21.9%. The median healing time was 44 days. Recurrence of infection which occurred in 53% was more common in patients with neuropathy and peripheral vascular disease (PVD). Conclusions Recurrence of foot infection was common among south Indian Type 2 diabetic subjects and was related to the presence of PVD and neuropathy. There is also a need for improvement in footwear and foot care education.
Glucagon‐like peptide (GLP)‐1 and leptin concentrations in obese patients with Type 2 diabetes mellitus
Authors: Mannucci E. , Ognibene A. , Cremasco F. , Bardini G. , Mencucci A. , Pierazzuoli E. , Ciani S. , Fanelli A. , Messeri G. , Rotella C. M. 
Published: March 2003

SUMMARY Aims  To assess differences in circulating leptin and glucagon‐like peptide (GLP)‐1 concentrations before and after an oral glucose load, in euglycaemic and isoinsulinaemic conditions, between obese patients with and without Type 2 diabetes mellitus.Methods  Ten male obese (body mass index (BMI) > 30 kg/m2) patients with Type 2 diabetes and 20 matched non‐diabetic subjects were studied. Leptin, GLP‐1(7–36)amide and GLP‐1(7–37) concentrations were measured 0, 30, 60, and 90 min after a 50‐g oral glucose load administered 90 min after the beginning of a euglycaemic hyperinsulinaemic clamp.Results  GLP‐1(7–36)amide concentrations before the glucose load were significantly lower in diabetic patients than in controls (median (quartiles): 50.5 (44.7–53.2) vs. 128.7(100–172.5) pg/ml; P < 0.01), while no difference was observed in baseline GLP‐1(7–37). In non‐diabetic subjects, GLP‐1(7–36)amide and GLP‐1(7–37) concentrations increased significantly after the oral glucose load, while no glucose‐induced increase in GLP‐1 concentration was observed in diabetic patients. GLP‐1(7–36)amide at 30, 60, and 90 min, and GLP‐1(7–37) at 30 min, of the glucose challenge, were significantly lower in diabetic patients. Leptin concentrations were not significantly different in diabetic patients when compared to non‐diabetic subjects, and they did not change after the oral glucose load.Discussion  Leptin concentrations are not significantly modified in obese Type 2 diabetic patients. GLP‐1(7–36)amide baseline concentrations are reduced in Type 2 diabetes; moreover, diabetic subjects show an impaired response of GLP‐1 to oral glucose in euglycaemic, isoinsulinaemic conditions. This impairment, which is not the result of differences in glycaemia or insulinaemia during assessment, could contribute to the pathogenesis of hyperglycaemia in Type 2 diabetes mellitus.
Mydriasis and glaucoma: exploding the myth. A systematic review
Authors: Pandit R. J. , Taylor R. 
Published: March 2003

SUMMARY Aims  To investigate the risk of inducing acute glaucoma following mydriasis.Methods  Systematic review of published research 1933–1999.Results  The risk of inducing acute glaucoma following mydriasis with tropicamide alone is close to zero, no case being identified. The risk with long‐acting or combined agents is between 1 in 3380 and 1 in 20 000. The presence of chronic glaucoma constitutes no additional risk.Conclusions  Mydriasis with tropicamide alone is safe even in people with chronic glaucoma. It should be advised in all patients when thorough retinal examination is indicated.
Prevalence of pernicious anaemia in patients with Type 1 diabetes mellitus and autoimmune thyroid disease
Authors: Perros P. , Singh R. K. , Ludlam C. A. , Frier B. M. 
Published: March 2003

SUMMARY Aims  To determine the prevalence of pernicious anaemia in patients with Type 1 diabetes mellitus and autoimmune thyroid disease.Methods  A randomly selected asymptomatic group of 63 patients with Type 1 diabetes who also had autoimmune thyroid disease was studied. Blood samples were taken and assayed for serum B12. Those subjects with serum B12 concentrations below the reference range had a further blood sample taken for determination of intrinsic factor antibody.Results  One patient had been diagnosed previously to have pernicious anaemia. Three patients had low serum B12 concentration and positive intrinsic factor antibody, confirming the diagnosis of pernicious anaemia. The prevalence of pernicious anaemia in this population with Type 1 diabetes and concomitant autoimmune thyroid disease was 6.3%. In female patients the prevalence of pernicious anaemia was 8.5%.Conclusions  Patients who have both Type 1 diabetes mellitus and autoimmune thyroid disease are at risk of developing pernicious anaemia.
Ethnicity and glycaemic control are major determinants of diabetic dyslipidaemia in Malaysia
Authors: Ismail I. S. , Nazaimoon W. , Mohamad W. , Letchuman R. , Singaraveloo M. , Hew F. L. , Shuguna C. , Khalid B. A. K. 
Published: March 2003

AbstractAims To define the prevalence of dyslipidaemia in young diabetic patients in Peninsular Malaysia and the contributory factors of dyslipidaemia in these subjects.Methods This is a cross‐sectional study involving 848 young diabetic patients from seven different centres, with representation from the three main ethnic groups. Clinical history and physical examination was done and blood taken for HbA1c, fasting glucose, total cholesterol, low‐density lipoprotein (LDL) and high‐density lipoprotein (HDL) cholesterol and triglycerides.Results The overall lipids were suboptimal, worse in Type 2 diabetes mellitus (DM) patients compared with Type 1 DM patients. Of the Type 2 patients, 73.2% had total cholesterol > 5.20 mmol/l, 90.9% had LDL‐cholesterol > 2.60 mmol/l, 52.6% had HDL‐cholesterol < 1.15 mmol/l and 27.3% had serum triglycerides > 2.30 mmol/l. There were ethnic differences in the lipid levels with the Malays having the highest total cholesterol (mean 6.19 mmol/l), and the highest LDL‐cholesterol (mean 4.16 mmol/l), while the Chinese had the highest HDL‐cholesterol (geometric mean 1.24 mmol/l). Ethnicity was an important determinant of total, LDL‐ and HDL‐cholesterol in Type 2 DM, and LDL‐ and HDL‐cholesterol and triglycerides in Type 1 DM. Glycaemic control was an important determinant of total, LDL‐cholesterol and triglycerides in both Type 1 and Type 2 DM. Waist–hip ratio (WHR) was an important determinant of HDL‐cholesterol and triglycerides in both types of DM. Gender was an important determinant of HDL‐cholesterol in Type 2 DM, but not in Type 1 DM. Socioeconomic factors and diabetes care facilities did not have any effect on the dyslipidaemia.Conclusions The prevalence of dyslipidaemia was high especially in Type 2 DM patients. Ethnicity, glycaemic control, WHR, and gender were important determinants of dyslipidaemia in young diabetic patients.Diabet. Med. 18, 501–508 (2001)
Treatment satisfaction and psychological well‐being with insulin glargine compared with NPH in patients with Type 1 diabetes
Authors: Witthaus E. , Stewart J. , Bradley C. 
Published: March 2003

AbstractAims  To assess satisfaction with treatment and psychological well‐being associated with insulin glargine and Neutral Protamine Hagedorn (NPH). Insulin glargine, a new long‐acting insulin analogue, provides constant, peakless insulin release following once‐daily administration and is associated with fewer hypoglycaemic episodes, despite metabolic control equivalent to that achieved with NPH human basal insulin.Methods  The Diabetes Treatment Satisfaction Questionnaire (DTSQ) and Well‐being Questionnaire (W‐BQ) were completed at baseline and at weeks 8, 20 or 28 by 517 patients with Type 1 diabetes participating in a randomized, controlled European trial comparing insulin glargine and NPH. Analysis of covariance was performed on change from baseline scores (main effects: treatment and pooled site; covariate: baseline scores).Results  Treatment satisfaction improved with insulin glargine at all time points, including endpoint, but deteriorated slightly with NPH. These differences were significant throughout the study (change from baseline to endpoint: +1.27 vs. −0.56; P = 0.0001). Outcomes were better with insulin glargine for the DTSQ items, Perceived Frequency of Hyperglycaemia and Hypoglycaemia, with statistically significant differences at week 28 and endpoint for hyperglycaemia (P = 0.0373 and 0.0379) and at week 20 for hypoglycaemia (P = 0.0024). There was no difference in psychological well‐being between the treatment groups, with mean scores increasing in both.Conclusions  Study participants had treatment‐independent improvements in General Well‐being. Advantages for insulin glargine were seen in significantly improved Treatment Satisfaction throughout the study, together with lower Perceived Frequency of Hyperglycaemia than for patients on NPH, without a significant increase in Perceived Frequency of Hypoglycaemia.
The effect of acute hyperglycaemia on appetite and food intake in Type 1 diabetes mellitus
Authors: Russell A. W. , Horowitz M. , Ritz M. , MacIntosh C. , Fraser R. , Chapman I. M. 
Published: March 2003

AbstractAims  To determine the effects of acute hyperglycaemia on appetite and food intake in Type 1 diabetes mellitus.Methods  Two separate studies, each involving eight adults with uncomplicated Type 1 diabetes, were performed: one in the fasted state (A) and the other after a nutrient preload (B). In both studies, perceptions of appetite (hunger and fullness) and food intake at a buffet meal were evaluated during euglycaemia (blood glucose, ∼ 6 mmol/l) and hyperglycaemia (blood glucose, ∼ 14 mmol/l). Both experiments were randomized and single‐blind. In study A, appetite was assessed in the fasted state for 90 min before the buffet meal. In study B, a nutrient ‘preload’ of Ensure® and milk containing 13C‐octanoic acid was consumed 90 min before the meal. Gastric emptying of the preload was quantified with a radioisotopic breath test technique.Results  There was no significant difference in plasma insulin concentrations between euglycaemia and hyperglycaemia in either study. In study A, there were no differences in hunger, fullness or energy intake between the two treatment days. In study B, subjects were slightly less hungry between the preload and buffet meal during hyperglycaemia than euglycaemia (P = 0.04), and tended to have slower gastric emptying during hyperglycaemia (emptying coefficient, 3.89 ± 0.16 vs. 3.57 ± 0.21; P = 0.052), but there was no difference in food intake between hyperglycaemia and euglycaemia.Conclusions  Acute hyperglycaemia suppresses hunger after a nutrient preload, but not in the fasted state, in patients with uncomplicated Type 1 diabetes. This effect is small and not associated with changes in food intake.Diabet. Med. 18, 718–725 (2001)
Phobia of self‐injecting and self‐testing in insulin‐treated diabetes patients: opportunities for screening
Authors: Mollema E. D. , Snoek F. J. , Heine R. J. , Van Der Ploeg H. M. 
Published: March 2003

AbstractAims  To define clinically relevant cut‐off points for severe fear of self‐injecting (FSI) and self‐testing (FST) (phobia) in insulin‐treated patients with diabetes, and to estimate the magnitude of these phobias in our research population.Methods  FSI and FST were assessed in a cross‐sectional survey using the Diabetes Fear of Injecting and Self‐testing Questionnaire (D‐FISQ). A sample of 24 insulin‐treated adult diabetic patients was selected from the high‐scorers on FSI and/or FST (≥ 95th percentile). FSI and FST were re‐assessed, after which patients participated in a behavioural avoidance test (BAT), thereby determining the current level of avoidance of either self‐injecting or self‐testing. FSI and FST scores were linked to the outcome of the BATs. Cut‐off scores for severe FSI/FST were determined and extrapolated to the total study population (n = 1275).Results  Seven patients participated in the self‐injecting BAT: two patients refused to perform an extra injection. In the self‐testing BAT (n = 17) four patients declined to perform the extra blood glucose self‐test. Extrapolation of FSI and FST cut‐off scores to the total research population showed that 0.2–1.3% of the population scored in the severe FSI range. In FST, 0.6–0.8% of the total study population obtained scores in the cut‐off range.Conclusions  Severe FSI and FST, characterized by emotional distress and avoidance behaviour, seems to occur in a small group of insulin‐treated patients with diabetes. The D‐FISQ can be of use to health care professionals (physicians, nurse specialists) in quickly providing valuable information on levels of FSI and FST in diabetes patients.Diabet. Med. 18, 671–674 (2001)
The hospital and home use of a 30‐second hand‐held blood ketone meter: guidelines for clinical practice
Authors: Wallace T. M. , Meston N. M. , Gardner S. G. , Matthews D. R. 
Published: March 2003

AbstractAims  To establish the role of the measurement of β‐hydroxybutyrate (β‐OHB) in distinguishing simple hyperglycaemia from ketosis, and as an indicator of adequate resolution of ketoacidosis, using an electrochemical blood ketone meter. The aim of the study is to assess the accuracy and precision of the meter and to develop clinical guidelines for the use of the ketone meter at home and in hospital.Patients and methods  Twenty patients with poor glycaemic control (mean HbA1c 10.2%) were recruited from the diabetes clinic and 14 patients admitted with diabetic ketoacidosis (DKA) were recruited from two Accident and Emergency Departments. The blood obtained at each routine fingerprick test for glucose measurement was tested for β‐OHB using the ketone meter. Plasma β‐OHB concentrations were also measured on admission using a laboratory enzymatic method.Results  Paired glucose and β‐OHB meter readings (n = 1099) in clinic patients demonstrated that, in the absence of intercurrent illness, β‐OHB levels did not exceed 1 mmol/l, irrespective of glucose readings. In the 14 ketoacidotic patients, the mean plasma β‐OHB concentration, measured in the laboratory, on admission was 7.4 mmol/l (range 3.9–12.3 mmol/l). The median half‐life of β‐OHB was 1.64 h (1st IQR 2.27 h, 3rd IQR 1.34 h). The median time taken, from the initiation of treatment, for β‐OHB concentrations to fall to below 1 mmol/l was 8.46 h (range 5–58.33 h).Conclusion  Near patient blood ketone testing is a useful adjunct to blood glucose monitoring in distinguishing between ketosis and simple hyperglycaemia. The data suggest that β‐OHB levels ≥ 1 mmol/l require further action and levels > 3 mmol/l necessitate medical review. In addition, the rate of fall of β‐OHB in DKA can be used as an indicator of the adequacy of treatment.Diabet. Med. 18, 640–645 (2001)
Obesity, insulin resistance and isolated low high‐density‐lipoprotein cholesterol in Chinese subjects
Authors: Ko G. T. C. , Cockram C. S. , Woo J. , Chan J. C. N. 
Published: March 2003

AbstractAim  Recent studies have shown that the risk of developing coronary heart disease in subjects with ‘isolated low high‐density‐lipoprotein cholesterol (HDL‐C)’ (defined as HDL‐C < 0.9 mmol/l and total cholesterol (TC) < 5.2 mmol/l) was similar to those with hypercholesterolaemia. We examined the prevalence of isolated low HDL‐C in Hong Kong Chinese and its relationship with insulin resistance and triglyceride (TG) level.Methods  Hong Kong Chinese subjects (n = 1493) recruited in a population‐based prevalence survey for cardiovascular risk factors were examined. Insulin resistance was calculated using a computer‐solved homeostasis model assessment method.Results  Of the 1493 subjects, 72 (4.8%) had isolated low HDL‐C, in whom half (n = 36) had TG ≥ 1.7 mmol/l and half (n = 36) had TG < 1.7 mmol/l. Compared with the ‘controls’ (subjects with TC < 5.2 mmol/l and HDL‐C ≥ 0.9 mmol/l; TC ≥ 5.2 mmol/l and HDL‐C < 0.9 mmol/l; or TC ≥ 5.2 mmol/l and HDL‐C ≥ 0.9 mmol/l, n = 1421), subjects with isolated low HDL‐C and high TG were more obese, had higher plasma glucose, fasting and 2 h plasma insulin concentrations and insulin resistance. Subjects with isolated low HDL‐C and TG < 1.7 mmol/l had similar insulin concentrations and insulin resistance, but were more obese than the ‘controls’. Subjects with isolated low HDL‐C and high TG also had higher fasting PG, insulin and insulin resistance than those with isolated low HDL‐C and low TG.Conclusions  In this population‐based study, 4.8% of Hong Kong Chinese had isolated low HDL‐C, which was closely associated with obesity. The coexistence of high TG suggests an insulin‐resistant state.Diabet. Med. 18, 663–666 (2001)
Non‐diabetic relatives of Type 2 diabetic families: dietary intake contributes to the increased risk of diabetes
Authors: Adamson A. J. , Foster E. , Butler T. J. , Bennet S. , Walker M. 
Published: March 2003

AbstractAims  Non‐diabetic first degree relatives of Type 2 diabetic patients are at increased risk of developing diabetes and cardiovascular disease. This is assumed to reflect a shared genetic predisposition. The aim of this study was to test the hypothesis that lifestyle factors, specifically dietary factors, are also important to the increased risk in non‐diabetic relatives.Methods  Dietary intake was assessed using a validated food frequency questionnaire in 149 non‐diabetic first degree relatives (age 20–65 years) from families of North European extraction with two or more living Type 2 diabetic family members, and 143 age‐ and sex‐matched control subjects from the background population with no family history of diabetes.Results Relatives reported higher absolute intakes of total fat (mean (95% confidence intervals) 83 (76–91) vs. 71 (66–76) g/day, P = 0.01), saturated fat (SFA; 39 (36–43) vs. 33 (30–36) g/day, P < 0.01) and cholesterol (391 (354–427) vs. 318 (287–349) mg/day, P < 0.01), and a lower intake of non‐starch polysaccharide (P < 0.05). Considered as percentage of total daily energy intake, relatives had higher intakes of total fat (P < 0.01) and SFA (P < 0.02), and a lower intake of carbohydrate (P < 0.02). These differences remained after exclusion of suspected under‐ and over‐reporters of dietary intake.Conclusions  Non‐diabetic relatives of Type 2 diabetic patients were found to consume diets that will promote rather than prevent the development of diabetes and cardiovascular disease. This suggests that the increased risk to non‐diabetic relatives is therefore not entirely genetic, and there is scope for decreasing the risk through lifestyle modification.Diabet. Med. 18, 984–990 (2001)
Biochemical markers of type III and I collagen: association with retinopathy and neuropathy in Type 1 diabetic subjects
Authors: Arkkila P. E. T. , Rönnemaa T. , Koskinen P. J. , Kantola I. M. , Seppänen E. , Viikari J. S. A. 
Published: March 2003

AbstractAims Connective tissue alterations may contribute to the development of diabetic long‐term complications in eyes, kidneys and peripheral nerves. Collagen deposition may be increased in micro‐ and macrovascular disease in diabetic subjects. We tested whether biochemical markers of type III and I collagen metabolism are associated with retinopathy and neuropathy in Type 1 diabetes.Methods A total of 28 patients, mean age 43.4 ± 9.5 (sd) and duration of diabetes 25.2 ± 9.7 years, were studied. Stereoscopic colour fundus photographs were taken for assessment of retinopathy which was classified as no, background or proliferative. Concentrations of aminoterminal propeptide of type III procollagen (PIIINP), carboxyterminal propeptide of type I procollagen (PICP) and carboxyterminal cross‐linked telopeptide of type I collagen (ICTP) in serum and urinary excretion of cross‐linked N‐telopeptides of type I collagen (NTX) and deoxypyridinoline crosslinks (DPyr) into urine were measured.Results Average serum PIIINP was higher in subjects with proliferative (3.2 ± 1.1 µg/l) than without proliferative retinopathy (2.5 ± 0.6 µg/l) (P = 0.03). Average serum PICP was higher in subjects without retinopathy (181.7 ± 19.5 µg/l) than in subjects with background retinopathy (132.1 ± 42.7 µg/l) (P = 0.02). Concentrations of other collagen markers were not different in subjects with or without retinopathy. No association between collagen markers and neuropathy was found.Conclusions The increased synthesis of type III collagen, reflecting deposition of matrix and basement membrane connective tissue, may be involved in the pathogenesis of proliferative retinopathy in Type 1 diabetic subjects. On the other hand, we observed decreased synthesis of Type I collagen, which can result in weakened vascular integrity in subjects with retinopathy.Diabet. Med. 18, 816–821 (2001)