title: A model for predicting the resolution of type 2 diabetes in severely obese subjects following roux-en y gastric bypass surgery

authors: Hayes, Mark Thomas

subjects: mathematical model

abstract: Background Severely obese type 2 diabetics who undergo Roux-en Y gastric bypass surgery have significant improvements in glycaemic control. Little work has been undertaken to establish the independent predictors of such resolution or to develop a predictive model. The aim of this study was to develop a mathematical model and establish independent predictors for the resolution of diabetes. Methods A consecutive sample of 130 severely obese type 2 diabetics who underwent gastric bypass surgery for weight loss from November 1997 to May 2007 with prospective pre-operative documentation of biochemical and clinical measurements was followed up over 12 months. Logistic discrimination analysis was undertaken to identify those variables with independent predictive value and to develop a predictive model for resolution of type 2 diabetes. Consecutive samples of 130 patients with body mass index (BMI)≥35 with type 2 diabetes were selected. One hundred and twenty-seven patients completed the study with a sufficient data set. Patients were deemed unresolved if (1) diabetic medication was still required after surgery; (2) if fasting plasma glucose (FPG) remained >7 mmol/L; or (3) HbA1c remained >7%. Results Resolution of diabetes was seen in 84%, while diabetes remained but was improved in 16% of patients. Resolution was rapid and sustained with 74% of those on medication before surgery being able to discontinue this by the time of discharge 6 days following surgery. Five preoperative variables were found to have independent predictive value for resolution of diabetes, including BMI, HbA1c, FPG, hypertension and requirement for insulin. Two models have been proposed for prediction of diabetes resolution, each with 86% correct classification in this cohort of patients. Conclusions Type 2 diabetes resolves in a very high percentage of patients undergoing gastric bypass surgery for severe obesity. The key predictive variables include preoperative BMI, HbA1c, FPG, the presence of hypertension and diabetic status.

text: A model for predicting the resolution of type 2 diabetes in severely obese subjects following roux-en y gastric bypass surgery Background Severely obese type 2 diabetics who undergo Roux-en Y gastric bypass surgery have significant improvements in glycaemic control. Little work has been undertaken to establish the independent predictors of such resolution or to develop a predictive model. The aim of this study was to develop a mathematical model and establish independent predictors for the resolution of diabetes. Methods A consecutive sample of 130 severely obese type 2 diabetics who underwent gastric bypass surgery for weight loss from November 1997 to May 2007 with prospective pre-operative documentation of biochemical and clinical measurements was followed up over 12 months. Logistic discrimination analysis was undertaken to identify those variables with independent predictive value and to develop a predictive model for resolution of type 2 diabetes. Consecutive samples of 130 patients with body mass index (BMI)≥35 with type 2 diabetes were selected. One hundred and twenty-seven patients completed the study with a sufficient data set. Patients were deemed unresolved if (1) diabetic medication was still required after surgery; (2) if fasting plasma glucose (FPG) remained >7 mmol/L; or (3) HbA1c remained >7%. Results Resolution of diabetes was seen in 84%, while diabetes remained but was improved in 16% of patients. Resolution was rapid and sustained with 74% of those on medication before surgery being able to discontinue this by the time of discharge 6 days following surgery. Five preoperative variables were found to have independent predictive value for resolution of diabetes, including BMI, HbA1c, FPG, hypertension and requirement for insulin. Two models have been proposed for prediction of diabetes resolution, each with 86% correct classification in this cohort of patients. Conclusions Type 2 diabetes resolves in a very high percentage of patients undergoing gastric bypass surgery for severe obesity. The key predictive variables include preoperative BMI, HbA1c, FPG, the presence of hypertension and diabetic status.

year: 2011

title: A dose response study to assess the effects of New Zealand Pine Bark extract on glycaemic responses in healthy participants.

authors: Lim, Wen Xin Janice

abstract: Background: The current estimation of 451 million people diagnosed with diabetes is expected to increase to 693 million by 2045. Plant extracts have been shown to improve glycaemic control in humans. However, evidence is lacking regarding the hypoglycaemic effects of New Zealand pine bark obtained from Pinus radiata trees.

text: A dose response study to assess the effects of New Zealand Pine Bark extract on glycaemic responses in healthy participants. Background: The current estimation of 451 million people diagnosed with diabetes is expected to increase to 693 million by 2045. Plant extracts have been shown to improve glycaemic control in humans. However, evidence is lacking regarding the hypoglycaemic effects of New Zealand pine bark obtained from Pinus radiata trees.

year: 2019

title: Sport in the Waikato c.1897-1974: Narratives of Play, Identity and Belonging

authors: Buckley, Karen

subjects: sport

abstract: Regional identities and allegiances in New Zealand have most often been revealed at sporting events. From the colours worn, the slogans chanted, and even the ringing of cowbells, players, teams and supporters have presented facets of their collective character. This thesis engages with narratives of sport in the Waikato region over a period of eighty years to examine these representations as they produced meanings of sporting activities for local people. Informed by competing ideas about historical truth, the thesis interprets printed media as reconstructions of both recurring events, and belonging and membership, to investigate the place of sport in the region, and to decode the ways these stories of drama and contest contribute to the development of some components of a local identity.
Historically, the area now known as the ‘Waikato’ was part of the Auckland Province. The thesis argues that sport is at the centre of a notion of separation from the urban metropolis, and provided opportunities to demonstrate a growing independence. By examining examples of recurring sporting events such as the annual Ngāruawāhia Regatta, regular Auckland/Waikato rugby matches, Empire and Commonwealth Games participation, and regular lawn bowls tournaments, the place and function of sport in a regional space is able to be, in part, exposed. Uneven, often subtle, changes both in aspects of these events and in the representations of them, reveal underlying tensions and power relationships.
Local, if not exclusive, understandings of the place and role of Māori, and depictions of normative gender roles, are central to the analysis of these relationships. Sport is most often a social activity, and dissection of the newspaper texts has enabled the formation of ideas about the ways sports-men, and sometimes women, are collectively presented and organised. In much of the material used, these men and women are also the most recognisable and celebrated ‘heroes’. Consideration of the role of heroes in the formation of culturally constructed group identities informs the thesis, and the relationships between local sporting participants and groups are also important. Divisions, dissension, and competition for resources are all revealed in the reported activities of sports organisations, and changes in the importance afforded these endeavours are also apparent.
The focussed critical use of a local media source provides a consistent, if sometimes homogenous, group of historical narratives. The inclusion of local club and association histories, often produced with extensive use of newspaper archives, changes the perspective and enables a more nuanced examination of the place of different types of heroes, of gender norms and, most importantly, of the ways sporting organisations see and project themselves as part of the region. The stories they collectively choose to remember and tell are central to this narrative of the place of sport in the Waikato.

text: Sport in the Waikato c.1897-1974: Narratives of Play, Identity and Belonging Regional identities and allegiances in New Zealand have most often been revealed at sporting events. From the colours worn, the slogans chanted, and even the ringing of cowbells, players, teams and supporters have presented facets of their collective character. This thesis engages with narratives of sport in the Waikato region over a period of eighty years to examine these representations as they produced meanings of sporting activities for local people. Informed by competing ideas about historical truth, the thesis interprets printed media as reconstructions of both recurring events, and belonging and membership, to investigate the place of sport in the region, and to decode the ways these stories of drama and contest contribute to the development of some components of a local identity.
Historically, the area now known as the ‘Waikato’ was part of the Auckland Province. The thesis argues that sport is at the centre of a notion of separation from the urban metropolis, and provided opportunities to demonstrate a growing independence. By examining examples of recurring sporting events such as the annual Ngāruawāhia Regatta, regular Auckland/Waikato rugby matches, Empire and Commonwealth Games participation, and regular lawn bowls tournaments, the place and function of sport in a regional space is able to be, in part, exposed. Uneven, often subtle, changes both in aspects of these events and in the representations of them, reveal underlying tensions and power relationships.
Local, if not exclusive, understandings of the place and role of Māori, and depictions of normative gender roles, are central to the analysis of these relationships. Sport is most often a social activity, and dissection of the newspaper texts has enabled the formation of ideas about the ways sports-men, and sometimes women, are collectively presented and organised. In much of the material used, these men and women are also the most recognisable and celebrated ‘heroes’. Consideration of the role of heroes in the formation of culturally constructed group identities informs the thesis, and the relationships between local sporting participants and groups are also important. Divisions, dissension, and competition for resources are all revealed in the reported activities of sports organisations, and changes in the importance afforded these endeavours are also apparent.
The focussed critical use of a local media source provides a consistent, if sometimes homogenous, group of historical narratives. The inclusion of local club and association histories, often produced with extensive use of newspaper archives, changes the perspective and enables a more nuanced examination of the place of different types of heroes, of gender norms and, most importantly, of the ways sporting organisations see and project themselves as part of the region. The stories they collectively choose to remember and tell are central to this narrative of the place of sport in the Waikato.

year: 2016