Diabetic Medicine最新文献

{"title":"Diabetic foot disease: Assessing adherence of national acute and screening referral pathways with NICE guidelines","authors":"Amy Jones, Aleksandra Staniszewska, Robert Hinchliffe","doi":"10.1111/dme.15478","DOIUrl":"10.1111/dme.15478","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between glycaemic variability and sleep quality and quantity in adults with type 1 and type 2 diabetes: A systematic review","authors":"Cecilia T. Pham,&nbsp;Aleena Ali,&nbsp;Leonid Churilov,&nbsp;Sara Baqar,&nbsp;Christel Hendrieckx,&nbsp;David N. O'Neal,&nbsp;Mark E. Howard,&nbsp;Elif I. Ekinci","doi":"10.1111/dme.15485","DOIUrl":"10.1111/dme.15485","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Individuals with diabetes frequently encounter sleep disturbances, which can detrimentally impact glycaemic management. We reviewed the relationship between sleep outcomes and glycaemic variability in adults with diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We systematically searched Medline, EMBASE and Cochrane Library (2002-March 2023) for studies evaluating sleep and glycaemic variability in adults with type 1 and type 2 diabetes. Among the 3049 records, 27 met the inclusion criteria (type 1 diabetes studies = 22). Due to methodological heterogeneity, a qualitative analysis was conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most studies measuring sleep quality (5 out 7; 71%) reported a significant association with glycaemic variability in type 1 and type 2 diabetes. Sleep duration was not significantly associated with glycaemic variability in type 1 diabetes, whereas other sleep metrics yielded inconclusive results. Hybrid closed-loop pump interventions (<i>n</i> = 12) demonstrated varying sleep outcomes with improved glycaemic variability. Similarly, sleep interventions (<i>n</i> = 3) consistently enhanced sleep but not glycaemic variability. Limitations included moderate to high risk of study bias, confounders, methodological heterogeneity and limited type 2 diabetes data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A potential association between sleep quality and glycaemic variability exists. However, associations with other sleep metrics remain elusive, with no discernible association between sleep duration and glycaemic variability in type 1 diabetes. Despite advancements in continuous glucose monitoring and ambulatory sleep monitoring, standardised sleep assessment methodologies are lacking in real-world studies. Establishing standard protocols for sleep assessment and defining optimal sleep targets are crucial for meaningful comparisons between studies. Understanding the complex interplay between sleep and glycaemic variability holds promise in improving diabetes management and sleep health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of Freestyle Libre 2.0 in children with type 1 diabetes mellitus and elevated HbA_1c: Extension phase results after a 12-week randomized controlled trial.","authors":"Yongwen Zhou, Benjamin J Wheeler, Alisa Boucsein, Sara E Styles, Bronte Chamberlain, Venus R Michaels, Hamish R Crockett, Anita Lala, Vicki Cunningham, Esko J Wiltshire, Anna S Serlachius, Craig Jefferies","doi":"10.1111/dme.15494","DOIUrl":"https://doi.org/10.1111/dme.15494","url":null,"abstract":"<p><strong>Aim: </strong>To investigate extension phase outcomes with intermittently scanned continuous glucose monitoring (isCGM 2.0) in children with type 1 diabetes mellitus (T1DM) and elevated HbA_1c (7.5-12.2% [58-110 mmol/mol]).</p><p><strong>Methods: </strong>One hundred children with T1DM aged 4-13 years were initially in a 12-week randomised controlled trial (RCT) comparing glycaemic outcomes with isCGM 2.0 (intervention group, n = 49) with self-monitored blood glucose (Control group, n = 51). After the 12-week RCT both groups were offered an extension phase with isCGM 2.0 for another 12 weeks. HbA_1c, CGM metrics, psychological outcomes and device utilization attitudes were measured.</p><p><strong>Results: </strong>After the initial 12-week RCT, 66 participants completed this 12-week extension: 36/49 (73%) and 30/51 (58.8%) from the isCGM/isCGM and Control/isCGM groups, respectively. In the isCGM/isCGM group, time below range 70 mg/dL (3.9 mmol/L) (TBR70) reduced from 10.7 ± 11.3% at baseline to 2.8 ± 2.8% and 2.1 ± 2.4% at 12 and 24 weeks, respectively (p < 0.01 for both 12 and 24 weeks). Glucose test frequency increased from 4.7 (2.7) at baseline to 10.7 (4.6) and 9.2 (4.7) at 12 and 24 weeks, respectively (p < 0.01 for both 12 and 24 weeks). The Control/isCGM group decreased TBR70 from 10.7 ± 7.4% at 12 weeks to 2.9 ± 2.8% at 24 weeks and increased daily glucose test frequency from 3.2 (1.6) to 10.7 (5.4) from 12 to 24 weeks (both p < 0.01). However, HbA_1c and time in range (TIR) were non-significant at 24 weeks in both groups.</p><p><strong>Conclusions: </strong>Extension phase outcomes with intermittently scanned continuous glucose monitoring (isCGM 2.0) in children with T1DM and elevated HbA_1c showed a sustained reduction in hypoglycaemia and increased testing frequency at 24 weeks.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15494"},"PeriodicalIF":3.2,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142805615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OptimAAPP, a smartphone insulin dose calculator for carbohydrate, fat, and protein: A cross-over, randomised controlled trial in adolescents and adults with type 1 diabetes using multiple daily injection therapy","authors":"Tenele A. Smith,&nbsp;Nisha Venkatesh,&nbsp;Kerryn Roem,&nbsp;Jean C. Lu,&nbsp;Emma Netzer,&nbsp;Adrian Medioli,&nbsp;Stuart Szwec,&nbsp;David N. O'Neal,&nbsp;Bruce R. King,&nbsp;Carmel E. Smart","doi":"10.1111/dme.15487","DOIUrl":"10.1111/dme.15487","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To (1) evaluate the efficacy of OptimAAPP, a smartphone insulin dose calculator for carbohydrate, fat, and protein in managing glycaemia compared with carbohydrate counting in adolescents and adults with type 1 diabetes using flexible multiple daily injection therapy (MDI, ≥4 injections/day) and (2) assess user acceptability of OptimAAPP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this free-living trial, participants aged 12–50 years were randomised to use carbohydrate counting or OptimAAPP for meal insulin dose calculation for 3 months, then use the alternate method for 3 months. The primary outcome, time-in-range (3.9–10.0 mmol/L) was measured in weeks 3–4 of each arm using continuous glucose monitoring. The acceptability of OptimAAPP was assessed at end intervention using a purpose-designed questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>An intention-to-treat analysis of 41 participants, mean age 28 ± 12 years and HbA1c 56 ± 10 mmol/mol (7.3 ± 0.9%) found no significant difference in glycaemic outcomes when using OptimAAPP compared with carbohydrate counting including time-in-range (70.5 vs. 67.6%, <i>p</i> = 0.102), above range (24.5% vs. 28.0%, <i>p</i> = 0.068), below range (4.9% vs. 4.4%, <i>p</i> = 0.318), and coefficient of variation (32.2% vs. 33.3%, <i>p</i> = 0.136). There was no severe hypoglycaemia. Participants reported that OptimAAPP was easy to use (79%), and they were confident in giving the recommended doses (82%). Barriers to use were the small food database and the time associated with food entry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In adolescents and adults using flexible MDI therapy, OptimAAPP use did not produce glycaemic outcomes that were significantly different from carbohydrate counting. Participant views of OptimAAPP indicate a high level of acceptability. Increasing the size of the food database will likely enhance the user experience.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fear of hypoglycemia relates to glycemic levels during and after real-world physical activity in adolescents with type 1 diabetes","authors":"Susana R. Patton,&nbsp;Simon Bergford,&nbsp;Robin L. Gal,&nbsp;Peter Calhoun,&nbsp;Mark A. Clements,&nbsp;Jennifer L. Sherr,&nbsp;Michael C. Riddell","doi":"10.1111/dme.15482","DOIUrl":"10.1111/dme.15482","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We explore the association between hypoglycaemia fear (FH) and glycaemia during and after exercise sessions in a large sample of physically active youth with type 1 diabetes (T1D).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used data from the Type 1 Diabetes Exercise Initiative Paediatric (T1DEXIP) Study. Youth self-reported on FH using the Hypoglycaemia Fear Survey-Child (HFS-C). They used a smart phone application to self-report food intake and insulin dosing (multiple daily injection only). We collected pump and continuous glucose monitoring data directly from the device.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our sample included <i>n</i> = 251 youth (mean age: 14 ± 2 years, 55% closed loop pump; 42% women). Youth reporting higher <i>HFS-C Total</i> and <i>Helplessness/Worry</i> scores (HFS-C subscale) had slightly fewer competitive and fewer high intensity exercise events compared to youth with lower <i>HFS-C</i> Total and Helplessness<i>/Worry</i> scores. Youth reporting the highest <i>Maintain High Blood Glucose</i> scores (HFS-C subscale) had the lowest percent glucose time in range, higher mean glucose levels, and higher percent time above range during exercise. Youth reporting the highest <i>Maintain High Blood Glucose</i> scores also tended to have higher mean glucose levels post-exercise and a smaller drop in glucose during exercise.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>FH relates to glycaemia during and after exercise in adolescents with T1D and may signal an inclination for some youth to engage in avoidance behaviours to reduce their vulnerability to exercise-induced hypoglycaemia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of attitudes towards and experiences with physician Associates in Diabetes and Endocrinology from a survey of Association of British Clinical Diabetologists members.","authors":"Saika Hussain, Oliver Hope, Ketan Dhatariya, Kate Fayers, Vijay Jayagopal, Hermione Price","doi":"10.1111/dme.15493","DOIUrl":"https://doi.org/10.1111/dme.15493","url":null,"abstract":"","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15493"},"PeriodicalIF":3.2,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility of liver function tests for resolution of metabolic dysfunction-associated steatotic liver disease after weight loss in the Diabetes Remission Clinical Trial","authors":"S. V. Zhyzhneuskaya,&nbsp;A. H. Al-Mrabeh,&nbsp;C. Peters,&nbsp;A. C. Barnes,&nbsp;K. G. Hollingsworth,&nbsp;P. Welsh,&nbsp;N. Sattar,&nbsp;M. E. J. Lean,&nbsp;R. Taylor","doi":"10.1111/dme.15462","DOIUrl":"10.1111/dme.15462","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Ectopic fat is reduced by effective weight management, but difficult to assess clinically.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We evaluated paired data on 42 participants in the intervention group of the Diabetes Remission Clinical Trial (DiRECT) at baseline, 12 and 24 months after weight loss as indicators of liver fat content measured by 3-point Dixon MRI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline liver fat was elevated at 13.0 [7.8–23.3]% with fasting plasma glucose 7.9 [7.1–10.1] mmol/L. Prevalence of baseline MASLD was 86.4%. After weight loss of 11.9 ± 1.2 kg (0–37 kg) at 12 months, remission of MASLD occurred in 74% and liver fat normalised for many (1.8 [1.2–5.2]%; <i>p</i> &lt; 0.0001) as did fasting glucose (5.9 [5.5–7.2] mmol/L; <i>p</i> &lt; 0.0001). Alanine aminotransferase (ALT) and gamma glutamyl transferase (GGT) decreased at 12 months by 38 [19–60]% (<i>p</i> &lt; 0·0001) and 38 [16–53]% (<i>p</i> &lt; 0.0001) respectively. The positive predictive value for decrease in liver fat, with baseline values of &gt;40 IU/L, was 100% for ALT and 87.5% for GGT. As expected, change in liver fat correlated with change in ALT (<i>r</i> = 0.64; <i>p</i> &lt; 0.0001), GGT (<i>r</i> = 0.38; <i>p</i> = 0.013), AST (<i>r</i> = 0.36; <i>p</i> = 0.018), fatty liver index (<i>r</i> = 0.50; <i>p</i> &lt; 0.0001) and hepatic steatosis index (<i>r</i> = 0.44; <i>p</i> &lt; 0.0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Metabolic dysfunction-associated steatotic liver disease, an important marker of ill-health is improved by intentional weight loss. If enzyme levels are raised at baseline, following weight loss, changes in ALT and GGT usefully reflect change in liver fat content, with high positive predictive value. Monitoring liver enzymes can provide a simple way to assess change in liver fat following weight loss in day-to-day clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15462","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the shadows: A qualitative study of fathers' perspectives and experiences of their partner's gestational diabetes mellitus and its implications","authors":"Madeleine Benton,&nbsp;Nabiha Waheed,&nbsp;Khalida Ismail","doi":"10.1111/dme.15488","DOIUrl":"10.1111/dme.15488","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Gestational diabetes mellitus (GDM) affects an increasing number of women each year. Research involving partners of women with GDM, such as fathers is limited, however, understanding their perspectives and involvement in GDM management could enhance health outcomes for both women and their families. This study aims to explore the impact and experiences of GDM on fathers in the perinatal period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Qualitative, individual, semi-structured interviews were conducted with individuals whose partners either currently had GDM or had been diagnosed with GDM within the past 3 years. All participants identified as biological fathers. Data were transcribed and analysed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Nine fathers participated in the study. Analysis resulted in four themes that explored fathers' experiences of GDM during the perinatal period: ‘navigating a GDM diagnosis’, ‘partnering in management and health’, ‘finding a place within the GDM journey’ and ‘the lasting impact of GDM’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Fathers encountered wide-ranging impacts of their partners' GDM. Fathers provided both practical and emotional support to their partners. Engaging fathers in discussions at diagnosis and in management could facilitate the maintenance of positive health behaviour changes postpartum, potentially reducing the risk of type 2 diabetes for both parents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 4","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15488","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucocorticoid treatment and new-onset hyperglycaemia and diabetes in people living with chronic obstructive pulmonary disease: A systematic review and meta-analysis","authors":"Rajna Golubic,&nbsp;Hudson Mumbole,&nbsp;Mouhamad Hussein Ismail,&nbsp;Alwyn Choo,&nbsp;Olivia Baker,&nbsp;Karyna Atha,&nbsp;Sarah Chew Sue Mei,&nbsp;Arjun Raj,&nbsp;Preethu Anand,&nbsp;Nwe Oo Aung,&nbsp;Niraj S. Kumar,&nbsp;Tulika Nahar,&nbsp;Ruth L. Coleman,&nbsp;Jeremy W. Tomlinson,&nbsp;Najib Rahman,&nbsp;Rishi Caleyachetty,&nbsp;Amanda Adler","doi":"10.1111/dme.15475","DOIUrl":"10.1111/dme.15475","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In people living with chronic obstructive pulmonary disease (COPD), we aimed to estimate: (1) the prevalence of glucocorticoid-induced hyperglycaemia (GIH); (2) whether the prevalence of GIH varies by age, baseline diabetes status, treatment duration, ascertainment of glycaemia, definition of hyperglycaemia, study design and year of publication; and (3) the relative risk (RR) of new-onset hyperglycaemia in exposed vs non-exposed to systemic glucocorticoids.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched electronic databases until 9 November 2023 for randomised controlled trials and observational studies including adults diagnosed with COPD, with or without diabetes at baseline, using systemic glucocorticoids equivalent to prednisolone ≥5 mg/day for ≥3 days if exposed. Hyperglycaemia was defined as a blood glucose above a study-specific cut-off. We extracted data on study and participant characteristics, exposure and outcome. We performed random-effects meta-analysis to calculate pooled prevalence estimate of GIH. Prevalence was expressed as the proportion of people who developed hyperglycaemia among all exposed to systemic glucocorticoids during follow-up. We calculated RR of new-onset hyperglycaemia in exposed vs non-exposed to systemic glucocorticoids from eight studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 25,806 citations, we included 18 studies comprising 3642 people of whom 3125 received systemic glucocorticoids and 1189 developed hyperglycaemia. Pooled prevalence of GIH was 38.6% (95%CI 29.9%–47.9%) with significant heterogeneity, <i>I</i>² = 96% (<i>p</i> &lt; 0.010), which was partially explained by differences in study design. Pooled RR = 2.39 (95%CI 1.51–3.78). Publication bias was present.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The prevalence of GIH was 38.6%. Being treated with systemic glucocorticoids for COPD was associated with 2.4 times higher risk of new-onset hyperglycaemia versus no glucocorticoid treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/dme.15475","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for a feasibility and acceptability study for UK general population paediatric type 1 diabetes screening-the EarLy Surveillance for Autoimmune diabetes (ELSA) study.","authors":"Lauren M Quinn, Renuka P Dias, Sheila M Greenfield, Alex G Richter, Joanna Garstang, David Shukla, Animesh Acharjee, Georgios Gkoutos, Richard Oram, Sian Faustini, Olga Boiko, Ian Litchfield, Felicity Boardman, Fatima Zakia, Christine Burt, Clair Connop, Amanda Lepley, Christine Gardner, Colin Dayan, Tim Barrett, Parth Narendran","doi":"10.1111/dme.15490","DOIUrl":"https://doi.org/10.1111/dme.15490","url":null,"abstract":"<p><strong>Aim: </strong>The EarLy Surveillance for Autoimmune (ELSA) study aims to explore the feasibility and acceptability of UK paediatric general population screening for type 1 diabetes.</p><p><strong>Methods: </strong>We aim to screen 20,000 children aged 3-13 years for islet-specific autoantibodies through dried blood spot sample collection at home, hospital or community settings. Children with two or more autoantibodies are offered metabolic staging via oral glucose challenge testing. Feasibility assessments will compare recruitment modalities and uptake according to demographic factors (age, gender, ethnicity, level of deprivation and family history of diabetes) to determine optimal approaches for general population screening. The study is powered to identify 60 children (0.3%) with type 1 diabetes (stage 1-3). Parents are invited to qualitative interviews following ELSA completion (child screened negative or positive, single autoantibody or multiple, stage 1-3) to share their screening experience, strengths of the programme and any areas for improvement (acceptability assessments). Parents who decline screening or withdraw from participation are invited to interview to explore any concerns. Finally, we will interview professional stakeholders delivering the ELSA study to explore barriers and facilitators to implementation.</p><p><strong>Conclusion: </strong>Early detection of type 1 diabetes allows insulin treatment to be started sooner, avoids diagnosis as an emergency, gives families time to prepare and the opportunity to benefit from future prevention trials and treatments. ELSA will provide essential feasibility and acceptability assessments for UK general population screening to inform a future national screening programme for paediatric type 1 diabetes.</p>","PeriodicalId":11251,"journal":{"name":"Diabetic Medicine","volume":" ","pages":"e15490"},"PeriodicalIF":3.2,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}