British Journal of Diabetes最新文献

{"title":"glimpse at the 83rd Scientific Sessions of the ADA","authors":"Caroline Day","doi":"10.15277/bjd.2023.428","DOIUrl":"https://doi.org/10.15277/bjd.2023.428","url":null,"abstract":"","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":"36 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139176163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PCSK9 inhibitor therapy: delayed-onset cutaneous reactions","authors":"Shahid Bukhari, Aikaterini Theodoraki, Emily Ward, Edson Nogueira, Michael Feher","doi":"10.15277/bjd.2023.419","DOIUrl":"https://doi.org/10.15277/bjd.2023.419","url":null,"abstract":"","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" 6","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138994780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rowan Hillson Inpatient Safety Award 2023: a new online patient flagging system for effective and safe diabetes patients’ follow-up when discharged from hospital","authors":"Shiu-Ching Soo, Jocelyn Garchitorena, Vilma Ramos, Chung Thong Lim","doi":"10.15277/bjd.2023.420","DOIUrl":"https://doi.org/10.15277/bjd.2023.420","url":null,"abstract":"One of the biggest challenges in improving patient safety is identifying them promptly when discharging them from hospital to allow effective planning of follow-ups. Previously, our diabetes team had to undergo a manually laborious pathway to achieve this, thereby risking delays and patient safety, and making poor use of time. When our hospital adopted the new software NerveCentre, we took this as an opportunity to make changes within the system to improve this aspect of diabetes care. NerveCentre initially had minimal diabetes care features. By working closely and meticulously with the company and hospital IT department, we developed a new diabetes ‘dashboard’ in the software that allows all diabetes inpatients to be flagged up effectively to the diabetes team, both upon admission and upon discharge. The dashboard could also hold all the important diabetes information relevant to the patient. This initiative was made possible with a great team understanding of the available resources and which aspects of inpatient diabetes care needed to be improved. We now have a safer and more efficient pathway for following up on diabetes patients upon discharge. This is also evident in our 3-month data: they show a 100% follow-up rate, timely telephone follow-up when required, and that fewer outpatient face-to-face clinic appointments are needed. We received positive feedback from healthcare members and patients. In addition, our initiatives are also easily translatable to other electronic software or adaptable by other hospitals. We are grateful to be winners of the prestigious Rowan Hillson Inpatient Safety Award 2023, and we hope that this will serve as a platform to allow greater exposure of this project idea to other healthcare professionals.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":"58 ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139175050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"factors predicting glucose and weight response to injectable semaglutide (Ozempic): real-world data from the Association of British Clinical Diabetologists’ audit programme","authors":"Tom Crabtree, Karen Adamson, A. Bickerton, A. Evans, S. Phillips, Alison Gallagher, Niels Larsen, Dennis Barnes, K. Dhatariya, Benjamin C. T. Field, Iskander Idris, Robert E. J. Ryder","doi":"10.15277/bjd.2023.418","DOIUrl":"https://doi.org/10.15277/bjd.2023.418","url":null,"abstract":"Background: Previous randomised controlled trials have observed individual differences in response to Glucagon-Like Peptide-1 Receptor Agonists (GLP1RA) according to baseline characteristics such as glycated haemoglobin (HbA1c) and weight. The Association of British Clinical Diabetologists (ABCD) launched a nationwide UK audit in January 2019 to assess the clinical utility, efficacy and safety of injectable semaglutide in routine practice. The aim of this analysis was to investigate associations between baseline characteristics and HbA1c and weight reductions with semaglutide in real-world use.\u0000Methods: Data were extracted from the secure online tool and individuals who had baseline and follow-up data available within a defined 6 (3-9) month window were included. Variables were assessed as both continuous variables and categorical variables in a multivariate regression model. Missing data were multiply imputed.\u0000Results: In total, 620 individuals were included. Baseline characteristics: (mean±SD) age was 58.7±10.7 years, HbA1c 81.6±18.5 mmol/mol (9.5±1.7%), weight 108.2±24.2 kg and body mass index (BMI) 37.6±7.6 kg/m2. Median diabetes duration was 11.2 years (IQR 6.6-16) and 50.5% (313/620) of subjects were male. The median follow-up time was 0.5 years. HbA1c reduced by 14.9 mmol/mol (95% CI 13.5, 16.1) [-1.4% (95% CI - 1.2, -1.5)]; p<0.001; and weight reduced by 4.2kg (95% CI 3.6, 4.8; p<0.001). Higher HbA1c, younger age and GLP1RA naïvety were associated with larger HbA1c reduction. Higher baseline weight/BMI and GP1RA naïvety were associated with larger weight reduction.\u0000Conclusion: In this real-world study, baseline HbA1c and weightwere important predictors of HbA1c and weight reduction outcomes following initiation of semaglutide in routine clinical practice. Our data mirror existing randomised controlled trial data, but further evidence is being collected over a longer follow-up period.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" 19","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138994679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropathic diabetic foot ulcers in the elderly: clinical outcomes and healing","authors":"Peter Lamont, Helena Meally, Emma Drydon, David A Russell, Anjali Santhakumar","doi":"10.15277/bjd.2023.414","DOIUrl":"https://doi.org/10.15277/bjd.2023.414","url":null,"abstract":"There is little evidence on healing outcomes of neuropathic foot ulcers in elderly patients. Aims: To determine the healing rates of neuropathic diabetic foot ulcers at 12 and 24 weeks achieved by standard care provided at an established multidisciplinary diabetes foot clinic in patients aged 65 years and above. Data on the incidence of falls and hypoglycaemia were also collected due to their perceived clinical risk in the group studied. Methods: This was a retrospective observational study looking at clinical outcomes of neuropathic foot ulcers. Patients aged 65 years or more presenting with a non-infected neuropathic ulcer at the time of their initial review were identified and classified into two groups: Group E patients were aged above 80 years and Group Y patients 65-80 years. Results: A total of 97 patients, presenting with 106 ulcer episodes, were identified. Mean HbA1c was 60 mmol/mol in Group Y and 55 mmol/mol in Group E. Healing rates of all ulcers at 12 and 24 weeks in the elderly group lagged behind rates in the younger group (67.6% at 12 weeks and 73% at 24 weeks in Group E vs. 78.2% at both intervals in Group Y). The elderly group had more falls, 11% vs. 2% in Group Y. In all, 50% of the falls in Group E were attributed to their prescribed pressure relief (off-loading) devices. Conclusions: With standard foot care given in a multi- disciplinary foot service, neuropathic diabetic foot ulcers can heal in the elderly despite their age-related skin changes. The rate of healing of neuropathic ulcers noted in our study provides a benchmark for healing outcomes and enables comparison with other age groups and centres. Our study identifies a risk of falls associated with off-loading devices and highlights the need for structured falls risk and mobility assessments in this group.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":"37 3","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139176145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ABCD 2023 winning poster","authors":"Scott C MacKenzie","doi":"10.15277/bjd.2023.423","DOIUrl":"https://doi.org/10.15277/bjd.2023.423","url":null,"abstract":"","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":"62 ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139175702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When is HbA1c useful and what do the numbers mean – do they help or hinder?","authors":"S. Manley, Samiul Mostafa, Jonathan Webber, Kavitha D Ganapathy, Roy Taylor, Randie R Little, Rajeev P Raghavan, Craig Webster, Alison Barratt, R. Round, Irene Stratton, Andreas Karwath, John A. Williams, Georgios V. Gkoutos, G. Roberts, Sandip Ghosh","doi":"10.15277/bjd.2023.417","DOIUrl":"https://doi.org/10.15277/bjd.2023.417","url":null,"abstract":"Background: Glycated haemoglobin (HbA1c) measurement is used for diagnosis, management and remission of type 2 diabetes (T2DM), with measurements comparable worldwide and the World Health Organization listing medical conditions that affect its accuracy. Admission glucose is in the ‘diabetes’ range in 5% of emergency hospital admissions without prior diagnosis, with literature searches indicating inconsistent practice on using HbA1c to confirm diagnosis. As oral glucose tolerance tests (OGTT) were not possible during the COVID-19 pandemic, guidance was issued by the Royal College of Obstetrics and Gynaecology on using HbA1c for gestational diabetes mellitus. Aims: This study explores use of HbA1c at Queen Elizabeth Hospital Birmingham, a large university hospital serving a multi- ethnic adult population. Methods: Information is presented on comparability, clinical audits, research studies and current practice, and is illustrated by case reports. Results: Data from the National Glycohemoglobin Standardization Program show comparability of laboratoryHbA1c and point-of-care testing methods from 1993 to 2023. Although HbA1c was used to diagnose gestational diabetes during the COVID-19 pandemic, hospitals have reverted to OGTT post pandemic. In contrast, HbA1c is now being used to assess T2DM remission. Case reports illustrate these scenarios and highlight the complexity of decision-making when the accuracy of the HbA1c reading is affected by multiple co- morbidities. Conclusions: This wider use of HbA1c includes remission of T2DM but the diagnosis of gestational diabetes has reverted to OGTT post pandemic. A pictorial representation of HbA1c range is presented to aid understanding of this test. It is suitable for diagnosis of diabetes in most people except those with some variant haemoglobins or abnormal red blood cell turnover.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":"85 ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139175439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Snippets from EASD 2023","authors":"Caroline Day","doi":"10.15277/bjd.2023.427","DOIUrl":"https://doi.org/10.15277/bjd.2023.427","url":null,"abstract":"","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":"35 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139175856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"association of dietary acid-base load with psychological disorders, sleep and circadian rhythm among obese and overweight women: a cross-sectional study","authors":"A. Mirzababaei, Sanaz Mehranfar, Farideh Shiraseb, Faezeh Abaj, Sara Hajishizari, Cain C.T. Clark, K. Mirzaei","doi":"10.15277/bjd.2023.425","DOIUrl":"https://doi.org/10.15277/bjd.2023.425","url":null,"abstract":"Background: Epidemiological studies have reported that dietary acid load is associated with psychological disorders through different pathways. We aimed to examine the association of dietary acid-base load with psychological disorders, sleep and circadian rhythm. Methods: This study was performed on 404 female subjects aged 18 years and above. We evaluated potential renal acid load (PRAL) and net endogenous acid production (NEAP) score by a validated food frequency questionnaire (FFQ) for Iran which contained 147 items. To assess psychological disorders, an Iranian validated version of the depression, anxiety and stress scale (DASS-21) was used. The Pittsburgh Sleep Quality Index (PSQI) and morning-evening questionnaire (MEQ) were applied to evaluate sleep quality and circadian rhythm status, respectively. Results: After adjustment for a wide range of confounding variables, a significant positive association was observed between dietary acid-base load and severe depression (ORPRAL=1.10, 95% CI=1.01-1.19, p=0.02 and ORNEAP=2.46, 95% CI=1.41-14.61, p=0.02). Women in the high dietary acid base load category had higher anxiety (ORPRAL=1.12, 95% CI=1.02-1.23, p=0.01 and ORNEAP=1.80,95% CI=1.12-10.72, p=0.01). There was a strong positive relationship between dietary acid-base load and sleep disturbance (p<0.05). Additionally, circadian rhythm assessment showed that those with greater commitment to PRAL had 23% higher risk of being completely evening type, while the odds of being completely morning type were decreased by 15% and 12% across higher adherence to PRAL and NEAP. Conclusion: Women with higher dietary acid-base load score had greater odds for depression, anxiety, psychological distress, sleep disturbance and evening-type circadian rhythm compared to lower ones.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":"36 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139173134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of race/ethnicity on the clinical outcomes of people with type 2 diabetes admitted to hospital with COVID-19: an observational multi-national analysis","authors":"E. Wilmot, S. Wild, Y. Ruan, S. Hadjadj, M. Wargny, Myia S. Williams, P. Saulnier, Xu Zhu, R. Ryder, R. Pekmezaris, M. Marre, Ben Field, P. Narendran, Sophie Harris, J. Gautier, D. Patel, K. Várnai, J. Davies, R. Roussel, R. Rea, P. Gourdy, B. Cariou, Alyson K. Myers, K. Khunti","doi":"10.15277/bjd.2023.411","DOIUrl":"https://doi.org/10.15277/bjd.2023.411","url":null,"abstract":"Aims: To describe the relationship between race/ethnicity and adverse outcomes related to coronavirus disease 2019 (COVID-19) in adults with T2DM admitted to hospital in the UK, France and USA.\u0000Methods: Study data from the UK ABCD nationwide COVID- 19 audit, the French CORONADO nationwide initiative and the USA AMERICADO multi-centre study were analysed to assess the association between race/ethnicity and severe COVID-19. Severe COVID-19 was defined as death in hospital and/or admission to the intensive care unit (ICU). Logistic regression models were used to generate age-adjusted odds ratios.\u0000Results: Data from 3,471 patients in the ABCD audit, from 2,451 CORONADO patients and from 9,321 AMERICADO patients admitted with COVID-19 and T2DM were analysed. Race/ethnicity data were available for 3,410 (98%), 2,173 (89%) and 8,893 (95%) patients, respectively. In the UK ABCD audit cohort, Asian and Black race/ethnicity were associated with an increased risk of death/ICU admission compared to White when adjusted for age and sex (OR 2.14; 1.38-3.29 and OR 2.09; 1.17-3.74, respectively). When adjusted for additional confounders the association was stronger (Asian OR 2.88; 1.72-4.82 and Black OR 2.20; 1.12-4.30). In the CORONADO cohort Middle Eastern/North African race/ethnicity was protective against death/ICU admission (OR 0.57; 0.36-0.91).\u0000There was no association between ethnicity and death alone in the AMERICADO dataset.\u0000Conclusion: In those with T2DM admitted to hospital with COVID-19, a non-White race/ethnicity was associated with higher risk of death/ICU admission in the UK ABCD data but not in French CORONADO or USA AMERICADO datasets. Further research is required to improve our understanding of the observed discrepancies in outcomes.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":" ","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46018399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}