British Journal of Diabetes最新文献

{"title":"Diabetes mellitus and periodontal disease: education, collaboration and information sharing between doctors, dentists and patients","authors":"Chris Turner, P. Bouloux","doi":"10.15277/bjd.2023.403","DOIUrl":"https://doi.org/10.15277/bjd.2023.403","url":null,"abstract":"People living with diabetes (DM) are at higher risk of developing periodontal disease than those without diabetes. This observation was first recorded in 1928. It is now believed that the risk is 3-4 times greater than for people without DM, and more for smokers. However, many doctors are not aware of this.\u0000DM and periodontal disease are bi-directionally linked, the one affecting the other and vice versa, although the mechanism is not fully understood. Periodontal disease has an adverse effect on glycaemic control. That improves when periodontitis is successfully treated.\u0000Doctors should consider periodontal disease when their patients have persistently high glycated haemoglobin (HbA1c) levels, and dentists should consider diabetes or pre-diabetes when they have patients with unstable periodontitis.\u0000Doctors and dentists, and their teams, need to share results. This paper considers what that shared information should be. A system of red, amber and green for both medical and dental risks is proposed. Until there are reliable methods of information exchanges and a paradigm shift in inter-professional working, patients should obtain their medical and dental results and share them with their respective advisors.\u0000Those patients who do not attend for dental care should be advised by their doctor about the potential benefits of dental screening for periodontitis.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44821513","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":"CRY1 polymorphism may influence the association of low carbohydrate diet (LCD) score on glucose homeostasis in overweight and obese women","authors":"A. Mirzababaei, Farideh Shiraseb, Sara Hajishizari, Mena Farazi, Hadith Tangestani, Leila Khorraminezhad, C. Clark, K. Mirzaei","doi":"10.15277/bjd.2023.402","DOIUrl":"https://doi.org/10.15277/bjd.2023.402","url":null,"abstract":"Background and aims: We sought to examine the interaction between CRY1 genotypes and low carbohydrate diet (LCD) score and the effect on insulin resistance, insulin sensitivity, homeostasis model assessment of insulin resistance (HOMA- IR) and quantitative insulin sensitivity check index (ISQUKI).\u0000Methods: This cross-sectional study was conducted with a total of 228 overweight and obese women. The data related to anthropometric and biochemical measures were collected and a food frequency questionnaire (FFQ), with 147 items, was used to assess dietary intake. Based on the FFQ, we calculated an LCD score for each study participant, ranging from 0 to 70. Biochemical assessments, including TC, HDL, LDL, TG, FBS, insulin and HOMA-IR, were performed. Deoxyribonucleic acid (DNA) samples were assessed to be genotyped for the rs2287161, which was genotyped by the restriction fragment length polymorphism (PCR-RFLP) method. A generalised linear model was performed for interaction analysis.\u0000Results: The results of the study demonstrated that, after controlling for several confounders, increased adherence to an LCD (T3 vs. T1) in the interaction with one risk allele genotype (CG) increases ISQUKI level (β: 0.001, CI: 0.00, 0.002, p=0.041). Also, there was a marginally negative interaction between higher adherence to LCD and two risk alleles genotype (CC) on insulin level (β: -0.012, CI: 0-0.024, 0.001, p=0.054).\u0000Conclusions: This study revealed a negative interaction of CRY1 genotypes with two risk allele and higher LCD adherence on insulin level, and a positive interaction on ISQUKI. However, the mechanism of interaction between LCDs and CRY1 genotypes remains unclear.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2023-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41731475","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":"British Journal of Diabetes (and Vascular Disease): a brief history","authors":"C. Day, Cliff Bailey","doi":"10.15277/bjd.2022.365","DOIUrl":"https://doi.org/10.15277/bjd.2022.365","url":null,"abstract":"","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47342191","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":"Gazing into the future. The next 100 years: the Medtronic perspective","authors":"D. Turner","doi":"10.15277/bjd.2022.376","DOIUrl":"https://doi.org/10.15277/bjd.2022.376","url":null,"abstract":"While it is difficult to predict the next 100 years of development, the current Medtronic product innovation pipeline is changing the lives of people with diabetes. The MiniMedTM 780G system with GuardianTM 4 sensor and extended wear infusion set is the advanced hybrid closed-loop pump system currently available in the UK from Medtronic. It has been clinically proven to achieve >70% time in range and to lower HbA1c levels in people with diabetes. Medtronic continues to innovate in the hybrid closed-loop and insulin pump and sensor area. The company is developing new sensor technology and personalised closed-loop options for future patients. Medtronic recognises that not all people with diabetes will want to use an insulin pump and therefore is launching a Smart MDI system for people looking for more from MDI therapy. The Smart MDI system brings together a collection of tools that provides real-time insights and comprehensive reports. These make it easier for people with diabetes to manage life on multiple daily injections. The system combines predictive glucose management with the GuardianTM 4 sensor, with no finger pricks and personalised high and low alerts up to 60 minutes in advance. Personalised insulin management with the inpen device allows informed insulin dosing with integrated real-time glucose data trends and shareable insight reports. The Medtronic extended-wear infusion set is due to launch in the UK soon. It is focused on improving user experience. It is the only infusion set approved for longer wear (with a wear twice as long as standard infusion sets) without compromising comfort, safety or insulin delivery. This new set will also reduce traditional infusion set plastic waste by half.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43976330","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":"#We don't have to wait any more Closed-loop systems: transforming the landscape","authors":"C. Boughton, R. Hovorka","doi":"10.15277/bjd.2022.374","DOIUrl":"https://doi.org/10.15277/bjd.2022.374","url":null,"abstract":"Hybrid closed-loop systems are transforming the clinical management of T1DM. Large randomised controlled trials of hybrid closed-loop systems have demonstrated safety and efficacy, with significant improvements in glycaemic control compared to control therapy, and there are now several commercially approved hybrid closed-loop systems available in the UK. There is also a growing body of evidence demonstrating the quality of life benefits associated with hybrid closed-loop systems, both for users and also for parents/caregivers and other family members.\u0000We review the clinical evidence supporting currently available hybrid closed-loop systems in the UK and also new systems on the horizon. We discuss the emerging evidence for associated psychosocial benefits of hybrid closed-loop therapy. We also address future challenges around healthcare professional readiness to deliver closed-loop technology and ensuring equitable access across the UK.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44418737","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":"100 years of insulin; 50 years of diabetic life*","authors":"Maggie Loughran","doi":"10.15277/bjd.2022.379","DOIUrl":"https://doi.org/10.15277/bjd.2022.379","url":null,"abstract":"","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46529728","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":"Islet cell transplantation","authors":"Y. Cheah","doi":"10.15277/bjd.2022.364","DOIUrl":"https://doi.org/10.15277/bjd.2022.364","url":null,"abstract":"","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43770648","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":"brief history of the UK Prospective Diabetes Study","authors":"R. Holman","doi":"10.15277/bjd.2022.359","DOIUrl":"https://doi.org/10.15277/bjd.2022.359","url":null,"abstract":"The UK Prospective Diabetes Study (UKPDS) epidemiological findings confirmed that T2DM is not a “mild” disease, with roughly 50% of patients having clinically evident complica- tions at diagnosis, emphasising the need for its early detection and treatment. Hyperglycaemia was identified as an independent coronary heart disease risk factor, with progressive hyperglycaemia shown to be a major pathophysiological feature of T2DM, driven by declining beta-cell function. People with T2DM and hypertension were found to be at double jeopardy for any diabetes endpoint, and worsening kidney function was shown to increase the risk of death substantially.\u0000The UKPDS 20-year trial results were the first to demon- strate that diabetic complications are not inevitable but can be prevented by more intensive blood glucose control and by metformin therapy, changing T2DM management guide- lines worldwide. The UKPDS also showed that tighter blood pressure control prevents diabetic complications; the benefits of the glucose and blood pressure interventions are additive. The UKPDS 10-year post-trial monitoring study was the first to identify the T2DM glycaemic and metformin legacy effects, with early more intensive therapy having continuing benefits long after the trial terminated. The trial demon- strated the need to achieve good glycaemic control as early as possible to minimise the risk of future complications.","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48656482","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":"Reflections on 60 years of caring for people with diabetes","authors":"A. Wright","doi":"10.15277/bjd.2022.362","DOIUrl":"https://doi.org/10.15277/bjd.2022.362","url":null,"abstract":"","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47159379","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":"beginning of the end for insulin? – enter immunotherapy for T1DM","authors":"C. Dayan","doi":"10.15277/bjd.2022.369","DOIUrl":"https://doi.org/10.15277/bjd.2022.369","url":null,"abstract":"Although we have treated type 1 diabetes (T1DM) with insulin for more than 100 years, it has been apparent since the discovery of insulitis in the 1960s and islet cell antibodies in 1974 that T1DM is fundamentally an autoimmune disease, not a metabolic disease.1 Almost all other autoimmune diseases, from inflammatory bowel disease to rheumatoid arthritis, are treated with immunotherapy but not T1DM. In large part this is because of the discovery of insulin: unlike most other autoimmune diseases, a replacement therapy exists for T1DM. As a result, the discovery of insulin can be viewed as both a blessing and a curse. It is a “curse” because most of the major drug companies have developed their large immunotherapy portfolios of drugs for autoimmune diseases other than T1DM, including some such as psoriasis or alopecia areata that might be considered less life-threatening. And it is likely that diabetes practitioners are also partly to blame since they fear immunotherapy since it is a treatment with which they are not familiar. It is important to remind ourselves of the challenges of insulin therapy. It is not a drug without risk: deaths still occur from underdosage (DKA) and overdosage (hypoglycaemia). According to ONS data, in 2021 in England and Wales, 44 people under the age of 50 died of DKA and 154 died of hypoglycaemia.2 Set against this, even despite the introduction of CGM and insulin pumps, fewer than 30% of adults and children with diabetes achieve a target HbA1c < 7.0%, or 53 mmol/mol which obviates the risks of longterm complications.3 Furthermore, insulin management consumes millions of hours of patients and healthcare professional time in training, adjustments, testing and decision-making. Despite this, 36% of children and families continue to need psychological support more than five years after diagnosis (NPDA national audit 2018-2019,3 and up to 50% of adults with T1DM report significant diabetes-related distress. 4 There is a large and expanding world of highly selective immunotherapies that does not include the classic immunosuppressents (e.g. cyclosporin, tacrolimus) used in transplantation. Rather, it includes many drugs known as “biologics” that have been widely used and have been very well tolerated in other autoimmune diseases for more than 20 years. Many are monoclonal antibodies, but small molecule inhibitors such as JAK kinase inhibitors are being introduced.5 At least seven selective immunotherapies have shown efficacy in Phase 2 studies in preserving beta cell function from diagnosis compared to controls.6,7 These treatments reduce progression of the underlying disease process but do not cause regrowth of beta cells. In current clinical practice, T1DM is diagnosed at the time that insulin replacement is required. This is late in the disease course, when it is estimated that more than 80% of functional beta cells have been lost. When selective immunotherapy is given at this stage, some impact on insulin dose (and in some","PeriodicalId":42951,"journal":{"name":"British Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2022-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43790790","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}