Practical diabetes international : the journal for diabetes care teams worldwide最新文献

{"title":"Family awareness and the diagnosis of diabetes","authors":"E. Wearmouth","doi":"10.1002/j.1528-252X.1994.tb00023.x","DOIUrl":"https://doi.org/10.1002/j.1528-252X.1994.tb00023.x","url":null,"abstract":"Between 1982 and 1990, 101 children between the ages of one and 15 years were admitted with newly diagnosed insulin‐dependent diabetes (IDDM). Patients with a family history of IDDM or knowledge of diabetes symptoms from other sources (grouped together as ‘family awareness‘) were significantly less acidotic (mean bicarbonate 21.5 vs 18.1 mmol/l) and had a shorter in‐patient stay (10.2 days vs 12.4 days) than those with no such family awareness. However there was no difference in the mean length of symptoms (3.97 vs 3.66 weeks), mean plasma glucose (25.2 vs 26.9 mmol/l) or percentage receiving intravenous rehydration (33.0% vs 36.6%).","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"47 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/j.1528-252X.1994.tb00023.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50683140","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":"In the next issue","authors":"","doi":"10.1002/j.1528-252X.1994.tb00027.x","DOIUrl":"https://doi.org/10.1002/j.1528-252X.1994.tb00027.x","url":null,"abstract":"Discussion The meter iscompact, easy to use, and has a large, clear display. Its construction appears robust and it is stable in use on a flat surface. The provisional instruction booklet supplied was clear and comprehensive, but the final version was not available at the time of this study. The nature of the analytic process with the Glucometer 4 is such that contamination of the optical surface by blood should not be possible. Correctly applied samples should not contact the strip carrier either, but this is easily removable for cleaning ifnecessary. The reagent strips are individually foilwrapped for stability, and the foil packets open easily for use. Sample application has been improved by use of a raised plastic sample cup plus spreading area. Once a small drop of blood contacts this layer it is automatically absorbed onto the reagent pad with no need for the patient to ensure its even application. On two occasions during the initial familiarisation period, the analyst managed to apply the sample in such a way that it formed a film across the top of the cup without contacting the spreading layer. However, this gave an error message rather than a false reading and, with experience, it becomes obvious if this has occurred. Correct sample application can easily be checked by turning the strip over to examine the reagent pad. It is understood that the sample application instructions will now be modified to minimise any chance of this occurring in routine use. Timing of the analytic process is no longer critical and introduction of the reagent strip into the meter is straightforward, such that the measurement process is relaxed compared with usage of previous models. Whilst accuracy and precision goals for laboratory glucose measurement have been derived from biological variation datav (CV<2.2%, zero bias), these standards are not routinely met by over 90% of chemical pathology departments, and it would be unrealistic to expect such performance from small bedside analysers used by untrained staff. The precision data achieved in this study on real patient samples in a clinic setting (overall CVof 6.7% on 145 paired patient samples) would seem to be a significant improvement on previous performance when compared with published data, that attained locally during prior studies, and also that which was measured during this study from the routine meters used in the diabetes clinic. The accuracy goal calculated by Tonk's method? is 10% bias, which is also that stated as desirable by the American Diabetes Association'', This was achieved in 86% measurements made on the new meter during this study, which compares well with 67% on other meters used in the local clinic by the same staff. In fact, 96% of all results obtained on the Glucometer 4 were within 15% of the YSI values and no difference exceeded 20%. Comparison ofthe Glucometer4 results with those obtained by analysis of the plasma fraction of the same sample showed a negative bias of 7%. This expe","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"276 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/j.1528-252X.1994.tb00027.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50683304","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":"Sulphonylurea‐induced hypoglycaemia in elderly people with diabetes","authors":"I. Campbell, J. Chalmers, OM Herlihy","doi":"10.1002/j.1528-252X.1994.tb00019.x","DOIUrl":"https://doi.org/10.1002/j.1528-252X.1994.tb00019.x","url":null,"abstract":"Table. Importantdrug interactions with sulphonylureas Introduction Sulphonylureas are widely prescribed for the management of Type 2 or non-insulindependent diabetes meIlitus (NIDDM). Sulphonylurea-induced hypoglycaemia (SIB) is much less common than insulininduced hypoglycaemia. The incidence of severe SIH with coma has been estimated at 0.19 to 0.25 per 1,000 patient years 1,2 in contrast with insulin-induced hypoglycaemia coma with an incidence of 100 per 1,000 patient years>. However, in everyday clinical practice the prevalence of hypoglycaemic symptoms may be more common. In a recent study from Sheffield, 20% of NIDDM patients treated with sulphonylureas had at least one episode of symptomatic hypoglycaemia in the preceding six months'.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"49 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/j.1528-252X.1994.tb00019.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50683079","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":"Poor home compliance in brittle diabetes","authors":"M. O'Hagan","doi":"10.1002/j.1528-252X.1994.tb00028.x","DOIUrl":"https://doi.org/10.1002/j.1528-252X.1994.tb00028.x","url":null,"abstract":"Glycaemic control in a 10‐year‐old girl with brittle diabetes remained poor during a study comparing two insulin regimens. Blood glucose profiles improved when she was asked to provide blood for insulin profiles, suggesting poor compliance. Greater awareness of poor home compliance with appropriate intervention improves glycaemic stability.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"275 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/j.1528-252X.1994.tb00028.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50683312","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":"Distal revascularisation and the diabetic foot","authors":"G. Sutton, J. Wolfe","doi":"10.1002/j.1528-252X.1994.tb00017.x","DOIUrl":"https://doi.org/10.1002/j.1528-252X.1994.tb00017.x","url":null,"abstract":"The scale of the problem More hospital beds in the United Kingdom are occupied by diabetic patients with foot problems than by patients with diabetes with any of the other complications of diabetes. These foot problems are caused by a combination of neuropathy and ischaemia, which may co-exist and together predispose to development of infection and subsequent tissue necrosis. Without skilled, multi-disciplinary, management these foot problems can easily progress to amputation. The scale of the problem cannot be understated. Twenty per cent of amputees referred to limb fitting centres have diabetes, and a third of all vascular amputations are carried out in people with diabetes. Fifty per cent of these patients with diabetes who lose a leg will lose the other one within five years. These figures are almost certainly an underestimate of the proportion of diabetic amputations as they only refer to patients seen in limb fitting centres: people with diabetes often have other major system disorders including, for example, cardiac or visual problems which may preclude limb fitting. How can this limb loss be averted? Until recently, the ischaemic complications of diabetes were said to be due to so-called 'small vessel disease' and therefore were not amenable to any form of surgical intervention. Indeed, for many years it was taught that if the popliteal pulse was palpable, no form of vascular reconstruction was possible.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"52 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/j.1528-252X.1994.tb00017.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50682456","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":"An audit of diabetes care in three district general hospitals in Cardiff","authors":"C. Hudson, J. Peters, J. Lazarus, P. Beck, A. Sinclair","doi":"10.1002/PDI.1960130115","DOIUrl":"https://doi.org/10.1002/PDI.1960130115","url":null,"abstract":"Our objective was to determine the overall prevalence of diabetes in three district general hospital inpatient populations and to compare the level of diabetes care provided, using a modification of guidelines recommended by the British Diabetic Association. The survey involved completing a standard proforma of all inpatients in the three district general hospitals in Cardiff on two separate occasions. We identified 104 diabetic patients from a total of 1,220 inpatients from the first survey, and 103 diabetic patients from of 1,236 inpatients from the second survey. The data from both groups of diabetic patients were pooled for analysis. \u0000 \u0000 \u0000 \u0000The mean age was 64.8 years with an even sex distribution. The percentage of hospital inpatients who had diabetes was 8.4%. Diabetes was the main cause of hospital admission in 58% of cases, with the majority of patients requiring management of the long-term vascular complications of diabetes. The mean duration of stay of diabetic inpatients at the time of the survey was 16 days. \u0000 \u0000 \u0000 \u0000In more than half of all patients with diabetes, no record of examination of the feet for ulceration (56%) or the lower limbs for peripheral pulses (54%) was found. In 66% of cases, no record of fundoscopy was present and mydriasis was carried out in fewer than 15% of these cases. Visual acuity was not measured in 85% of cases. Measurement of glycated haemoglobin was performed in less than 40% of cases whilst approximately 75% of cases had no measurement of blood lipids recorded. Half of the patients with diabetes had not seen a hospital dietitian at the time of the survey. Only 44% of cases had a specific diabetes follow-up plan recorded. \u0000 \u0000 \u0000 \u0000This audit has identified several important deficiencies in the medical care of patients with diabetes in three district general hsopitals in South Wales. These are considered to be representative of other hospitals in the United Kingdom and this study emphasises the importance of strategies to improve and co-ordinate diabetes care in the secondary sector.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"13 1","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2014-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1960130115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51040280","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 effects of mixing different insulin analogues","authors":"J. H. D. S. N. and, R. Consultant","doi":"10.1002/pdi.1609","DOIUrl":"https://doi.org/10.1002/pdi.1609","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"63 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pdi.1609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025827","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":"Hypertriglyceridaemia in statin‐treated type 2 diabetic patients","authors":"S. Hamilton, G. Chew, T. Davis, B. Stuckey, G. Watts","doi":"10.1002/PDI.1610","DOIUrl":"https://doi.org/10.1002/PDI.1610","url":null,"abstract":"In this cross-sectional study, we investigated the prevalence of hypertriglyceridaemia (hyperTG) in 182 statin-treated type 2 diabetic (T2DM) patients. Predictors of hyperTG (≥2.3mmol/L) were investigated using logistic regression. The prevalence of hyperTG was 20.9%, with lower prevalence in patients with low-density lipoprotein (LDL)-cholesterol <2.5mmol/L (13.7%), and LDL-cholesterol <2.0mmol/L (8.8%). The prevalence of hyperTG plus low high-density lipoprotein (HDL)-cholesterol (≤0.9mmol/L) was lower at 6.0%. The independent predictors of hyperTG were waist circumference (odds ratio [OR] 1.033 [95% confidence interval 1.004–1.063], p=0.027) and glucose (OR 1.30 [1.05–1.61], p=0.01), with glucose being the sole predictor in patients with LDL-cholesterol <2.5mmol/L (OR 1.45 [1.11–1.89], p=0.01) and LDL-cholesterol <2.0mmol/L (OR 1.59 [1.12–2.26], p=0.01). In this group of statin-treated T2DM patients, the prevalence of hyperTG was relatively high, but lower in patients with lower LDL-cholesterol levels. Residual hyperTG in statintreated patients could be addressed by therapeutic lifestyle interventions aimed at weight loss and improved glycaemic control and by further lowering of LDL-cholesterol. Copyright © 2011 John Wiley & Sons. Practical Diabetes 2011; 28(6): 257–260","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"58 6","pages":"257-260"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1610","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025838","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":"Triple-B (basal-bolus-booster) subcutaneous insulin regimen: a pragmatic approach to managing hospital inpatient hyperglycaemia","authors":"N. Perera, A. Harding, M. Constantino, L. Molyneaux, M. McGill, E. Chua, S. Twigg, G. Ross, D. Yue","doi":"10.1002/PDI.1612","DOIUrl":"https://doi.org/10.1002/PDI.1612","url":null,"abstract":"The objective of this study was to introduce a practical insulin protocol for hospital inpatients with hyperglycaemia.The acronym BBB emphasised the insulin supply in three components, basal, bolus (nutrition correction) and booster (blood glucose level [BGL] correction). The insulin dosage was based on patient weight and adjusted to BGL at pre-specified times. Compliance of BGL measurements and insulin injections, and efficacy were evaluated prospectively. Fifty-seven hospital inpatients with significant hyperglycaemia were treated and compared with 45 historical controls (with similar age, HbA1c and diabetes duration) treated with sliding scale insulin (SSI).The BGL (mean±SD) was significantly lower during BBB treatment (11.7±2.6 vs 13.6±2.4mmol/L; p<0.0001), while episodes of hyperglycaemia were less (median: 3 [IQR 1–8] vs 7 [IQR 4–12]; p=0.001). Patients who experienced hypoglycaemia were also less likely to have a repeat episode with the BBB protocol (median: 1 [IQR 1–3] vs 3 [IQR 2–4.5]).The BBB protocol is easy to implement and resulted in significant improvement in BGL control compared with SSI. Copyright © 2011 John Wiley & Sons.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"25 6","pages":"266-269"},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025898","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":"Post‐partum diabetic ketoacidosis in a patient with gestational diabetes mellitus","authors":"N. Sabir, Mq Yip, M. Elrishi","doi":"10.1002/PDI.1608","DOIUrl":"https://doi.org/10.1002/PDI.1608","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"27 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2011-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1608","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025780","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}