GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Continuous subcutaneous insulin infusion therapy is associated with reduced retinopathy progression compared with multiple daily injections of insulin
    Springer Science and Business Media LLC ; 2021
    In:  Diabetologia Vol. 64, No. 8 ( 2021-08), p. 1725-1736
    Details
    In: Diabetologia, Springer Science and Business Media LLC, Vol. 64, No. 8 ( 2021-08), p. 1725-1736
    Abstract: We aimed to compare diabetic retinopathy outcomes in people with type 1 diabetes following introduction of continuous subcutaneous insulin infusion (CSII) therapy with outcomes in people receiving continuing therapy with multiple daily insulin injections (MDI). Methods This is a retrospective cohort study using the Scottish Care Information – Diabetes database for retinal screening outcomes and HbA 1c changes in 204 adults commenced on CSII therapy between 2013 and 2016, and 211 adults eligible for CSII during the same period but who continued on MDI therapy. Diabetic retinopathy progression (time to minimum one-grade worsening in diabetic retinopathy from baseline grading) was plotted for CSII and MDI cohorts using Kaplan–Meier curves, and outcomes were compared using multivariate Cox regression analysis adjusting for age, sex, baseline HbA 1c , blood pressure, cholesterol, smoking status and socioeconomic quintile. Impact of baseline HbA 1c and change in HbA 1c on diabetic retinopathy progression was assessed within CSII and MDI cohorts. Results CSII participants were significantly younger, were from less socially deprived areas, and had lower HbA 1c and higher diastolic BP at baseline. There was a larger reduction in HbA 1c at 1 year in those on CSII vs MDI (−6 mmol/mol [−0.6%] vs −2 mmol/mol [−0.2%] , p   〈  0.01). Diabetic retinopathy progression occurred in a smaller proportion of adults following commencement of CSII vs continued MDI therapy over mean 2.3 year follow-up (26.5% vs 18.6%, p  = 0.0097). High baseline HbA 1c (75 mmol/mol [9%]) was associated with diabetic retinopathy progression in the MDI group ( p  = 0.0049) but not the CSII group ( p  = 0.93). Change in HbA 1c at follow-up, irrespective of baseline glycaemic status, did not significantly affect diabetic retinopathy progression in either group. Conclusions/interpretation CSII was associated with reduced diabetic retinopathy progression compared with continued MDI therapy, and may be protective against diabetic retinopathy progression for those with high baseline HbA 1c . Progression of diabetic retinopathy over 3 years was not associated with a change in HbA 1c . Graphical abstract
    Type of Medium: Online Resource
    ISSN: 0012-186X , 1432-0428
    URL: Article
    DOI: 10.1007/s00125-021-05456-w
    RVK:
    XA 40615
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 1458993-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    HbA1c Is Disproportionately Higher in Women and Older People With Type 1 Diabetes Compared With Flash Glucose Monitoring Metrics of Glycemic Control
    SAGE Publications ; 2022
    In:  Journal of Diabetes Science and Technology Vol. 16, No. 2 ( 2022-03), p. 446-453
    Details
    In: Journal of Diabetes Science and Technology, SAGE Publications, Vol. 16, No. 2 ( 2022-03), p. 446-453
    Abstract: Discrepancy between HbA1c and glucose exposure may have significant clinical implications. We sought to assess predictors of disparity between HbA1c and flash monitoring metrics and how these relate to microvascular complications. Methods: We conducted a cross-sectional study of adults with type 1 diabetes ( n = 518). We assessed the relationship between clinic HbA1c and flash monitoring metrics, predictors of discrepancy between these measurements, and whether discrepancy was associated with microvascular complications. Results: Actual HbA1c and estimated HbA1c were strongly correlated ( r = .779, P 〈 .001). The likelihood of having a higher actual HbA1c than estimated HbA1c was greater with increasing age (OR = 1.055 per year, P 〈 .001) and lower in men (OR = .208, P 〈 .001). HbA1c was significantly lower in men (58 mmol/mol [51-67]) (7.5% [6.8-8.3] ) compared to women (61 mmol/mol [54-70], P = .021) (7.7% [7.1-8.6] ), despite no significant differences in any flash monitoring metrics. Whereas HbA1c was not different between younger (≤39 years) and older individuals ( 〉 39 years) despite significantly higher glucose exposure, in younger people, based on multiple flash monitoring metrics. Having a lower estimated than actual HbA1c was independently associated with a lower prevalence of retinopathy (OR = .55, P = .004). Conclusions: HbA1c appears to overestimate glucose exposure in women and older people with type 1 diabetes. This has potentially important clinical implications, as is hinted at by the independent relationship with retinopathy prevalence. It may also be of relevance when considering the use of HbA1c for the diagnosis of diabetes.
    Type of Medium: Online Resource
    ISSN: 1932-2968 , 1932-2968
    URL: Article
    DOI: 10.1177/1932296820967335
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2467312-2
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    COVID-19 vaccine-associated subacute thyroiditis: an unusual suspect for de Quervain’s thyroiditis
    BMJ ; 2021
    In:  BMJ Case Reports Vol. 14, No. 11 ( 2021-11), p. e246425-
    Details
    In: BMJ Case Reports, BMJ, Vol. 14, No. 11 ( 2021-11), p. e246425-
    Abstract: Subacute thyroiditis following vaccination is an uncommon presentation of thyrotoxicosis. As the world undertakes its largest immunisation campaign to date in an attempt to protect the population from COVID-19 infections, an increasing number of rare post vaccine side effects are being observed. We report a case of a middle-aged woman who presented with painful thyroid swelling following the second dose of the COVID-19 mRNA vaccine BNT162b2 (Pfizer–BioNTech) with clinical, biochemical and imaging features consistent with destructive thyrotoxicosis. Symptomatic management only was required for the self-limiting episode. Thyroiditis typically has a mild and self-limiting course and thus this observation should not deter people from vaccination, as COVID-19 infection has a far greater morbidity and mortality risk than thyroiditis.
    Type of Medium: Online Resource
    ISSN: 1757-790X
    URL: Article
    DOI: 10.1136/bcr-2021-246425
    Language: English
    Publisher: BMJ
    Publication Date: 2021
    detail.hit.zdb_id: 2467301-8
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Substantial HbA1c Reduction Following Intermittent-Scanning Continuous Glucose Monitoring Was Not Associated With Early Worsening of Retinopathy in Type 1 Diabetes
    SAGE Publications ; 2022
    In:  Journal of Diabetes Science and Technology Vol. 16, No. 4 ( 2022-07), p. 921-928
    Details
    In: Journal of Diabetes Science and Technology, SAGE Publications, Vol. 16, No. 4 ( 2022-07), p. 921-928
    Abstract: Early worsening of diabetic retinopathy (EWDR) was observed in the intensively treated arm of the Diabetes Control and Complications Trial (DCCT) before long-term benefits accrued. We sought to assess whether there may be an increased risk of EWDR in high-risk individuals following intermittent-scanning continuous glucose monitoring (iscCGM) commencement. Methods: An observational study of 139 individuals with type 1 diabetes ≥5 years duration and with baseline HbA1c 〉 75 mmol/mol (9.0%). This cohort was stratified by subsequent HbA1c response to iscCGM (best responders and non-responders). Pan-retinal photocoagulation (PRP), worsening retinopathy status and new development of retinopathy were compared between groups. Results: HbA1c change was -23 mmol/mol (IQR -32 to -19) (-2.1% [-2.9 to -1.8]) in responders and +6 mmol/mol (2-12) (+0.6 [0.2-1.1] ) in non-responders ( P  〈  .001). There was no difference in subsequent PRP between responders (14.1%) and non-responders (10.3%, P = .340). Baseline HbA1c (HR 1.052 per mmol/mol, P = .002) but not response category (HR 1.244, P = .664) was independently associated with the risk of requiring PRP. Worsening of retinopathy was not different between responders (16.9%) and non-responders (20.6%, P = .577), and the same was true with respect to new development of retinopathy (33.3% vs 31.8%, P = .919). Conclusions: In a cohort enriched for risk of diabetic retinopathy, reduction in HbA1c did not result in an increased risk of PRP, worsening retinopathy, or new development of retinopathy. These findings offer reassurance that substantial reduction in HbA1c is not independently associated with early worsening of diabetic eye disease in iscCGM users.
    Type of Medium: Online Resource
    ISSN: 1932-2968 , 1932-2968
    URL: Article
    DOI: 10.1177/1932296821994091
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2467312-2
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    Impact of routine clinic measurement of serum C‐peptide in people with a clinician‐diagnosis of type 1 diabetes
    Wiley ; 2021
    In:  Diabetic Medicine Vol. 38, No. 7 ( 2021-07)
    Details
    In: Diabetic Medicine, Wiley, Vol. 38, No. 7 ( 2021-07)
    Abstract: Click here to access the podcast for this paper.
    Type of Medium: Online Resource
    ISSN: 0742-3071 , 1464-5491
    URL: Issue
    URL: Article
    DOI: 10.1111/dme.v38.7
    DOI: 10.1111/dme.14449
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2019647-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Interest in hybrid closed loop is high across the socioeconomic spectrum despite current inequalities in provision in a large UK diabetes centre
    Wiley ; 2023
    In:  Diabetic Medicine Vol. 40, No. 5 ( 2023-05)
    Details
    In: Diabetic Medicine, Wiley, Vol. 40, No. 5 ( 2023-05)
    Type of Medium: Online Resource
    ISSN: 0742-3071 , 1464-5491
    URL: Issue
    URL: Article
    DOI: 10.1111/dme.v40.5
    DOI: 10.1111/dme.15058
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2019647-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    Adrenal insufficiency in patients on long‐term opioid analgesia
    Wiley ; 2016
    In:  Clinical Endocrinology Vol. 85, No. 6 ( 2016-12), p. 831-835
    Details
    In: Clinical Endocrinology, Wiley, Vol. 85, No. 6 ( 2016-12), p. 831-835
    Abstract: Opioid analgesia has been implicated as a cause of secondary adrenal insufficiency, but little is known of the prevalence of this potentially serious adverse effect in patients with chronic pain. Design Cross‐sectional study of chronic pain patients on long‐term opioid analgesia. Patients Patients attending tertiary chronic pain clinics at the Western General Hospital, Edinburgh, treated with long‐term opioid analgesia ( n = 48) with no recent exposure to exogenous glucocorticoids. Results Four patients (8·3%) had basal morning plasma cortisol concentrations below 100 nmol/l, of whom three failed to achieve a satisfactory cortisol response to exogenous ACTH 1‐24 stimulation (peak cortisol 〉 430 nmol/l). Basal cortisol was positively associated with age ( R = 0·398, P = 0·005) and negatively associated with BMI ( R = −0·435, P = 0·002). Conclusions Suppression of the hypothalamic−pituitary−adrenal axis is present in a clinically significant proportion of chronic pain patients treated with opioid analgesia. Studies of larger populations should be conducted to better define the prevalence and potential clinical consequences of adrenal insufficiency in this context.
    Type of Medium: Online Resource
    ISSN: 0300-0664 , 1365-2265
    URL: Issue
    URL: Article
    DOI: 10.1111/cen.2016.85.issue-6
    DOI: 10.1111/cen.13125
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2004597-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    Validated criteria for the interpretation of a single measurement of serum cortisol in the investigation of suspected adrenal insufficiency
    Wiley ; 2019
    In:  Clinical Endocrinology Vol. 91, No. 5 ( 2019-11), p. 608-615
    Details
    In: Clinical Endocrinology, Wiley, Vol. 91, No. 5 ( 2019-11), p. 608-615
    Abstract: The diagnostic value of a single measurement of serum cortisol as a first step in the investigation of suspected adrenal insufficiency remains unclear. Previously proposed criteria have not been validated, and little is known regarding the performance of the test outwith morning samples in outpatients. We aimed to identify and validate criteria for morning and afternoon serum cortisol which could be used to determine which individuals require dynamic testing, in both outpatient and medical inpatient settings. Methods We performed a retrospective analysis of 2768 patients attending endocrinology clinics and patients admitted to general medical units in two hospitals in Edinburgh, UK. In baseline samples from the short synacthen test, thresholds which identified a subnormal‐stimulated serum cortisol ( 〈 430 nmol/L using the Abbott Architect assay) with 95% sensitivity were identified. Criteria drawn from data in patients attending outpatient clinics in one hospital were tested in additional outpatient and inpatient validation cohorts. Results A morning (8  am ‐12  pm ) serum cortisol of  〈 275 nmol/L identified subnormal‐stimulated cortisol with 96.2% sensitivity. For afternoon (12  pm ‐6  pm ) samples, a cut‐off of  〈 250 nmol/L achieved 96.1% sensitivity. Sensitivity was maintained when the criteria were applied to outpatients in the validation cohort for both morning and afternoon samples. For inpatients, the test was sufficiently sensitive in morning samples only. Conclusions A single measurement of serum cortisol carries the potential to significantly reduce the need for dynamic testing in the investigation of adrenal insufficiency, whether this is taken in morning or afternoon outpatient clinics, or in morning samples from medical inpatients.
    Type of Medium: Online Resource
    ISSN: 0300-0664 , 1365-2265
    URL: Issue
    URL: Article
    DOI: 10.1111/cen.v91.5
    DOI: 10.1111/cen.14071
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2004597-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    Predicting outcomes and complications following radioiodine therapy in Graves’ thyrotoxicosis
    Wiley ; 2019
    In:  Clinical Endocrinology Vol. 90, No. 1 ( 2019-01), p. 192-199
    Details
    In: Clinical Endocrinology, Wiley, Vol. 90, No. 1 ( 2019-01), p. 192-199
    Abstract: Radioiodine (RAI) is an effective treatment for Graves’ thyrotoxicosis but is associated with a failure rate of 15% and may be a risk factor for thyroid eye disease (TED) and weight gain. We sought to examine predictors of RAI failure, weight gain, TED and patient satisfaction. Design Retrospective cohort study. Patients A total of 655 episodes of RAI in Graves’ thyrotoxicosis patients (2006‐2015). Measurements Biochemical assessment, including TFTs and thyrotropin receptor antibodies (TRAb), clinical features (eg, TED, weight and thionamide use) and patient questionnaire. Results The treatment failure rate was 17%. Failure was greater with higher fT4 ( P  = 0.002) and higher TRAb ( P  = 0.004). Failure rate was 42.2% when TRAb 〉 40 U/L. Median weight gain was 3.2 kg in those with normal fT4 prior to RAI and 5.8 kg when fT4 was elevated ( P   〈  0.001). New TED developed in 7.6% but was not associated with post‐RAI dysthyroidism. Treatment satisfaction was generally high (median response 8/10). Conclusions Treatment failure after RAI occurs in predictable groups and this should be reflected in the information provided to patients. Weight gain is common and may not entirely be explained by a return to pre‐thyrotoxic baseline. We were unable to detect any significant impact of post‐RAI dysthyroidism on weight gain, TED or thyroid symptoms in this large cohort.
    Type of Medium: Online Resource
    ISSN: 0300-0664 , 1365-2265
    URL: Issue
    URL: Article
    DOI: 10.1111/cen.2019.90.issue-1
    DOI: 10.1111/cen.13873
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2004597-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    Changes in continuous glucose monitoring metrics and predictors of improvement 12 months after conversion from Freestyle Libre to Freestyle Libre 2
    Wiley ; 2023
    In:  Diabetic Medicine
    Details
    In: Diabetic Medicine, Wiley
    Abstract: We sought to assess whether conversion from Freestyle Libre to Freestyle Libre 2 (with low and high glucose alert functions) was associated with improved glucose metrics. Research Design and Methods A prospective observational study to assess changes in CGM metrics in 672 adults with type 1 diabetes when converting to Freestyle Libre 2. Secondary outcomes included predictors of reduction in time below range (TBR) and increase in time in range (TIR). Results TBR fell by a median of 1.0% (IQR −2.7 to 0.3, p   〈  0.001) after 12 months and TIR decreased by 1.0% (−8.7 to 6.0, p  = 0.004). TIR did not fall in people using high glucose alerts ( p  = 0.353). Average duration of low glucose events ( 〈 3.9 mmoL/L) fell by 10 min (−46 to 18, p   〈  0.001). Significant improvements in TIR ( p  = 0.029) and time above 13.9 mM ( p  = 0.002) were observed in those using high glucose alerts. Alert threshold settings were not associated with glycaemic response; however, low alert use was independently associated with a fall in TBR of ≥0.5% (HR 1.9 [95% CI 1.2–3.1], p  = 0.009) and high alert use was independently associated with a rise in TIR of ≥5% (HR 1.6 [95% CI 1.0–2.5], p  = 0.043) at 12 months. Conclusions Conversion to Freestyle Libre 2 was associated with significant improvements in low glucose metrics. Alert function users were more likely to see improvements across all CGM metrics. Challenges remain in encouraging alert use, helping users set optimal alert thresholds and optimizing response to alerts.
    Type of Medium: Online Resource
    ISSN: 0742-3071 , 1464-5491
    URL: Article
    DOI: 10.1111/dme.15130
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2019647-7
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...