Objective— To compare the effects of placebo and GLA on course mild diabetic neuropathy over 1 yr. Research Design Methods— We entered 111 patients with from seven centers into a randomized, double-blind, placebo-controlled parallel study at dose 480 mg/day. MNCV, SNAP, CMAP, hot cold thresholds, sensation, tendon reflexes, muscle strength were assessed by standard tests in upper lower limbs. Results— For all 16 parameters, change yr response to was more favorable than placebo, for 13...

Fasting is not routinely recommended for renal function tests, despite the known effects of cooked meat on creatinine. We therefore studied variation in creatinine and estimated glomerular filtration rate (eGFR) after a standardized meal 80 subjects: healthy volunteers diabetic patients with chronic kidney disease (CKD) stages 1 2, 3a, 3b, 4 (n = 16/group).The interventions were nonmeat meal, each providing ∼54 g protein, together 250 mL water, separate days. postprandial blood samples at 1,...

<h3>Abstract</h3> <b>Problem:</b> Wasted outpatient appointments as a result of clinic non-attendance, exacerbating waiting times. <b>Design:</b> Single centre, prospective, non-randomised, controlled study. <b>Background and setting:</b> Diabetes in district general hospital run by consultant, one or two diabetes nurse specialists, dietitian, podiatrist. Clinic receives 10–15 new referrals week health with population 340 000. <b>Key measure for improvement:</b> Non-attendance rate 325...

Colour vision function was assessed in 38 non-complicated type 1 diabetic patients whom fluorescein angiography normal, and compared with that 36 age-matched, non-diabetic controls. All of the were healthy none taking medication except insulin. The eye examination, which normal every patient, included Ishihara City University tests, measurement Snellen acuity, slit-lamp tonometry, fundal photography as well angiography. discrimination ability measured Farnsworth-Munsell 100-hue test. Mean...

Background Glycated haemoglobin (HbA1c) targets are commonly used to guide patient management in diabetes reduce future risk of complications, but little is known the psychological impact HbA1c target-setting. We explored feasibility undertaking a conclusive study evaluating setting explicit adults with diabetes. Methods A randomised, mixed-methods design was quantitatively and qualitatively evaluate psychometric biomedical intensified or relaxed glycaemic Alongside baseline measurement...

Abstract Introduction Type 2 diabetes is associated with excess hospital admissions and increased mortality. Structured self‐management education (DSME) recommended internationally improved skills, well‐being minor improvements in glycated haemoglobin (HBA1c), but does it reduce or prevent premature mortality? Our aim to examine the relationship between DSME attendance, hospitalisations, mortality 3‐point major adverse cardiovascular events (MACE) people type inform future healthcare policy...

Summary Obstructive sleep apnea is associated with obesity and metabolic syndrome, leading to greater cardiovascular risk. Severely obese patients obstructive may still be at risk of adverse health outcomes, even without previous disease. Pulse wave analysis non‐invasively measures peripheral pulse waveforms derives haemodynamic status, including arterial stiffness, augmentation pressure subendocardial viability ratio. We hypothesized that the presence in severe obesity, absence an...

OBJECTIVE—To compare the effect on glycemic control and weight gain of repaglinide versus metformin combined with bedtime NPH insulin in patients type 2 diabetes. RESEARCH DESIGN AND METHODS—A total 80 subjects treated 850 or 1,000 mg t.i.d. were randomized to 13 weeks open-label treatment 4 (n = 39) (dose unchanged) 41). Insulin dose was titrated at clinician’s discretion, aiming for a fasting blood glucose (FBG) ≤6.0 mmol/l. RESULTS—Baseline age, diabetes duration, requirement, weight,...

Erectile dysfunction (ED) is common in diabetes and may be related to the high prevalence of hypertension consequent anti-hypertensive drug therapy diabetic patients. The risk factors for ED were studied with particular reference drugs.We performed a retrospective case note analysis 763 consecutive male patients (34% Type 1 diabetes, 65% 2 diabetes) attending an adult clinic collect data on ED. We specifically recorded use drugs.Two hundred ninety-nine (39%) had Mean age (61 years) was...

#### Case scenario A 58 year old woman attends a diabetes clinic with type 2 of seven years’ duration and no history macrovascular disease. She is obese (body mass index 37), but says she eats healthy diet describes this. Her blood pressure 134/78 mm Hg, has microalbuminuria, normal renal function lipid profile within target levels ranges. taking simvastatin 40 mg daily perindopril 4 daily. Glycated haemoglobin (HbA1c) 8.3% despite treatment metformin 850 three times day gliclazide 160...

Abstract Background Obstructive sleep apnoea ( OSA ) is a common complication of obesity and can have substantial negative impact on patient's quality life risk cardiovascular disease. The aim this case–control study was to undertake discovery profiling urinary peptides using capillary electrophoresis–mass spectrometry CE ‐ MS in obese subjects with without , history coronary artery Materials methods Urinary samples were analysed by . Body composition blood pressure measurements recorded....

The slow progression of diabetic retinopathy makes it difficult to assess the effects intervention therapy. There is thus a need for surrogate markers visual change in diabetes. Colour vision tests and electroretinography (ERG) may be useful this regard; yet little known their relative performance assessment dysfunction aim present study was compare colour discrimination (100 hue test) ERG indices (oscillatory potentials (OP) pattern (PERG)) evaluation aretinopathic IDDM patients. abnormal...

The relationship between clinic‐measured random blood glucose and glycated haemoglobin was investigated in 204 non‐insulin‐dependent diabetic patients to determine the value of on management decisions these patients. Treatment with diet alone 104 (51%: Group 1), oral hypoglycaemic agents 100 (49%: 2). Random were lower 1 than 2 (10.9 ± 4.0 vs 13.0 mmol l −1 , p &lt; 0.001, 8.5 (7.8–10.2) 9.6 (8.1–11.0)%, 0.01, respectively), there a positive correlation both groups ( r Group1 = 0.76, Group2...

OBJECTIVE To see if glucocorticoid deficiency might explain increased insulin sensitivity causing severe brittle diabetes in two type 1 diabetic patients. CASES We describe patients who developed characterized by recurrent hypoglycemia on small daily doses with hyperglycemia further dose reduction. In both patients, requirements had fallen markedly. RESULTS Both were found to have deficiency. one patient, this was a result of hypopituitarism, which aggravated growth hormone the other primary...

OBJECTIVE— To examine the usefulness of liposuction surgery on diabetic patients with lipohypertrophy. RESEARCH DESIGN AND METHODS— We treated a patient who suffered from severe localized thigh When she did not respond to conventional treatment resting injection site, we recommended surgery. RESULTS— Our patient's lipohypertrophy was immediately cured by procedure. CONCLUSIONS— Liposuction could be useful in do more conservative treatments.

Debate exists about the optimum way to screen for diabetic retinopathy. Cameras produce a permanent record, but offer patients less choice when and where be screened. Optometrists flexibility sensitivity specificity of schemes have varied considerably, perhaps because variability in screening methodology that there is frequently no quality assurance programme.To audit our district-wide (population 340000) programme retinopathy against national targets: > 80%, 95% referral review < 3...

This study was designed to assess the frequency of dawn phenomenon in patients with type 2 diabetes. A secondary aim examine influence varying treatment regimens on phenomenon. The defined as a rise plasma glucose levels > or = 0.5 mmol/L (10 mg/dL) between 0500 and 0900 h occurring after growth hormone surge 5 microg/L. Sixteen subjects (six men, 10 women) diabetes were studied overnight their current mode therapy General Clinical Research Center. Additionally, six these restudied random...

Obstructive sleep apnoea (OSA) may increase the risk of hyperuricaemia and predispose to gout. The evidence for effects OSA on serum urate in severe obesity is limited. This study investigated whether was associated with continuous positive airway pressure (CPAP) treatment a fall urate. Severely obese subjects without known or gout were recruited. Baseline assessments included urate, metabolic parameters, spirometry overnight polysomnography. patients initially naive offered CPAP. At...