Endocrine Abstracts; B Roisin, L Hayley, C Surendran

Epidemiology and risk factors for diabetic retinopathy in CYP with type 1 diabetes mellitus in a DGH

B Roisin, L Hayley, C Surendran – 2014

Endocrine Abstracts (2014) 36 P30 | DOI:10.1530/endoabs.36.P30
Introduction: Nearly all patients with type 1 diabetes mellitus develop diabetic retinopathy (DR) within 20 years of diagnosis. It is the second largest cause of blindness in those of working age in the UK. Several risk factors have been accepted by the Royal College of Ophthalmologists, including gender, duration of diabetes, glycaemic control, blood lipid profile, blood pressure, and renal impairment.

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Updates from NICE: Eyes on Evidence

This month in Eyes on Evidence

Acid-suppressive drugs and oesophageal adenocarcinoma in Barrett’s oesophagus
A systematic review and meta-analysis indicates that proton pump inhibitors reduce the risk of oesophageal adenocarcinoma and high-grade dysplasia in people with Barrett’s oesophagus.

Prescriptions for anxiolytics and hypnotics and risk of death
A population-based cohort study in UK primary care suggests that people who are prescribed anxiolytic and hypnotic drugs have a significantly increased risk of death from any cause over a 7-year period.

Assessment and treatment of dementia in older adults
A systematic review finds that brief cognitive assessment tools can adequately detect early dementia, but whether interventions for mild cognitive impairment or early dementia have a clinically significant effect is unclear.

Bedtime schedules and children’s cognition and behaviour
Two analyses of 7-year-olds in the UK Millennium Cohort Study suggest that not having a regular bedtime is associated with impaired cognition in girls and behavioural difficulties in both girls and boys.

Trained glycaemia alert dogs for people with type 1 diabetes

A small UK intervention study suggests that trained glycaemia alert dogs may be able to notify people with type 1 diabetes during blood glucose variations.

NICE opens consultation on the NICE Accreditation Process Manual Update
NICE is inviting comments on its proposals to update the NICE Accreditation Process Manual.

Evidence Updates

NICE has recently published Evidence Updates on:

  • Physical activity and the environment
  • Autism in adults
  • Opioids in palliative care

Diabetes Week: 8-14 June 2014

Diabetes Week is Diabetes UK’s annual awareness and fundraising week.  Taking place from Sunday 8 to Saturday 14 June, thetheme is ‘I Can’.


Here are some useful website links to reputable sites:


Recent search articles from NHS Evidence:

Why do young adults with Type 1 diabetes find it difficult to manage diabetes in the workplace?

Author(s) Balfe, Myles, Brugha, Ruairi, Smith, Diarmuid, Sreenan, Seamus, Doyle, Frank, Conroy, Ronan
Citation: Health & Place, 01 March 2014, vol./is. 26/(180-187), 13538292
Publication Date: 01 March 2014
Source: CINAHL
Patients with diabetes in cardiac rehabilitation:attendance and exercise capacity.

Author(s) Armstrong MJ, Martin BJ, Arena R, Hauer TL, Aggarwal S, Sigal RJ
Citation: Medicine & Science in Sports & Exercise, May 2014, vol./is. 46/5(845-50), 0195-9131;1530-0315 (2014 May)
Publication Date: May 2014
Source: Medline
Hormone replacement therapy for women with type 1 diabetes mellitus (The Cochrane Library)

Liz Mackay , Lynn Kilbride ,et al.  Online Publication Date: June 2013


Alsaffar H.; Whitby T.; Chandrasekaran S. Hormone Research in Paediatrics, October 2013

The effect of automated bolus calculators on HbA1c in children with type 1 diabetes in Macclesfield

Hormone Research in Paediatrics, October 2013, vol./is. 80/(413), 1663-2818

diabetesBackground: Previous studies have shown that using Automated bolus calculators (ABC) in type1 diabetic children showed noticeable reduction in HbA1C(1). Furthermore, it showed reduction in post prandial blood glucose level(2) and glucose variability(3) for those children treated with insulin pumps. Data from adults has already shown improvement in HbA1C following usage of ABC(4).

Objective: To confirm the effect of ABC on HbA1C in children with type1 diabetes who are on multiple daily insulin injection regimes in our unit.

Methods: This is a cross-sectional study. We have collected the data via Accu-check software and by reviewing the case notes. HbA1C was measured
before and after ABC use. Some of the patients were started immediately on ABC following their diagnosis with diabetes and others were started later after they showed poor glycaemic control.

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SG Anderson, NS Malipatil, H Roberts, G Dunn; Primary Care Diabetes 2014

Socioeconomic deprivation independently predicts symptomatic painful diabetic neuropathy in type 1 diabetes

Volume 8, Issue 1, April 2014, Pages 65–69

George Dunn of East Cheshire Trust Podiatry Service co-authored this article published in Primary Care Diabetes.

Introduction: Painful peripheral neuropathy in people with type 1 diabetes is a disabling and costly complication. A greater understanding of predisposing factors and prescribing may facilitate more effective resource allocation.

Methods: The Townsend index of deprivation (numerically higher for greater disadvantage) was examined in the pseudonymised records of 1621 (684 females) individuals with type 1 diabetes and related to prevalence of drug treated severe diabetes related neuropathic pain.

Results: Treatment for neuropathic pain was initiated in 280 patients, who were older at 57.1 vs 45.6 years and had greater BMI (29.8 vs 27.8 kg/m2p < 0.0001). HbA1C was similar between groups, whilst eGFR was lower in the neuropathic pain group.

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Anderson S.G., Roberts H., Malipatil N., Dunn G., Heald A.H: Diabetic Medicine

A higher index of multiple socioeconomic deprivation predisposes to development of painful peripheral neuropathy in Type 1 diabetes.

Anderson S.G., Roberts H., Malipatil N., Dunn G., Heald A.H.

Diabetic Medicine. Conference: Diabetes UK Professional Conference 2013 Manchester United Kingdom. Conference Start: 20130313 Conference End: 20130315. Conference Publication: (var.pagings). 30  (pp 70), 2013. Date of Publication: March 2013.

DOI http://dx.doi.org/10.1111/dme.12091

Moult D.; Chandrasekaran S; Diabetic Medicine, March 2013,

Comparison of multiple daily injections (MDI) vs continuous subcutaneous insulin infusion (CSII) methods of insulin delivery in children with Type 1 diabetes in a small district general hospital

Citation: Diabetic Medicine, March 2013, vol./is. 30/(100-101), 0742-3071 (March 2013)

Author(s): Moult D.; Chandrasekaran S.

Language: English

Abstract: Objective: To compare the efficacies of two different methods of insulin delivery in diabetic children in a small district general hospital, with regard to their average HbA1c, their daily insulin requirements and the results on their body mass index (BMI), the average reported number of non-severe hypoglycaemic events a week, and the rate of both long-term and acute complications in these children.

Methods: Data were collected retrospectively between December 2010 and December 2011. A total of 80 patients were included in this audit (40 MDI vs 40 CSII). The patients were divided into thre e different age groups (below five, five to 12, over 12). Results: The average HbA1c was 8.8% for the MDI group compared with 8.4% for the CSII group. The average daily insulin requirement was 0.81u/kg/day for the MDI group compared with 0.74u/kg /day for the CSII group. The average BMI was  0.6kg/m<sup>2</sup> for the MDI group compared with 19.6kg/m<sup>2</sup> for the CSII group. The number of non-severe hypoglycaemic events was recorded at an average of 0.69 episodes per week for the MDI group compared with 1.84 episodes per week for the CSII group. The difference in HbA1c was most marked in under fives (8.4% vs 7.8%). There were no signs of nephropathy in either group among the over 12s. However, lipid abnormalities in the form of elevated cholesterol was more often seen in the CSII group compared with the MDI group in the over 12s (seven vs five). Conclusions: CSII was found to be the overall better treatment in younger age groups, but loses its effectiveness in over 12 year olds.

Publication Type: Journal: Conference Abstract

Source: EMBASE

This article is not available fulltext but can be ordered through our inter-library loan scheme.