ISSN:1357-8170    

DOI:10.1002/pdi.1960160503

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960160504

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

摘要:

AbstractWe have explored detailed coronary artery disease risk factors in a group of 257 people with type 2 diabetes aged>50 years (130 women, 127 men) with a mean (SD) age of 66±8 years and diabetes duration of 9±7 years. Major coronary risk factors were highly adverse in women, in particular total cholesterol (6.1±1.3vs. 5.3±1.1 mmol/L, p<0.0001), triglyceride (2.5±1.4 vs. 2.0±1.1 mmol/L, p<0.05) and LDL‐cholesterol (3.8±1.0vs. 3.4±1.1 mmol/L, p<0.005). HbA1c(8.1±1.7vs. 7.5±1.6%, p<0.005) and Body Mass Index (31.0±6.5 vs. 28.7±4.6, p<0.005) were also significantly higher in women. Hypertension was more common (43% vs. 33%) and smoking rates lower (21% vs. 27%), but these differences were not significant. HDL‐cholesterol, lipoprotein(a) levels and urinary albumin:creatinine ratio (ACR) were similar between sexes. Angina was more common in women than men (38% vs. 26%, p<0.05). Our results show that female type 2 diabetic patients of post‐menopausal age have significantly adverse lipid profiles compared to age and duration‐matched male counterparts. In addition, they have poor glycaemic control, and a greater degree of obesity. These results raise the question of whether hormone replacement therapy (HRT) may be beneficia

ISSN:1357-8170    

DOI:10.1002/pdi.1960160505

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960160506

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

摘要:

AbstractCapillary blood glucose monitoring plays an important part in the monitoring of diabetes. There are a large number of different blood glucose meters, each of which have satisfactory analytical performance for monitoring purposes in the hands of experienced personnel. Of less certainty is their performance and acceptability (including ease of use) in the hands of nursing staff, but these factors are more difficult to assess. This study assessed these non‐analytical factors by administering a structured questionnaire to nursing staff who were asked to compare two meters in the clinical setting. Although both meters had adequate analytical performance, there were significant differences in terms of ease of use, especially applying a satisfactory blood sample and speed of operation. These and other user factors could have a significant impact on the successful performance of hospital near patient blood glucose monitoring. This method of non‐analytical method comparison could play an important part in the selection of an appropriate monitoring sys

ISSN:1357-8170    

DOI:10.1002/pdi.1960160507

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960160508

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

摘要:

AbstractStaged Diabetes Management (SDM) is a disease state management programme, that was developed by the International Diabetes Center, Minneapolis, USA. Its primary aim is to achieve near‐normal to normal blood glucose control in all patients with diabetes, using community involvement and simple, complete clinical pathways. SDM contains methods of diagnosis, an overview of therapy, practice guidelines, and specific detailed treatment protocols (decision paths) for type 1 and type 2 diabetes and gestational diabetes (GDM). Formal training in SDM was conducted for participating physicians and nurses, including an introduction to the philosophy and approach of SDM, provision of the materials and elucidation of the expected goals and results. After training and implementation, a series of trials were performed to determine the effectiveness of SDM in improving diabetes care in this region. The trial results evaluated the overall influence of SDM on such clinical parameters as HbA1cand fasting blood glucose, to assess the appropriateness of treatment modalities and timing of therapeutic choices, eg minimal delay to choice of appropriate stage.The introduction of the SDM programme led to significant reductions of HbA1cand fasting and postprandial blood sugar, without hypoglycaemia, in a representative group of people with type 1 diabetes. In patients with type 2 diabetes, significant reductions of HbA1c, fasting and postprandial blood glucose without hypoglycaemia or weight‐gain was achieved.To our knowledge, this is one of the first times that these goals have been achieved in people with type 1 diabetes, without hypoglycaemia, and in type 2 diabetes, without weight‐gain. Using SDM we achieved 100% screening of 500 women referred for evaluation of menopausal symptoms. Approximately 5% of peri‐ and post‐menopausal women were found to have frank diabetes (type 2) and an additional 8% had impaired glucose tolerance. Using the SDM programme, tight metabolic control in pregnant women with type 1 diabetes decreased the incidence of serious complications, eg urinary tract infections and pre‐eclampsia, particularly in the critical last few weeks before delivery. We found a decrease in the incidence of serious neonatal complications in the SDM group — lower levels of: neonatal death (none seen in the SDM group); fetal congenital malformations; hypoglycaemia and respiratory distress syndrome. With respect to GDM, screening of pregnant women and proper treatment using SDM resulted in lower pregnancy and neonatal complication rates as well as fewer Caesarean sections.The success of these early pilot studies has led to a training programme that aims to introduce SDM to up to 500 primary care providers per year throughout Poland. Once trained, a larger more definitive multi‐centre study of the effects of SDM will be needed to confirm the e

ISSN:1357-8170    

DOI:10.1002/pdi.1960160509

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960160510

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960160511

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY

摘要:

AbstractWe studied whether the use of 8 mm insulin pen needles, shorter than the standard 12.7 mm needles, affects glucose control in obese and non‐obese people with type 1 or type 2 diabetes. A prospective, open‐label, nine‐week, crossover study involved 106 insulin pen‐using patients. During the initial period, all subjects used B‐D brand standard length needles. In the second period, subjects were randomised to either B‐D or NovoFine brand 8 mm pen needles. In the third period, subjects were crossed over to the alternative brand. Fructosamine levels were measured, leakage of insulin from injection sites was quantified, and pain was assessed. Glucose control was not altered in either obese or nonobese subgroups after switching to either brand of 8 mm needle. However, a few individuals, most of whom were obese, experienced a clinically significant increase in fructosamine levels after switching to an 8 mm needle. B‐D 8 mm needles were significantly less painful than either of the other needles tested. Obese subjects were significantly more likely to experience insulin leakage from their injection sites compared to non‐obese people, but the leakage was not significantly correlated with changes in fructosamine levels. Non‐obese people with type 1 or type 2 diabetes can switch to 8 mm insulin pen needles without compromising their glucose control and with less pain. Some obese patients who switch to 8 mm needles may have a higher risk of poorer glucose control, and should therefore consult with their healthcare professional. All patients should carefully monitor their blood glucose when changing to

ISSN:1357-8170    

DOI:10.1002/pdi.1960160512

出版商:John Wiley&Sons, Ltd.    

年代:1999

数据来源: WILEY