ISSN:1357-8170    

DOI:10.1002/pdi.1960100202

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960100203

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960100204

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960100205

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960100206

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960100207

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractWe have investigated the clinical and biochemical features (including C‐peptide responsiveness) in 10 patients with insulin‐dependent diabetes (IDDM) of over 50 years' duration (Nabarro Medal Winners). Age (mean ± SD) was 67 ± 7 years and diabetes duration 54 ± 2 years. Serum C‐peptide was undetectable both fasting and 2 hours after 1 mg intramuscular (I/M) glucagon. Glycosylated haemoglobin (HbA1) was 10.0 ± 1.5% and cholesterol 6.2 ± 0.7 mmol/1. Only one had hypertension and only one was obese (BMI>30.0). Four (40%) had microvascular complications (4 retinopathy, 1 nephropathy and 1 neuropathy). None were blind, had amputations, or required renal support therapy. Large vessel disease was present in only 1 (mild, stable angina). This group thus represented patients with “true” IDDM, who for their long diabetes duration were remarkably fit and relatively free of complications (particularly macrovascular). Further detailed investigation of larger numbers of Nabarro Medal Winners may provide valuable clues as to “protective” factors operating in the evolution of com

ISSN:1357-8170    

DOI:10.1002/pdi.1960100208

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractThe Alan Nabarro Medal is awarded by the British Diabetic Association to people who have had diabetes for more than 50 years. We have analysed the national distribution of medal winners by Regional Health Authorities/Boards of the UK and the English Health Districts. Up to December 31st 1990, 446 medals had been awarded but sufficient details were available only for the 303 requested between mid‐1987 and the end of 1990. Number of mean annual awards was 82. All Regions/Boards were represented. The Regional mean was 18 (range 8–41) for total medals and 5.7 (2.3–17) for medals per million total population. The estimated mean “expected medal number” per Region should be 134 (64–208) with a total of 2,272 medals awarded. There is therefore a potential shortfall of 1,826; Regional shortfalls varying from 64 to 191 (67%–94%). English District Health Authorities were also analysed −88 (46%) were not represented at all. Clinical details of medal winners from one English District are reported. We present this survey hoping to increase awareness of the Ala

ISSN:1357-8170    

DOI:10.1002/pdi.1960100209

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractWith the current emphasis on stricter control of blood glucose levels in insulin‐treated diabetics, instances of severe hypoglycaemia seem to be increasing. In order to reduce the known risks of prolonged untreated hypoglycaemia ambulance paramedics have been trained to administer glucagon to hypoglycaemic patients in their homes. During an 18 month period glucagon was administered on 28 occasions to 17 patients, and in 25 instances hospital admission was avoided. This study has shown that the administration of glucagon by ambulance personnel is a safe and effective way of treating severely hypoglycaemic patients at home. Widespread adoption of this policy would reduce the risk of hypoglycaemic brain damage as well as saving NHS resource

ISSN:1357-8170    

DOI:10.1002/pdi.1960100210

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY

摘要:

AbstractDelay in referral of patients with significant diabetic retinopathy by the diabetic physician to the ophthalmologist may compromise visual outcome. We prospectively audited the ophthalmic assessment of 37 newly referred diabetic patients to the diabetic clinic. Unbeknown to the diabetologist, patients underwent retinal photography with review of photographs by a consultant ophthalmologist and finally another examination with slit‐lamp biomicroscopy by an independent ophthalmologist as “gold standard”. Maculopathy present in 12 of 74 eyes was missed on seven occasions by the diabetic physician and on one occasion by photography (p<0.03 McNemar's test; confidence intervals −15.2% −72.3% physicians, 61.5 −99.8% photography). Inaccuracies in visual acuity measurement and inconsistencies in pupil dilation were noted. Retinal photography may provide a superior means for detection of maculopathy in the newly referred diabetic than assessment by the diabeti

ISSN:1357-8170    

DOI:10.1002/pdi.1960100211

出版商:John Wiley&Sons, Ltd.    

年代:1993

数据来源: WILEY