ISSN:1357-8170    

DOI:10.1002/pdi.1960110502

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960110503

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960110504

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractA 31 year old woman with a 26 year history of Type 1 diabetes mellitus and reslstance to subcutaneous insulin who used a programmable implantable insulin infusion pump for intravenous insulin delivery became pregnant. This report describes our experience of management of this patient through her pregnancy. The pregnancy was complicated by, first, failure of the power supply of the insulin Infusion pump in the second trimester and, second, the later development of pregnancy‐induced hypertension and proteinurla. Throughout this pregnancy, glycaemic control was good with glycated haemoglobin ranging from 7.0−9.0% (non‐diabetic reference range 4.9−7.6%). A normal female infant was subsequently delivered by Caesarean section at 34 weeks' gestation.This report illustrates the fact that, with a well‐motivated patient, glycaemic control through pregnancy may be optimised using an implantable programmable insulin infu

ISSN:1357-8170    

DOI:10.1002/pdi.1960110505

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThis study examined the ophthalmic screening practices for diabetic patients conducted by general practitioners throughout one health region of the United Kingdom. A malled questionnaire was despatched to 1,481 GPs in Wessex and achieved a response rate of 48%. Visual acuity checks were performed on a regular basis by 60% of the responders. Of these, 76% of the GPs performed fundoscopy although 41% of them failed to dilate the pupils before examination. This study indicates that optimum eye screening is not being carried out by GPs in Wessex and it could be likely that the study is representative of other regions in the United Kingdom.

ISSN:1357-8170    

DOI:10.1002/pdi.1960110506

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe objective of the study was to determine whether a general practitioner could effectively interpret fundal photographs obtained from clinics organised in a primary care setting ‐ in this case, a rural group general practice in Mid Wales. All patients registered with the practice and indentified as having diabetes were included into the study. The study was designed as a population‐based study and the GP diabetes register used to arrange photographic clinics in general practice. Comparison was made between the GP's and the ophthalmologist's (reference standard) interpretation of fundal photographs. Observers were unaware of the identity of the subjects and of each others results.Ascertainment rate for diabetes was 2.2% (166 patients). Photographs were obtained in 143 (86%); quality was sufficient for analysis in 137 (82.5%). Twenty‐three patients were identified by ophthalmologists as having retinopathy, eight (6% of whole sample) with sight‐threatening lesions. The GP's sensitivity for the presence of retinopathy was 87% (95% CI 66%‐97%), and specificity 77% (95% CI 70%‐85%). No sight‐threatening lesions were missed by the GP. Of 18 false positives with good picture quality, 10 (56%) had drusen; eight other false positives had photographic artefacts or poor picture quality.It was concluded that, given adequate training, GPs could act as first screeners for diabetic retinopathy by utilising fundal photographs taken in general practice. Analysis of the effectiveness of screening methods for diabetes should take into account ascertainment rate of diabetes in the stu

ISSN:1357-8170    

DOI:10.1002/pdi.1960110507

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe glycaemic and insulinaemic effects of an Asian and a European meal were compared. The Asian meal contained 1,439 kcal (14% protein, 45% carbohydrate, 41% fat, 28g dietary fibre), and the European meal 1,370 kcal (18% protein, 25% carbohydrate, 57% fat, 11g dietary fibre). Fifteen normal voiunteers were tested with each meal after an overnight fast, and on consecutive days in random order. There were no differences at fasting or after one hour between either meal. Two hours after the Asian meal, subjects had a higher degree of glycaemia, mean (SE) 5.29 (0.35)vs4.32 (0.09) mmoI/I (p<0.02) and a higher degree of insulinaemia, mean (SE) 28.17 (6.86)vs8.06 (1.54) mU/I (p<0.02). These effects were maintained at three hours: plasma glucose 5.12 (0.25)vs9.84 (2.46) mU/I (p<0.01). The fasting glucose and insulin levels following the Asian meal had not been achieved at three hours so the study was repeated using 11 normal volunteers with a longer follow‐up time of six hours. Only then did the glucose values return to fasting levels, although insulin levels remained slightly elevated. These preliminary results suggest the need for more detailed long‐term observations on the metabolic effects of culturally different me

ISSN:1357-8170    

DOI:10.1002/pdi.1960110508

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960110509

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

摘要:

AbstractThe results of a controlled trial of providing up‐to‐date on‐site dietetic advice in primary health care diabetes clinics in a deprived FHSA area in the North of England are described. Performance of these practices are compared with similar practices who utilise the existing open access service in the district. The study was part of a continuing audit cycle involving all practices with diabetes clinics in the district. Data were collected over one month. In the 10 practices that had an on‐site dietitian, 191 patients were offered appointments. There was a 92% attendance rate; in the previous year 89% had a record of an HbA1c, 85% had a record of fundoscopy and 89% had seen the dietitian. By contrast, in the six practices who had open access to a centrally‐based dietitian, 81 patients were offered an appointment, there was a 70% attendance rate (p<0.001), 74% had a record of an HbA1c(p<0.001), and 84% had a record of fundoscopy. Only 52% of this group had seen the dietitian (p<0.001). There was no significant difference in the HbA1clevel as a percentage of Hb in either group.It is concluded that there is an association between the placing of a dietitian in general practice diabetes clinics and an improvement in the uptake of dietet

ISSN:1357-8170    

DOI:10.1002/pdi.1960110510

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY

ISSN:1357-8170    

DOI:10.1002/pdi.1960110511

出版商:John Wiley&Sons, Ltd.    

年代:1994

数据来源: WILEY