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  Subjects -> PSYCHOLOGY (Total: 871 journals)
Showing 1 - 174 of 174 Journals sorted alphabetically
Acción Psicológica     Open Access   (Followers: 2)
Acta Colombiana de Psicología     Open Access   (Followers: 4)
Acta Comportamentalia     Open Access   (Followers: 3)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Psychologica     Hybrid Journal   (Followers: 21)
Activités     Open Access   (Followers: 1)
Actualidades en Psicologia     Open Access   (Followers: 1)
Ad verba Liberorum : Journal of Linguistics & Pedagogy & Psychology     Open Access   (Followers: 8)
Addictive Behaviors Reports     Open Access   (Followers: 5)
ADHD Attention Deficit and Hyperactivity Disorders     Hybrid Journal   (Followers: 20)
ADHD Report The     Full-text available via subscription   (Followers: 6)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 38)
Advances in Mental Health     Hybrid Journal   (Followers: 68)
Advances in Physiotherapy     Hybrid Journal   (Followers: 50)
Advances in Psychology     Full-text available via subscription   (Followers: 56)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 28)
African Journal of Cross-Cultural Psychology and Sport Facilitation     Full-text available via subscription   (Followers: 3)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 388)
Aggressive Behavior     Hybrid Journal   (Followers: 16)
Aging, Neuropsychology, and Cognition     Hybrid Journal   (Followers: 33)
Ágora - studies in psychoanalytic theory     Open Access   (Followers: 3)
Aletheia     Open Access   (Followers: 1)
American Behavioral Scientist     Hybrid Journal   (Followers: 15)
American Imago     Full-text available via subscription   (Followers: 3)
American Journal of Applied Psychology     Open Access   (Followers: 33)
American Journal of Community Psychology     Hybrid Journal   (Followers: 24)
American Journal of Health Behavior     Full-text available via subscription   (Followers: 23)
American Journal of Orthopsychiatry     Hybrid Journal   (Followers: 4)
American Journal of Psychoanalysis     Hybrid Journal   (Followers: 20)
American Journal of Psychotherapy     Full-text available via subscription   (Followers: 33)
American Psychologist     Full-text available via subscription   (Followers: 161)
Anales de Psicología     Open Access   (Followers: 2)
Análise Psicológica     Open Access   (Followers: 1)
Análisis y Modificación de Conducta     Open Access   (Followers: 2)
Analysis     Full-text available via subscription   (Followers: 4)
Annual Review of Clinical Psychology     Full-text available via subscription   (Followers: 66)
Annual Review of Organizational Psychology and Organizational Behavior     Full-text available via subscription   (Followers: 25)
Annual Review of Psychology     Full-text available via subscription   (Followers: 195)
Anuario de Psicología / The UB Journal of Psychology     Open Access   (Followers: 1)
Anuario de Psicología Jurídica     Open Access   (Followers: 1)
Anxiety, Stress & Coping: An International Journal     Hybrid Journal   (Followers: 22)
Applied and Preventive Psychology     Hybrid Journal   (Followers: 13)
Applied Cognitive Psychology     Hybrid Journal   (Followers: 65)
Applied Neuropsychology : Adult     Hybrid Journal   (Followers: 32)
Applied Neuropsychology : Child     Hybrid Journal   (Followers: 18)
Applied Psychological Measurement     Hybrid Journal   (Followers: 17)
Applied Psychology     Hybrid Journal   (Followers: 124)
Applied Psychology: Health and Well-Being     Hybrid Journal   (Followers: 48)
Applied Psychophysiology and Biofeedback     Hybrid Journal   (Followers: 6)
Archive for the Psychology of Religion / Archiv für Religionspychologie     Hybrid Journal   (Followers: 16)
Archives of Clinical Neuropsychology     Hybrid Journal   (Followers: 26)
Archives of Scientific Psychology     Open Access   (Followers: 3)
Arquivos Brasileiros de Psicologia     Open Access   (Followers: 1)
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 8)
Asia-Pacific Psychiatry     Hybrid Journal   (Followers: 3)
Asian American Journal of Psychology     Full-text available via subscription   (Followers: 5)
Asian Journal of Business Ethics     Hybrid Journal   (Followers: 7)
Assessment     Hybrid Journal   (Followers: 9)
At-Tajdid : Jurnal Ilmu Tarbiyah     Open Access   (Followers: 2)
Attachment: New Directions in Psychotherapy and Relational Psychoanalysis     Full-text available via subscription   (Followers: 16)
Attention, Perception & Psychophysics     Full-text available via subscription   (Followers: 10)
Australian and Aotearoa New Zealand Psychodrama Association Journal     Full-text available via subscription  
Australian Educational and Developmental Psychologist, The     Full-text available via subscription   (Followers: 6)
Australian Journal of Psychology     Hybrid Journal   (Followers: 16)
Australian Psychologist     Hybrid Journal   (Followers: 11)
Autism Research     Hybrid Journal   (Followers: 31)
Autism Research and Treatment     Open Access   (Followers: 29)
Autism's Own     Open Access  
Autism-Open Access     Open Access   (Followers: 5)
Avaliação Psicológica     Open Access  
Avances en Psicologia Latinoamericana     Open Access   (Followers: 1)
Aviation Psychology and Applied Human Factors     Hybrid Journal   (Followers: 17)
Balint Journal     Hybrid Journal   (Followers: 3)
Barbaroi     Open Access  
Basic and Applied Social Psychology     Hybrid Journal   (Followers: 31)
Behavior Analysis in Practice     Full-text available via subscription   (Followers: 6)
Behavior Analysis: Research and Practice     Full-text available via subscription   (Followers: 2)
Behavior Analyst     Hybrid Journal   (Followers: 3)
Behavior Modification     Hybrid Journal   (Followers: 9)
Behavior Research Methods     Hybrid Journal   (Followers: 17)
Behavior Therapy     Hybrid Journal   (Followers: 45)
Behavioral Development Bulletin     Full-text available via subscription  
Behavioral Interventions     Hybrid Journal   (Followers: 7)
Behavioral Neuroscience     Full-text available via subscription   (Followers: 49)
Behavioral Sciences & the Law     Hybrid Journal   (Followers: 20)
Behavioral Sleep Medicine     Hybrid Journal   (Followers: 6)
Behaviour     Hybrid Journal   (Followers: 13)
Behaviour Research and Therapy     Hybrid Journal   (Followers: 17)
Behavioural and Cognitive Psychotherapy     Hybrid Journal   (Followers: 109)
Behavioural Processes     Hybrid Journal   (Followers: 6)
Biofeedback     Hybrid Journal   (Followers: 4)
BioPsychoSocial Medicine     Open Access   (Followers: 6)
BMC Psychology     Open Access   (Followers: 15)
Body, Movement and Dance in Psychotherapy: An International Journal for Theory, Research and Practice     Hybrid Journal   (Followers: 9)
Boletim Academia Paulista de Psicologia     Open Access  
Boletim de Psicologia     Open Access  
Brain Informatics     Open Access   (Followers: 1)
British Journal of Clinical Psychology     Full-text available via subscription   (Followers: 122)
British Journal of Developmental Psychology     Full-text available via subscription   (Followers: 35)
British Journal of Educational Psychology     Hybrid Journal   (Followers: 31)
British Journal of Health Psychology     Full-text available via subscription   (Followers: 42)
British Journal of Mathematical and Statistical Psychology     Full-text available via subscription   (Followers: 19)
British Journal of Psychology     Full-text available via subscription   (Followers: 56)
British Journal of Psychotherapy     Hybrid Journal   (Followers: 66)
British Journal of Social Psychology     Full-text available via subscription   (Followers: 31)
Burnout Research     Open Access   (Followers: 7)
Cadernos de psicanálise (Rio de Janeiro)     Open Access  
Cadernos de Psicologia Social do Trabalho     Open Access  
Canadian Art Therapy Association     Hybrid Journal  
Canadian Journal of Behavioural Science     Full-text available via subscription   (Followers: 6)
Canadian Journal of Experimental Psychology     Full-text available via subscription   (Followers: 11)
Canadian Psychology / Psychologie canadienne     Full-text available via subscription   (Followers: 10)
Cendekia : Jurnal Kependidikan dan Kemasyarakatan     Open Access  
Child Development Perspectives     Hybrid Journal   (Followers: 26)
Child Development Research     Open Access   (Followers: 13)
Ciencia Cognitiva     Open Access   (Followers: 2)
Ciencia e Interculturalidad     Open Access  
Ciências & Cognição     Open Access  
Ciencias Psicológicas     Open Access  
Clínica y Salud     Open Access  
Clinical Medicine Insights : Psychiatry     Open Access   (Followers: 9)
Clinical Practice in Pediatric Psychology     Full-text available via subscription   (Followers: 10)
Clinical Psychological Science     Hybrid Journal   (Followers: 11)
Clinical Psychologist     Hybrid Journal   (Followers: 15)
Clinical Psychology & Psychotherapy     Hybrid Journal   (Followers: 67)
Clinical Psychology and Special Education     Open Access   (Followers: 1)
Clinical Psychology Review     Hybrid Journal   (Followers: 33)
Clinical Psychology: Science and Practice     Hybrid Journal   (Followers: 20)
Clinical Schizophrenia & Related Psychoses     Full-text available via subscription   (Followers: 8)
Coaching Psykologi - The Danish Journal of Coaching Psychology     Open Access   (Followers: 1)
Cogent Psychology     Open Access  
Cógito     Open Access  
Cognition & Emotion     Hybrid Journal   (Followers: 36)
Cognitive Behaviour Therapy     Hybrid Journal   (Followers: 14)
Cognitive Neuropsychology     Hybrid Journal   (Followers: 26)
Cognitive Psychology     Hybrid Journal   (Followers: 58)
Consciousness and Cognition     Hybrid Journal   (Followers: 26)
Construção Psicopedagógica     Open Access  
Consulting Psychology Journal : Practice and Research     Full-text available via subscription   (Followers: 3)
Contagion : Journal of Violence, Mimesis, and Culture     Full-text available via subscription   (Followers: 8)
Contemporary Educational Psychology     Hybrid Journal   (Followers: 21)
Contemporary School Psychology     Hybrid Journal   (Followers: 4)
Contextos Clínicos     Open Access  
Counseling Outcome Research and Evaluation     Hybrid Journal   (Followers: 10)
Counseling Psychologist     Hybrid Journal   (Followers: 14)
Counseling Psychology and Psychotherapy     Open Access   (Followers: 7)
Counselling and Psychotherapy Research : Linking research with practice     Hybrid Journal   (Followers: 19)
Counselling and Values     Hybrid Journal   (Followers: 2)
Counselling Psychology Quarterly     Hybrid Journal   (Followers: 10)
Couple and Family Psychoanalysis     Full-text available via subscription   (Followers: 1)
Couple and Family Psychology : Research and Practice     Full-text available via subscription   (Followers: 4)
Creativity Research Journal     Hybrid Journal   (Followers: 20)
Creativity. Theories - Research - Applications     Open Access   (Followers: 1)
Criminal Justice Ethics     Hybrid Journal   (Followers: 6)
Cuadernos de Neuropsicología     Open Access   (Followers: 1)
Cuadernos de Psicologia del Deporte     Open Access  
Cuadernos de Psicopedagogía     Open Access  
Cultural Diversity and Ethnic Minority Psychology     Full-text available via subscription   (Followers: 12)
Cultural-Historical Psychology     Open Access  
Culturas Psi     Open Access  
Culture and Brain     Hybrid Journal   (Followers: 3)
Current Addiction Reports     Hybrid Journal   (Followers: 9)
Current Behavioral Neuroscience Reports     Hybrid Journal   (Followers: 2)
Current Directions In Psychological Science     Hybrid Journal   (Followers: 46)
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 1)
Current Opinion in Psychology     Hybrid Journal   (Followers: 3)
Current Psychological Research     Hybrid Journal   (Followers: 13)
Current Psychology     Hybrid Journal   (Followers: 14)
Current psychology letters     Open Access   (Followers: 2)
Current Research in Psychology     Open Access   (Followers: 20)
Cyberpsychology, Behavior, and Social Networking     Hybrid Journal   (Followers: 13)
Decision     Full-text available via subscription   (Followers: 2)
Depression and Anxiety     Hybrid Journal   (Followers: 14)
Depression Research and Treatment     Open Access   (Followers: 13)
Developmental Cognitive Neuroscience     Open Access   (Followers: 16)
Developmental Neuropsychology     Hybrid Journal   (Followers: 15)
Developmental Psychobiology     Hybrid Journal   (Followers: 9)
Developmental Psychology     Full-text available via subscription   (Followers: 44)
Diagnostica     Hybrid Journal   (Followers: 2)
Dialectica     Hybrid Journal   (Followers: 1)
Discourse     Full-text available via subscription   (Followers: 8)
Diversitas: Perspectivas en Psicologia     Open Access  
Drama Therapy Review     Hybrid Journal   (Followers: 1)
Dreaming     Full-text available via subscription   (Followers: 11)
Drogues, santé et société     Full-text available via subscription  
Dynamics of Asymmetric Conflict: Pathways toward terrorism and genocide     Hybrid Journal   (Followers: 12)
E-Journal of Applied Psychology     Open Access   (Followers: 7)
Ecopsychology     Hybrid Journal   (Followers: 6)
ECOS - Estudos Contemporâneos da Subjetividade     Open Access  
Educational Psychology Review     Hybrid Journal   (Followers: 25)
Educational Psychology: An International Journal of Experimental Educational Psychology     Hybrid Journal   (Followers: 46)
Educazione sentimentale     Full-text available via subscription  
Electronic Journal of Research in Educational Psychology     Open Access   (Followers: 6)
Elpis - Czasopismo Teologiczne Katedry Teologii Prawosławnej Uniwersytetu w Białymstoku     Open Access  
Emotion     Full-text available via subscription   (Followers: 33)
Emotion Review     Hybrid Journal   (Followers: 17)
En-Claves del pensamiento     Open Access   (Followers: 1)
Enseñanza e Investigacion en Psicologia     Open Access  
Epiphany     Open Access   (Followers: 3)
Escritos de Psicología : Psychological Writings     Open Access   (Followers: 2)

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Journal Cover Developmental Psychobiology
  [SJR: 1.329]   [H-I: 72]   [9 followers]  Follow
    
   Hybrid Journal Hybrid journal (It can contain Open Access articles)
   ISSN (Print) 0012-1630 - ISSN (Online) 1098-2302
   Published by John Wiley and Sons Homepage  [1587 journals]
  • Cost-effectiveness of population-based, community, workplace and
           individual policies for diabetes prevention in the UK
    • Authors: P. R. Breeze; C. Thomas, H. Squires, A. Brennan, C. Greaves, P. Diggle, E. Brunner, A. Tabak, L. Preston, J. Chilcott
      Abstract: AimTo analyse the cost-effectiveness of different interventions for Type 2 diabetes prevention within a common framework.MethodsA micro-simulation model was developed to evaluate the cost-effectiveness of a range of diabetes prevention interventions including: (1) soft drinks taxation; (2) retail policy in socially deprived areas; (3) workplace intervention; (4) community-based intervention; and (5) screening and intensive lifestyle intervention in individuals with high diabetes risk. Within the model, individuals follow metabolic trajectories (for BMI, cholesterol, systolic blood pressure and glycaemia); individuals may develop diabetes, and some may exhibit complications of diabetes and related disorders, including cardiovascular disease, and eventually die. Lifetime healthcare costs, employment costs and quality-adjusted life-years are collected for each person.ResultsAll interventions generate more life-years and lifetime quality-adjusted life-years and reduce healthcare spending compared with doing nothing. Screening and intensive lifestyle intervention generates greatest lifetime net benefit (£37) but is costly to implement. In comparison, soft drinks taxation or retail policy generate lower net benefit (£11 and £11) but are cost-saving in a shorter time period, preferentially benefit individuals from deprived backgrounds and reduce employer costs.ConclusionThe model enables a wide range of diabetes prevention interventions to be evaluated according to cost-effectiveness, employment and equity impacts over the short and long term, allowing decision-makers to prioritize policies that maximize the expected benefits, as well as fulfilling other policy targets, such as addressing social inequalities.
      PubDate: 2017-04-18T23:56:14.688413-05:
      DOI: 10.1111/dme.13349
       
  • Differential increments of basal glucagon-like-1 peptide concentration
           among SLC47A1 rs2289669 genotypes were associated with inter-individual
           variability in glycaemic response to metformin in Chinese people with
           newly diagnosed Type 2 diabetes
    • Authors: H. Liang; W. Xu, L. Zhou, W. Yang, J. Weng
      Abstract: AimTo elucidate the effects of rs2289669, an intron variant of the SLC47A1 gene, on glucose response to metformin in Chinese people with newly diagnosed Type 2 diabetes.MethodsRs2289669 was genotyped, using Sequenom, in 291 participants receiving 48 weeks of metformin monotherapy. The changes in HbA1c were compared among rs2289669 genotypes, and associations with rs2289669 were evaluated using linear regression analysis.ResultsWe found that, compared with participants with a homozygous G allele, those carrying the minor A allele had significantly greater HbA1c reduction and greater increases in basal glucagon-like peptide-1 concentration. Regression analysis showed that there was a significant association between rs2289669 and the glucose response to metformin after adjusting for confounding factors, except for changes in basal glucagon-like peptide-1, for which an association was not observed.ConclusionsOur findings suggest that rs2289669 might help predict the glycaemic response to metformin in Chinese people newly diagnosed with Type 2 diabetes, and that differential increases in basal glucagon-like peptide-1 concentration among rs2289669 genotypes might be associated with inter-individual response to metformin.
      PubDate: 2017-04-16T23:05:48.890448-05:
      DOI: 10.1111/dme.13351
       
  • In Memoriam: Gilbert W. Meier (1927–2016)
    • Authors: Richard P. Meier
      PubDate: 2017-04-13T10:22:53.339153-05:
      DOI: 10.1002/dev.21519
       
  • Pre-ejection period reactivity to reward is associated with anhedonic
           symptoms of depression among adolescents
    • Authors: Joshua J. Ahles; Amy H. Mezulis, Sheila E. Crowell
      Abstract: Pre-ejection period (PEP) reactivity to reward has been posited as a specific index of behavioral approach and incentive motivation, suggesting it might be uniquely associated with the affective and motivational deficits of anhedonia. This study evaluated PEP reactivity to a reward task as a predictor of depressive symptoms among adolescents, examining global depressive symptoms as well as specific anhedonic and nonanhedonic symptoms clusters. Participants included 76 adolescents, ages 11–15 years (52% female). This study found marginal support for an association between PEP reactivity to reward and concurrent anhedonia symptoms, but no association with nonanhedonic or the global scale. Findings are discussed in terms of potential associations between peripheral psychophysiological measures and dopaminergic functioning and also the utility of this measure for future research on anhedonia.
      PubDate: 2017-04-13T10:22:45.788689-05:
      DOI: 10.1002/dev.21518
       
  • Comparative study of HbA1c and fasting plasma glucose vs the oral glucose
           tolerance test for diagnosis of diabetes in people with tuberculosis
    • Authors: H. Aftab; A. Ambreen, M. Jamil, P. Garred, J. H. Petersen, S. D. Nielsen, I. C. Bygbjerg, D. L. Christensen
      Abstract: AimTo compare HbA1c and fasting plasma glucose assessment, with the 2-h oral glucose tolerance test as reference, in screening for diabetes in people with turberculosis.MethodsIndividuals (N=268) with newly diagnosed smear-positive tuberculosis were screened for diabetes at a tertiary hospital in Lahore, Pakistan. Diabetes diagnosis was based on WHO criteria: thresholds were ≥ 48 mmol/mol (≥6.5%) for HbA1c and ≥7.0mmol/l for fasting plasma glucose.ResultsThe proportion of participants diagnosed with diabetes was 4.9% (n =13) by oral glucose tolerance test, while 11.9% (n =32) and 14.6% (n =39) were diagnosed with diabetes using HbA1c and fasting plasma glucose criteria, respectively. The area under the receiver-operating characteristic curve was 0.79 (95% CI 0.64 to 0.94) for HbA1c and 0.61 (95% CI 0.50 to 0.73) for fasting plasma glucose, with a borderline significant difference between the two tests (P=0.07).ConclusionsHbA1c and fasting plasma glucose performed equally in terms of diagnosing new diabetes cases in individuals with tuberculosis, but the proportion of participants falsely classified as positive was higher for fasting plasma glucose. This may be explained by acute blood glucose fluctuations when using fasting plasma glucose. HbA1c may be a more reliable test in individuals with transient hyperglycaemia.
      PubDate: 2017-04-11T01:35:29.958202-05:
      DOI: 10.1111/dme.13354
       
  • Incidence, recurrence and cost of hyperglycaemic crises requiring
           emergency treatment in Andalusia, Spain
    • Authors: R. J. Barranco; F. Gomez-Peralta, C. Abreu, M. Delgado-Rodriguez, A. Moreno-Carazo, F. Romero, M. A. de la Cal, J. M. Barranco, F. J. Pasquel, G. E. Umpierrez
      Abstract: AimsHyperglycaemic crises (diabetic ketoacidosis and hyperosmolar hyperglycaemic state) are medical emergencies in people with diabetes. We aimed to determine their incidence, recurrence and economic impact.MethodsAn observational study of hyperglycaemic crises cases using the database maintained by the out-of-hospital emergency service, the Healthcare Emergency Public Service (EPES) during 2012. The EPES provides emergency medical services to the total population of Andalusia, Spain (8.5 million inhabitants) and records data on the incidence, resource utilization and cost of out-of-hospital medical care. Direct costs were estimated using public prices for health services updated to 2012.ResultsAmong 1 137 738 emergency calls requesting medical assistance, 3157 were diagnosed with hyperglycaemic crises by an emergency coordinator, representing 2.9 cases per 1000 persons with diabetes [95% confidence intervals (CI) 2.8 to 3.0]. The incidence of diabetic ketoacidosis was 2.5 cases per 1000 persons with diabetes (95% CI 2.4 to 2.6) and the incidence of hyperosmolar hyperglycaemic state was 0.4 cases per 1000 persons with diabetes (95% CI 0.4 to 0.5). In total, 17.7% (n = 440) of people had one or more hyperglycaemic crisis. The estimated total direct cost was €4 662 151, with a mean direct cost per episode of €1476.8 ± 217.8.ConclusionsHyperglycaemic crises require high resource utilization of emergency medical services and have a significant economic impact on the health system.
      PubDate: 2017-04-11T01:35:27.204941-05:
      DOI: 10.1111/dme.13355
       
  • Factors determining uptake of diabetic retinopathy screening in
           Oxfordshire
    • Authors: R. B. R. Moreton; I. M. Stratton, S. J. Chave, H. Lipinski, P. H. Scanlon
      Abstract: AimsTo investigate variables at the demographic and primary care practice levels that influence the uptake of diabetic retinopathy screening.MethodsData were extracted from the management software of one screening programme for 21 797 people registered with 79 general practices. Uptake was examined by gender, age group, modality of screening (mobile unit at general practice versus high-street optometrist), and by general practice. A telephone survey of high-street optometrists provided information on the availability of screening appointments.ResultsUptake was 82.4% during the study period, and was higher for men (83.2%) than for women (81.5%) (P = 0.001). Uptake varied by age group (P < 0.001), being lowest in those aged 12–39 years (67%). Uptake was higher for people invited to a general practice for screening by a mobile unit (83.5%) than for those invited for screening by a high-street optometrist (82%) (P = 0.006). After adjusting for these factors and for socio-economic deprivation score at the location of the general practice, heterogeneity in uptake rate was still observed between some practices. Our survey of optometrists indicated wide variation in the availability of time slots for screening during the week and of screening appointment provision.ConclusionsDiabetic retinopathy screening services do not achieve high uptake among the youngest or oldest age groups. Practices in the least deprived areas had the highest uptake. Variation in uptake between general practices after adjustment for individual-level variables and deprivation suggests that practice-level factors may have an important role in determining rates of screening attendance.
      PubDate: 2017-04-10T23:40:28.150292-05:
      DOI: 10.1111/dme.13350
       
  • Distress vocalization delay in the neonate lamb as a neurobehavioral
           assessment tool
    • Authors: Christine L. Morton; Geoffrey Hinch, Alison Small
      Abstract: Acoustic features of infant distress vocalizations including latency and rate of emission are used as indices of neurological deficit and integrity in human and rodent neonates. This paper investigates the relationship between temporal characteristics of distress calls, elicited by an isolation stimulus, and indicators of neurobehavioral development over 12 hr postpartum in the neonate lamb. Delayed vocalization initiation was found to be associated with poor locomotor and orientation behavior reflecting the capacity of the lamb to reunite with and follow its dam, and a lowered rate of signal emission following commencement of vocalization. Animals demonstrating delayed vocalization initiation also appeared more likely to be of a birth weight predisposed to fetal distress, and to urinate when exposed to a novel environment. Based on these preliminary studies, we propose that compromised emission of vocal signals is indicative of neurobehavioral deficit in the neonate lamb.
      PubDate: 2017-04-09T11:20:38.730668-05:
      DOI: 10.1002/dev.21517
       
  • Pubertal development and anxiety risk independently relate to startle
           habituation during fear conditioning in 8–14 year-old females
    • Authors: Felicia Jackson; Brady D. Nelson, Alexandria Meyer, Greg Hajcak
      Abstract: Reduced habituation to aversive stimuli has been observed during adolescence and may reflect an underlying mechanism of vulnerability for anxiety disorders. This study examined the startle reflex during a fear-learning task in 54 8–14-year-old girls. We examined the relationship between mean startle, startle habituation, pubertal development, and two measures linked to risk for anxiety: behavioral inhibition system (BIS) and the error-related negativity (ERN). Puberty, BIS, and the ERN were unrelated to mean startle; however, each measure modulated startle habituation. Greater pubertal development was associated with reduced startle habituation across the CS+ and CS−. Higher BIS related to a larger ERN, and both were associated with reduced startle habituation specifically to the CS+. All effects were independent of each other. Findings suggest that puberty alters habituation of defense system activation to both threat and safety cues, and this is independent of risk for anxiety, which uniquely impacts habituation to threat cues.
      PubDate: 2017-04-06T09:00:41.999877-05:
      DOI: 10.1002/dev.21506
       
  • A dissociation between renewal and contextual fear conditioning in
           juvenile rats
    • Authors: Chun Hui J. Park; Despina E. Ganella, Jee Hyun Kim
      Abstract: We investigated whether juvenile rats do not express renewal following extinction of conditioned fear due to their inability to form a long-term contextual fear memory. In experiment 1, postnatal day (P) 18 and 25 rats received 3 white-noise and footshock pairings, followed by 60 white-noise alone presentations the next day. When tested in a different context to extinction, P25 rats displayed renewal whereas P18 rats did not. Experiments 2A and 2B surprisingly showed that P18 and P25 rats do not show differences in contextual and cued fear, regardless of the conditioning-test intervals and the number of white-noise-footshock pairings received. Finally, we observed age differences in contextual fear when P25 rats were weaned at P21 in experiment 3. These results indicate that the developmental dissociation observed in renewal of extinguished fear is not related to the widely believed late emergence of contextual fear learning.
      PubDate: 2017-04-06T09:00:35.125245-05:
      DOI: 10.1002/dev.21516
       
  • A MRI study of the corpus callosum in monkeys: Developmental trajectories
           and effects of neonatal hippocampal and amygdala lesions
    • Authors: Christa Payne; Laetitia Cirilli, Jocelyne Bachevalier
      Abstract: This study provides the first characterization of early developmental trajectories of corpus callosum (CC) segments in rhesus macaques using noninvasive MRI techniques and assesses long-term effects of neonatal amygdala or hippocampal lesions on CC morphometry. In Experiment 1, 10 monkeys (5 males) were scanned at 1 week—2 years of age; eight additional infants (4 males) were scanned once at 1–4 weeks of age. The first 8 months showed marked growth across all segments, with sustained, albeit slower, growth through 24 months. Males and females had comparable patterns of CC maturation overall, but exhibited slight differences in the anterior and posterior segments, with greater increases in the isthmus for males and greater increases in the rostrum for females. The developmental changes are likely a consequence of varying degrees of axonal myelination, redirection, and pruning. In Experiment 2, animals with neonatal lesions of the amygdala (n = 6; 3 males) or hippocampus (n = 6; 4 males) were scanned at 1.5 years post-surgery and compared to scans of six control animals from Experiment 1. Whereas amygdala damage yielded larger rostral and posterior body segments, hippocampal damage yielded larger rostrum and isthmus. These differences demonstrate that early perturbations to one medial temporal lobe structure may produce extensive and long-lasting repercussions in other brain areas. The current findings emphasize the complexity of neural circuitry putatively subserving neurodevelopmental disorders such as autism spectrum disorder and Williams syndrome, which are each characterized by malformations and dysfunction of complex neural networks that include regions of the medial temporal lobe.
      PubDate: 2017-04-03T06:47:48.133194-05:
      DOI: 10.1002/dev.21514
       
  • Maternal rearing environment impacts autonomic nervous system activity
    • Authors: Eliza Bliss-Moreau; Gilda Moadab, John P. Capitanio
      Abstract: While it is now well known that social deprivation during early development permanently perturbs affective responding, accumulating evidence suggests that less severe restriction of the early social environment may also have deleterious effects. In the present report, we evaluate the affective responding of rhesus macaque (Macaca mulatta) infants raised by their mothers in restricted social environments or by their mothers in large social groups by indexing autonomic nervous system activity. Following a 25-hr evaluation of biobehavioral organization, electrocardiogram, and an index of respiration were recorded for 10 min. This allowed for an evaluation of both heart rate and respiratory sinus arrhythmia (RSA), an index of parasympathetic activity, during a challenging situation. Three- to four-month-old infants raised in restricted social environments had significantly higher heart rates and lower RSA as compared to infants raised in unrestricted social environments, consistent with a more potent stress response to the procedure. These results are consistent with mounting evidence that the environment in which individuals are raised has important consequences for affective processing.
      PubDate: 2017-04-03T06:47:46.17645-05:0
      DOI: 10.1002/dev.21513
       
  • Recognizing facial expressions of emotion in infancy: A replication and
           extension
    • Authors: Kristina Safar; Margaret C. Moulson
      Abstract: Infants may recognize facial expressions of emotion more readily when familiar faces express the emotions. Studies 1 and 2 investigated whether familiarity influences two metrics of emotion processing: Categorization and spontaneous preference. In Study 1 (n = 32), we replicated previous findings showing an asymmetrical pattern of categorization of happy and fearful faces in 6.5-month-old infants, and extended these findings by demonstrating that infants’ categorization did not differ when emotions were expressed by familiar (i.e., caregiver) faces. In Study 2 (n = 34), we replicated the spontaneous preference for fearful over happy expressions in 6.5-month-old infants, and extended these findings by demonstrating that the spontaneous preference for fear was also present for familiar faces. Thus, infants’ performance on two metrics of emotion processing did not differ depending on face familiarity.
      PubDate: 2017-04-03T06:47:41.142461-05:
      DOI: 10.1002/dev.21515
       
  • The effect of an education programme (MEDIAS 2 BSC) of non-intensive
           insulin treatment regimens for people with Type 2 diabetes: a randomized,
           multi-centre trial
    • Authors: N. Hermanns; D. Ehrmann, S. Schall, B. Maier, T. Haak, B. Kulzer
      Abstract: AimsA self-management oriented education programme (MEDIAS 2 BSC) for people with Type 2 diabetes who are on a non-intensive insulin treatment regimen was developed. In a randomized, multi-centre trial, the effect of MEDIAS 2 BSC was compared with an established education programme that acted as a control group.MethodsThe primary outcome was the impact of MEDIAS 2 BSC on glycaemic control. Secondary outcomes included the incidence of severe hypoglycaemia, hypoglycaemia unawareness, diabetes-related distress, diabetes knowledge, quality of life and self-care behaviour.ResultsIn total, 182 participants were randomized to the control group or MEDIAS 2 BSC [median age 64.0 (interquartile range 58.0–68.5) vs. 63.5 (57.0–70.0) years; HbA1c 62.8 ± 12.7 mmol/mol vs. 63.7 ± 14.0 mmol/mol; 7.9% ± 1.2% vs. 8.0% ± 1.3%]. After a 6-month follow-up, there was a mean decrease in HbA1c of 3.5 mmol/mol (0.32%) in the control group and 6.7 mmol/mol (0.61%) in MEDIAS 2 BSC. After adjusting for baseline differences and study centre, the mean difference between the groups was −3.3 mmol/mol [95% confidence interval (CI) −0.54 to −5.90 mmol/mol] [−0.30% (95% CI −0.05 to −0.54)] in favour of MEDIAS 2 BSC (P = 0.018). There were no increases in severe hypoglycaemia or hypoglycaemia unawareness. The education programmes had no significant effects on psychosocial outcome variables.ConclusionMEDIAS 2 BSC was more effective in lowering HbA1c than the control condition. MEDIAS 2 BSC is a safe educational tool that improves glycaemic control without increasing the risk for hypoglycaemia. (Clinical Trials Registry No; NCT 02748239)
      PubDate: 2017-04-02T22:45:29.345269-05:
      DOI: 10.1111/dme.13346
       
  • Pre-exposure to cocaine or morphine attenuates taste avoidance
           conditioning in adolescent rats: Drug specificity in the US pre-exposure
           effect
    • Authors: Matthew M. Clasen; Briana J. Hempel, Anthony L. Riley
      Abstract: Although the attenuating effects of drug history on conditioned taste avoidance (CTA) learning have been widely investigated in adults, such effects in adolescents have not been well characterized. Recent research has suggested that the display of the drug pre-exposure effect during adolescence may be drug dependent given that pre-exposure to ethanol attenuates subsequent conditioning, whereas pre-exposure to the classic emetic lithium chloride (LiCl) fails to do so. The present study began investigating the possible drug-dependent nature of the effects of drug pre-exposure by pre-exposing and conditioning adolescent male Sprague–Dawley rats to drugs from two additional classes, specifically psychostimulants (cocaine; Experiment 1) and opioids (morphine; Experiment 2). Consistent with prior work with ethanol (but not LiCl), prior exposure to both cocaine and morphine attenuated taste avoidance induced by these compounds. Although this work supports the view of drug-dependent pre-exposure effects on taste avoidance learning during adolescence, research is needed to assess its mechanisms.
      PubDate: 2017-03-28T13:05:28.053847-05:
      DOI: 10.1002/dev.21512
       
  • Care of women with diabetes before, during and after pregnancy: time for a
           new approach?
    • Authors: A. M. Egan; L. Carmody, B. Kirwan, F. P. Dunne,
      Abstract: AimsThis study assesses the impact of pregnancy and pre-pregnancy care on longer-term treatment goals in women with diabetes.MethodsThis retrospective study included women with Type 1 (n = 247) and Type 2 diabetes (n = 137) who were evaluated before, during and after pregnancy.ResultsAmong women with Type 1 diabetes, average HbA1c at 12 months post-partum was similar to the preconception level [63 vs. 64 mmol/mol (7.9% vs. 8.0%), P = 0.60]. This was also the case for women with Type 2 diabetes [52 vs. 52 mmol/mol (6.9% vs. 6.9%), P = 0.79]. At 12 months post-partum, there was no improvement in other measures of diabetes control and one in five women are lost to follow-up from clinical care. In total, 44.9% of women with Type 1 diabetes and 27.7% of those with Type 2 diabetes attended pre-pregnancy care. Attendees maintained superior glycaemic control throughout the study and were more likely to be receiving specialist care post-partum.ConclusionsThese findings identify a need to change our approach to the reproductive care of women with diabetes. In particular, efforts should be made to ensure all women have access to and attend pre-pregnancy care, and barriers to engagement with post-partum care should be addressed.
      PubDate: 2017-03-21T23:47:00.474362-05:
      DOI: 10.1111/dme.13342
       
  • Effectiveness of group-based self-management education for individuals
           with Type 2 diabetes: a systematic review with meta-analyses and
           meta-regression
    • Authors: K. Odgers-Jewell; L. E. Ball, J. T. Kelly, E. A. Isenring, D. P. Reidlinger, R. Thomas
      Abstract: AimsPatient education for the management of Type 2 diabetes can be delivered in various forms, with the goal of promoting and supporting positive self-management behaviours. This systematic review aimed to determine the effectiveness of group-based interventions compared with individual interventions or usual care for improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.MethodsSix electronic databases were searched. Group-based education programmes for adults with Type 2 diabetes that measured glycated haemoglobin (HbA1c) and followed participants for ≥ 6 months were included. The primary outcome was HbA1c, and secondary outcomes included fasting blood glucose, weight, body mass index, waist circumference, blood pressure, blood lipid profiles, diabetes knowledge and self-efficacy.ResultsFifty-three publications describing 47 studies were included (n = 8533 participants). Greater reductions in HbA1c occurred in group-based education compared with controls at 6–10 months [n = 30 studies; mean difference (MD) = 3 mmol/mol (0.3%); 95% confidence interval (CI): −0.48, −0.15; P = 0.0002], 12–14 months [n = 27 studies; MD = 4 mmol/mol (0.3%); 95% CI: −0.49, −0.17; P < 0.0001], 18 months [n = 3 studies; MD = 8 mmol/mol (0.7%); 95% CI: −1.26, −0.18; P = 0.009] and 36–48 months [n = 5 studies; MD = 10 mmol/mol (0.9%); 95% CI: −1.52, −0.34; P = 0.002], but not at 24 months. Outcomes also favoured group-based education for fasting blood glucose, body weight, waist circumference, triglyceride levels and diabetes knowledge, but not at all time points. Interventions facilitated by a single discipline, multidisciplinary teams or health professionals with peer supporters resulted in improved outcomes in HbA1c when compared with peer-led interventions.ConclusionsGroup-based education interventions are more effective than usual care, waiting list control and individual education at improving clinical, lifestyle and psychosocial outcomes in people with Type 2 diabetes.
      PubDate: 2017-03-20T23:45:37.659807-05:
      DOI: 10.1111/dme.13340
       
  • Increasing the protein quantity in a meal results in dose-dependent
           effects on postprandial glucose levels in individuals with Type 1 diabetes
           mellitus
    • Authors: M. A. Paterson; C. E. M. Smart, P. E. Lopez, P. Howley, P. McElduff, J. Attia, C. Morbey, B. R. King
      Abstract: AimTo determine the glycaemic impact of increasing protein quantities when consumed with consistent amounts of carbohydrate in individuals with Type 1 diabetes on intensive insulin therapy.MethodsParticipants with Type 1 diabetes [aged 10–40 years, HbA1c ≤ 64 mmol/mol (8%), BMI ≤ 91st percentile] received a 30-g carbohydrate (negligible fat) test drink daily over 5 days in randomized order. Protein (whey isolate 0 g/kg carbohydrate, 0 g/kg lipid) was added in amounts of 0 (control), 12.5, 25, 50 and 75 g. A standardized dose of insulin was given for the carbohydrate. Postprandial glycaemia was assessed by 5 h of continuous glucose monitoring.ResultsData were collected from 27 participants (15 male). A dose–response relationship was found with increasing amount of protein. A significant negative relationship between protein dose and mean excursion was seen at the 30- and 60-min time points (P = 0.007 and P = 0.002, respectively). No significant relationship was seen at the 90- and 120-min time points. Thereafter, the dose–response relationship inverted, such that there was a significant positive relationship for each of the 150–300-min time points (P < 0.004). Mean glycaemic excursions were significantly greater for all protein-added test drinks from 150 to 300 min (P < 0.005) with the 75-g protein load, resulting in a mean excursion that was 5 mmol/l higher when compared with the control test drink (P < 0.001).ConclusionsIncreasing protein quantity in a low-fat meal containing consistent amounts of carbohydrate decreases glucose excursions in the early (0–60-min) postprandial period and then increases in the later postprandial period in a dose-dependent manner.
      PubDate: 2017-03-19T23:41:17.253812-05:
      DOI: 10.1111/dme.13347
       
  • Updated 24-year trend of Type 1 diabetes incidence in children in Poland
           reveals a sinusoidal pattern and sustained increase
    • Authors: A. Chobot; J. Polanska, A. Brandt, G. Deja, B. Glowinska-Olszewska, O. Pilecki, A. Szadkowska, M. Mysliwiec, P. Jarosz-Chobot
      Abstract: AimsTo present the incidence trend for Type 1 diabetes in Polish children aged 0–14 years, updated using data collected during 2005–2012, and assess the reliability of the predictive model constructed previously using the 1989–2004 database.MethodsChildren aged < 15 years with newly diagnosed Type 1 diabetes are recorded prospectively (EURODIAB criteria) in several regional registers in Poland. Age- and gender-standardized incidence rates for Type 1 diabetes were calculated per 100 000 persons/year. Incidence rates were analysed in terms of the dependency on age, gender, geographical region and population density. Incidence rate trends over time were modelled using generalized linear models.ResultsThe mean standardized incidence for 1989–2012 was 12.72 per 100 000 persons/year [95% confidence interval (CI), 11.35 to 14.21]. Over the 24-year observation period, the incidence increased from 5.36 to 22.74 per 100 000 persons/year. The lowest incidence rate was in children aged 0–4 years (8.35, 95% CI 7.27 to 9.57 per 100 000 persons/year). There was no difference between genders, or urban and rural regions. Incidence rates were higher in northern compared with southern Poland [14.04 (95% CI 12.59 to 15.63) vs. 11.94 (95% CI 10.62 to 13.39) per 100 000 persons/year]. The new data corrected the earlier predictive model by changing the estimates of some factors related to patient age, gender and their interactions with the remaining factors. The incidence rate shows periodic 5.33-year fluctuations. The periodicity component allows for a more accurate prediction of the incidence rate over time.ConclusionsThis cohort study reveals a sustained increase in Type 1 diabetes incidence in Polish children aged 0–14 years with regular, sinusoidal fluctuations and a slight levelling off in past few years. It is of concern that are the highest increases in incidence are found in children aged 0–4 years.
      PubDate: 2017-03-19T23:41:16.079847-05:
      DOI: 10.1111/dme.13345
       
  • Preschoolers’ genetic, physiological, and behavioral sensitivity factors
           moderate links between parenting stress and child internalizing,
           externalizing, and sleep problems
    • Authors: Molly Davis; Kristel Thomassin, Joanie Bilms, Cynthia Suveg, Anne Shaffer, Steven R.H. Beach
      Abstract: This study examined three potential moderators of the relations between maternal parenting stress and preschoolers’ adjustment problems: a genetic polymorphism—the short allele of the serotonin transporter (5-HTTLPR, ss/sl allele) gene, a physiological indicator—children's baseline respiratory sinus arrhythmia (RSA), and a behavioral indicator—mothers’ reports of children's negative emotionality. A total of 108 mothers (Mage = 30.68 years, SDage = 6.06) reported on their parenting stress as well as their preschoolers’ (Mage = 3.50 years, SDage = 0.51, 61% boys) negative emotionality and internalizing, externalizing, and sleep problems. Results indicated that the genetic sensitivity variable functioned according to a differential susceptibility model; however, the results involving physiological and behavioral sensitivity factors were most consistent with a diathesis-stress framework. Implications for prevention and intervention efforts to counter the effects of parenting stress are discussed.
      PubDate: 2017-03-14T11:45:31.638243-05:
      DOI: 10.1002/dev.21510
       
  • Paediatric parenting stress in fathers and mothers of young children with
           Type 1 diabetes: a longitudinal study
    • Authors: A. Nieuwesteeg; E. Hartman, W. Emons, H. Bakel, H-J. Aanstoot, E. Mil, F. Pouwer
      Abstract: AimTo compare levels of paediatric parenting stress in the fathers and mothers of young children with Type 1 diabetes and study the variation in this stress over time.MethodsOne hundred and twelve parents (56 mothers and 56 fathers) of young children (0–7 years) with Type 1 diabetes participated in this study. They completed the Pediatric Inventory for Parents to assess paediatric parenting stress (frequency and difficulty scores on the Communication, Emotional Distress, Medical Care and Role Functioning subscales and Total Score); 44 mothers (79%) and 31 fathers (55%) completed the questionnaire again, 1 year later. Independent and paired sample t-tests were used to examine the differences between fathers and mothers and the changes over time. Cohen's d effect sizes were also calculated.ResultsMothers scored significantly higher than fathers on the stress subscales for Communication frequency and difficulty, Emotional Distress frequency and difficulty, Medical Care frequency and Total Score frequency and difficulty (d ranged from −0.44 to −0.56). Furthermore, fathers reported a decrease in Medical Care frequency (d = 0.10) and an increase in Emotional Distress difficulty (d = −0.32) and Total Score difficulty (d = −0.29), whereas mothers reported a decrease in Emotional Distress frequency, Medical Care frequency and Total Score frequency (d ranged from 0.31 to 0.66) over a 1-year period.ConclusionsThese results show that within families with a young child with Type 1 diabetes, the burden of care increases in fathers and decreases in mothers, suggesting that fathers assume more responsibility for care of their child with Type 1 diabetes as the child grows.
      PubDate: 2017-03-13T23:25:28.765475-05:
      DOI: 10.1111/dme.13300
       
  • Deficiencies in postgraduate training for healthcare professionals who
           provide diabetes education and support: results from the Diabetes
           Attitudes, Wishes and Needs (DAWN2) study
    • Authors: J. L. Byrne; M. J. Davies, I. Willaing, R. I. G. Holt, M. E. Carey, H. Daly, S. Skovlund, M. Peyrot
      Abstract: AimsTo consider the global provision of self-management diabetes education and training for healthcare professionals using data from the second Diabetes Attitudes, Wishes and Needs (DAWN2) study.MethodsA total of 4785 healthcare professionals caring for people with diabetes were surveyed in 17 countries to assess diabetes healthcare provision, self-management support and training.ResultsOf the healthcare professionals surveyed, 33.5% received formal postgraduate training in self-management (19.3–51.4% across countries) and 62.9% received training for medical management of diabetes (47.6–70.6% variation). Training in psychological management was low (19.1%), ranging from 3.6 to 36.5%, while 20.4% (a range of 3.6–36.4% across countries) had received no postgraduate training. Overall, the greatest training need was in the management of psychological aspects of diabetes (59.5%). For some, training in a domain was positively associated with a perceived need for further training. Communication skills, for example, listening (76.9%) and encouraging questions (76.1%), were the skills most widely used. Discussion of emotional issues was limited; 31–60% of healthcare professionals across the different countries reported that this only occurred if initiated by patients. Approximately two-thirds of participants reported a need for major improvements in emotional/psychological support, but few had received training in this area, with consistent findings across professional affiliations.ConclusionsThe present study shows that healthcare professionals report being insufficiently equipped to provide diabetes self-management education, including emotional and psychological aspects of diabetes, and many are not receiving postgraduate training in any part (including medical care) of the management of diabetes. It is paramount that those responsible for the continuing professional development of healthcare professionals address this skills gap.
      PubDate: 2017-03-09T04:05:39.184956-05:
      DOI: 10.1111/dme.13334
       
  • Incidence of chronic kidney disease among people with diabetes: a
           systematic review of observational studies
    • Authors: D. N. Koye; J. E. Shaw, C. M. Reid, R. C. Atkins, A. T. Reutens, D. J. Magliano
      Abstract: AimsThe aim was to systematically review published articles that reported the incidence of chronic kidney disease among people with diabetes.MethodsA systematic literature search was performed using MEDLINE, Embase and CINAHL databases. The titles and abstracts of all publications identified by the search were reviewed and 10 047 studies were retrieved.ResultsA total of 71 studies from 30 different countries with sample sizes ranging from 505 to 211 132 met the inclusion criteria. The annual incidence of microalbuminuria and albuminuria ranged from 1.3% to 3.8% for Type 1 diabetes. For Type 2 diabetes and studies combining both diabetes types, the range was from 3.8% to 12.7%, with four of six studies reporting annual rates between 7.4% and 8.6%. In studies reporting the incidence of eGFR < 60 ml/min/1.73 m2 using the Modification of Diet on Renal Disease (MDRD) equation, apart from one study which reported an annual incidence of 8.9%, the annual incidence ranged from 1.9% to 4.3%. The annual incidence of end-stage renal disease ranged from 0.04% to 1.8%.ConclusionsThe annual incidence of microalbuminuria and albuminuria is ~ 2–3% in Type 1 diabetes, and ~ 8% in Type 2 diabetes or mixed diabetes type. The incidence of developing eGFR < 60 ml/min/1.73 m2 is ~ 2–4% per year. Despite the wide variation in methods and study design, within a particular category of kidney disease, there was only modest variation in incidence rates. These findings may be useful in clinical settings to help understand the risk of developing kidney disease among those with diabetes.
      PubDate: 2017-03-09T02:30:54.260422-05:
      DOI: 10.1111/dme.13324
       
  • Healthcare costs of Type 2 diabetes in Germany
    • Authors: E. Jacobs; A. Hoyer, R. Brinks, A. Icks, O. Kuß, W. Rathmann
      Abstract: AimTo describe for the first time the direct costs of Type 2 diabetes treatment by analysing nationwide routine data from statutory health insurance in Germany.MethodsThis cost-of-illness-study was based on a 6.8% random sample of all German people with statutory health insurance (4.3 out of 70 million people). The healthcare expenses show direct per capita costs from the payer perspective. Healthcare expenses for physicians, dentists, pharmacies, hospitals, sick benefits and other healthcare costs were considered. Per capita costs, cost ratios for people with Type 2 diabetes and without diabetes as well as diabetes-attributable costs were calculated.ResultsPer capita costs for people with Type 2 diabetes amounted to €4,957 in 2009 and €5,146 in 2010. People with Type 2 diabetes had 1.7-fold higher health expenses than people without diabetes. The largest differences in health expenses were found for prescribed medication from pharmacies (cost ratio diabetes/no diabetes: 2.2) and inpatient treatment (1.8). Ten percent of the total statutory health insurance expense, in total €16.1 billion, was attributable to the medical care of people with Type 2 diabetes.ConclusionsThis nationwide study indicates that one in 10 Euros of healthcare expenses is spent on people with Type 2 diabetes in Germany. In the future, national statutory health insurance data can be used to quantify time trends of costs in the healthcare system.
      PubDate: 2017-03-09T02:30:47.587221-05:
      DOI: 10.1111/dme.13336
       
  • Prevalence, glucose control and relative survival of people with Type 2
           diabetes in the UK from 1991 to 2013
    • Authors: S. E. Holden; S. Jenkins-Jones, C. Ll. Morgan, J. R. Peters, G. Schernthaner, C. J. Currie
      Abstract: AimsTo characterize the prevalence of Type 2 diabetes between 1991 and 2013 in the UK and to determine whether corresponding glucose control and survival had changed in the diabetic population during this period.MethodsFor this retrospective cohort study, people diagnosed with Type 2 diabetes between 1991 and 2013 were identified from the Clinical Practice Research Datalink (CPRD) and the annual point prevalence calculated. Mean HbA1c by year was estimated. The Cox proportional hazards model was used to calculate the risk of all-cause mortality by year for incident cases of Type 2 diabetes treated with glucose-lowering therapy.ResultsCrude prevalence of diagnosed Type 2 diabetes increased from 1.32% [95% confidence interval (95% CI) 1.30% to 1.34%] in 1991 to 4.54% (4.52% to 4.56%) in 2013. Mean HbA1c for people with diagnosed Type 2 diabetes was 71 mmol/mol (8.6%) in 1991, 59 mmol/mol (7.5%) in 2003 and 58 mmol/mol (7.5%) in 2013. For diagnosed Type 2 diabetes treated with glucose-lowering therapy, when compared with 1991, the hazard ratio for all-cause mortality was 0.33 (0.27–0.41) in 2013.ConclusionThe prevalence of diagnosed Type 2 diabetes trebled in the UK between 1991 and 2013. Improved survival in people with diagnosed Type 2 diabetes is likely to account, at least in part, for the increase in prevalence observed.
      PubDate: 2017-03-09T02:30:37.234377-05:
      DOI: 10.1111/dme.13332
       
  • Factors influencing attendance at structured education for Type 1 diabetes
           in south London
    • Authors: S. M. Harris; P. Shah, H. Mulnier, A. Healey, S. M. Thomas, S. A. Amiel, D. Hopkins
      Abstract: AimTo investigate the factors influencing uptake of structured education for people with Type 1 diabetes in our local population in order to understand why such uptake is low.MethodsWe conducted a cross-sectional database study of adults with Type 1 diabetes in two south London boroughs, analysed according to Dose Adjustment For Normal Eating (DAFNE) attendance or non-attendance. Demographics, glycaemic control and service use, with subset analysis by ethnicity, were compared using univariate analysis. An exploratory regression model was used to identify influencing factors.ResultsThe analysis showed that 73% of adults had not attended the DAFNE programme. For non-attenders vs attenders, male gender (59 vs 48%; P = 0.002), older age (39 vs 35 years; P < 0.001), non-white ethnicity (30 vs 20%; P = 0.001) and coming from an area of social deprivation (index of multiple deprivation score 31 vs 28; P < 0.001) were associated with non-attendance. The difference in gender (88% men vs 70% women; P < 0.001) and age (43 vs 34 years) persisted in the non-white group. Regression analysis showed that higher baseline HbA1c level (odds ratio 1.96; P = 0.004), younger age (odds ratio 0.98; P = 0.001) and lower social deprivation (odds ratio 0.52; P = 0.001) was associated with attendance.ConclusionSocio-economic status and factors perceived as indicating greater severity of disease (HbA1c) influence attendance at DAFNE. More work is necessary to understand the demography of non-attenders to aid future service design and alternative engagement strategies for these groups.
      PubDate: 2017-03-09T02:30:25.292104-05:
      DOI: 10.1111/dme.13333
       
  • Use of self-collected capillary blood samples for islet autoantibody
           screening in relatives: a feasibility and acceptability study
    • Authors: Y. Liu; L. E. Rafkin, D. Matheson, C. Henderson, D. Boulware, R. E. J. Besser, C. Ferrara, L. Yu, A. K. Steck, P. J. Bingley,
      Abstract: AimsTo evaluate the feasibility of using self-collected capillary blood samples for islet autoantibody testing to identify risk in relatives of people with Type 1 diabetes.MethodsParticipants were recruited via the observational TrialNet Pathway to Prevention study, which screens and monitors relatives of people with Type 1 diabetes for islet autoantibodies. Relatives were sent kits for capillary blood collection, with written instructions, an online instructional video link and a questionnaire. Sera from capillary blood samples were tested for autoantibodies to glutamic acid decarboxylase, islet antigen-2, insulin and zinc transporter 8. ‘Successful’ sample collection was defined as obtaining sufficient volume and quality to provide definitive autoantibody results, including confirmation of positive results by repeat assay.ResultsIn 240 relatives who returned samples, the median (range) age was 15.5 (1–49) years and 51% were male. Of these samples, 98% were sufficient for glutamic acid decarboxylase, islet antigen-2 and zinc transporter 8 autoantibody testing and 84% for insulin autoantibody testing and complete autoantibody screen. The upper 90% confidence bound for unsuccessful collection was 4.4% for glutamic acid decarboxylase, islet antigen-2 and/or zinc transporter 8 autoantibody assays, and 19.3% for insulin autoantibodies. Despite 43% of 220 questionnaire respondents finding capillary blood collection uncomfortable or painful, 82% preferred home self-collection of capillary blood samples compared with outpatient venepuncture (90% of those aged 18 years). The perceived difficulty of collecting capillary blood samples did not affect success rate.ConclusionsSelf-collected capillary blood sampling offers a feasible alternative to venous sampling, with the potential to facilitate autoantibody screening for Type 1 diabetes risk.
      PubDate: 2017-03-08T23:20:42.785235-05:
      DOI: 10.1111/dme.13338
       
  • Hypercholesterolaemia screening in Type 1 Diabetes: a difference of
           opinion
    • Authors: T. Candler; O. Mahmoud, J. Edge, J. Hamilton-Shield
      Abstract: AimTo assess cholesterol screening of children with Type 1 diabetes by diabetes professionals using a survey of current practice, given that National Institute of Health and Care Excellence guidelines on childhood Type 1 diabetes do not recommend cholesterol screening, yet the National Paediatric Diabetes Audit has an annual cholesterol measure (> 12 years) as a key outcome indicator.MethodsAn online survey was sent to 280 members of the Association of Children's Diabetes Clinicians to assess cholesterol screening practice in children.ResultsA total of 87 diabetes professionals (31%) responded. The results showed that 94% of respondents measured cholesterol, 33% did this annually on all children, and 7% measured fasting cholesterol. A total of 63% used no guidelines to decide treatment or further investigation. The definition of ‘high’ cholesterol varied from > 4.5 to > 8 mmol/l, with 40% giving no response or specific level. Only 14% of clinicians had started statin therapy in their diabetes clinic in the previous 5 years.ConclusionWhilst the majority of diabetes professionals measured cholesterol in children with Type 1 diabetes, there was marked variability in sampling, in children screened and in action taken if levels were considered abnormal. It is debatable whether cholesterol measures should be undertaken, certainly more than once, and whether cholesterol level should feature as a key outcome in the national audit in future.
      PubDate: 2017-03-08T07:41:12.365631-05:
      DOI: 10.1111/dme.13322
       
  • Seasonal variation in hospital encounters with hypoglycaemia and
           hyperglycaemia
    • Authors: K. K. Clemens; S. Shariff, L. Richard, G. Booth, J. Gilliland, A. X. Garg
      Abstract: AimTo assess whether rates of hospital encounters with hypoglycaemia and hyperglycaemia display seasonal variation.MethodsTime series analyses of the monthly rates of hospital encounters (emergency room visits or inpatient admissions) with hypoglycaemia and hyperglycaemia from 2003 to 2012 using linked healthcare databases in Ontario, Canada.ResultsOver the study period, there were 129 887 hypoglycaemia and 79 773 hyperglycaemia encounters. The characteristics of people at the time of their encounters were similar across the seasons in 2008 (median age 68 years for hypoglycaemia encounters and 53 years for hyperglycaemia encounters; 50% female; 90% with diabetes). We observed moderate seasonality in both types of encounters (R2 autoregression coefficient 0.58 for hypoglycaemia; 0.59 for hyperglycaemia). The rate of hypoglycaemia encounters appeared to peak between April and June, when on average, there was an additional 49 encounters per month (0.36 encounters per 100 000 persons per month) compared with the other calendar months (5% increase). The rate of hyperglycaemia encounters appeared to peak in January, when on average, there was an additional 69 encounters per month (0.50 encounters per 100 000 persons per month) compared with the other calendar months (11% increase).ConclusionsIn our region, there is seasonal variation in the rate of hospital encounters with hypoglycaemia and hyperglycaemia. Our findings may help to highlight periods of vulnerability for people, may inform future epidemiological studies and may aid in the appropriate planning of healthcare resources.
      PubDate: 2017-03-08T07:10:30.113189-05:
      DOI: 10.1111/dme.13327
       
  • Impact of neighbourhood-level inequity on paediatric diabetes care
    • Authors: A. B. M. Clarke; D. Daneman, J. R. Curtis, F. H. Mahmud
      Abstract: AimsTo evaluate the association between neighbourhood-level inequity and glycaemic control in paediatric participants with Type 1 diabetes using the Neighbourhood Equity Index (NEI).MethodsThe NEI was linked to the clinical data of 519 children with diabetes followed at the Hospital for Sick Children (Toronto, Canada). The NEI is a composite measure of inequity developed using the World Health Organization's Urban Health Equity Assessment and Response Tool (HEART), which encompasses 15 weighted indicators evaluating economic, social, environmental and lifestyle factors. The geographic distribution of participants was determined using postal codes, and the relationship between HbA1c and NEI was evaluated using regression and spatial analysis techniques.ResultsParticipants’ mean HbA1c was significantly correlated with NEI (R = −0.24, P < 0.0001). Regression analysis demonstrated that NEI was a strong predictor of mean HbA1c (P < 0.0001), accounting for differences in HbA1c as large as 1.0% (11 mmol/mol) when controlled for age, sex, diabetes duration, insulin pump therapy and number of annual clinic visits. Geo-mapping using spatial scan testing revealed the presence of two clusters of low-equity neighbourhoods containing 3.22 (P = 0.001) and 2.83 (P = 0.02) times more participants with HbA1c ≥ 9.5% (80 mmol/mol) than expected.ConclusionsOur findings demonstrated that NEI was a significant predictor of HbA1c in our clinic population and a useful tool for investigating spatial trends related to inequities in health, providing evidence that a composite, area-based measure of overall inequity is well suited to the study of glycaemic control in urban paediatric Type 1 diabetes populations.
      PubDate: 2017-03-08T07:10:26.662129-05:
      DOI: 10.1111/dme.13326
       
  • Parasympathetic reactivity and disruptive behavior problems in young
           children during interactions with their mothers and other adults: A
           preliminary investigation
    • Authors: Christine E. Cooper-Vince; Mariah DeSerisy, Danielle Cornacchio, Amanda Sanchez, Katie A. McLaughlin, Jonathan S. Comer
      Abstract: Parasympathetic nervous system influences on cardiac functions—commonly indexed via respiratory sinus arrhythmia (RSA)—are central to self-regulation. RSA suppression during challenging emotional and cognitive tasks is often associated with better emotional and behavioral functioning in preschoolers. However, the links between RSA suppression and child behavior across various challenging interpersonal contexts remains unclear. The present study experimentally evaluated the relationship between child RSA reactivity to adult (mother vs. study staff) direction and disruptive behavior problems in children ages 3–8 with varying levels of disruptive behavior problems (N = 43). Reduced RSA suppression in the context of mothers’ play-based direction was associated with more severe child behavior problems. In contrast, RSA suppression in the context of staff play-based direction was not associated with behavior problems. Findings suggest that the association between RSA suppression and child behavior problems may vary by social context (i.e., mother vs. other adult direction-givers). Findings are discussed in regard to RSA as an indicator of autonomic self-regulation that has relevance to child disruptive behavior problems.
      PubDate: 2017-03-06T00:50:43.465647-05:
      DOI: 10.1002/dev.21511
       
  • Context-dependent individual differences in playfulness in male rats
    • Authors: Jessica F. Lampe; Oliver Burman, Hanno Würbel, Luca Melotti
      Abstract: Play has been proposed as an indicator of positive emotions and welfare in higher vertebrates. This study investigated playfulness in male rats by exploring its consistency across motivational states (with/without prior short social isolation) and two age points at early and late adolescence. Twenty-four male Lister Hooded rats housed in cages of four underwent two play tests: conspecific Play-in-Pairs and Tickling by the experimenter, which were compared with play in the home cage and basal anxiety levels. Play-in-Pairs measures were consistent across age and motivational states, and were independent from anxiety. Positively valenced vocalizations in the Tickling test were also consistent across age, yet were negatively related to anxiety. Play-in-Pairs and Tickling play contexts, as well as social and solitary play types, were unrelated. Therefore, this study supports the existence of consistent individual differences in playfulness in rats, and suggests that different play contexts and types represent motivationally distinct systems.
      PubDate: 2017-03-01T00:50:59.679096-05:
      DOI: 10.1002/dev.21509
       
  • The association of admission hyperglycaemia and adverse clinical outcome
           in medical emergencies: the multinational, prospective, observational
           TRIAGE study
    • Authors: A. Kutz; T. Struja, P. Hausfater, D. Amin, A. Amin, S. Haubitz, M. Bernard, A. Huber, B. Mueller, P. Schuetz,
      Abstract: AimsThe clinical relevance of hyperglycaemia in an emergency department population remains incompletely understood. We investigated the association between admission blood glucose levels and adverse clinical outcomes in a large emergency department cohort.MethodsWe prospectively enrolled 7132 adult medical patients seeking emergency department care in three tertiary care hospitals in Switzerland, France and the USA. We used adjusted multivariable logistic regression models to examine the association between admission blood glucose levels and 30-day mortality, as well as adverse clinical course stratified by pre-existing diabetes and principal medical diagnoses.ResultsIn 6044 people without diabetes (84.7%), severe hyperglycaemia, defined as a glucose level of > 11.1 mmol/l (200 mg/dl), was associated with a doubling in the risk of 30-day mortality [adjusted odds ratio (OR) 1.9; 95% confidence interval (95% CI), 1.1 to 3.3; P = 0.018] and a three-fold increase in the risk of intensive care unit admission (adjusted OR 3.0; 95% CI, 1.9 to 4.9; P < 0.001). These associations were similar among different diagnoses. In the population with diabetes (n = 1088), no association with 30-day mortality was found (adjusted OR 1.0; 95% CI, 0.6 to 1.8; P for interaction = 0.001), whereas the association with intensive care unit admission was weaker (adjusted OR 2.4; 95% CI, 1.5 to 4.1; P for interaction = 0.011). Overall 30-day mortality was higher in those with diabetes than in those without (6.1 vs. 4.4%, P = 0.015).ConclusionsIn this large medical emergency department patient cohort, admission hyperglycaemia was strongly associated with adverse clinical course in people without diabetes. (Clinical Trial Registry No: NCT01768494)
      PubDate: 2017-02-28T03:15:50.986386-05:
      DOI: 10.1111/dme.13325
       
  • Association between grip strength and diabetes prevalence in black,
           South-Asian, and white European ethnic groups: a cross-sectional analysis
           of 418 656 participants in the UK Biobank study
    • Authors: U. E. Ntuk; C. A. Celis-Morales, D. F. Mackay, N. Sattar, J. P. Pell, J. M. R. Gill
      Abstract: AimsTo quantify the extent to which ethnic differences in muscular strength might account for the substantially higher prevalence of diabetes in black and South-Asian compared with white European adults.MethodsThis cross-sectional study used baseline data from the UK Biobank study on 418 656 white European, black and South-Asian participants, aged 40–69 years, who had complete data on diabetes status and hand-grip strength. Associations between hand-grip strength and diabetes were assessed using logistic regression and were adjusted for potential confounding factors.ResultsLower grip strength was associated with higher prevalence of diabetes, independent of confounding factors, across all ethnicities in both men and women. Diabetes prevalence was approximately three- to fourfold higher in South-Asian and two- to threefold higher in black participants compared with white European participants across all levels of grip strength, but grip strength in South-Asian men and women was ~ 5–6 kg lower than in the other ethnic groups. Thus, the attributable risk for diabetes associated with low grip strength was substantially higher in South-Asian participants (3.9 and 4.2 cases per 100 men and women, respectively) than in white participants (2.0 and 0.6 cases per 100 men and women, respectively). Attributable risk associated with low grip strength was also high in black men (4.3 cases) but not in black women (0.4 cases).ConclusionsLow strength is associated with a disproportionately large number of diabetes cases in South-Asian men and women and in black men. Trials are needed to determine whether interventions to improve strength in these groups could help reduce ethnic inequalities in diabetes prevalence.
      PubDate: 2017-02-23T00:40:30.927911-05:
      DOI: 10.1111/dme.13323
       
  • Development of an acceptable and feasible self-management group for
           children, young people and families living with Type 1 diabetes
    • Authors: R. A. Cai; R. I. G. Holt, L. Casdagli, R. M. Viner, R. Thompson, K. Barnard, D. Christie
      Abstract: AimsThis study developed an acceptable and feasible self-management intervention that addresses the self-identified needs of children and young people with Type 1 diabetes and their parents.MethodsPhase 1 reviewed previous interventions and interviewed the clinical team, young people and families. Phase 2 ran three age-matched focus groups with 11 families of children aged 8–16 years. Feedback was used to modify the workshop. Phase 3 evaluated feasibility of delivery, as well as the effects on metabolic control, quality of life and fear of hypoglycaemia, measured at baseline and 1–3 months post intervention.ResultsEighty-nine families were invited to take part. Twenty-two (25%) participated in seven pilot groups (median age of young people 10 years, 36% girls). The intervention comprised a developmentally appropriate workshop for young people and parents addressing: (1) blood glucose control, (2) the potential impact of long-term high HbA1c, (3) the effects of ‘hypos’ and ‘hypers’, (4) self-management techniques and (5) talking confidently to people about diabetes. Participants were enthusiastic and positive about the workshop and would recommend it to others. Young people liked sharing ideas and meeting others with diabetes, while parents enjoyed listening to their children talk about their diabetes knowledge.ConclusionsFamilies living with Type 1 diabetes participated in developing a self-management group intervention. Although we demonstrated acceptability and feasibility, the pilot study results do not support the development of a randomized control trial to evaluate the effectiveness in improving HbA1c.This article is protected by copyright. All rights reserved.
      PubDate: 2017-02-22T15:05:27.30256-05:0
      DOI: 10.1111/dme.13341
       
  • Systematic review of treatments for diabetic peripheral neuropathy: lost
           in translation
    • Authors: I. A. Volchegorskii
      Abstract: We read with great interest the systematic review by Çakici et al. [1] on treatments for diabetic peripheral neuropathy. Unfortunately, on careful reading, we found a number of inaccuracies and factual errors. First, we were rather surprised that there was almost no mention of mexidol, although a conclusion about its effectiveness in treating diabetic peripheral neuropathy is in the ‘What's new?’ section, as well as in the final sentence of the main text under the ‘Strengths and limitations’ section and in the abstract. Furthermore, the results on mexidol are presented in Table 2 (page 1470) from our article, Volchegorskii et al. [2].This article is protected by copyright. All rights reserved.
      PubDate: 2017-02-22T15:00:33.637255-05:
      DOI: 10.1111/dme.13339
       
  • Dyadic flexibility mediates the relation between parent conflict and
           infants’ vagal reactivity during the Face-to-Face Still-Face
    • Authors: Alex Busuito; Ginger A. Moore
      Abstract: Parent conflict is related to attenuated infant vagal reactivity, suggesting less effective regulation. Because infants’ self-regulation develops in the context of coregulation, the current study examined a novel measure, flexibility, purported to reflect dyadic reorganization in response to contextual demands. Flexibility was expected to mediate the relation between greater conflict and lesser vagal reactivity during the reunion episode of the Face-to-Face Still-Face (FFSF). Six-month-old infants’ and their mothers’ (N = 53) affective behaviors were observed during the FFSF and heart rate data were collected for infants. Flexibility was computed using state-space analysis of dyadic behaviors and measured variability in and movement among dyadic states. Conflict was related to lesser infant vagal reactivity in the reunion through lower flexibility, suggesting less effective recovery from social stress. Flexibility may capture aspects of coregulation affected by environmental stress and may be one mechanism by which conflict contributes to developing vagal regulation.
      PubDate: 2017-02-21T01:25:27.521225-05:
      DOI: 10.1002/dev.21508
       
  • Biological embedding of perinatal social relationships in infant stress
           reactivity
    • Authors: Jenna C. Thomas; Nicole Letourneau, Crystal I. Bryce, Tavis S. Campbell, Gerald F. Giesbrecht,
      Abstract: Whereas significant advances have been made in understanding how exposure to early adversity “gets under the skin” of children to result in long term changes in developmental outcomes, the processes by which positive social relationships become biologically embedded remain poorly understood. The aim of this study was to understand the pathways by which maternal and infant social environments become biologically embedded in infant cortisol reactivity. Two hundred seventy-two pregnant women and their infants were prospectively assessed during pregnancy and at 6 months postpartum. In serial mediation analyses, higher perceived social support from partners during pregnancy was associated with lower infant cortisol reactivity or larger decreases in cortisol in response to a stressor at 6 months of age via lower self-reported prenatal maternal depression and higher mother–infant interaction quality. The findings add to our understanding of how perinatal social relationships become biologically embedded in child development.
      PubDate: 2017-02-21T01:25:25.845144-05:
      DOI: 10.1002/dev.21505
       
  • Glycated haemoglobin (HbA1c) and fasting plasma glucose relationships in
           sea-level and high-altitude settings
    • Authors: J. C. Bazo-Alvarez; R. Quispe, T. D. Pillay, A. Bernabé-Ortiz, L. Smeeth, W. Checkley, R. H. Gilman, G. Málaga, J. J. Miranda
      Abstract: AimHigher haemoglobin levels and differences in glucose metabolism have been reported among high-altitude residents, which may influence the diagnostic performance of HbA1c. This study explores the relationship between HbA1c and fasting plasma glucose (FPG) in populations living at sea level and at an altitude of > 3000 m.MethodsData from 3613 Peruvian adults without a known diagnosis of diabetes from sea-level and high-altitude settings were evaluated. Linear, quadratic and cubic regression models were performed adjusting for potential confounders. Receiver operating characteristic (ROC) curves were constructed and concordance between HbA1c and FPG was assessed using a Kappa index.ResultsAt sea level and high altitude, means were 13.5 and 16.7 g/dl (P > 0.05) for haemoglobin level; 41 and 40 mmol/mol (5.9% and 5.8%; P 
      PubDate: 2017-02-14T13:10:25.676521-05:
      DOI: 10.1111/dme.13335
       
  • Altered walking strategy and increased unsteadiness in participants with
           impaired glucose tolerance and type 2 diabetes relates to small-fibre
           neuropathy but not vitamin D deficiency
    • Authors: M. M. Almurdhi; S. J. Brown, F. L. Bowling, A. J. M. Boulton, M. Jeziorska, R. A. Malik, N. D. Reeves
      Abstract: AimsTo investigate alterations in walking strategy and dynamic sway (unsteadiness) in people with impaired glucose tolerance and people with Type 2 diabetes in relation to severity of neuropathy and vitamin D levels.MethodsA total of 20 people with Type 2 diabetes, 20 people with impaired glucose tolerance and 20 people without either Type 2 diabetes or impaired glucose tolerance (control group) underwent gait analysis using a motion analysis system and force platforms, and detailed assessment of neuropathy and serum 25 hydroxy-vitamin D levels.ResultsAnkle strength (P = 0.01) and power (P = 0.003) during walking and walking speed (P = 0.008) were preserved in participants with impaired glucose tolerance but significantly lower in participants with Type 2 diabetes compared with control participants; however, step width (P = 0.005) and dynamic medio-lateral sway (P = 0.007) were significantly higher and posterior maximal movement (P = 0.000) was lower in participants with impaired glucose tolerance, but preserved in those with Type 2 diabetes compared with the control group. Dynamic medio-lateral sway correlated with corneal nerve fibre length (P = 0.001) and corneal nerve branch density (P = 0.001), but not with vibration perception threshold (P = 0.19). Serum 25 hydroxy-vitamin D levels did not differ significantly among the groups (P = 0.10) and did not correlate with any walking variables or measures of dynamic sway.ConclusionsEarly abnormalities in walking strategy and dynamic sway were evident in participants with impaired glucose tolerance, whilst there was a reduction in ankle strength, power and walking speed in participants with Type 2 diabetes. Unsteadiness correlated with small-, but not large-fibre neuropathy and there was no relationship between vitamin D levels and walking variables.
      PubDate: 2017-02-09T03:20:41.590695-05:
      DOI: 10.1111/dme.13316
       
  • Hyperglycaemia-related complications at the time of diagnosis can cause
           permanent neurological disability in children with neonatal diabetes
    • Authors: J. O. Day; S. E. Flanagan, M. H. Shepherd, A. W. Patrick, N. Abid, L. Torrens, A. J. Zeman, K. A. Patel, A.T. Hattersley
      Abstract: BackgroundChildren with neonatal diabetes often present with diabetic ketoacidosis and hence are at risk of cerebral oedema and subsequent long-term neurological deficits. These complications are difficult to identify because neurological features can also occur as a result of the specific genetic aetiology causing neonatal diabetes.Case reportsWe report two cases of neonatal diabetes where ketoacidosis-related cerebral oedema was the major cause of their permanent neurological disability. Case 1 (male, 18 years, compound heterozygous ABCC8 mutation) and case 2 (female, 29 years, heterozygous KCNJ11 mutation) presented with severe diabetic ketoacidosis at 6 and 16 weeks of age. Both had reduced consciousness, seizures and required intensive care for cerebral oedema. They subsequently developed spastic tetraplegia. Neurological examination in adulthood confirmed spastic tetraplegia and severe disability. Case 1 is wheelchair-bound and needs assistance for transfers, washing and dressing, whereas case 2 requires institutional care for all activities of daily living. Both cases have first-degree relatives with the same mutation with diabetes, who did not have ketoacidosis at diagnosis and do not have neurological disability.DiscussionKetoacidosis-related cerebral oedema at diagnosis in neonatal diabetes can cause long-term severe neurological disability. This will give additional neurological features to those directly caused by the genetic aetiology of the neonatal diabetes. Our cases highlight the need for increased awareness of neonatal diabetes and earlier and better initial treatment of the severe hyperglycaemia and ketoacidosis often seen at diagnosis of these children.This article is protected by copyright. All rights reserved.
      PubDate: 2017-02-07T18:15:34.923219-05:
      DOI: 10.1111/dme.13328
       
  • Incidence and prevalence of childhood-onset Type 1 diabetes in Japan: the
           T1D study
    • Authors: Y. Onda; S. Sugihara, T. Ogata, S. Yokoya, T. Yokoyama, N. Tajima,
      Abstract: AimsA majority of children with Type 1 diabetes in Japan are registered with the government-subsidized Specified Pediatric Chronic Disease Treatment Research Projects (SPCDTRP). In this study, the incidence and prevalence of childhood-onset (< 15 years) Type 1 diabetes in Japan were estimated by drawing on SPCDTRP data.MethodsData available for 2005–2012 from the SPCDTRP and Statistics Bureau, Ministry of Internal Affairs and Communications were used to estimate the incidence of Type 1 diabetes for 2005–2010, adjusted to cover those registered within 3 years of disease onset and stratified by sex, age at onset and period of onset.ResultsThe incidence of Type 1 diabetes for 2005–2010 was 2.25/100,000 persons [95% confidence intervals (95% CI), 2.14–2.36] (boys: 1.91, 95% CI, 1.83–1.98; girls: 2.52, 95% CI, 2.34–2.69), with that for the age brackets 0–4, 5–9 and 10–14 years being 1.48 (95% CI, 1.29–1.66), 2.27 (95% CI, 2.08–2.47) and 3.00 (95% CI, 2.74–3.25), respectively. The onset of disease was shown to peak at age 13 among boys (3.28, 95% CI, 3.02–3.55) and at age 10 among girls (3.28, 95% CI, 3.02–3.55). The peak periods of disease onset were April/May and December. The number of children aged < 15 years with Type 1 diabetes for 2005–2012 was estimated to be 2326 (95% CI, 2202–2450) with the prevalence estimated as 13.53/100,000 persons (95% CI, 12.63–14.43).ConclusionsStudy findings demonstrated no increase in the incidence of Type 1 diabetes, although suggesting, in agreement with earlier reports, that the onset of disease peaks in adolescence with a female predominance. In addition, the incidence of childhood-onset diabetes exhibited an annual bimodal pattern in this study.
      PubDate: 2017-02-02T02:15:52.961906-05:
      DOI: 10.1111/dme.13295
       
  • Type 2 diabetes mellitus in people with severe mental illness:
           inequalities by ethnicity and age. Cross-sectional analysis of 588 408
           records from the UK
    • Authors: J. Das-Munshi; M. Ashworth, M. E. Dewey, F. Gaughran, S. Hull, C. Morgan, J. Nazroo, I. Petersen, P. Schofield, R. Stewart, G. Thornicroft, M. J. Prince
      Abstract: AimsTo investigate whether the association of severe mental illness with Type 2 diabetes varies by ethnicity and age.MethodsWe conducted a cross-sectional analysis of data from an ethnically diverse sample of 588 408 individuals aged ≥18 years, registered to 98% of general practices (primary care) in London, UK. The outcome of interest was prevalent Type 2 diabetes.ResultsRelative to people without severe mental illness, the relative risk of Type 2 diabetes in people with severe mental illness was greatest in the youngest age groups. In the white British group the relative risks were 9.99 (95% CI 5.34, 18.69) in those aged 18–34 years, 2.89 (95% CI 2.43, 3.45) in those aged 35–54 years and 1.16 (95% CI 1.04, 1.30) in those aged ≥55 years, with similar trends across all ethnic minority groups. Additional adjustment for anti-psychotic prescriptions only marginally attenuated the associations. Assessment of estimated prevalence of Type 2 diabetes in severe mental illness by ethnicity (absolute measures of effect) indicated that the association between severe mental illness and Type 2 diabetes was more marked in ethnic minorities than in the white British group with severe mental illness, especially for Indian, Pakistani and Bangladeshi individuals with severe mental illness.ConclusionsThe relative risk of Type 2 diabetes is elevated in younger populations. Most associations persisted despite adjustment for anti-psychotic prescriptions. Ethnic minority groups had a higher prevalence of Type 2 diabetes in the presence of severe mental illness. Future research and policy, particularly with respect to screening and clinical care for Type 2 diabetes in populations with severe mental illness, should take these findings into account.
      PubDate: 2017-01-30T01:10:48.427468-05:
      DOI: 10.1111/dme.13298
       
  • Mortality and morbidity in offspring of mothers with diabetes compared
           with a population group: a Danish cohort study with 8–35 years of
           follow-up
    • Authors: G. L. Nielsen; L. Welinder, M. Berg Johansen
      Abstract: AimsTo assess mortality and morbidity in the offspring of mothers with diabetes compared with a control cohort of offspring of mothers without diabetes.MethodsThe mortality rate, percentage of days admitted to hospital, diagnostic categories and incidence of diabetes mellitus among 691 offspring of mothers with diabetes were compared with a control group of 168 831 offspring not exposed to maternal diabetes. Offspring of mothers with diabetes were identified from the North Jutland Pregnancy database (521 Type 1; 34 Type 2; 136 gestational diabetes) born between 1976 and 2003. Outcome data were retrieved from the National Registry of Patients with follow-up until 31 December 2011. In a subgroup with the longest hospital stay we reviewed hospital records for clinical details until 2016.ResultsMortality was 1.45% in the diabetes group compared with 1.36% in the control group. In the first 2 years, offspring exposed to diabetes spent significantly more time in hospital than the control offspring, but this difference faded to an insignificant difference of 0.04% of time spent in hospital between age 2 and 8 years. The offspring of mothers with diabetes had a sixfold increased risk of developing diabetes mellitus.ConclusionsThe offspring of mothers with and without diabetes had almost identical mortality. The increased morbidity was restricted to the first 2 years of life, and was primarily attributable to a few individuals with very severe but probably non-diabetes-related disease burden. The large majority of offspring of mothers with diabetes experienced health conditions similar to those not exposed to diabetes.
      PubDate: 2017-01-24T23:25:33.899862-05:
      DOI: 10.1111/dme.13312
       
  • Validation of the Composite Autonomic Symptom Score 31 (COMPASS 31) for
           the assessment of symptoms of autonomic neuropathy in people with diabetes
           
    • Authors: C. Greco; F. Di Gennaro, C. D'Amato, R. Morganti, D. Corradini, A. Sun, S. Longo, D. Lauro, G. Pierangeli, P. Cortelli, V. Spallone
      Abstract: AimTo validate the Composite Autonomic Symptom Score (COMPASS) 31, in its Italian version, for the diagnosis of diabetic cardiovascular autonomic neuropathy in a clinic-based, single-centre study.MethodsA total of 73 participants with diabetes (age 55 ± 14 years) completed the COMPASS 31 questionnaire before undergoing cardiovascular autonomic neuropathy and diabetic polyneuropathy assessment according to cardiovascular reflex tests, neuropathic symptoms and signs, and vibration and thermal thresholds.ResultsThe COMPASS 31 total weighted score differed between participants with and without cardiovascular autonomic neuropathy (29.9 ± 19.5 vs 16.1 ± 14.7; P = 0.003) and with and without diabetic polyneuropathy (28.9 ± 19.1 vs 12.7 ± 11.3; P < 0.0001). It was related to cardiovascular reflex tests score (rho = 0.38, P = 0.0013) as well as diabetic polyneuropathy symptoms (rho=0.61, P < 0.0001) and signs scores (rho = 0.49, P < 0.0001). Receiver-operating curve analysis showed a fair diagnostic accuracy of total score for cardiovascular autonomic neuropathy (area under the curve 0.748 ± 0.068, 95% CI 0.599–0.861) and diabetic polyneuropathy (area under the curve 0.742 ± 0.061, 95% CI 0.611–0.845). The best score thresholds were 16 for early cardiovascular autonomic neuropathy (sensitivity 75.0%, specificity 64.9%, positive predictive value 37.5% and negative predictive value 90.2%), and 17 for both confirmed cardiovascular autonomic neuropathy and diabetic polyneuropathy (sensitivity 70.0% and 65.5%, respectively; specificity 66.7% and 79.5%, respectively; positive predictive value 25.0% and 67.9%, respectively; and negative predictive value 93.0% and 77.8%, respectively). COMPASS 31 had a good internal consistency according to Cronbach's α coefficient of 0.73.ConclusionsCOMPASS 31 can represent a valid, easy-to-use, quantitative assessment tool for autonomic symptoms in diabetic neuropathy, with a fair diagnostic accuracy for both cardiovascular autonomic neuropathy and diabetic polyneuropathy.
      PubDate: 2017-01-19T01:45:25.923255-05:
      DOI: 10.1111/dme.13310
       
  • Cover, Ed Board and TOC
    • Pages: 419 - 422
      PubDate: 2017-04-20T20:22:43.894678-05:
      DOI: 10.1002/dev.21459
       
  • Table of Contents 1
    • Pages: 597 - 597
      PubDate: 2017-04-18T05:28:23.121168-05:
      DOI: 10.1111/dme.13222
       
  • Table of Contents 2
    • Pages: 599 - 599
      PubDate: 2017-04-18T05:28:24.443313-05:
      DOI: 10.1111/dme.13223
       
  • Aims and Scope
    • Pages: 600 - 600
      PubDate: 2017-04-18T05:28:23.578511-05:
      DOI: 10.1111/dme.13224
       
  • Diabetes technology
    • Authors: R. I. G. Holt
      Pages: 603 - 603
      PubDate: 2017-04-18T05:28:27.056029-05:
      DOI: 10.1111/dme.13352
       
  • Impact of accelerometer and pedometer use on physical activity and
           glycaemic control in people with Type 2 diabetes: a systematic review and
           meta-analysis
    • Authors: R. Baskerville; I. Ricci-Cabello, N. Roberts, A. Farmer
      Pages: 612 - 620
      Abstract: BackgroundSelf-directed pedometer use increases physical activity levels in the general population; however, evidence of benefit for Type 2 diabetes is unclear and has not been systematically reviewed for accelerometers.AimTo examine the impact of using physical activity monitoring devices (pedometers and accelerometers) on free-living physical activity and HbA1c levels in people with Type 2 diabetes.MethodsWe conducted a systematic literature review. Bibliographic databases included Medline, Embase, Web of Science, CINAHL, SportDiscus and the Cochrane Central Register of Controlled Trials. We included controlled trials evaluating interventions based on the use of pedometers or accelerometers to promote physical activity in people with Type 2 diabetes. Primary outcomes were physical activity (min/week or steps) and HbA1c [mmol/mol (%)]. Secondary outcomes were weight, blood pressure and lipid profile.ResultsTwelve trials (1458 participants) were identified, of which nine studied pedometers and three accelerometers. Random-effects meta-analysis showed an overall increase in physical activity (standardized mean difference 0.57, 95% CI 0.24, 0.91) in the intervention groups. Accelerometers and pedometers produced a similar effect size. No significant differences were observed in HbA1c, BMI, blood pressure or lipid profile.ConclusionsPeople with Type 2 diabetes, provided with an accelerometer or pedometer, substantially increased their free-living physical activity. There is no evidence that monitor use alone improves HbA1c or other clinical outcomes. Further trials are needed to compare the relative effects of activity monitors within differing complex interventions.
      PubDate: 2017-03-19T23:45:36.226389-05:
      DOI: 10.1111/dme.13331
       
  • Insulin pump failures in Italian children with Type 1 diabetes:
           retrospective 1-year cohort study
    • Authors: I. Rabbone; N. Minuto, R. Bonfanti, M. Marigliano, F. Cerutti, V. Cherubini, G. d'Annunzio, A. P. Frongia, D. Iafusco, G. Ignaccolo, F. Lombardo, R. Schiaffini, S. Toni, S. Tumini, S. Zucchini, A. Pistorio, A. E. Scaramuzza,
      Pages: 621 - 624
      Abstract: AimsInsulin pump failure and/or malfunction requiring replacement have not been thoroughly investigated. This study evaluated pump replacement in children and adolescents with Type 1 diabetes using insulin pump therapy.MethodsData were collected for all participants younger than 19 years, starting insulin pump therapy before 31 December 2013. For each child, age, disease duration, date of insulin pump therapy initiation, insulin pump model, failure/malfunction/replacement yes/no and reason were considered for the year 2013.ResultsData were returned by 40 of 43 paediatric centres belonging to the Diabetes Study Group of the Italian Society of Paediatric Endocrinology and Diabetology. In total, 1574 of 11 311 (13.9%) children and adolescents with Type 1 diabetes were using an insulin pump: 29.2% Animas VIBE™, 9.4% Medtronic MiniMed 715/515™, 34.3% Medtronic MiniMed VEO™, 24.3% Accu-Check Spirit Combo™ and 2.8% other models. In 2013, 0.165 insulin pump replacements per patient-year (11.8% due to pump failure/malfunction and 4.7% due to accidental damage) were recorded. Animas VIBE™ (22.1%) and Medtronic MiniMed VEO™ (17.7%) were the most replaced.ConclusionsIn a large cohort of Italian children and adolescents with Type 1 diabetes, insulin pump failure/malfunction and consequent replacement are aligned with rates previously reported and higher in more sophisticated pump models.
      PubDate: 2017-01-16T00:00:25.596618-05:
      DOI: 10.1111/dme.13294
       
  • Comparing effects of insulin analogues and human insulin on nocturnal
           glycaemia in hypoglycaemia-prone people with Type 1 diabetes
    • Authors: P. L. Kristensen; L. Tarnow, C. Bay, K. Nørgaard, T. Jensen, H.-H. Parving, H. Perrild, H. Beck-Nielsen, J. S. Christiansen, B. Thorsteinsson, U. Pedersen-Bjergaard
      Pages: 625 - 631
      Abstract: AimsTo assess the difference between analogue and human insulin with regard to nocturnal glucose profiles and risk of hypoglycaemia in people with recurrent severe hypoglycaemia.MethodsA total of 72 people [46 men, mean ± sd age 54 ± 12 years, mean ± sd HbA1c 65 ± 12 mmol/mol (8.1 ± 1.1%), mean ± sd duration of diabetes 30 ± 14 years], who participated in a 2-year randomized, crossover trial of basal-bolus therapy with insulin detemir/insulin aspart or human NPH insulin/human regular insulin (the HypoAna trial) were studied for 2 nights during each treatment. Venous blood was drawn hourly during sleep. Primary endpoints were nocturnal glucose profiles and occurrence of hypoglycaemia (blood glucose ≤ 3.9 mmol/l).ResultsDuring insulin analogue treatment, the mean nocturnal plasma glucose level was significantly higher than during treatment with human insulin (10.6 vs 8.1 mmol/l). The fasting plasma glucose level was similar between the treatments. Nocturnal hypoglycaemia was registered during 41/101 nights (41%) in the human insulin arm and 19/117 nights (16%) in the insulin analogue arm, corresponding to a hazard ratio of 0.26 (95% CI 0.14 to 0.45; P 
      PubDate: 2017-02-14T23:40:27.216446-05:
      DOI: 10.1111/dme.13317
       
  • The impact of Type 2 diabetes prevention programmes based on
           risk-identification and lifestyle intervention intensity strategies: a
           cost-effectiveness analysis
    • Authors: P. R. Breeze; C. Thomas, H. Squires, A. Brennan, C. Greaves, P. J. Diggle, E. Brunner, A. Tabak, L. Preston, J. Chilcott
      Pages: 632 - 640
      Abstract: AimsTo develop a cost-effectiveness model to compare Type 2 diabetes prevention programmes targeting different at-risk population subgroups with a lifestyle intervention of varying intensity.MethodsAn individual patient simulation model was constructed to simulate the development of diabetes in a representative sample of adults without diabetes from the UK population. The model incorporates trajectories for HbA1c, 2-h glucose, fasting plasma glucose, BMI, systolic blood pressure, total cholesterol and HDL cholesterol. Patients can be diagnosed with diabetes, cardiovascular disease, microvascular complications of diabetes, cancer, osteoarthritis and depression, or can die. The model collects costs and utilities over a lifetime horizon. The perspective is the UK National Health Service and personal social services. We used the model to evaluate the population-wide impact of targeting a lifestyle intervention of varying intensity to six population subgroups defined as high risk for diabetes.ResultsThe intervention produces 0.0003 to 0.0009 incremental quality-adjusted life years and saves up to £1.04 per person in the general population, depending upon the subgroup targeted. Cost-effectiveness increases with intervention intensity. The most cost-effective options are to target individuals with HbA1c > 42 mmol/mol (6%) or with a high Finnish Diabetes Risk (FINDRISC) probability score (> 0.1).ConclusionThe model indicates that diabetes prevention interventions are likely to be cost-effective and may be cost-saving over a lifetime. In the model, the criteria for selecting at-risk individuals differentially impact upon diabetes and cardiovascular disease outcomes, and on the timing of benefits. These findings have implications for deciding who should be targeted for diabetes prevention interventions.
      PubDate: 2017-03-10T06:58:46.323672-05:
      DOI: 10.1111/dme.13314
       
  • Clinical, behavioural and social indicators for poor glycaemic control
           around the time of transfer to adult care: a longitudinal study of 126
           young people with diabetes
    • Authors: P. Castensøe-Seidenfaden; A. K. Jensen, H. Smedegaard, E. Hommel, G. R. Husted, U. Pedersen-Bjergaard, G. Teilmann
      Pages: 667 - 675
      Abstract: AimsTo describe and compare changes in glycaemic control in young people with Type 1 diabetes over time between the last 2 years in paediatric care and the first 2 years in adult care and to identify risk factors for poor glycaemic control.MethodsOur retrospective cohort study followed participants aged 14–22 years from 2 years before to 2 years after transfer from paediatric to adult care. Changes in glycaemic control were calculated using repeated measurements. We adjusted for gender, age at diabetes onset, age at transfer, duration of diabetes at transfer, gap (amount of time) between last paediatric and first adult visit, comorbidity, learning disability and/or mental health conditions and family structure. We examined associations between acute hospital admissions, low visit attendance rate, loss to follow-up and baseline HbA1c level.ResultsAmong 126 participants, the mean HbA1c level was 80 mmol/mol (9.4%) pre-transfer but decreased by an average of 3 mmol/mol (0.3%) each year post-transfer (P = 0.005). Young people with a learning disability and/or a mental health condition had worse glycaemic control (P = 0.041) and the mean HbA1c of those with divorced parents was 14 mmol/mol (1.2%) higher (P = 0.014). Almost one-third of participants were admitted to the hospital for acute diabetes care. Low visit attendance rate, high baseline HbA1c level, learning disability and/or mental health conditions and divorced parents predicted acute hospital admissions.ConclusionsGlycaemic control improved significantly after transfer to adult care, but the mean HbA1c level remained high. Future interventions should focus on young people with divorced parents, those with a learning disability and/or mental health condition and those who do not attend clinical visits to improve HbA1c levels and thereby reduce hospitalization rates.
      PubDate: 2017-03-04T00:25:28.548755-05:
      DOI: 10.1111/dme.13318
       
  • Socio-economic factors influencing the development of end-stage renal
           disease in people with Type 1 diabetes – a longitudinal population study
           
    • Authors: C. Toppe; A. Möllsten, S. Schön, G. Dahlquist
      Pages: 676 - 682
      Abstract: AimsThe development of end-stage renal disease (ESRD) in Type 1 diabetes is multifactorial. Familial socio-economic factors may influence adherence to and understanding of diabetes treatment, and also general health behaviour. We investigate how parental and personal education level and exposure to low economic status, indicated by the need for income support, influence the development of ERSD caused by Type 1 diabetes.MethodsParticipants were retrieved from the nationwide Swedish Childhood Diabetes Registry, which was linked to the Swedish Renal Registry, to find people with ESRD caused by Type 1 diabetes, and to Statistic Sweden to retrieve longitudinal socio-economic data on participants and their parents. Data were analysed using Cox regression modelling.ResultsOf 9287 people with diabetes of duration longer than 14 years, 154 had developed ESRD due to diabetes. Median diabetes duration (range) for all participants was 24.2 years (14.0–36.7 years). Low maternal education (≤ 12 years) more than doubled the risk of developing ESRD, hazard ration (HR) = 2.9 [95% confidence interval (95% CI): 1.7-4.8]. For people with a low personal level of education HR was 5.7 (3.4–9.5). In an adjusted model, the person's own education level had the highest impact on the risk of ESRD. If at least one of the parents had ever received income support the HR was 2.6 (1.9–3.6).ConclusionsSocio-economic factors, both for the parents and the person with diabetes, have a strong influence on the development of ESRD in Type 1 diabetes. It is important for caregivers to give enough support to more vulnerable people and their families.
      PubDate: 2017-01-16T05:55:23.902375-05:
      DOI: 10.1111/dme.13289
       
  • A population-based study of the association between dysglycaemia and
           hearing loss in middle age
    • Authors: J. Sommer; C. G. Brenann-Jones, R. H. Eikelboom, M. Hunter, W. A. Davis, M. D. Atlas, T. M. E. Davis
      Pages: 683 - 690
      Abstract: AimsTo investigate the independent associations between hearing loss and dysglycaemia in a sample of middle-aged adults, including separate analysis of those aged < 60 years.MethodsThe first 2023 participants in the cross-sectional Busselton Health Ageing Survey were assessed for hearing loss ≥ 26 dB (better ear) for four-frequency average (4FA) of pure-tone thresholds at 500, 1000, 2000 and 4000 Hz, and high-frequency average (HFA) of pure-tone thresholds at 4000 and 8000 Hz.ResultsValid data from 1864 participants in the Busselton Health Ageing Survey [92.1%; mean ± sd age 56.2 ± 5.5 years, 46.0% men, 120 (7.0%) with diabetes, 274 (14.7%) with prediabetes] were analysed, of whom 103 (5.5%) had four-frequency average hearing loss and 561 (30.1%) had high-frequency average hearing loss. In multivariable analyses, glycaemic status was not independently associated with four-frequency or high-frequency average hearing loss. In the 1286 participants aged < 60 years, there was no relationship between dysglycaemia and high-frequency average hearing loss, but the prevalence of four-frequency average hearing loss increased from 2.3% (95% CI 1.5–3.4) in participants with normoglycaemia to 5.7% (95% CI 3.0–10.6) in those with prediabetes and 10.2% (4.2–21.5) in those with diabetes (trend P = 0.003). In multivariable analysis with normoglycaemia as reference, the odds ratios for four-frequency average hearing loss were 2.84 (95% CI 1.29–6.27) for prediabetes and 5.93 (95% CI 1.67–21.05) for diabetes (P ≤ 0.01) in the < 60 year age group.ConclusionsThere was progressively increasing mid-range hearing loss with worsening glucose tolerance in younger individuals, suggesting dysglycaemia-associated early-onset presbycusis.
      PubDate: 2017-02-20T23:00:32.43626-05:0
      DOI: 10.1111/dme.13320
       
  • Influence of health locus of control and fear of hypoglycaemia on
           glycaemic control and treatment satisfaction in people with Type 1
           diabetes on insulin pump therapy
    • Authors: L. Indelicato; V. Mariano, S. Galasso, F. Boscari, E. Cipponeri, C. Negri, A. Frigo, A. Avogaro, E. Bonora, M. Trombetta, D. Bruttomesso
      Pages: 691 - 697
      Abstract: AimTo assess the influence of health locus of control and fear of hypoglycaemia on metabolic control and treatment satisfaction in people with Type 1 diabetes mellitus on continuous subcutaneous insulin infusion.MethodsPeople with Type 1 diabetes on continuous subcutaneous insulin infusion for at least 1 year, sub-classified as an ‘acceptable glucose control’ group [HbA1c ≤ 58 mmol/mol (7.5%)] and a ‘suboptimum glucose control’ group [HbA1c > 58 mmol/mol (7.5%)], were consecutively enrolled in a multicentre cross-sectional study. Questionnaires were administered to assess health locus of control [Multidimensional Health Locus of Control (MHLC) scale, with internal and external subscales], fear of hypoglycaemia [Hypoglycaemia Fear Survey II (HFS-II)] and treatment satisfaction [Diabetes Treatment Satisfaction Questionnaire (DTSQ)].ResultsWe enrolled 214 participants (mean ± sd age 43.4 ± 12.1 years). The suboptimum glucose control group (n = 127) had lower mean ± sd internal MHLC and DTSQ scores than the acceptable glucose control group (19.6 ± 5.2 vs 21.0 ± 5.0, P = 0.04 and 28.8 ± 4.8 vs 30.9 ± 4.5, P < 0.001). HFS-II scores did not differ between the two groups. Internal MHLC score was negatively associated with HbA1c (r = −0.15, P < 0.05) and positively associated with the number of mild and severe hypoglycaemic episodes (r = 0.16, P < 0.05 and r = 0.18, P < 0.001, respectively) and with DTSQ score (r = 0.17, P < 0.05).HFS-II score was negatively associated with DTSQ score (r = −0.18, P < 0.05) and positively with number of severe hypoglycaemic episodes (r = 0.16, P < 0.5).ConclusionsIn adults with Type 1 diabetes receiving continuous subcutaneous insulin infusion, high internal locus represents the most important locus of control pattern for achieving good metabolic control.
      PubDate: 2017-02-20T23:00:26.403361-05:
      DOI: 10.1111/dme.13321
       
  • The duration of intrapartum maternal hyperglycaemia predicts neonatal
           hypoglycaemia in women with pre-existing diabetes
    • Authors: T. Joshi; C. Oldmeadow, J. Attia, K. Wynne
      Pages: 725 - 731
      Abstract: AimThere is a high incidence of neonatal hypoglycaemia in neonates born to mothers with pre-existing diabetes. This often necessitates admission to the neonatal intensive care. Guidelines suggest maintaining intrapartum blood glucose levels (BGLs) of 4–7 mmol/l in women with diabetes to reduce the risk of neonatal hypoglycaemia. This study assessed whether intrapartum BGLs in women with pre-gestational Type 1 and 2 diabetes were predictive of neonatal hypoglycaemia.MethodsA retrospective analysis of 261 births delivered at a tertiary hospital in Australia from 2009 to 2014.ResultsThere were 122 cases of neonatal hypoglycaemia (glucose ≤ 2.6 mmol/l) in 261 births (47%). The mothers in the neonatal hypoglycaemia group spent less time with BGL in the range 4–7 mmol/l [55 ± 37% vs. 65 ± 35%, P = 0.02; odds ratio (OR) 0.992, P = 0.03] and more time with BGL in the 7–10 mmol/l range (31 ± 34% vs. 18 ± 27%, P = 0.003; OR 1.013, P = 0.003) compared with those without neonatal hypoglycaemia. Although statistically significant, receiver operating characteristic (ROC) curve analysis showed that time spent with maternal BGLs in the range 4–7 mmol/l [area under the curve (AUC) = 0.58] or 7–10 mmol (AUC = 0.60) was not strong enough to be a useful clinical predictor of neonatal hypoglycaemia. HbA1c in the second trimester of pregnancy (P = 0.02, OR 1.42) and percentage time spent in BGL range of 7–10 mmol/l (P = 0.001, OR 1.02) were both associated with a risk of neonatal hypoglycaemia in a logistic regression model. HbA1c in the third trimester (P = 0.07, OR 1.28) approached, but did not reach, significance.ConclusionsThese data support a BGL range of 4–7 mmol/l as an intrapartum target. Glycaemic control in the second trimester is associated with neonatal hypoglycaemia. Improvement in ante- and intrapartum glycaemic control may reduce neonatal hypoglycaemia in women with pre-existing diabetes.
      PubDate: 2017-03-08T07:41:08.580076-05:
      DOI: 10.1111/dme.13337
       
  • Flash Glucose Monitoring is associated with improved glycaemic control but
           use is largely limited to more affluent people in a UK diabetes centre
    • Authors: J. A. McKnight; F. W. Gibb
      Pages: 732 - 732
      PubDate: 2017-04-18T05:28:27.38563-05:0
      DOI: 10.1111/dme.13315
       
  • One-hour plasma glucose as a predictor of Type 2 diabetes mellitus
    • Authors: T. Kawada
      Pages: 733 - 733
      PubDate: 2017-04-18T05:28:24.348179-05:
      DOI: 10.1111/dme.13330
       
  • Reply to Kawada: One-hour plasma glucose as a predictor of Type 2 diabetes
           mellitus
    • Authors: R. Oka; T. Aizawa, T. Yoneda, M. Yamagishi
      Pages: 734 - 734
      PubDate: 2017-04-18T05:28:27.645813-05:
      DOI: 10.1111/dme.13329
       
  • List of reviewers 2016
    • Pages: 735 - 738
      PubDate: 2017-04-18T05:28:27.472261-05:
      DOI: 10.1111/dme.13344
       
  • Associations between benign cutaneous nevi and risk of Type 2 diabetes
           mellitus in men and women: results from two prospective cohort studies
    • Authors: H. Dai; Q. Sun, C. Zhang, X. Zhang, W.-Q. Li, J. E. Manson, F. B. Hu, Y. Song
      Abstract: AimTo examine the association of cutaneous nevi with Type 2 diabetes risk.MethodsWe prospectivly examined the associations between nevus count and risk of Type 2 diabetes among 26 240 men (1988–2010) from the Health Professionals Follow-up Study and 67 050 women (1986–2010) from the Nurses' Health Study. Information on the numbers of cutaneous nevi on arms at baseline and incident cases of Type 2 diabetes was collected using validated questionnaires.ResultsDuring 1 879 287 person-years of follow-up, we documented 9040 incident cases of Type 2 diabetes. After adjustment for age, BMI and other diabetes risk factors, greater number of nevi was associated with higher risk of Type 2 diabetes. Multivariable-adjusted hazard ratios for
      PubDate: 2016-12-29T03:38:42.814035-05:
      DOI: 10.1111/dme.13297
       
  • Changing paradigms and challenges: evidence on the epidemiological and
           economic burden of diabetes in Latin America
    • Authors: Armando Arredondo
      Abstract: According to Sortsø et al. [1], in Denmark, 59% of the economic burden due to diabetes is related to the direct costs of the disease and its complications, and 41% is attributable to lost productivity associated with diabetes. In Latin American countries, 45% of the total costs are due to diabetes and its complications, and 55% to lost productivity attributable to premature mortality, temporal disability and permanent disability [2]. The difference in the internal distribution of direct vs. indirect costs is similar; 18% in Denmark and 10% in Latin America.This article is protected by copyright. All rights reserved.
      PubDate: 2016-12-22T03:12:58.561563-05:
      DOI: 10.1111/dme.13311
       
  • Blood donation by persons with diabetes
    • Authors: S. Kalra; Y. Gupta
      Abstract: Blood donation helps save lives, and is a service to humanity. Blood donation may also help improve the metabolic health of the donor, by reducing iron load on the pancreas and increasing insulin sensitivity [1,2]. However, there is a lack of clarity regarding the ability of a person with diabetes to donate blood.This article is protected by copyright. All rights reserved.
      PubDate: 2016-12-19T02:40:27.370587-05:
      DOI: 10.1111/dme.13308
       
  • Economic evaluation of chronic disease self-management for people with
           diabetes: a systematic review
    • Authors: C. Teljeur; P. S. Moran, S. Walshe, S. M. Smith, F. Cianci, L. Murphy, P. Harrington, M. Ryan
      Abstract: AimsTo systematically review the evidence on the costs and cost-effectiveness of self-management support interventions for people with diabetes.BackgroundSelf-management support is the provision of education and supportive interventions to increase patients’ skills and confidence in managing their health problems, potentially leading to improvements in HbA1c levels in people with diabetes.MethodsRandomized controlled trials, observational studies or economic modelling studies were eligible for inclusion in the review. The target population was adults with diabetes. Interventions had to have a substantial component of self-management support and be compared with routine care. Study quality was evaluated using the Consensus on Health Economic Criteria and International Society of Pharmacoeconomic Outcomes Research questionnaires. A narrative review approach was used.ResultsA total of 16 costing and 21 cost-effectiveness studies of a range of self-management support interventions were identified. There was reasonably consistent evidence across 22 studies evaluating education self-management support programmes suggesting these interventions are cost-effective or superior to usual care. Telemedicine-type interventions were more expensive than usual care and potentially not cost-effective. There was insufficient evidence regarding the other types of self-management interventions, including pharmacist-led and behavioural interventions. The identified studies were predominantly of poor quality, with outcomes based on short-term follow-up data and study designs at high risk of bias.ConclusionsSelf-management support education programmes may be cost-effective. There was limited evidence regarding other formats of self-management support interventions. The poor quality of many of the studies undermines the evidence base regarding the economic efficiency of self-management support interventions for people with diabetes.
      PubDate: 2016-11-29T03:35:24.09842-05:0
      DOI: 10.1111/dme.13281
       
  • Diabetes incidence and prevalence in Hong Kong, China during
           2006–2014
    • Authors: J. Quan; T. K. Li, H. Pang, C. H. Choi, S. C. Siu, S. Y. Tang, N. M. S. Wat, J. Woo, J. M. Johnston, G. M. Leung
      Abstract: AimsTo estimate recent secular changes in the incidence and prevalence of diabetes and pre-diabetes among Hong Kong Chinese adults, and thus show possible future trends for developing mainland China.MethodsBased on a complete census of the public sector health records of 6.4 million people from 2006 to 2014, diabetes cases were ascertained using different methods including the World Health Organization (WHO) 2011 guidelines (HbA1c, fasting plasma glucose and glucose tolerance test), American Diabetes Association (ADA) 2015 guidelines (plus random plasma glucose), and additionally recorded diagnosis codes and medication dispensation. Pre-diabetes was defined using ADA 2015 guidelines.ResultsWe identified 697 201 people with diabetes (54.2% were incident cases); and 1 229 731 people with diabetes or pre-diabetes. In 2014, the overall incidence of diabetes was 9.46 per 1000 person-years [95% confidence interval (CI): 9.38 to 9.54], and overall prevalence was 10.29% (95% CI: 10.27% to 10.32%). Incidence of diabetes decreased significantly from 2007 to 2014 (quadratic trend, P < 0.001). From 2006 to 2014, the prevalence of diabetes increased significantly in both sexes and across all age groups (quadratic trend, P < 0.001). The overall incidence of pre-diabetes in 2014 was 18.88 per 1000 person-years (95% CI: 18.76 to 18.99), and the overall prevalence of pre-diabetes was 8.90% (95% CI: 8.87% to 8.92%).ConclusionsSimilar to other developed western and Asian populations, diabetes (and pre-diabetes) incidence in Hong Kong Chinese appeared to have stabilized and there have been small declines during the period of observation. Ageing and survivorship will likely drive a continued increase in the prevalence of diabetes and pre-diabetes, albeit with a decelerating growth rate if past trends persist.
      PubDate: 2016-11-29T00:25:25.652382-05:
      DOI: 10.1111/dme.13284
       
  • A systematic review of interventions to improve outcomes for young adults
           with Type 1 diabetes
    • Authors: M. C. O'Hara; L. Hynes, M. O'Donnell, N. Nery, M. Byrne, S. R. Heller, S. F. Dinneen,
      Abstract: BackgroundMany young adults with Type 1 diabetes experience poor outcomes. The aim of this systematic review was to synthesize the evidence regarding the effectiveness of interventions aimed at improving clinical, behavioural or psychosocial outcomes for young adults with Type 1 diabetes.MethodsElectronic databases were searched. Any intervention studies related to education, support, behaviour change or health service organizational change for young adults aged between 15-30 years with Type 1 diabetes were included. A narrative synthesis of all studies was undertaken due to the large degree of heterogeneity between studies.ResultsEighteen studies (of a possible 1700) were selected and categorized: Health Services Delivery (n = 4), Group Education and Peer Support (n = 6), Digital Platforms (n = 4) and Diabetes Devices (n = 4). Study designs included one randomized controlled trial, three retrospective studies, seven feasibility/acceptability studies and eight studies with a pre/post design. Continuity, support, education and tailoring of interventions to young adults were the most common themes across studies. HbA1c was the most frequently measured outcome, but only 5 of 12 studies that measured it showed a significant improvement.ConclusionBased on the heterogeneity among the studies, the effectiveness of interventions on clinical, behavioural and psychosocial outcomes among young adults is inconclusive. This review has highlighted a lack of high-quality, well-designed interventions, aimed at improving health outcomes for young adults with Type 1 diabetes.
      PubDate: 2016-11-25T23:37:51.30152-05:0
      DOI: 10.1111/dme.13276
       
  • Validation of administrative and clinical case definitions for gestational
           diabetes mellitus against laboratory results
    • Authors: S. L. Bowker; A. Savu, L. E. Donovan, J. A. Johnson, P. Kaul
      Abstract: AimTo examine the validity of International Classification of Disease, version 10 (ICD-10) codes for gestational diabetes mellitus in administrative databases (outpatient and inpatient), and in a clinical perinatal database (Alberta Perinatal Health Program), using laboratory data as the ‘gold standard’.MethodsWomen aged 12–54 years with in-hospital, singleton deliveries between 1 October 2008 and 31 March 2010 in Alberta, Canada were included in the study. A gestational diabetes diagnosis was defined in the laboratory data as ≥2 abnormal values on a 75-g oral glucose tolerance test or a 50-g glucose screen ≥10.3 mmol/l.ResultsOf 58 338 pregnancies, 2085 (3.6%) met gestational diabetes criteria based on laboratory data. The gestational diabetes rates in outpatient only, inpatient only, outpatient or inpatient combined, and Alberta Perinatal Health Program databases were 5.2% (3051), 4.8% (2791), 5.8% (3367) and 4.8% (2825), respectively. Although the outpatient or inpatient combined data achieved the highest sensitivity (92%) and specificity (97%), it was associated with a positive predictive value of only 57%. The majority of the false-positives (78%), however, had one abnormal value on oral glucose tolerance test, corresponding to a diagnosis of impaired glucose tolerance in pregnancy.ConclusionsThe ICD-10 codes for gestational diabetes in administrative databases, especially when outpatient and inpatient databases are combined, can be used to reliably estimate the burden of the disease at the population level. Because impaired glucose tolerance in pregnancy and gestational diabetes may be managed similarly in clinical practice, impaired glucose tolerance in pregnancy is often coded as gestational diabetes.
      PubDate: 2016-11-16T00:05:47.384649-05:
      DOI: 10.1111/dme.13271
       
  • Profile of diabetes in men aged 79–97 years: the Western Australian
           Health in Men Study
    • Authors: M. Henze; H. Alfonso, L. Flicker, J. George, S. A. P. Chubb, G. J. Hankey, O. P. Almeida, J. Golledge, P. E. Norman, B. B. Yeap
      Abstract: AimsTo investigate behavioural, physical and biochemical characteristics associated with diabetes in the oldest age group of elderly men.MethodsWe conducted a cross-sectional analysis of community-dwelling men aged 79–97 years from Perth, Western Australia. Lifestyle behaviours, self-rated health, physical function, and fasting glucose and HbA1c levels were assessed.ResultsOf 1426 men, 315 had diabetes (22%). Men with diabetes were of similar age to men without (84.9 vs 84.5 years; P = 0.14). Only 26.5% of men with diabetes self-rated their health as excellent or very good, compared with 40.6% of men without diabetes (P < 0.001). Diabetes was associated with less involvement with recreational walking (32.7 vs 41.0%; P < 0.01) and leisure activities (19.0 vs 26.5%; P < 0.01). Men with diabetes had poorer physical function on multiple measures, including longer times for the Timed Up-and-Go test (15.0 ± 6.9 s vs 13.4 ± 5.3 s; P < 0.001) and weaker knee extension (20.2 vs 21.9 kg; P < 0.001). In multivariate analyses, diabetes was associated with an increased prevalence of myocardial infarction (odds ratio 1.80, 95% CI 1.25–2.60; P < 0.001) and falls resulting in injury (odds ratio 1.55, 95% CI 1.06–2.26; P = 0.02). Average HbA1c was 49 ± 8 mmol/mol (6.6 ± 0.8%) in men with diabetes, with 90.6% of these men on diet or oral hypoglycaemic therapy.ConclusionsIn older men, diabetes is associated with poorer self-perceived health, reduced healthy lifestyle behaviours and physical function, heart disease and injurious falls. The majority of these men with diabetes had good glycaemic control. Encouraging healthy lifestyle behaviours and improving physical function should be evaluated as interventions to improve quality-of-life and health outcomes.
      PubDate: 2016-11-10T02:10:50.752032-05:
      DOI: 10.1111/dme.13274
       
  • Short- and medium-term effects of light to moderate alcohol intake on
           glycaemic control in diabetes mellitus: a systematic review and
           meta-analysis of randomized trials
    • Authors: J. A. Hirst; J. K. Aronson, B. G. Feakins, C. Ma, A. J. Farmer, R. J. Stevens
      Pages: 604 - 611
      Abstract: BackgroundPeople with diabetes are told that drinking alcohol may increase their risk of hypoglycaemia.AimsTo report the effects of alcohol consumption on glycaemic control in people with diabetes mellitus.MethodsMedline, EMBASE and the Cochrane Library databases were searched in 2015 to identify randomized trials that compared alcohol consumption with no alcohol use, reporting glycaemic control in people with diabetes. Data on blood glucose, HbA1c and numbers of hypoglycaemic episodes were pooled using random effects meta-analysis.ResultsPooled data from nine short-term studies showed no difference in blood glucose concentrations between those who drank alcohol in doses of 16–80 g (median 20 g, 2.5 units) compared with those who did not drink alcohol at 0.5, 2, 4 and 24 h after alcohol consumption. Pooled data from five medium-term studies showed that there was no difference in blood glucose or HbA1c concentrations at the end of the study between those who drank 11–18 g alcohol/day (median 13 g/day, 1.5 units/day) for 4–104 weeks and those who did not. We found no evidence of a difference in number of hypoglycaemic episodes or in withdrawal rates between randomized groups.ConclusionsStudies to date have not provided evidence that drinking light to moderate amounts of alcohol, with or without a meal, affects any measure of glycaemic control in people with Type 2 diabetes. These results suggest that current advice that people with diabetes do not need to refrain from drinking moderate quantities of alcohol does not need to be changed; risks to those with Type 1 diabetes remain uncertain.
      PubDate: 2016-10-13T06:45:44.538773-05:
      DOI: 10.1111/dme.13259
       
  • DPD epitope-specific glutamic acid decarboxylase (GAD)65 autoantibodies in
           children with Type 1 diabetes
    • Authors: N. Bansal; C. S. Hampe, L. Rodriguez, E. O'Brian Smith, J. Kushner, A. Balasubramanyam, M. J. Redondo
      Pages: 641 - 646
      Abstract: AimTo study whether DPD epitope-specific glutamate decarboxylase autoantibodies are found more frequently in children with milder forms of Type 1 diabetes.MethodsWe prospectively evaluated 75 children with new-onset autoimmune Type 1 diabetes, in whom we collected demographic, anthropometric and clinical data and measured islet autoantibodies. Glutamate decarboxylase 65 autoantibody-positive samples were analysed for epitope specificities using recombinant Fab against the DPD-defined epitope of glutamate decarboxylase 65.ResultsAfter adjustment for age, positive DPD epitope recognition was significantly associated with higher C-peptide levels at onset (P = 0.02, r2=0.21, n = 35), and high DPD recognition in the highest quartile tended to be associated with HbA1c ≤ 53 mmol/mol (7%) at the last follow-up [mean (sd) follow-up 1.3 (0.4) years; P = 0.07; for the model, P = 0.044, n = 30)]. Age- and sex-adjusted BMI percentile was significantly correlated with recognition of the DPD-defined epitope (P < 0.03, r2=0.14, n = 34), but this correlation was driven by the older age group (age ≥ 10 years; P = 0.016, r2=0.27, n = 21) and was not significant in younger children (P = 0.93, n = 13). There were no independent associations with sex, race/ethnicity, diabetic ketoacidosis, HbA1c, HLA DR3-DQ2/DR4-DQ8 or autoantibody number.ConclusionsOur findings suggest that recognition of the DPD-defined glutamate decarboxylase 65 autoantibody epitope at Type 1 diabetes onset is directly associated with β-cell function, BMI and age, which supports the hypothesis that immunological factors contribute to the clinical heterogeneity of Type 1 diabetes. Larger studies relating epitope-specific glutamate decarboxylase 65 autoantibody to clinical phenotype in children with Type 1 diabetes are warranted.
      PubDate: 2016-02-12T23:50:15.199584-05:
      DOI: 10.1111/dme.13077
       
  • Baseline characteristics of participants in the Kerala Diabetes Prevention
           Program: a cluster randomized controlled trial of lifestyle intervention
           in Asian Indians
    • Authors: T. Sathish; B. Oldenburg, R. J. Tapp, J. E. Shaw, R. Wolfe, B. Sajitha, F. D'Esposito, P. Absetz, E. Mathews, P. Z. Zimmet, K. R. Thankappan
      Pages: 647 - 653
      Abstract: AimsTo describe the baseline characteristics of participants in the Kerala Diabetes Prevention Program.MethodsThe Kerala Diabetes Prevention Program is a cluster randomized controlled trial of lifestyle intervention for prevention of Type 2 diabetes mellitus in India. Participants in the study were those aged 30–60 years who had an Indian Diabetes Risk Score ≥ 60 and who were without Type 2 diabetes on oral glucose tolerance test. Data on demographic, lifestyle, clinical and biochemical characteristics were collected using standardized tools.ResultsA total of 2586 individuals were screened with the Indian Diabetes Risk Score, of these 1529 people (59.1%) had a score ≥ 60, of whom 1209 (79.1%) underwent an oral glucose tolerance test. A total of 202 individuals (16.7%) had undiagnosed Type 2 diabetes and were excluded, and the remaining 1007 individuals were enrolled in the trial (control arm, n = 507; intervention arm, n = 500). The mean participant age was 46.0 ± 7.5 years, and 47.2% were women. The mean Indian Diabetes Risk Score was 67.1 ± 8.4. More than two-thirds (69.0%) had prediabetes and 31.0% had normal glucose tolerance. The prevalence of cardiometabolic risk factors was high, including current tobacco use (34.4% in men), current alcohol use (39.3% in men), no leisure time exercise (98.0%), no daily intake of fruit and vegetables (78.7%), family history of diabetes (47.9%), overweight or obesity (68.5%), hypertension (22.3%) and dyslipidemia (85.4%).ConclusionsThe Kerala Diabetes Prevention Program recruited participants using a diabetes risk score. A large proportion of the participants had prediabetes and there were high rates of cardiometabolic risk factors. The trial will evaluate the effectiveness of lifestyle intervention in a population selected on the basis of a diabetes risk score.
      PubDate: 2016-07-15T07:06:39.13432-05:0
      DOI: 10.1111/dme.13165
       
  • Trends in diabetes and obesity in Samoa over 35 years, 1978–2013
    • Authors: S. Lin; T. Naseri, C. Linhart, S. Morrell, R. Taylor, S. T. McGarvey, D. J. Magliano, P. Zimmet
      Pages: 654 - 661
      Abstract: AimsPopulation surveys of Type 2 diabetes mellitus and obesity conducted in Samoa over three decades have used varying methodologies and definitions. This study standardizes measures, and trends of Type 2 diabetes mellitus and obesity for 1978–2013 are projected to 2020 for adults aged 25–64 years.MethodsUnit records from eight surveys (n = 12 516) were adjusted to the previous census for Division of residence, sex and age to improve national representativeness. Type 2 diabetes mellitus is defined as a fasting plasma glucose ≥ 7.0 mmol/l and/or on medication. Obesity is defined as BMI ≥ 30 kg/m2. Random effects meta-regression was employed to assess time trends following logit transformation. Poisson regression from strata was used to assess the effects of mean BMI changes on Type 2 diabetes mellitus period trends.ResultsOver 1978–2013, Type 2 diabetes mellitus prevalence increased from 1.2% to 19.6% in men (2.3% per 5 years), and from 2.2% to 19.5% in women (2.2% per 5 years). Obesity prevalence increased from 27.7% to 53.1% in men (3.6% per 5 years) and from 44.4% to 76.7% (4.5% per 5 years) in women. Type 2 diabetes mellitus and obesity prevalences increased in all age groups. From period trends, Type 2 diabetes mellitus prevalence in 2020 is projected to be 26% in men and women. Projected obesity prevalence is projected to be 59% in men and 81% in women. Type 2 diabetes mellitus period trends attributable to BMI increase are estimated as 31% (men) and 16% (women), after adjusting for age.ConclusionThis is the first study to produce trends of Type 2 diabetes mellitus and obesity in Samoa based on standardized data from population surveys. Type 2 diabetes mellitus is equally prevalent in both sexes, and obesity is widespread. Type 2 diabetes mellitus prevalence in Samoa is likely to continue to increase in the near future.
      PubDate: 2016-08-25T23:20:26.095802-05:
      DOI: 10.1111/dme.13197
       
  • Prevalence of diabetes mellitus and impaired glucose metabolism in the
           adult population of the Basque Country, Spain
    • Authors: A. Aguayo; I. Urrutia, T. González-Frutos, R. Martínez, L. Martínez-Indart, L. Castaño, S. Gaztambide,
      Pages: 662 - 666
      Abstract: AimsTo assess the prevalence of diabetes mellitus and impaired glucose metabolism in the Basque Country and their relationship with cardiovascular risk factors.MethodsA population-based, cross-sectional, cluster sampling design study was carried out in an adult (≥18 years) Basque population. A total of 847 participants completed a questionnaire on personal and family medical history and lifestyle. Anthropometric variables and blood pressure were measured and biochemical analysis and an oral glucose tolerance test (75 g) were also performed.ResultsThe total prevalence of diabetes was 10.6% (95% CI 8.65–12.95). Among them 6.3% (95% CI 4.79–8.22) had previously been diagnosed and 4.3% (95% CI 3.04–5.92) were not aware that they had diabetes. Impaired glucose tolerance was present in 7.2% (95% CI 5.53–9.15) and impaired fasting glucose in 3.8% (95% CI 2.64–5.37) of the population. In total, 21.6% of the population had some type of glucose metabolism disturbance, with a higher rate among men (28.3 vs 16.3%; P
      PubDate: 2016-09-11T23:35:22.461379-05:
      DOI: 10.1111/dme.13181
       
  • Walking Away from Type 2 diabetes: a cluster randomized controlled trial
    • Authors: T. Yates; C. L. Edwardson, J. Henson, L. J. Gray, N. B. Ashra, J. Troughton, K. Khunti, M. J. Davies
      Pages: 698 - 707
      Abstract: AimsThis study aimed to investigate whether an established behavioural intervention, Walking Away from Type 2 Diabetes, is effective at promoting and sustaining increased walking activity when delivered within primary care.MethodsCluster randomized controlled trial involving 10 general practices recruited from Leicestershire, UK, in 2009–2010. Eight hundred and eight (36% female) individuals with a high risk of Type 2 diabetes mellitus, identified through a validated risk score, were included. Participants in five practices were randomized to Walking Away from Type 2 Diabetes, a pragmatic 3-h group-based structured education programme incorporating pedometer use with annual follow-on refresher sessions. The primary outcome was accelerometer assessed ambulatory activity (steps/day) at 12 months. Longer term maintenance was assessed at 24 and 36 months. Results were analysed using generalized estimating equation models, accounting for clustering.ResultsComplete accelerometer data for the primary outcome were available for 571 (71%) participants. Increases in ambulatory activity of 411 steps/day [95% confidence interval (CI): 117, 704] and self-reported vigorous-intensity physical activity of 218 metabolic equivalent min/week (95% CI: 6, 425) at 12 months were observed in the intervention group compared with control; differences between groups were not sustained at 36 months. No differences between groups were observed for markers of cardiometabolic health. Replacing missing data with multiple imputation did not affect the results.ConclusionsA pragmatic low-resource group-based structured education programme with pedometer use resulted in modest increases in ambulatory activity compared with control conditions after 12 months when implemented within a primary care setting to those at high risk of Type 2 diabetes mellitus; however, the results were not maintained over 36 months.
      PubDate: 2016-10-19T07:05:28.312339-05:
      DOI: 10.1111/dme.13254
       
  • Effects of advanced carbohydrate counting guided by an automated bolus
           calculator in Type 1 diabetes mellitus (StenoABC): a 12-month, randomized
           clinical trial
    • Authors: E. Hommel; S. Schmidt, D. Vistisen, K. Neergaard, M. Gribhild, T. Almdal, K. Nørgaard
      Pages: 708 - 715
      Abstract: AimsTo test whether concomitant use of an automated bolus calculator for people with Type 1 diabetes carrying out advanced carbohydrate counting would induce further improvements in metabolic control.MethodsWe conducted a 12-month, randomized, parallel-group, open-label, single-centre, investigator-initiated clinical study. We enrolled advanced carbohydrate counting-naïve adults with Type 1 diabetes and HbA1c levels 64–100 mmol/mol (8.0–11.3%), who were receiving multiple daily insulin injection therapy. In a 1:1-ratio, participants were randomized to receive training in either advanced carbohydrate counting using mental calculations (MC group) or advanced carbohydrate counting using an automated bolus calculator (ABC group) during a 3.5-h group training course. For 12 months after training, participants attended a specialized diabetes centre quarterly. The primary outcome was change in HbA1c from baseline to 12 months.ResultsBetween August 2012 and September 2013, 168 participants (96 men and 72 women) were recruited and randomly assigned to the MC group (n = 84) and the ABC group (n = 84). Drop-out rates were 23.8 and 21.4%, respectively (P = 0.712); 130 participants completed the study. The baseline HbA1c was 75 ± 9 mmol/mol (9.0 ± 0.8%) in the MC group and 74 ± 8 mmol/mol (8.9 ± 0.7%) in the ABC group. At 12 months, change in HbA1c was significant within both groups: MC group: -2 mmol/mol (95% CI -4 to -1) or -0.2% (95% CI -0.4 to -0.1; P = 0.017) and ABC group: -5 mmol/mol (95% CI -6 to -3) or -0.5% (95% CI -0.6 to -0.3; P < 0.0001), but HbA1c reductions were significantly greater in the ABC group (P = 0.033). No episodes of severe hypoglycaemia were reported.ConclusionsPeople with Type 1 diabetes initiating advanced carbohydrate counting obtained significantly greater HbA1c reductions when guided by an automated bolus calculator (NCT02084498).
      PubDate: 2016-11-10T02:07:43.251956-05:
      DOI: 10.1111/dme.13275
       
  • Glucose challenge test screening for prediabetes and early diabetes
    • Authors: S. L. Jackson; S. E. Safo, L. R. Staimez, D. E. Olson, K. M. V. Narayan, Q. Long, J. Lipscomb, M. K. Rhee, P. W. F. Wilson, A. M. Tomolo, L. S. Phillips
      Pages: 716 - 724
      Abstract: AimsTo test the hypothesis that a 50-g oral glucose challenge test with 1-h glucose measurement would have superior performance compared with other opportunistic screening methods.MethodsIn this prospective study in a Veterans Health Administration primary care clinic, the following test performances, measured by area under receiver-operating characteristic curves, were compared: 50-g oral glucose challenge test; random glucose; and HbA1c level, using a 75-g oral glucose tolerance test as the ‘gold standard’.ResultsThe study population was comprised of 1535 people (mean age 56 years, BMI 30.3 kg/m2, 94% men, 74% black). By oral glucose tolerance test criteria, diabetes was present in 10% and high-risk prediabetes was present in 22% of participants. The plasma glucose challenge test provided area under receiver-operating characteristic curves of 0.85 (95% CI 0.78–0.91) to detect diabetes and 0.76 (95% CI 0.72–0.80) to detect high-risk dysglycaemia (diabetes or high-risk prediabetes), while area under receiver-operating characteristic curves for the capillary glucose challenge test were 0.82 (95% CI 0.75–0.89) and 0.73 (95% CI 0.69–0.77) for diabetes and high-risk dysglycaemia, respectively. Random glucose performed less well [plasma: 0.76 (95% CI 0.69–0.82) and 0.66 (95% CI 0.62–0.71), respectively; capillary: 0.72 (95% CI 0.65–0.80) and 0.64 (95% CI 0.59–0.68), respectively], and HbA1c performed even less well [0.67 (95% CI 0.57–0.76) and 0.63 (95% CI 0.58–0.68), respectively]. The cost of identifying one case of high-risk dysglycaemia with a plasma glucose challenge test would be $42 from a Veterans Health Administration perspective, and $55 from a US Medicare perspective.ConclusionsGlucose challenge test screening, followed, if abnormal, by an oral glucose tolerance test, would be convenient and more accurate than other opportunistic tests. Use of glucose challenge test screening could improve management by permitting earlier therapy.
      PubDate: 2016-11-02T03:58:25.644267-05:
      DOI: 10.1111/dme.13270
       
  • The publication of Diabetes UK position statements and care
           recommendations; a virtual issue
    • Authors: R. I. G. Holt; G. A. Hitman, Barbara S Young, K. G. M. M. Alberti
      Abstract: Diabetes UK is the charity that cares for, connects with and campaigns on behalf of all people affected by and at risk of diabetes. Founded in 1934 by the novelist H. G. Wells and Dr R. D. Lawrence, the charity has always combined the expertise of lay and professional members to achieve its mission to improve the lives of people with diabetes and to work towards a future without diabetes.
      PubDate: 2012-05-23T10:01:56.258554-05:
      DOI: 10.1111/j.1464-5491.2012.03696.x
       
 
 
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