Publisher: Diabetologists-ABCD   (Total: 1 journals)   [Sort by number of followers]

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British J. of Diabetes & Vascular Disease     Open Access   (Followers: 21, SJR: 0.286, CiteScore: 0)
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British Journal of Diabetes & Vascular Disease
Journal Prestige (SJR): 0.286
Number of Followers: 21  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1474-6514 - ISSN (Online) 1753-4305
Published by Diabetologists-ABCD Homepage  [1 journal]
  • Diabetes care in times of armed conflict

    • Authors: Michael Stacey, Robert Gifford, Amanda Pye
      Pages: 1 - 4
      Abstract: Recent events in Ukraine emphasise the danger and uncertainty faced by people who are caught in armed conflict. Those living with diabetes face an additional crisis: the complexity of diabetes management during war. This editorial describes the challenges of caring for people with diabetes in this scenario, including the impact on healthcare systems, mass displacement, refocused priorities of wider healthcare, fiscal challenges, and disruption to supply lines, storage of medicines and communications. We consider the effects on people living with diabetes and suggest some strategies for healthcare workers providing care during conflict, including equipping healthcare providers to deal with diabetes emergencies, and adaptation of technological innovations.
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.339
      Issue No: Vol. 22, No. 1 (2022)
       
  • Driving and new technologies for diabetes

    • Authors: Mark Evans
      Pages: 5 - 6
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.338
      Issue No: Vol. 22, No. 1 (2022)
       
  • The NHS England Low-Calorie Diet Programme

    • Authors: Chris Walton, Marie Reid
      Pages: 7 - 8
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.340
      Issue No: Vol. 22, No. 1 (2022)
       
  • Protocol for the Diabetes Technology Network UK and Association of British
           Clinical Diabetologists’ closed-loop insulin delivery audit programme

    • Authors: Thomas Simon James Crabtree, Tomás P Griffin, Alistair Lumb, Peter Hammond, Robert EJ Ryder, Pratik Choudhary, Emma G Wilmot
      Pages: 9 - 13
      Abstract: Background: The Association of British Clinical Diabetologists (ABCD) closed-loop audit aims to capture real-world out- comes from all who use hybrid closed-loop (HCL) insulin delivery systems in routine clinical care. In addition, NHS England has announced a pilot programme this year to expand access to HCL insulin delivery systems to people with type 1 diabetes (T1D) who are already using pump therapy and FreeStyle Libre with a HbA1c ≥ 69mmol/mol (≥ 8.5%). This group is often underrepresented in current randomised control trial evidence and, vitally, the planned audit will capture their data. Methods: The ABCD nationwide audit programme has Caldicott guardian approval and has also been approved by Confidentiality Advisory Group (CAG). Clinical teams collect anonymised user data using a secure online tool. Baseline characteristics and routinely collected outcome data at follow-up will include: assessment of glycaemic outcomes ( HbA1c, time in range, time below range); patient-reported outcome measures (Gold score and diabetes-related distress); and frequency of resource utilisation (hospital admissions, paramedic callouts, diabetic ketoacidosis [DKA] and severe hypoglycaemia). Discussion: The ABCD closed-loop audit will produce an inde- pendent real-world dataset of outcomes in closed-loop users across multiple systems. These data will provide insight into the real-world benefits and challenges of HCL systems used within the NHS in England.
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.335
      Issue No: Vol. 22, No. 1 (2022)
       
  • Ramadan in Egyptian people with type 2 diabetes: effect on cardiometabolic
           parameters

    • Authors: Hanan Amer, Yara Eid, Maram Aboromia, Yomna kabany
      Pages: 14 - 19
      Abstract: Background: Most Muslims with diabetes have a strong desire to fast during the month of Ramadan but some cannot perform it because of the risk of complications such as hypoglycemia, hyperglycemia, diabetic ketoacidosis, dehydration and thrombosis. During Ramadan, the meal pattern and fluid intake are markedly altered and there are delayed and shortened periods of sleep. These changes in meal and sleep rhythm could lead to undesirable changes in metabolism and increased risk of complications. Aims: To study the effect of Ramadan fasting on metabolic parameters and cardiovascular disease risk in patients with type 2 diabetes mellitus (T2D). Methods: This cohort study was conducted on 80 people with T2D who were intending to fast during Ramadan in the year 2014; the average number of fasting hours was 15 hours. They were subjected to clinical, anthropometric and laboratory evaluation before and after Ramadan. Results: There were significant increases between pre- and post-Ramadan total cholesterol levels (3.77±1.19 mmol/l vs 5.24±1.03 mmol/l, p< 0.001), triglycerides (1.7±0.95 mmol/l vs 2.22±1.51 mmol/l, p< 0.004), LDL-C (2.03±1.08 mmol/l vs 3.04±1.19 mmol/l, p< 0.001), fasting insulin (6.1±3.7 mu/l vs 12.6±8.2 mu/l, p<0.001), HOMA IR (2.42±1.6 IU vs 7.02±8.9 IU, p< 0.001), creatinine (71.62±17.68 umol/l vs 83.11±26.53 umol/l , p< 0.001 ), systolic blood pressure (SBP) (134.9±10.8 mmHg vs 141.2±11.9 mmHg , p< 0.001 ) and diastolic blood pressure (DBP) ( 94.7±10.7 mmHg vs 101.8±11.3 mmHg, p < 0.001). The 10-year cardiovascular disease risk increased from 5.18±7.8 to 7.6±9.9 (p< 0.001). There was no significant change in body mass index. Conclusion: Ramadan fasting in Egyptian people with T2D appears to have a significant effect on lipid profiles and blood pressure that could adversely impact cardiovascular risk. Current guidance is more focused on glycemic control, with adjustments to oral hypoglycemic agents and insulin dose. Cardiovascular disease risk assessment and guidance prior to Ramadan fasting should not be overlooked.
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.337
      Issue No: Vol. 22, No. 1 (2022)
       
  • How is the NHS Low-Calorie Diet Programme expected to produce behavioural
           change to support diabetes remission: An examination of underpinning
           theory

    • Authors: Tamla Evans, Rhiannon Hawkes, Christopher Keyworth, Lisa Newson, Duncan Radley, Andrew Hill, Jamie Matu, Louisa Ells
      Pages: 20 - 29
      Abstract: Background: In 2020, the National Health Service Low-Calorie Diet Programme (NHS-LCD) was launched, piloting a total diet (TDR) replacement intervention with behaviour change support for people living with Type 2 Diabetes (T2D) and excess weight. Four independent service providers were commissioned to design and deliver theoretically grounded programmes in localities across England. Aims: 1) to develop a logic model detailing how the NHS-LCD programme is expected to produce changes in health behaviour, and (2) to analyse and evaluate the use of behaviour change theory in providers’ NHS-LCD Programme designs. Methods: A documentary review was conducted. Information was extracted from the NHS-LCD service specification documents on how the programme expected to produce outcomes. The Theory Coding Scheme (TCS) was used to analyse theory use in providers’ programme design documents. Results: The NHS-LCD logic model included techniques aimed at enhancing positive outcome expectations of programme participation and beliefs about social approval of behaviour change, to facilitate programme uptake and behaviour change intentions. This was followed by techniques aimed at shaping knowledge and enhancing the ability of participants to self-regulate their health behaviours, alongside a supportive social environment and person-centred approach. Application and type of behaviour change theory within service providers’ programme designs varied. One provider explicitly linked theory to programme content; two providers linked 63% and 70% of intervention techniques to theory; and there was limited underpinning theory identified in the programme design documents for one of the providers. Conclusion: The nature and extent of theory use underpinning the NHS-LCD varied greatly amongst service providers, with some but not all intervention techniques explicitly linked to theory. How this relates to outcomes across providers should be evaluated. It is recommended that explicit theory use in programme design and evidence of its implementation becomes a requirement of future NHS commissioning processes.
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.341
      Issue No: Vol. 22, No. 1 (2022)
       
  • PCSK9 inhibitors and treatment targets: an audit-based evaluation of a
           specialist lipid clinic

    • Authors: Anirudh Suresh , Aikaterini Theodoraki, Emily Ward, Michael Feher
      Pages: 30 - 35
      Abstract: Background: Trial evidence for lower LDL cholesterol (LDL-C) treatment targets for cardiovascular benefit were incorporated into recent European Society of Cardiology/European Atherosclerosis Society and NICE guidelines. Treatment targets are LDL-C <1.4mmol/L, LDL-C <1.8mmol/L and ≥50% LDL-C reduction for atherosclerotic cardiovascular disease (ASCVD) and/or Familial Hypercholesterolaemia (FH). There is limited real-world evidence of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9is), with enhanced LDL-C lowering, achieving these targets. Aims: To assess attainment of guideline LDL-C targets using PCSK9is ± oral lipid-lowering therapies (LLT) in ASCVD and/or FH. Methods: Clinic-based audit using retrospective case-note review of adults prescribed PCSK9is. Anonymised data were collected before and after PCSK9i initiation. Standards were attainment of LDL-C <1.8mmol/L, LDL-C <1.4mmol/L and ≥50% LDL-C reduction. Results: Fifty-five patients (mean age 60.8 years) receiving PCSK9is (35% monotherapy; median treatment duration 1.5 years) were identified (ASCVD, n=50; FH, n=18). Target attainment was 80% for ≥50% LDL-C reduction, 46% for LDL-C <1.8mmol/L and 24% for LDL-C <1.4mmol/L. Greater attainment of these targets occurred with ≥2 additional LLTs versus one additional LLT or PCSK9i monotherapy. Conclusion: Most ASCVD and/or FH patients achieved ≥50% LDL-C reductions with PCSK9is. Fewer achieved LDL-C <1.8mmol/L and <1.4mmol/L targets. PCSK9is in combination with other LLT achieved targets more often compared to PCSK9i monotherapy. Achievement of recommended lipid targets may require greater use of PCSK9i combination therapies.
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.342
      Issue No: Vol. 22, No. 1 (2022)
       
  • Improving glycaemic management in people with diabetes on maintenance
           haemodialysis

    • Authors: Apexa Kuverji, Jo Reed, Harpreet Sawhney, June James, Rob Gregory, James Burton, Andrew Frankel
      Pages: 36 - 41
      Abstract: The Diabetes Care in Haemodialysis (DiH) working group aims to improve the care of people with diabetes mellitus on the haemodialysis unit by supporting the implementation of the 2016 JBDS guidelines. In order to support the implementation of the guideline recommendations the DiH working group have established a set of standards, developed an audit tool to demonstrate adherence to standards, and have developed educational support for haemodialysis staff both online and delivered face-to-face. We publish audit findings from five distinct haemodialysis units, highlighting the impact of the educational programme on the achievement of guideline standards. We also report the impact of the COVID-19 pandemic on diabetes care and quality improvement.
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.343
      Issue No: Vol. 22, No. 1 (2022)
       
  • Series: Cardiovascular outcome trials for diabetes drugs. Linagliptin,
           CARMELINA and CAROLINA

    • Authors: Miles Fisher
      Pages: 42 - 46
      Abstract: Dipeptidyl peptidase-4 (DPP-4) inhibitors were the first class of new antidiabetic drugs to be studied using modern cardiovascular safety trials, as mandated by the Food and Drug Administration (FDA) and the European Medicines Agency (EMA). Trials with saxagliptin, alogliptin and sitagliptin satisfied the safety criteria with no increase in major cardiovascular adverse events (MACE), a composite of cardiovascular death, non-fatal myocardial infarction and non-fatal stroke. No reduction in MACE was demonstrated in these trials, and an unexpected increase in the secondary outcome of hospitalisation for heart failure was observed in the SAVOR-TIMI 53 trial with saxagliptin. Unusually, linagliptin was studied in two separate safety trials: CARMELINA compared linagliptin with placebo and CAROLINA compared linagliptin with glimepiride. In both trials MACE events were similar in the linagliptin and comparator groups, and no significant differences were observed in rates of hospitalisation for heart failure. These trials provide evidence of cardiovascular safety for linagliptin but show no clear cardiovascular benefits, and indirectly provide evidence of cardiovascular safety for the sulfonylurea glimepiride.
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.336
      Issue No: Vol. 22, No. 1 (2022)
       
  • Dapagliflozin use in type 1 diabetes: industry, business and ethics

    • Authors: Sufyan Hussain, Hilary Nathan, Susannah Rowles
      Pages: 47 - 48
      Abstract: We provide a summary on the unprecedented withdrawal of dapagliflozin’s license in Type 1 diabetes by AstraZeneca. We also provide a summary from a national survey of 52 sites in the United Kingdom, with 70% respondents reporting clinically significant benefits following dapagliflozin use in type 1 diabetes. We describe some of the challenges faced by clinicians supporting people with type 1 diabetes using dapagliflozin. This withdrawal, which was solely for commercial reasons and not due to adverse safety events, raises important considerations about ethics and transparency required from the pharmaceutical industry. It also strongly highlights the need for consultation from key stakeholders including clinicians and patient groups prior to such decisions.
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.344
      Issue No: Vol. 22, No. 1 (2022)
       
  • COVID-19 toes in a patient with atrial fibrillation on anticoagulation

    • Authors: Songo J Lolomari, Sheena Thayyil, Rachel Berrington, Marie-France Kong
      Pages: 49 - 51
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.345
      Issue No: Vol. 22, No. 1 (2022)
       
  • Notes from the Diabetes UK conference

    • Authors: Umesh Dashora
      Pages: 52 - 53
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.349
      Issue No: Vol. 22, No. 1 (2022)
       
  • The Silver Jubilee of the ABCD: the early history of the Association

    • Authors: Admin Three, Ken Shaw, Richard Greenwood
      Pages: 54 - 57
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.346
      Issue No: Vol. 22, No. 1 (2022)
       
  • ABCD News

    • Authors: Dipesh Patel, Umesh Dashora, Rebecca Reeve, Pratik Choudhary, Thomas Simon James Crabtree
      Pages: 58 - 65
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.347
      Issue No: Vol. 22, No. 1 (2022)
       
  • Technology FAQ

    • Authors: Iain Cranston
      Pages: 66 - 67
      PubDate: 2022-06-29
      DOI: 10.15277/bjd.2022.348
      Issue No: Vol. 22, No. 1 (2022)
       
 
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