Imperial College London

DrIanGodsland

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

Wynn Reader in Human Metabolism
 
 
 
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Contact

 

+44 (0)20 3312 6573i.godsland

 
 
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Assistant

 

Mrs Heather Bones +44 (0)20 7594 2429

 
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Location

 

Room G1Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Publication Type
Year
to

325 results found

Thomas MG, Avari P, Godsland IF, Lett AM, Reddy M, Oliver Net al., 2021, Optimizing type 1 diabetes after multiple daily injections and capillary blood monitoring: Pump or sensor first? A meta-analysis using pooled differences in outcome measures, DIABETES OBESITY & METABOLISM, ISSN: 1462-8902

Journal article

Uduku C, Pendolino V, Godsland I, Oliver N, Reddy M, Fothergill RTet al., 2021, Cross-sectional analysis of emergency hypoglycaemia and outcome predictors among people with diabetes in an urban population, DIABETIC MEDICINE, ISSN: 0742-3071

Journal article

Avari P, Unsworth R, Rilstone S, Uduku C, Logan KM, Hill NE, Godsland IF, Reddy M, Oliver Net al., 2021, Improved glycaemia during the Covid-19 pandemic lockdown is sustained post-lockdown and during the "Eat Out to Help Out" Government Scheme, in adults with Type 1 diabetes in the United Kingdom, PLOS ONE, Vol: 16, ISSN: 1932-6203

Journal article

Ngaosuwan K, Johnston DG, Godsland IF, Cox J, Majeed A, Quint JK, Oliver N, Robinson Set al., 2021, Increased mortality risk in patients with primary and secondary adrenal insufficiency, Journal of Clinical Endocrinology and Metabolism, Vol: 106, Pages: e2759-e2768, ISSN: 0021-972X

CONTEXT: Mortality data in patients with adrenal insufficiency are inconsistent, possibly due to temporal and geographical differences between patients and their reference populations. OBJECTIVE: To compare mortality risk and causes of death in adrenal insufficiency with an individually-matched reference population. DESIGN: Retrospective cohort study. SETTING: UK general practitioner database (CPRD). PARTICIPANTS: 6821 patients with adrenal insufficiency (primary, 2052; secondary, 3948) and 67564 individually-matched controls (primary, 20366; secondary, 39134). MAIN OUTCOME MEASURES: All-cause and cause-specific mortality; hospital admission from adrenal crisis. RESULTS: With follow-up of 40799 and 406899 person-years for patients and controls respectively, the hazard ratio (HR; [95%CI]) for all-cause mortality was 1.68 [1.58 - 1.77]. HRs were greater in primary (1.83 [1.66 - 2.02]) than in secondary (1.52 [1.40 - 1.64]) disease; (HR; primary versus secondary disease, 1.16 [1.03 - 1.30]). The leading cause of death was cardiovascular disease (HR 1.54 [1.32-1.80]), along with malignant neoplasms and respiratory disease. Deaths from infection were also relatively high (HR 4.00 [2.15 - 7.46]). Adrenal crisis contributed to 10% of all deaths. In the first two years following diagnosis, the patients' mortality rate and hospitalisation from adrenal crisis were higher than in later years. CONCLUSION: Mortality was increased in adrenal insufficiency, especially primary, even with individual matching and was observed early in the disease course. Cardiovascular disease was the major cause but mortality from infection was also high. Adrenal crisis was a common contributor. Early education for prompt treatment of infections and avoidance of adrenal crisis hold potential to reduce mortality.

Journal article

Washirasaksiri C, Srivanichakorn W, Godsland IF, Kositamongkol C, Chariyalertsak S, Kessomboon P, Assanangkornchai S, Taneepanichskul S, Neelapaichit N, Phisalprapa P, Johnston DG, Oliver NS, Aekplakorn Wet al., 2021, Increasing glycaemia is associated with a significant decline in HDL cholesterol in women with prediabetes in two national populations, SCIENTIFIC REPORTS, Vol: 11, ISSN: 2045-2322

Journal article

Avari P, Unsworth R, Rilstone S, Uduku C, Logan K, Hill N, Godsland I, Reddy M, Oliver Net al., 2021, HIGHER LEVELS OF SOCIAL DEPRIVATION ASSOCIATED WITH INCREASED PERCENTAGE TIME IN RANGE IN PEOPLE WITH TYPE 1 DIABETES DURING COVID-19 LOCKDOWN, Publisher: MARY ANN LIEBERT, INC, Pages: A197-A197, ISSN: 1520-9156

Conference paper

Avari P, Unsworth R, Uduku C, Rilstone S, Hill N, Godsland I, Reddy M, Oliver Net al., 2021, IMPROVED GLYCAEMIA DURING THE COVID-19 LOCKDOWN IS SUSTAINED IN ADULTS WITH TYPE 1 DIABETES, Publisher: MARY ANN LIEBERT, INC, Pages: A200-A201, ISSN: 1520-9156

Conference paper

Unsworth R, Godsland I, Avari P, Bound C, Vieira S, Logan K, Oliver N, Reddy Met al., 2021, THE EFFECT OF LOCKDOWN AND EASING OF RESTRICTIONS ON GLYCAEMIA IN CHILDREN WITH TYPE 1 DIABETES DURING THE COVID-19 PANDEMIC, Publisher: MARY ANN LIEBERT, INC, Pages: A200-A200, ISSN: 1520-9156

Conference paper

Ngaosuwan K, Johnston DG, Godsland IF, Cox J, Majeed A, Quint JK, Oliver N, Robinson Set al., 2021, Full Mortality risk in patients with adrenal insufficiency using Prednisolone or Hydrocortisone: A Retrospective Cohort study., J Clin Endocrinol Metab

CONTEXT: Prednisolone has been recommended rather than hydrocortisone for glucocorticoid replacement in adrenal insufficiency due its longer duration of action and lower cost. OBJECTIVE: To determine mortality rates with prednisolone versus hydrocortisone. DESIGN: Observational study. SETTING: A UK primary care database (Clinical Practice Research Datalink). PARTICIPANTS: Patients with primary and secondary adrenal insufficiency, treated with either prednisolone or hydrocortisone, and controls individually matched for age, sex, period and place of follow-up. INTERVENTIONS: Nil. OUTCOMES: Mortality relative to individually matched controls. RESULTS: As expected, mortality in adrenal insufficiency irrespective of cause was increased, based on 5478 patients (4228 on hydrocortisone; 1250 on prednisolone) and 54314 controls (41934 and 12380, respectively). Overall, the adjusted hazard ratio (HR) was similar with the two treatments (prednisolone, 1.76 [95% CI, 1.54-2.01] vs. hydrocortisone 1.69 [1.57-1.82]; p=0.65). This was also the case for secondary adrenal insufficiency. In primary disease (1405 on hydrocortisone vs. 137 on prednisolone:13965 and 1347 controls, respectively), prednisolone-users were older, more likely to have another autoimmune disease and malignancy, and less likely to have mineralocorticoid replacement. Nevertheless, after adjustment, the HR for prednisolone-treated patients remained higher than for those taking hydrocortisone (2.92 [2.19-3.91] vs. 1.90 [1.66-2.16]; p=0.0020). CONCLUSIONS: In primary but not in secondary adrenal insufficiency mortality was higher with prednisolone. The study was large, but the number of prednisolone-treated patients was small, and they had greater risk factors. Nonetheless the increased mortality associated with prednisolone persisted despite statistical adjustment. Further evidence is needed regarding the long-term safety of prednisolone as routine replacement.

Journal article

Ngaosuwan K, Johnston DG, Godsland IF, Cox J, Majeed A, Quint JK, Oliver N, Robinson Set al., 2021, Cardiovascular disease in patients with primary and secondary adrenal insufficiency and the role of comorbidities, Journal of Clinical Endocrinology and Metabolism, Vol: 106, Pages: 1284-1293, ISSN: 0021-972X

CONTEXT: Mortality studies have established that cardiovascular disease is the leading cause of death in patients with adrenal insufficiency and the risk is greater than that observed in individually-matched controls. OBJECTIVE: Here we have performed a detailed analysis of cardiovascular morbidity and mortality, taking account of the role of co-morbidities. DESIGN: Retrospective cohort study. SETTING: UK general practitioner database (CPRD). PARTICIPANTS: 6821 patients with adrenal insufficiency (primary, 2052; secondary, 3948) compared with 67564 individually-matched controls, with and without adjustment for comorbidities (diabetes, hypertension, dyslipidaemia, previous cardiovascular disease, and smoking). MAIN OUTCOME MEASURES: Composite cardiovascular events recorded in CPRD and cardiovascular mortality in those participants with linked national mortality data. RESULTS: Hazard ratios (95%CI) for composite cardiovascular events in patients with adrenal insufficiency of any cause were 1.28 (1.20-1.36, unadjusted) and 1.07 (1.01-1.14, adjusted). Increased cerebrovascular events in patients with secondary adrenal insufficiency accounted for most of the increased hazard (1.53 (1.34-1.74, adjusted)) and were associated with cranial irradiation therapy. Cardiovascular mortality data were available for 3547 patients and 34944 controls. The adjusted hazard ratio for ischaemic heart disease mortality was 1.86 (1.25-2.78) for primary adrenal insufficiency and 1.39 (1.02-1.89) for secondary. CONCLUSION: Co-morbidities largely accounted for the increased cardiovascular events but in secondary adrenal insufficiency, cerebrovascular events were independently increased and associated with irradiation treatment. However, the risk of cardiovascular mortality remained increased even following adjustment for co-morbidities in both primary and secondary adrenal insufficiency.

Journal article

Agha-Jaffar R, Oliver NS, Kostoula M, Godsland IF, Yu C, Terry J, Johnston D, Gable D, Robinson Set al., 2021, Hyperglycemia Recognized in Early Pregnancy Is Phenotypically Type 2 Diabetes Mellitus Not Gestational Diabetes Mellitus: A Case Control Study, OBSTETRICAL & GYNECOLOGICAL SURVEY, Vol: 76, Pages: 133-135, ISSN: 0029-7828

Journal article

Agha-Jaffar R, Oliver NS, Kostoula M, Godsland IF, Yu C, Terry J, Johnston D, Gable D, Robinson Set al., 2020, Hyperglycemia recognised in early pregnancy is phenotypically type 2 diabetes mellitus not gestational diabetes mellitus: a case control study, Journal of Maternal-Fetal and Neonatal Medicine, Vol: 33, Pages: 3977-3983, ISSN: 1476-4954

OBJECTIVE: Gestational diabetes mellitus is defined as "diabetes recognized in the second or third trimester that is not clearly overt diabetes". Evidence relating to women with hyperglycemia early in pregnancy is limited. We aimed to evaluate women diagnosed with hyperglycemia early in pregnancy (eGDM) and compared them to those with pregestational established type 2 diabetes mellitus (T2DM) and gestational diabetes diagnosed routinely at 24-28-week gestation (rtGDM) to determine if the length of exposure to hyperglycemia adversely affected outcomes. METHODS: Forty consecutive women with eGDM who attended a multidisciplinary antenatal clinic were reviewed. Two separate BMI-matched control groups were identified, recognized pregestational T2DM (n = 80) and rtGDM (n = 80). Baseline demographics and outcomes were compared. RESULTS: A higher proportion of women in the eGDM and T2DM group required insulin and the incidence of hypertensive disorders was similarly increased compared with the rtGDM group (88.6, 77.0 versus 8.1%, p < .001 and 42.5%, 37.5 versus 12.5% p < .001, respectively). The proportion of infants born small for gestational age varied (eGDM 11.1%, T2DM 13.0%, and rtGDM 2.5%, p=.049). Postpartum, 7.5% of eGDM women were diagnosed with T2DM versus 1.3% in the rtGDM group (p<.001). CONCLUSIONS: These novel data demonstrate that the length of exposure to glucose adversely affects materno-foetal outcomes independent of maternal adiposity.

Journal article

Petropoulou K, Salt LJ, Edwards CH, Warren FJ, Garcia-Perez I, Chambers ES, Alshaalan R, Khatib M, Perez-Moral N, Cross KL, Kellingray L, Stanley R, Koev T, Khimyak YZ, Narbad A, Penney N, Serrano-Contreras JI, Charalambides MN, Miguens Blanco J, Castro Seoane R, McDonald JAK, Marchesi JR, Holmes E, Godsland IF, Morrison DJ, Preston T, Domoney C, Wilde PJ, Frost GSet al., 2020, A natural mutation in Pisum sativum L. (pea) alters starch assembly and improves glucose homeostasis in humans, Nature Food

Journal article

Misra S, Humayra H, Busbridge M, Bhardwaj N, Godsland IF, Owen K, Oliver N, Johnston DGet al., 2020, Type 2 diabetes diagnosed between 18 and 30 years in south Asian (SA) and White individuals is clinically similar but treated differently, Publisher: WILEY, Pages: 62-62, ISSN: 0742-3071

Conference paper

Ji H, Godsland I, Oliver NS, Hill NEet al., 2020, Loss of association between HbA1c and vascular disease in older adults with type 1 diabetes, PLOS ONE, Vol: 15, ISSN: 1932-6203

Journal article

Misra S, Godsland IF, Bhardwaj N, Oliver N, Owen KR, Johnston DGet al., 2020, Type 2 Diabetes Diagnosed between 16-30 Years in South Asian and White Individuals Is Phenotypically Similar, 80th Scientific Sessions of the American-Diabetes-Association (ADA), Publisher: AMER DIABETES ASSOC, ISSN: 0012-1797

Conference paper

Johnson A, Hill NE, Godsland I, Oliver NSet al., 2020, Glycemic Tracking Before and After Insulin Pump Initiation., J Diabetes Sci Technol, Pages: 1932296820910506-1932296820910506

Journal article

Kotecha PT, Godsland IF, Crook D, Stevenson JCet al., 2020, Effects of tibolone or continuous combined oestradiol and norethisterone acetate on lipids, high-density lipoprotein subfractions and apolipoproteins in postmenopausal women in a two-year, randomized, double-blind, placebo-controlled trial, Clinical Endocrinology, Vol: 92, Pages: 303-311, ISSN: 0300-0664

ObjectiveTo compare the effects of (a) tibolone, (b) continuous combined oestrogen plus progestogen and (c) placebo on plasma lipid and lipoprotein markers of cardiovascular risk in healthy postmenopausal women.Study designRandomized, single‐centre, placebo‐controlled, double‐blind study.PatientsOne hundred and one postmenopausal women were randomized (1:1:1) into one of three groups taking daily 2.5 mg tibolone, continuous oral oestradiol‐17β 2 mg plus norethisterone acetate 1 mg daily (E2/NETA) or placebo.Main outcome measuresFasting serum lipid, lipoprotein and apolipoprotein concentrations measured at baseline and after 6, 12 and 24 months of treatment.ResultsBoth tibolone and E2/NETA lowered plasma total cholesterol concentrations relative to placebo. With tibolone, high‐density lipoprotein cholesterol (HDL‐C) was reduced (−27% at 24 months, P < .001), the greatest effect being in the cholesterol‐enriched HDL2 subfraction (−40%, P < .001). Tibolone's effect on HDL concentrations was also apparent in the principal HDL protein component, apolipoprotein AI (−29% at 24 months, P < .001). However, there was no significant effect of tibolone on low‐density or very low‐density lipoprotein cholesterol (LDL‐C and VLDL‐C, respectively). By contrast, the greatest reduction in cholesterol with E2/NETA was in LDL‐C (−22% at 24 months, P = .008). E2/NETA reduced HDL‐C to a lesser extent than tibolone (−12% at 24 months, P < .001). Effects on HDL apolipoproteins were similarly diminished relative to tibolone. E2/NETA had no effect on VLDL‐C or on the protein component of LDL, apolipoprotein B.ConclusionTibolone reduces serum HDL. E2/NETA reduces LDL cholesterol but not apolipoprotein B, suggesting decreased cholesterol loading of LDL. Any impact these changes may have on CVD risk needs further investigation.

Journal article

Oliver N, Johnston D, Godsland I, Srivanichakorn W, Majeed A, Darzi Aet al., 2020, A pragmatic and scalable strategy using mobile technology to promote sustained lifestyle changes to prevent Type 2 diabetes in India and the UK – a randomised controlled trial, Diabetologia, Vol: 63, Pages: 486-496, ISSN: 0012-186X

Aims/hypothesis This randomised controlled trial was performed in India and UK in people with prediabetes to study whether mobile phone short message services can be used to motivate and educate people to follow lifestyle modification, to prevent type 2 diabetes.Methods The study was performed in people with prediabetes (n=2062, control: n=1031; intervention: n=1031) identified by glycosylated haemoglobin A1c42 and 47mmol/mol (6.0% and 6.4%). Participants were recruited from public and private sector organisations in India and by the NHS Health Checks programme in the UK. Allocation to the study groups was performed using a computer generated sequence (1:1) in India and by stratified randomisation in permuted blocks in the UK. Investigators in both countries remained blinded throughout the study period. All participants received advice on healthy lifestyle at baseline. The intervention group in addition received supportive text messages using mobile phone short messaging services2-3 times per week. Participants were assessed at intervals for 2years. The primary outcome was conversion to diabetes and secondary outcomes included anthropometry, biochemistry, dietary and physical activity change, blood pressure and quality of life. Results At 2years follow-up, in the intention-to-treat population the hazard ratio for development of diabetes calculated using a discrete-time proportional hazards model was 0.89,95%CI(0.74-1.07) p=0.22. There were no significant differences in the secondary outcomes.Conclusions/Interpretation This trial in 2 countries with varied ethnic and cultural backgrounds showed no significant reduction in the progression in diabetes in 2 years by lifestyle modification using short messaging services (Hazard Ratio 0.89, 95% CI 0.74 – 1.07, p=0.22)

Journal article

Bhattarai S, Godsland IF, Misra S, Johnston DG, Oliver Net al., 2019, Metabolic health and vascular complications in type 1 diabetes, Journal of Diabetes and its Complications, Vol: 33, Pages: 634-640, ISSN: 1056-8727

AIMS: Optimal glycaemic control benefits risk of microvascular and macrovascular complications in type 1 diabetes (T1DM) but the importance of other components of metabolic health is less certain, particularly in the context of routine clinical practice. METHODS: Data for this cross-sectional analysis derived from a database covering inner North West London adult diabetes clinics. People with T1DM and with complete information for height, weight, blood pressure and serum high and low-density lipoprotein cholesterol (HDL-c and LDL-c) and triglyceride concentration measurements were included. RESULTS: Among the 920 participants, those with complications were older and had longer duration of diabetes but had similar HbA1c to people without complications. Systolic hypertension and low HDL-c were independently associated with complications. From having 0 risk factors, the prevalence of micro and macrovascular disease increased with increasing number of risk factors. Relative to those with ≥1 risk factor, those with 0 risk factors (n = 179) were at lower risk of retinopathy (OR 0.6 (0.4-0.9), p = 0.01) and nephropathy [OR 0.1 (0.04-0.3), p = 0.002], independent of individual characteristics. CONCLUSIONS: In routine clinical management of T1DM, associations between lipid and blood pressure risk factors and prevalent micro and macrovascular disease remain, implying that more intensive risk factor management may be beneficial.

Journal article

Groom O, McLaughlin K, Johns J, Walkey H, Kaur A, Williams A, Godsland I, Oliver N, Johnston D, Misra Set al., 2019, Utility of anti-tetraspanin 7 auto-antibodies in adults and children with type 1 diabetes: insights from the ADDRESS-2 study, 55th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Publisher: SPRINGER, Pages: S204-S205, ISSN: 0012-186X

Conference paper

Sivapatham S, Walkey HC, Kaur A, Godsland IF, Ahmed F, Busbridge M, Oliver NS, Johnston DJ, Misra Set al., 2019, Changes in beta cell function 6 and 12 months after a diagnosis of type 1 diabetes: insights from the ADDRESS-2 study, 55th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Publisher: SPRINGER, Pages: S155-S155, ISSN: 0012-186X

Conference paper

Humphreys A, Bravis V, Kaur A, Walkey HC, Godsland IF, Misra S, Johnston DG, Oliver NSet al., 2019, Individual and diabetes presentation characteristics associated with partial remission status in children and adults evaluated up to 12 months following diagnosis of type 1 diabetes: An ADDRESS-2 (After Diagnosis Diabetes Research Support System-2) study analysis, Diabetes Research and Clinical Practice, Vol: 155, ISSN: 0168-8227

AIMS: People with recently-diagnosed type 1 diabetes mellitus (T1D) may undergo a transient period of glycaemic control with less exogenous insulin. Identification of predictors of this 'remission' could inform a better understanding of glycaemic control. METHODS: Participants in the ADDRESS-2 study were included who had 1 or 2 assessments of remission status (coincident insulin dose and HbA1c measurement, with remission defined by ≤0.4 units insulin/kg-body-weight/day with HbA1c < 53 mmol/mol). Demographic and clinical presentation characteristics were compared according to remission status and predictors of remission were explored by logistic regression analysis. RESULTS: 1470 first and 469 second assessments of remission status were recorded within 12 months of diagnosis of T1D. Step increases in the probability of remission were identified at age-at-diagnosis 20 years and 3 months after diagnosis (both p < 0.001). Among those aged < 20 years, remission was associated with male gender (p = 0.02), no ketoacidosis (p = 0.02) and fewer than 2 symptoms at presentation (p = 0.004). None of these characteristics predicted remission in those aged ≥ 20 years. In the subgroup with two assessments, transition to remission was independently associated with first remission assessment in months 1-2 post-diagnosis (p = 0.01), with age-at-diagnosis ≥ 20 years (p = 0.01) and, in those aged < 20 years, with an early HbA1c of <57 mmol/mol. Adiposity, ethnicity, autoantibody status and other autoimmune disease were unrelated to remission. CONCLUSIONS: For those diagnosed before 20 years of age, males, ketoacidosis-free, with fewer symptoms and low early HbA1c were more likely to experience remission, but remission was most likely in anyone aged ≥ 20 at diagnosis.

Journal article

Loh WJ, Stevenson JC, Godsland IF, 2019, Independent relationships between bone mineral density, regional body fat and insulin sensitivity in white males, Clinical Endocrinology, Vol: 91, Pages: 63-71, ISSN: 1365-2265

BACKGROUND: Adiposity and insulin sensitivity may affect bone mineral density (BMD) but the confounding effect of weight hinders discrimination of independent associations. We explored whether regional fat masses and insulin sensitivity are independently related to BMD. MATERIALS AND METHODS: Relationships between total and regional body fat, insulin sensitivity and measures of BMD in 8 different regions were evaluated in a cross-section of 590 generally healthy, white males, 274 of whom received measurement of insulin sensitivity (Si) using the intravenous glucose tolerance test. Measurements included total, android and gynoid fat and lean body mass and regional BMDs by dual-energy X-ray absorptiometry. Linear regression analyses were combined in a mediation analysis to explore associations with each regional BMD. RESULTS: Weight correlated positively with total fat mass (R2 =0.67, p<0.001) and negatively with Si (R2 =0.14, p<0.001). Body composition measures were consistently positively related to BMD in all regions except lumbar and thoracic spine. Accounting for body weight rendered negative the majority of associations between total and regional fat masses and BMDs. An independent association between android fat and spine BMD was particularly apparent. Si was positively associated with total and limb BMD (p<0.01) specifically among exercisers. Accounting for Si diminished the associations of total fat (negative) and lean body mass (positive) with total and limb BMD. CONCLUSION: Android fat is independently negatively associated with spine BMD. Among those taking exercise, increased insulin sensitivity is associated with higher limb BMD and may underlie positive associations between lean body mass and BMD.

Journal article

Walkey HC, Kaur A, Godsland IF, Williams AJ, Oliver N, Johnston DG, Misra Set al., 2019, The impact of ethnicity on clinical characteristics and autoantibody status at clinical onset of Type 1 diabetes-from the ADDRESS-2 study, 79th Scientific Sessions of the American-Diabetes-Association (ADA), Publisher: AMER DIABETES ASSOC, Pages: 1-2, ISSN: 0012-1797

Introduction: The phenotype of type 1 diabetes (T1D) has been explored mainly in white populations. People of non-white ethnicity are reportedly less likely to be antibody positive, but phenotypic differences are not well characterised. We investigated ethnic group differences in the clinical characteristics and antibody (Ab) status at clinical onset of T1D.Methods: We studied people of white European (WE), Asian (A) and black African/Caribbean (AC) ethnicity with clinically-assigned T1D, age ≥5 years, recruited ≤ 6 months after diagnosis, and with Abs (GADA, IA-2A and ZnT8A) measured by radioimmunoassay.Results: Ethnic breakdown: WE n=1,997, A n=50, AC n=41. Median (IQR) ages were: WE 23(14-24), A 18(12-29), AC 26 (15-41) years p=0.007. Presentation with DKA was more common in AC (65%) than WE (42%) or A (53%) p=0.006; otherwise clinical presentation (polyuria/dipsia, weight loss, fatigue, symptom duration) was similar. Proportions with 0, 1 and ≥2 Abs differed by ethnicity: WE (15%, 24%, 61%); A (28%, 26%, 46%); AC (36%, 32%, 32%) p<0.001. For Ab negative (0 Abs), ethnic groups differed in BMI (p=0.001) and presentation with DKA (<0.001), but other characteristics, including daily insulin dose, were similar. For Ab positive (≥1 Ab), there were differences in parental history of diabetes p=0.02; otherwise ethnicity had no impact. Also, differences were seen in the frequency of IA-2A: WE (67%), A (53%), AC (50%) p=0.03 and ZnT8A: WE (60%), A (39%), AC (42%) p=0.01, but not GADA: WE (83%), A (94%) AC (92%) p=0.09.Conclusion: Although clinical presentation of T1D was remarkably similar across ethnic groups, variations were found in the proportions with Ab positivity and frequencies of individual Abs. Antibody negativity was more common in non-white ethnic groups and the presence of >1 Ab most common in white ethnicity. Practitioners should be alert to differences in phenotype according to antibody status that may impact classification in some ethn

Conference paper

Godsland IF, 2019, Stats: abuse by researchers' lust for certainty, Nature, Vol: 569, Pages: 192-192, ISSN: 0028-0836

Journal article

Srivanichakorn W, Godsland IF, Washirasaksiri C, Phisalprapa P, Charatcharoenwitthaya P, Pramyothin P, Sitasuwan T, Preechasuk L, Elkeles R, Alberti KGMM, Johnston DG, Oliver NSet al., 2019, Cardiometabolic risk factors in Thai individuals with prediabetes treated in a high-risk, prevention clinic - unexpected relationship between HDL cholesterol and glycaemia in men, Journal of Diabetes Investigation, Vol: 10, Pages: 771-779, ISSN: 2040-1124

BACKGROUND: Relationships between cardiometabolic risk and glycaemia have been rarely studied in people under clinical evaluation and treatment for cardiometabolic risk and with prediabetes. We investigated relationships between glycaemia and cardiometabolic risk factors in clinic participants with prediabetes. METHODS: This was a cross-sectional analysis of data collected at a centre in Thailand. Clinic attendees were at high-risk of diabetes or cardiovascular disease, with HbA1c 39-<48 mmol/mol or fasting plasma glucose (FPG) 5.6-<7.0 mmol/L. The relationships between glycaemia and cardiometabolic risk factors were explored. RESULTS: Of 357 participants, two or more insulin resistance-related metabolic disturbances were present in 84%; 61% took a statin and 75% an antihypertensive agent. Independently of age, gender, adiposity, medication use, possible NAFLD and gender-glycaemia interaction, neither FPG nor HbA1c were associated with variation in any other cardiometabolic risk factors. HDL cholesterol decreased with HbA1c in women (female*HbA1c interaction, p=0.03) but, unexpectedly, increased with FPG in men (male*FPG interaction, p=0.02). CONCLUSION: Overall, in Thai people treated for high-cardiometabolic risk and with prediabetes defined by FPG and/or HbA1c, neither FPG nor HbA1c were associated with other cardiometabolic risk factors. However, according to gender, HDL cholesterol showed the expected relationship with glycaemia in women but the reverse in men.

Journal article

Izzi-Engbeaya CN, Comninos AN, Clarke S, Abbara A, Lewis M, Holmes E, Nicholson J, Tan T, Rutter G, Dhillo Wet al., 2018, The effects of kisspeptin on β-cell function, serum metabolites and appetite in humans, Diabetes, Obesity and Metabolism, Vol: 20, Pages: 2800-2810, ISSN: 1462-8902

AimsTo investigate the effect of kisspeptin on glucose‐stimulated insulin secretion and appetite in humans.Materials and methodsIn 15 healthy men (age: 25.2 ± 1.1 years; BMI: 22.3 ± 0.5 kg m−2), we compared the effects of 1 nmol kg−1 h−1 kisspeptin versus vehicle administration on glucose‐stimulated insulin secretion, metabolites, gut hormones, appetite and food intake. In addition, we assessed the effect of kisspeptin on glucose‐stimulated insulin secretion in vitro in human pancreatic islets and a human β‐cell line (EndoC‐βH1 cells).ResultsKisspeptin administration to healthy men enhanced insulin secretion following an intravenous glucose load, and modulated serum metabolites. In keeping with this, kisspeptin increased glucose‐stimulated insulin secretion from human islets and a human pancreatic cell line in vitro. In addition, kisspeptin administration did not alter gut hormones, appetite or food intake in healthy men.ConclusionsCollectively, these data demonstrate for the first time a beneficial role for kisspeptin in insulin secretion in humans in vivo. This has important implications for our understanding of the links between reproduction and metabolism in humans, as well as for the ongoing translational development of kisspeptin‐based therapies for reproductive and potentially metabolic conditions.

Journal article

Raghavan A, Nanditha A, Snehalatha C, Vinitha R, Susairaj P, Simon M, Selvam S, Satheesh K, Ram J, Kumar APN, Godsland IF, Oliver N, Johnston DG, Ramachandran Aet al., 2018, Incidence of type 2 diabetes is higher among men with persistent impaired glucose tolerance than in transient impaired glucose tolerance – A 5 year follow up study, Journal of Association of Physicians of India, Vol: 66, Pages: 22-26, ISSN: 0004-5772

© 2018, Journal of Association of Physicians of India. All rights reserved. Objective: This was a 5 year comparative analysis of the incidence of type 2 diabetes in men who had persistent impaired glucose tolerance (P-IGT) versus transient impaired glucose tolerance (T-IGT). P-IGT (positive IGT on two oral glucose tolerance tests (OGTT), T-IGT (IGT in first OGTT and normal glucose tolerance (NGT) in the 2 nd OGTT). Methods: The samples were collected from a randomized controlled diabetes prevention study. The prevention study was done using lifestyle modification (LSM) promoted by use of mobile short message services (SMS) for 2 years. The control group of the randomized study who received advice on LSM at only the baseline formed the P-IGT group for the 3 years follow up study (n=236). T-IGT (n=569) were available from those who had NGT on the 2 nd OGTT while screening for the prevention study. The total diabetes incidence at 5 years in the study groups were compared using standard OGTT (WHO criteria). Results: The conversion rate to diabetes in 5 years was significantly lower among T-IGT than among P-IGT, OR=0.202 (95% CI, 0.145-0.296,p<0.0001). P-IGT had higher rate of risk factors for diabetes than T-IGT. Conclusion: The risk of conversion to diabetes was 80 percent lower in T-IGT than in P-IGT. Identification of P-IGT will help in selecting persons who require early intervention for diabetes.

Journal article

Raghavan A, Nanditha A, Snehalatha C, Vinitha R, Susairaj P, Simon M, Selvam S, Satheesh K, Ram J, Kumar APN, Godsland IF, Oliver N, Johnston DG, Ramachandran Aet al., 2018, Incidence of Type 2 Diabetes is Higher among Men with Persistent Impaired Glucose Tolerance than in Transient Impaired Glucose Tolerance - A 5 year Follow up Study., J Assoc Physicians India, Vol: 66, Pages: 22-26, ISSN: 0004-5772

Objective: This was a 5 year comparative analysis of the incidence of type 2 diabetes in men who had persistent impaired glucose tolerance (P-IGT) versus transient impaired glucose tolerance (T-IGT). P-IGT (positive IGT on two oral glucose tolerance tests (OGTT), T-IGT (IGT in first OGTT and normal glucose tolerance (NGT) in the 2nd OGTT). Methods: The samples were collected from a randomized controlled diabetes prevention study. The prevention study was done using lifestyle modification (LSM) promoted by use of mobile short message services (SMS) for 2 years. The control group of the randomized study who received advice on LSM at only the baseline formed the P-IGT group for the 3 years follow up study (n=236). T-IGT (n=569) were available from those who had NGT on the 2nd OGTT while screening for the prevention study. The total diabetes incidence at 5 years in the study groups were compared using standard OGTT (WHO criteria). Results: The conversion rate to diabetes in 5 years was significantly lower among T-IGT than among P-IGT, OR=0.202 (95% CI, 0.145-0.296,p< 0.0001). P-IGT had higher rate of risk factors for diabetes than T-IGT. Conclusion: The risk of conversion to diabetes was 80 percent lower in T-IGT than in P-IGT. Identification of P-IGT will help in selecting persons who require early intervention for diabetes.

Journal article

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