Imperial College London

ProfessorNickOliver

Faculty of MedicineDepartment of Metabolism, Digestion and Reproduction

Wynn Chair in Human Metabolism (Clinical)
 
 
 
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Contact

 

+44 (0)20 7594 1796nick.oliver

 
 
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Location

 

7S7aCommonwealth BuildingHammersmith Campus

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Summary

 

Publications

Publication Type
Year
to

380 results found

Godsland I, Johnston DG, Alberti KGMM, Oliver Net al., 2024, The importance of intravenous glucose tolerance test glucose stimulus for the evaluation of insulin secretion, Scientific Reports, ISSN: 2045-2322

Journal article

Preechasuk L, Oliver N, Avari P, Reddy Met al., 2024, Switching from Intermittently Scanned Continuous Glucose Monitoring to Real Time Continuous Glucose Monitoring with a predictive urgent low soon alert reduces exposure to hypoglycaemia., Diabetes Technol Ther

Differences in the effectiveness of real-time continuous glucose monitoring (rtCGM) and intermittently scanned continuous glucose monitoring (isCGM) in type 1 diabetes (T1D) are reported. The impact on percentage time in range of switching from an isCGM with glucose threshold-based optional alerts only (FreeStyle Libre 2, FSL2) to rtCGM (Dexcom G7) with an urgent low soon predictive alert was assessed, alongside other secondary outcomes including HbA1c and other CGM metrics. Adults with T1D using FSL2 were switched to Dexcom G7 for 12 weeks. HbA1c and continuous glucose data during FSL2 and Dexcom G7 use were compared. Data from 29 participants (aged 44.8±16.5 years, 12 male) were analysed. After switching to rtCGM, participants spent less time in hypoglycaemia below 3.9mmol/L (70 mg/dL) (3.0[1.0,5.0] vs. 2.0[1.0,3.0] %, P=0.006) and had higher percentage achievement of time below 3.9 mmol/L (70 mg/dl) less than 4% (55.2 vs. 82.8%, P= 0.005). Coefficient of variation was lower (39.3±6.6 vs. 37.2±5.6%, p=0.008). In conclusion, adults with T1D that switch from isCGM to rtCGM may benefit from reduced exposure to hypoglycaemia and glycaemic variability.

Journal article

Jendle J, Adolfsson P, Choudhary P, Dovc K, Fleming A, Klonoff DC, Mader JK, Oliver N, Sherr JL, Šoupal J, Heinemann Let al., 2024, A narrative commentary about interoperability in medical devices and data used in diabetes therapy from an academic EU/UK/US perspective., Diabetologia, Vol: 67, Pages: 236-245

People living with diabetes have many medical devices available to assist with disease management. A critical aspect that must be considered is how systems for continuous glucose monitoring and insulin pumps communicate with each other and how the data generated by these devices can be downloaded, integrated, presented and used. Not only is interoperability associated with practical challenges, but also devices must adhere to all aspects of regulatory and legal frameworks. Key issues around interoperability in terms of data ownership, privacy and the limitations of interoperability include where the responsibility/liability for device and data interoperability lies and the need for standard data-sharing protocols to allow the seamless integration of data from different sources. There is a need for standardised protocols for the open and transparent handling of data and secure integration of data into electronic health records. Here, we discuss the current status of interoperability in medical devices and data used in diabetes therapy, as well as regulatory and legal issues surrounding both device and data interoperability, focusing on Europe (including the UK) and the USA. We also discuss a potential future landscape in which a clear and transparent framework for interoperability and data handling also fulfils the needs of people living with diabetes and healthcare professionals.

Journal article

Rilstone S, Oliver N, Godsland I, Tanushi B, Thomas M, Hill Net al., 2024, A Randomized Controlled Trial Assessing the Impact of Continuous Glucose Monitoring with a Predictive Hypoglycemia Alert Function on Hypoglycemia in Physical Activity for People with Type 1 Diabetes (PACE)., Diabetes Technol Ther, Vol: 26, Pages: 95-102

Background: Uptake of exercise in people with type 1 diabetes (T1D) is low despite significant health benefits. Fear of hypoglycemia is the main barrier to exercise. Continuous glucose monitoring (CGM) with predictive alarms warning of impending hypoglycemia may improve self-management of diabetes around exercise. Aim: To assess the impact of Dexcom G6 real-time CGM system with a predictive hypoglycemia alert function on the frequency, duration, and severity of hypoglycemia occurring during and after regular (≥150 min/week) physical activity in people with T1D. Methods: After 10 days of blinded run-in (Baseline), CGM was unblinded and participants randomized 1:1 to have the "urgent low soon" (ULS) alert switched "on" or "off" for 40 days. Participants then switched alerts "off" or "on," respectively, for a further 40 days. Physical activity, and carbohydrate and insulin doses were recorded. Results: Twenty-four participants (8 men, 16 women) were randomized. There was no difference in change from baseline of hypoglycemia <3.0 and <3.9 mmol/L with the ULS on or off during the 24 h after exercise. With ULS alert "on" time spent below 2.8 mmol/L compared with baseline was significantly (P = 0.04) lower than with ULS "off" in the 24 h after exercise. In mixed effects regression, timing of the exercise and baseline HbA1c independently affected risk of hypoglycemia during exercise; exercise timing also affected hypoglycemia risk after exercise. Conclusion: A CGM device with an ULS alert reduces exposure to hypoglycemia below 2.8 mmol/L overall and in the 24 h after exercise compared with a threshold alert.

Journal article

Oliver N, 2024, Baby steps., Diabet Med, Vol: 41

Journal article

McKechnie V, Broomhead A, Scior K, Roe D, Oliver Net al., 2024, Stigma experiences of adults living with diabetes: Results from a Diabetes UK survey., Diabet Med

Journal article

Alexiadou K, Ansari S, Jones B, Yu C, Dornhorst A, Oliver N, Tsironis C, Purkayastha S, Ahmed A, Agha-Jaffar R, Khoo B, Tan TM-Met al., 2024, Increased glycemic variability in pregnant women with Roux-en-Y gastric bypass compared with sleeve gastrectomy, BMJ Open Diabetes Research & Care, Vol: 12, ISSN: 2052-4897

INTRODUCTION: Bariatric surgery is associated with adverse pregnancy outcomes such as reduced birth weight and premature birth. One possible mechanism for this is increased glycemic variability (GV) which occurs after bariatric surgery. The objective of this study was to compare the effect of Roux-en-Y gastric bypass (RYGB) versus vertical sleeve gastrectomy (SG) on GV during pregnancy and to investigate the relationships of GV, type of bariatric surgery and maternal and neonatal outcomes. RESEARCH DESIGN AND METHODS: Fourteen pregnant women after RYGB and 14 after SG were investigated with continuous glucose monitoring in their second or third trimester in this observational study carried out as part of routine clinical care. RESULTS: Pregnant women with RYGB had similar mean interstitial glucose values but significantly increased indices of GV and a lower %time in range 3.9-7.8 mmol/L (70-140 mg/dL), compared with SG. CONCLUSIONS: Pregnant women who have undergone RYGB have greater GV during pregnancy compared with those who have undergone SG. Further research is needed to establish the relationship between GV and pregnancy outcomes to determine the preferred bariatric operation in women of reproductive age, and whether interventions to reduce GV might improve outcomes.

Journal article

Oliver N, 2024, Impatient for Inpatient Data., Diabet Med, Vol: 41

Journal article

Daultrey H, Levett T, Oliver N, Vera J, Chakera AJet al., 2023, HIV and type 2 diabetes: An evolving story., HIV Med

INTRODUCTION: Diabetes is widely reported to be more common in people living with HIV (PLWH). Much of the data supporting this originated during the earlier HIV era. The perceived increased risk of type 2 diabetes is reflected in HIV clinical guidelines that recommend screening for diabetes in PLWH on anti-retroviral therapy (ART). However, international HIV clinical guidelines do not agree on the best marker of glycaemia to screen for diabetes. This stems from studies that suggest HbA1c underestimates glycaemia in PLWH. METHODS: Within this review we summarise the literature surrounding the association of HIV and type 2 diabetes and how this has changed over time. We also present the evidence on HbA1c discrepancy in PLWH. CONCLUSION: We suggest there is no basis to any international guidelines to restrict HbA1c based on HIV serostatus. We recommend, using the current evidence, that PLWH should be screened annually for diabetes in keeping with country specific guidance. Finally, we suggest future work to elucidate phenotype and natural history of type 2 diabetes in PLWH across all populations.

Journal article

Zimmermann P, Schierbauer J, Kopf N, Sourij H, Oliver N, Aberer F, Wachsmuth NB, Moser Oet al., 2023, Speckle-Tracking Analysis of the Right and Left Heart after Peak Exercise in Healthy Subjects with Type 1 Diabetes: An Explorative Analysis of the AppEx Trial., J Cardiovasc Dev Dis, Vol: 10

In eight healthy participants with Type 1 diabetes (T1D) exercise-related dynamic cardiac remodeling was analyzed by performing two-dimensional echocardiography, including deformation analysis of the left-ventricular (LV) global longitudinal strain (LV-GLS), and the deformation pattern of the left atrium (LA) and right ventricle (RV) at rest and post-peak performance on a bicycle. The feasibility echocardiographic speckle-tracking analysis was performed on eight asymptomatic participants with T1D (n = 8, male n = 5, age: 23-65 years). The obtained echocardiographic data were compared for various echocardiographic parameters at rest and post exercise. Across our participating T1D individuals no structural echocardiographic abnormalities of concern could be revealed. All participating T1D subjects showed preserved contractile reserve of the LV and no significant diastolic dysfunction. Significant differences were found for the phasic LA contractile strain pattern at rest and post exercise (p < 0.001), whereby the dynamic RV (p = 0.5839 and p = 0.7419) and LV strain pattern (p = 0.5952) did not reveal significant differences in comparison to resting conditions. This descriptive secondary outcome analysis describes preserved contractile reserve of the LV and elucidates dynamic modification of the phasic LA contractile deformation pattern in asymptomatic T1D individuals after exhaustive exercise on a bicycle.

Journal article

McKechnie V, Oliver N, Amiel SA, Fox JREet al., 2023, Hyperglycaemia aversion in type 1 diabetes: A grounded theory study, BRITISH JOURNAL OF HEALTH PSYCHOLOGY, ISSN: 1359-107X

Journal article

Hudson J, Cruickshank M, Quinton R, Aucott L, Wu F, Grossmann M, Bhasin S, Snyder PJ, Ellenberg SS, Travison TG, Brock GB, Gianatti EJ, van der Schouw YT, Emmelot-Vonk MH, Giltay EJ, Hackett G, Ramachandran S, Svartberg J, Hildreth KL, Antonic KG, Tenover JL, Tan HM, Ho Chee Kong C, Tan WS, Marks LS, Ross RJ, Schwartz RS, Manson P, Roberts SA, Skovsager Andersen M, Velling Magnussen L, Aceves-Martins M, Gillies K, Hernández R, Oliver N, Dhillo WS, Bhattacharya S, Brazzelli M, Jayasena CNet al., 2023, Symptomatic benefits of testosterone treatment in patient subgroups: a systematic review, individual participant data meta-analysis, and aggregate data meta-analysis., Lancet Healthy Longev, Vol: 4, Pages: e561-e572

BACKGROUND: Testosterone replacement therapy is known to improve sexual function in men younger than 40 years with pathological hypogonadism. However, the extent to which testosterone alleviates sexual dysfunction in older men and men with obesity is unclear, despite the fact that testosterone is being increasingly prescribed to these patient populations. We aimed to evaluate whether subgroups of men with low testosterone derive any symptomatic benefit from testosterone treatment. METHODS: We did a systematic review and meta-analysis to evaluate characteristics associated with symptomatic benefit of testosterone treatment versus placebo in men aged 18 years and older with a baseline serum total testosterone concentration of less than 12 nmol/L. We searched major electronic databases (MEDLINE, Embase, Science Citation Index, and the Cochrane Central Register of Controlled Trials) and clinical trial registries for reports published in English between Jan 1, 1992, and Aug 27, 2018. Anonymised individual participant data were requested from the investigators of all identified trials. Primary (cardiovascular) outcomes from this analysis have been published previously. In this report, we present the secondary outcomes of sexual function, quality of life, and psychological outcomes at 12 months. We did a one-stage individual participant data meta-analysis with a random-effects linear regression model, and a two-stage meta-analysis integrating individual participant data with aggregated data from studies that did not provide individual participant data. This study is registered with PROSPERO, CRD42018111005. FINDINGS: 9871 citations were identified through database searches. After exclusion of duplicates and publications not meeting inclusion criteria, 225 full texts were assessed for inclusion, of which 109 publications reporting 35 primary studies (with a total 5601 participants) were included. Of these, 17 trials provided individual participant data (3431 participants; m

Journal article

Oliver N, 2023, Key to prevention?, DIABETIC MEDICINE, Vol: 40, ISSN: 0742-3071

Journal article

Oliver N, 2023, Maintaining awareness., Diabet Med, Vol: 40

Journal article

Oliver N, 2023, Education is repetition, DIABETIC MEDICINE, Vol: 40, ISSN: 0742-3071

Journal article

Unsworth R, Avari P, Lett AM, Oliver N, Reddy Met al., 2023, Adaptive bolus calculators for people with type 1 diabetes: A systematic review, DIABETES OBESITY & METABOLISM, ISSN: 1462-8902

Journal article

Rubner S, D'Annibale M, Oliver N, Mcgowan B, Guess N, Lorencatto F, Gibson Ret al., 2023, Individual, social and environmental factors influencing dietary behaviour in shift workers with type 2 diabetes working in UK healthcare: A cross-sectional survey, JOURNAL OF HUMAN NUTRITION AND DIETETICS, ISSN: 0952-3871

Journal article

Afentakis I, Unsworth R, Herrero P, Oliver N, Reddy M, Georgiou Pet al., 2023, Development and Validation of Binary Classifiers to Predict Nocturnal Hypoglycemia in Adults With Type 1 Diabetes, JOURNAL OF DIABETES SCIENCE AND TECHNOLOGY, ISSN: 1932-2968

Journal article

Avari P, Tang W, Jugnee N, Hersi I, Al-Balah A, Tan T, Frankel AH, Oliver N, Reddy Met al., 2023, The Accuracy of Continuous Glucose Sensors in People with Diabetes Undergoing Hemodialysis (ALPHA Study), DIABETES TECHNOLOGY & THERAPEUTICS, Vol: 25, Pages: 447-456, ISSN: 1520-9156

Journal article

Uduku C, Pendolino V, Jugnee N, Oliver N, Fothergill R, Reddy Met al., 2023, Real-time continuous glucose monitoring immediately after severe hypoglycaemia requiring emergency medical services: A randomised controlled trial, DIABETIC MEDICINE, Vol: 40, ISSN: 0742-3071

Journal article

Oliver N, 2023, Distress and stigma priority call, DIABETIC MEDICINE, Vol: 40, ISSN: 0742-3071

Journal article

Oliver N, 2023, June Editorial, DIABETIC MEDICINE, Vol: 40, ISSN: 0742-3071

Journal article

Rilstone SK, Oliver N, Godsland IF, Hill NEet al., 2023, Prediction of Hypoglycaemia in the 24 Hours after Exercise in Adults with Type 1 Diabetes, 83rd Annual Scientific Sessions of the American-Diabetes-Association (ADA), Publisher: AMER DIABETES ASSOC, ISSN: 0012-1797

Conference paper

Massen GM, Allen RJ, Leavy OC, Selby NM, Aithal GP, Oliver N, Parfrey H, Wain LV, Jenkins G, Stewart I, Quint JK, DEMISTIFI consortiumet al., 2023, Classifying the unclassifiable – A Delphi study to reach consensus on the fibrotic nature of diseases, QJM: an international journal of medicine, Vol: 116, Pages: 429-435, ISSN: 1460-2393

BackgroundTraditionally, clinical research has focused on individual fibrotic diseases or fibrosis in a particular organ. However, it is possible for people to have multiple fibrotic diseases. While multi-organ fibrosis may suggest shared pathogenic mechanisms, yet there is no consensus on what constitutes a fibrotic disease and therefore fibrotic multimorbidity.AimA Delphi study was performed to reach consensus on which diseases may be described as fibrotic.MethodsParticipants were asked to rate a list of diseases, sub-grouped according to eight body regions, as ‘fibrotic manifestation always present’, ‘can develop fibrotic manifestations’, ‘associated with fibrotic manifestations’ or ‘not fibrotic nor associated’. Classifications of ‘fibrotic manifestation always present’ and ‘can develop fibrotic manifestations’ were merged and termed ‘fibrotic’. Clinical consensus was defined according to the interquartile range, having met a minimum number of responses. Clinical agreement was used for classification where diseases did not meet the minimum number of responses (required for consensus measure), were only classified if there was 100% consensus on disease classification.ResultsAfter consulting experts, searching the literature and coding dictionaries, a total of 323 non-overlapping diseases which might be considered fibrotic were identified; 92 clinical specialists responded to the first round of the survey. Over three survey rounds, 240 diseases were categorized as fibrotic via clinical consensus and 25 additional diseases through clinical agreement.ConclusionUsing a robust methodology, an extensive list of diseases was classified. The findings lay the foundations for studies estimating the burden of fibrotic multimorbidity, as well as investigating shared mechanisms and therapies.

Journal article

Esdaile H, Hill N, Mayet J, Oliver Net al., 2023, Glycaemic control in people with diabetes following acute myocardial infarction, Diabetes Research and Clinical Practice, Vol: 199, ISSN: 0168-8227

Diabetes is a highly prevalent disease associated with considerable cardiovascular end organ damage and mortality. Despite significant changes to the management of acute myocardial infarction over the last two decades, people with diabetes remain at risk of complications and mortality following a myocardial infarct for a multitude of reasons, including increased coronary atherosclerosis, associated coronary microvascular dysfunction, and diabetic cardiomyopathy. Dysglycaemia causes significant endothelial dysfunction and upregulation of inflammation within the vasculature and epigenetic changes mean that these deleterious effects may persist despite subsequent efforts to tighten glycaemic control. Whilst clinical guidelines advocate for the avoidance of both hyper- and hypoglcyaemia in the peri-infarct period, the evidence base is lacking, and currently there is no consensus on the benefits of glycaemic control beyond this period. Glycaemic variability contributes to the glycaemic milieu and may have prognostic importance following myocardial infarct. The use of continuous glucose monitoring means that glucose trends and parameters can now be captured and interrogated, and its use, along with newer medicines, may provide novel opportunities for intervention after myocardial infarction in people with diabetes.

Journal article

Oliver N, 2023, Being fearless, DIABETIC MEDICINE, Vol: 40, ISSN: 0742-3071

Journal article

Unsworth R, Armiger R, Jugnee N, Thomas M, Herrero P, Georgiou P, Oliver N, Reddy Met al., 2023, Safety and efficacy of an adaptive bolus calculator for Type 1 diabetes: a randomised control cross over study, Diabetes Technology and Therapeutics, Vol: 25, Pages: 414-425, ISSN: 1520-9156

Background The Advanced Bolus Calculator for Type 1 Diabetes (ABC4D) is a decision support system employing the artificial intelligence technique of case-based reasoning to adapt and personalise insulin bolus doses. The integrated system comprises a smartphone application and clinical web portal. We aimed to assess safety and efficacy of the ABC4D (intervention) compared to a non-adaptive bolus calculator (control). Methods This was a prospective randomised controlled crossover study. Following a 2-week run-in period, participants were randomised to ABC4D or control for 12 weeks. After a 6-week washout period, participants crossed over for 12 weeks. The primary outcome was difference in percentage (%) time in range (TIR) (3.9-10.0 mmol/L (70-180mg/dL)) change during the daytime (07:00-22:00) between groups. Results 37 adults with type 1 diabetes on multiple daily injections of insulin were randomised, median (IQR) age 44.7 (28.2-55.2) years, diabetes duration 15.0 (9.5-29.0) years, HbA1C 61.0 (58.0-67.0) mmol/mol (7.7 (7.5-8.3)%). Data from 33 participants were analysed. There was no significant difference in daytime %TIR change with ABC4D compared to control (median (IQR) +0.1 (-2.6 to + 4.0)% versus +1.9 (-3.8 to + 10.1)%; p = 0.53). Participants accepted fewer meal dose recommendations in the intervention compared to control (78.7 (55.8-97.6)% versus 93.5 (73.8-100)%; p = 0.009) with a greater reduction in insulin dosage from that recommended. Conclusion The ABC4D is safe for adapting insulin bolus doses and provided the same level of glycaemic control as the non-adaptive bolus calculator. Results suggest that participants did not follow ABC4D recommendations as frequently as control, impacting its effectiveness.

Journal article

Avari P, O'Regan A, Preechasuk L, Oliver N, Agha-Jaffar Ret al., 2023, Adjustment of Maternal Variable Rate Insulin Infusions Using Real-Time Continuous Glucose Monitoring in Pregnant Women with Type 1 Diabetes, DIABETES TECHNOLOGY & THERAPEUTICS, Vol: 25, Pages: 293-297, ISSN: 1520-9156

Journal article

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