Publications
385 results found
Smith S, Normahani P, Lane T, et al., 2022, Prevention and management strategies for diabetic neuropathy, Life, Vol: 12, Pages: 1185-1185, ISSN: 2075-1729
Diabetic neuropathy (DN) is a common complication of diabetes that is becoming an increasing concern as the prevalence of diabetes rapidly rises. There are several types of DN, but the most prevalent and studied type is distal symmetrical polyneuropathy, which is the focus of this review and is simply referred to as DN. It can lead to a wide range of sensorimotor and psychosocial symptoms and is a major risk factor for diabetic foot ulceration and Charcot neuropathic osteoarthropathy, which are associated with high rates of lower limb amputation and mortality. The prevention and management of DN are thus critical, and clinical guidelines recommend several strategies for these based on the best available evidence. This article aims to provide a narrative review of DN prevention and management strategies by discussing these guidelines and the evidence that supports them. First, the epidemiology and diverse clinical manifestations of DN are summarized. Then, prevention strategies such as glycemic control, lifestyle modifications and footcare are discussed, as well as the importance of early diagnosis. Finally, neuropathic pain management strategies and promising novel therapies under investigation such as neuromodulation devices and nutraceuticals are reviewed.
Elbalshy M, Haszard J, Smith H, et al., 2022, Effect of divergent continuous glucose monitoring technologies on glycaemic control in type 1 diabetes mellitus: A systematic review and meta-analysis of randomised controlled trials, DIABETIC MEDICINE, Vol: 39, ISSN: 0742-3071
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- Citations: 22
Oliver N, 2022, Unprecedented?, DIABETIC MEDICINE, Vol: 39, ISSN: 0742-3071
Smith S, Normahani P, Lane T, et al., 2022, Pathogenesis of distal symmetrical polyneuropathy in diabetes, Life, Vol: 12, Pages: 1-16, ISSN: 2075-1729
Distal symmetrical polyneuropathy (DSPN) is a serious complication of diabetes associated with significant disability and mortality. Although more than 50% of people with diabetes develop DSPN, its pathogenesis is still relatively unknown. This lack of understanding has limited the development of novel disease-modifying therapies and left the reasons for failed therapies uncertain, which is critical given that current management strategies often fail to achieve long-term efficacy. In this article, the pathogenesis of DSPN is reviewed, covering pathogenic changes in the peripheral nervous system, microvasculature and central nervous system (CNS). Furthermore, the successes and limitations of current therapies are discussed, and potential therapeutic targets are proposed. Recent findings on its pathogenesis have called the definition of DSPN into question and transformed the disease model, paving the way for new research prospects.
Oliver N, 2022, Prevention, DIABETIC MEDICINE, Vol: 39, ISSN: 0742-3071
Zhu T, Uduku C, Li K, et al., 2022, Enhancing self-management in type 1 diabetes with wearables and deep learning, npj Digital Medicine, Vol: 5, ISSN: 2398-6352
People living with type 1 diabetes (T1D) require lifelong selfmanagement to maintain glucose levels in a safe range. Failure to do socan lead to adverse glycemic events with short and long-term complications. Continuous glucose monitoring (CGM) is widely used in T1Dself-management for real-time glucose measurements, while smartphoneapps are adopted as basic electronic diaries, data visualization tools, andsimple decision support tools for insulin dosing. Applying a mixed effectslogistic regression analysis to the outcomes of a six-week longitudinalstudy in 12 T1D adults using CGM and a clinically validated wearablesensor wristband (NCT ID: NCT03643692), we identified several significant associations between physiological measurements and hypo- andhyperglycemic events measured an hour later. We proceeded to developa new smartphone-based platform, ARISES (Adaptive, Real-time, and Intelligent System to Enhance Self-care), with an embedded deep learning algorithm utilizing multi-modal data from CGM, daily entries of mealand bolus insulin, and the sensor wristband to predict glucose levels andhypo- and hyperglycemia. For a 60-minute prediction horizon, the proposed algorithm achieved the average root mean square error (RMSE)of 35.28±5.77 mg/dL with the Matthews correlation coefficients fordetecting hypoglycemia and hyperglycemia of 0.56±0.07 and 0.70±0.05,respectively. The use of wristband data significantly reduced the RMSEby 2.25 mg/dL (p < 0.01). The well-trained model is implemented onthe ARISES app to provide real-time decision support. These resultsindicate that the ARISES has great potential to mitigate the risk ofsevere complications and enhance self-management for people with T1D.
Herrero P, Reddy M, Georgiou P, et al., 2022, Identifying Continuous Glucose Monitoring Data Using Machine Learning, DIABETES TECHNOLOGY & THERAPEUTICS, Vol: 24, Pages: 403-408, ISSN: 1520-9156
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- Citations: 4
Oliver N, 2022, It's complicated, DIABETIC MEDICINE, Vol: 39, ISSN: 0742-3071
Hudson J, Cruickshank M, Quinton R, et al., 2022, Adverse cardiovascular events and mortality in men during testosterone treatment: an individual patient and aggregate data meta-analysis., The Lancet Healthy Longevity, Vol: 3, Pages: e381-e393, ISSN: 2666-7568
Background: Testosterone is the standard treatment for male hypogonadism, but there is uncertainty about its cardiovascular safety due to inconsistent findings. We aimed to provide the most extensive individual participant dataset (IPD) of testosterone trials available, to analyse subtypes of all cardiovascular events observed during treatment, and to investigate the effect of incorporating data from trials that did not provide IPD. Methods: We did a systematic review and meta-analysis of randomised controlled trials including IPD. We searched MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, MEDLINE Epub Ahead of Print, Embase, Science Citation Index, the Cochrane Controlled Trials Register, Cochrane Database of Systematic Reviews, and Database of Abstracts of Review of Effects for literature from 1992 onwards (date of search, Aug 27, 2018). The following inclusion criteria were applied: (1) men aged 18 years and older with a screening testosterone concentration of 12 nmol/L (350 ng/dL) or less; (2) the intervention of interest was treatment with any testosterone formulation, dose frequency, and route of administration, for a minimum duration of 3 months; (3) a comparator of placebo treatment; and (4) studies assessing the pre-specified primary or secondary outcomes of interest. Details of study design, interventions, participants, and outcome measures were extracted from published articles and anonymised IPD was requested from investigators of all identified trials. Primary outcomes were mortality, cardiovascular, and cerebrovascular events at any time during follow-up. The risk of bias was assessed using the Cochrane Risk of Bias tool. We did a one-stage meta-analysis using IPD, and a two-stage meta-analysis integrating IPD with data from studies not providing IPD. The study is registered with PROSPERO, CRD42018111005. Findings: 9871 citations were identified through database searches and after exclusion of duplicates and of irrelevant citations, 225
Daultrey H, Levett T, Wright J, et al., 2022, Is There a Discrepancy between Interstitial Glucose and Laboratory HbA1c in People Living with HIV?, Publisher: AMER DIABETES ASSOC, ISSN: 0012-1797
Afentakis I, Herrero P, Unsworth R, et al., 2022, PREDICTION OF NOCTURNAL HYPOGLYCAEMIA IN ADULTS WITH TYPE 1 DIABETES USING MACHINE LEARNING CLASSIFIERS, Publisher: MARY ANN LIEBERT, INC, Pages: A226-A226, ISSN: 1520-9156
Anjana RM, Oliver N, Nitika S, et al., 2022, USING MHEALTH APPS FOR BEHAVIOUR CHANGE IN URBAN AND RURAL INDIA -A PILOT STUDY, Publisher: MARY ANN LIEBERT, INC, Pages: A187-A187, ISSN: 1520-9156
Ranjani H, Avari P, Nitika S, et al., 2022, ACCEPTABILITY OF TWO NOVEL MHEALTH APPLICATIONS FOR DIABETES PREVENTION IN URBAN AND RURAL INDIA, Publisher: MARY ANN LIEBERT, INC, Pages: A186-A187, ISSN: 1520-9156
Shah V, Akturk H, Herrero P, et al., 2022, THE IMPACT OF CONTINUOUS GLUCOSE MONITORING DATA LOSS ON GLYCEMIC OUTCOMES - IS 70% OF DATA SAMPLING OVER 14 DAYS ENOUGH?, Publisher: MARY ANN LIEBERT, INC, Pages: A125-A125, ISSN: 1520-9156
Acciaroli G, Van der Linden J, Oliver N, 2022, LONGITUDINAL ANALYSIS OF HYPOGLYCEMIA IN RT-CGM USERS FROM GERMANY, SWEDEN, AND THE UNITED KINGDOM (2018-2020), Publisher: MARY ANN LIEBERT, INC, Pages: A130-A131, ISSN: 1520-9156
Ranjani H, Anjana RM, Valabhji J, et al., 2022, USING MHEALTH FOR TYPE 2 DIABETES RISK REDUCTION IN URBAN AND RURAL INDIA - A PILOT STUDY, Publisher: MARY ANN LIEBERT, INC, Pages: A186-A186, ISSN: 1520-9156
Uduku C, Jugnee N, Pendolino V, et al., 2022, THE ASSESSMENT OF IMPACT OF REAL-TIME CONTINUOUS GLUCOSE MONITORING ON PEOPLE PRESENTING WITH SEVERE HYPOGLYCAEMIA (AIR-CGM) STUDY, Publisher: MARY ANN LIEBERT, INC, Pages: A15-A15, ISSN: 1520-9156
Oliver N, 2022, Diagnostic challenge, DIABETIC MEDICINE, Vol: 39, ISSN: 0742-3071
Eng PC, Distaso W, Durreshahwar H, et al., 2022, The benefit of dexamethasone in patients with COVID-19 infection is preserved in patients with diabetes., Diabetes, Obesity and Metabolism: a journal of pharmacology and therapeutics, Vol: 24, Pages: 1385-1389, ISSN: 1462-8902
Dexamethasone significantly reduces mortality1 and is now standard treatment for patients with COVID-19 who require supplemental oxygen and/or mechanical ventilation. However, supraphysiological doses of glucocorticoids may exacerbate dysglycaemia and precipitate hyperglycaemic complications, particularly in those with or at risk of Type 2 diabetes2. The RECOVERY trial1 reported a low incidence of hyperglycaemic complications (2/1996, 0.1%), although the real-world incidence is likely to be much higher3. Type 2 diabetes itself increases the risk of severe COVID-194, and hyperglycaemia independently predicts poor outcomes5. We investigated the possibility that patients with diabetes may derive less survival benefit from steroid therapy in the setting of severe COVID-19 infection
Oliver N, 2022, Taking back control, DIABETIC MEDICINE, Vol: 39, ISSN: 0742-3071
Clarke S, Phylactou M, Patel B, et al., 2022, Preserved C-peptide in survivors of COVID-19: post-hoc analysis, Diabetes, Obesity and Metabolism: a journal of pharmacology and therapeutics, Vol: 24, Pages: 570-574, ISSN: 1462-8902
Gibson R, Oliver N, McGowan B, et al., 2022, Towards targeted dietary support for shift workers with type 2 diabetes (Shift-Diabetes study): A mixed-methods case study protocol, DIABETIC MEDICINE, Vol: 39, ISSN: 0742-3071
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- Citations: 2
Oliver N, van der Linden J, Acciaroli G, 2022, Utilisation and time in range outcomes of real-time continuous glucose monitoring systems in Germany, Sweden, and the United Kingdom (2018-2020), Publisher: WILEY, ISSN: 0742-3071
Bevan GT, Chew S, Godsland I, et al., 2022, A game for all shapes and sizes? Changes in anthropometric and performance measures of elite professional rugby union players 1999-2018, BMJ Open Sport and Exercise Medicine, Vol: 8, Pages: 1-9, ISSN: 2055-7647
Background: Rugby union player size has increased since the game turned professional in 1995. Changes in physical and performance capability over this period have yet to be fully described.Hypothesis: Increases in player momentum would result from changes in body mass.Methods: Within-player rates of change in anthropometric and kinetic variables with season played were sampled in three successively studied professional rugby union club cohorts playing at the highest level of European competition between 1999-2019. Data comprised 910 seasons of observation for 291 elite male players. Most players had 2, 3 or 4 seasons of observation. Mixed-effects modelling distinguished changes independent of position played, club and international status.Results: With each season played, player body mass, fat-free mass, and maximum speed increased significantly, while percent fat decreased. The mean maximal velocity of a rugby player in 1999 was 8.2 (±0.18) m/s, which in 2019 had risen to 9.1 (±0.10) m/s. Player’s momentum in 2019 was 14% more than those playing in 1999. In the Front Five, momentum increased in this period by more than 25%, mainly driven by greater running speed, disproving our hypothesis.Conclusions: The momentum of players, particularly forwards, increased markedly over 20 seasons of professional rugby. The resulting forces generated in collisions are thus significantly greater, although these may be mitigated by better player conditioning. Proactive regulation to address player safety may be required to address the changing nature of anthropometric measures and physical performance, minimising injury rates and potential long-term sequelae.
Oliver N, 2022, Variance of concern, DIABETIC MEDICINE, Vol: 39, ISSN: 0742-3071
Aceves-Martins M, Quinton R, Brazzelli M, et al., 2022, Identifying the outcomes important to men with hypogonadism: A qualitative evidence synthesis, Andrology, Vol: 10, ISSN: 2047-2919
OBJECTIVE: Men with male hypogonadism (MH) experience sexual dysfunction, which improves with testosterone replacement therapy (TRT). However, randomised controlled trials provide little consensus on functional and behavioural symptoms in hypogonadal men; these are often better captured by qualitative information from individual patient experience. METHODS: We systematically searched major electronic databases to identify qualitative data from men with hypogonadism, with or without TRT. Two independent authors performed the selection, extraction, and thematic analysis of data. Quality of eligible studies was assessed using the Critical Appraisals Skills Programme and Grading of Recommendations Assessment, Development and Evaluation-Confidence in the Evidence from Reviews of Qualitative research tools. RESULTS: We analysed data from five studies published in nine reports that assessed a total of 284 participants. Published data were only available within North America, with no ethnic minority or other underserved groups included. In addition to sexual dysfunction, men with MH experienced adverse changes in physical strength, perceptions of masculinity, cognitive function, and quality of life. The experience of MH appeared dependent on the source(s) of educational material. DISCUSSION: We propose a patient-centred approach to clinician interactions rather than focusing on discreet MH symptoms. Current evidence about the experience of MH is limited to North America and predominantly white ethnicity, which may not be broadly applicable to other geographic regions. Broadening our understanding of the MH experience may improve the targeting of information to patients. In addition, a multidisciplinary approach may better address symptoms neither attributable to MH nor alleviated by TRT.
Oliver N, 2022, Baby Steps, DIABETIC MEDICINE, Vol: 39, ISSN: 0742-3071
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- Citations: 1
Armiger R, Reddy M, Oliver NS, et al., 2022, An In Silico Head-to-Head Comparison of the Do-It-Yourself Artificial Pancreas Loop and Bio-Inspired Artificial Pancreas Control Algorithms, JOURNAL OF DIABETES SCIENCE AND TECHNOLOGY, Vol: 16, Pages: 29-39, ISSN: 1932-2968
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- Citations: 1
Thomas NJ, Dennis JM, Sharp SA, et al., 2022, DR15-DQ6 remains dominantly protective against type 1 diabetes throughout the first five decades of life (vol 64, pg 2258, 2021), DIABETOLOGIA, Vol: 65, Pages: 258-258, ISSN: 0012-186X
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- Citations: 1
Scott R, Oliver N, Thomas M, et al., 2021, Pregnancy and contraception in women with Pre-Gestational diabetes in secondary Care- A questionnaire study, DIABETES RESEARCH AND CLINICAL PRACTICE, Vol: 182, ISSN: 0168-8227
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- Citations: 1
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