The effect of pre-pregnancy counselling for women with pre-gestational diabetes on maternal health status.

Objective: To assess the impact of pre-pregnancy counselling (PPC) on the health of diabetic women in early pregnancy as compared to their health at the time of PPC.

Study Design: Retrospective cohort study involving all the diabetic women who attended PPC and subsequently become pregnant in the decade 1997-2007. The proforma had two sections: one for the PPC visit and one for the booking visit.

Sulphonyurea as a cause of severe hypoglycaemia in the community.

Introduction: Hypoglycaemia is a well recognised side effect of insulin and sulphonyurea therapy in the treatment of, patients with diabetes mellitus.

Methods: We performed a retrospective analysis of patients who developed severe hypoglycaemia in Hull and, East Yorkshire, United Kingdom over a 4-month period to assess the different therapies that contribute the most to the problem and the patient groups who are at greatest risk.

Results: Of the 75 patients with diabetes mellitus who developed severe hypoglycaemia, 61 (80%) were taking, insulin, 5 in combination with metformin.

The potential for the use of insulin lispro in pregnancy complicated by diabetes.

The target of improved perinatal outcome in diabetic pregnancies may be achieved by new insulin preparations that more closely mirror the physiological response of insulin and not exclusively the traditional means of strict adherence to diet and frequent blood glucose testing.No insulin preparation has been systematically tested in pregnancy; it is a responsibility of all clinicians who look after pregnant diabetic women to record the outcomes of IL-treated pregnancies. More data is needed before this preparation can be either recommended in pregnancy or alternatively avoided.

Neuroendocrinology of female aging.

Background: Because the average human life span has increased, a greater part of more women's lives will be lived in a hypoestrogenic state.

Objective: This article provides an overview of our current knowledge of the neuroendocrine processes in the aging female brain.

Methods: Using the search terms cardiovascular disease, cognition, dementia, depression, estrogens, female aging, gonadotropins, immune function, mood, neuroendocrinology, neurotransmitters, osteoporosis, and ovarian steroids, a review of English-language literature on the MEDLINE database was conducted from 1970 through June 2004.

Smell perception during early pregnancy: no evidence of an adaptive mechanism.

Objective: It has been suggested that nausea and vomiting in pregnancy is an evolutionary adaptive mechanism to avoid the ingestion of potentially harmful foods. It has also been suggested that the mechanism that triggers nausea and vomiting in pregnancy may be olfaction and that olfactory senses are invoked to provide this protection. This study aimed to test this theory in a systematic design.

Dermatological care of the diabetic foot.

Approximately 30% of patients with diabetes mellitus will have disease-related dermatological problems. Dry skin can be associated with autonomic neuropathy and may be fragile, promoting bacterial invasion. Any potentially infected 'diabetic foot' must be taken seriously, and non-painful deep sepsis suspected if there is evidence of sensory loss.

A novel approach to the diagnosis and assessment of symptomatic diabetic neuropathy.

The McGill Pain Questionnaire has previously been shown to be useful in the differential diagnosis of painful conditions and has also been used to assess the efficacy of therapeutic intervention. We have applied this simple test to 42 patients with painful diabetic neuropathy and 49 control subjects with painful legs or feet of varying aetiologies. Analysis of responses by stepwise linear discriminant analysis confirmed a significant difference between the 2 groups (Wilks' lambda, P less than 0.