The ABCD semaglutide audit was designed to capture the routine clinical outcomes of people commenced on semaglutide in the UK. Previous work showed differential reductions in HbA1c and weight dependent on previous glucagon-like peptide-1 receptor agonist (GLP-1RA) exposure. The analysis, in this research letter, shows that decreases in HbA1c and weight associated with semaglutide occur irrespective of previous GLP-1RA use.
View Article and Find Full Text PDFRegular exercise is important for health, fitness and longevity in people living with type 1 diabetes, and many individuals seek to train and compete while living with the condition. Muscle, liver and glycogen metabolism can be normal in athletes with diabetes with good overall glucose management, and exercise performance can be facilitated by modifications to insulin dose and nutrition. However, maintaining normal glucose levels during training, travel and competition can be a major challenge for athletes living with type 1 diabetes.
View Article and Find Full Text PDFType 1 diabetes is a challenging condition to manage for various physiological and behavioural reasons. Regular exercise is important, but management of different forms of physical activity is particularly difficult for both the individual with type 1 diabetes and the health-care provider. People with type 1 diabetes tend to be at least as inactive as the general population, with a large percentage of individuals not maintaining a healthy body mass nor achieving the minimum amount of moderate to vigorous aerobic activity per week.
View Article and Find Full Text PDFAim: To systematically review the literature on women with both diabetes in pregnancy (DIP) and depression during or after pregnancy.
Methods: In this systematic literature review, PubMed/MEDLINE and EMBASE were searched (13 November 2015) using terms for diabetes (type 1, type 2, or gestational), depression, and pregnancy (no language or date restrictions). Publications that reported on women who had both DIP (any type) and depression or depressive symptoms before, during, or within one year after pregnancy were considered for inclusion.
Exercise in people with type 1 diabetes (T1DM) can produce large changes in blood glucose, with hypo- and hyperglycaemia before and following exercise. Different exercise types, intensity and duration have significantly different effects on blood glucose control, and on the endocrine response to exercise. Exercise performance can also be impaired in T1DM.
View Article and Find Full Text PDFPeople with type 1 diabetes (T1DM) want to enjoy the benefits of sport and exercise, but management of diabetes in this context is complex. An understanding of the physiology of exercise in health, and particularly the control of fuel mobilization and metabolism, gives an idea of problems which may arise in managing diabetes for sport and exercise. Athletes with diabetes need to be advised on appropriate diet to maximize performance and reduce fatigue.
View Article and Find Full Text PDFImmunocompromised patients who are infected with Strongyloides stercoralis may develop a potentially fatal auto-infection syndrome characterised by non-specific pulmonary and gastrointestinal symptoms and Gram negative sepsis. We present the case of one such patient who underwent a negative laparotomy for a presumed intra-abdominal surgical catastrophe with a subsequent protracted stay on the intensive care unit. Once the diagnosis of strongyloidiasis was made, the patient was successfully treated with subcutaneous antihelminthic drugs.
View Article and Find Full Text PDFPurpose Of Review: People with type 1 diabetes want to enjoy the benefits of sport and exercise, but management of diabetes in this context is complex. An understanding of the physiology of exercise in health, and particularly the control of fuel mobilization and metabolism, gives an idea of problems that may arise in managing diabetes for sport and exercise.
Recent Findings: Exercise is complicated both by hypoglycaemia and hyperglycaemia in particular circumstances.
Aim: To examine pregnancy outcome in women with Type 1 diabetes treated with glargine.
Methods: Glargine use in pregnancy was surveyed over 2 years in 20 UK obstetric-diabetes centres. Outcomes, including maternal complications, miscarriage, congenital abnormalities, perinatal morbidity and mortality, were recorded in a standardized format.
Winning an Olympic gold medal represents the pinnacle of achievement in any sporting event, to do so with diabetes is almost miraculous. This report outlines the history and management of Steven Redgrave's diabetes, and describes the physiology associated with the extremes of human endurance and the difficulties that this presents.
View Article and Find Full Text PDFObjective: HNF-1alpha gene mutations (MODY3) present with marked hyperglycemia in lean young adults and may, therefore, be mistaken for type 1 diabetes, with implications for individual treatment and risk of diabetes in other family members. We examined the prevalence of HNF-1alpha mutations in families with three generations of diabetes identified in a population-based study of childhood diabetes, representing a subpopulation in which misclassification was likely.
Research Design And Methods: In a study population of 1,470 families, 36 families (2.
Aims: The use of insulin lispro in pregnancy has not been systematically investigated despite its increasing use. Pooled data from seven centres with experience in the use of insulin lispro were accumulated to evaluate pregnancy outcome in women with Type 1 diabetes.
Methods: Seven units with specialist obstetric diabetes services were recruited to describe their total experience with insulin lispro in pregnancy.
A 75 year old woman was treated for over three years with the somatostatin analogue, octreotide for an insulinoma. She had presented in a hypoglycaemic coma. C-peptide and insulin concentrations were both raised and an area of increased vascularity within the pancreas was shown by angiography.
View Article and Find Full Text PDFDietary potassium restriction increases sodium and chloride retention, whereas potassium administration promotes both diuresis and natriuresis. In epidemiologic and clinical studies, potassium intake is inversely related to blood pressure and is lower in blacks than in whites. The present studies examined the mechanism by which potassium restriction fosters sodium conservation and the impact of race on this response.
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