Long-term follow-up of a randomized controlled trial of a text-message diabetes self-management support programme, SMS4BG.

Aims: To determine the long-term effectiveness of an individually tailored text-message diabetes self-management support programme, SMS4BG, on glycaemic control at 2 years in adults with diabetes with an HbA concentration > 64 mmol/mol (8%).

Methods: We conducted a 2-year follow-up of a two-arm, parallel, randomized controlled trial across health services in New Zealand. Participants were English-speaking adults with type 1 or 2 diabetes and with an HbA >64 mmol/mol (8%).

Differing protocols of managing adult diabetic ketoacidosis outside of the intensive care unit make no difference to the rate of resolution of hyperglycaemia and acidosis.

Aims: To compare the outcome of people with type 1 diabetes admitted to the general ward with diabetic ketoacidosis (DKA) to two hospitals in Auckland, using different protocols of care.

Methods: North Shore Hospital uses a UK weight-based, ketone centric protocol while Auckland Hospital uses a protocol based on glucose measurements only. All notes of people over 16 years of age admitted to the general wards with DKA to these hospitals in one year were reviewed and their outcome compared.

Glucocrinology of Modern Sulfonylureas: Clinical Evidence and Practice-Based Opinion from an International Expert Group.

Aim: The primary objective of this document is to develop practice-based expert group opinion on certain important but less discussed endocrine and metabolic effects of modern sulfonylureas (SUs) and their usage in the management of diabetes mellitus (DM).

Background: Modern SUs may be considered a panacea in DM care with their beneficial extra-pancreatic, pleiotropic, and cardiovascular effects. Safe glycemic control with SUs could be achieved with appropriate patient selection, drug and dosage selection, and patient empowerment.

Euthymia in Diabetes: Clinical Evidence and Practice-Based Opinion from an International Expert Group.

Aim: To develop an evidence-based expert group opinion on various types of euthymia associated with diabetes mellitus (DM) and its management.

Background: Diabetes mellitus is a metabolic syndrome characterized by diverse biomedical and psychosocial features. Emotional health disturbances may lead to psychological and psychiatric dysfunction and may negatively influence glycemic control.

Adherence to medication, glycaemic control and hospital attendance in young adults with type 2 diabetes.

Type 2 diabetes is becoming common among people in their 20s and 30s. Glycaemic control is suboptimal in this group and is associated with poor medication adherence. We studied medication adherence over a 24-month period in all diabetes clinic registrants (n = 266) between the ages of 18 and 39 years.

Effectiveness of text message based, diabetes self management support programme (SMS4BG): two arm, parallel randomised controlled trial.

Objective: To determine the effectiveness of a theoretically based and individually tailored, text message based, diabetes self management support intervention (SMS4BG) in adults with poorly controlled diabetes.

Design: Nine month, two arm, parallel randomised controlled trial.

Setting: Primary and secondary healthcare services in New Zealand.

The Effect of a Pediatric Intensive Care Severity-Tiered Pathway for Status Asthmaticus on Quality Measures and Outcomes.

Patients with status asthmaticus admitted to the hospital contribute tremendous costs to the healthcare system. Treatment protocols directed at improving care to pediatric inpatients have improved both clinical and financial outcomes; however, there are limited data demonstrating the impact of goal-driven therapy for patients with status asthmaticus in the pediatric intensive care unit (PICU). The purpose of this initiative was to standardize care of children with status asthmaticus in the PICU to improve clinical outcomes.

Type 2 diabetes in young adults in Central Auckland: demography and complications.

Background: Type 2 diabetes (T2D) in young adults is associated with a high risk of diabetes complications.

Aims: To investigated the demography and the emergence of complications of young adults with T2D in the central Auckland region where there has been substantial immigration.

Methods: In total, 310 young adults with T2D (<40 years) were registered with the Auckland Diabetes Centre in 2015.

23 years of managing diabetic ketoacidosis at Auckland Hospital.

Aims: To examine the length of stay and need for intensive care of people admitted with diabetic ketoacidosis (DKA) to a single centre between 1988 and 2011.

Methods: Patients aged ≥15 years admitted for the first time with DKA (plasma glucose ≥ 10mmol/L and a bicarbonate concentration ≤15mmol/L and a pH <7.35, and raised plasma or urine ketones or anion gap) to Auckland City Hospital from 1988-2011 were identified retrospectively.

The Use of Mobile Health to Deliver Self-Management Support to Young People With Type 1 Diabetes: A Cross-Sectional Survey.

Background: Young people living with type 1 diabetes face not only the challenges typical of adolescence, but also the challenges of daily management of their health and evolving understanding of the impact of their diagnosis on their future. Adolescence is a critical time for diabetes self-management, with a typical decline in glycemic control increasing risk for microvascular diabetes complications. To improve glycemic control, there is a need for evidence-based self-management support interventions that address the issues pertinent to this population, utilizing platforms that engage them.

Text message-based diabetes self-management support (SMS4BG): study protocol for a randomised controlled trial.

Background: Addressing the increasing prevalence, and associated disease burden, of diabetes is a priority of health services internationally. Interventions to support patients to effectively self-manage their condition have the potential to reduce the risk of costly and debilitating complications. The utilisation of mobile phones to deliver self-management support allows for patient-centred care at the frequency and intensity that patients desire from outside the clinic environment.

Risk factors for recurrent admissions with diabetic ketoacidosis: a case-control observational study.

Aim: To perform a detailed analysis of patients with recurrent diabetic ketoacidosis admissions in order to establish risk factors for readmission.

Methods: The medical records of all adults and young people (> 15 years) with Type 1 diabetes admitted to Auckland City Hospital over a 15-year period from 1997 to 2011 with a primary diagnosis of ketoacidosis were analysed. Patients readmitted with ketoacidosis within 5 years of their index admission were identified and compared with patients without ketoacidosis readmission who were matched for age, gender, ethnicity and duration of diabetes.

Practical Guidance on the Use of Premix Insulin Analogs in Initiating, Intensifying, or Switching Insulin Regimens in Type 2 Diabetes.

Introduction: Premix insulin analogs are a well-established treatment for type 2 diabetes (T2D). However, there is a lack of simple, clear guidance on some aspects of their use. These include choosing a regimen for insulin initiation, recognizing when patients need intensification of therapy, and switching from basal-bolus to a premix insulin analog when appropriate.

Starting insulin in type 2 diabetes: real-world outcomes after the first 12 months of insulin therapy in a new zealand cohort.

Aims: Currently, there is no consensus on which form of insulin to use when initiating insulin in type 2 diabetes (T2D). Our aim was to compare glycated hemoglobin (HbA1C) reduction, weight change and severe hypoglycemia rates during the first year after initiation of intermediate-acting insulin isophane, insulin glargine and pre-mixed insulin in patients with T2D.

Methods: Electronic clinical records of patients with T2D, starting insulin at a tertiary referral center in Auckland, New Zealand, from January 1 to December 31, 2012, were retrospectively evaluated.

Visfatin is regulated by rosiglitazone in type 2 diabetes mellitus and influenced by NFκB and JNK in human abdominal subcutaneous adipocytes.

Visfatin has been proposed as an insulin-mimicking adipocytokine, predominantly secreted from adipose tissue and correlated with obesity. However, recent studies suggest visfatin may act as a proinflammatory cytokine. Our studies sought to determine the significance of this adipocytokine and its potential role in the pathogenesis of T2DM.

The biological relevance and measurement of plasma markers of oxidative stress in diabetes and cardiovascular disease.

Oxidative stress is associated with many chronic diseases. In this review, we look at the role that oxidative stress may play in diabetes and related cardiovascular disease (CVD) and how oxidative damage may be measured in the plasma. Increased production of reactive oxygen species (ROS) has been implicated in the initiation and progression of both of these conditions and it may be that oxidative stress accounts for the unexplained increase in cardiovascular risk observed in diabetes.

The diabetic foot.

Diabetes is reaching epidemic proportions and with it carries the risk of complications. Disease of the foot is among one of the most feared complications of diabetes. The ultimate endpoint of diabetic foot disease is amputation, which is associated with significant morbidity and mortality, besides having immense social, psychological and financial consequences.

Rosiglitazone produces a greater reduction in circulating platelet activity compared with gliclazide in patients with type 2 diabetes mellitus--an effect probably mediated by direct platelet PPARgamma activation.

Aims: Type 2 diabetes mellitus (T2DM) is associated with enhanced platelet activation. We conducted a randomised double-blind study to compare the effects of combination metformin and rosiglitazone or metformin and gliclazide therapy on platelet function in persons with T2DM.

Methods: Fifty subjects on metformin monotherapy received either rosiglitazone 4 mg or gliclazide 80 mg.

Lipopolysaccharide activates an innate immune system response in human adipose tissue in obesity and type 2 diabetes.

Unlabelled: Type 2 diabetes (T2DM) is associated with chronic low-grade inflammation. Adipose tissue (AT) may represent an important site of inflammation. 3T3-L1 studies have demonstrated that lipopolysaccharide (LPS) activates toll-like receptors (TLRs) to cause inflammation.

Primary fourth ventricular hemorrhage.

A case of primary fourth ventricular hemorrhage with spontaneous recovery is reported. To the best of our knowledge, there is no previous report of this rare clinical entity.

Modified method for determination of serum beta-glucuronidase: A comparative study using P-nitrophenyl glucuronide and phenolphthalein glucuronide as substrate in gastrointestinal tract carcinomas.

Serum beta-glucuronidase activity was estimated by our modified method using two substrates phenolphthalein glucuronide and p-nitrophenyl glucoronide in 49 healthy subjects and 94 patients with gastrointestinal tract (GIT) carcinoma. The correlation coefficient using the two substrates was found to be r=0.8383.

Serum leucine amino peptidase levels as a marker in testicular tumours.

Serum levels of leucine aminopeptidase (LAP) were studied in 60 patients with testicular tumours and 26 normal individuals, and were found to be significantly elevated in patients with seminomas, nonseminomas and benign tumours of the testis. After treatment the LAP levels decreased in patients with seminomas, nonseminomas and mixed cell carcinomas indicating response to therapy. The quantitative method used for estimation of LAP, which is simple, quick, accurate and cost-effective, could be used more effectively as a tumour marker in testicular malignancies.

Comparative study on determination of alpha-hydroxybutyrate dehydrogenase, lactate dehydrogenase isoenzyme LDH-1 by adsorption on DEAE Sephadex A-50 & electrophoresis.

Serum alpha-hydroxybutyrate dehydrogenase (HBDH) and lactate dehydrogenase isoenzyme (LDH-1) levels by two techniques viz., adsorption on DEAE Sephadex A-50 and by electrophoresis were estimated in healthy subjects and patients with testicular tumours. The correlation coefficient between HBDH and LDH-1 by adsorption technique was found to be r = 0.