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In a consecutive series of 41 hirsute women clinically classified as benign androgen excess, only 34% were found to have elevated plasma 'total' testosterone (T), 22% having subnormal sex hormone binding globulin (SHBG). When expressed as the ratio T/SHBG ('free androgen index'), 85% of the patients had values above the normal range. It is concluded that(More)
OBJECTIVE To evaluate the effectiveness of a structured group education programme on biomedical, psychosocial, and lifestyle measures in people with newly diagnosed type 2 diabetes. DESIGN Multicentre cluster randomised controlled trial in primary care with randomisation at practice level. SETTING 207 general practices in 13 primary care sites in the(More)
OBJECTIVE To evaluate the effectiveness of continuous glucose monitoring during pregnancy on maternal glycaemic control, infant birth weight, and risk of macrosomia in women with type 1 and type 2 diabetes. DESIGN Prospective, open label randomised controlled trial. SETTING Two secondary care multidisciplinary obstetric clinics for diabetes in the(More)
The microvascular response of foot skin to minor thermal injury and the skin of the anterior abdominal wall to injury from a needle was assessed by laser Doppler flowmetry in 23 patients with type I diabetes and 21 healthy control subjects. After minor thermal injury mean (SD) maximum skin blood flow was significantly lower in the diabetic group than the(More)
These Joint British Diabetes Societies guidelines, commissioned by NHS Diabetes, for the perioperative management of the adult patient undergoing surgery are available in full in the Supporting Information. This document goes through the seven stages of the patient journey when having surgery. These are: primary care referral; surgical outpatients;(More)
OBJECTIVE To assess changes in diabetic lower-extremity amputation rates in a defined relatively static population over an 11-year period following the introduction of a multidisciplinary foot team. RESEARCH DESIGN AND METHODS All diabetic patients with foot problems admitted to Ipswich Hospital, a large district general hospital, were identified by(More)
OBJECTIVE The objective of this study was to accurately determine the incidence of lower-extremity amputation using prospective data collection and to compare the results with those obtained by retrospective methods. RESEARCH DESIGN AND METHODS The study was carried out over a 3-year period in a large district general hospital covering a clearly defined(More)
BACKGROUND The LDIflare technique (LDIflare) is a simple non-invasive test of small fibre function in dorsal foot skin involving skin heating and measuring the size of the resulting axon reflex-mediated vasodilator (flare) response using a laser Doppler imager (LDI). This study establishes age-related normative reference ranges for the test and determines(More)
AIM To estimate the annual cost of diabetic foot care in a universal healthcare system. METHODS National datasets and economic modelling were used to estimate the cost of diabetic foot disease to the National Health Service in England in 2010-2011. The cost of hospital admissions specific to foot disease or amputation was estimated from Hospital Episode(More)
AIMS/HYPOTHESIS To assess thiamine status by analysis of plasma, erythrocytes and urine in type 1 and type 2 diabetic patients and links to markers of vascular dysfunction. METHODS Diabetic patients (26 type 1 and 48 type 2) with and without microalbuminuria and 20 normal healthy control volunteers were recruited. Erythrocyte activity of transketolase,(More)