Gerry Rayman

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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)
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)
OBJECTIVE This study evaluated closed-loop insulin delivery with a model predictive control (MPC) algorithm during early (12-16 weeks) and late gestation (28-32 weeks) in pregnant women with type 1 diabetes. RESEARCH DESIGN AND METHODS Ten women with type 1 diabetes (age 31 years, diabetes duration 19 years, BMI 24.1 kg/m(2), booking A1C 6.9%) were(More)
OBJECTIVE This study explored the importance of glycemic burden compared with features of the metabolic syndrome in the pathogenesis of diabetic neuropathy by comparing C-fiber function in people with type 1 diabetes to that in people with impaired glucose tolerance (IGT). RESEARCH DESIGN AND METHODS The axon reflex-elicited flare areas (LDIflares) were(More)
OBJECTIVE Abnormal small nerve fiber function may be an early feature of diabetic neuropathy and may also underlie painful symptoms. Methods for assessing small-fiber damage include quantitative sensory testing (QST) and determining intraepidermal nerve fiber density. We recently described a reproducible physiological technique, the LDIflare, which assesses(More)
Vasodilation induced by both acetylcholine iontophoresis (ACh Ionto) and the laser Doppler flare technique (LDIFT) can be used to measure small-fiber function. The aim of this study was to compare the neurogenic nature of these methods. ACh Ionto and the LDIFT were performed on 10 controls, with and without local anesthetic cream. The local anesthetic cream(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)
INTRODUCTION The diagnosis and quantification of chemotherapy-induced peripheral neuropathy (CIPN) remains a challenge. Conventional methods including quantitative sensory testing (QST), nerve conduction tests, and biopsy are unable to detect subclinical changes, and do not consistently correlate with severity of patients' symptoms and functional(More)
OBJECTIVE Sympathetic denervation and hyperemia are implicated in the pathogenesis of Charcot neuroarthropathy (CN) but are also features of diabetic peripheral neuropathy (DPN). Differences in these physiological parameters were sought by determining C-fiber function (laser Doppler imager [LDI]flare technique) and maximum microvascular hyperemia (MMH) in(More)
OBJECTIVES To determine whether temporal patterns of hypoglycaemia exist in inpatients with diabetes 'at risk' of hypoglycaemia (those on insulin and/or sulfonylureas), and if so whether patterns differ between hospitals and between these treatments. SETTING Retrospective multicentre audit of inpatients with diabetes involving 11 acute UK National Health(More)