J P Hosker

Doncaster Royal Infirmary

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David R. Matthews

University of Oxford

A. Rudenski

University of Manchester

R. C. Turner

Presbyterian College

M. A. Burnett

University of Oxford

Stephen O’Rahilly

University of Cambridge

R. C. Turner

New York Proton Center

Caroline Gordon

University of Birmingham

Sudhesh Kumar

National Council Of Educational Research And Training

A. J. M. Boulton

Diabetes UK

Zoann Nugent

University of Manitoba

Cooperative Institutions

University College London

University of Oxford

Moorfields Eye Hospital

Great Ormond Street Hospital

Moorfields Eye Hospital NHS Foundation Trust

National Institute for Health Research

Ulverscroft (United Kingdom)

John Radcliffe Hospital

Oxford Centre for Diabetes, Endocrinology and Metabolism

University of Manchester

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Diabetic thoracic polyradiculoneuropathy (DTP) following normalization of blood glucose post‐pancreatic transplantation

Diabetic Medicine (2009)

Agbor Ndip Alakananda Basu J P Hosker Andrew J.M. Boulton

10.1111/j.1464-5491.2009.02746.x

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Citations (3)

Prednisolone enhances β-cell function independently of ambient glycemic levels in type II diabetes

Metabolism (1993)

J P Hosker M. A. Burnett David R. Matthews R. C. Turner

Prednisolone

10.1016/0026-0495(93)90268-s

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Citations (9)

Vulnerabilities in diabetic eye screening for children and young people in England

Pediatric Diabetes (2019)

Maria Carolina Ibanez-Bruron Ameenat Lola Solebo Phillippa Cumberland Jugnoo S. Rahi Susanne Althauser

Background Children and young people (CYP) living with diabetes require integrated child-centered care. We hypothesized that suboptimal uptake to diabetic retinopathy screening in CYP may be partly related to the degree of services integration. We investigated the structure of the current pediatric diabetic eye care pathway and associations between service-level characteristics and screening uptake. Methods A quality improvement project between January and May 2017 comprising a survey of practice of all 158 pediatric diabetes services (pediatric diabetes units, PDUs) across England and secondary data analysis of routinely collected service data. Generalized linear models for proportional responses were fitted to investigate associations between reported PDU characteristics and screening uptake. Results 124 PDUs (78%) responded. In 67% (n = 83), patients could be referred directly to screening programs; the remainder relied on primary care for onward referral. 97% (n = 120) considered eye screening results useful for counseling patients but only 65% (n = 81) reported it was “easy” to obtain them. Factors independently associated with higher screening uptake were a higher proportion of patients referred from primary care (OR = 1.005; 95%CI = 1.004-1.007 per 1% of increase), absence of “out-of-catchment area” patients (OR = 1.13; 95%CI = 1.04-1.22), and easy access to eye screening results (OR = 1.45; 95%CI = 1.34-1.56). Conclusions There is limited direct communication between the services involved in diabetic eye care for CYP in England. This risks reducing the effectiveness of diabetic retinopathy screening. Similar vulnerabilities are likely to exist in other countries where retinopathy screening for CYP has been “bolted on” to provision for adults.

National Service Framework

10.1111/pedi.12887

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Citations (2)

BETA-CELL DYSFUNCTION, RATHER THAN INSULIN INSENSITIVITY, IS THE PRIMARY DEFECT IN FAMILIAL TYPE 2 DIABETES

The Lancet (1986)

Stephen O’Rahilly A. Rudenski M. A. Burnett Zoann Nugent J P Hosker

First-degree relatives

Glucose tolerance test

10.1016/s0140-6736(86)90052-8

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Citations (232)

Metabolic abnormalities in children of non-insulin dependent diabetics

BMJ (1986)

Stephen O’Rahilly David R. Matthews J P Hosker R. C. Turner

10.1136/bmj.293.6559.1437-b

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Citations (1)

Sulphonylurea therapy doubles B-cell response to glucose in Type 2 diabetic patients

Diabetologia (1985)

J P Hosker M. A. Burnett Eleanor Davies E. Harris R. C. Turner

Glucose clamp technique

C-peptide

10.1007/bf00291069

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Citations (48)

Continuous infusion of glucose with model assessment: measurement of insulin resistance and ?-cell function in man

Diabetologia (1985)

J P Hosker David R. Matthews A. Rudenski M. A. Burnett Pauline Darling

Glucose clamp technique

Homeostasis

Glycosuria

Glucose tolerance test

10.1007/bf00280882

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Citations (289)

Diet Treatment of Newly Presenting Type 2 Diabetes Improves Insulin Secretory Capacity, but Has No Effect on Insulin Sensitivity

Diabetic Medicine (1993)

J P Hosker Sudhesh Kumar Caroline Gordon Deepak Bhatnagar M. France

Fifteen newly diagnosed obese Type 2 diabetic subjects were treated with diet alone for 3 months with a median 1.5 kg weight loss. Each had a Continuous Infusion of Glucose with Model Assessment (CIGMA) test, at diagnosis and at 3 months, measuring insulin and C‐peptide responses, and deriving mathematically modelled measures of beta‐cell function and insulin sensitivity. Median fasting glucoses were 9.6 mmol l −1 at diagnosis and 8.5 mmol l −1 at 3 months (NS). Median fasting insulin was 9.3 mU l −1 at diagnosis and 11.7 mU l −1 at 3 months (NS). Median fasting C‐peptide was 0.58 nmol l −1 at diagnosis and 0.64 nmol l −1 at 3 months ( p < 0.05). Median achieved plasma insulin increased from 13.8 mU l −1 at diagnosis to 17 mU l −1 at 3 months ( p < 0.02); median achieved plasma C‐peptide increased from 0.72 nmol l −1 at diagnosis to 0.81 nmol l −1 at 3 months ( p < 0.002). Modelled beta‐cell function rose from median 26 % at diagnosis to 37 % at 3 months ( p < 0.02). Modelled insulin sensitivity showed no significant change (median 0.31 at diagnosis, 0.27 at 3 months, NS). Elevation of achieved C‐peptide was positively correlated with weight loss ( R s = 0.53, p < 0.05), but not with change in fasting glucose. Diet treatment of newly diagnosed Type 2 diabetes, with modest weight loss, results primarily in improvement of insulin secretory capacity, rather than insulin sensitivity.

C-peptide

10.1111/j.1464-5491.1993.tb00111.x

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Citations (8)

Transient, selective factor X deficiency and acute liver failure following chest infection treated with erythromycin BP

Postgraduate Medical Journal (1983)

J P Hosker D P Jewell

Summary A 57-year-old man developed symptoms of a respiratory tract infection which was treated with erythromycin BP. He subsequently went into acute liver failure. Investigation of a very prolonged prothrombin time revealed a marked, selective factor X deficiency (1% of normal activity). He later recovered virtually normal liver function and completely normal factor X activity.

Prothrombin time

Respiratory tract

10.1136/pgmj.59.694.514

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Citations (20)

Does adding fibre to a low energy, high carbohydrate, low fat diet confer any benefit to the management of newly diagnosed overweight type II diabetics?

BMJ (1988)

V. Beattie C. A. Edwards J P Hosker D. R. Cullen J. D. Ward

The effect of supplementing a low energy (roughly 5·0 MJ), high carbohydrate (180 g), low fat (roughly 25 g) diet with 10-15 g of either cereal fibre or guar gum was investigated in 24 newly diagnosed overweight non-insulin-dependent (type II) diabetics. The patients were divided into three treatment groups: one received a low fibre control diet throughout the study period of 20 weeks and the other received two supplements of cereal fibre and guar gum in a crossover manner. The nutrient content of the diets was kept constant throughout. Though patients taking the low fibre diet showed a smaller reduction in fasting plasma glucose concentrations over the first eight weeks than patients taking a high fibre diet, this difference was not evident at the end of 20 weeks; reductions in weight and glycated haemoglobin values were similar for each dietary regimen throughout the trial. There was little evidence that supplementing a low energy, high carbohydrate diet with fibre confers any therapeutic benefit to type II diabetics and no evidence that taking fibre as viscous polysaccharides is any more beneficial to overweight diabetics than taking a similar fibre supplement as cereal. On the contrary, guar gum caused more abdominal discomfort and flatulence than the other diets.

Flatulence

Guar gum

Dietary fibre

Crossover study

Regimen

Low energy

10.1136/bmj.296.6630.1147

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Citations (37)