https://ogma.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:50246 Wed 28 Feb 2024 15:28:44 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:54979 Wed 27 Mar 2024 09:31:09 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:41056 10 mmol/L); occurrence of maternal hypoglycaemia (BGL < 3.8 mmol/l) and incidence of neonatal hypoglycaemia (BGL ≤ 2.5 mmol/L). Analysis was stratified by diabetes type. Results: Overall, Pregnancy-IVI achieved a higher proportion of on-IVI time-in-range (70%, IQR 56-78%) compared to Adult-IVI (52%, IQR 41-69%, p < 0.0001). The duration of critical hyperglycaemia with Pregnancy-IVI was also reduced (2% [IQR 0-7] vs 8% [IQR 4-17], p < 0.0001), without an increase in hypoglycaemia. Glycaemic variability was significantly reduced with Pregnancy-IVI. No difference in the rate of neonatal hypoglycaemia was observed. The Pregnancy-IVI was most effective in women with Type 1 diabetes. Conclusion: The Pregnancy-IVI algorithm is safe and effective when used following betamethasone in type 1 diabetes in pregnancy. Further study of women with type 2 diabetes is required.]]> Wed 22 Nov 2023 16:02:08 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:30973 Wed 19 Jan 2022 15:16:49 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:30673 Wed 17 Nov 2021 16:32:00 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:24093 0.05). Protein loads of 75 and 100 g resulted in lower glycaemic excursions than control in the 60-120 min postprandial interval, but higher excursions in the 180-300 min interval. In comparison with 20 g glucose, the large protein loads resulted in significantly delayed and sustained glucose excursions, commencing at 180 min and continuing to 5 h. Conclusions: Seventy-five grams or more of protein alone significantly increases postprandial glycaemia from 3 to 5 h in people with Type 1 diabetes mellitus using intensive insulin therapy. The glycaemic profiles resulting from high protein loads differ significantly from the excursion from glucose in terms of time to peak glucose and duration of the glycaemic excursion. This research supports recommendations for insulin dosing for large amounts of protein.]]> Wed 11 Apr 2018 17:03:56 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:21916 Wed 10 Jul 2019 15:18:42 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:31350 Wed 09 Feb 2022 15:55:23 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:35891 3 months attending diabetes centres in Newcastle, Australia. Rates of overweight and obesity were compared with matched population survey results. Results: Data from 308 youth and 283 young adults were included. In girls, significantly higher prevalence of overweight and obesity were seen in the 5–8 (43% vs. 18%), 13–16 (41% vs. 27%), 18–24 (46% vs. 34%) and 25–30 (60% vs. 43%) years age groups; whereas in boys increased prevalence was observed in the 5–8 years age group only (41% vs. 18%). Rates of overweight and obesity increased with age across sexes. In youth, BMI standard deviation score was correlated with socio‐economic status, insulin regimen, blood pressure and blood lipids (P < 0.05). In adults, BMI was positively associated with blood pressure, and longer diabetes duration (P < 0.02). Conclusions: Overweight and obesity are over‐represented in young persons with type 1 diabetes, particularly girls. As overweight is associated with other cardiovascular disease markers early intervention is paramount.]]> Wed 06 Apr 2022 13:57:00 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:49963 Tue 20 Jun 2023 14:36:29 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:44265 Tue 11 Oct 2022 13:54:48 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:45992 Tue 08 Nov 2022 15:15:05 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:42869 Tue 06 Sep 2022 09:31:19 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:30870 P = 0.02; odds ratio (OR) 0.992, P = 0.03] and more time with BGL in the 7–10 mmol/l range (31 ± 34% vs. 18 ± 27%, P = 0.003; OR 1.013, P = 0.003) compared with those without neonatal hypoglycaemia. Although statistically significant, receiver operating characteristic (ROC) curve analysis showed that time spent with maternal BGLs in the range 4–7 mmol/l [area under the curve (AUC) = 0.58] or 7–10 mmol (AUC = 0.60) was not strong enough to be a useful clinical predictor of neonatal hypoglycaemia. HbA_1c in the second trimester of pregnancy (P = 0.02, OR 1.42) and percentage time spent in BGL range of 7–10 mmol/l (P = 0.001, OR 1.02) were both associated with a risk of neonatal hypoglycaemia in a logistic regression model. HbA_1c in the third trimester (P = 0.07, OR 1.28) approached, but did not reach, significance. Conclusions: These data support a BGL range of 4–7 mmol/l as an intrapartum target. Glycaemic control in the second trimester is associated with neonatal hypoglycaemia. Improvement in ante- and intrapartum glycaemic control may reduce neonatal hypoglycaemia in women with pre-existing diabetes.]]> Thu 17 Mar 2022 14:40:12 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:49335 Thu 11 May 2023 15:21:16 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:49334 Thu 11 May 2023 15:21:15 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:34937 10 mmol/l), occurrence of maternal hypoglycaemia (BGL < 3.8 mmol/l), and incidence of neonatal hypoglycaemia (BGL ≤ 2.5 mmol/l) if betamethasone was administered within 48 h of birth. Results: The cohorts comprised 151 women (Adult‐IVI n = 86; Pregnancy‐IVI n = 65). The primary outcome was 68% time‐at‐target [95% confidence interval (CI) 64–71%) for Pregnancy‐IVI compared with 55% (95% CI 50–60%) for Adult‐IVI (P = 0.0002). Critical maternal hyperglycaemia (0% vs. 2%, P = 0.02) and hypoglycaemia (2% vs. 12%, P = 0.02) were both lower with Pregnancy‐IVI than Adult‐IVI. Neonatal hypoglycaemia was less common after Pregnancy‐IVI (29%) than after Adult‐IVI (54%, P = 0.03). A multiple logistic regression model adjusting for potential confounders gave an odds ratio for neonatal hypoglycaemia with Pregnancy‐IVI of 0.27 (95% CI 0.10–0.76, P = 0.01). Conclusions: An IVI protocol designed for pregnancy effectively controlled maternal hyperglycaemia following betamethasone administration in GDM. This is the first intervention to show a reduction in betamethasone‐associated neonatal hypoglycaemia, linked with optimum maternal glycaemic control.]]> Thu 04 Nov 2021 10:39:22 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:9586 0.05). Mean gram error and meal size were negatively correlated (r = -0.70, P < 0.0001). The longer children had been CHO counting the greater the mean percentage error (r = 0.173, P = 0.014). Core foods in non-standard quantities were most frequently inaccurately estimated, while individually labelled foods were most often accurately estimated. Conclusions: Children with Type 1 diabetes and their caregivers can estimate the carbohydrate content of meals with reasonable accuracy. Teaching CHO counting in gram increments did not improve accuracy compared with CHO portions or exchanges. Large meals tended to be underestimated and snacks overestimated. Repeated age-appropriate education appears necessary to maintain accuracy in carbohydrate estimations.]]> Sat 24 Mar 2018 08:39:11 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7663 0.05). The 10-g variations in CHO quantity resulted in no differences in BGLs or area under the glucose curves for 2.5 h (P > 0.05). Hypoglycaemic episodes were not significantly different (P = 0.32). The 70-g meal produced higher glucose excursions after 2.5 h, with a maximum difference of 1.9 mmol/l at 3 h (P = 0.01), but the BGLs remained within international postprandial targets. Conclusions: In patients using intensive insulin therapy, an individually calculated insulin dose for 60 g of carbohydrate maintains postprandial BGLs for meals containing between 50 and 70 g of carbohydrate. A single mealtime insulin dose will cover a range in carbohydrate amounts without deterioration in postprandial control.]]> Sat 24 Mar 2018 08:36:00 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:7614 Sat 24 Mar 2018 08:34:43 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:16009 Sat 24 Mar 2018 08:19:29 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:11062 25 kg/m2 [odds ratio (OR) 4.50, 95% confidence interval (CI) (3.12, 6.51)], a family history of diabetes [OR 3.80, 95% CI (2.67, 5.33)] and use of insulin during pregnancy [OR 1.92, 95% CI (1.31, 2.61)]. Conclusions: Although women with known risk factors for Type 2 diabetes were more likely to perceive their risk as high, we found that one third still considered themselves to be at low or very low risk for the development of diabetes. These results suggest a need for increased awareness of gestational diabetes as a strong predictor of Type 2 diabetes risk.]]> Sat 24 Mar 2018 08:13:33 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:17877 Sat 24 Mar 2018 07:56:43 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:4973 Sat 24 Mar 2018 07:46:55 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:29378 Sat 24 Mar 2018 07:36:20 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:29173 N = 149 049). Women with GDM (N = 49 684) were matched on age and year of giving birth, in a ratio of 1:2, to pregnant women without diabetes (N = 99 365). Results: Over a median 8-year follow-up, there were a total of 2927 (1.5%) cancers. After adjustment for covariates, we found no significant difference in overall risk of cancer between women with GDM and matched control subjects; however, GDM was associated with a significantly greater risk of thyroid cancer (adjusted hazard ratio 1.24, 95% CI 1.05, 1.46) and a significantly lower risk of premenopausal breast cancer (hazard ratio 0.86, 95% CI 0.75, 0.98) compared with matched control subjects. Conclusions: This large population-based study did not find a greater risk of cancers among women with GDM during the first decade postpartum; however, GDM was associated with a higher risk of thyroid cancer and a lower risk of premenopausal breast cancer. Further studies are needed to confirm these findings.]]> Sat 24 Mar 2018 07:35:44 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:26141 Sat 24 Mar 2018 07:35:27 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:4888 Sat 24 Mar 2018 07:21:59 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:50795 Sat 05 Aug 2023 13:56:55 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:44790 Mon 24 Oct 2022 09:17:35 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:40679 Mon 18 Jul 2022 09:21:13 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:41203 Mon 08 Jan 2024 11:42:26 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:42280 Fri 19 Aug 2022 14:51:53 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:40131 1c < 65 mmol/mol (8.1%), received a 50 g protein, 30 g carbohydrate, low-fat (< 1 g) breakfast drink over five consecutive days at home. A standard insulin dose (100%) was compared with additional doses of 115, 130, 145 and 160% for the protein, in randomized order. Doses were commenced 15-min pre-drink and delivered over 3 h using a combination bolus with 65% of the standard dose given up front. Postprandial glycaemia was assessed by 4 h of continuous glucose monitoring. Results: The 100% dosing resulted in postprandial hyperglycaemia. From 120 min, ≥ 130% doses resulted in significantly lower postprandial glycaemic excursions compared with 100% (P < 0.05). A 130% dose produced a mean (sd) glycaemic excursion that was 4.69 (2.42) mmol/l lower than control, returning to baseline by 4 h (P < 0.001). From 120 min, there was a significant increase in the risk of hypoglycaemia compared with control for 145% [odds ratio (OR) 25.4, 95% confidence interval (CI) 5.5–206; P < 0.001) and 160% (OR 103, 95% CI 19.2–993; P < 0.001). Some 81% (n = 21) of participants experienced hypoglycaemia following a 160% dose, whereas 58% (n = 15) experienced hypoglycaemia following a 145% dose. There were no hypoglycaemic events reported with 130%. Conclusions: The addition of 30% more insulin to a standard dose for a high-protein meal, delivered using a combination bolus, improves postprandial glycaemia without increasing the risk of hypoglycaemia.]]> Fri 15 Jul 2022 09:55:16 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:45562 P =0.001], with inter‐individual requirements ranging from 0.9 to six times the low‐protein meal requirement. Approximately half the additional insulin [1.1 units/h (CI 0.5, 1.8; P =0.001)] was given in the first 2 h, compared with an additional 0.5 units/h (CI –0.2, 1.2; P =0.148) in the second 2 h and 0.1 units (CI –0.6, 0.8; P =0.769) in the final hour. Conclusions: A high‐protein meal requires ~50% more insulin to maintain euglycaemia than a low‐protein meal that contains the same quantity of carbohydrate. The majority is required within the first 2 h. Inter‐individual differences exist in insulin requirements for dietary protein.]]> Fri 04 Nov 2022 14:45:18 AEDT ]]>