19 results on '"D Jane Holmes-Walker"'
Search Results
2. Less Nocturnal Hypoglycemia but Equivalent Time in Range Among Adults with Type 1 Diabetes Using Insulin Pumps Versus Multiple Daily Injections
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Christel Hendrieckx, Kavita Kumareswaran, Sara Vogrin, D Jane Holmes-Walker, Jane Speight, Leon A. Bach, Elizabeth A. Davis, David N O'Neal, Martin de Bock, Mary B Abraham, Timothy W. Jones, Roland W. McCallum, Richard J MacIsaac, Steven Trawley, Vijaya Sundararajan, Morton G. Burt, Catriona M. Sims, Alicia J. Jenkins, Anthony C Keech, Joey Kaye, Peter G. Colman, Barbora Paldus, Stephen N Stranks, Neale Cohen, Glenn M. Ward, Sybil A McAuley, and Melissa H Lee
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Adult ,Blood Glucose ,Insulin pump ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Hypoglycemia ,03 medical and health sciences ,Insulin Infusion Systems ,0302 clinical medicine ,Endocrinology ,Interquartile range ,Internal medicine ,Blood Glucose Self-Monitoring ,Diabetes mellitus ,medicine ,Humans ,Hypoglycemic Agents ,Insulin ,030212 general & internal medicine ,Glycated Hemoglobin ,Type 1 diabetes ,business.industry ,Australia ,nutritional and metabolic diseases ,medicine.disease ,Confidence interval ,Medical Laboratory Technology ,Diabetes Mellitus, Type 1 ,business - Abstract
Background: This prerandomization analysis from the Australian HCL-Adult trial (registration number: ACTRN12617000520336) compared masked continuous glucose monitoring (CGM) metrics among adults using insulin pumps versus multiple daily injections (MDIs), who were all self-monitoring blood glucose (SMBG). Methods: Adults with type 1 diabetes, using an insulin pump or MDIs without real-time CGM (and entering a trial of closed-loop technology), were eligible. MDI users were given an insulin dosage calculator. All participants received diabetes and carbohydrate-counting education, then wore masked CGM sensors for 3 weeks. Ethics Approval: HREC-D 088/16 Results: Adults using MDIs (n = 61) versus pump (n = 59) did not differ by age, sex, diabetes duration, insulin total daily dose, or HbA1c at baseline. After education, median (interquartile range) CGM time in range (TIR) 70-180 mg/dL (3.9-10.0 mmol/L) was 54% (47, 62) for those using MDIs and 56% (48, 66) for those using pump (P = 0.40). All CGM metrics were equivalent for 24 h/day for MDI and pump users. Overnight, those using MDIs (vs. pump) spent more time with glucose
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- 2021
3. Determinants of Cardiovascular Risk in 7000 Youth With Type 1 Diabetes in the Australasian Diabetes Data Network
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Kim C Donaghue, Bruce R. King, D Jane Holmes-Walker, Craig Jefferies, Meng Tuck Mok, P Shane Hamblin, Melissa Chee, Timothy W. Jones, Helen L. Barrett, Elizabeth E Davis, Arul Earnest, Benjamin J Wheeler, Richard O. Sinnott, Stephanie R. Johnson, Anthony Zimmermann, Glenn M. Ward, Fergus J. Cameron, P. Gerry Fegan, Jenny Couper, Maria E. Craig, Philip Bergman, and Peter G. Colman
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Databases, Factual ,Endocrinology, Diabetes and Metabolism ,Clinical Biochemistry ,Overweight ,Community Networks ,Biochemistry ,Body Mass Index ,Young Adult ,chemistry.chemical_compound ,Endocrinology ,Risk Factors ,Interquartile range ,Internal medicine ,Diabetes mellitus ,Humans ,Medicine ,Longitudinal Studies ,Child ,Creatinine ,Type 1 diabetes ,Australasia ,business.industry ,Cholesterol ,Biochemistry (medical) ,Age Factors ,medicine.disease ,Diabetes Mellitus, Type 1 ,Blood pressure ,chemistry ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Child, Preschool ,Female ,medicine.symptom ,business ,Body mass index ,Diabetic Angiopathies - Abstract
Context Cardiovascular disease occurs prematurely in type 1 diabetes. The additional risk of overweight is not well characterized. Objective The primary aim was to measure the impact of body mass index (BMI) in youth with type 1 diabetes on cardiovascular risk factors. The secondary aim was to identify other determinants of cardiovascular risk. Design Observational longitudinal study of 7061 youth with type 1 diabetes followed for median 7.3 (interquartile range [IQR] 4-11) years over 41 (IQR 29-56) visits until March 2019. Setting 15 tertiary care diabetes centers in the Australasian Diabetes Data Network. Participants were aged 2 to 25 years at baseline, with at least 2 measurements of BMI and blood pressure. Main Outcome Measure Standardized systolic and diastolic blood pressure scores and non–high-density lipoprotein (HDL) cholesterol were co-primary outcomes. Urinary albumin/creatinine ratio was the secondary outcome. Results BMI z-score related independently to standardized blood pressure z- scores and non-HDL cholesterol. An increase in 1 BMI z-score related to an average increase in systolic/diastolic blood pressure of 3.8/1.4 mmHg and an increase in non-HDL cholesterol (coefficient + 0.16 mmol/L, 95% confidence interval [CI], 0.13-0.18; P Conclusions BMI had a modest independent effect on cardiovascular risk. Females and Indigenous Australians in particular had a more adverse risk profile.
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- 2020
4. Author response for 'Longitudinal audit of assessment and pharmaceutical intervention for cardiovascular risk in the Australasian Diabetes Data Network'
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null Claire A. Robertson, null Arul Earnest, null Melissa Chee, null Maria E. Craig, null Peter Colman, null Helen L. Barrett, null Philip Bergman, null Fergus Cameron, null Elizabeth A. Davis, null Kim C. Donaghue, null P. Gerry Fegan, null P. Shane Hamblin, null D. Jane Holmes–Walker, null Craig Jefferies, null Stephanie Johnson, null Meng T. Mok, null Bruce R. King, null Richard Sinnott, null Glenn Ward, null Benjamin J. Wheeler, null Anthony Zimmermann, null Timothy W. Jones, null Jenny J. Couper, and null the ADDN Study Group
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medicine.medical_specialty ,business.industry ,Diabetes mellitus ,Intervention (counseling) ,Family medicine ,medicine ,Audit ,medicine.disease ,business - Published
- 2021
5. Longitudinal audit of assessment and pharmaceutical intervention for cardiovascular risk in the Australasian Diabetes Data Network
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Craig Jefferies, Arul Earnest, D Jane Holmes-Walker, Timothy W. Jones, Benjamin J Wheeler, Meng Tuck Mok, P. Gerry Fegan, Jenny Couper, Stephanie R. Johnson, Richard O. Sinnott, Helen L. Barrett, Claire A. Robertson, Elizabeth E Davis, P Shane Hamblin, Anthony T. Zimmermann, Bruce R. King, Philip Bergman, Melissa Chee, Peter G. Colman, Glenn M. Ward, Fergus J. Cameron, Maria E. Craig, and Kim C. Donaghue
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Type 1 diabetes ,medicine.medical_specialty ,business.industry ,Endocrinology, Diabetes and Metabolism ,MEDLINE ,Audit ,Disease ,medicine.disease ,Risk Assessment ,Endocrinology ,Diabetes Mellitus, Type 2 ,Pharmaceutical Preparations ,Cardiovascular Diseases ,Heart Disease Risk Factors ,Risk Factors ,Intervention (counseling) ,Family medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Life expectancy ,Diabetes Mellitus ,Humans ,business ,Cohort study - Published
- 2021
6. Benchmarking care outcomes for young adults with type 1 diabetes in Australia after transition to adult care
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Phidias Rueter, D Jane Holmes-Walker, Peter G. Colman, Maria E. Craig, Kaye Farrell, Helen Phelan, and Jenny E. Gunton
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Adult ,Blood Glucose ,young adults ,Transition to Adult Care ,medicine.medical_specialty ,Adolescent ,endocrine system diseases ,Diabetic ketoacidosis ,type 1 diabetes ,Endocrinology, Diabetes and Metabolism ,Adult care ,Diseases of the endocrine glands. Clinical endocrinology ,Young Adult ,Original Research Articles ,Internal medicine ,Diabetes mellitus ,Humans ,Medicine ,Original Research Article ,Young adult ,Type 1 diabetes ,business.industry ,Blood Glucose Self-Monitoring ,Australia ,care outcomes ,Albumin/creatinine ratio ,RC648-665 ,medicine.disease ,Benchmarking ,Diabetes Mellitus, Type 1 ,Cohort ,Registry data ,business - Abstract
Aim To determine advantages conferred by a youth‐specific transition clinic model for young adults with type 1 diabetes (T1D) at Westmead Hospital (WH) as compared with Australian registry data. Methods Prospectively collected data included age, diabetes duration, visit frequency, post code, BMI, mode of insulin delivery, continuous glucose monitoring, HbA1c, albumin creatinine ratio, BP, retinopathy and diabetic ketoacidosis (DKA) for all WH T1D clinic attendees aged 16–25 between January 2017 and June 2018 (n = 269). Results were compared with data collected during the same time period from 2 separate Australian data registries, one longitudinal (Australasian Diabetes Data Network, ADDN) and one a spot survey (the Australian National Diabetes Audit, ANDA). Results Across the three cohorts, HbA1c was similar (respectively, WH, ADDN, ANDA; 8.7%[72mmol/mol], 8.7%[72mmol/mol], 8.5%[69mmol/mol]) and HbA1c was significantly higher in young adults, A model of care for young people with type I diabetes as they transition to adult care was benchmarked with two separate Australian data registries. Similar glycaemic outcomes were achieved nationally but the care model achieved a marked reduction in diabetic ketoacidosis and increased clinic attendance frequency.
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- 2021
7. Australian experience with total pancreatectomy with islet autotransplantation to treat chronic pancreatitis
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David J. Torpy, Wayne J. Hawthorne, D Jane Holmes-Walker, Christine Russell, Thomas Loudovaris, Lindy Williams, Toni Radford, Tristan J. Bampton, Gordon Thomas, Pamela E. Macintyre, H. E. Thomas, Jennifer J Couper, C. Etherton, Natasha M. Rogers, P. J. O'connell, John W. Chen, Paul Z. Benitez-Aguirre, Denghao Wu, R. L. T. Couper, Lyle J. Palmer, Henry Pleass, Chris Drogemuller, Patricia Anderson, Eu Ling Neo, Thomas W.H. Kay, Sanjeev Khurana, and P. Toby Coates
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medicine.medical_specialty ,medicine.medical_treatment ,Transplantation, Autologous ,03 medical and health sciences ,0302 clinical medicine ,Pancreatectomy ,Interquartile range ,Internal medicine ,Diabetes mellitus ,Pancreatitis, Chronic ,Medicine ,Humans ,Pain Management ,Hereditary pancreatitis ,geography ,geography.geographical_feature_category ,business.industry ,Australia ,General Medicine ,medicine.disease ,Islet ,Autotransplantation ,Transplantation ,030220 oncology & carcinogenesis ,Pancreatitis ,030211 gastroenterology & hepatology ,Surgery ,business - Abstract
BACKGROUND This study aimed to describe the clinical outcomes of total pancreatectomy with islet autotransplantation (TP-IAT) in Australia. METHODS Individuals selected for TP-IAT surgery according to the Minnesota Criteria (Appendix) without evidence of diabetes were evaluated including time to transplantation from pancreatectomy, islet numbers infused and post-transplantation HbA1c, C-peptide, total daily insulin and analgesic requirement. RESULTS Sixteen individuals underwent TP-IAT from Australia and New Zealand between 2010 and 2020. Two recipients are deceased. The median islet equivalents/kg infused was 4244 (interquartile range (IQR) 2290-7300). The median C-peptide 1 month post-TP-IAT was 384 (IQR 210-579) pmol/L and at median 29.5 (IQR 14.5-46.5) months from transplant was 395 (IQR 139-862) pmol/L. Insulin independence was achieved in eight of 15 (53.3%) surviving recipients. A higher islet equivalents transplanted was most strongly associated with the likelihood of insulin independence (P
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- 2021
8. Six-months of hybrid closed-loop versus manual insulin delivery with finger-prick blood glucose monitoring in adults with type 1 diabetes: a randomized, controlled trial
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Anthony C Keech, D Jane Holmes-Walker, Martin de Bock, Sybil A McAuley, Vijaya Sundararajan, Morton G. Burt, Timothy W. Jones, Joey Kaye, Stephen N Stranks, Elizabeth A. Davis, Alicia J. Jenkins, Kavita Kumareswaran, Sara Vogrin, Melissa H Lee, Christel Hendrieckx, Leon A. Bach, Jane Speight, Steven Trawley, Peter G. Colman, Barbora Paldus, Catriona M. Sims, Glenn M. Ward, Neale Cohen, Mary B Abraham, Richard J MacIsaac, David N O'Neal, and Roland W. McCallum
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Insulin pump ,Adult ,Blood Glucose ,Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,030209 endocrinology & metabolism ,Personal Satisfaction ,Gastroenterology ,Artificial pancreas ,law.invention ,Injections ,Fingers ,03 medical and health sciences ,0302 clinical medicine ,Insulin Infusion Systems ,Randomized controlled trial ,law ,Internal medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,Humans ,Hypoglycemic Agents ,Insulin ,030212 general & internal medicine ,Needlestick Injuries ,Glycemic ,Aged ,Advanced and Specialized Nursing ,Blood glucose monitoring ,Glycated Hemoglobin ,Type 1 diabetes ,Blood Specimen Collection ,medicine.diagnostic_test ,business.industry ,Blood Glucose Self-Monitoring ,Middle Aged ,medicine.disease ,Diabetes Mellitus, Type 1 ,Female ,business - Abstract
OBJECTIVE To investigate glycemic and psychosocial outcomes with hybrid closed-loop (HCL) versus user-determined insulin dosing with multiple daily injections (MDI) or insulin pump (i.e., standard therapy for most adults with type 1 diabetes). RESEARCH DESIGN AND METHODS Adults with type 1 diabetes using MDI or insulin pump without continuous glucose monitoring (CGM) were randomized to 26 weeks of HCL (Medtronic 670G) or continuation of current therapy. The primary outcome was masked CGM time in range (TIR; 70–180 mg/dL) during the final 3 weeks. RESULTS Participants were randomized to HCL (n = 61) or control (n = 59). Baseline mean (SD) age was 44.2 (11.7) years, HbA1c was 7.4% (0.9%) (57 [10] mmol/mol), 53% were women, and 51% used MDI. HCL TIR increased from (baseline) 55% (13%) to (26 weeks) 70% (10%) with the control group unchanged: (baseline) 55% (12%) and (26 weeks) 55% (13%) (difference 15% [95% CI 11, 19]; P < 0.0001). For HCL, HbA1c was lower (median [95% CI] difference −0.4% [−0.6, −0.2]; −4 mmol/mol [−7, −2]; P < 0.0001) and diabetes-specific positive well-being was higher (difference 1.2 [95% CI 0.4, 1.9]; P < 0.0048) without a deterioration in diabetes distress, perceived sleep quality, or cognition. Seventeen (9 device-related) versus 13 serious adverse events occurred in the HCL and control groups, respectively. CONCLUSIONS In adults with type 1 diabetes, 26 weeks of HCL improved TIR, HbA1c, and their sense of satisfaction from managing their diabetes compared with those continuing with user-determined insulin dosing and self-monitoring of blood glucose. For most people living with type 1 diabetes globally, this trial demonstrates that HCL is feasible, acceptable, and advantageous.
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- 2020
9. Access to a youth-specific service for young adults with type 1 diabetes mellitus is associated with decreased hospital length of stay for diabetic ketoacidosis
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Kris Park, D Jane Holmes-Walker, Kharis Burns, Kaye Farrell, and Rickie Myszka
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Pediatrics ,medicine.medical_specialty ,Type 1 diabetes ,Diabetic ketoacidosis ,business.industry ,Attendance ,Length of hospitalization ,030209 endocrinology & metabolism ,Retrospective cohort study ,medicine.disease ,03 medical and health sciences ,0302 clinical medicine ,Diabetes mellitus ,Internal Medicine ,medicine ,030212 general & internal medicine ,Medical emergency ,Young adult ,business ,Adolescent health - Abstract
Background Management of Type 1 diabetes mellitus (T1DM) in youth with diabetes is complex and glycaemic control often deteriorates during this challenging period. We hypothesise that attendance at a youth-specific diabetes clinic reduces hospital admission rates and length of stay for diabetic ketoacidosis (DKA). Aims This study aimed to assess the impact of a youth specific diabetes service for youth with diabetes (YWD) on DKA admissions in two adjacent local health districts (LHDs). Methods A retrospective cohort analysis of admissions for DKA in YWD aged 15-25, presenting to four hospitals in Western Sydney in 2011 was performed. Number of admissions, length of stay (LOS) and DKA severity were assessed. Cost was analysed as a function of LOS. Groups were divided by attendance at a youth-specific diabetes service or no record of attendance. Results There were 55 DKA admissions from 39 patients (median age 20.0 years); the majority of admissions (82%) were YWD not supported by a youth-specific diabetes service. Median LOS was significantly longer in the unsupported group (3.0 days vs. 1.5 days, p=0.028). Median pH at presentation in the unsupported group was significantly lower, 7.11 versus 7.23 (p=0.05). There was a 4-fold greater admission rate in those not supported by youth-specific diabetes services, 5.5% compared with 1.6% (p=0.001). The estimated cost saved by youth-specific services was over $250,000pa. Conclusions Lack of access to supported care for YWD at the transition has an adverse impact on DKA admission rates and LOS.
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- 2018
10. Meal-time glycaemia in adults with type 1 diabetes using multiple daily injections vs insulin pump therapy following carbohydrate-counting education and bolus calculator provision
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Peter G. Colman, D Jane Holmes-Walker, Martin de Bock, Sybil A McAuley, Barbora Paldus, Melissa H Lee, Morton G. Burt, Glenn M. Ward, Neale Cohen, Sara Vogrin, Kerryn L. Roem, Stephen N Stranks, Kavita Kumareswaran, Jean C Lu, David N O'Neal, Timothy W. Jones, Steven Trawley, Catriona M. Sims, Philip Clarke, Alicia J. Jenkins, Leon A. Bach, Richard J MacIsaac, Vijaya Sundararajan, Anthony C Keech, Joey Kaye, and Roland W. McCallum
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Adult ,Blood Glucose ,Insulin pump ,Diabetes duration ,medicine.medical_specialty ,endocrine system diseases ,Endocrinology, Diabetes and Metabolism ,Carbohydrate counting ,Insulin Infusion Systems ,Endocrinology ,Primary outcome ,Diabetes mellitus ,Internal medicine ,parasitic diseases ,Internal Medicine ,medicine ,Humans ,Hypoglycemic Agents ,Insulin ,Meals ,Glycated Hemoglobin ,Type 1 diabetes ,Meal ,business.industry ,Blood Glucose Self-Monitoring ,digestive, oral, and skin physiology ,General Medicine ,medicine.disease ,Diabetes Mellitus, Type 1 ,Bolus (digestion) ,business - Abstract
Aims To compare meal-time glycaemia in adults with type 1 diabetes mellitus (T1D) managed with multiple daily injections (MDI) vs. insulin pump therapy (IPT), using self-monitoring blood glucose (SMBG), following diabetes education. Methods Adults with T1D received carbohydrate-counting education and a bolus calculator: MDI (Roche Aviva Expert) and IPT (pump bolus calculator). All then wore 3-weeks of masked-CGM (Enlite, Medtronic). Meal-times were assessed by two approaches: 1) Set time-blocks (breakfast 06:00–10:00hrs; lunch 11:00–15:00hrs; dinner 17:00–21:00hrs) and 2) Bolus-calculator carbohydrate entries signalling meal commencement. Post-meal masked-CGM time-in-range (TIR) 3.9–10.0 mmol/L was the primary outcome. Results MDI(n = 61) and IPT (n = 59) participants were equivalent in age, sex, diabetes duration and HbA1c. Median (IQR) education time provided did not differ (MDI: 1.1 h (0.75, 1.5) vs. IPT: 1.1 h (1.0, 2.0); p = 0.86). Overall, daytime (06:00–24:00hrs), lunch and dinner TIR did not differ for MDI vs. IPT participants but was greater for breakfast with IPT in both analyses with a mean difference of 12.8%, (95 CI 4.8, 20.9); p = 0.002 (time-block analysis). Conclusion After diabetes education, MDI and IPT use were associated with similar day-time glycemia, though IPT users had significantly greater TIR during the breakfast period. With education, meal-time glucose levels are comparable with use of MDI vs. pumps.
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- 2021
11. Technologies in the management of type 1 diabetes
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Jennifer R Snaith and D Jane Holmes-Walker
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Blood Glucose ,Gerontology ,Type 1 diabetes ,business.industry ,Australia ,Biomedical Technology ,General Medicine ,medicine.disease ,Diabetes Mellitus, Type 1 ,Insulin Infusion Systems ,Diabetes mellitus ,Humans ,Insulin ,Medicine ,business ,Monitoring, Physiologic - Published
- 2021
12. Effect of 6 months of hybrid closed-loop insulin delivery in adults with type 1 diabetes: a randomised controlled trial protocol
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Stephen N Stranks, Joey Kaye, Jan Fairchild, D Jane Holmes-Walker, Christel Hendrieckx, Vijaya Sundararajan, Morton G. Burt, Martin de Bock, Leon A. Bach, Jane Speight, Richard J MacIsaac, David N O'Neal, Glenn M. Ward, Steven Trawley, Jennifer A. Nicholas, Fergus J. Cameron, Elizabeth A. Davis, Roland W. McCallum, Neale Cohen, Catriona M. Sims, Kavita Kumareswaran, Philip Clarke, Jodie C. Horsburgh, Alicia J. Jenkins, Timothy W. Jones, Sybil A McAuley, Sara Vogrin, Geoff Ambler, Bruce R. King, Melissa H Lee, Peter G. Colman, Barbora Paldus, and Anthony C Keech
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Insulin pump ,Adult ,Blood Glucose ,medicine.medical_specialty ,Time Factors ,type 1 diabetes ,medicine.medical_treatment ,030209 endocrinology & metabolism ,closed loop ,Artificial pancreas ,Diabetes Therapy ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Insulin Infusion Systems ,Randomized controlled trial ,law ,Diabetes mellitus ,medicine ,Protocol ,Humans ,Hypoglycemic Agents ,Insulin ,Multicenter Studies as Topic ,030212 general & internal medicine ,Prospective Studies ,Randomized Controlled Trials as Topic ,Glycated Hemoglobin ,Type 1 diabetes ,business.industry ,Blood Glucose Self-Monitoring ,Australia ,General Medicine ,medicine.disease ,Home Care Services ,Hypoglycemia ,Clinical trial ,Diabetes and Endocrinology ,Diabetes Mellitus, Type 1 ,Treatment Outcome ,Emergency medicine ,Quality of Life ,Regression Analysis ,business - Abstract
IntroductionManual determination of insulin dosing largely fails to optimise glucose control in type 1 diabetes. Automated insulin delivery via closed-loop systems has improved glucose control in short-term studies. The objective of the present study is to determine the effectiveness of 6 months’ closed-loop compared with manually determined insulin dosing on time-in-target glucose range in adults with type 1 diabetes.Methods and analysisThis open-label, seven-centre, randomised controlled parallel group clinical trial will compare home-based hybrid closed-loop versus standard diabetes therapy in Australia. Adults aged ≥25 years with type 1 diabetes using intensive insulin therapy (via multiple daily injections or insulin pump, total enrolment target n=120) will undertake a run-in period including diabetes and carbohydrate-counting education, clinical optimisation and baseline data collection. Participants will then be randomised 1:1 either to 26 weeks of MiniMed 670G hybrid closed-loop system therapy (Medtronic, Northridge, CA, USA) or continuation of their current diabetes therapy. The hybrid closed-loop system delivers insulin automatically to address basal requirements and correct to target glucose level, while bolus doses for meals require user initiation and carbohydrate estimation. Analysis will be intention to treat, with the primary outcome time in continuous glucose monitoring (CGM) target range (3.9–10.0 mmol/L) during the final 3 weeks of intervention. Secondary outcomes include: other CGM parameters, HbA1c, severe hypoglycaemia, psychosocial well-being, sleep, cognition, electrocardiography, costs, quality of life, biomarkers of vascular health and hybrid closed-loop system performance. Semistructured interviews will assess the expectations and experiences of a subgroup of hybrid closed-loop users.Ethics and disseminationThe study has Human Research Ethics Committee approval. The study will be conducted in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice. Results will be disseminated at scientific conferences and via peer-reviewed publications.Trial registration numberNCT12617000520336.
- Published
- 2018
13. Mortality in People With Type 1 Diabetes, Severe Hypoglycemia, and Impaired Awareness of Hypoglycemia Referred for Islet Transplantation
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D Jane Holmes-Walker, P. Toby Coates, Glenn M. Ward, BN Kathy Howe, Philip J. O'Connell, Thomas W.H. Kay, MN Patricia Anderson, BN Toni Radford, Mbbs Melissa H. Lee, David Goodman, and Richard J MacIsaac
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Transplantation ,geography ,Type 1 diabetes ,Pediatrics ,medicine.medical_specialty ,geography.geographical_feature_category ,business.industry ,lcsh:Surgery ,030209 endocrinology & metabolism ,lcsh:RD1-811 ,Hypoglycemia ,Islet ,medicine.disease ,Severe hypoglycemia ,03 medical and health sciences ,0302 clinical medicine ,medicine ,030212 general & internal medicine ,business ,Letter to the Editor - Published
- 2018
14. Cystic Fibrosis Related Diabetes: Potential pitfalls in the transition from paediatric to adult care
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D Jane Holmes-Walker, Shihab Hameed, Paul Robinson, Angela G. Matson, Tamarah Katz, and Peter G. Middleton
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Adult ,Pulmonary and Respiratory Medicine ,American diabetes association ,Transition to Adult Care ,Dieticians ,Pediatrics ,medicine.medical_specialty ,Adolescent ,Cystic Fibrosis ,business.industry ,Incidence (epidemiology) ,Cystic fibrosis-related diabetes ,Adult care ,medicine.disease ,Cystic fibrosis ,Diabetes Complications ,Diabetes mellitus ,Pediatrics, Perinatology and Child Health ,medicine ,Humans ,Major complication ,business - Abstract
One of the major complications of Cystic Fibrosis (CF) is CF-Related Diabetes (CFRD), which increases in incidence with age, from 1-2% below the age of 10 years to ∼20% of adolescents and 40-50% of adults. Multiple guidelines have been published over the last few years for the diagnosis and management of CFRD, from the American Diabetes Association (ADA) / US Cystic Fibrosis Foundation, International Society for Pediatric and Adolescent Diabetes (ISPAD) and the Thoracic Society of Australia and New Zealand-Australian Diabetes Society. However, little is published about the particular issues involved in transition of patients with CFRD from paediatric to adult care, nor the issues concerning the development of CFRD during the transition period. This document seeks to provide assistance to physicians, dieticians, nurses, diabetes educators, CF patients and their families by outlining the issues surrounding CFRD during transition from paediatric to adult care.
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- 2014
15. Long-term effects of islet transplantation
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D Jane Holmes-Walker and Thomas W.H. Kay
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Insulin pump ,medicine.medical_specialty ,Islets of Langerhans Transplantation ,030209 endocrinology & metabolism ,030230 surgery ,Hypoglycemia ,03 medical and health sciences ,0302 clinical medicine ,Immunology and Allergy ,Medicine ,Humans ,Pure autonomic failure ,Intensive care medicine ,Sensitization ,Transplantation ,geography ,geography.geographical_feature_category ,business.industry ,Islet ,medicine.disease ,Term (time) ,medicine.anatomical_structure ,Type i diabetes ,business - Abstract
Islet transplantation has made great progress in recent years. This is a remarkable technical feat but raises the question of what the long-term benefits and risks are for type I diabetes recipients.Graft survival continues to improve, and recent multicenter studies show that islet transplantation is particularly effective to prevent hypoglycemic events even in those who do not become insulin-independent and to achieve excellent glycemic control. Concerns include histocompatability leucocyte antigen (HLA) sensitization and other risks including from immunosuppression that islet transplantation shares with other forms of allotransplantation.Reversal of hypoglycemia unawareness and protection from severe hypoglycemia events are two of the main benefits of islet transplantation and they persist for the duration of graft function. Islet transplantation compares favorably with other therapies for those with hypoglycemia unawareness, although new technologies have not been tested head-to-head with transplantation. HLA sensitization increases with time after transplantation especially if immunosuppression is ceased and is a risk for those who may require future transplantation as well as being associated with loss of graft function.
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- 2016
16. Clinical islet transplantation in type 1 diabetes mellitus: results of Australia's first trial
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D Jane Holmes-Walker, Brian J. Nankivell, Henry Pleass, Stacey N. Walters, Richard D. M. Allen, Anita T. Patel, Philip J. O'Connell, Wayne J. Hawthorne, Jenny E. Gunton, and Jeremy R. Chapman
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Adult ,Blood Glucose ,endocrine system ,medicine.medical_specialty ,Daclizumab ,Time Factors ,endocrine system diseases ,medicine.medical_treatment ,Islets of Langerhans Transplantation ,Antibodies, Monoclonal, Humanized ,Tacrolimus ,Postoperative Complications ,Diabetes mellitus ,medicine ,Humans ,Sirolimus ,Type 1 diabetes ,geography ,geography.geographical_feature_category ,business.industry ,Insulin ,Graft Survival ,Age Factors ,Australia ,Antibodies, Monoclonal ,General Medicine ,Middle Aged ,medicine.disease ,Islet ,Thrombosis ,Hypoglycemia ,Portal vein thrombosis ,Surgery ,Transplantation ,Diabetes Mellitus, Type 1 ,Treatment Outcome ,Immunoglobulin G ,Pancreatic islet transplantation ,business ,Immunosuppressive Agents ,Follow-Up Studies - Abstract
Objective To determine whether pancreatic islet transplantation can control diabetes and prevent severe life-threatening hypoglycaemia. Design, setting and participants A single-arm observation study of six patients undergoing islet transplantation. All patients had had type 1 diabetes mellitus for over 5 years and documented episodes of repeated severe hypoglycaemia. Islets were isolated from donor pancreases digested by Liberase. Separated islets were infused into the recipient's liver via the portal vein. Patients were immunosuppressed with daclizumab, sirolimus and tacrolimus. The transplants were performed at Westmead Hospital, NSW, between October 2002 and February 2005. Main outcome measures Normal blood glucose control without administration of exogenous insulin; demonstration of islet function and abolition of hypoglycaemia. Results Five of the patients received two islet infusions, and the sixth was withdrawn after one infusion following a portal vein thrombosis. Three patients became insulin-independent, with excellent glycaemic control. Two had islet function with circulating C-peptide, improved glycaemic control, reduced insulin requirement and abolition of severe hypoglycaemia. However, over a 2-year period, graft function deteriorated. Recipients who were initially insulin free remained C-peptide positive but required supplemental insulin. Complications included one postoperative bleed, two portal vein thromboses (which resolved completely), presumed recurrence of tuberculosis in one patient, and deterioration in renal function in one patient. Conclusions Islet transplantation is effective at improving glycaemic control and hypoglycaemia unawareness in the short to medium term. However, problems with long-term safety of immunosuppression, islet-induced thrombosis and early detection of loss of islet function remain to be addressed.
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- 2005
17. Congenital Adrenal Hyperplasia Associated with Mania and Serious Violence
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D Jane Holmes-Walker, Kate Steinbeck, Matthew Large, and Olav Nielssen
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Pediatrics ,medicine.medical_specialty ,Injury control ,business.industry ,Human factors and ergonomics ,Poison control ,medicine.disease ,Suicide prevention ,Occupational safety and health ,Injury prevention ,medicine ,Congenital adrenal hyperplasia ,Medical emergency ,medicine.symptom ,business ,Mania ,Biological Psychiatry - Published
- 2011
18. Improved Second Phase Insulin Secretion and Preserved Insulin Sensitivity After Islet Transplantation
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Shireene Ratna Vethakkan, D Jane Holmes-Walker, Alicia J. Jenkins, Jacqueline M. Walters, Raymond C. Boston, Thomas W.H. Kay, David Goodman, Glenn M. Ward, and Judith L. Gooley
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Transplantation ,Glucose tolerance test ,medicine.medical_specialty ,geography ,geography.geographical_feature_category ,medicine.diagnostic_test ,C-peptide ,business.industry ,Insulin ,medicine.medical_treatment ,Islet ,medicine.disease ,Insulin oscillation ,chemistry.chemical_compound ,medicine.anatomical_structure ,Endocrinology ,chemistry ,Internal medicine ,Diabetes mellitus ,medicine ,Pancreas ,business - Published
- 2010
19. Maintaining bone health in patients with prostate cancer
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D Jane Holmes-Walker, David Chipps, Howard Gurney, Henry H. Woo, and V. Do
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Male ,medicine.medical_specialty ,Time Factors ,Bone density ,medicine.medical_treatment ,Osteoporosis ,Urology ,vitamin D deficiency ,Androgen deprivation therapy ,Fractures, Bone ,Prostate cancer ,Sex Factors ,Bone Density ,Risk Factors ,medicine ,Humans ,Prospective Studies ,Vitamin D ,Prospective cohort study ,Exercise ,Aged ,Randomized Controlled Trials as Topic ,Retrospective Studies ,Aged, 80 and over ,Prostatectomy ,Bone mineral ,Diphosphonates ,business.industry ,Age Factors ,Prostatic Neoplasms ,General Medicine ,Middle Aged ,medicine.disease ,Surgery ,Calcium ,business ,Orchiectomy - Abstract
Loss of bone mineral density with androgen deprivation therapy (ADT) for prostate cancer is well recognised, with significant loss of bone mineral density (BMD) occurring within 12 months of starting therapy. With ADT, annual loss of BMD is about 2%-8% per year at the lumbar spine and 1.8%-6.5% at the hip; the loss appears to continue indefinitely while treatment continues, and there is no recovery after therapy is ceased. 19.4% of men surviving at least 5 years after diagnosis of prostate cancer have a fracture if treated with ADT compared with 12.6% of men not receiving ADT; this is equivalent to one additional fracture for every 28 men treated with ADT. Vitamin D deficiency exacerbates the development of osteoporosis, so vitamin D status should be evaluated before commencing ADT in men with prostate cancer. Treatment with bisphosphonates (zoledronate, pamidronate and alendronate) in men treated with ADT have been shown to prevent bone loss in prospective studies and to increase BMD in one randomised controlled trial; bisphosphonates have not been shown to prevent fractures in men with prostate cancer. Further prospective trials are required to assess the efficacy and cost-effectiveness of bisphosphonates in men with prostate cancer who require treatment with ADT. All doctors need to take an active role in monitoring bone health in patients with prostate cancer requiring ADT.
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