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669 results on '"MURPHY, HELEN R."'

9. AiDAPT: automated insulin delivery amongst pregnant women with type 1 diabetes: a multicentre randomized controlled trial – study protocol

Author

Lee, Tara T. M., Collett, Corinne, Man, Mei-See, Hammond, Matt, Shepstone, Lee, Hartnell, Sara, Gurnell, Eleanor, Byrne, Caroline, Scott, Eleanor M., Lindsay, Robert S., Morris, Damian, Brackenridge, Anna, Dover, Anna R., Reynolds, Rebecca M., Hunt, Katharine F., McCance, David R., Barnard-Kelly, Katharine, Rankin, David, Lawton, Julia, Bocchino, Laura E., Sibayan, Judy, Kollman, Craig, Wilinska, Malgorzata E., Hovorka, Roman, and Murphy, Helen R.

Published
2022
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10. An integrated primary care-based programme of PRE-Pregnancy cARE to improve pregnancy outcomes in women with type 2 Diabetes (The PREPARED study): protocol for a multi-method study of implementation, system adaptation and performance

Author

Forde, Rita, Abiola, Olubunmi, Anderson, Janet, Bick, Debra, Brackenridge, Anna, Banerjee, Anita, Chamley, Mark, Chua, Kia-Chong, Hopkins, Lily, Hunt, Katharine, Murphy, Helen R., Rogers, Helen, Romeo, Renee, Shearer, James, Winkley, Kirsty, and Forbes, Angus

Published
2022
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13. Characteristics and outcomes of pregnant women with type 1 or type 2 diabetes: a 5-year national population-based cohort study

Author

Anglioni, Emily, Barron, Emma, Bell, Ruth, Berry, Alex, Cartright, Cher, Colling, Sophie, Curley, Matt, Duggan, Anna, Draper, Liz, Fargher, Laura, Flanagan, Melissa, Hawdon, Jane, Holt, Richard, Kurinczuk, Jenny, Maresh, Mike, Pinnock, Angela, Shonegeval, Lucy, Todd, Di, Tomkins, Nicola, Murphy, Helen R, Howgate, Carla, O'Keefe, Jackie, Myers, Jenny, Morgan, Margery, Coleman, Matthew A, Jolly, Matthew, Valabhji, Jonathan, Scott, Eleanor M, Knighton, Peter, Young, Bob, and Lewis-Barned, Nick

Published
2021
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14. Impact of COVID‐19 on gestational diabetes pregnancy outcomes in the UK: A multicentre retrospective cohort study.

Author

Mclennan, Niamh‐Maire, Lindsay, Robert, Saravanan, Ponnusamy, Sukumar, Nithya, White, Sara L., von Dadelszen, Peter, Burden, Christy, Hunt, Kathryn, George, Priya, Hirst, Jane E., Lattey, Katherine, Lee, Tara T. M., Murphy, Helen R., Scott, Eleanor M., Magee, Laura A., and Reynolds, Rebecca M.

Subjects
GESTATIONAL diabetes, PREGNANCY outcomes, COVID-19 pandemic, COVID-19, COHORT analysis
Abstract

Objective: To determine the impact of implementing emergency care pathway(s) for screening, diagnosing and managing women with gestational diabetes (GDM) during COVID‐19. Design: Retrospective multicentre cohort. Setting: Nine National Health Service (NHS) Hospital Trusts/Health boards in England and Scotland. Population: 4915 women with GDM pre‐pandemic (1 April 2018 to 31 March 2020), and 3467 women with GDM during the pandemic (1 May 2020 to 31 March 2021). Methods: We examined clinical outcomes for women with GDM prior to and during the pandemic following changes in screening methods, diagnostic testing, glucose thresholds and introduction of virtual care for monitoring of antenatal glycaemia. Main Outcome Measures: Intervention at birth, perinatal mortality, large‐for‐gestational‐age infants and neonatal unit admission. Results: The new diagnostic criteria more often identified GDM women who were multiparous, had higher body mass index (BMI) and greater deprivation, and less frequently had previous GDM (all p < 0.05). During COVID, these women had no differences in the key outcome measures. Of the women, 3% were identified with pre‐existing diabetes at antenatal booking. Where OGTT continued during COVID, but virtual care was introduced, outcomes were also similar pre‐ and during the pandemic. Conclusions: Using HbA1c and fasting glucose identified a higher risk GDM population during the pandemic but this had minimal impact on pregnancy outcomes. The high prevalence of undiagnosed pre‐existing diabetes suggests that women with GDM risk factors should be offered HbA1c screening in early pregnancy. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Gestational diabetes: opportunities for improving maternal and child health

Author

Magee, Laura A, Banerjee, Anita, Coleman, Matthew Anthony, Von Dadelszen, Peter, Denison, Fiona, Farmer, Andrew, Finer, Sarah, Fox-Rushby, Julia, Holt, Richard, Lindsay, Robert S, MacKillop, Lucy, Maresh, Michael, McAuliffe, Fionnuala M, McCance, David, McCarthy, Fergus P, Meek, Claire L, Murphy, Helen R, Myers, Jenny, Pasupathy, Dharmintra, Poston, Lucilla, Reynolds, Rebecca M, Saravanan, Ponnusamy, Scott, Eleanor, Sukumar, Nithya, Tan, Bee K, Thangaratinam, Shakila, Webster, Louise, White, Sara Loiuse, and Williamson, Catherine

Published
2020
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20. A Diabetes Pregnancy Technology Roadmap: The 2023 Norbert Freinkel Award Lecture.

Author

Murphy, Helen R.

Subjects
*GESTATIONAL diabetes, *CONTINUOUS glucose monitoring, *TYPE 1 diabetes, *HEALTH care teams, *WEIGHT gain
Abstract

Norbert Freinkel emphasized the need for “more aggressive therapy with exogenous insulin” during type 1 diabetes (T1D) pregnancy. Recent advances in diabetes technology, continuous glucose monitoring (CGM), and hybrid closed-loop (HCL) insulin delivery systems allow us to revisit Freinkel’s observations from a contemporary perspective. The Continuous Glucose Monitoring in Women With Type 1 Diabetes in Pregnancy Trial (CONCEPTT) led to international recommendations that CGM be offered to all pregnant women with T1D to help them meet their pregnancy glucose targets and improve neonatal outcomes. However, despite CGM use, only 35% of trial participants reached the pregnancy glucose targets by 35 weeks’ gestation, which is too late for optimal obstetric and neonatal outcomes. The constant vigilance to CGM data and insulin dose adjustment, with perpetual worry about the impact of hyperglycemia on the developing fetal structures, leave many pregnant women feeling overwhelmed. HCL systems that can adapt to marked gestational changes in insulin sensitivity and pharmacokinetics may help to bridge the gap between the nonpregnant time in range glycemic targets (70–180 mg/dL) and the substantially more stringent pregnancy-specific targets (TIRp) (63–140 mg/dL) required for optimal obstetric and neonatal outcomes. Use of HCL (CamAPS FX system) was associated with a 10.5% higher TIRp, 10.2% less hyperglycemia, and 12.3% higher overnight TIRp. Clinical benefits were accompanied by 3.7 kg (8 lb) less gestational weight gain and consistently achieved across a representative patient population of insulin pump or injection users, across trial sites, and across maternal HbA1c categories. Working collaboratively, women, HCL technology, and health care teams achieved improved glycemia with less worry, less work, and more positive pregnancy experiences. [ABSTRACT FROM AUTHOR]

Published
2024
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21. Automated Insulin Delivery in Women with Pregnancy Complicated by Type 1 Diabetes

Author

Lee, Tara T.M., primary, Collett, Corinne, additional, Bergford, Simon, additional, Hartnell, Sara, additional, Scott, Eleanor M., additional, Lindsay, Robert S., additional, Hunt, Katharine F., additional, McCance, David R., additional, Barnard-Kelly, Katharine, additional, Rankin, David, additional, Lawton, Julia, additional, Reynolds, Rebecca M., additional, Flanagan, Emma, additional, Hammond, Matthew, additional, Shepstone, Lee, additional, Wilinska, Malgorzata E., additional, Sibayan, Judy, additional, Kollman, Craig, additional, Beck, Roy, additional, Hovorka, Roman, additional, and Murphy, Helen R., additional

Published
2023
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24. Rollout of Closed-Loop Technology to Pregnant Women with Type 1 Diabetes: Healthcare Professionals' Views About Potential Challenges and Solutions

Author

Rankin, David, Hart, Ruth, Kimbell, Barbara, Barnard-Kelly, Katharine, Brackenridge, Anna, Byrne, Caroline, Collett, Corinne, Dover, Anna, Hartnell, Sara, Hunt, Katherine F, Lee, Tara, Lindsay, Robert S., McCance, David R, Mckelvey, Alastair, Rayman, Gerry, Reynolds, Rebecca M, Scott, Eleanor M, White, Sara L, Hovorka, Roman, Murphy, Helen R, and Lawton, Julia

Subjects
Medical Laboratory Technology, Endocrinology, Endocrinology, Diabetes and Metabolism
Abstract

Aims: To explore healthcare professionals’ views about the training and support needed to rollout closed-loop technology to pregnant women with type 1 diabetes.Methods: We interviewed (n=19) healthcare professionals who supported pregnant women using CamAPS FX closed-loop during the AiDAPT trial. Data were analysed descriptively. An online workshop involving (n=15) trial team members was used to inform recommendations.Results: Interviewees expressed enthusiasm for a national rollout of closed-loop, but anticipated various challenges, some specific to use during pregnancy. These included variations in insulin pump and continuous glucose monitoring expertise and difficulties embedding and retaining key skills, due to the relatively small numbers of pregnant women using closed-loop. Inexperienced staff also highlighted difficulties interpreting data downloads. To support rollout, interviewees recommended providing expert initial advice training, delivered by device manufacturers together with online training resources and specific checklists for different systems. They also highlighted a need for 24-hour technical support, especially when supporting technology naïve women after first transitioning onto closed-loop in early pregnancy. They further recommended providing case-based meetings and mentorship for inexperienced colleagues, including support interpreting data downloads. Interviewees were optimistic that if healthcare professionals received training and support, their longer-term workloads could be reduced because closed-loop lessened women’s need for glycaemic management input, especially in later pregnancy.Conclusions: Interviewees identified challenges and opportunities to rolling-out closed-loop and provided practical suggestions to upskill inexperienced staff supporting pregnant women using closed-loop. A key priority will be to determine how best to develop mentorship services to support inexperienced staff delivering closed-loop.

Published
2023

25. Consensus Recommendations for the Use of Automated Insulin Delivery Technologies in Clinical Practice

Author

Phillip, Moshe, Nimri, Revital, Bergenstal, Richard M, Barnard-Kelly, Katharine, Danne, Thomas, Hovorka, Roman, Kovatchev, Boris P, Messer, Laurel H, Parkin, Christopher G, Ambler-Osborn, Louise, Amiel, Stephanie A, Bally, Lia, Beck, Roy W, Biester, Sarah, Biester, Torben, Blanchette, Julia E, Bosi, Emanuele, Boughton, Charlotte K, Breton, Marc D, Brown, Sue A, Buckingham, Bruce A, Cai, Albert, Carlson, Anders L, Castle, Jessica R, Choudhary, Pratik, Close, Kelly L, Cobelli, Claudio, Criego, Amy B, Davis, Elizabeth, de Beaufort, Carine, de Bock, Martin I, DeSalvo, Daniel J, DeVries, J Hans, Dovc, Klemen, Doyle, Francis J, Ekhlaspour, Laya, Shvalb, Naama Fisch, Forlenza, Gregory P, Gallen, Geraldine, Garg, Satish K, Gershenoff, Dana C, Gonder-Frederick, Linda A, Haidar, Ahmad, Hartnell, Sara, Heinemann, Lutz, Heller, Simon, Hirsch, Irl B, Hood, Korey K, Isaacs, Diana, Klonoff, David C, Kordonouri, Olga, Kowalski, Aaron, Laffel, Lori, Lawton, Julia, Lal, Rayhan A, Leelarathna, Lalantha, Maahs, David M, Murphy, Helen R, Nørgaard, Kirsten, O'Neal, David, Oser, Sean, Oser, Tamara, Renard, Eric, Riddell, Michael C, Rodbard, David, Russell, Steven J, Schatz, Desmond A, Shah, Viral N, Sherr, Jennifer L, Simonson, Gregg D, Wadwa, R Paul, Ward, Candice, Weinzimer, Stuart A, Wilmot, Emma G, Battelino, Tadej, General Internal Medicine, APH - Health Behaviors & Chronic Diseases, and AGEM - Amsterdam Gastroenterology Endocrinology Metabolism

Subjects
closed-loop, Endocrinology, consensus recommendations, automated insulin delivery, type 1 diabetes, Endocrinology, Diabetes and Metabolism, 610 Medicine & health, 610 Medizin und Gesundheit
Abstract

The significant and growing global prevalence of diabetes continues to challenge people with diabetes (PwD), healthcare providers, and payers. While maintaining near-normal glucose levels has been shown to prevent or delay the progression of the long-term complications of diabetes, a significant proportion of PwD are not attaining their glycemic goals. During the past 6 years, we have seen tremendous advances in automated insulin delivery (AID) technologies. Numerous randomized controlled trials and real-world studies have shown that the use of AID systems is safe and effective in helping PwD achieve their long-term glycemic goals while reducing hypoglycemia risk. Thus, AID systems have recently become an integral part of diabetes management. However, recommendations for using AID systems in clinical settings have been lacking. Such guided recommendations are critical for AID success and acceptance. All clinicians working with PwD need to become familiar with the available systems in order to eliminate disparities in diabetes quality of care. This report provides much-needed guidance for clinicians who are interested in utilizing AIDs and presents a comprehensive listing of the evidence payers should consider when determining eligibility criteria for AID insurance coverage.

Published
2023

26. Healthcare professionals' views about how pregnant women can benefit from using a closed-loop system: Qualitative study

Author

Lawton, Julia, Rankin, David, Hartnell, Sara, Lee, Tara, Dover, Anna R, Reynolds, Rebecca M, Hovorka, Roman, Murphy, Helen R, Hart, Ruth I, AiDAPT Collaborative Group, Lawton, Julia [0000-0002-8016-7374], Rankin, David [0000-0002-5835-3402], Reynolds, Rebecca M [0000-0001-6226-8270], Hovorka, Roman [0000-0003-2901-461X], Murphy, Helen R [0000-0001-6876-8727], Hart, Ruth I [0000-0003-2129-9163], and Apollo - University of Cambridge Repository

Subjects
Blood Glucose, type 1 diabetes, Blood Glucose Self-Monitoring, healthcare professionals, Diabetes Mellitus, Type 1, Insulin Infusion Systems, Pregnancy, technology, Humans, continuous glucose monitoring, Female, Pregnant Women, closed-loop system, Delivery of Health Care, qualitative research
Abstract

Funder: Efficacy and Mechanism Evaluation (EME) Programme; Id: http://dx.doi.org/10.13039/501100001922, Funder: National Institute for Health Research Cambridge Biomedical Research Centre; Id: http://dx.doi.org/10.13039/501100018956, Funder: Juvenile Diabetes Research Foundation International; Id: http://dx.doi.org/10.13039/100000901, BACKGROUND: Interest is growing in how closed-loop systems can support attainment of within-target glucose levels amongst pregnant women with type 1 diabetes. We explored healthcare professionals' views about how, and why, pregnant women benefitted from using the CamAPS FX system during the AiDAPT trial. METHODS: We interviewed 19 healthcare professionals who supported women using closed-loop during the trial. Our analysis focused on identifying descriptive and analytical themes relevant to clinical practice. RESULTS: Healthcare professionals highlighted clinical and quality-of-life benefits to using closed-loop in pregnancy; albeit, they attributed some of these to the continuous glucose monitoring component. They emphasised that the closed-loop was not a panacea and that, to gain maximum benefit, an effective collaboration between themselves, the woman and the closed-loop was needed. Optimal performance of the technology, as they further noted, also required women to interact with the system sufficiently, but not excessively; a requirement that they felt some women had found challenging. Even where healthcare professionals felt that this balance was not achieved, they suggested that women had still benefitted from using the system. Healthcare professionals reported difficulties predicting how specific women would engage with the technology. In light of their trial experiences, healthcare professionals favoured an inclusive approach to closed-loop rollout in routine clinical care. CONCLUSIONS: Healthcare professionals recommended that closed-loop systems be offered to all pregnant women with type 1 diabetes in the future. Presenting closed-loop systems to pregnant women and healthcare teams as one pillar of a three-party collaboration may help promote optimal use.

Published
2023

28. Usual dietary treatment of gestational diabetes mellitus assessed after control diet in randomized controlled trials: subanalysis of a systematic review and meta-analysis

Author

García-Patterson, Apolonia, Balsells, Montserrat, Yamamoto, Jennifer M., Kellett, Joanne E., Solà, Ivan, Gich, Ignasi, van der Beek, Eline M., Hadar, Eran, Castañeda-Gutiérrez, Eurídice, Heinonen, Seppo, Hod, Moshe, Laitinen, Kirsi, Olsen, Sjurdur F., Poston, Lucilla, Rueda, Ricardo, Rust, Petra, van Lieshout, Lilou, Schelkle, Bettina, Murphy, Helen R., and Corcoy, Rosa

Published
2019
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29. Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial

Author

Grisoni, Jeannie, Byrne, Carolyn, Davenport, Katy, Neoh, Sandra, Gougeon, Claire, Oldford, Carolyn, Young, Catherine, Green, Louisa, Rossi, Benedetta, Rogers, Helen, Cleave, Barbara, Strom, Michelle, Adelantado, Juan María, Isabel Chico, Ana, Tundidor, Diana, Malcolm, Janine, Henry, Kathy, Morris, Damian, Rayman, Gerry, Fowler, Duncan, Mitchell, Susan, Rosier, Josephine, Temple, Rosemary, Turner, Jeremy, Canciani, Gioia, Hewapathirana, Niranjala, Piper, Leanne, Kudirka, Anne, Watson, Margaret, Bonomo, Matteo, Pintaudi, Basilio, Bertuzzi, Federico, Daniela, Giuseppina, Mion, Elena, Lowe, Julia, Halperin, Ilana, Rogowsky, Anna, Adib, Sapida, Lindsay, Robert, Carty, David, Crawford, Isobel, Mackenzie, Fiona, McSorley, Therese, Booth, John, McInnes, Natalia, Smith, Ada, Stanton, Irene, Tazzeo, Tracy, Weisnagel, John, Mansell, Peter, Jones, Nia, Babington, Gayna, Spick, Dawn, MacDougall, Malcolm, Chilton, Sharon, Cutts, Terri, Perkins, Michelle, Scott, Eleanor, Endersby, Del, Dover, Anna, Dougherty, Frances, Johnston, Susan, Heller, Simon, Novodorsky, Peter, Hudson, Sue, Nisbet, Chloe, Ransom, Thomas, Coolen, Jill, Baxendale, Darlene, Holt, Richard, Forbes, Jane, Martin, Nicki, Walbridge, Fiona, Dunne, Fidelma, Conway, Sharon, Egan, Aoife, Kirwin, Collette, Maresh, Michael, Kearney, Gretta, Morris, Juliet, Quinn, Susan, Bilous, Rudy, Mukhtar, Rasha, Godbout, Ariane, Daigle, Sylvie, Lubina, Alexandra, Jackson, Margaret, Paul, Emma, Taylor, Julie, Houlden, Robyn, Breen, Adriana, Banerjee, Anita, Brackenridge, Anna, Briley, Annette, Reid, Anna, Singh, Claire, Newstead-Angel, Jill, Baxter, Janet, Philip, Sam, Chlost, Martyna, Murray, Lynne, Castorino, Kristin, Frase, Donna, Lou, Olivia, Pragnell, Marlon, Feig, Denice S, Donovan, Lois E, Corcoy, Rosa, Murphy, Kellie E, Amiel, Stephanie A, Hunt, Katharine F, Asztalos, Elizabeth, Barrett, Jon F R, Sanchez, J Johanna, de Leiva, Alberto, Hod, Moshe, Jovanovic, Lois, Keely, Erin, McManus, Ruth, Hutton, Eileen K, Meek, Claire L, Stewart, Zoe A, Wysocki, Tim, O'Brien, Robert, Ruedy, Katrina, Kollman, Craig, Tomlinson, George, and Murphy, Helen R

Published
2017
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32. Molecular typing of Cyclospora cayetanensis in produce and clinical samples using targeted enrichment of complete mitochondrial genomes and next-generation sequencing

Author

Cinar, Hediye Nese, Gopinath, Gopal, Murphy, Helen R., Almeria, Sonia, Durigan, Mauricio, Choi, Dajung, Jang, AhYoung, Kim, Eunje, Kim, RaeYoung, Choi, Seonju, Lee, Jeongu, Shin, Yurim, Lee, Jieon, Qvarnstrom, Yvonne, Benedict, Theresa K., Bishop, Henry S., and da Silva, Alexandre

Published
2020
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42. Interventions to enhance pre‐pregnancy care for women with type 2 diabetes: A systematic review of the literature.

Author

Hopkins, Lily, Forbes, Angus, Anderson, Janet E., Bick, Debra, Brackenridge, Anna, Banerjee, Anita, Chamley, Mark, Chua, Kia‐Chong, Flynn, Angela C., Hunt, Katherine, Murphy, Helen R., Rogers, Helen, White, Sara L., Winkley, Kirsty, and Forde, Rita

Subjects
ONLINE information services, MEDICAL databases, PREGNANCY, MEDICAL information storage & retrieval systems, SYSTEMATIC reviews, WOMEN, TYPE 2 diabetes, TREATMENT effectiveness, MEDLINE, LONGITUDINAL method
Abstract

Aims: The aim of the study was to examine the content and impact of interventions that have been used to increase the uptake of pre‐pregnancy care for women with type 2 diabetes, and their impact on maternal and fetal outcomes. Methods: A systematic search of multiple databases was conducted in November 2021, and updated July 2022, to identify studies assessing interventions to enhance pre‐pregnancy care for women with type 2 diabetes. Over 10% of articles were screened by two reviewers at title and abstract phase, after which all selected full‐text articles were screened by two reviewers. Quality assessment was conducted using the Critical Appraisal Skills Programme checklist for cohort studies. Meta‐analysis was not possible due to study heterogeneity; therefore, narrative synthesis was conducted. Results: Four eligible cohort studies were identified. The conclusions able to be drawn by this review were limited as women with type 2 diabetes (n = 800) were in the minority in all four studies (35%–40%) and none of the interventions were exclusively tailored for them. The uptake of pre‐pregnancy care was lower in women with type 2 diabetes (8%–10%) compared with other participant groups in the studies. Pregnancy preparation indicators generally improved among all groups exposed to pre‐pregnancy care, with varying impact on pregnancy outcomes. Conclusions: This review demonstrates that previous interventions have had a limited impact on pre‐pregnancy care uptake in women with type 2 diabetes. Future studies should focus on tailored interventions for improving pre‐pregnancy care for women with type 2 diabetes, particularly those from ethnic minorities and living in poorer communities. [ABSTRACT FROM AUTHOR]

Published
2023
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50. Automated Insulin Delivery in Women With Pregnancy Complicated by Type 1 Diabetes

Author

Lee, Tara T.M., Collett, Corinne, Bergford, Simon, Hartnell, Sara, Scott, Eleanor M., Lindsay, Robert S., Hunt, Katharine F., McCance, David R., Barnard-Kelly, Katharine, Rankin, David, Lawton, Julia, Reynolds, Rebecca M., Flanagan, Emma, Hammond, Matthew, Shepstone, Lee, Wilinska, Malgorzata E., Sibayan, Judy, Kollman, Craig, Beck, Roy, Hovorka, Roman, and Murphy, Helen R.

Abstract

(Abstracted from N Engl J Med2023;389:1566–1578Hyperglycemia during pregnancy is an important risk factor for complications, such as preterm birth, large birth weight, and admission to the intensive care unit. Those at highest risk already have glycated hemoglobin above target levels at the start of pregnancy.

Published
2024
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