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1. Ethnic Differences in the Incidence of Lower Extremity Amputation Secondary to Diabetes Mellitus

Author

J.S. Gujral, P.G. McNally, A C Burden, and B.P. O'Malley

Subjects
Adult, Male, medicine.medical_specialty, Asia, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Population, Ethnic group, Ethnic origin, Disease, Amputation, Surgical, White People, Diabetes Complications, Sex Factors, Endocrinology, Internal medicine, Diabetes mellitus, Diabetes Mellitus, Ethnicity, Prevalence, Internal Medicine, medicine, Humans, Child, education, Aged, Leg, education.field_of_study, Foot, business.industry, Incidence, Incidence (epidemiology), Age Factors, Toes, medicine.disease, Surgery, England, Amputation, Female, Complication, business
Abstract

Patients of Asian ethnic origin with diabetes mellitus living in the United Kingdom (UK) have been shown to have a higher prevalence of coronary heart disease and renal disease. Little is known about the incidence of lower extremity amputation in this racial group. The incidence of lower extremity amputation was estimated for patients of Asian ethnic origin and White Caucasians with diabetes mellitus in the county of Leicestershire from 1980 to 1985. The age and sex-adjusted incidence rate of lower extremity amputation for the estimated population of patients with diabetes mellitus in patients of Asian ethnic origin was 3.4 (95% CI, 1.1-10.7) cases per 10,000 patients year-1, compared to 14.2 (12.6-15.9) in White Caucasians. Similarly, a lower incidence rate of lower extremity amputation was recorded in patients of Asian ethnic origin without diabetes mellitus (0.4 (0.2-0.6) vs 1.5 (1.4 to 1.6) cases per 10,000 persons year-1). These findings contrast markedly with the high rates of coronary heart disease and renal disease previously reported in patients of Asian ethnic origin residing in the UK.

Published
1993
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2. Contents, Vol. 59, 1991

Author

Hajime Nakamura, Patrick Netter, Motoyuki Minato, Naoki Fujitsuka, Chris Frampton, Ryoko Ozaki, S. Delprato, P.G. McNally, Richard Sainsbury, Tamar Shkolnik, Joon H. Hong, G. Rostoker, K. Jochmans, Florencio Garcia-Martín, Fernando Saiz, Batia Kristal, A. Davenport, P. Fardellone, Susan R. Nicoll, Nikolaos Sofikitis, J. L. Sebert, Patrick Fener, Vera Delaney, Yasuhiko Tomino, Christina Kanaka, Charles van Ypersele de Strihou, J. R. Elliot, Ornanong Bejraputra, Oskar H. Oetliker, Serge Quérin, C. Jacobs, Karin Sydow, J. Bonal, H. Terzidis, A. Vigil, Hatem Smaoui, Eduardo Martín-Escobar, N. El Esper, Osnat Steinberger, Shyi-Jang Shin, Sacristán Del Castillo, Brigitte Schiller, Takahiko Kawagishi, J. Bonet, Lea-Yea Chuang, Ioannis Alexopoulos, S. Saivin, J. Feehally, Shunichi Shiozawa, Horacio Ajzen, Sumine Onaga, T. Horsburgh, Yumio Kikkawa, F. Roca, R. Molina, Ana Gonzalo, Norishige Yoshikawa, J. van der Meulen, D. Verbeelen, Teruo Kitagawa, Alain Gaucher, George E. Digenis, Louise Charron, Klaus Precht, Prathip Phantumvanit, H.W.L. Ziegler-Heitbwck, L. Guerra, A. Caralps, Kaoru Yoshinaga, Audrey King, Kazuyoshi Okada, Soto Alvarez, Jose Tiburcio M. Neto, Yutaka Kobayashi, D.D. Tran, David Nusam, Dhevy Watana, B. Boneu, Josef Kovarik, B.J. Nankivell, Mitsumine Fukui, J.M. Dubert, Kunihiro Doi, Borràs Sans, Kazunari Iidaka, Keishi Abe, Yuji Nagura, Khalid M.H. Butt, Yasuhisa Okuno, Toshio Kameie, Michiyo Saitoh, Kyoko Ohno, Hidekazu Shigematsu, E.J. Will, Koji Ono, Nigel Wardle, N. Kaminsky, Juei-Hsiung Tsai, Pierre Wallemacq, Lg. Thijs, E. Raz, Miriam Barzilai, Carlos Quereda, A.M. Davison, R. Rodriguez, Fernando Moldenhauer, Peter Pietschmann, Yoshiyuki Hiki, R.V. Heatley, Ross R. Bailey, J. Muñoz-Gomez, Alkis Kostakis, Bärbel Schmidt, Michinobu Hatano, Francisco Mampaso, Madeleine Cheignon, Nicholas Zeferos, Hikaru Koide, J. Walls, M. Llanos, B. Weil, C. Goudable, H. Deramond, Aiju Kameda, T.M. Shallcross, Yoshiki Nishizawa, Wolfgang Henke, G. Deray, Tsutomu Koumi, Vitoon Prasongwattana, A. Fournier, Caroline Borot, Nobuyuki Watanabe, Nabil Sumrani, Mary Christophoraki, Masatoshi Wakui, Jinn-Yuh Guh, José Pedraza-Chaverri, J.M. Suc, Misao Owada, Takao Saruta, Daniel Burnel, P. Lang, Kyoji Kondo, H. Tonthat, Silke Klotzek, Alain Bonnardeaux, G. Lagrue, G. Brillet, Makumkrong Poshyachinda, Wolfgang Woloszczuk, Prasit Futrakul, J. Arnal, Mitsuharu Narita, Piyarat Tosukhowong, Takako Yokozawa, J. G. Turner, J.J.P. Nauta, Yoshihiko Ueda, Joaquín Ortuño, E. Mirapeix, A. Baumelou, Akihiw Iino, Nicolette Meyer, Akihiro Toyokawa, Lea Labin, A. Marie, Ikuo Miyagawa, Gabriel de Arriba, Li Ning Wang, Hikokichi Oura, Zenshiro Inage, Susumu Takahashi, P. Van der Niepen, J.E. Crabtree, Alberto Huberman, J. Sennesael, Mario G. Bianchetti, Pote Sriboonlue, Yutaka Yaguchi, Chawalit Preeyasombati, M. Brezis, Klaus Jung, P. Sie, Rajanee Sensirivatana, Takako Matsuzaki, Akira Osawa, Hirotoshi Morii, P. Gallar, A. Remond, L.O. Simpson, Toru Hyodo, M. Petit-Phar, Jean-Pierre Mallie, Jean Schaeverbeke, Michèle Kessler, Marcos Bosi Ferraz, A.G. Herman, E. Hernández, Aparecido B. Pereira, Visith Sitprija, G. Houin, Helen Gyftaki, Jm. Campistol, Julio Pascual, Frank Martinez, Kazuo Tsunoda, Ricardo Sesso, Ana Pardo, Hajime Inamoto, Spyros Moulopoulos, A.B.J. Groeneveld, Masaki Kobayashi, Alsar Ortiz, Bernd-Detlef Schulze, L. Revert, Tetsuo Shoji, Shaul M. Shasha, Kriang Tungsanga, Ph. Morinière, M. De Waele, Matthias Blumenstein, Andreas Vychytil, Yung-Hsiung Lai, Yves Pirson, A. Oliet, Ehud U. Makov, and Akio Koyama

Subjects
Traditional medicine, business.industry, Medicine, business
Published
1991
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3. Subject Index, Vol. 59, 1991

Author

A. Davenport, P. Fardellone, Richard Sainsbury, L. Revert, Yves Pirson, Carlos Quereda, Ryoko Ozaki, A. Oliet, Charles van Ypersele de Strihou, D.D. Tran, A.G. Herman, Francisco Mampaso, G. Brillet, Shyi-Jang Shin, Yuji Nagura, Alberto Huberman, J. Sennesael, Ikuo Miyagawa, J. Muñoz-Gomez, Shaul M. Shasha, Takao Saruta, Hikaru Koide, Mario G. Bianchetti, J. R. Elliot, N. El Esper, Koji Ono, Julio Pascual, Sacristán Del Castillo, Patrick Netter, Motoyuki Minato, Pote Sriboonlue, Spyros Moulopoulos, A.B.J. Groeneveld, E. Hernández, Aparecido B. Pereira, Yutaka Yaguchi, J. Walls, George E. Digenis, Ana Pardo, Chawalit Preeyasombati, B. Weil, H. Tonthat, Hajime Inamoto, Frank Martinez, Peter Pietschmann, R. Molina, Masaki Kobayashi, Alsar Ortiz, C. Goudable, Patrick Fener, A. Fournier, Ehud U. Makov, J.M. Suc, Ricardo Sesso, J. Bonal, S. Delprato, Kazuo Tsunoda, P.G. McNally, Yoshiki Nishizawa, Borràs Sans, E. Raz, Tamar Shkolnik, Mitsuharu Narita, T.M. Shallcross, J. Bonet, J. Feehally, Alain Gaucher, R. Rodriguez, Ph. Morinière, Visith Sitprija, G. Houin, Fernando Moldenhauer, Jose Tiburcio M. Neto, Helen Gyftaki, Christina Kanaka, K. Jochmans, P. Lang, Fernando Saiz, Michiyo Saitoh, Akio Koyama, L.O. Simpson, Lg. Thijs, G. Rostoker, Joon H. Hong, Florencio Garcia-Martín, Ana Gonzalo, Norishige Yoshikawa, Matthias Blumenstein, Miriam Barzilai, R.V. Heatley, Horacio Ajzen, Ornanong Bejraputra, A. Baumelou, Pierre Wallemacq, Vera Delaney, Yasuhiko Tomino, A. Remond, Soto Alvarez, Yoshiyuki Hiki, Nicolette Meyer, Lea Labin, Serge Quérin, C. Jacobs, Susan R. Nicoll, Mary Christophoraki, Masatoshi Wakui, Yutaka Kobayashi, Dhevy Watana, Silke Klotzek, Andreas Vychytil, Josef Kovarik, Li Ning Wang, Bärbel Schmidt, Michinobu Hatano, Jean Schaeverbeke, Hikokichi Oura, G. Lagrue, J. L. Sebert, J.M. Dubert, Ioannis Alexopoulos, Eduardo Martín-Escobar, Toshio Kameie, Hatem Smaoui, Osnat Steinberger, Misao Owada, Kyoko Ohno, M. Llanos, Aiju Kameda, M. De Waele, Hidekazu Shigematsu, Juei-Hsiung Tsai, S. Saivin, Makumkrong Poshyachinda, Wolfgang Henke, H. Terzidis, Vitoon Prasongwattana, G. Deray, Tsutomu Koumi, Sumine Onaga, Daniel Burnel, Wolfgang Woloszczuk, F. Roca, Michèle Kessler, Rajanee Sensirivatana, Ross R. Bailey, Klaus Precht, N. Kaminsky, Prathip Phantumvanit, Jinn-Yuh Guh, Lea-Yea Chuang, Batia Kristal, Alkis Kostakis, Kyoji Kondo, Akihiro Toyokawa, Nikolaos Sofikitis, Hirotoshi Morii, P. Gallar, Takako Matsuzaki, J. van der Meulen, D. Verbeelen, L. Guerra, Hajime Nakamura, Naoki Fujitsuka, Oskar H. Oetliker, M. Petit-Phar, Jean-Pierre Mallie, Teruo Kitagawa, Chris Frampton, Kaoru Yoshinaga, H. Deramond, J.J.P. Nauta, David Nusam, H.W.L. Ziegler-Heitbwck, Karin Sydow, Brigitte Schiller, B. Boneu, A. Vigil, Caroline Borot, Bernd-Detlef Schulze, Takahiko Kawagishi, Yung-Hsiung Lai, A. Caralps, B.J. Nankivell, Kunihiro Doi, T. Horsburgh, Yumio Kikkawa, Joaquín Ortuño, Louise Charron, Yasuhisa Okuno, Kazunari Iidaka, Tetsuo Shoji, Shunichi Shiozawa, Akira Osawa, Audrey King, Kazuyoshi Okada, Keishi Abe, E. Mirapeix, Khalid M.H. Butt, A. Marie, Zenshiro Inage, E.J. Will, Kriang Tungsanga, J.E. Crabtree, M. Brezis, Mitsumine Fukui, Klaus Jung, P. Sie, Nigel Wardle, Nabil Sumrani, Nobuyuki Watanabe, Piyarat Tosukhowong, Takako Yokozawa, J. G. Turner, Yoshihiko Ueda, José Pedraza-Chaverri, Toru Hyodo, Marcos Bosi Ferraz, Jm. Campistol, Akihiw Iino, Alain Bonnardeaux, Prasit Futrakul, J. Arnal, Gabriel de Arriba, Susumu Takahashi, P. Van der Niepen, A.M. Davison, Madeleine Cheignon, and Nicholas Zeferos

Subjects
Index (economics), business.industry, Statistics, Medicine, Subject (documents), business
Published
1991
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4. Cow's milk and type 1 childhood diabetes: no increase in risk

Author

A C Burden, P.G. McNally, and M.J. Bodington

Subjects
Pediatrics, medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, Childhood diabetes, Endocrinology, Risk Factors, Diabetes mellitus, Surveys and Questionnaires, Internal Medicine, medicine, Odds Ratio, Animals, Humans, Child, Type 1 diabetes, business.industry, Incidence (epidemiology), Infant, Newborn, Odds ratio, medicine.disease, Breast Feeding, Diabetes Mellitus, Type 1, Milk, El Niño, Case-Control Studies, Etiology, Cattle, Female, Infant Food, business, Breast feeding
Abstract

A retrospective case-control study was undertaken to investigate the relationship between the early introduction of cow's milk and the subsequent risk of developing Type 1 diabetes (< 15 years at diagnosis). A total of 268 children who developed diabetes during the period 1980-1990 (11 years inclusive) in Leicestershire were identified. Age-, sex-, and race-matched controls were identified using the Leicestershire population register. Parents of children with diabetes and their controls completed a structured questionnaire on infant feeding habits from birth. A total of 184 questionnaires (67%) were analysed. There was no difference between the diabetic and control children with respect to the introduction of cow's milk at an early age and the risk of developing diabetes (odds ratio: 0.98 (0.65-1.47)). In addition, short duration of breast-feeding (< 3 months) had no influence on the incidence of diabetes (1.05 (0.64-1.75)). This study does not support the hypothesis that the early introduction of cow's milk or a short duration of breast-feeding increases the risk of developing Type 1 diabetes.

Published
1994

5. Childhood-onset diabetes in the white and South Asian population in Leicestershire, UK

Author

A C Burden, P.G. McNally, J. L. Botha, and J. S. Gujral

Subjects
Male, medicine.medical_specialty, Asia, Adolescent, Endocrinology, Diabetes and Metabolism, Population, Prevalence, Mongoloid, White People, Endocrinology, Sex Factors, Diabetes mellitus, Epidemiology, Internal Medicine, medicine, Humans, education, Child, Type 1 diabetes, education.field_of_study, business.industry, Age Factors, Infant, Newborn, Infant, Census, medicine.disease, United Kingdom, Diabetes Mellitus, Type 1, El Niño, England, Child, Preschool, Female, business, Demography
Abstract

The prevalence of childhood-onset Type 1 diabetes mellitus is important for determining health care provisions. In Leicestershire 13.5% of the childhood population (0-14 years) is of South Asian origin (census 1991). This study determined the prevalence of Type 1 diabetes in Whites and South Asians in Leicestershire, using a capture/recapture method to coincide with the 1991 Census day. Children (0-14 years) with Type 1 diabetes were captured from the central diabetic register. The health visitor and consultant records were used to recapture the cases. Total ascertainment of cases was 95-100%. The prevalence of Type 1 diabetes in White children (107 cases) was 0.75/1000 children (95% CI 0.61-0.89) compared with the South Asian prevalence (18 cases) of 0.77/1000 (95% CI 0.41-1.13). The overall prevalence in White males was 0.82/1000 (0.61-1.03) compared with 0.68/1000 (0.48-0.87) in females. In South Asian males it was 0.59/1000 (0.15-1.03) compared with 0.96/1000 (0.39-1.53) in females. The prevalence of Type 1 diabetes in children of South Asian migrants to the United Kingdom cannot be said to be different from White children.

Published
1994

6. Does the prepubertal duration of diabetes influence the onset of microvascular complications?

Author

P.G. McNally, Peter G.F. Swift, Neil T. Raymond, J.R. Hearnshaw, and A.C. Burden

Subjects
Male, medicine.medical_specialty, Pediatrics, Adolescent, Endocrinology, Diabetes and Metabolism, Eye disease, Endocrinology, Risk Factors, Diabetes mellitus, Internal Medicine, medicine, Humans, Risk factor, Age of Onset, Child, Diabetic Retinopathy, business.industry, Microangiopathy, Puberty, Age Factors, Diabetic retinopathy, medicine.disease, Survival Analysis, Surgery, Diabetes Mellitus, Type 1, El Niño, Child, Preschool, Female, business, Complication, Diabetic Angiopathies, Retinopathy
Abstract

This study investigated the relationship between the development of diabetic retinopathy and pubertal status at onset of diabetes in 521 Type 1 diabetic patients diagnosed between 1950 and 1985. Pubertal status was based on age at onset (girls > or = 11 years and boys > or = 12 years). Retinopathy (all forms) developed in 112 patients (21.5%; 65 background and 47 proliferative retinopathy). For subjects diagnosed in either the prepubertal or postpubertal period, a similar proportion survived without developing retinopathy for any given duration of diabetes (chi 2 = 0.3822, p = 0.54). However, if only the postpubertal duration of diabetes is considered, then the proportion of patients surviving without retinopathy was significantly less for those diagnosed in the prepubertal period (chi 2 = 14.2, p = 0.002). This study suggests that the prepubertal duration of diabetes is an important phase and that the years prior to puberty do contribute to the risk of developing microvascular injury.

Published
1993

7. The Prevalence and Risk Factors Associated With the Onset of Diabetic Nephropathy in Juvenile-Onset (Insulin-dependent) Diabetics Diagnosed Under the Age of 17 Years in Leicestershire 1930–1985

Author

P. G. F. Swift, A. C. Burden, J. R. Hearnshaw, J. Walls, and P.G. McNally

Subjects
medicine.medical_specialty, education.field_of_study, Proteinuria, business.industry, Insulin, medicine.medical_treatment, Population, Diastole, General Medicine, medicine.disease, Surgery, Diabetic nephropathy, Blood pressure, Diabetes mellitus, Internal medicine, medicine, Age of onset, medicine.symptom, education, business
Abstract

The prevalence of diabetic nephropathy was studied in a population of 847 juvenile-onset (insulin-dependent) diabetics diagnosed under the age of 17 years who attended diabetic clinics in Leicestershire between 1930 and 1985. Seven hundred and eighty-nine patients (93.2 per cent) were traced. Eight patients with non-diabetic proteinuria and four classified as maturity-onset diabetics of the young were excluded from further analysis. The mean age at onset was 9.3 +/- 4.2 years (mean +/- SD) and the mean duration of diabetes 17.0 +/- 10.6 years (range 3-63 years). Overall, 28 patients (3.6 per cent) developed persistent proteinuria and 39 patients (five per cent) intermittent proteinuria. End-stage renal failure developed in eight patients. In patients with diabetes of 20 years duration (n = 254) the prevalence of persistent proteinuria was 9.1 per cent and of intermittent proteinuria, 7.9 per cent. Systolic and diastolic blood pressures were elevated in diabetics with persistent proteinuria compared to patients without proteinuria (154/89 +/- 27/15 vs 123/76 +/- 15/9 mm Hg mean +/- SD; p less than 0.001). Systolic blood pressure was also raised in patients with intermittent proteinuria (133/77 +/- 17/12, p less than 0.005). In addition, proteinuria (intermittent and persistent) was significantly associated with the use of once-daily insulin therapy in childhood and poor clinic attendance. This study suggests that twice-daily insulin therapy from diagnosis in childhood and regular contact with the diabetic clinic decreased the prevalence of diabetic nephropathy in this population.

Published
1990
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