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14 results on '"Tricia M. Tan"'

1. A glucagon analogue decreases body weight in mice via signalling in the liver

Author

Charlotte E. Hinds, Bryn M. Owen, David C. D. Hope, Philip Pickford, Ben Jones, Tricia M. Tan, James S. Minnion, and Stephen R. Bloom

Subjects
Medicine, Science
Abstract

Abstract Glucagon receptor agonists show promise as components of next generation metabolic syndrome pharmacotherapies. However, the biology of glucagon action is complex, controversial, and likely context dependent. As such, a better understanding of chronic glucagon receptor (GCGR) agonism is essential to identify and mitigate potential clinical side-effects. Herein we present a novel, long-acting glucagon analogue (GCG104) with high receptor-specificity and potent in vivo action. It has allowed us to make two important observations about the biology of sustained GCGR agonism. First, it causes weight loss in mice by direct receptor signalling at the level of the liver. Second, subtle changes in GCG104-sensitivity, possibly due to interindividual variation, may be sufficient to alter its effects on metabolic parameters. Together, these findings confirm the liver as a principal target for glucagon-mediated weight loss and provide new insights into the biology of glucagon analogues.

Published
2021
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2. Partial agonism improves the anti-hyperglycaemic efficacy of an oxyntomodulin-derived GLP-1R/GCGR co-agonist

Author

Phil Pickford, Maria Lucey, Roxana-Maria Rujan, Emma Rose McGlone, Stavroula Bitsi, Fiona B. Ashford, Ivan R. Corrêa, David J. Hodson, Alejandra Tomas, Giuseppe Deganutti, Christopher A. Reynolds, Bryn M. Owen, Tricia M. Tan, James Minnion, Ben Jones, and Stephen R. Bloom

Subjects
GLP-1, Glucagon, Oxyntomodulin, Biased agonism, Partial agonism, β-arrestin, Internal medicine, RC31-1245
Abstract

Objective: Glucagon-like peptide-1 and glucagon receptor (GLP-1R/GCGR) co-agonism can maximise weight loss and improve glycaemic control in type 2 diabetes and obesity. In this study, we investigated the cellular and metabolic effects of modulating the balance between G protein and β-arrestin-2 recruitment at GLP-1R and GCGR using oxyntomodulin (OXM)-derived co-agonists. This strategy has been previously shown to improve the duration of action of GLP-1R mono-agonists by reducing target desensitisation and downregulation. Methods: Dipeptidyl dipeptidase-4 (DPP-4)-resistant OXM analogues were generated and assessed for a variety of cellular readouts. Molecular dynamic simulations were used to gain insights into the molecular interactions involved. In vivo studies were performed in mice to identify the effects on glucose homeostasis and weight loss. Results: Ligand-specific reductions in β-arrestin-2 recruitment were associated with slower GLP-1R internalisation and prolonged glucose-lowering action in vivo. The putative benefits of GCGR agonism were retained, with equivalent weight loss compared to the GLP-1R mono-agonist liraglutide despite a lesser degree of food intake suppression. The compounds tested showed only a minor degree of biased agonism between G protein and β-arrestin-2 recruitment at both receptors and were best classified as partial agonists for the two pathways measured. Conclusions: Diminishing β-arrestin-2 recruitment may be an effective way to increase the therapeutic efficacy of GLP-1R/GCGR co-agonists. These benefits can be achieved by partial rather than biased agonism.

Published
2021
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3. Beyond Weight Loss: Establishing a Postbariatric Surgery Patient Support Group—What Do Patients Want?

Author

Saira Hameed, Victoria Salem, Tricia M. Tan, Alma Collins, Krishna Shah, Samantha Scholtz, Ahmed R. Ahmed, and Harvinder Chahal

Subjects
Internal medicine, RC31-1245
Abstract

Purpose. There are limited resources for long-term specialist follow-up after bariatric surgery. In selected centres, patients can access a postoperative support group, but there is no clear evidence to guide their delivery. Materials and Methods. A retrospective study of bariatric surgery patients (n = 152) who had been discharged from specialist follow-up (mean time since surgery 5.5 years), covering weight history, physical and psychosocial comorbidities, and the need for a postoperative bariatric support group. Results. Fifty-eight percent wanted a postbariatric surgery patient support group. This was not associated with operation type or the amount of weight lost or regained. However, those who wanted a support group were significantly more likely to be struggling to keep the weight off, to be unhappy with the way they look, or to be experiencing difficulties returning to work. Conclusions. These data point to an unmet patient requirement for a postoperative support group that is independent of weight loss success. More research is required to ascertain how such a group should be delivered, but our data would suggest that supporting patients with weight loss maintenance, body image, and return to work is an important part of postoperative care, and these needs extend well beyond the immediate period of specialist follow-up.

Published
2018
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4. Tripeptide gut hormone infusion does not alter food preferences or sweet taste function in volunteers with obesity and prediabetes/diabetes but promotes restraint eating: A secondary analysis of a randomized single‐blind placebo‐controlled study

Author

Preeshila Behary, Haya Alessimii, Alexander D. Miras, George Tharakan, Kleopatra Alexiadou, Madhawi M. Aldhwayan, Sanjay Purkayastha, Krishna Moorthy, Ahmed R. Ahmed, Stephen R. Bloom, Tricia M. Tan, and Medical Research Council (MRC)

Subjects
Volunteers, Sucrose, bariatric surgery, Endocrinology, Diabetes and Metabolism, Gastric Bypass, WEIGHT-LOSS, BRAIN ACTIVITY, GASTRIC BYPASS-SURGERY, weight control, Prediabetic State, Gastrointestinal Hormones, Endocrinology & Metabolism, Food Preferences, Endocrinology, Glucagon-Like Peptide 1, DIETARY-INTAKE, randomized trial, Internal Medicine, Humans, Single-Blind Method, Peptide YY, Obesity, Science & Technology, GLUCAGON-LIKE PEPTIDE-1, 1103 Clinical Sciences, VERTICAL BANDED GASTROPLASTY, HEDONIC HUNGER, MORBIDLY OBESE, GLP-1 RESPONSE, Taste, obesity therapy, antiobesity drug, GLP-1, Life Sciences & Biomedicine
Abstract

Aims To investigate whether the elevation in postprandial concentrations of the gut hormones glucagon-like peptide-1 (GLP-1), oxyntomodulin (OXM) and peptide YY (PYY) accounts for the beneficial changes in food preferences, sweet taste function and eating behaviour after Roux-en-Y gastric bypass (RYGB). Materials and methods This was a secondary analysis of a randomized single-blind study in which we infused GLP-1, OXM, PYY (GOP) or 0.9% saline subcutaneously for 4 weeks in 24 subjects with obesity and prediabetes/diabetes, to replicate their peak postprandial concentrations, as measured at 1 month in a matched RYGB cohort (ClinicalTrials.gov NCT01945840). A 4-day food diary and validated eating behaviour questionnaires were completed. Sweet taste detection was measured using the method of constant stimuli. Correct sucrose identification (corrected hit rates) was recorded, and sweet taste detection thresholds (EC50s: half maximum effective concencration values) were derived from concentration curves. The intensity and consummatory reward value of sweet taste were assessed using the generalized Labelled Magnitude Scale. Results Mean daily energy intake was reduced by 27% with GOP but no significant changes in food preferences were observed, whereas a reduction in fat and increase in protein intake were seen post-RYGB. There was no change in corrected hit rates or detection thresholds for sucrose detection following GOP infusion. Additionally, GOP did not alter the intensity or consummatory reward value of sweet taste. A significant reduction in restraint eating, comparable to the RYGB group was observed with GOP. Conclusion The elevation in plasma GOP concentrations after RYGB is unlikely to mediate changes in food preferences and sweet taste function after surgery but may promote restraint eating.

Published
2023

5. The effects of kisspeptin on food intake in women with overweight or obesity

Author

Chioma Izzi‐Engbeaya, Muhammad M. Choudhury, Bijal Patel, Beatrice Muzi, Ambreen Qayuum, Edouard G. Mills, Maheen Ahsan, Maria Phylactou, Sophie A. Clarke, Laura Aslett, Alexander N. Comninos, Ali Abbara, Tricia M. Tan, and Waljit S. Dhillo

Subjects
Endocrinology, Endocrinology, Diabetes and Metabolism, Internal Medicine
Published
2023

6. The benefit of dexamethasone in patients with <scp>COVID</scp> ‐19 infection is preserved in patients with diabetes

Author

Pei Chia Eng, Walter Distaso, Hashmi Durreshahwar, Yusuf Shaikhali, Divani Narendranathan, Rebecca Cassin‐Scott, Shivani Misra, Neil E. Hill, George Tharakan, Nick S. Oliver, Tricia M. Tan, Chioma Izzi‐Engbeaya, Victoria Salem, and Imperial College Healthcare NHS Trust- BRC Funding

Subjects
Science & Technology, diabetes, SARS-CoV-2, Endocrinology, Diabetes and Metabolism, COVID-19, 1103 Clinical Sciences, mortality, Dexamethasone, COVID-19 Drug Treatment, Endocrinology & Metabolism, Endocrinology, Diabetes Mellitus, Internal Medicine, Humans, Life Sciences & Biomedicine
Abstract

Dexamethasone significantly reduces mortality1 and is now standard treatment for patients with COVID-19 who require supplemental oxygen and/or mechanical ventilation. However, supraphysiological doses of glucocorticoids may exacerbate dysglycaemia and precipitate hyperglycaemic complications, particularly in those with or at risk of Type 2 diabetes2. The RECOVERY trial1 reported a low incidence of hyperglycaemic complications (2/1996, 0.1%), although the real-world incidence is likely to be much higher3. Type 2 diabetes itself increases the risk of severe COVID-194, and hyperglycaemia independently predicts poor outcomes5. We investigated the possibility that patients with diabetes may derive less survival benefit from steroid therapy in the setting of severe COVID-19 infection

Published
2022

7. Author response for 'Tripeptide gut hormone infusion does not alter food preferences or sweet taste function in volunteers with obesity and pre‐diabetes/diabetes but promotes restraint eating: A secondary analysis of a randomised single‐blind placebo‐controlled study'

Author

null Preeshila Behary, null Haya Alessmii, null Alexander D Miras, null George Tharakan, null Kleopatra Alexiadou, null Madhawi M. Aldhwayan, null Sanjay Purkayastha, null Krishna Moorthy, null Ahmed R Ahmed, null Stephen R Bloom FRS, and null Tricia M Tan

Published
2023

9. 362-OR: The Role of Intraislet Glucagon in Pulsatile Insulin Secretion

Author

KINGA SUBA, YATEEN S. PATEL, ANNA ROBERTS, JED V. SHREWSBURY, SHIQIAN CHEN, RACHEL KWOK, VASILIKI KALOGIANNI, XIAOXUAN LIU, GUY A. RUTTER, BEN JONES, TRICIA M. TAN, BRYN OWEN, DANIEL J. DRUCKER, STEPHEN BLOOM, KEVIN MURPHY, and VICTORIA SALEM

Subjects
Endocrinology, Diabetes and Metabolism, Internal Medicine
Abstract

Background: Type 2 diabetes (T2D) is characterised by the loss of pulsatile insulin secretion. We studied mice with β-cell specific loss of the glucagon receptor (GCGRflox/flox X Ins-1 cre) , to investigate the role of intra-islet glucagon signalling on pan-islet calcium oscillations and islet pulsatility. Methods: Frequently sampled intravenous glucose tolerance tests were conducted on GCGRKOβ-cells-/-and littermate controls. Crossing with GCaMP6f (STOP flox) animals allowed for β-cell specific expression of a fluorescent calcium indicator. These islets were functionally imaged in vitro and in vivo. Wild-type mice were transplanted with islets expressing GCaMP6f in β-cells into the anterior eye chamber and placed on a high fat diet. Half of the cohort received a glucagon analogue (GCG-analogue) for 40 days and the control group were fed to achieve weight matching. Calcium imaging was performed regularly during the development of hyperglycaemia and in response to GCG-analogue treatment. Results: GCGRKOβ-cells-/- mice had poorer glucose tolerance in an intraperitoneal glucose tolerance test (control 12.7mmol/L ±0.6 vs. GCGRKOβ-cells-/- 15.4mmol/L ±0.0 at 15 min, p=0.002) ; fasting glycaemia was not different to controls. In vitro, GCGRKOβ-cells-/- islets showed profound loss of synchronised calcium waves in response to glucose which is only partially rescued in vivo. First-phase insulin pulsatility on peripheral blood sampling (n=5) was significantly disordered in GCGRKOβ-cells-/- mice (burst mass GCGRKOβ-cells-/- 0.30 ±0.03 versus 0.84 ±0.23 for controls p=0.04) . Diet induced obesity and hyperglycaemia resulted in a loss of co-ordinated calcium waves in transplanted islets. This was reversed with GCG-analogue treatment, independently of weight-loss (n=8) . Conclusion: These data provide novel evidence for the role of intra-islet glucagon in sustaining synchronised calcium oscillations and support a possible therapeutic role for glucagonergic agents to restore the insulin pulsatility lost in T2D. Disclosure K.Suba: n/a. B.Jones: None. T.M.Tan: Consultant; Zihipp Ltd. B.Owen: None. D.J.Drucker: Consultant; Kallyope, Merck Sharp & Dohme Corp., Novo Nordisk, Pfizer Inc., Other Relationship; Eli Lilly and Company. S.Bloom: None. K.Murphy: None. V.Salem: None. Y.S.Patel: Employee; PerkinElmer. A.Roberts: None. J.V.Shrewsbury: None. S.Chen: None. R.Kwok: None. V.Kalogianni: None. X.Liu: None. G.A.Rutter: Advisory Panel; Sun Pharmaceutical Industries Ltd., Research Support; Sun Pharmaceutical Industries Ltd.

Published
2022

10. The acute effect of glucagon on components of energy balance and glucose homoeostasis in adults without diabetes: a systematic review and meta-analysis

Author

James Frampton, Chioma Izzi-Engbeaya, Victoria Salem, Kevin G. Murphy, Tricia M. Tan, and Edward S. Chambers

Subjects
Adult, Nutrition and Dietetics, Glucose, Endocrinology, Diabetes and Metabolism, Diabetes Mellitus, Medicine (miscellaneous), Humans, Insulin, Homeostasis, Glucagon, Energy Metabolism, Randomized Controlled Trials as Topic
Abstract

Objective Using a systematic review and meta-analysis, we aimed to estimate the mean effect of acute glucagon administration on components of energy balance and glucose homoeostasis in adults without diabetes. Methods CENTRAL, CINAHL, Embase, MEDLINE, PubMed, and Scopus databases were searched from inception to May 2021. To be included, papers had to be a randomised, crossover, single- or double-blind study, measuring ad libitum meal energy intake, energy expenditure, subjective appetite, glucose, and/or insulin following acute administration of glucagon and an appropriate comparator in adults without diabetes. Risk of bias was assessed using the Revised Cochrane Risk of Bias Tool for Randomized trials with additional considerations for cross-over trials. Certainty of evidence was assessed using the GRADE approach. Random-effect meta-analyses were performed for outcomes with at least five studies. This study is registered on PROSPERO (CRD42021269623). Results In total, 13 papers (15 studies) were considered eligible: energy intake (5 studies, 77 participants); energy expenditure (5 studies, 59 participants); subjective appetite (3 studies, 39 participants); glucose (13 studies, 159 participants); insulin (12 studies, 147 participants). All studies had some concerns with regards to risk of bias. Mean intervention effect of acute glucagon administration on energy intake was small (standardised mean difference [SMD]: –0.19; 95% CI, –0.59 to 0.21; P = 0.345). Mean intervention effect of acute glucagon administration on energy expenditure (SMD: 0.72; 95% CI, 0.37–1.08; P P P Conclusions Acute glucagon administration produces substantial increases in energy expenditure, and in circulating insulin and glucose concentrations. However, the effect of acute glucagon administration on energy intake is unclear. Insufficient evidence was available to evaluate the acute effect of glucagon on subjective appetite.

Published
2022

12. Beyond Weight Loss: Establishing a Postbariatric Surgery Patient Support Group-What Do Patients Want?

Author

Saira, Hameed, Victoria, Salem, Tricia M, Tan, Alma, Collins, Krishna, Shah, Samantha, Scholtz, Ahmed R, Ahmed, and Harvinder, Chahal

Subjects
Adult, Male, Bariatric Surgery, Patient Preference, Middle Aged, Obesity, Morbid, Self-Help Groups, Surveys and Questionnaires, Weight Loss, Humans, Female, Needs Assessment, Aged, Retrospective Studies, Research Article
Abstract

Purpose There are limited resources for long-term specialist follow-up after bariatric surgery. In selected centres, patients can access a postoperative support group, but there is no clear evidence to guide their delivery. Materials and Methods A retrospective study of bariatric surgery patients (n = 152) who had been discharged from specialist follow-up (mean time since surgery 5.5 years), covering weight history, physical and psychosocial comorbidities, and the need for a postoperative bariatric support group. Results Fifty-eight percent wanted a postbariatric surgery patient support group. This was not associated with operation type or the amount of weight lost or regained. However, those who wanted a support group were significantly more likely to be struggling to keep the weight off, to be unhappy with the way they look, or to be experiencing difficulties returning to work. Conclusions These data point to an unmet patient requirement for a postoperative support group that is independent of weight loss success. More research is required to ascertain how such a group should be delivered, but our data would suggest that supporting patients with weight loss maintenance, body image, and return to work is an important part of postoperative care, and these needs extend well beyond the immediate period of specialist follow-up.

Published
2017

13. Contributors

Author

Reidunn B. Aalen, Yasser H.A. Abdel-Wahab, Michael E. Adams, Roger A.H. Adan, Rexford S. Ahima, Naima Ahmed, Omar Al-Massadi, Miriam Altstein, Youssef Anouar, Laura Anselmi, Siegfried Ansorge, Nikolinka Antcheva, Yevgeniya Antonova-Koch, Jon R. Appel, Anam J. Arik, Alison L. Arter, Peter Arvan, Avraham Ashkenazi, P.W. Baas, André Bado, Andrew Baird, Monica Baiula, Lauren O. Bakaletz, Earl E. Bakken, Márta Balaskó, Graham S. Baldwin, William A. Banks, Donatella Barra, Jessica R. Barson, Magali Basille, Natalie N. Bauer, Andrea Bedini, Christine Beeton, David J. Begley, Margery C. Beinfeld, William G. Bendena, Stephen C. Benoit, Itay Bentov, Howard Bern, Gabriele Bierbaum, Charles J. Billington, Anna Blasiak, Norman L. Block, Stephen. R. Bloom, Iwona Bonney, John H. Bowie, Sunny K. Boyd, Susan D. Brain, Dag A. Brede, Jozef Vanden Broeck, Kelly L. Brown, Mark R. Brown, James M. Bugni, Jens R. Bundgaard, Delphine Burel, Melinka A. Butenko, Melissa J. Call, Girolamo Calò, Duncan John Campbell, Anna Carlsson, Daniel B. Carr, Robert E. Carraway, Marcos C. Carreira, Felipe F. Casanueva, Sarah N. Cassella, Stuart A. Casson, Justo P. Castaño, Marek Cebrat, Valerie Chappe, David Chatenet, Keqiang Chen, Chen Chen, Longchuan Chen, Duan Chen, Carrie Y.Y. Cheng, Sung Ki Cho, Billy K.C. Chow, Arthur Christopoulos, Shijian Chu, Iain J. Clarke, Geoffrey M. Coast, Vincent Compere, Gisela P. Concepcion, Roger D. Cone, J. Michael Conlon, Germaine Cornélissen, Maité Courel, Réjean Couture, W.A. Cramer, Nathan P. Croft, Ana B. Crujeiras, Frank Cuttitta, Holger Cynis, F. D’Acquisto, Jon F. Davis, Thomas P. Davis, Claire Barbier de La Serre, Guillaume de Lartigue, Luis de Lecea, Marcelo de Oliveira Santos, Michel De Waard, Carolyn F. Deacon Bolette Hartmann, Charlène Delestre, Mario Delgado, Hans-Ulrich Demuth, Xiaoming Deng, Palitha Dharmawardhana, Anna Di Cosmo, Simoni Campos Dias, Jonathan W. Dickerson, Dzung B. Diep, H. Dircksen, Jasmin Dischinger, Jean-Claude do Rego, Paul R. Dobner, Graham J. Dockray, Robert M. Dores, Robert Ducroc, Nadine L. Dudek, Yvan Dumont, Celine Duraffourd, Dominique Duterte-Boucher, Alex N. Eberlé, Richard D. Egleton, Betty A. Eipper, Jorg B. Engel, Ella W. Englander, Jacques Epelbaum, Charlotte Erlanson-Albertsson, S. Evangelista, Karen A. Fagan, Joshua M. Farber, Klára Farkasfalvi, Csaba Fekete, Peter R. Flatt, R.J. Flower, Wolf-Georg Forssmann, Alain Fournier, Kevin Chu Foy, Octávio Luiz Franco, Dan Frenkel, Lloyd D. Fricker, César de la Fuente-Núñez, Hiroo Fukuda, Gerd Gäde, Ludovic Galas, Patricia E. Gallagher, Pierrick Gandolfo, Maria A. Garcia-Espinosa, Josune García-Sanmartín, Nori Geary, Hua Geng, Patrizia M. Germano, Jens P. Goetze, Alexis A. Gonzalez, Ana Gonzalez, Blake A. Gosnell, Katsutoshi Goto, Guillaume Gourcerol, I. Gozes, Francisco Gracia-Navarro, Bernadette E. Grayson, George H. Greeley, Megan Greenwald-Yarnell, Pierre Gressens, John R. Grider, Jan Grünewald, Juliano R. Guerreiro, Remo Guerrini, Filomena Guida, Laure Guilhaudis, Sandra Guilmeau, Andrew L. Gundlach, Jolanta Gutkowska, Clifton Hackbarth, Y. Haim Ohana, Franz Halberg, Mathias Hallberg, Sayyed A. Hamidi, Song Han, Ji-Sheng Han, Robert E.W. Hancock, Samer-ul Haque, Ikuko Hara-Nishimura, Aliza Hariton, Wendy J. Hartsock, Alan L. Harvey, Itaru Hasunuma, Robert J. Henning, Kristy M. Heppner, Kate L. Hertweck, Herbert Herzog, Tetsuya Higashiyama, Shuji Hinuma, Stefan Hippenstiel, Yuki Hirakawa, Shuichi Hirose, Jochen R. Hirsch, Andreas C. Hocke, Robert S. Hodges, Werner Hoffmann, Tomas Hökfelt, Jens Juul Holst, Peter Holzer, Frank M. Horodyski, Hiroshi Hosoda, Xiaowen Hou, Alisa Huffaker, Norio Iijima, Momoko Ikeuchi, Julita S. Imperial, Giovanna Improta, Akio Inui, Nigel Irwin, Munehiro Ishii, Xavier Iturrioz, Ljubica Ivanisevic, Hiroshi Iwao, Takeo Iwata, Yasukatsu Izumi, Hajime Izumiyama, Marek Jankowski, Tom Janssen, Sylvie Jégou, Robert T. Jensen, Preeti H. Jethwa, Helene Johannessen, Conrad Johanson, Valeria Judkowski, Przemyslaw Kaczmarek, Haruaki Kageyama, Tatsuo Kakimoto, Ki Sung Kang, Kenji Kangawa, Abba J. Kastin, Johji Kato, Pravin T.P. Kaumaya, Richard F. Keep, William R. Kem, Tetyana Khomenko, Sakae Kikuyama, Young-Joon Kim, Sadao Kimura, Ross King, Paul Kiptoo, Ichiro Kishimoto, Kazuo Kitamura, Alicja Kluczyk, Hiroyuki Kobori, Yosuke Kodama, Masayasu Kojima, Yuki Kondo, Meike Körner, Piotr Kosson, Catherine M. Kotz, Bhavani Krishnan, Bård Kulseng, Robert Kumpf, Marc Laburthe, Hélène Lacaille, Ellen E. Ladenheim, Ali Ladram, Marlyn D. Laksitorini, David G. Lambert, Angela B. Lange, Wolfgang Langhans, Muriel Larauche, Dan Larhammar, Ignacio M. Larráyoz, Roberta Lattanzi, Ronald M. Lechan, Benjamin Lefranc, Sarah F. Leibowitz, Vincent Lelièvre, Jérôme Leprince, Allen S. Levine, Qun Li, Veronica Lifshitz, Isabelle Lihrmann, James Chi-Jen Lin, Iris Lindberg, Keith Lindsey, Andrzej W. Lipkowski, T. Liron, Junli Liu, Ying Liu, Min Liu, Catherine Llorens-Cortes, Marilena Loizidou, C. Lopez, David A. Lovejoy, Vincenzo Luca, Thomas A. Lutz, Sherie Ma, Richard E. Mains, Maria M. Malagon, Ludwik K. Malendowicz, Jennifer Man-Fan Wan, Maria Luisa Mangoni, Michaele B Manigrasso, Mohamed A. Marahiel, Heather G. Marco, Christine Maric-Bilkan, Nikki J. Marks, Roland Martin, Vicente Martinez, Alfredo Martínez, Antonio J. Martinez-Fuentes, Edward P. Masler, Yoshikatsu Matsubayashi, Harman S. Mattu, Aaron G. Maule, Patricia J. McLaughlin, Ivan F. McMurtry, Ellen Meelkop, Saher Mehdi, Pietro Melchiorri, R.P. Millar, Laurence J. Miller, Miles Miller, Mulugeta Million, Naoto Minamino, M. Mittelman, Takashi Miyauchi, Mikiya Miyazato, Hirokazu Mizoguchi, Malte Mohme, Maité Montero-Hadjadje, Terry W. Moody, Neeloffer Mookherjee, Timothy H. Moran, Irene Morganstern, Masatomo Mori, Fabrice Morin, John F. Morris, Daniel S. Moura, Anna J. Mudge, Joram D. Mul, Karnam S. Murthy, Martin G. Myers, Ronald J. Nachman, Jean-Louis Nahon, Sushma Naithani, Tomoaki Nakada, Tomoya Nakamachi, Yuki Nakamura, Natalia N. Nalivaeva, June B. Nasrallah, Dick R. Nässel, L. Gabriel Navar, Pratap Neelakantan, Lucia Negri, Ingolf F. Nes, D. Neumann, Cindy Neveu, Tzi Bun Ng, Stephanie Y.L. Ng, Graham M. Nicholson, Pierre Nicolas, Toshio Nishikimi, Mariko Nishiyama, Rubén Nogueiras, Raymond S. Norton, Laura A. Novotny, Krzysztof W. Nowak, Fred Nyberg, Laura Ochoa-Callejero, Sven Ove Ögren, Hideko Ohgusu, Shinsuke Oh-I, Opeolu O. Ojo, Baldomero M. Olivera, Francisco E. Olucha-Bordonau, Joost J. Oppenheim, Ian Orchard, André J. Ouellette, Gustavo Pacheco-López, Nigel M. Page, Mario Sergio Palma, Weihong Pan, Yoonseong Park, Marc Parmentier, Sandrine Passemard, Michael Patterson, Brankica Paunovic, Gregory Pearce, Jens Pedersen, Theo L. Peeters, A. Eugene Pekary, Georges Pelletier, Simona Perboni, Diego Pérez-Tilve, Ábel Perjés, M. Perretti, Erika Pétervári, Clemencia Pinilla, Jacek Pinskim, Joseph R. Pisegna, Kristof Plankensteiner, Sonia Podvin, Pierre Poitras, Gianluca Polese, David M. Pollock, William Farias Porto, Lourival D. Possani, Charalabos Pothoulakis, Françoise Presse, Minolfa C. Prieto, S. Prutchi-Sagiv, Anthony W. Purcell, Louise Purtell, Rémi Quirion, Catalina Abad Rabat, Miriam Rademaker, Gautam Rajpal, Harpal S. Randeva, Sylvie Rebuffat, Joseph R. Reeve, Jens F. Rehfeld, Dirk Reinhold, Rainer K. Reinscheid, Jean Claude Reubi, Katayoun Rezvani, Suzana Meira Ribeiro, D. Richard, Mark Richards, Michael A. Riehle, Andrea C. Rinaldi, Bernd M. Rode, Ricardo C. Rodríguez de la Vega, Susan Rotzinger, Marcin Rucinski, Heikki Ruskoaho, Philip J. Ryan, Jean-Marc Sabatier, Hans-Georg Sahl, Sami I. Said, Tsukasa Sakurada, Shinobu Sakurada, David S. Salomon, Willis K. Samson, Zsuzsanna Sandor, H. Uri Saragovi, Kazuki Sasaki, Takahiro Sato, Ryousuke Satou, Shinichiro Sawa, Ayman I. Sayegh, Andrew V. Schally, Stephan Schilling, Liliane Schoofs, David A. Schooley, Mitchell L. Schubert, Isabelle Segalas-Milazzo, Nabil G. Seidah, Michael E. Selsted, Kim B. Seroogy, Cinzia Severini, Patrick M. Sexton, Yechiel Shai, O. Sharma, Masayoshi Shichiri, Tomoo Shimada, Hiroyuki Shimizu, Seiji Shioda, Arthur Shulkes, Teruna J. Siahaan, Ignacy Z. Siemion, Osmar Nascimento Silva, Marcio C. Silva-Filho, Mariusz Skwarczynski, Caroline. J. Small, Craig M. Smith, David E. Smith, A. Ian Smith, Beka Solomon, Travis E. Solomon, Mireia Sospedra, M.C. Souroujon, Santi Spampinato, Eliot R. Spindel, A. Steiger, Andreas Stengel, Catia Sternini, Frederik J. Steyn, Edward Stopa, Mathias Z. Strowski, Shigeo S. Sugano, Görel Sundström, J. Gregor Sutcliffe, Norbert Suttorp, Jonathan V. Sweedler, Sandor Szabo, Miklós Székely, István Szokodi, Yvette Taché, Kazuhiro Takahashi, Yoshio Takei, Fumiko Takenoya, Sébastien Talbot, E. Ann Tallant, Tricia M. Tan, Liesbet Temmerman, Bettina Temmesfeld-Wollbrück, Manuel Tena-Sempere, Annika Thorsell, Nanda Tilakaratne, Stephen S. Tobe, Takeshi Tokudome, Ganna Tolstanova, Marie-Christine Tonon, Jennifer F. Topping, Alessandro Tossi, Hervé Tostivint, Istvan Toth, Kazuhito Totsune, Fumiyo Toyoda, Rachel Troke, Matthias H. Tschöp, Patrick Tso, Hirokazu Tsukaya, Kazuyoshi Tsutsui, Hong Tu, Anthony J. Turner, Takayoshi Ubuka, Elene R. Valdivia, Hans Peter Vandersmissen, David Vaudry, Hubert Vaudry, Rafael Vazquez-Martinez, Joseph G. Verbalis, Daniele Vicari, Nicolas Vidal, Marzia Vignoni, Cécile Viollet, K.S. Vishwanatha, Mirella Vivoli, Thierry Voisin, John P. Vu, John C. Walker, B.A. Wallace, Ji Ming Wang, Lixin Wang, Jonathan H. Wardman, Takuya Watanabe, Hazel Welch, Haim Werner, L. Whitmore, Imke Wiedemann, Raphaelle Winsky-Sommerer, Ken A. Witt, Tatiana Wojciechowicz, Jack Ho Wong, Stephen C. Woods, Denise Wootten, Vincent Wu, Olivier Wurtz, Ximing Xiong, Zhi-Qing David Xu, Yube Yamaguchi, Takahiro Yamaguchi, Kazutoshi Yamamoto, E. Yamashita, Hiroyuki Yamazaki, De Yang, Masaaki Yoshikawa, Pu-Qing Yuan, Sunny C. Yung, Ian S. Zagon, S.D. Zakharov, Mehfuz Zaman, M.V. Zhalnina, Ning Zhang, Lixin Zhang-Auberson, Chun-Mei Zhao, Agnieszka Ziolkowska, and Dusan Zitnan

Published
2013

14. Adverse outcomes in COVID-19 and diabetes: a retrospective cohort study from three London teaching hospitals

Author

Neil E Hill, Nick S Oliver, Wei Yang, Christine Shi, Chioma Izzi-Engbeaya, Walter Distaso, Anjali Amin, Oluwagbemiga Idowu, Julia S Kenkre, Ronak J Shah, Evelina Woin, Nael Alavi, Hala Bedri, Niamh Brady, Sophie Blackburn, Martina Leczycka, Sanya Patel, Elizaveta Sokol, Edward Toke-Bjolgerud, Ambreen Qayum, Mariana Abdel-Malek, David C D Hope, Vasiliki Bravis, Tricia M Tan, and Victoria Salem

Subjects
Diseases of the endocrine glands. Clinical endocrinology, RC648-665
Abstract

Introduction Patients with diabetes mellitus admitted to hospital with COVID-19 have poorer outcomes. However, the drivers of poorer outcomes are not fully elucidated. We performed detailed characterization of patients with COVID-19 to determine the clinical and biochemical factors that may be drivers of poorer outcomes.Research design and methods This is a retrospective cohort study of 889 consecutive inpatients diagnosed with COVID-19 between March 9 and April 22, 2020 in a large London National Health Service Trust. Unbiased multivariate logistic regression analysis was performed to determine variables that were independently and significantly associated with increased risk of death and/or intensive care unit (ICU) admission within 30 days of COVID-19 diagnosis.Results 62% of patients in our cohort were of non-white ethnic background and the prevalence of diabetes was 38%. 323 (36%) patients met the primary outcome of death/admission to the ICU within 30 days of COVID-19 diagnosis. Male gender, lower platelet count, advancing age and higher Clinical Frailty Scale (CFS) score (but not diabetes) independently predicted poor outcomes on multivariate analysis. Antiplatelet medication was associated with a lower risk of death/ICU admission. Factors that were significantly and independently associated with poorer outcomes in patients with diabetes were coexisting ischemic heart disease, increasing age and lower platelet count.Conclusions In this large study of a diverse patient population, comorbidity (ie, diabetes with ischemic heart disease; increasing CFS score in older patients) was a major determinant of poor outcomes with COVID-19. Antiplatelet medication should be evaluated in randomized clinical trials among high-risk patient groups.

Published
2021
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