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Biomedical subjects

A C Burden

Publications and source records attributed to A C Burden.

At least 73 records · Page 4Linked to original sources
PubMed1989

Glucose tolerance during pregnancy in Asian women.

The present study was aimed at examining differences in gestational diabetes mellitus (GDM) between two ethnic populations (immigrant Asians and indigenous White Caucasians) residing in Leicester, U.K. The study was divided into two parts: to determine the prevalence of GDM and to determine the level at which glycaemia may impose a risk to the mother and the foetus. Of a total of 12,005 pregnancies (4561 Asian and 7444 White Caucasian), over a 3-year period, 314 (6.8%) Asian and 504 (6.7%) White Caucasian were given a 75-g oral glucose tolerance test (OGTT) at 28-32 weeks for indications of 'large for date' pregnancies, hydramnios, glycosuria, a history of previous abortions, stillbirths, congenital abnormalities or glucose intolerance, and family history of diabetes. Abnormal glucose tolerance (AGT) was taken as a 2-h venous plasma glucose greater than or equal to 7.8 mmol/l which reverted to normal when formally tested during the puerperium (WHO criteria, 1985). AGT was found in 1.38% Asian and 0.87% White Caucasian pregnancies (P less than 0.01). This was further divided into impaired glucose tolerance (IGT) (2-h value 7.8-11.1 mmol/l) and gestational diabetes mellitus (GDM) (2-h value greater than or equal to 11.1 mmol/l). IGT was found in 1.2% Asian and 0.84% White Caucasian pregnancies (P less than 0.01), and GDM in 0.18% and 0.02% respectively (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Diabetes mellitus as a risk factor for acute myocardial infarction in Asians and Europeans.

Ischaemic heart disease is commoner among immigrants from the Indian subcontinent than among Europeans in the United Kingdom. The excess cannot be accounted for by differences in smoking, blood pressure, or lipid concentrations. There is, however, an increased prevalence of diabetes mellitus in the Asian population. Separate estimates of the relative risk of acute myocardial infarction associated with diabetes from parallel case-control studies were made to compare the importance of diabetes as a risk factor in the two ethnic groups. For Asians the relative risk was 3.3 (95% confidence interval 1.9 to 5.8) and for Europeans 1.3 (1.0 to 1.7). Calculations of population attributable risk indicated that clinical diabetes mellitus accounts for 21% of the incidence of myocardial infarction in Asians but only 3% of the incidence in Europeans. Diabetes mellitus is of sufficient quantitative importance as a risk factor to account for the whole of the observed excess of deaths from ischaemic heart disease among Asians in the United Kingdom.

Asia↗
PubMed1987

Comparative prevalence of non-insulin-dependent diabetes mellitus in Asian and white Caucasian adults.

The prevalence of diabetes mellitus in adults was determined within a specific area of Leicester City, containing 20,053 Asians and 18,068 White Caucasian over the age of 16 years in the 1981 census. Subjects who had ever had classical symptoms with a random venous plasma glucose greater than or equal to 11.1 mmol/l were taken as diabetic. Exact numbers were ascertained from an analysis of diabetic clinic records and specialist health visitor records. The latter have formed an important part of community care for diabetics in Leicester for the last 30 years, and patients are referred by hospital consultants and nursing staff, and by general practitioners. Diabetes was ascertained in 967 Asians and 1194 White Caucasians. Age-adjusted relative risk of diabetes (95% confidence interval) increased in Asians over 45 years of age and was 1.6 (1.3-1.8) and 2.7 (2.5-3.2) for those aged 45-64 years and over 65 years, respectively. Relative risk of NIDDM was significantly higher (approximately x 2) in Asians in all age-groups. Our study shows that in Asians the prevalence of diabetes rises above 45 years of age and that NIDDM occurs more frequently in adult Asians. The causes and long-term effects of this require further analysis.

Adolescent↗
PubMed1987

Insulin secretion to glucose infusion in gestational diabetes subjects with differing DNA polymorphisms flanking the insulin gene.

Glucose-stimulated insulin secretion was assessed in relation to the DNA polymorphism flanking the insulin gene in 16 women who had had gestational diabetes. When not pregnant they were studied by a Constant Glucose Infusion for 1 hr with Model Assessment (CIGMA). The patients with either heterozygous 1/3 alleles or homozygous 1/1 or 3/3 alleles in the 5' flanking region of the insulin gene had similar plasma insulin and C-peptide concentrations and similar estimates of beta-cell function. This suggests that the large DNA insert (Class 3 allele) near the insulin gene does not directly affect insulin secretion. The association of polymorphisms with Type 2 diabetes may be due to linkage disequilibrium with other disease-related alleles.

Adult↗
PubMed1987

A comparative study of sulphonylurea and insulin therapy in non insulin dependent diabetics who had failed on diet therapy alone.

20 patients with non insulin dependent diabetes mellitus (NIDDM), and within 20% of their ideal body weight were studied. They had failed to achieve adequate diabetic control following 3 months of dietary therapy. They were randomly allocated to insulin or sulphonylurea therapy for 3 months and then "crossed over" for the same period of time. Patients were maintained at euglycaemia (plasma glucose 4-7 mmol/l) for 24 hr using an open-loop intravenous insulin infusion, and then underwent a standard 75 gm oral glucose tolerance test (OGTT) following each mode of therapy. Mean glycosylated haemoglobin and preprandial blood glucose were 8.7% and 7.7 mmol/l respectively after sulphonylurea, and 7.8% (p less than 0.05) and 6.6 mmol/l (p less than 0.05) after insulin therapy. There was no significant difference in change in body weight. Following a 75 gm OGTT mean plasma insulin at 1/2 hr and 1 hr was 14.0 mu/l and 16.5 mu/l after sulphonylurea, and 23.4 mu/l (p less than 0.05) and 22.1 mu/l (p less than 0.05) after insulin therapy. Plasma C-peptide responses were also improved at 1/2, 1 and 1 1/2 hr after a period of insulin therapy being 0.61 nmol/l, 0.65 nmol/l and 0.59 nmol/l respectively. After sulphonylurea therapy comparable plasma C-peptide responses were 0.31, 0.41 and 0.37 nmol/l respectively (p less than 0.05). There was no significant difference in the total amount of intravenous insulin required for 24 hr euglycaemia. Our study shows that short term insulin therapy in patients with NIDDM who had failed on diet alone has advantages over sulphonylurea therapy in that it achieves better diabetic control and an improved B-cell response to glucose stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Dietary habits of Asian diabetics in a general practice clinic.

Initial dietary advice for Asian diabetics attending a general practice diabetic clinic was given in Asian languages. Between 2 and 3 years later a questionnaire interview was conducted to assess the effectiveness of the advice given. Forty of the 59 Asian diabetic patients in the practice attended for interview. The majority continued to use sugar or 'gur' (jaggery), Asian sweets, and Asian snacks (which have a high fat content). Fat and oil consumption per person per month was also high. Failure to achieve dietary objectives seemed to result from lack of sufficient emphasis on the types of foods usually consumed and an inadequate understanding of eating and cooking habits of Asians. We conclude that for dietary advice to be successful, emphasis must be placed on specific types of food eaten together with an understanding of the sociocultural implications of eating practices in ethnic groups.

Adult↗
PubMed1986

Glucose tolerance following strokes in the elderly.

Two standard 75 g oral glucose tolerance tests (OGTT) were performed on each of 16 patients, aged 65-84 years, presenting with a thrombotic stroke, and not previously known to have diabetes mellitus. The tests were performed within the first week and 12 weeks after the initial episode. There was no significant difference in the plasma glucose values between the tests. Six patients were diagnosed diabetic on the basis of both OGTTs being abnormal. Of the remaining ten, there was no worsening of glucose tolerance immediately following a stroke. It is concluded that an abnormal glucose tolerance soon after a stroke in the elderly represents true diabetes mellitus rather than 'functional diabetes'.

Aged↗
PubMed1986

Metastatic follicular carcinoma of the thyroid presenting with thyrotoxic induced impaired control of diabetes mellitus.

We report a patient with pulmonary and bony metastases due to follicular carcinoma of the thyroid, occurring 12 years after the initial diagnosis. This was brought to light by worsening diabetic control due to thyrotoxicosis from functioning malignant thyroid tissue. Following radio-active iodine therapy, she remains well with good control of her diabetes.

Adenocarcinoma↗