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Biomedical subjects

M Balme

Publications and source records attributed to M Balme.

4 recordsLinked to original sources
PubMed2002

Retinopathy in latent autoimmune diabetes of adults: the Fremantle Diabetes Study.

AIMS: To determine the prevalence of retinopathy and its associations in patients diagnosed clinically with Type 2 diabetes and serum antibodies to glutamic acid decarboxylase (GADA) from a community-based sample. METHODS: In a case-control design, 24 GADA-positive Type 2 patients from the Fremantle Diabetes Study (FDS) cohort were recruited and matched as closely as possible for age, sex and diabetes duration with 72 GADA-negative Type 2 patients from the FDS. Each patient had a detailed clinical and biochemical assessment including slit lamp biomicroscopy and colour fundus photography with Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) grading. RESULTS: The GADA-positive patients had a significantly higher HbA1c (median (interquartile range); 8.4 (7.3, 9.6)%) than those who were GADA-negative (7.2 (6.5, 8.1)%: P = 0.002). The overall prevalence of retinopathy amongst the 96 subjects was 26.0%. The majority (92%) of the retinopathy detected was mild and non-proliferative. GADA-positive patients had double the retinopathy prevalence of the GADA-negative group (41.7% vs. 20.8%; P = 0.044). In a logistic regression model, diabetes duration, HbA1c, systolic blood pressure and current smoking were each significantly and independently predictive of retinopathy (P < 0.025), but GADA status was not. CONCLUSIONS: These data show that GADA-positive patients have an increased prevalence of retinopathy compared with GADA-negative controls with Type 2 diabetes from an urban Australian community. This increased prevalence is due mainly to relatively poor glycaemic control in the GADA-positive group.

Adult↗
PubMed2000

The diagonal ear lobe crease (Frank's sign) is not associated with coronary artery disease or retinopathy in type 2 diabetes: the Fremantle Diabetes Study.

BACKGROUND: The diagonal ear lobe crease (ELC) has been suggested as a simple marker of vascular disease in the general population but there are few data from diabetic patients despite their increased risk of angiopathy. AIM: To determine whether the ELC is a clinically useful sign of coronary artery disease (CAD) or retinopathy in type 2 diabetes. METHODS: One thousand and twenty-two patients from the multi-ethnic urban catchment area of Fremantle Hospital in Western Australia were studied. This sample represents 79% of the type 2 diabetic subjects recruited to the ongoing Fremantle Diabetes Study and 49% of all 2072 patients with type 2 diabetes identified through active case detection in a postcode-defined region of 120,097 people. In addition to other comprehensive data relating to diabetes and its management, the presence of an ELC and evidence of both CAD and retinopathy were ascertained for each patient. RESULTS: The prevalence of ELC was 55%. Patients with an ELC were more likely to have CAD than those without an ELC (p=0.019), but the proportions with retinopathy were not significantly different (p=0.085). The sensitivity and specificity of ELC for detecting CAD were 60% and 48%, and for retinopathy 61% and 47% respectively. The patients with an ELC were significantly older, more likely to be male and had a higher systolic blood pressure than those without (p<0.02). After adjusting for known vascular risk factors, socioeconomic variables and ethnicity in a logistic regression model, an ELC was neither a significant independent predictor of CAD (p=0.45) nor of retinopathy (p=0.14). CONCLUSIONS: The ELC is of little value as a sign of the presence of diabetic vascular complications.

Adult↗