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Biomedical subjects

R G Moses

Publications and source records attributed to R G Moses.

At least 37 records · Page 2Linked to original sources
PubMed1995

Pregnancy outcomes in women without gestational diabetes mellitus related to the maternal glucose level. Is there a continuum of risk?

OBJECTIVE: To examine selected pregnancy outcomes in women without gestational diabetes mellitus to see whether there was a continuum of risk related to the maternal glucose level. RESEARCH DESIGN AND METHODS: Consecutive women attending two prenatal clinics and three obstetricians in private practice were tested for GDM at the beginning of the third trimester using a 75-g glucose load in the fasting state. The rate of induction, the number of assisted deliveries, the presence of pregnancy-induced hypertension, fetal birth weights, and morbidity were examined with respect to the maternal 2-h glucose level. RESULTS: Data were available for 1,441 women with a 2-h glucose level < 8.0 mmol/l (144 mg/dl). For each 1.0 mmol/l (18 mg/dl) increase in the glucose level, the odds in favor of an assisted delivery increased by 15.2%, and the odds in favor of the baby being admitted to a special care nursery (SCN) increased by 22.6%. There was no significant association between maternal glucose levels and the probability of either pregnancy-induced hypertension or a large-for-gestational-age (LGA) baby after adjustment for other variables. CONCLUSIONS: In normal women there is a continuum of risk related to the maternal glucose level 2 h after a glucose tolerance test for the probability of having an assisted delivery and the likelihood of the baby being admitted to an SCN. The chance of having pregnancy-induced hypertension or a LGA baby also increased as the maternal glucose level increased but could be largely explained by an increasing body mass index.

Adult↗
PubMed1994

The medical management of gestational diabetes in Australia within a solo private practice.

This study reports the obstetric and fetal outcomes of 266 consecutive patients with gestational diabetes managed by a solo practitioner in private practice. Labour was spontaneous in 75.6% and 93.2% had a gestational age of delivery between 37 and 41 weeks. The elective Caesarean section rate of 14.7% was slightly higher than the rate for the overall obstetric population. Insulin therapy was required in 12.8% of the patients with a mean daily dose of 35.3 units. The rate of insulin use increased to 23.8% during 1993 when the criteria for its use was revised. This was associated with a significantly lower macrosomic rate of 3.6%. Overall there was a significant reduction in the number of babies weighing < or = 2500 g and no increase in the number of babies weighing > or = 4000 g. One patient only was admitted to hospital during this 30-month period and there was 1 neonatal death. These results indicate that successful medical management of gestational diabetes, with obstetric and fetal results similar to the overall obstetric population, is possible outside of tertiary institutions and specialized clinics.

Adult↗
PubMed1994

The clinical usefulness of 3 alpha-androstanediol glucuronide in premenopausal women with hirsutism.

A biochemical parameter correlating with the clinical assessment of the severity of hirsutism and changing appropriately with the clinical response to treatment would be extremely useful. Preliminary reports of androstanediol glucuronide indicated that it was a peripherally-derived androgen and had a high correlation with clinical gradings of hirsutism. More recent reports have cast doubts on this association. This paper presents an evaluation of the clinical usefulness of androstanediol in 121 consecutive premenopausal patients with hirsutism. Androstanediol had a positive correlation with the clinical grading of hirsutism (p < 0.02) and the BMI (p < 0.01) but a negative correlation with age (p < 0.01). After adjustment for the effects of age and BMI there was no significant association between the degree of hirsutism and the level of androstanediol.

Adolescent↗
PubMed1994

The incidence of gestational diabetes mellitus in the Illawarra area of New South Wales.

The incidence of gestational diabetes in the Illawarra area is 7.2% (95% CI: 6.0-8.4). This was determined by data collected by 2 prenatal clinics and 3 private practitioners during 1993. The incidence rate varied between 5.1% at one hospital to 11.3% with a private practitioner. This variation was mainly due to differences in age and ethnic background. The highest incidence rate of 11.9% was found in women of Asian background.

Adult↗
PubMed1993

Diabetes in the workplace. Employment experiences of young people with diabetes mellitus.

OBJECTIVE: To assess some of the employment experiences of people with diabetes mellitus and to compare their experiences with those of a non-diabetic sibling control group. DESIGN: A questionnaire about employment experiences was administered to diabetic subjects aged 16-39 years, and an abbreviated questionnaire was administered to their eligible siblings. SETTING: The Illawarra area of New South Wales. PARTICIPANTS: The names of diabetic subjects were obtained from the Illawarra diabetes register. RESULTS: Interviews were conducted with 184 of 226 (81.4%) eligible diabetic subjects and with 70 eligible siblings. There were no significant differences between the diabetic subjects and their siblings with respect to educational achievements and rates of employment. Siblings reported a mean of 2.6 days sickness absenteeism in the year prior to the survey. Diabetics were absent from work for a mean of 4.5 days for reasons not related to their diabetes and for a mean of 2.6 days for diabetic causes. Within the diabetic group, 50% felt that having diabetes would make it more difficult to find another job, 33.7% felt that diabetes would influence their search for alternative employment and 19.6% felt that at some stage they had been refused employment because of their diabetes. Fifteen per cent of diabetics were aware of an example of discrimination and 24.2% of diabetics in employment had at some stage tried to hide their diagnosis from their employer. CONCLUSIONS: Diabetics do not appear disadvantaged compared with their siblings with respect to employment participation but are more likely to be absent from work due to sickness. However, many diabetic subjects had experienced a job refusal, had tried to hide their diagnosis from employers, were aware of examples of discrimination and were very negative about future employment prospects.

Absenteeism↗
PubMed1993

Patients' attitudes toward screening for gestational diabetes mellitus in the Illawarra area, Australia.

OBJECTIVE: To examine the attitudes toward screening of a group of women who have had GDM compared with a group who were screened but did not have GDM. RESEARCH DESIGN AND METHODS: We surveyed 90 women with GDM and 100 control women with a postal questionnaire. They were asked to mark on a six-point Likert scale their responses to statements about certain aspects of screening for diabetes in pregnancy. RESULTS: No significant differences were found in mean responses between the two groups. The method of screening was found to be convenient (GDM group, 5.02; control group, 4.77). A strong belief that all women should be screened in pregnancy (GDM group, 5.76; control group, 5.66) and a personal desire for screening in any future pregnancy (GDM group, 5.73; control group, 5.62) were expressed. CONCLUSIONS: Both groups of women surveyed in this study were extremely positive about the convenience of the screening method used, the need for all women to be screened in pregnancy, and their desire for screening in future pregnancies.

Attitude to Health↗
PubMed1991

Human insulins.

Explore the source record for details and available documents.

Humans↗
PubMed1990

The quality of self-monitoring of blood glucose.

The accuracy of self-monitoring of blood glucose (SBGM) was assessed by a quality control programme. Ninety diabetic patients who were routinely performing SBGM were supplied with a series of quality control solutions which they tested with their usual meter and reagent strip. The overall error rate (a result outside the range of the mean +/- 3SD for each quality control solution) was 39% for users of the Ames system and 33% in Boehringer Mannheim system users. The clinical relevance of these errors was determined by examining the effect on the clinical decision which would have been based on the erroneous result, either in taking inappropriate action or in failing to take appropriate action. In 30% of all patients, 25% or more of the errors were of such a degree as to be clinically misleading. The most common error was an underestimation of the result, which gave the impression of better than actual blood glucose control. The main reason for these errors was the failure of patients to take sufficient care in following the manufacturers' instructions when performing the test. Clinically relevant erroneous results are common among patients performing SBGM.

Blood Glucose↗