Biomedical subjects
R J Jarrett
Publications and source records attributed to R J Jarrett.
Obesity and type 2 (non-insulin-dependent) diabetes.
Explore the source record for details and available documents.
Duration of non-insulin-dependent diabetes and development of retinopathy: analysis of possible risk factors.
Thirty men aged 44-73 years were followed from the stage of impaired glucose tolerance-detected in the Whitehall Survey-to the diagnosis of diabetes and for a minimum of 3 years after. Eight men developed diabetic retinopathy during follow-up after diagnosis, the minimum time from diabetes diagnosis being 59 months. The only significant difference between the groups with and without retinopathy was in the time from screening to diagnosis of diabetes-mean 45.3 and 71.5 months, respectively. Of baseline variables, mean systolic and diastolic blood pressure levels were substantially higher in those who subsequently developed retinopathy, though the differences were not statistically significant (p greater than 0.05).
Economics of coronary artery bypass grafting.
Explore the source record for details and available documents.
Macrovascular disease in Caucasoid diabetic patients.
Explore the source record for details and available documents.
Risk of nephropathy in diabetes mellitus: problems of methodology and terminology.
Explore the source record for details and available documents.
Physical activity and prevalence of diabetes.
Explore the source record for details and available documents.
Fasting hyperglycaemia and cardiovascular risk.
Explore the source record for details and available documents.
Mortality and associated risk factors in diabetics.
In 168 male diabetics aged 40-64 years participating in the Whitehall Study, ten-year age adjusted mortality rates were significantly higher than in non-diabetics for all causes, coronary heart disease, all cardiovascular disease and, in addition, causes other than cardiovascular. Mortality rates were not significantly related to known duration of the diabetes. The predictive effects of several major mortality risk factors were similar in diabetics and non-diabetics. Excess mortality rates in the diabetics could not be attributed to differences in levels of blood pressure or any other of the major risk factors measured.
Risk factors of macrovascular disease in diabetes mellitus.
Explore the source record for details and available documents.
Predicting diabetic nephropathy.
Explore the source record for details and available documents.
Atherosclerosis, the ear lobe crease, and chromosome 11.
Explore the source record for details and available documents.
Glycaemia, arterial pressure and micro-albuminuria in type 1 (insulin-dependent) diabetes mellitus.
Plasma glucose control and arterial pressure were assessed in 28 Type 1 (insulin-dependent) diabetic patients with different degrees of micro-albuminuria. They were divided into two groups according to their urinary albumin excretion rate: a low micro-albuminuria group (n = 16) with albumin excretion ranging between 12.1 and 28.9 micrograms/min and a high micro-albuminuria group (n = 12) with albumin excretion between 32.4 and 91.3 micrograms/min. The groups were matched for age, sex and duration of diabetes with the same number of normo-albuminuric (2.0-10.4 micrograms/min) diabetic control subjects. Both the low and high micro-albuminuria groups had significantly higher glycosylated haemoglobin levels and mean plasma glucose concentrations during a 24-h profile than their respective normo-albuminuric control subjects. A correlation between glycosylated haemoglobin level and urinary albumin excretion rate was found in the whole study group (r = 0.48; p less than 0.001). Arterial pressure (both systolic and diastolic) was significantly higher in the high micro-albuminuria group than in either the control group or the low micro-albuminuria group. A significant correlation was found between arterial pressure and albumin excretion rate in the whole study population (r = 0.49; p less than 0.001) as well as in the pooled micro-albuminuria groups (r = 0.43; p less than 0.05). Multiple regression analysis showed that glycosylated haemoglobin and arterial pressure levels were independently correlated with albumin excretion rates. Diabetic patients with micro-albuminuria of any degree have worse glycaemic control than normo-albuminuric patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Screening blood glucose values: effects of season and time of day.
Blood glucose screening results, obtained using two different screening procedures, are reported from two occupational groups. Post-prandial blood glucose levels were measured in 3346 subjects aged 45 years or more employed by the Greater London Council/Inner London Education Authority. In women, mean blood glucose levels were higher in the afternoon than the morning (p less than 0.05). Ninety-fifth centile levels were substantially higher in the afternoon in both sexes, though the differences were not constant in all age and sex sub-groups. In both sexes mean glucose levels were highest in the winter (December-February, inclusive), but seasonal variation did not significantly affect the proportion exceeding the ninety-fifth centile for the total population. In the Whitehall study, the blood glucose was measured in men, in the morning, 2h after a 50-g glucose load. Significant seasonal variation in mean blood glucose values occurred, with highest values in winter and lowest in spring (March-May, inclusive). However, there was no significant difference by season in the proportions exceeding the arbitrary cut-off levels of 7.8 and 11.1 mmol/l.
Type 2 (non-insulin-dependent) diabetes mellitus and coronary heart disease-chicken, egg or neither?
review of the literature yields much evidence against a correlation between duration of non-insulin-dependent diabetes mellitus (Type 2 diabetes) and the degree of coronary atherosclerosis or the risk of clinically evident coronary heart disease (CHD). Furthermore, an increased risk of CHD, similar to that in previously diagnosed diabetic subjects, has been demonstrated in persons with impaired glucose tolerance. These observations suggest that an increased risk of CHD is not a consequence of the development of diabetes (i.e. persistent hyperglycaemia). It is more likely that diabetes develops in individuals who already possess characteristics which increase the risk of CHD in addition to the risk of developing diabetes.
Microalbuminuria predicts mortality in non-insulin-dependent diabetics.
Forty-four non-insulin-dependent diabetics (NIDD), all with urine negative to Albustix, were studied in 1966/67. By the end of 1980, 17 had died, all but two from cardiovascular causes. All causes of mortality and time to death were significantly related in univariate analyses to age and to the overnight urinary albumin excretion rate (AER), but not to systolic and diastolic blood pressure levels or to duration of diabetes when the latter was corrected for age. Age and duration were highly correlated with each other. In multivariate analyses age and AER were independent predictors of both mortality and time to death, with AER having the greater degree of significance. Thus subclinically elevated albumin excretion rates ('microalbuminuria') indicate a substantially increased mortality risk in non-insulin-dependent diabetes.
The Whitehall Study: ten year follow-up report on men with impaired glucose tolerance with reference to worsening to diabetes and predictors of death.
Two-hundred and four men with a defined degree of impaired glucose tolerance derived from the Whitehall Survey and its pilot study were enrolled in a therapeutic trial and followed for ten years. For the first five years of the trial approximately half the group received 50 mg phenformin daily and the other half an identical placebo. For the whole ten years of the trial approximately half the group were recommended a diet in which carbohydrate intake was limited to 120 g/day, while the other half was recommended a qualitative limitation of sugar intake. 60 men (29.4%) worsened to diabetes during the follow-up period. The major independent predictor of worsening was the baseline blood glucose level (glucose tolerance). High baseline plasma triglyceride levels and low baseline systolic blood pressure levels were also independent predictors of worsening, though of lower significance (0.01 less than p less than 0.05). Obesity, measured as body mass index, was not a significant risk factor. Thirty-nine men died, with 19 deaths ascribed to coronary heart disease (CHD). Baseline blood pressure significantly predicted both all causes and CHD mortality. All causes mortality rates were higher in the less obese. Allocation to drug or diet therapy did not significantly affect mortality rates or the proportions worsening to diabetes.