Diabetes
Diabetes
Project Leads: Dr Andrew Farmer, Dr Rafael Perera and Dr Carl Heneghan
The Diabetes & Vascular Disease Research Group in collaboration with the MaDOX Group is developing an international collaboration to carry out an individual patient data meta-analysis of the impact of self-monitoring for type 2 diabetes.
Glycaemic Monitoring in Diabetes
Project Leads: Dr Andrew Farmer, Dr Richard Stevens
The Diabetes & Vascular Disease Research Group is developing a series of studies using trial data and statistical modeling techniques in collaboration with the MaDOX Group to study glycaemic monitoring in diabetes. Initially, data obtained from the DiGEM trial is being used to investigate optimal strategies for monitoring glycaemia and these studies are now being extended with larger datasets.
Optimal HbA1c measurement
Investigators: Andrew Farmer, Richard Stevens, Jason Oke
Current practice in diabetes measurement is to use HbA1c to monitor glycaemic control, but the optimal interval between HbA1c tests is not known. We have developed a model for the properties of HbA1c testing over time, which can be used to inform evidence-based recommendations on HbA1c monitoring in people with type 2 diabetes. A statistical methodology paper is under second review at the journal Statistical methods in medical research (M4 New). A paper for a clinical journal, currently in preparation, uses this model to draw conclusions about HbA1c monitoring programmes in diabetes care.
Telemedicine 2 trial (development work)
Investigators: Andrew Farmer
Initiating and adjusting insulin treatment for people with type 2 diabeties requires frequent clinician contacts both face-to-ace and by telephone. We explored the use of a telehealth system to offer additional support to these patients.
Telemedicine 2 trial (randomised)
Investigators: Andrew Farmer, Rafael Perera, Jason Oke
Telemedicine in type 2 diabetes: An exploratory study to evaluate a telemedicine system to assist patients with type 2 diabetes to manage their insulin regimen is currently underway, funded jointly by the NIHR School of Primary Care Research and the Oxford Biomedical Research Centre. Patients adding insulin to their treatment regimens are being recruited to a six month trial and provided with a mobile phone and glucose monitor. Glucose results are transmitted via Bluetooth connection to their mobile phone and onward, together with other diary data, to a main server. Results are regularly monitored on-line and advice provided regarding insulin titration.
Self-monitoring of blood glucose IPD
Investigators: Andrew Farmer, Rafael Perera, Carl Heneghan, Alison Ward, and the trialists collaboration
Recent trials have provided differing estimates of the benefits of self-monitoring of blood glucose (SMBG) for non-insulin treated patients with type 2 diabetes. Variations in the components of the intervention delivered, target population selected, and reporting methods used have limited the conclusions drawn in recent systematic reviews. We will systematically examine these factors within the trials of SMBG to enable further investigation of the data through an individual patient data analysis (IPD). With current uncertainty about the extent of benefit from SMBG for non-insulin treated patients with type 2 diabetes, this study will provide the best estimates to date of overall effectiveness, effectiveness within potential target populations, and optimal components of the Pre-diabetes Optimal HbA1c Measurement.
Pre-diabetes Optimal HbA1c Measurement
Investigators: Osamu Takahashi, Paul Glasziou, Andrew Farmer
To evaluate optimal interval for HbA1c re-screening, we use a retrospective cohort study at a teaching hospital in Tokyo, Japan of 15810 adults not diabetic at baseline. Annual measurement of theHbA1c was undertaken for four years.
Diabetes Renal Function
Project Leads: Dr Andrew Farmer, Dr. Richard Stevens, Dr Rafael Perera, Prof Paul Glasziou
The Diabetes & Vascular Disease Research Group is developing a series of studies in collaboration with the MaDOX Group to study renal monitoring in diabetes. The project is funded to use large trial datasets to examine test performance, systematically examine the research literature to inform analysis and develop health economic models to guide clinical practice.