Biomedical subjects

H Alban-Davies

Publications and source records attributed to H Alban-Davies.

3 recordsLinked to original sources

PubMed1991

Self testing for diabetes mellitus.

OBJECTIVE: To develop a simple, economically viable, and effective means of population screening for diabetes mellitus. DESIGN: A postal request system for self testing for glycosuria with foil wrapped dipsticks. Preprandial and postprandial tests were compared with a single postprandial test. The subjects were instructed how to test, and a result card was supplied on which to record and return the result. All those recording a positive test result and 50 people recording a negative result were invited for an oral glucose tolerance test. SETTING: General practice in east Suffolk, list size 11534. PATIENTS: All subjects aged 45-70 years registered with the practice were identified by Suffolk Family Health Services Authority (n = 3057). The 73 subjects known to have diabetes from the practice's register were excluded, leaving 2984 subjects, 2363 (79.2%) of whom responded. 1167 subjects completed the single test and 1196 the two tests. MAIN OUTCOME MEASURES: Response rate and number of patients with glycosuria. Sensitivity, specificity, and positive predictive value of a single postprandial test and preprandial and postprandial tests. Number of new cases of diabetes identified and cost of screening. RESULTS: Of the patients completing the single postprandial test, 29 had a positive result, an oral glucose tolerance test showed that eight (28%) had diabetes, six (21%) impaired glucose tolerance, and 14 (48%) normal glucose tolerance. 44 of the group who tested before and after eating had a positive result; nine (20%) had diabetes, five (11%) impaired tolerance, and 26 (11%) normal tolerance. Screening cost 59p per subject and 81 pounds per case detected. Of the 17 people with previously undiagnosed diabetes, eight were asymptomatic and 11 had not visited their general practitioner in the past three months. CONCLUSIONS: A postal request system for self testing for postprandial glycosuria in people aged 45-70 is a simple and effective method of population screening for diabetes mellitus.

Aged↗

PubMed1991

A long-term clinical review of patients with oesophageal pain.

Oesophageal and cardiac chest pain are often difficult to distinguish on clinical grounds. The clinical course of 32 patients with recurrent chest pain due to oesophageal dysmotility has recently been assessed by questionnaire 9 years after diagnosis. Twenty-six of the 27 who replied continued to have pain, but despite this there was a significant reduction in the number of hospital admissions associated with chest pain. Repeat oesophageal manometry in nine showed that the disturbance in motility persisted. Three had died, one of them from a myocardial infarction; two patients could not be traced.

Adult↗

PubMed1987

Problems of comprehensive shared diabetes care.

In its first year 747 diabetics were entered into a comprehensive shared care scheme in which general practitioners agreed to follow up their own patients. After two years patients were recalled to hospital for review through a computer based recall system. Analysis of the first 209 patients reviewed showed that the recall system worked well with failure to trace only eight patients. Six new cases of foot ulcer, 15 of retinopathy, 14 of macular degeneration, and 15 of raised blood pressure requiring treatment were detected at review. Sixty four patients appeared to have had no check on their diabetes during the two years. Of the 117 with written evidence in their cooperation books that they had received some diabetic supervision, many had had no measurement of weight (32), blood pressure (49), or urine (68) or blood glucose (70), and only 55 had had foot and 65 eye examination. This erratic and generally poor standard of supervision suggests that much tighter organisation is required within each practice, with time being set aside specifically for care of diabetics. Practice nurses could have an important role in the delivery and organisation of care.

Comprehensive Health Care↗