Current Research
The Galway Diabetes Foot Study: Epidemiology, Cost, Feasibility and
Implications for Clinical Practice and Policy – started 2008-2011
This study is estimating the prevalence and incidence of diabetic foot disease in the West of Ireland, the financial and personal burden of foot ulceration in order to inform practice guidelines and policy. A community based podiatrist (chiropody expert) is training and supporting practice nurses attached to up to 15 GP practices to carry out foot examinations on people with diabetes with immediate access to specialist services as needed.
This study is delivering a service which was not previously available thereby having immediate benefits to people with diabetes. The study will confirm the number of people having diabetes related foot problems and will provide information on the cost of these foot problems to the health service. Results will be used to lobby for investment in community service delivery of specialist diabetes care as a model of cost effective use of resources.
Adipocyte size and type 2 diabetes in obesity; a study of patients
undergoing bariatric surgery – started 2007 - 2010
Twenty-six people with diabetes and twenty-six without diabetes from the Dublin based obesity clinic were recruited into this study prior to having surgical intervention as a treatment for their obesity. Surgical intervention allowed for the omentum (visceral fat) to be more closely examined. Initial results of this study suggest that future health may be better predicted by examination of visceral fat cells rather than fat quality or quantity. The diabetes group had larger fat cells and initial indications are that these cells being unable to accommodate any more fat allow the overflow of fat to be laid down in the liver and muscles causing insulin resistance. In addition, local inflammation is present which have led researchers to examine the lymph system of the omentum. The overflow of fat and local inflammation may play a role in cancer development, Obesity may result in a significant compromise to the immune system as well as the metabolic system. The study is ongoing. This work may lead to treatments that help fat to function more efficiently and thus improve diabetes and cholesterol.
Health beliefs and management behaviours of
people with Type 2 diabetes – completed.
This study examined the adoption of diabetes self-management, dietary, physical exercise and medication adherence behaviours of people newly diagnosed with type 2 diabetes and what perceptions might influence them. Results give an indication of the profile of people newly diagnosed which previously was not available in an Irish setting. This study showed that the average age of diagnosis with type 2 diabetes was 55 years of age. Men at diagnosis were younger, attended group diabetes education quicker, had a more positive diabetes attitude and perceived themselves to have more social support than women should they need it. People newly diagnosed with type 2 diabetes required and undertook diabetes self-management behaviours differently which are influenced by demographic factors. The results indicate that women know what dietary recommendations they need to undertake and have already acted on those prior to attending for care. However, women fail to increase their level of physical activity and may require more support to do so.
Peer support education for people with Type 2 Diabetes –
Funded by the Health Research Board.
Diabetes is a chronic illness, which requires the individual to assume responsibility for their own care with the aim of maintaining glucose and blood pressure levels as close to normal as possible. In recent times alternatives to the traditional delivery of diabetes care have been investigated, for example, the concept of peer support which emphasises patient rather than professional domination. Funding was secured from the Health Research Board for a five-year randomised control trial (RCT) to evaluate whether a peer support programme delivered at community levels for people with type 2 diabetes improves biophysical and psychosocial outcomes and whether it is an acceptable, cost effective intervention in the primary care setting. This RCT is ongoing.
Impaired glucose tolerance in children with cystic fibrosis – completed
Cystic Fibrosis (CF) is the most common life-threatening autosomal recessive disease within the Caucasian population. Treatment includes the use of steroid medication which combined with the high energy intake may result in impaired glucose tolerance. This study established the prevalence of diabetes and pre-diabetes in children with CF attending the 3 national paediatric centres in Dublin. The study results highlighted that introduction of insulin therapy earlier in the management of impaired glucose improved quality of life and reduced morbidly.
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APP/KOL/AC 12/01/2009