George Alberti

George Alberti
Imperial College London | Imperial · Division of Diabetes, Endocrinology and Metabolism

DPhil FRCP

About

1,157
Publications
135,850
Reads
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117,918
Citations
Additional affiliations
October 1997 - present
Imperial College London
Position
  • Senior research investigator

Publications

Publications (1,157)
Article
Full-text available
Background To compare the predictive value of the circadian syndrome (CircS) and Metabolic syndrome (MetS) for cardiovascular disease. Method We used the data of 9360 Chinese adults aged ≥40 years from the 2011 China Health and Retirement Longitudinal Study (CHARLS). Of the participants, 8253 people were followed in the 2015 survey. MetS was defin...
Article
The coronavirus disease 2019 pandemic is wreaking havoc on society, especially health-care systems, including disrupting bariatric and metabolic surgery. The current limitations on accessibility to non-urgent care undermine postoperative monitoring of patients who have undergone such operations. Furthermore, like most elective surgery, new bariatri...
Article
Diabetes is one of the most important comorbidities linked to the severity of all three known human pathogenic coronavirus infections, including severe acute respiratory syndrome coronavirus 2. Patients with diabetes have an increased risk of severe complications including Adult Respiratory Distress Syndrome and multi-organ failure. Depending on th...
Article
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The Metabolic Syndrome is a cluster of cardio‐metabolic risk factors and comorbidities conveying high risk of both cardiovascular disease and type 2 diabetes. It is responsible for huge socio‐economic costs with its resulting morbidity and mortality in most countries. The underlying aetiology of this clustering has been the subject of much debate....
Article
Intrahepatic lipid (IHL) is linked with reduced hepatic insulin sensitivity and insulin clearance. Despite their high risk for type 2 diabetes (T2D), there have been limited investigations of these relationships in Black populations. We investigated these relationships in 18 White European (WE) and 18 Black West African (BWA) men with T2D <5 years....
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Aims/hypothesis Type 2 diabetes is more prevalent in black African than white European populations although, paradoxically, black African individuals present with lower levels of visceral fat, which has a known association with insulin resistance. Insulin resistance occurs at a tissue-specific level; however, no study has simultaneously compared wh...
Data
Table S1 | Glycemia subgroup: independent influences of fasting plasma glucose, hemoglobin A1c, age, sex, body mass index, waist circumference, non‐alcoholic fatty liver disease and sex–glycemia interaction on high‐density lipoprotein cholesterol: multivariable analysis. Table S2 | Less metabolically unhealthy prediabetes subgroup: not taking or t...
Article
Context Intrapancreatic lipid (IPL) has been linked with beta-cell dysfunction. Black populations suffer disproportionately from type 2 diabetes (T2D) and show distinctions in beta-cell function compared to Whites. Objective We aimed to quantify IPL in White European (WE) and Black West African (BWA) men with early T2D, and to investigate relation...
Article
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Background Relationships between cardiometabolic risk and glycaemia have been rarely studied in people under clinical evaluation and treatment for cardiometabolic risk and with prediabetes. We investigated relationships between glycaemia and cardiometabolic risk factors in clinic participants with prediabetes. Methods This was a cross‐sectional an...
Article
Aims: Populations of African ancestry suffer high rates of type 2 diabetes (T2D) compared to Caucasians. Phenotypic differences in pre-diabetic populations, particularly marked hyperinsulinaemia, suggest ethnic distinctions in T2D pathophysiology. We tested the hypothesis that men of Black (West) African (BAM) ethnicity with early T2D would have g...
Article
Aims: Variation in cardiometabolic risk in prediabetes and any impacts of ethnicity on such variation have been little studied. In an ethnically diverse dataset, selected according to a high-risk HbA1c-based definition of prediabetes, we have investigated relationships between glycaemia and cardiometabolic risk factors and the influence of ethnici...
Article
Aims: To examine the proportion of people with diabetes in the multi-ethnic country of Mauritius meeting American Diabetes Association targets in 2009 and 2015. Methods: Data from independent population-based samples of 858 and 656 adults with diagnosed diabetes in 2009 and 2015, respectively, were analysed with regard to recommended American Di...
Article
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Background Despite growing evidence that bariatric/metabolic surgery powerfully improves type 2 diabetes (T2D), existing diabetes treatment algorithms do not include surgical options. AimThe 2nd Diabetes Surgery Summit (DSS-II), an international consensus conference, was convened in collaboration with leading diabetes organizations to develop globa...
Article
Diabetes mellitus is one of the most important public health challenges of the twenty-first century. Until the past decade, it has been seriously underrated as a global health threat. Major gaps exist in efforts to comprehend the burden nationally and globally, especially in developing nations, due to a lack of accurate data for monitoring and surv...
Article
Background: Despite growing evidence that bariatric/metabolic surgery powerfully improves type 2 diabetes (T2D), existing diabetes treatment algorithms do not include surgical options. Aim: The 2nd Diabetes Surgery Summit (DSS-II), an international consensus conference, was convened in collaboration with leading diabetes organizations to develop...
Article
Full-text available
Background: Despite growing evidence that bariatric/metabolic surgery powerfully improves type 2 diabetes (T2D), existing diabetes treatment algorithms do not include surgical options. Aim: The 2nd Diabetes Surgery Summit (DSS-II), an international consensus conference, was convened in collaboration with leading diabetes organizations to develop...
Article
The number of people with diabetes worldwide has more than doubled during the past 20 years. One of the most worrying features of this rapid increase is the emergence of type 2 diabetes in children, adolescents, and young adults. Although the role of traditional risk factors for type 2 diabetes, such as genetic, lifestyle, and behavioral risk facto...
Article
De Taskforce Epidemiologie en Preventie van de International Diabetes Federation heeft een consensus-werkgroep bijeengebracht bestaande uit diabetologen, endocrinologen, chirurgen en epidemiologen om te beoordelen welke rol bariatrische chirurgie en andere gastrointestinale interventies horen te krijgen in de behandeling en preventie van type 2 dia...
Article
Developing countries face a high and growing burden of type 2 diabetes. We surveyed physicians in a diverse range of countries in the Middle East and Africa (Egypt, Kingdom of Saudi Arabia, United Arab Emirates, South Africa and Lebanon) with regard to their perceptions of barriers to type 2 diabetes care identified as potentially important in the...
Article
Type 2 diabetes can often be prevented by lifestyle modification; however, successful lifestyle intervention programmes are labour intensive. Mobile phone messaging is an inexpensive alternative way to deliver educational and motivational advice about lifestyle modification. We aimed to assess whether mobile phone messaging that encouraged lifestyl...
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The burden of stroke on health systems in low-income and middle-income countries is increasing. However, high-quality data for modifiable stroke risk factors in sub-Saharan Africa are scarce, with no community-based, case-control studies previously published. We aimed to identify risk factors for stroke in an incident population from rural and urba...
Article
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Three major studies have made a brave attempt to quantify mortality and disability worldwide from 289 diseases and their sequelae. Striking data are presented that confirm the rising tide of noncommunicable diseases, particularly diabetes mellitus. The predictions for diabetes mellitus are, however, probably underestimated owing to underdiagnosis a...
Article
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Background: This study aimed to identify correlates of case fatality within an incident stroke population in rural Tanzania. Methods: Stroke patients, identified by the Tanzanian Stroke Incidence Project, underwent a full examination and assessment around the time of incident stroke. Records were made of demographic data, blood pressure, pulse r...
Article
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OBJECTIVE To determine whether glucose-independent differences in HbA(1c) exist between people of African, South Asian, and Chinese ethnicities.RESEARCH DESIGN AND METHODS Data from 6,701 people aged 19-78 years, without known diabetes, from Mauritius, and participating in the population-based Non-Communicable Disease Surveys of the main island and...
Article
There are accumulating data describing the association between diabetes and cancer mortality from Westernised populations. There are no data describing the relationship between diabetes and cancer mortality in African or South Asian populations from developing countries. We explored the relationship of abnormal glucose tolerance and diabetes on can...
Article
Diabetes UK is the charity that cares for, connects with and campaigns on behalf of all people affected by and at risk of diabetes. Founded in 1934 by the novelist H. G. Wells and Dr R. D. Lawrence, the charity has always combined the expertise of lay and professional members to achieve its mission to improve the lives of people with diabetes and t...
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Previous studies suggest that over-nutrition in early infancy may programme long-term susceptibility to insulin resistance. To assess the association of breast milk and quantity of infant formula and cows' milk intake during infancy with insulin resistance measures in early adulthood. Long-term follow-up of the Barry Caerphilly Growth cohort, into...
Data
Multivariable regression analyses showing changes (and 95% confidence intervals) in waist circumference at follow-up (23–27 y) per quartile of formula/cow's milk intake, and also relative changes in waist circumference of participants who consumed formula/cow's milk (FF) compared to those who were breastfed (BF), at 10 days, 6 weeks and 3 months du...
Data
Multivariable regression analyses showing changes in outcomes (and 95% confidence intervals) at follow-up (23–27 y) per gender-specific quartile of formula/cow's milk intake at 10 days, 6 weeks and 3 months during infancy. (DOCX)
Data
Comparison of baseline characteristics by subjects who were and were not followed up during the Barry and Caerphilly Growth study, 1972–1974 (mean and SD, unless stated %). (DOC)
Article
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Type 2 diabetes is one of the fastest growing epidemics in human history and is closely associated with obesity.(1) Furthermore, the disease has multiple manifestations and is associated with progressive beta-cell failure.(2) Although lifestyle measures, including weight loss and physical activity, should be first-line treatment, success is difficu...
Article
Health care systems around the world are being stretched by pressing needs to cater for populations that are becoming more and more overweight and obese. Obesity is associated with substantial morbidity and mortality rates and, although dietary and lifestyle advice can help some, bariatric surgery is an increasingly popular option in the treatment...
Article
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Higher waist circumference and lower hip circumference are both associated with increased cardiovascular disease (CVD) risk, despite being directly correlated. The real effects of visceral obesity may therefore be underestimated when hip circumference is not fully taken into account. We hypothesized that adding waist and hip circumference to tradit...
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Secular trends in the epidemiology of diabetes are best described by studying the same population over time, but few such studies exist. Using surveys from Mauritius in 1987 and 2009, we examined 1) the change in the prevalence of diabetes, 2) the extent to which changes in traditional diabetes risk factors explained the increase, and 3) the change...
Article
The International Diabetes Federation Taskforce on Epidemiology and Prevention of Diabetes convened a consensus working group of diabetologists, endocrinologists, surgeons and public health experts to review the appropriate role of surgery and other gastrointestinal interventions in the treatment and prevention of Type 2 diabetes. The specific goal...
Article
Type 2 diabetes (T2D) and obesity are both complex and chronic medical disorders, each with an escalating worldwide prevalence. When obesity is severe, and/or available medical therapies fail to control the diabetes, bariatric surgery becomes a cost-effective therapy for T2D. When there are other major comorbidities and cardiovascular risk, the opt...
Article
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Diabet. Med. 28, 628–642 (2011) The International Diabetes Federation Taskforce on Epidemiology and Prevention of Diabetes convened a consensus working group of diabetologists, endocrinologists, surgeons and public health experts to review the appropriate role of surgery and other gastrointestinal interventions in the treatment and prevention of Ty...
Article
To establish post-stroke case fatality rates within a community based incident stroke population in rural Tanzania. Incident stroke cases were identified by the Tanzanian Stroke Incidence Project and followed-up over the next 3-6 years. In order to provide a more complete picture, verbal autopsy (VA) was also used to identify all stroke deaths occu...
Article
During the 1980s and 1990s general medicine was progressively displaced by medical specialties as the major focus of a consultant physician’s career. Fewer and fewer people were appointed as ‘general physicians with a specialist interest’, which had been the norm prior to this. Specialists whose main focus was their ‘ology’ were continuing to be ex...
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Little information is available on the impact of abnormal glucose tolerance on mortality in South Asian and African populations in the developing world. We explored this issue in a large, multiethnic cohort from the developing nation of Mauritius. Population-based surveys were undertaken in 1987, 1992, and 1998. The 9,559 participants (20-82 years...
Article
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There are no methodologically rigorous studies of the incidence of stroke in sub-Saharan Africa. We aimed to provide reliable data on the incidence of stroke in rural and urban Tanzania. The Tanzania Stroke Incidence Project (TSIP) recorded stroke incidence in two well defined demographic surveillance sites (DSS) over a 3-year period from June, 200...
Chapter
IntroductionDefinitionsClassificationDiagnostic criteriaReferences
Article
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Leptin predicts cardiovascular diseases and type 2 diabetes, diseases to which Asian Indians are highly susceptible. As a risk marker, leptin's intra-individual and seasonal stability is unstudied and only small studies have compared leptin levels in Asian Indians with other populations. The aim of this study was to explore ethnicity related differ...
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Adults of South Asian origin living in the United Kingdom have high risks of type 2 diabetes and central obesity; raised circulating insulin, triglyceride, and C-reactive protein concentrations; and low HDL-cholesterol when compared with white Europeans. Adults of African-Caribbean origin living in the UK have smaller increases in type 2 diabetes r...
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Increases in the prevalence of type 2 diabetes will likely be greater in the Middle East and other developing countries than in most other regions during the coming two decades, placing a heavy burden on regional healthcare resources. Medline search, examination of data from major epidemiological studies in the Middle Eastern countries. The aetiolo...
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This article presents the conclusions of a WHO Expert Consultation that evaluated the utility of the 'metabolic syndrome' concept in relation to four key areas: pathophysiology, epidemiology, clinical work and public health. The metabolic syndrome is a concept that focuses attention on complex multifactorial health problems. While it may be conside...
Article
There is little strong evidence that currently recommended higher waist circumference cut-points for Europids compared with South Asians are associated with similar risk for type 2 diabetes. This study was designed to provide such evidence. Longitudinal studies over 5 years were conducted among 5,515 Europid and 2,214 ethnically South Asian partici...
Article
A cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus, which occur together more often than by chance alone, have become known as the metabolic syndrome. The risk factors include raised blood pressure, dyslipidemia (raised triglycerides and lowered high-density lipoprotein cholesterol), raised fasting glucose, and centra...
Article
To develop risk prediction models of future diabetes in Mauritian Indians. Three thousand and ninety-four Mauritian Indians (1141 men, aged 20-65 years) without diabetes in 1987 or 1992 were followed up to 1992 or 1998. Subjects underwent repeated oral glucose tolerance tests and diabetes was diagnosed according to 2006 World Health Organization/In...
Article
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Background: Diabetes prevalence is increasing. The Finnish Diabetes Prevention Study (DPS) showed a 58% reduction in Type 2 Diabetes (T2D) incidence in adults with impaired glucose tolerance (IGT). The European Diabetes Prevention Study (EDIPS) extends the DPS to different European populations, using the same study design. In the Newcastle arm of...
Article
The prevalence of coronary heart disease (CHD) was determined in a population survey in Mauritius where the prevalence of non-insulin dependent diabetes and mortality from CHD are amongst the highest in the world. Men and women aged 35–74 years of all major ethnic groups were included: Asian Indians (Hindus and Muslims). Creoles and Chinese. ECG ab...
Article
The value of clinical definitions of the metabolic syndrome has been questioned, with confusion surrounding their intended use and purpose. Our aim was to construct a mission statement that outlines the value of the metabolic syndrome in clinical and public health settings. Case studies have been used to demonstrate three key points. We argue here...
Article
Macrovascular disease is the major cause of premature death in diabetes. The ageadjusted mortality from coronary heart disease (CHD) is 2-4 times higher than in the non-diabetic population. The major role of screening for diabetes is to diagnose it early to prevent or delay the complications. This chapter presents the arguments for and against scre...