Sam Philip

NHS Grampian | National Health Service · Diabetes and Endocrinology

Sodium‐glucose co‐transporters (SGLTs) mediate sodium and glucose transport across cell membranes. SGLT2 inhibitors have a recognized place within heart failure (HF) guidelines. We evaluated the effect of sotagliflozin on HF and cardiovascular outcomes in participants with type 2 diabetes. Scopus, Medline, Embase and Central were searched from ince...

Type 2 Diabetes Mellitus (T2DM) may be a novel risk factor for Parkinson's Disease (PD). Due to the mechanistic plausibility and conflicting reports in clinical studies of an association between PD and T2DM, we conducted a systematic review and meta-analysis to further investigate the relationship between the two conditions. We searched EMBASE, MED...

Various diabetic retinopathy (DR) prediction models include drugs as predictors. Drug exposure however is not consistently assessed for model inclusion, with substantial variation identified in how drug exposure is coded. We aimed to assess drug exposure handling, identify the drugs associated with DR by performing a network meta-analysis and dete...

Despite opposing insulin sensitivity and cardiometabolic risk, both athletes and patients with type 2 diabetes have increased skeletal myocyte fat storage: the so-called “athlete’s paradox”. In a parallel non-randomised, non-blinded trial (NCT03065140), we characterised and compared the skeletal myocyte lipid signature of 29 male endurance athletes...

Aims: The effects of sotagliflozin, a novel SGLT 1 and 2 inhibitor, on heart failure (HF) have not been explored. This systematic review evaluated the effect of sotagliflozin on HF and cardiovascular outcomes in participants with type 2 diabetes. Methods: Scopus, Medline, Embase and Central were searched from database inception until 2nd of June 2...

Exercise is recommended in the treatment of type 2 diabetes and can improve insulin sensitivity. However, previous evidence suggests that exercise at different times of the day in people with type 2 diabetes may have opposing outcomes on glycaemia. Metformin is the most commonly prescribed initial pharmacological intervention in type 2 diabetes, an...

Aim To investigate the renal safety profile of sotagliflozin, a novel sodium-glucose co-transporter-1 and -2 inhibitor, in patients with type 1 diabetes and type 2 diabetes, with or without renal impairment, as well as its efficacy in decreasing the risk of further renal events, with an emphasis on those with previous renal impairment. Methods Emb...

Objective Atherosclerosis is a chronic inflammatory process induced by the influx and entrapment of excess lipoproteins into the intima media of arteries. Previously, our lab demonstrated that systemic PTP1B inhibition protects against atherosclerosis in preclinical LDLR −/− models. Similarly, it was shown that myeloid-specific PTP1B ablation decre...

Biomedical image segmentation plays an important role in Diabetic Retinopathy (DR)-related biomarker detection. DR is an ocular disease that affects the retina in people with diabetes and could lead to visual impairment if management measures are not taken in a timely manner. In DR screening programs, the presence and severity of DR are identified...

Exercise is recommended in the treatment of Type 2 Diabetes and can improve insulin sensitivity [1]. However, previous evidence suggests that exercise at different times of the day in people with type 2 diabetes may have opposing outcomes on glycaemia [2]. Metformin is the most commonly prescribed initial pharmacological intervention in Type 2 Diab...

Background: Routine clinical coding of clinical outcomes in outpatient consultations still lags behind the coding of episodes of inpatient care. Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) offers an opportunity for standardised coding of key clinical information. Identifying the most commonly required SNOMED terms and grouping...

Aims: To describe type 1 diabetes incidence in Scotland between 2006 and 2019. Methods: Repeated annual cross-sectional studies of type 1 diabetes incidence were conducted. Incident cases were identified from the Scottish Care Information - Diabetes Collaboration (SCI-DC), a population-based register of people with diagnosed diabetes derived fro...

Background: Increased intramyocellular lipid storage occurs in skeletal muscle of both athletes and type 2 diabetes patients (T2D) but their metabolic phenotypes are at opposite ends of insulin sensitivity and cardiometabolic risk. Hypothesis: Intramyocellular lipid saturation and flux are determinants of insulin resistance. Methods: Age-matched at...

Purpose: The Scottish Diabetes Research Network (SDRN)-diabetes research platform was established to combine disparate electronic health record data into research-ready linked datasets for diabetes research in Scotland. The resultant cohort, 'The SDRN-National Diabetes Dataset (SDRN-NDS)', has many uses, for example, understanding healthcare burde...

Aims/hypothesis We assessed the real-world effect of flash monitor (FM) usage on HbA 1c levels and diabetic ketoacidosis (DKA) and severe hospitalised hypoglycaemia (SHH) rates among people with type 1 diabetes in Scotland and across sociodemographic strata within this population. Methods This study was retrospective, observational and registry ba...

Objective: To describe incidence of foot ulceration and amputation-free survival associated with foot ulceration status in a national population-based cohort study of people with diabetes. Research design and methods: The study population included 233,459 people with diabetes who were alive in Scotland on 1 January 2012 identified from the natio...

Background Diabetes mellitus (DM) is a global public health concern, with significant increase in the transitioning low- and middle-income countries (LMICs), such as India, with limited resources and poor health care systems. Recognising the need for innovative, feasible, targeted interventions for diabetes care, a non-randomized, controlled, phase...

Aims/hypothesis Our aim was to assess the use of continuous subcutaneous insulin infusion (CSII) in people with type 1 diabetes in Scotland and its association with glycaemic control, as measured by HbA 1c levels, frequency of diabetic ketoacidosis (DKA) and severe hospitalised hypoglycaemia (SHH), overall and stratified by baseline HbA 1c . Metho...

BACKGROUND Diabetes and its complications account for 10% of annual UK healthcare spending. Digital healthcare interventions (DHIs) can provide scalable care, fostering diabetes self-management and reducing the risk of complications. Tailorability and usability are key to DHI engagement/effectiveness. User-centred design of DHIs, aligning features...

Background: Diabetes and its complications account for 10% of annual health care spending in the United Kingdom. Digital health care interventions (DHIs) can provide scalable care, fostering diabetes self-management and reducing the risk of complications. Tailorability (providing personalized interventions) and usability are key to DHI engagement/...

Background and Purpose Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Ev...

Background We aimed to ascertain the cumulative risk of fatal or critical care unit-treated COVID-19 in people with diabetes and compare it with that of people without diabetes, and to investigate risk factors for and build a cross-validated predictive model of fatal or critical care unit-treated COVID-19 among people with diabetes. Methods In thi...

Background The epidemic of type 2 diabetes mellitus is growing at large globally, more so in Low- and Middle-Income Countries (LMIC) like India, who concurrently battles the burden of infectious diseases. In such a health setting, people with diabetes (PWD) often receive sub-optimal care due to lack of understanding, physician-patient time, social...

Aims/hypothesisWe aimed to examine whether crude mortality and mortality relative to the general population below 50 years of age have improved in recent years in those with type 1 diabetes.Methods Individuals with type 1 diabetes aged below 50 and at least 1 year old at any time between 2004 and 2017 in Scotland were identified using the national...

Objective: In 2019, the European Society of Cardiology led and released new guidelines for diabetes cardiovascular (CV) risk management, reflecting recent evidence of CV disease (CVD) reduction with sodium-glucose cotransporter 2 inhibitors (SGLT-2is) and some glucagon-like peptide 1 receptor agonists (GLP-1RAs) in type 2 diabetes (T2D). A key rec...

Background National guidelines in most countries set screening intervals for diabetic retinopathy (DR) that are insufficiently informed by contemporary incidence rates. This has unspecified implications for interval disease risks (IDs) of referable DR, disparities in ID between groups or individuals, time spent in referable state before screening (...

Background Endurance trained athletic healthy volunteers (Athl-HV) and type 2 diabetes patients (T2D) have higher levels of lipids in their skeletal myocytes compared to healthy controls. Despite apparently similar metabolic storage, they are at opposite ends of insulin sensitivity and cardio-metabolic risk. Purpose We investigated if the degree o...

Background Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. Methods In this...

Background: Glucagon-like peptide 1 receptor agonists differ in chemical structure, duration of action, and in their effects on clinical outcomes. The cardiovascular effects of once-weekly albiglutide in type 2 diabetes are unknown. We aimed to determine the safety and efficacy of albiglutide in preventing cardiovascular death, myocardial infarcti...

Objective: To evaluate the performance of five cardiovascular disease (CVD) risk scores developed in diabetes populations and compare their performance to QRISK2. Research design and methods: A cohort of people diagnosed with type 2 diabetes between 2004 and 2016 was identified from the Scottish national diabetes register. CVD events were identi...

Aims/hypothesis: We aimed to examine time trends in national perinatal outcomes in pregnancies complicated by pre-existing type 1 or type 2 diabetes. Methods: We analysed episode-level data on all obstetric inpatient delivery events (live or stillbirth) between 1 April 1998 and 31 March 2013 (n = 813,921) using the Scottish Morbidity Record (SMR...

METHODSWe randomly assigned patients with type 2 diabetes, with or without previous car-diovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite out-come was the first occurrence of death from cardiovascular causes, nonfatal myo-cardial infarction,...

Background: Pregnant women with type 1 diabetes are a high-risk population who are recommended to strive for optimal glucose control, but neonatal outcomes attributed to maternal hyperglycaemia remain suboptimal. Our aim was to examine the effectiveness of continuous glucose monitoring (CGM) on maternal glucose control and obstetric and neonatal h...

Background Metformin might reduce insulin requirement and improve glycaemia in patients with type 1 diabetes, but whether it has cardiovascular benefits is unknown. We aimed to investigate whether metformin treatment (added to titrated insulin therapy) reduced atherosclerosis, as measured by progression of common carotid artery intima-media thickne...

Purpose Recruitment to trials is often difficult. Many trials fail to meet recruitment targets resulting in underpowered studies which waste resources and the time of those who participated. While there is evidence that many people are willing to take part in research, particularly if it involves a condition from which they suffer, researchers are...

Aims: Adrenal crisis (AC) is a life- threatening condition with an incidence of 6–10 adrenal crises per 100 patient year in European populations. The aim of our study is to identify the prevalence of adrenal crisis in our clinic population and assess the preventative measures in use. Methods: Data was obtained from electronic records and paper reco...

Aims: Recent Endocrine Society Guidelines (2016) suggest establishing the aetiology of primary adrenal insufficiency (PAI) and screening for other autoimmune conditions. The aim of our audit was to compare current practice against these recommendations. Methods: We identified patients seen in clinic over 18 months between January 2015 and May 2016....

Introduction Providing systemic screening to a growing diabetes population is a challenge for most screening programmes. We have previously developed software for the automated detection of diabetic retinopathy which is now routinely used within the Scottish Diabetic Retinopathy Screening programme. Purpose In this study we explored whether automa...

Objectives To determine weight change patterns in Scottish patients 2 years after diagnosis of type 2 diabetes and to examine these in association with medium-term glycaemic, mortality and cardiovascular outcomes. Setting Using a retrospective cohort design, ethical approval was obtained to link the Scottish diabetes care database to hospital admi...

Aims: To assess the cost-effectiveness of adopting risk-stratified approaches to extended screening intervals in the national diabetic retinopathy screening programme in Scotland. Methods: A continuous-time hidden Markov model was fitted to national longitudinal screening data to derive transition probabilities between observed non-referable and...

Background: Global cesarean section (CS) rates range from 1% to 52%, with a previous CS being the commonest indication. Labour following a previous CS carries risk of scar rupture, with potential for offspring hypoxic brain injury, leading to high rates of repeat elective CS. However, the effect of delivery by CS on long-term outcomes in children...

Comparison of offspring outcomes between planned repeat CS and unscheduled births (unscheduled repeat CS and VBAC). (DOCX)

Complete case analysis of offspring health outcomes by mode of birth. (DOCX)

Comparison of case characteristics between cases with complete and those with missing data. (DOCX)

Predictor variables included in the multiple imputation process. (DOCX)

Study protocol. (DOCX)

Completed STROBE checklist. (DOC)

Aim Retinal screening for diabetic retinopathy, involving taking images of the retina, has been shown to be cost-effective. This project explored the feasibility of using automated analysis of sequential retinal images to identify specific features, which could be used to identify those people at risk of their disease progressing and require referr...

Importance Planned cesarean delivery comprises a significant proportion of births globally, with combined rates of planned and unscheduled cesarean delivery in a number of regions approaching 50%. Observational studies have shown that offspring born by cesarean delivery are at increased risk of ill health in childhood, but these studies have been...

Potential differences in cardiovascular risk by ethnicity remain uncertain. We evaluated the association of ethnicity with cardiovascular disease (CVD) incidence in a large cohort of people with type 2 diabetes living in Scotland. Data from Scottish Care Information-Diabetes (SCI-Diabetes) were linked to Scottish Morbidity Records (SMR01) and Natio...

Type 1 diabetes has historically been associated with a significant reduction in life expectancy. Major advances in treatment of type 1 diabetes have occurred in the past 3 decades. Contemporary estimates of the effect of type 1 diabetes on life expectancy are needed. To examine current life expectancy in people with and without type 1 diabetes in...

Background: Increasing prevalence of diabetes worldwide is projected to lead to an increase in patients with end-stage renal disease (ESRD) requiring renal replacement therapy (RRT). Aim: To provide contemporary estimates of the prevalence of ESRD and requirement for RRT among people with diabetes in a nationwide study and to report associated surv...

The purpose of this study was to compare contemporary risk of hip fracture in type 1 and type 2 diabetes with the non-diabetic population. Using a national diabetes database, we identified those with type 1 and type 2 diabetes aged 20-84 years alive anytime from 01/01/2005 to 12/31/2007. All hospitalised events for hip fracture in 2005-2007 for dia...

Retinal screening programmes in England and Scotland have similar photographic grading schemes for background (non-proliferative) and proliferative diabetic retinopathy, but diverge over maculopathy. We looked for the most cost-effective method of identifying diabetic macular oedema from retinal photographs including the role of automated grading a...

Diabetic retinopathy screening aims to detect people at risk of visual loss due to proliferative diabetic retinopathy, but also refers cases of suspected macular oedema (maculopathy). At the introduction of screening, ophthalmology was concerned that referral rates would be unmanageable. We report yield of referable disease by referral reason for t...

To describe characteristics associated with statin prescribing for the primary prevention of cardiovascular disease in people with newly diagnosed diabetes. Data from the Scottish Care Information-Diabetes Collaboration data set for 2006-2008 were used. This data set contains socio-demographic and prescribing data for over 99% of people with diagno...