Stephen Colagiuri

• Professor at The University of Sydney

Aims To determine the adherence rate in users of each class of glucose‐lowering medication and identify the key socio‐demographic factors influencing adherence. Methods The 45 and Up Study is an ongoing cohort study of residents aged ≥45 years in New South Wales, Australia. We analysed Pharmaceutical Benefits Scheme records from 2013 to 2019 of th...

Objectives This study aimed to evaluate the effects of a novel, low-volume combined high-intensity interval training (HIIT) and progressive resistance training (PRT) in overweight/obese adults. Methods This randomised control trial compared the effect of regular supervised HIIT combined with PRT (Exercise) with an unsupervised stretching intervent...

Aims To investigate circulating angiogenic cells in adults with prediabetes and the effect of a structured exercise program. Methods A cohort of adults with overweight/obesity and either normal glucose (NG) or prediabetes were randomised to receive exercise (Exercise) (as twice weekly supervised combined high intensity aerobic exercise and progres...

Background The global prevalence of diabetes is similar in men and women; however, there is conflicting evidence regarding sex differences in diabetes-related complications. The aim of this study was to investigate sex differences in incident microvascular and macrovascular complications among adults with diabetes. Methods This prospective cohort...

Aim To determine sex and age differences in the use of medications for diabetes and cardiovascular risk factors in people with diabetes in Australia. Methods Pharmaceutical claims data of participants in the 45 and Up Study who self-reported having diabetes before 2013, were alive on 1st January 2013 and had at least one medication dispensing reco...

OBJECTIVE We aimed to assess whether remission of type 2 diabetes (T2D) could be achieved with a low-energy total diet replacement (TDR) in an Australian primary care setting. RESEARCH DESIGN AND METHODS Individuals age 20 to 65 years with T2D duration up to 6 years, BMI >27.0 kg/m2 and not treated with insulin were prescribed a 13-week low-energy...

Aims: To investigate the association between self-reported oral health and incident micro and macrovascular diabetes complications. Methods: This prospective cohort study linked data from the 45 and Up Study, Australia, to administrative health records. The participants were 24,862 men and women, aged ≥45 years, with diabetes at baseline (2006-2...

Aims: To examine whether simple measures of oral health are associated with incident diabetes. Methods: This prospective cohort study linked data from the 45 and Up Study, Australia, to administrative health records. The study participants were 213,389 men and women, aged ≥ 45 years, with no diabetes at baseline. The oral health of participants...

Aims: To describe morbidity and mortality trends of type 2 diabetes in Australia, from 1990 to 2019, compared with similar sociodemographic index (SDI) countries. Methods: Australia-specific Global Burden of Diseases data were used to estimate age-standardised, age-specific, and sex-specific rates for prevalence, years lived with disability (YLD...

Background: Public health bodies in Australia remain concerned about marketing of unhealthy commodities; namely unhealthy food, alcohol and gambling products. Children are particularly susceptible to the influence of unhealthy commodity marketing. This study explored adults' perceptions of unhealthy commodities sponsorship in elite sport and polic...

A Correction to this paper has been published: https://doi.org/10.1007/s00125-021-05544-x

Aims/hypothesis Type 2 diabetes increases the risk of cardiovascular and renal complications, but early risk prediction could lead to timely intervention and better outcomes. Genetic information can be used to enable early detection of risk. Methods We developed a multi-polygenic risk score (multiPRS) that combines ten weighted PRSs (10 wPRS) comp...

Diabetes diagnosis has important implications for individuals. Diagnostic criteria for fasting and 2-hour plasma glucose and HbA1c are universally agreed. Intermediate hyperglycemia/prediabetes is a risk factor for diabetes and cardiovascular disease. Because risk is a continuum, determining cut-point is problematic and reflected in significant dif...

In prediabetes (PD), circulating inflammatory biomarkers are associated with increased CVD1 risk. Exercise (Ex) has a positive effect on cardiovascular fitness and metabolic outcomes in PD but Ex effects on inflammation markers in PD are not fully known and were investigated in this study. Adults with PD (n=34) and normal fasting glucose (NG) (n=34...

Objective: To estimate the impact of reduced consumption of free sugars in line with World Health Organization recommendations, on sugar farmers globally. Methods: Using multiregion input-output analysis, we estimated the proportional impact on production volumes of a 1% reduction in free sugars consumption by the public. We extracted data on su...

Diet is central to the management of type 2 diabetes (T2D) and better outcomes are achieved when the dietary intervention is delivered by a dietitian. Yet, many people with T2D never see a dietitian. It has been proposed that doctors prefer to provide the dietary advice themselves or rely on medication to treat their patients instead of referring t...

Background Diet is central to treatment of type 2 diabetes. This review aimed to compare the effectiveness of nutrition therapy delivered by dietitians to nutrition advice delivered by other healthcare professionals in adults with type 2 diabetes on metabolic parameters. Methods Cochrane CENTRAL, CINAHL, EMBASE, MEDLINE and PsychINFO were searched...

The Rule of Halves (ROH) is a theoretical framework which states that roughly half of all people with a condition are diagnosed; half of those diagnosed receive care; half of those who receive care achieve their treatment targets; and half of those who reach their targets achieve the desired treatment outcomes. This review examined the applicabilit...

Objective Determine the effectiveness and acceptability of a text message intervention (DTEXT) on HbA1c and self-management behaviors for Australian adults with type 2 diabetes. Methods Using intention to treat analysis and generalized estimating equations, this randomized controlled trial of 395 adults determined change in HbA1c at 3 and 6 months...

Objective To estimate the impact on sugar farmers globally of reduced consumption of free sugars, in line with World Health Organization recommendations. Methods Using multiregion input-output analysis, we estimated the proportional impact on production volumes of a 1% reduction in free sugars consumption by the public. We extracted data on sugar p...

Objective To describe the experiences and perspectives of people with type 2 diabetes mellitus (T2DM) regarding dietetic services and to suggest improvements for their access and delivery. Design Semistructured telephone interviews. Setting Urban and rural Australia. Participants A total of 30 English-speaking adults with T2DM recruited by means...

Background The management of diabetes costs in excess of $1.3 trillion per annum worldwide. Diet is central to the management of type 2 diabetes. It is not known whether dietetic intervention is cost effective. This scoping review aimed to map the existing literature concerning the cost effectiveness of medical nutrition therapy provided by dietiti...

Background Diet is central to treatment of type 2 diabetes. This review aimed to compare the effectiveness of nutrition therapy delivered by dietitians to nutrition advice delivered by other healthcare professionals in adults with type 2 diabetes on metabolic parameters. Methods Cochrane CENTRAL, CINAHL, EMBASE, MEDLINE and PsychINFO were searched...

Aims To investigate whether long-term glycaemic variability (GV) is associated with vascular complication development in Type 2 diabetes Methods In a post-hoc FIELD trial analysis, GV was calculated as the standard deviation and coefficient of variation (CV) of HbA1c and fasting plasma glucose. Baseline variables were compared across quartiles of...

Importance Screening for diabetic retinopathy for early detection and treatment can prevent vision loss. Background We aimed to assess rates of eye examination of people with diabetes, adherence with national guidelines and investigate characteristics of those who do not adhere. Design We used data from the 45 and Up Study, a cohort study of 267,...

This ePoster was presented in June 2020 at the annual conference of the American Society for Nutrition (ASN), the "Nutrition 2020". Initially planned to take place in Seattle USA, this conference was rendered virtual due to COVID-19, attracting 29,598 registrants from 164 countries.

Background Mobile phone text message interventions have the potential to improve the health of people with type 2 diabetes at a population level. This study aimed to determine the effectiveness and acceptability of a mobile phone text message intervention (DTEXT) on diabetes control and self-management behaviours for Australian adults with type 2 d...

Objectives Nutrition therapy is crucial for the treatment of type 2 diabetes. Preliminary data indicate that nutrition therapy delivered by accredited dietitians achieves better clinical outcomes than when delivered by other healthcare professionals. We compared dietetic intervention provided by accredited dietitians with nutrition advice provided...

This review investigated the association of periodontal disease with diabetes mellitus (DM) and diabetic complications. PubMed/MEDLINE was searched including search terms “periodontal” OR “periodontitis” AND “diabetic complications” OR “diabetic retinopathy” OR “diabetic nephropathy” OR “diabetic neuropathy” OR “cardiovascular disease diabetes” OR...

Globally, 43 jurisdictions have implemented a tax on sugar-sweetened beverages (SSBs) for obesity prevention; however, there is significant political resistance to adopting such a policy in Australia. This paper applies Kingdon’s Multiple Streams Framework (MSF) to the case study of an SSB tax in Australia to identify barriers and enablers to polic...

Objectives To assess the effects of early management of hyperglycaemia with antidiabetic drugs plus lifestyle intervention compared with lifestyle alone, on microvascular function in adults with pre-diabetes. Methods Trial design: International, multicenter, randomised, partially double-blind, placebo-controlled, clinical trial. Participants Male...

Aims: Dietetic intervention improves glycaemic control of type 2 diabetes mellitus (T2DM). The aim of this study was to explore the views of Australian dietitians with respect to the nutritional management of people with T2DM, patient access to dietitians and any suggested improvements for access to and delivery of dietetic services. Methods: Se...

Diabetes can be classified into four categories, type 1 diabetes (T1D), type 2 diabetes (T2D), gestational diabetes (GDM), and diabetes due to other causes. Insulin resistance is a physiological phenomenon that raises insulin levels and is primarily associated with T2D and GDM. T1D results from severe insulin deficiency and requires exogenous insul...

Objective There are currently five widely used definition of prediabetes. We compared the ability of these to predict 5-year conversion to diabetes and investigated whether there were other cut-points identifying risk of progression to diabetes that may be more useful. Research design and methods We conducted an individual participant meta-analysi...

Type 2 diabetes increases the risk of cardiovascular and renal complications, but early risk prediction can lead to timely intervention and better outcomes. Through summary statistics of meta-analyses of published genome-wide association studies performed in over 1.2 million of individuals, we combined 9 PRS gathering genomic variants associated to...

Aims: To provide global estimates of diabetes prevalence for 2019 and projections for 2030 and 2045. Methods: A total of 255 high-quality data sources, published between 1990 and 2018 and representing 138 countries were identified. For countries without high quality in-country data, estimates were extrapolated from similar countries matched by e...

Aims: Examining pre-diabetes and diabetes rates using glycated haemoglobin (HbA1c) in emergency department (ED) and in general practice (GP) in western Sydney. Methods: Epidemiological study of HbA1c measurements in individuals ≥18 years receiving a blood test (1) in the hospital setting of the ED at Blacktown/Mt Druitt hospital (1/06/2016 to 31...

Background Diabetes prevalence is rapidly increasing, with type 2 diabetes predicted to be the leading contributor of non-communicable disease in Australia by 2020. It is anticipated that rates of type 2 diabetes will continue to increase if factors such as overweight and obesity, low physical activity and poor nutrition are not addressed. The majo...

Background: Qatar is currently experiencing a worrying increase in the prevalence of diabetes mellitus (DM). One of the most common reasons for uncontrolled DM is non-adherence to medications. The socio-behavioral intervention has proven effective in some chronic illnesses. Objectives: To assess the stages of change (SOC) and medication adherenc...

The obesogenic food environment is likely driving excessive weight gain in young adults. Our study aimed to investigate the nutritional quality of current food and drink offerings in an Australian university. This cross-sectional study included baseline environmental audits of 30 food outlets and 62 vending machines across campus. A recent food and...

Objective: This study aimed to assess population-level cost-effectiveness of the Weight Watchers (WW) program with doctor referral compared with standard care (SC) for Australian adults with overweight and obesity. Methods: The target population was Australian adults ≥ 20 years old with BMI ≥ 27 kg/m2 , whose obesity status was subsequently mode...

Aims: To assess and compare the direct healthcare and non-healthcare costs and government subsidies by body weight and diabetes status. Methods: The Australian Diabetes, Obesity and Lifestyle study collected health service utilisation and health related expenditure data at the 2011-12 follow-up surveys. Costing data were available on 4409 participa...

The sulfonylureas are effective oral glucose-lowering agents with a long history of clinical use. While all have the same general mechanism of action, their pharmacokinetic properties are influenced by factors such as dosage, rate of absorption, duration of action, route of elimination, tissue specificity, and binding affinity for pancreatic β-cell...

Purpose: To determine if online medical education for diabetologists/endocrinologists (diabs/endos) and primary care physicians (PCPs) can improve knowledge regarding treatment options for intensification of insulin in patients with T2DM, the rationale, clinical evidence, and benefits of novel basal insulins/GLP-1 receptor agonist (GLP-1 RA) fixed-...

Abstract Background There is growing recognition among public health circles of the need for regulatory action for overweight and obesity, but there has been limited research into whether the Australian public supports government intervention. This study aimed to determine the level of public support for food-related regulations for obesity, and to...

Aims/hypothesisPrevious studies have suggested that the haemoglobin glycation index (HGI) can be used as a predictor of diabetes-related complications in individuals with type 1 and type 2 diabetes. We investigated whether HGI was a predictor of adverse outcomes of intensive glucose lowering and of diabetes-related complications in general, using d...

Aim We developed and implemented a national audit and benchmarking programme to describe the clinical status of people with diabetes attending specialist diabetes services in Australia. Methods The Australian National Diabetes Information Audit and Benchmarking (ANDIAB) initiative was established as a quality audit activity. De‐identified data on...

Nutrition therapy is considered a key component of diabetes management, yet evidence around the ideal macronutrient composition of the diet remains inconclusive. A systematic review and meta-analysis was performed to assess the effects of carbohydrate-restricted diets (≤ 45% of total energy) compared to high carbohydrate diets (> 45% of total energ...

Diabetes is a large and increasing global public health concern. Hyperglycaemia in pregnancy (HIP) is an important component and contributor to the diabetes epidemic. Quantifying the burden of HIP is challenging due to shifting definitions. However, early identification is key to preventing adverse outcomes for mother and child. HIP shares many ris...

Australia has a very diverse but relatively small population considering its large land mass. While the diabetes burden is generally increasing in Australia, three population groups are particular affected – Indigenous Australians, people from culturally and linguistically diverse backgrounds, and people living in rural and remote areas. Life expec...

Aims: To compare the diabetes prevention impact and cost of several screening scenarios for diabetes prevention programs with the scenario which included an oral glucose tolerance test (OGTT). Methods: We included 4864 participants of the Australian Diabetes, Obesity and Lifestyle study who were aged ≥40 years, did not have known diabetes at bas...

Objective: To assess the association between 2-year changes in urine albumin-to-creatinine ratio (UACR) and the risk of clinical outcomes in type 2 diabetes. Research design and methods: We analyzed data from 8,766 participants in the ADVANCE-ON study. Change in UACR was calculated from UACR measurements 2 years apart, classified into three grou...

Aim: There is strong and consistent evidence from large scale randomised controlled trials that type 2 diabetes can be prevented or delayed through lifestyle modification which improves diet quality, increases physical activity and achieves weight loss in people at risk. Worldwide, the prevalence of type 2 diabetes is increasing in individuals of...

Background Microvascular disease is associated with a high risk of macrovascular events in patients with type 2 diabetes, but the impact of macrovascular disease on the risk of microvascular events remains unknown. We sought to evaluate the respective effects of prior microvascular and macrovascular disease on the risk of major outcomes, including...

Visit-to-visit variability in systolic blood pressure (SBP) is a risk factor for cardiovascular events. However, whether it provides additional predictive information beyond traditional risk factors, including mean SBP, in the long term is unclear. The ADVANCE trial (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release C...

Objectives: To describe the management of cardiovascular disease (CVD) risk in Australian patients with diabetes; to compare the effectiveness of a quality improvement initiative for people with and without diabetes. Research design and methods: Subgroup analyses of patients with and without diabetes participating in a cluster randomised trial....

Abstract Background Increased marketing of energy-dense, nutrient-poor foods has been identified as a driver of the global obesity epidemic and a priority area for preventative efforts. Local and international research has focused on the unhealthiness of television advertising, with limited research into the growing outdoor advertising industry. Th...

Objective To develop and recalibrate an Australian 5-year cardiovascular disease (CVD) mortality risk score to produce contemporary predictions of risk. Methods Data were pooled from six Australian cohort studies (n = 54,829), with baseline data collected between 1989 and 2003. Participants included were aged 40–74 years and free of CVD at baselin...

The new IDF Clinical Practice Recommendations for managing Type 2 Diabetes in Primary Care seek to summarise current evidence around optimal management of people with type 2 diabetes. It is intended to be a decision support tool for general practitioners, hospital based clinicians and other primary health care clinicians working in diabetes.

Background: This study utilized data from different sources to identify the extent of the unmet need for postprandial glycaemic control in patients with type 2 diabetes mellitus (T2DM) following initiation of basal insulin therapy in Europe, Asia Pacific, the United States and Latin America. Methods: Different levels of evidence were used as ava...

Background: Peripheral arterial disease (PAD) is known to be associated with high cardiovascular risk, but the individual impact of PAD presentations on risk of macrovascular and microvascular events has not been reliably compared in patients with type 2 diabetes. We aimed to evaluate the impact of major PAD, and its different presentations, on th...

Background This study assessed the impact of kilojoule (kJ) labelling alone or accompanied by a social marketing campaign on food sales and selection of less energy-dense meals by young adults from a university food outlet. Methods There were two kJ labelling intervention phases each of five weeks: (1) kJ labelling alone (2) kJ labels with marketin...

Table S1. Number of patients, mean baseline body mass index and mean baseline glycated haemoglobin included in different treatment arms from the liraglutide clinical programme.

Dietary patterns that induce excessive insulin secretion may contribute to worsening insulin resistance and beta-cell dysfunction. Our aim was to generate mathematical algorithms to improve the prediction of postprandial glycaemia and insulinaemia for foods of known nutrient composition, glycemic index (GI) and glycemic load (GL).We used an expande...

Aim: To estimate and compare the results from all randomised trials of triple combinations of anti-diabetes therapies that reported the reduction of glycated haemoglobin (HbA1c) and associated effects on body weight and hypoglycaemia. Methods: PubMed and the Cochrane Library were searched for trials with at least one study arm on triple therapy...

Background: The Food Insulin Index (FII) is a novel algorithm for ranking foods based on their insulin demand relative to an isoenergetic reference food. We compared the effect of carbohydrate counting (CC) versus the FII algorithm for estimating insulin dosage on glycemic control in type 1 diabetes. Materials and methods: In a randomized, contr...

Chronic disease and the associated risk factors are an ongoing public health concern. They represent a major burden of disease and result in significant health expenditure. The purpose of this paper is to describe the development and attributes of the microsimulation model NCDMod, an Australian, purpose-built model that simulates multiple chronic d...

In the liraglutide clinical trial programme, liraglutide 1.2 mg and 1.8 mg were found to effectively lower glycated haemoglobin (HbA1c ) in patients with type 2 diabetes (T2D). It is unknown whether baseline body mass index (BMI) is a predictor for change in HbA1c observed during a clinical trial with liraglutide or placebo treatment. This meta-ana...

Aims/hypothesis: The Sydney Diabetes Prevention Program (SDPP) was a community-based type 2 diabetes prevention translational research study with screening and recruitment in the primary health care setting. We aimed to investigate the program's effectiveness in reducing risk factors for diabetes as well as the program's reach, adoption and implem...

Introduction: The PREVIEW lifestyle intervention study is a 3-y randomised controlled trial for prevention of type 2 diabetes (T2D) involving 8 sites in Europe, Australia and New Zealand and funded by the EU-FP7 program (No: 312057 FP7-KBBE-2012) and NH&MRC (Australia). This analysis aimed to identify the main barriers to recruitment of overweight/...