Asian Science Citation Index is committed to provide an authoritative, trusted and significant information by the coverage of the most important and influential journals to meet the needs of the global scientific community.  
ASCI Database
308-Lasani Town,
Sargodha Road,
Faisalabad, Pakistan
Fax: +92-41-8815544
Contact Via Web
Suggest a Journal
Articles by T. C. Skinner
Total Records ( 9 ) for T. C. Skinner
  K. D. Barnard , C. E. Lloyd and T. C. Skinner

Aim To review systematically the published literature addressing whether continuous subcutaneous insulin infusion (CSII) provides any quality of life benefits to people with Type 1 diabetes.

Methods Electronic databases and published references were searched and a consultation with two professional groups was undertaken to identify relevant studies published up to July 2005. A multistep selection process was then undertaken to identify those articles which met the specific selection criteria, which were then critically reviewed.

Results Eighty-four potential relevant articles were identified from examination of titles and abstracts published during the specified time frame. Of these, 28 articles were retrieved in full text, of which 17 fulfilled the specific criteria for inclusion. Mixed results emerged from existing literature. Of the five randomized controlled trials, three reported mixed results, with one study reporting quality of life benefits and one reporting no evidence of quality of life benefits.

Conclusions There is conflicting evidence reported in the various studies on the quality of life benefits of CSII in Type 1 diabetes. Existing research is flawed, making a judgement about the quality of life benefits of insulin pump use difficult. There is no strong evidence against quality of life benefits associated with CSII or otherwise, with poor methodology and inconsistent assessment of quality of life clouding the issue. The lack of reported benefit is probably a function of this rather than pump therapy not offering any quality of life benefits.

  K. G. Asimakopoulou , C. Fox , J. Spimpolo , S. Marsh and T. C. Skinner
  Aims  We examined the impact of communicating risk of coronary heart disease (CHD) and stroke, using three time frames (1, 5 or 10 years), on Type 2 diabetic (T2D) patients' understanding of risk of CHD/stroke and their memory for these risks.

Methods  Patients (N = 95) estimated their risk of developing CHD/having a stroke as a result of diabetes, in one of three time frames. Using the United Kingdom Prospective Diabetes Study Risk Engine and the same time frame, patients were then given individualized, objective risk estimates of developing CHD/stroke. Following explanation of these risks, patients' risk understanding was examined by asking them to report again their risk of developing CHD/stroke. Six weeks later we assessed patient memory for these risks by asking them to recall their actual risk estimates for CHD/stroke.

Results  In all time frames, we successfully reduced participants' originally inflated risk perceptions of CHD (F1,92 = 73.01, P < 0.001) and stroke (F1,91 = 119.05, P < 0.001), although the 10-year risk group was the most resistant to correction for both CHD (F1,90 = 9.32, P < 0.001) and stroke (F2,88 = 3.97, P < 0.02). Participants' recall of their stroke risk at 6 weeks regressed towards original, inflated risk perceptions for the 10-year group only (F4,176 = 4.73, P < 0.001).

Conclusion  Patients' inflated perceptions of CHD/stroke risk can be easily corrected using shorter (1- or 5-year) risk communication time frames.

  K. Khunti , T. C. Skinner , S Heller , M. E Carey , H. M. Dallosso and M. J Davies
  Aims  To describe the characteristics of newly diagnosed people with Type 2 diabetes (T2DM) and compare these with published studies.

Methods  Baseline data of participants recruited to the DESMOND randomized controlled trial conducted in 13 sites across England and Scotland were used. Biomedical measures and questionnaires on psychological characteristics were collected within 4 weeks of diagnosis.

Results  Of 1109 participants referred, 824 consented to participate (74.3%). Mean (± sd) age was 59.5 ± 12 years and 54.9% were male. Mean HbA1c was 8.1 ± 2.1% and did not differ by gender. Mean body mass index (BMI) was significantly higher in women (33.7 vs. 31.3 kg/m2; P < 0.001); 69% of women and 54% of men were obese (BMI > 30 kg/m2). Total cholesterol was significantly higher in women (5.6 vs. 5.2 mmol/l; P < 0.001). Overall, 14.7% reported smoking. Percentages reporting recommended levels of vigorous activity (≥ 3 times/week) and moderate activity (≥ 5 times/week) were 10.6 and 16.0%, respectively, and were lower in women. Specific illness beliefs included 73% being unclear about symptoms and only 54% believing diabetes is a serious condition. Symptoms indicative of depression were reported by significantly more women than men (16.1% vs. 8.2%; P = 0.001).

Conclusion  Data from this large and representative cohort of newly diagnosed people with T2DM show that many have modifiable cardiovascular risk factors. Comparison with the literature suggests that the profile of the newly diagnosed may be changing, with lower HbA1c and higher prevalence of obesity. Many expressed beliefs about and poor understanding of their diabetes that need to be addressed in order for them to engage in effective self-management.

  C. A. Eigenmann , R. Colagiuri , T. C. Skinner and L. Trevena
  Aims  To critically appraise the suitability, validity, reliability, feasibility and sensitivity to change of available psychometric tools for measuring the education outcomes identified in the (Australian) National Consensus on Outcomes and Indicators for Diabetes Patient Education.

Methods  Potentially suitable psychometric measurement tools were identified through a two-step process. Step 1: a structured semi-systematic literature review and consultation with experts; step 2: development of inclusion criteria and a formal, purpose-designed, systematically derived Appraisal Checklist-from the literature and with expert psychometric advice-to critically appraise the identified tools for relevance, validity, reliability, responsiveness to change, burden, feasibility and acceptability.

Results  Searching medline, PubMed, PsycINFO and cinhal yielded 37 diabetes-specific and generic measurement tools. Eleven of these did not address the research questions, leaving 26 tools. Of these, 11 assessed indicators of psychological adjustment; seven assessed various domains of self-determination; five measured self-management behaviours, for example, foot care, blood glucose testing and lifestyle domains; and three measured diabetes knowledge und understanding, respectively. When the Appraisal Checklist was applied, only three tools met all criteria, namely the Problem Areas in Diabetes (PAID) scale, the Summary of Diabetes Self-Care Activities (SDSCA) scale and the Appraisal of Diabetes Scale (ADS). However, a number of other suitable tools [i.e. the Diabetes Integration Scale (ATT19), the Diabetes Health Profile (DHP-1/18), the Self-Care Inventory-Revised (SCI-R), the Diabetes Management Self Efficacy Scale Australian/English version (DMSES-A/E), the Diabetes Empowerment Scale-Short Form (DES-SF)] met all except one criteria, that is, either no formal test-retest or no responsiveness to change data.

Conclusions  Although numerous tools were identified, few met rigorous psychometric appraisal criteria. Issues of suitability, adequate psychometric testing for the intended purpose, burden and feasibility need to be considered before adopting tools for measuring diabetes education outcomes.

  N. Aujla , T. C. Skinner , K. Khunti and M. J. Davies
  Aims  To compare the identification of prevalent depressive symptoms by the World Health Organization-5 Wellbeing Index (WHO-5) and Centre for Epidemiological Studies Depression Scale (CES-D) for South Asian and white European people, male and female, attending a diabetes screening programme, and to explore the adequacy of the screening tools for this population. An additional aim was to further explore associations of depressive symptoms with impaired glucose regulation (IGR) and Type 2 diabetes mellitus (Type2 DM).

Methods  Eight hundred and sixty-four white European (40-75 years old) and 290 South Asian people (25-75 years old) underwent an oral glucose tolerance test (OGTT), detailed history and anthropometric measurements and completed the WHO-5 and CES-D. Depressive symptoms were defined by a WHO-5 score ≤ 13, and CES-D score ≥ 16.

Results  Unadjusted prevalence of depressive symptoms with the WHO-5, for people with Type2 DM was 42.3% (47.4% in white European; 28.6% in South Asian) and for IGR 30.7% (26% in white European; 45.8% in South Asian). With the CES-D, the prevalence in Type2 DM was 27.2% (25.4% in white European; 31.8% in South Asian) and for IGR 30.7% (27.8% in white European; 40.7% in South Asian). Statistically significant differences in the prevalence of depressive symptoms for sex or ethnicity were not identified. Odds ratios adjusted for age, sex and ethnicity showed no significant association of depression with Type2 DM or IGR, with either WHO-5 or CES-D. Agreement was moderate (κ = 0.48, 95% confidence intervals 0.42-0.54), and reduced when identifying depressive symptoms in people with Type2 DM. For this group, a WHO-5 cut-point of ≤ 10 was optimal.

Conclusions  Depressive symptoms, identified by WHO-5 or CES-D, were not significantly more prevalent in people with Type2 DM or IGR. The WHO-5 and CES-D differed in their identification of depressive symptoms in people with Type2 DM, though discrepancies between sex and ethnicity were not identified.

  T. C. Skinner , M. E. Carey , S. Cradock , H. M. Dallosso , H. Daly , M. J. Davies , Y. Doherty , S. Heller , K. Khunti and L. Oliver
  Aims  To describe the course of depressive symptoms during the first year after diagnosis of Type 2 diabetes.

Methods Post hoc analysis of data from a randomized controlled trial of self-management education for 824 individuals newly diagnosed with Type 2 diabetes. Participants completed the Depression scale of the Hospital Anxiety and Depression Scale after diagnosis and at 4, 8 and 12 months follow-up. Participants also completed the Problem Areas in Diabetes scale at 8 and 12 months follow-up. We present descriptive statistics on prevalence and persistence of depressive symptoms. Logistic regression is used to predict possible depression cases, and multiple regression to predict depressive symptomatology.

Results  The prevalence of depressive symptoms in individuals recently diagnosed with diabetes (18-22% over the year) was not significantly different from normative data for the general population (12%) in the UK. Over 20% of participants indicated some degrees of depressive symptoms over the first year of living with Type 2 diabetes; these were mostly transient episodes, with 5% (1% severe) reporting having depressive symptoms throughout the year. At 12 months post diagnosis, after controlling for baseline depressive symptoms, diabetes-specific emotional distress was predictive of depressive symptomatology.

Conclusions  The increased prevalence of depressive symptoms in diabetes is not manifest until at least 1 year post diagnosis in this cohort. However, there are a significant number of people with persistent depressive symptoms in the early stages of diabetes, and diabetes-specific distress may be contributing to subsequent development of depressive symptoms in people with Type 2 diabetes.

  N. Aujla , M. J. Davies , T. C. Skinner , L. J. Gray , D. R. Webb , B. Srinivasan and K. Khunti
  Aim  To investigate associations between anxiety and measures of glycaemia in a White European and South Asian population attending community-based diabetes screening.

Methods  In total, 4688 White European and 1353 South Asian participants (aged 40-75 years) without a previous diagnosis of Type 2 diabetes underwent an oral glucose tolerance test and HbA1c measurement, detailed history, anthropometric measurements and completed the short-form Spielberger State Trait Anxiety Inventory.

Results  Anxiety was significantly higher in South Asian participants (mean 34.1; sd 0.37) compared with White European participants (mean 29.8; sd 0.13). Significant correlations were not identified between anxiety and fasting (r = −0.01, P = 0.75), 2-h glucose (r = −0.10, P = 0.24) or HbA1c (r = 0.01, P = 0.40).

Conclusions  Anxiety levels at screening were greater among South Asian people. Fasting, 2-h plasma glucose and HbA1c are not affected by anxiety during screening tests for diabetes. Current and proposed screening methods for diagnosis of diabetes are not affected by anxiety at screening.

  B. M. Perrin , H. Swerissen , C. B. Payne and T. C. Skinner


The aim of this study was to explore the cognitive representations of peripheral neuropathy and self-reported foot-care behaviour in an Australian sample of people with diabetes and peripheral neuropathy.


This cross-sectional study was undertaken with 121 participants with diabetes and peripheral neuropathy. Cognitive representations of peripheral neuropathy were measured by the Patients' Interpretation of Neuropathy questionnaire and two aspects of self-foot-care behaviour were measured using a self-report questionnaire. Hierarchical cluster analysis using the average linkage method was used to identify distinct illness schemata related to peripheral neuropathy.


Three clusters of participants were identified who exhibited distinct illness schemata related to peripheral neuropathy. One cluster had more misperceptions about the nature of peripheral neuropathy, one cluster was generally realistic about the nature of their condition and the final cluster was uncertain about their condition. The cluster with high misperceptions of their condition undertook more potentially damaging foot-care behaviours than the other clusters (F = 4.98; P < 0.01).


People with diabetes and peripheral neuropathy have different illness schemata that may influence health-related behaviour. Education aimed at improving foot-care behaviour and foot-health outcomes should be tailored to specific illness schemata related to peripheral neuropathy.

  T. C. Skinner , D. G. Bruce , T. M. E. Davis and W. A. Davis


To determine whether the personality traits of conscientiousness and agreeableness are associated with self-care behaviours and glycaemia in Type 2 diabetes.


The Big Five Inventory personality traits Agreeableness, Conscientiousness, Extraversion, Neuroticism and Openness were determined along with a range of other variables in 1313 participants with Type 2 diabetes (mean age 65.8 ± 11.1 years; 52.9% men) undertaking their baseline assessment as part of the community-based longitudinal observational Fremantle Diabetes Study Phase II. Age- and sex-adjusted generalized linear modelling was used to determine whether personality was associated with BMI, smoking, self-monitoring of blood glucose and medication taking. Multivariable regression was used to investigate which traits were independently associated with these self-care behaviours and HbA1c.


Patients with higher conscientiousness were less likely to be obese or smoke, and more likely to perform self-monitoring of blood glucose and take their medications (P ≤ 0.019), with similar independent associations in multivariate models (P ≤ 0.024). HbA1c was independently associated with younger age, indigenous ethnicity, higher BMI, longer diabetes duration, diabetes treatment, self-monitoring of blood glucose (negatively) and less medication taking (P ≤ 0.009), but no personality trait added to the model.


Although there was no independent association between personality traits and HbA1c, the relationship between high conscientiousness and low BMI and beneficial self-care behaviours suggests an indirect positive effect on glycaemia. Conscientiousness could be augmented by the use of impulse control training as part of diabetes management.

Copyright   |   Desclaimer   |    Privacy Policy   |   Browsers   |   Accessibility