Professor Andrew Boulton

Professor of Medicine

Manchester Royal Infirmary
Division of Medicine                                                                             
Oxford Road
Manchester
M13 9WL

Role

Andrew Boulton is Professor of Medicine with a special interest in diabetes and its complications at the University of Manchester and Consultant Physician at Manchester Royal Infirmary.  His clinical role includes inpatient supervision of patients with diabetic complications and outpatient clinics at the Manchester Diabetes Centre.  As director of the DIALEX (Diabetes Lower Extremity) Research Group I am responsible for:

  • Planning clinical research into diabetic complications
  • Developing collaborative research with colleagues in Europe and North America
  • Running undergraduate and postgraduate teaching in diabetes and its complications
  • In these roles I work closely with Professor Rayaz A Malik, Professor of Medicine

Memberships of Committees and Professional Bodies

  • Andrew Boulton is member of the British, European and American Diabetes Associations, and the Association of Physicians of Great Britain and Northern Ireland.  From 1995 - 2002 he was Director of Postgraduate Education for the European Association for the Study of Diabetes (EASD), and from 2002 to 2004 he was Programme Chair/Honorary Secretary of the EASD.
  • He is currently President of the EASD and EFSD (European Foundation for the Study of Diabetes).
  • He sits as the expert on diabetic neuropathy and foot problems on the NIH/NIDDK/DCCT/EDIC Advisory Board
  • He is also Honorary President of the Diabetic Foot Society of South Africa
     

Research

I am a member of the Institute of Health Sciences Diabetes and Obesity Research Network. My research interests in this area include:

  • Clinical Research in Diabetic Foot: The Manchester DIALEX (Diabetes Lower Extremity Research Group) has been actively researching clinical aspects of diabetic foot disease over the last 20 years. Over 200 peer reviewed research articles have been published as a result of research in this group.
  • Clinical Aspects of Diabetic Somatic Peripheral Neuropathy: Again the DIALEX Research Group has been active in researching clinical aspects of the pathogenesis and treatment of diabetic peripheral neuropathy.
  • Clinical Research in Diabetic Nephropathy: In collaboration with Professor Gokal and more recently Dr Anand Vardhan, the Group has been active in researching clinical aspects of the management of diabetic nephropathy at all stages.
  • Grants: Prof Boulton holds grants from a number of organisations including Diabetes UK and the National Institutes of Health, USA.

Keywords

  • Epidemiology
  • Micro-vascular problems (eg nephropathy, retinopathy, neuropathy)

Methodological Knowledge

  • Case control studies
  • Clinical Trials
  • Epidemiology
  • Randomised control trials/experimental studies
  • Systematic reviews/evidence based practise

Teaching

Undergraduate

Andrew Boulton regularly teaches undergraduate medical students in their clinical years and has supervised many students in reseach projects.

Postgraduate

Andrew has successfully supervised around 15 PhD and MD Students. He is currently supervising 2 PhD and one MD students.

Biography

  • Professor Boulton has been Chairman of Postgraduate Education for the European Diabetes Association and Honorary Secretary/ Programme Chair for the EASD in the last 5 years. In addition he has strong links with American centres
  • He is currently Professor of Medicine (Diabetes) at the University of Manchester and Consultant Physician at the Manchester Royal Infirmary
  • He has published over 300 peer review papers and currently holds major grants as listed above
  • Andrew was the first Awardee of the International Award into Diabetic Foot Research (1995) and has also received the Castelli-Pedroli Prize from the European Association for the Study of Diabetes (2003) and the Roger Pecoraro Award from the American Diabetes Association (1996)
  • More recently he was awarded (2005) the Edward Olmos Award for Advocacy in the Prevention of Amputation in Diabetes
  • Andrew was formally Editor of Diabetic Medicine (1991- 1995) and is currently an Associate Editor for Diabetes Care as well as being on the Editorial Board of Current Diabetes reports and the International Diabetes Monitor. He currently is the advisor to the NIH for the EDIC Study (Epidemiology of Diabetes and its Complications), the follow up of the DCTT Study
  • From 2002 to 2004 Andrew Boulton was Professor of Medicine at the University of Miami and he still holds a visiting professorship to the Diabetes Research Institute of that University

Qualifications

  • Andrew Boulton graduated with honours in medicine from the University of Newcastle upon Tyne (MB, BS (Honours), 1976) and subsequently obtained the MRCP (UK) in 1979 and he was elected FRCP in 1992. He obtained his MD in complications of diabetes from the University of Newcastle upon Tyne in 1985. After clinical training in Newcastle upon Tyne, Sheffield and later Miami, Andrew Boulton was appointed Senior Lecturer in Medicine/Consultant Physician at the University of Manchester in 1986. He was subsequently promoted to Reader and then in 1995 to Professor of Medicine.  DSc (Hon), University of Cluj (Romania), 2004.

Collaborators and affiliated staff

  • Professor David Armstrong
    Professor Armstrong is Professor of Surgery at the University of Arizona, Tucson, USA. 
  • Professor John Bowker & Professor Mark Mizel
    School of Orthopaedics, University of Miami, Florida, USA
  • Professor Robert Gailey
    School of Orthopaedics, University of Miami, Florida, USA
  • Professor Robert Kirsner
    University of Miami, Department of Dermatology, Florida, USA
  • Professor Lawrence Lavery
    University of Texas, Dallas, Texas, USA

Publications

2013

  • Armstrong DG, Kanda VA, Lavery LA, Marston W, Mills JL Sr, Boulton AJM. (2013). Mind the gap: disparity between research funding and costs of care for diabetic foot ulcers. Diabetes Care, 36, 1815-1817. eScholarID:204136
  • Boulton AJ, Kempler P, Ametov A, Ziegler D. (2013). Whither pathogenetic treatments for diabetic polyneuropathy. Diabetes Metabolism Research and Reviews, eScholarID:197336
  • Crawford F, Anandan C, Chappell FM, Murray GD, Price JF, Sheikh A, Simpson CR, Maxwell M, Stansby GP, Young MJ, Abbott CA, Boulton AJ, Boyko EJ, Kastenbauer T, Leese GP, Monami M, Monteiro-Soares M, Rith-Najarian SJ, Veves A, Coates N, Jeffcoate WJ, Leech N, Fahey T, Tierney J. (2013). Protocol for a systematic review and individual patient data meta-analysis of prognosis factors of foot ulceration in people with diabetes: the international research collaboration for the predication of diabetic foot ulcerations (PODUS). BMC Med Res Methodol, eScholarID:197338
  • Malone M, Bowling FL, Gannass A, Jude EB, Boulton AJM. (2013). Deep wound culture. Diabetes Metab Res Rev, 13, eScholarID:197340
  • Papanas N, Boulton AJ, Malik RA, Manes C, Schnell O, Spallone V, Tentolouris N, Tesfaye S, Valensi P, Ziegler D, Kempler P. (2013). A simple new non-invasive sweat indicator test for the diagnosis of diabetic neuropathy. Diabetic Medicine, 30, 525-534. eScholarID:197333
  • Petropoulos IN, Alam U, Fadavi H, Asghar O, Green P, Ponirakis G, Marshall A, Boulton AJM. (2013). Corneal nerve loss detected with corneal confocal microscopy is symmetrical and related to the severity of diabetic polyneuropathy. Diabetes Care, eScholarID:204137
  • Tavakoli M, Mitu-Pretorian M, Petropoulos IN, Fadavi H, Asghar O, Alam U, Ponirakis G, Jeziorska M, Marshall A, Efron N, Boulton AJ, Augustine T, Malik RA. (2013). Corneal confocal microscopy detects early nerve degeneration in diabetic neuropathy after simultaneous pancreas and kidney transplantation. Diabetes, 62, 254-260. eScholarID:197334
  • Halban PA, Boulton AJ, Smith U. (2013). A new paradigm for improved coordination and efficacy of European biomedical research: taking diabetes as a model. Diabetologia, 56, 439-443. eScholarID:197335
  • Lamont P, Franklyn K, Rayman G, Boulton AJM. (2013). Update on the diabetic foot 2012: the 14th biennial Malvern Diabetic Foot Conference, May 9-11, 2012. Int J Low Extrem Wounds, 12, 71-75. eScholarID:197339

2012

  • Bowling FL, Abbott CA, Harris WE, Atanasov S, Malik RA, Boulton AJ. (2012). A pocket-sized disposable device for testing the integrity of sensation in the outpatient setting. 29, 1550-1552. eScholarID:197327
  • Malone M, Gannass A, Binahmed A, Bowling FL, Boulton AJ. (2012). An extensive primary nodular melanoma of the foot with associated distant metastases: a case report. Foot (Edinb), 235-239. eScholarID:197322
  • Oates A, Bowling FL, Boulton AJM, McBain AJ. (2012). Molecular and culture based assessment of the microbial diversity of diabetic chronic foot wounds and contralateral skin sites. Journal of Clinical Microbiology, 2263-2271. eScholarID:197318
  • Boulton AJ, Del Prato S. (2012). Regulation of medical devices used in diabetology in Europe: time for reform? Diabetologia, 2295-2297. eScholarID:197323
  • Boulton AJM. (2012). Diabetic Foot - what can we learn from diabetes? A legacy to Dr Paul W Brand. Diabetes Metabolism Research Reviews, 3-7. eScholarID:197317
  • Boulton AJM. (2012). Diabetic neuropathy: is pain God's greatest gift to mankind. Seminars in Vascular Surgery, 25, 61-65. eScholarID:197332

2011

  • Abbott CA, Malik RA, van Ross ER, Kulkarni J, Boulton AJM. (2011). Prevalence and characteristics of painful diabetic neuropathy in a large community-based diabetic population in the UK. Diabetes Care, 34(10), 2220-2224. eScholarID:135020 | DOI:10.2337/dc11-1108
  • Ndip A, Williams A, Jude EB, Serracino-Inglott F, Richardson S, Smyth JB, Boulton AJM, Alexander MY. (2011). The RANKL/RANK/OPG Signaling Pathway Mediates Medial Arterial Calcification in Diabetic Charcot Neuroarthropathy. Diabetes, 60(8), 2187-2196. eScholarID:127947 | DOI:10.2337/db10-1220
  • Rogers LC, Frykberg RG, Armstrong DG, Boulton AJM, Edmonds M, Van GH, Hartemann A, Game F, Jeffcoate W, Jirkovska A, Jude E, Morbach S, Morrison WB, Pinzur M, Pitocco D, Sanders L, Wukich DK, Uccioli L. (2011). The Charcot foot in diabetes. Diabetes Care, 34(9), 2123-2129. eScholarID:135031 | DOI:10.2337/dc11-0844
  • Tavakoli M, Kallinikos P, Iqbal A, Herbert A, Fadavi H, Efron N, Boulton AJM, Malik RA. (2011). Corneal confocal microscopy detects improvement in corneal nerve morphology with an improvement in risk factors for diabetic neuropathy. Diabetic Medicine, 28(10), 1261-1267. eScholarID:135017 | DOI:10.1111/j.1464-5491.2011.03372.x
  • Ziegler D, Low PA, Litchy WJ, Boulton AJM, Vinik AI, Freeman R, Samigullin R, Tritschler H, Munzel U, Maus J, Schutte K, Dyck PJ. (2011). Efficacy and safety of antioxidant treatment with alpha-lipoic acid over 4 years in diabetic polyneuropathy: the NATHAN 1 trial. Diabetes Care, 34(9), 2054-2060. eScholarID:135018 | DOI:10.2337/dc11-0503
  • Katsilambros NL, Boulton AJM, Tentolouris N, Kokkinos A, Liatis S. (2011). Autonomic neuropathy in diabetes mellitus and obesity: an update. Exp Diabetes Res, eScholarID:197316
  • Rogers LC, Frykberg RG, Armstrong DG, Boulton AJ, Edmonds M, Van GH, Hartemann A, Game F, Jeffcoate W, Jirkovska A, Jude E, Morbach S, Morrison WB, Pinzur M, Pitocco D, Sanders L, Wukich DK, Uccioli L. (2011). The Charcot foot in diabetes. Diabetes Care, 2123-2129. eScholarID:197315

2010

  • Abbott CA, Chaturvedi N, Malik RA, Salgami E, Yates AP, Emberton PW, Boulton AJM. (2010). Explanations for the lower rates of diabetic neuropathy in Indian Asians versus Europeans. Diabetes Care, 33: epub ahead of print to March 9, eScholarID:77746
  • Abbott CA, Chaturvedi N, Malik RA, Salgami E, Yates AP, Pemberton PW, Boulton AJM. Diabetes Care 2010; 33: 1325-1330. (2010). Explanations for the lower rates of diabetic neuropathy in Indian Asians versus Europeans. Diabetes Care, 33(6), 1325. eScholarID:127944 | DOI:10.2337/dc09-2067
  • Ndip A, Lavery LA, Lafontaine J, Rutter MK, Vardhan A, Vileikyte L, Boulton AJM. Diabetes Care 2010; 33: 878-880. (2010). High levels of foot ulceration and amputation risk in a multiracial cohort of diabetic patients on dialysis therapy. eScholarID:127948
  • Ndip A, rutter MK, vileikyte L, Vardhan A, Jameel M, Lavery LA, Boulton AJM. Diabetes Care 2010; 33: 1811-1816. (2010). Dialysis Treatment Is an Independent Risk Factor for Foot Ulceration in Patients With Diabetes and Stage 4 or 5 Chronic Kidney Disease. Diabetes care, 33(8), 1811. eScholarID:127946 | DOI:10.2337/dc10-0255

2009

  • Boulton AJM, Jeffcoate W, Jones T, Ulbrecht J. (2009). International collaborative research on Charcot's disease. Lancet, 373( 9658), eScholarID:1d20957 | DOI:10.1016/S0140-6736(09)60019-2
  • Bowling F, King L, Fadavi H, Paterson J, Preece K, Daniel R, Matthews D, Boulton AJM. (2009). An assessment of the accuracy and usability of a novel optical wound measurement system. Diabet Med, 26( 1), eScholarID:1d20959 | DOI:10.1111/j.1464-5491.2008.02611.x
  • Bowling FL, King L, Fadavi H, Paterson JA, Preece K, Daniel RW, Matthews DJ, Boulton AJM. Diabetic Medicine 2009; 26: 93-96. (2009). Assessment of the accuracy and usability of a novel optical wound measurement system . eScholarID:127949
  • Vileikyte L, Peyrot M, Gonzalez JS, Rubin RR, Garrow AP, Waterman C, Cavanagh PR, Boulton AJM. Diabetologia 2009; 52: 11265-1273. (2009). Predictors of depressive symptoms in persons with diabetic peripheral neuropathy: a longitudinal study. Diabetologia, 52(7), 1265. eScholarID:127941 | DOI:10.1007/s00125-009-1363-2
  • Vileikyte, L, Peyrot, M, Gonzalez, J, Rubin, R, Garrow, A, Stickings, D, Waterman, C, Ulbrecht, J, Cavanagh, P, Boulton, AJM. (2009). Predictors of depressive symptoms in persons with diabetic peripheral neuropathy: a longitudinal study. Diabetologia, 52( 7), eScholarID:1d20953 | DOI:10.1007/s00125-009-1363-2

2008

  • Apelqvist J, Armstrong D, Lavery L, Boulton AJM. (2008). Resource utilization and economic costs of care based on a randomized trial of vacuum-assisted closure therapy in the treatment of diabetic foot wounds. Am J Surg, 195( 6), eScholarID:1d20966 | DOI:10.1016/j.amjsurg.2007.06.023
  • Quattrini C, Jeziorska M, Boulton AJM, Malik RA. (2008). Reduced Vascular Endothelial Growth Factor Expression and Intra-Epidermal Nerve Fiber Loss in Human Diabetic Neuropathy. Diabetes Care, 31(1), 140-145. eScholarID:1d19432 | DOI:10.2337/dc07-1556
  • Solano M, Prieto L, Varon J, Moreno M, Boulton AJM. (2008). Ethnic differences in plantar pressures in diabetic patients with peripheral neuropathy. Diabet Med, 25( 4), eScholarID:1d20965 | DOI:10.1111/j.1464-5491.2008.02381.x

2007

  • Bowling FL, Salgami EV, Boulton AJM. (2007). Larval Therapy: A novel treatment in eliminating Methycillin-Staphylococcus Aureus from diabetic foot ulcers. 30, 370-371. eScholarID:1d16593
  • Hardy T, Sachson R, Shen S, Armbruster M, Boulton AJM. (2007). Does treatment with duloxetine for neuropathic pain impact glycemic control? Diabetes Care, 30(1), 21-6. eScholarID:1d27547
  • Mehra S, Tavakoli M, Kallinikos P, Efron N, Boulton AJM, Augustine T, Malik R. (2007). Corneal confocal microscopy detects early nerve regeneration after pancreas transplantation in patients with type 1 diabetes. Diabetes Care, 30( 10), eScholarID:1d20970 | DOI:10.2337/dc07-0870
  • Mehra S, Tavakoli M, Kallinikos PA, Efron N, Boulton AJM, Augustine T, Malik RA. (2007). Corneal Confocal Microscopy Detects Early Nerve Regeneration After Pancreas Transplantation. Diabetes Care, e-pub ahead of print, eScholarID:1d15994
  • Quattrini, C, Tavakoli, M, Jeziorska, M, Kallinikos, P, Tesfaye, S, Finnigan, J, Marshall, A, Boulton, AJM, Efron, N, Malik, RA. (2007). Surrogate Markers of Small Fiber Damage in Human Diabetic Neuropathy. Diabetes, 56, 2148-54. eScholarID:1d15990 | DOI:10.2337/db07-0285

2006

  • Vileikyte L, Gonzales JS, Leventhal H, Peyrot MF, Rubin RR, Garrow A, Ulbrecht JS, Cavanagh PR, Boulton AJM. (2006). Patient Interpretation of Neuropathy (PIN)questionnaire: an instrument for assessment of cognitive and emotional factors associated with foot self-care. Diabetes Care, 29(12), 2617-24. eScholarID:1d27546
  • Vileikyte L, Gonzalez J, Leventhal H, Peyrot M, Rubin R, Garrow A, Ulbrecht J, Cavanagh P, Boulton AJM. (2006). Patient Interpretation of Neuropathy (PIN) questionnaire: an instrument for assessment of cognitive and emotional factors associated with foot self-care. Diabetes Care, 29( 12), eScholarID:1d20980 | DOI:10.2337/dc06-1550
  • Vileikyte L, Gonzalez JS, Leventhal H, Peyrot MF, Rubin RR, Garrow A, Ulbrecht JS, Cavanagh PR, Boulton AJM. (2006). Patient interpretation of neuropathy (PIN) questionnaire: an instrument for assessment of cognitive and emotional factors associated with foot self-care. Diabetes Care, 29(12), 2617-2624. eScholarID:84799

2005

  • Abbott CA, Garrow A, Carrington AL, Morris JJA, Van Ross EE, Boulton AJM. (2005). Foot ulcer risk is lower in South-Asian and African-Caribbean compared with European diabetic patients in the UK: The North-West diabetes foot study care. Diabetes Care, 28(8), 1869-75. eScholarID:1d26765 | DOI:10.2337/diacare.28.8.1869
  • Boulton AJM, Vileikyte L, Ragnarson-Tennvall, Apelqvist J. (2005). The global burden of diabetic foot disease. Lancet, 366, 1721-1725. eScholarID:1d26704
  • van Schie CH M, Rawat F, Boulton AJM. (2005). Reduction of plantar pressure using a prototype pressure-relieving dressing. Diabetes Care, 28(9), 2236-2237. eScholarID:1d26533
  • Vileikyte, L, Leventhal, Howard, Gonzalez, JS, Peyrot, Mark, Rubin, Richard R, Ulbrecht, Jan S, Garrow, A, Waterman, CG, Cavanagh, Peter R, Boulton, AJM. (2005). Diabetic peripheral retinopathy and depressive symptoms. Diabetes Care, 28, 2378-2383. eScholarID:1d27009 | DOI:10.2337/diacare.28.4.956

2002

  • E B Jude, R Blakytny, J Bulmer, Boulton AJM, Ferguson MW.J. (2002). Transforming growth factor-beta 1,2,3 and receptor type I and II in diabetic foot ulcers. Diabetic Medicine, 19, 440-7. eScholarID:1d3599 | DOI:10.1046/j.1464-5491.2002.00692.x

2001

  • Purves T, Middlemas A, Agthong S, Jude E, Boulton AJM, Ferneyhough P, Tomlinson D. (2001). A role for mitogen-activated protein kinases in the etiology of diabetic neuropathy. Faseb Journal, Nov ; 15 (13), 2508-14. eScholarID:1d26045
  • Purves T, Middlemas A, Agthong S, Jude E, Boulton AJM, Fernyhough P, Tomlinson D. (2001). A role for mitogen-activated protein kinases in the etiology of diabetic neuropathy. FASEB J, 15( 13), 2508-14. eScholarID:1d29741

2000

  • R Blakytny, EB Jude, Gibson JM, Boulton AJM, Ferguson MW.J. (2000). Lack of insulin-like growth factor 1 (IGF1) in the basal keratinocyte layer of diabetic skin and diabetic foot ulcers. Journal Of Pathology, 190, 589-596. eScholarID:1d33776

1999

  • EB Jude, Boulton AJM, Ferguson MW.J, I Appleton. (1999). The role of nitric oxide synthase isoforms and arginase in the pathogenesis of diabetic foot ulcers: possible modulatory effects by transforming growth factor beta 1. Diabetologia, 42, 748-757. eScholarID:1d33929
  • Jude E, Boulton AJM, Ferguson MW.J, I Appleton. (1999). The role of nitric oxide synthase isoforms and arginase in the pathogenesis of diabetic foot ulcers: possible modulatory effects by transforming growth factor beta 1. Diabetologia, 42, 748-57. eScholarID:1d3605

1996

  • Bhatnagar D, Durrington PN, Kumar S, Mackness MI, Boulton AJM. (1996). Plasma lipoprotein composition and cholesteryl ester transfer from high density lipoproteins to very low density and low density lipoproteins in patients with non-insulin-dependent diabetes mellitus. Diabet Med, 13( 2), eScholarID:1d19563 | DOI:10.1002/(SICI)1096-9136(199602)13:2<139::AID-DIA15
  • Kumar, S, Durrington, PN, O'Rahilly, S, Laing, I, Humphreys, P, Olukoga, A, Bhatnagar, D, Mackness, MI, Davis, JRE, Boulton, AJM. (1996). Severe insulin resistance, diabetes mellitus, hypertriglyceridemia, and pseudoacromegaly. J Clin Endocrinol Metab, 81( 10), eScholarID:1d19568

1995

  • Bhatnagar D, Durrington PN, Kumar S, Mackness MI, Dean J, Boulton AJM. (1995). Effect of treatment with a hydroxymethylglutaryl coenzyme A reductase inhibitor on fasting and postprandial plasma lipoproteins and cholesteryl ester transfer activity in patients with NIDDM. Diabetes, 44( 4), eScholarID:1d19553