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Primary Care Diabetes

Mariana Prestes, María Angelica Gayarre, Jorge Federico Elgart, Lorena Gonzalez, Enzo Rucci, Juan José Gagliardino
AIM: To test the one year-post effect of an integrated diabetes care program that includes system changes, education, registry (clinical, metabolic and therapeutic indicators) and disease management (DIAPREM), implemented at primary care level, on care outcomes and costs. METHODS: We randomly selected 15 physicians and 15 nurses from primary care units of La Matanza County to be trained (Intervention-IG) and another 15 physicians/nurses to use as controls (Control-CG)...
January 5, 2017: Primary Care Diabetes
Annalisa Giandalia, Elisabetta Lucia Romeo, Maria Concetta Ruffo, Marco Muscianisi, Letterio Giorgianni, Fiorella Forte, Domenico Cucinotta, Giuseppina Tiziana Russo
AIMS: To evaluate the prevalence and the clinical implication of persistently elevated liver enzymes in diabetic subjects, with no evidence of viral hepatitis infection or alcohol abuse. METHODS: Clinical, lifestyle, anthropometric data and laboratory test values were collected in 916 type 2 diabetic subjects, examined for alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyltranspeptidase (γ-GT) levels at two different time points. RESULTS: Five hundred forty four patients (59...
December 22, 2016: Primary Care Diabetes
Richard William Grant, Andrea Altschuler, Connie Si Uratsu, Gabriela Sanchez, Julie Ann Schmittdiel, Alyce Sophia Adams, Michele Heisler
OBJECTIVE: The purpose of this study was to examine how patients with diabetes and their primary care physicians identify and discuss visit priorities prior to and during visits. METHODS: We conducted a qualitative study involving patients with diabetes (4 focus groups, n=29) and primary care physicians (6 provider practice meeting discussions, n=67). RESULTS: Four key themes related to prioritization were identified: 1) the value of identifying visit priorities before the visit; 2) challenges to negotiating priorities during the time-limited visit; 3) the importance of "non-medical" priorities; and 4) the need for strategies to help patients prepare for visits...
December 1, 2016: Primary Care Diabetes
Almina Kalkan, Johan Bodegard, Johan Sundström, Bodil Svennblad, Carl Johan Östgren, Peter Nilsson Nilsson, Gunnar Johansson, Mattias Ekman
AIMS: To compare long-term changes in healthcare utilization and costs for type 2 diabetes patients before and after insulin initiation, as well as healthcare costs after insulin versus non-insulin anti-diabetic (NIAD) initiation. METHODS: Patients newly initiated on insulin (n=2823) were identified in primary health care records from 84 Swedish primary care centers, between 1999 to 2009. First, healthcare costs per patient were evaluated for primary care, hospitalizations and secondary outpatient care, before and up to seven years after insulin initiation...
November 25, 2016: Primary Care Diabetes
Olgun Göktaş, Özen Öz Gül, Erdinç Ertürk
AIM: The aim of the study was to investigate the treatment and monitoring patterns of type 2 diabetes patients in the Bursa region over the last 5 years since the implementation of family practice in Turkey in 2010. METHODS: A total of 216 volunteer family doctors working in family health centers took part in this study. The records of 44,819 diabetic patients who visited these doctors between January 1, 2010 and December 31, 2014 were inspected retrospectively...
November 13, 2016: Primary Care Diabetes
Jun Wu, Mary Lynn Davis-Ajami, Virginia Noxon, Zhiqiang Kevin Lu
AIMS: To determine predictors associated with the diabetes self-management education and training (DSME) venue and its impact on oral antidiabetic (OAD) medication adherence. METHODS: The Medical Expenditure Panel Survey household component (MEPS-HC) data (2010-2012) identified adults with diabetes prescribed OAD medication(s) who completed a supplemental Diabetes Care Survey (DCS). Based on the DCS responses to questions about the number and type of DSME venue(s), two groups were created: (1) multiple venues (a physician or health professional plus internet and/or group classes) vs (2) single venue (physician or health professional only)...
November 10, 2016: Primary Care Diabetes
Charles Grafton Taylor, Gordon Taylor, Anique Atherley, Ian Hambleton, Nigel Unwin, Oswald Peter Adams
AIMS: With regards to insulin initiation in Barbados we explored primary care doctor (PCD) perception, healthcare system factors and predictors of PCD reluctance to initiate insulin. METHODS: PCDs completed a questionnaire based on the theory of planned behaviour (TPB) and a reluctance to initiate insulin scale. Using linear regression, we explored the association between TPB domains and the reluctance to initiate insulin scale. RESULTS: Of 161 PCDs, 70% responded (75 private and 37 public sector)...
November 4, 2016: Primary Care Diabetes
Marcos M Lima-Martínez, Carlos Arrau, Saimar Jerez, Mariela Paoli, Juan P González-Rivas, Ramfis Nieto-Martínez, Gianluca Iacobellis
AIM: To assess the relationship between 25-hydroxyvitamin D [25(OH)D] blood concentrations in subjects with obesity and type 2 diabetes mellitus (T2D) risk according to the Finnish Diabetes Risk Score (FINDRISC) modified for Latin America (LA-FINDRISC). METHODS: This study was conducted in Ciudad Bolívar, Venezuela. Eighty two women and 20 men (53 obese and 49 nonobese), with an average age of 42.6±12.30 years were enrolled. Weight, height, body mass index (BMI), waist circumference (WC), fasting glucose, basal insulin, plasma lipids, Homeostasis Model Assessment-Insulin Resistance (HOMA-IR), and 25(OH)D levels were measured...
February 2017: Primary Care Diabetes
Kamlesh Khunti, David Millar-Jones
Achieving tight glycaemic control early following the diagnosis of type 2 diabetes is key to optimising clinical outcomes, yet many patients and clinicians are reluctant to initiate and intensify insulin therapy. Reasons for this arise primarily from a lack of time, clinical expertise and patient understanding. However, meaningful progress can be achieved with self-management educational programmes soon after diagnosis. Clinician education and training, along with easy-to-use and well-tolerated therapies (for example, those carrying a low risk of hypoglycaemia and/or avoiding weight gain), may also increase the likelihood of patient adherence...
February 2017: Primary Care Diabetes
Noël Christopher Barengo, Diana Carolina Tamayo, Teresa Tono, Jaakko Tuomilehto
AIMS: (i) To develop a diabetes mellitus risk score model for the Colombian population (ColDRISC); and (ii) to evaluate the accuracy of the ColDRISC unknown Type 2 diabetes mellitus METHODS: Cross-sectional screening study of the 18-74 years-old population of a health-care insurance company (n=2060) in northern Colombia. Lifestyle habits and risk factors for diabetes mellitus were assessed by an interview using a questionnaire consisting of information regarding sociodemographic factors, history of diabetes mellitus, tobacco consumption, hypertension, nutritional and physical activity habits...
February 2017: Primary Care Diabetes
Rickard Claesson, Claes Ignell, Nael Shaat, Kerstin Berntorp
AIM: We wanted to investigate third-trimester HbA1c as a predictor of diabetes after gestational diabetes mellitus (GDM). METHODS: Women with GDM were followed up prospectively for five years from pregnancy to detect the development of diabetes. The ability of HbA1c to predict diabetes was evaluated with receiver-operating characteristic (ROC) curves and logistic regression analysis. RESULTS: By five years, 73 of 196 women had been diagnosed with diabetes...
February 2017: Primary Care Diabetes
Milena Ilic, Irena Ilic
PURPOSE: The aim of this study was to analyze the mortality trends of diabetes mellitus in Serbia (excluding the Autonomous Province of Kosovo and Metohia). METHODS: A population-based cross sectional study analyzing diabetes mortality in Serbia in the period 1991-2015 was carried out based on official data. The age-standardized mortality rates (per 100,000) were calculated by direct standardization, using the European Standard Population. Average annual percentage of change (AAPC) and the corresponding 95% confidence interval (CI) were computed using the joinpoint regression analysis...
February 2017: Primary Care Diabetes
Anne Meike Boels, Huberta E Hart, Guy E Rutten, Rimke C Vos
AIMS: To compare the proportion of cardiometabolic well-controlled type 2 diabetes mellitus (T2DM) patients according to a clearly defined, simple personalised approach, versus the 'one-size-fits-all' approach. METHODS: Observational study using routine data of primary care type 2 diabetes patients in the Netherlands. The proportions of patients that reach the targets for HbA1c, systolic blood pressure and low-density lipoprotein cholesterol in the two different approaches were compared...
February 2017: Primary Care Diabetes
Hsu-Min Tseng, Shu-Fen Liao, Yu-Ping Wen, Yuh-Jue Chuang
AIMS: Health literacy has been recognized as a key construct associated with clinical outcomes; however, few studies have explored the mechanism underlying the association. The transtheoretical model (TTM) has long been considered a useful conceptualization in the process of intentional behavior change. Stages of change lies at the heart of the TTM as studies of change have found that people move through a series of stages when modifying behavior. This study focuses on the role of knowledge and stages of change (SOC) as serial mediators linking health literacy to glycemic control...
February 2017: Primary Care Diabetes
Rebecka Husdal, Andreas Rosenblad, Janeth Leksell, Björn Eliasson, Stefan Jansson, Lars Jerdén, Jan Stålhammar, Lars Steen, Thorne Wallman, Eva Thors Adolfsson
AIMS: To compare the resource allocation and organisational features in Swedish primary diabetes care for patients with type 2 diabetes mellitus (T2DM) between 2006 and 2013. METHODS: Using a repeated cross-sectional study design, questionnaires covering personnel resources and organisational features for patients with T2DM in 2006 and 2013 were sent to all Swedish primary health care centres (PHCCs) during the following year. In total, 684 (74.3%) PHCCs responded in 2006 and 880 (76...
February 2017: Primary Care Diabetes
Jinah K Shin, Eduard Poltavskiy, Tae Nyun Kim, Abdullah Hasan, Heejung Bang
AIM: To investigate patterns of and factors associated with help-seeking behaviors among individuals with diabetes mellitus (DM) and/or serious psychological distress (SPD). METHODS: The analysis was conducted with the California Health Interview Survey (CHIS) 2011-2012 of 40,803 adults. Logistic regression was used to examine the associations between the multiple facilitating/preventing factors and outcome, guided by the Andersen's Health Care Utilization Model...
February 2017: Primary Care Diabetes
Alain Lekoubou, Nkoke Clovis, Anastase Dzudie, Andre Pascal Kengne
BACKGROUND: Estimates from developed countries show that early mortality after stroke is unaffected by diabetes status. Despite the high burden of both conditions in sub-Saharan Africa, data on the association between diabetes status and early mortality are lacking. OBJECTIVE: In a major referral hospital in the Capital city of Cameroon, among acute stroke patients diagnosed using the World Health Organization criteria, we compared mortality rates in patents with and without known diabetes...
February 2017: Primary Care Diabetes
V A Holmes, L L Hamill, F A Alderdice, M Spence, R Harper, C C Patterson, S Loughridge, S McKenna, A Gough, D R McCance
AIM: To evaluate the effect of regional implementation of a preconception counselling resource into routine diabetes care on pregnancy planning indicators. METHODS: A preconception counselling DVD was distributed to women by diabetes care teams and general practices. Subsequently, in a prospective population-based study, pregnancy planning indicators were evaluated. The post-DVD cohort (n=135), including a viewed-DVD subgroup (n=58), were compared with an historical cohort (pre-DVD, n=114)...
February 2017: Primary Care Diabetes
Louis Jacob, Karel Kostev
AIM: To analyze psoriasis risk in type 2 diabetes mellitus (T2DM) patients treated in German primary care practices. METHODS: The study included 87,964 T2DM patients aged 40 years or over who received their initial diabetes diagnosis between 2004 and 2013. Patients were excluded if they had been diagnosed with psoriasis prior to diabetes diagnosis or if the observation period prior to the index date was less than 365 days. After applying these exclusion criteria, 72,148 T2DM patients were included...
February 2017: Primary Care Diabetes
Elizabeth A Bertran, Nicole R Pinelli, Stephen J Sills, Linda A Jaber
AIMS: Culturally-specific lifestyle diabetes prevention programs require an assessment of population disease perceptions and cultural influences on health beliefs and behaviors. The primary objectives were to assess Arab Americans' knowledge and perceptions of diabetes and their preferences for a lifestyle intervention. METHODS: Sixty-nine self-identified Arab or Arab Americans ≥30 years of age and without diabetes participated in 8 focus groups. RESULTS: Emerging themes from the data included myths about diabetes etiology, folk remedies, and social stigma...
February 2017: Primary Care Diabetes
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