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Primary Care Diabetes

Attila Nagy, Nóra Kovács, Anita Pálinkás, Valéria Sipos, Ferenc Vincze, Gergő Szőllősi, Orsolya Csenteri, Róza Ádány, János Sándor
AIMS: The study aimed to launch a T2DM adult cohort that is representative of Hungary through a cross-sectional study, to produce the most important quality indicators for T2DM care, to describe social inequalities, and to estimate the absolute number of T2DM adult patients with uncontrolled HbA1c levels in Hungary. METHODS: A representative sample of the Hungarian T2DM adults (N=1280) was selected in 2016. GPs collected data on socio-demographic status by questionnaire, and on history and laboratory parameters from medical records...
January 8, 2018: Primary Care Diabetes
Ramfis Nieto-Martínez, Jeffrey I Mechanick, Imperia Brajkovich, Eunice Ugel, Alejandro Risques, Hermes Florez, Juan Pablo González-Rivas
OBJECTIVE: The prevalence of diabetes in multiple regions of Venezuela is unknown. To determine the prevalence of diabetes in five populations from three regions of Venezuela. METHODS: During 2006-2010, 1334 subjects ≥20years were selected by multistage stratified random sampling from all households from 3 regions of Venezuela. Anthropometric measurements and biochemical analysis were obtained. Statistical methods were calculated using SPSS 20 software. FINDINGS: Mean (SE) age was 44...
December 14, 2017: Primary Care Diabetes
Caroline King, Sidney Atwood, Chris Brown, Adrianne Katrina Nelson, Mia Lozada, Jennie Wei, Maricruz Merino, Cameron Curley, Olivia Muskett, Samantha Sabo, Vikas Gampa, John Orav, Sonya Shin
OBJECTIVES: To evaluate the role of primary care healthcare delivery on survival for American Indian patients with diabetes in the southwest United States. METHODS: Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses. RESULTS: Of the 2661 patients included in analysis, 286 patients died during the study period. Having visited a primary care provider in the year prior to first admission of the study period was protective against all-cause mortality in unadjusted analysis (HR (95% CI)=0...
December 8, 2017: Primary Care Diabetes
Jennifer A Andersen, Larry Gibbs
OBJECTIVE: To evaluate adherence to care standards for people with diabetes (PWDs) on insulin therapy versus PWDs who are not on insulin therapy, controlling for social determinants. RESEARCH DESIGN AND METHODS: Utilizing the United States 2015 Behavioral Risk Factor Surveillance System Survey, this study used logistic regression analyses to estimate differences in self-care behaviors, healthcare provider quality of care, and diabetic complications for individuals on insulin therapy and individuals not on insulin therapy...
December 6, 2017: Primary Care Diabetes
Andrés Gaviria-Mendoza, Jorge Andrés Sánchez-Duque, Diego Alejandro Medina-Morales, Jorge Enrique Machado-Alba
AIMS: To determine the prescription patterns of antidiabetic medications and the variables associated with their use in a Colombian population. METHODS: A cross-sectional study using a systematized database of approximately 3.5 million affiliates of the Colombian Health System. Patients of both genders and all ages treated uninterruptedly with antidiabetic medications for three months (June-August 2015) were included. A database was designed that included sociodemographic, pharmacological, comedication, and cost variables...
November 28, 2017: Primary Care Diabetes
Myriam Jaam, Mohamed Izham Mohamed Ibrahim, Nadir Kheir, Muhammad Abdul Hadi, Mohammad Issam Diab, Ahmed Awaisu
BACKGROUND: Studies conducted in Qatar have reported a high prevalence of diabetic nephropathy, retinopathy, and neuropathy. These complications are often associated with poor medication adherence and uncontrolled diabetes. The objectives of this study were to determine the rate of medication adherence among patients with uncontrolled diabetes, and to compare the characteristics and identified barriers between patients with good and those with poor medication adherence. METHOD: A cross-sectional quantitative study was conducted among patients living in Qatar with uncontrolled diabetes attending primary healthcare clinics from October 2016 to January 2017...
November 20, 2017: Primary Care Diabetes
Jéssica Azevedo Aquino, Nayara Ragi Baldoni, Cristina Rabelo Flôr, Cristina Sanches, Cláudia Di Lorenzo Oliveira, Geisa Cristina Silva Alves, Amaury Lelis Dal Fabbro, André Oliveira Baldoni
AIMS: To identify and evaluate the effectiveness of individual empowerment strategies in patients with diabetes mellitus (DM). METHODS: A systematic review was performed in the PubMed, Scopus, Science Direct and BVS. For meta-analysis and evaluation of Cochrane Risk and Bias, Revman V 5.2 software was used. RESULTS: Eleven studies of 1073 publications met the inclusion criteria. The strategies used were individual consultations, phone calls, sessions via a website and use of a booklet...
November 18, 2017: Primary Care Diabetes
Courtney H Van Houtven, Melissa A Greiner, Brooke Heidenfelder, Susan E Spratt, Bradi B Granger, Ashley A Dunham, Laura G Qualls, Lesley H Curtis
AIMS: Type 2 diabetes mellitus imposes significant burdens on patients and health care systems. Population-level interventions are being implemented to reach large numbers of patients at risk of or diagnosed with diabetes. We describe a population-based evaluation of the Southeastern Diabetes Initiative (SEDI) from the perspective of a payer, the Centers for Medicare & Medicaid Services (CMS). The purpose of this paper is to describe the population-based evaluation approach of the SEDI intervention from a Medicare utilization and cost perspective...
November 1, 2017: Primary Care Diabetes
Samaneh Kalirai, Judith Stephenson, Magaly Perez-Nieves, Michael Grabner, Irene Hadjiyianni, Caroline Geremakis, Roy Daniel Pollom, Beverly Reed, Lawrence Fisher
AIMS: To describe primary care physicians' (PCPs) perceptions of patient reactions and concerns about insulin initiation and identify opportunities for increased support. METHODS: Cross-sectional, online survey of PCPs prescribing basal insulin to adults with type 2 diabetes mellitus (T2DM). PCPs were identified from administrative claims of a large commercial health plan and descriptive results of PCP responses were reported. RESULTS: PCPs (N=100) treated an average of 17 patients receiving insulin during a typical week...
October 31, 2017: Primary Care Diabetes
Olga Horvat, Jelena Popržen, Ana Tomas, Milica Paut Kusturica, Zdenko Tomić, Ana Sabo
AIMS: The aims of this study were to assess patients' non-adherence and associated factors to antidiabetic medication in the primary care setting in the eastern part of Bosnia and Herzegovina (BiH). METHODS: We conducted a retrospective chart review of 323 patients with type 2 diabetes mellitus (T2DM) attending the primary health care center of the Foča municipality in eastern part of BiH and measured adherence to antidiabetic medication. Adherence was measured using a pill count method...
October 28, 2017: Primary Care Diabetes
Samuel Seidu, Tun Than, Deb Kar, Amrit Lamba, Pam Brown, Azhar Zafar, Rizwan Hussain, Ahmed Amjad, Mathew Capehorn, Elizabeth Martin, Kevin Fernando, Jim McMoran, David Millar-Jones, Shahzada Kahn, Nigel Campbell, Richard Brice, Rahul Mohan, Mukesh Mistry, Naresh Kanumilli, Joan St John, Richard Quigley, Colin Kenny, Kamlesh Khunti
INTRODUCTION: As the therapeutic options in the management of type 2 diabetes increase, there is an increase confusion among health care professionals, thus leading to the phenomenon of therapeutic inertia. This is the failure to escalate or de-escalate treatment when the clinical need for this is required. It has been studied extensively in various settings, however, it has never been reported in any studies focusing solely on primary care physicians with an interest in diabetes. This group is increasingly becoming the focus of managing complex diabetes care in the community, albeit with the support from specialists...
February 2018: Primary Care Diabetes
Sun Hee Kim, Tae Sun Park, Heung Yong Jin
AIMS: We investigated the specificity of the 75g oral glucose tolerance test (OGTT) and the clinical usefulness of the 2h post loading glucose (2h PLG) value in the clinical care of diabetes patients. METHODS: The 75g OGTT data of 1755 subjects were analyzed. The relationships and degrees of consistency among 2h PLG, fasting plasma glucose (FPG), and HbA1c values were assessed. We also investigated the degree of contribution of 2h PLG in the prescription of glucose-lowering agents and in the pitfall group for use of 75g OGTT...
December 2017: Primary Care Diabetes
Kurt Azzopardi, Alfred Gatt, Nachiappan Chockalingam, Cynthia Formosa
AIM: Diabetic peripheral neuropathy is an important complication and contributes to the morbidity of diabetes mellitus. Evidence indicates early detection of diabetic peripheral neuropathy results in fewer foot ulcers and amputations. The aim of this study was to compare different screening modalities in the detection of diabetic peripheral neuropathy in a primary care setting. METHOD: A prospective non-experimental comparative multi-centre cross sectional study was conducted in various Primary Health Centres...
October 10, 2017: Primary Care Diabetes
Yolanda Ortega, Enric Aragonès, Josep L Piñol, Josep Basora, Alvaro Araujo, Juan J Cabré
OBJECTIVES: To determine the role of anxiety and depression on the incidence of cardiovascular events (CVE) in a Catalonian population with metabolic syndrome (MetS) over a five-year follow-up according to the number/type of MetS criteria. METHODS: Prospective study to determine the incidence of CVE according to the presence of anxiety and depression disorders among individuals with different combinations of clinical traits of the MetS. SETTING: Primary Care, Catalonia (Spain)...
October 4, 2017: Primary Care Diabetes
Jo-Anne Manski-Nankervis, John Furler, David O'Neal, Louise Ginnivan, Sharmala Thuraisingam, Irene Blackberry
AIM: To examine the two-year impact of Stepping Up, a general practice based model of care intervention for insulin initiation and titration in Australia. METHODS: 266 participants from 74 general practices participated in the Stepping Up cluster randomised controlled trial between 2012-2014. Control practices received training in the model of care on completion of the 12-month trial. Patients were followed for 24 months. Participant baseline characteristics, insulin and non-insulin medication use were summarised for each study group...
October 2017: Primary Care Diabetes
J Wilding, C Bailey, U Rigney, B Blak, M Kok, C Emmas
AIMS: To investigate prescribing patterns and effect of dapagliflozin among individuals with T2DM using UK primary care data. METHODS: Adult patients with T2DM initiating dapagliflozin treatment were identified from the Clinical Practice Research Datalink. Changes in HbA1c, body weight and systolic blood pressure were assessed in subgroups defined by glucose lowering treatment at baseline and compliance with the Summary of Product Characteristics. Logistic regression examined the association of baseline characteristics with achievement of target HbA1c (≤53mmol/mol) and weight reduction (by ≥3...
October 2017: Primary Care Diabetes
Zahra Aghanouri, Mansour Siavash, Hafizollah Mombeini, Maryam Monfared, Mortaza Mojahedi, Reza Ilkhani
We present a 4-year-old newly diagnosed T1DM boy who presented with sever polyuria and polydipsia and HbA1C of 9.3%. Coincident with onset of ITM program insulin doses were tapered and the baby got free from insulin soon. Only three months after traditional anti-diabetic medications, his HbA1C improved to 5.8%.
September 28, 2017: Primary Care Diabetes
Rebecka Husdal, Andreas Rosenblad, Janeth Leksell, Björn Eliasson, Stefan Jansson, Lars Jerdén, Jan Stålhammar, Lars Steen, Thorne Wallman, Ann-Marie Svensson, Eva Thors Adolfsson
AIMS: To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbA1c level in people with Type 2 diabetes mellitus (T2DM). METHODS: People with T2DM attending 846 PHCCs (n=230958) were included in this cross-sectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities...
September 27, 2017: Primary Care Diabetes
Andreas Heltberg, John Sahl Andersen, Håkon Sandholdt, Volkert Siersma, Jakob Kragstrup, Christina Ellervik
AIMS: To investigate how self-reported risk factors (including socioeconomic status) predict undiagnosed, prevalent type 2 diabetes mellitus (T2DM). To externally validate Leicester Risk Assessment Score (LRAS), Finnish Diabetes Risk Score (FINDRISC) and Danish Diabetes Risk Score (DDRS), and to investigate how these predict a European Heart SCORE≥5% in a Danish population study. METHODS: We included 21,205 adults from the Danish General Suburban Population Study...
September 27, 2017: Primary Care Diabetes
Adrian Hugh Heald, Simon George Anderson, Gabriela Janet Cortes, Videlina Cholokova, Marcos Narajos, Adnan Khan, Gemma Donnahey, Mark Livingston
INTRODUCTION: Hypoglycaemia has been recognised as a problem in the treatment for type 2 diabetes. Here we describe how levels of HbA1C and treatment with a sulphonylurea or insulin relate to risk of significant hypoglycaemia. METHODS: Incident hypoglycaemia as recorded for the previous 10 years was determined from the GP records for patients with T2DM aged 75 years or more. RESULTS: The anonymised GP records of 5974 T2DM patients (2934 men and 3040 women) aged 75 years or more were analysed...
September 20, 2017: Primary Care Diabetes
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