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Diabetes transition to adult care

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https://www.readbyqxmd.com/read/28691009/endoscopic-vs-microscopic-resection-of-sellar-lesions-a-matched-analysis-of-clinical-and-socioeconomic-outcomes
#1
Tej D Azad, Yu-Jin Lee, Daniel Vail, Anand Veeravagu, Peter H Hwang, John K Ratliff, Gordon Li
BACKGROUND: Direct comparisons of microscopic and endoscopic resection of sellar lesions are scarce, with conflicting reports of cost and clinical outcome advantages. OBJECTIVE: To determine if the proposed benefits of endoscopic resection are realized on a population level. METHODS: We performed a matched cohort study of 9,670 adult patients in the MarketScan database who underwent either endoscopic or microscopic surgery for sellar lesions...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28686786/disparities-in-the-use-of-diabetes-screening-in-appalachia
#2
Jennifer M Lobo, Roger Anderson, George J Stukenborg, Anthony McCall, Hyojung Kang, Fabian Camacho, Min-Woong Sohn
PURPOSE: The Appalachian region presents disproportionately high rates of chronic disease compared to the rest of the United States. Early diagnosis of diabetes through screening is an important step in reducing diabetes complications. This study examines disparities in the use of diabetes screening in Appalachia. METHODS: We analyzed 2009 and 2010 Behavioral Risk Factor Surveillance System data for 96,111 adults aged ≥45 years from 11 Appalachian states. Based on economic status, Appalachian counties were grouped into distressed (least affluent), at-risk, transitional, and competitive (most affluent)...
July 7, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28685482/hospital-readmissions-among-commercially-insured-and-medicare-advantage-beneficiaries-with-diabetes-and-the-impact-of-severe-hypoglycemic-and-hyperglycemic-events
#3
Rozalina G McCoy, Kasia J Lipska, Jeph Herrin, Molly M Jeffery, Harlan M Krumholz, Nilay D Shah
BACKGROUND: Hospital readmission is common among patients with diabetes. Some readmissions, particularly for hypoglycemia and hyperglycemia, may be avoidable with better care transitions and post-discharge management. OBJECTIVE: To ascertain the most common reasons and risk factors for readmission among adults with diabetes, with specific consideration of severe dysglycemia. DESIGN: Retrospective analysis of data from the OptumLabs Data Warehouse, an administrative data set of commercially insured and Medicare Advantage beneficiaries across the U...
July 6, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28647945/the-emerging-adult-with-diabetes-transitioning-from-pediatric-to-adult-care
#4
Jodi Krall, Ingrid Libman, Linda Siminerio
Transfer from pediatric to adult health care is a significant life event for youth with chronic medical conditions. Unfortunately, youth may not be well prepared to navigate the shift in health care services, increasing their risk for loss to follow up and poor health outcomes. This review explores transition in care through the lens of type 1 diabetes, highlighting current practices and guidelines and offering recommendations for future consideration. Limited evidence suggests that transition programs that focus on strategies to prepare youth developmentally and equip the health care system appropriately have positive impact on the hand off of care, and health outcomes...
June 2017: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/28534683/transfer-from-pediatric-to-adult-endocrinology
#5
Marybeth R Jones, Brett W Robbins, Marilyn Augustine, Jackie Doyle, Jean Mack-Fogg, Heather Jones, Patience H White
OBJECTIVE: Adult and pediatric endocrinologists share responsibility for the transition of youth with type 1 diabetes from pediatric to adult healthcare. This study aimed to increase successful transfers to adult care in subspecialty practices by establishing a systematic healthcare transition (HCT) process. METHODS: Providers from the adult and pediatric endocrinology divisions at the University of Rochester Medical Center (URMC) met monthly to customize and integrate the 6 Core Elements (6CEs) of HCT into clinical workflows...
May 23, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28490305/long-term-risk-of-severe-retinopathy-in-childhood-onset-type-1-diabetes-a-data-linkage-study
#6
Mary White, Matthew A Sabin, Costan G Magnussen, Michele A O'Connell, Peter G Colman, Fergus Cameron
OBJECTIVES: To determine the relationship between glycaemic control trajectory and the long term risk of severe complications in people with type 1 diabetes mellitus, as well as the effects of paediatric and adult HbA1c levels. DESIGN, SETTING, PARTICIPANTS: Data linkage study of data for adults with childhood-onset type 1 diabetes (diagnosed during 1975-2010) who had transitioned from paediatric diabetes care at the Royal Children's Hospital (Melbourne) to adult diabetes care at the Royal Melbourne Hospital during 1992-2013...
May 15, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28489225/models-of-care-for-adolescents-and-young-adults-with-type-1-diabetes-in-transition-shared-medical-appointments-and-telemedicine
#7
Jennifer K Raymond
Transitioning through adolescence and young adulthood is challenging, and even more so for patients living with a chronic disease such as type 1 diabetes. Patients in this age group encounter multiple obstacles to effectively managing their diabetes, experience suboptimal glycemic control, face higher rates of acute complications, and are often lost to medical follow-up. Comprehensive strategies and innovative clinical models are needed to engage this population in diabetes medical care, address barriers to ideal management, and improve outcomes...
May 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28460055/health-care-transition-for-young-adults-with-type-1-diabetes-stakeholder-engagement-for-defining-optimal-outcomes
#8
Jessica S Pierce, Karen Aroian, Elizabeth Schifano, Amy Milkes, Tiani Schwindt, Anthony Gannon, Tim Wysocki
Research on the transition to adult care for young adults with type 1 diabetes (T1D) emphasizes transition readiness, with less emphasis on transition outcomes. The relatively few studies that focus on outcomes use a wide variety of measures with little reliance on stakeholder engagement for measure selection. This study engaged multiple stakeholders (i.e., young adults with T1D, parents, pediatric and adult health care providers, and experts) in qualitative interviews to identify the content domain for developing a multidimensional measure of health care transition (HCT) outcomes...
April 27, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28456694/predictive-indices-for-functional-improvement-and-deterioration-institutionalization-and-death-among-elderly-medicare%C3%A2-beneficiaries
#9
Jibby E Kurichi, Pui L Kwong, Dawei Xie, Hillary R Bogner
BACKGROUND: Prediction models can help clinicians provide the best and most appropriate care to their patients and can help policy makers design services for groups at highest risk for poor outcomes. OBJECTIVE: To develop prediction models identifying both risk factors and protective factors for functional deterioration, institutionalization, and death. DESIGN: Cohort study using data from the Medicare Current Beneficiary Survey (MCBS) SETTING: Community survey...
April 26, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28338247/impact-of-diabetic-ketoacidosis-management-in-the-medical-intensive-care-unit-after-order-set-implementation
#10
Benjamin Laliberte, Siu Yan Amy Yeung, Jeffrey P Gonzales
OBJECTIVE: To determine the rate of compliance to the 2006 and 2009 ADA DKA guidelines in the medical intensive care unit (MICU) at a large academic medical centre after the implementation of a computerised DKA order set and protocol. METHODS: Retrospective chart review of adult patients with DKA admitted to the MICU. Results of pre-order set (PRE) were compared to those of data post-order set (POST). The primary outcome was a composite administration of intravenous fluid resuscitation in the first 24 h, insulin bolus and initial insulin infusion rate...
June 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28325798/management-of-inpatient-hyperglycemia-and-diabetes-in-older-adults
#11
Guillermo E Umpierrez, Francisco J Pasquel
Adults aged 65 years and older are the fastest growing segment of the U.S. population, and their number is expected to double to 89 million between 2010 and 2050. The prevalence of diabetes in hospitalized adults aged 65-75 years and over 80 years of age has been estimated to be 20% and 40%, respectively. Similar to general populations, the presence of hyperglycemia and diabetes in elderly patients is associated with increased risk of hospital complications, longer length of stay, and increased mortality compared with subjects with normoglycemia...
April 2017: Diabetes Care
https://www.readbyqxmd.com/read/28231265/resist-diabetes-a-randomized-clinical-trial-for-resistance-training-maintenance-in-adults-with-prediabetes
#12
Brenda M Davy, Richard A Winett, Jyoti Savla, Elaina L Marinik, Mary Elizabeth Baugh, Kyle D Flack, Tanya M Halliday, Sarah A Kelleher, Sheila G Winett, David M Williams, Soheir Boshra
OBJECTIVE: To determine whether a social cognitive theory (SCT)-based intervention improves resistance training (RT) maintenance and strength, and reduces prediabetes prevalence. RESEARCH DESIGN AND METHODS: Sedentary, overweight/obese (BMI: 25-39.9 kg/m2) adults aged 50-69 (N = 170) with prediabetes participated in the 15-month trial. Participants completed a supervised 3-month RT (2×/wk) phase and were randomly assigned (N = 159) to one of two 6-month maintenance conditions: SCT or standard care...
2017: PloS One
https://www.readbyqxmd.com/read/28192030/medical-care-expenditures-for-individuals-with-prediabetes-the-potential-cost-savings-in-reducing-the-risk-of-developing-diabetes
#13
Tamkeen Khan, Stavros Tsipas, Gregory Wozniak
The United States has 86 million adults with prediabetes. Individuals with prediabetes can prevent or delay the development of type 2 diabetes through lifestyle modifications such as participation in the National Diabetes Prevention Program (DPP), thereby mitigating the medical and economic burdens associated with diabetes. A cohort analysis of a commercially insured population was conducted using individual-level claims data from Truven Health MarketScan(®) Lab Database to identify adults with prediabetes, track whether they develop diabetes, and compare medical expenditures for those who are newly diagnosed with diabetes to those who are not...
February 13, 2017: Population Health Management
https://www.readbyqxmd.com/read/28177592/predictors-of-type-1-diabetes-mellitus-outcomes-in-young-adults-after-transition-from-pediatric-care
#14
Alassaf Abeer, Gharaibeh Lubna, Grant Christina, Punthakee Zubin
BACKGROUND: Type 1 diabetes is a common chronic disease. Poor health outcomes are often noted after transfer to adult health care. It is important to determine the predictors of such outcomes to decrease the morbidity and mortality. METHODS: This retrospective study included patients followed ≥1year pre-transfer and ≥1 year post-transfer to adult care in a Canadian tertiary diabetes center. Data including demographics, education, comorbidity and pediatric diabetes management-related factors were analyzed as possible independent predictors of adult HbA1c, number of adult diabetes-related hospitalization and clinic visits...
February 8, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28176508/a-structured-therapeutic-education-program-for-children-and-adolescents-with-type-1-diabetes-an-analysis-of-the-efficacy-of-the-pediatric-education-for-diabetes-project
#15
Alessandra Mauri, Susanna Schmidt, Valentina Sosero, Maria Sambataro, Laura Nollino, Francesco Fabris, Anna Corò, Antonella Scantamburlo, Michela Cazziola-Merlotto, Tania Ciani, Michele Tessarin, Agostino Paccagnella
BACKGROUND: Therapeutic education for Type 1 Diabetes involves the process of transmitting knowledge and developing the skills and behavior required to treat the disease. guidelines agree on stressing the importance of therapeutic educational intervention in teaching self-management skills to children and adolescents with Type 1 Diabetes (T1D). This study presents the results of the "Pediatric Education for Type 1 Diabetes (T1D)" (PED) project, specifically designed for children and adolescents aged 6 to 16, and structured on guidelines indications, as part of a broader clinical-educational intervention for Type 1 diabetes...
February 7, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/28163084/research-needs-for-effective-transition-in-lifelong-care-of-congenital-genitourinary-conditions-a-workshop-sponsored-by-the-national-institute-of-diabetes-and-digestive-and-kidney-diseases
#16
REVIEW
Michael H Hsieh, Hadley M Wood, Brad E Dicianno, Nienke P Dosa, Veronica Gomez-Lobo, Tej K Mattoo, Rosalia Misseri, Jenna M Norton, Kathleen J Sawin, Peter Scal, James E Wright, Robert A Star, Tamara Bavendam
Over the last 5 decades, health-care advances have yielded quantum improvements in the life expectancy of individuals with congenital genitourinary conditions (CGCs), leading to a crisis of care. Many individuals with CGC enter adulthood unprepared to manage their condition. Pediatric CGC specialists lack training to manage adulthood-related health-care issues, whereas adult genitourinary specialists lack training within the context of CGCs. To address these challenges, the National Institutes of Diabetes and Digestive and Kidney Diseases convened individuals with CGCs and experts from a variety of fields to identify research needs to improve transitional urology care...
May 2017: Urology
https://www.readbyqxmd.com/read/28146141/type-1-diabetes-from-adolescence-to-adulthood-is-there-a-permanent-need-for-nutrition-education-and-reeducation
#17
Maja Baretić, Martina Matovinović Osvatić, Eva Pavić, Nada Rabađija, Valentina Uroić, Carolina Koletić, Nataša Rojnić Putarek, Ivana Pavlić Renar
BACKGROUND: The transition for type 1 diabetes patients from paediatric to adult diabetology care is challenging process for both medical team and patients. Adult diabetology usually insists on stricter goals and focuses on increased empowerment and self-care. We set to find a more practical and effective way to determine patient knowledge and skills during the transition. The aim of the study was to identify screening questions which best represent knowledge in management of type 1 diabetes and to explore the differences in the effect of a structured educational program for type 1 diabetes patient diagnosed in childhood versus adulthood...
January 31, 2017: Minerva Endocrinologica
https://www.readbyqxmd.com/read/28138821/transitioning-the-adult-with-type-2-diabetes-from-the-acute-to-chronic-care-setting-strategies-to-support-pragmatic-implementation-success
#18
REVIEW
Michelle Magee, Joan K Bardsley, Amisha Wallia, Kelly M Smith
Scientific evidence is available to guide the how to of medications management when patients with diabetes are hospitalized or present to the Emergency Department. However, few clinical trials in the diabetes field have addressed the execution, coupled with established implementation effectiveness evaluation frameworks to help inform and assess implementation practices to support the transition in care. These deficiencies may be overcome by (1) applying the principles of implementation and delivery systems science; (2) engaging the principles of human factors (HF) throughout the design, development, and evaluation planning activities; and (3) utilizing mixed methods to design the intervention, workflow processes, and evaluate the intervention for sustainability within existing care delivery models...
January 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28118128/an-adult-health-care-based-pediatric-to-adult-transition-program-for-emerging-adults-with-type-1-diabetes
#19
Shivani Agarwal, Jennifer K Raymond, Mark H Schutta, Serena Cardillo, Victoria A Miller, Judith A Long
Purpose The purpose of the study was to evaluate an adult health care program model for emerging adults with type 1 diabetes transitioning from pediatric to adult care. Methods Evaluation of the Pediatric to Adult Diabetes Transition Clinic at the University of Pennsylvania included a cohort of 72 emerging adults with type 1 diabetes, ages 18 to 25 years. Data were extracted from transfer summaries and the electronic medical record, including sociodemographic, clinical, and follow-up characteristics. Pre- and postprogram assessment at 6 months included mean daily blood glucose monitoring frequency (BGMF) and glycemic control (A1C)...
February 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28117535/high-hba1c-at-onset-cannot-be-used-as-a-predictor-for-future-metabolic-control-for-the-individual-child-with-type-1-diabetes-mellitus
#20
John Nilsson, Karin Åkesson, Lena Hanberger, Ulf Samuelsson
BACKGROUND: To study how metabolic control at onset of type 1 diabetes correlates to metabolic control and clinical parameters during childhood until transition from pediatric care to adult diabetes care. MATERIALS AND METHODS: Data at onset, three months, one, three, and five years after diagnosis and at transition, on HbA1c and clinical parameters, on 8084 patients in the Swedish pediatric quality registry, SWEDIABKIDS, were used. Of these patients, 26% had been referred to adult diabetes care by 2014...
January 24, 2017: Pediatric Diabetes
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