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Diabetes transition to adult care

Marion Waite, Clare Martin, Rachel Franklin, David Duce, Rachel Harrison
BACKGROUND: People with type 1 diabetes (T1D) undertake self-management to prevent short and long-term complications. Advanced technology potentially supports such activities but requires consideration of psychological and behavioral constructs and usability issues. Economic factors and health care provider capacity influence access and uptake of advanced technology. Previous reviews have focused upon clinical outcomes or were descriptive or have synthesized studies on adults with those on children and young people where human factors are different...
March 15, 2018: JMIR Human Factors
K Farrell, R Fernandez, Y Salamonson, R Griffiths, D J Holmes-Walker
AIMS: To identify a) determinants of glycated haemoglobin (HbA1c) at 18 and 30 months following transition in young people with Type 1 diabetes mellitus (T1DM) to a youth-specific diabetes service; and to b) evaluate the impact of the service on acute admissions with diabetic ketoacidosis (DKA) over a 14-year period. METHODS: An audit of records of youth with T1DM referred from paediatric services to the multidisciplinary transition service at Westmead Hospital, from 2001-2012, and followed-up to 2014...
March 10, 2018: Diabetes Research and Clinical Practice
Scott J Pilla, James R Dotimas, Nisa M Maruthur, Jeanne M Clark, Hsin-Chieh Yeh
AIMS: When patients with type 2 diabetes initiate insulin, metformin should be continued while continuation of other antihyperglycemics has unclear benefit. We aimed to identify practice patterns in antihyperglycemic therapy during the insulin transition, and determine factors associated with metformin continuation. METHODS: We performed a retrospective analysis of the Look AHEAD (Action for Health in Diabetes) trial which randomized overweight/obese adults under ambulatory care for type 2 diabetes to an intensive lifestyle intervention or diabetes support and education...
March 7, 2018: Diabetes Research and Clinical Practice
Christina R Whitehouse, Nancy C Sharts-Hopko, Suzanne C Smeltzer, David A Horowitz
The aim of the current study was to compare outcomes for older adults with type 2 diabetes mellitus and obesity following participation in a transitional care intervention that included diabetes self-management education (DSME) and homecare. The three groups analyzed comprised an inpatient DSME plus homecare group (n = 35); an inpatient DSME only group (n = 100); and a group who received usual care (n = 45). Outcomes of interest included rehospitalization rates and hemoglobin A1C (A1C) for up to 1-year post hospital discharge...
March 1, 2018: Research in Gerontological Nursing
Gitte Reventlov Husted, Janne Weis, Grete Teilmann, Pernille Castensøe-Seidenfaden
BACKGROUND: Adequate self-management is the cornerstone of preventing type 1 diabetes mellitus (T1DM) complications. However, T1DM self-management is challenging for young people, who often struggle during the transition from childhood to adulthood. The mobile health (mHealth) app Young with Diabetes (YWD) was developed in collaboration with young people to enhance their T1DM self-management during this transition. OBJECTIVE: The purpose of this study was to explore the influence of YWD on young people's self-management during a 12-month period...
February 28, 2018: JMIR MHealth and UHealth
MaryJane Simms, Katherine Baumann, Maureen Monaghan
Objective: In an effort to refine a model of clinical care identifying effective communication with health care providers (HCPs) as a key skill for successful transition to adult medical care, this study explored the perspectives of emerging adults with type 1 diabetes (T1D) about factors that impact the quality and content of communication with their HCPs. Methods: Twenty emerging adults with T1D were interviewed about health communication experiences with their pediatric HCP and readiness for transition to adult diabetes care...
December 2017: Clinical Practice in Pediatric Psychology
Alison J Price, Amelia C Crampin, Alemayehu Amberbir, Ndoliwe Kayuni-Chihana, Crispin Musicha, Terence Tafatatha, Keith Branson, Debbie A Lawlor, Elenaus Mwaiyeghele, Lawrence Nkhwazi, Liam Smeeth, Neil Pearce, Elizabeth Munthali, Beatrice M Mwagomba, Charles Mwansambo, Judith R Glynn, Shabbar Jaffar, Moffat Nyirenda
BACKGROUND: Sub-Saharan Africa is in rapid demographic transition, and non-communicable diseases are increasingly important causes of morbidity and mortality. We investigated the burden of diabetes, overweight and obesity, hypertension, and multimorbidity, their treatment, and their associations with lifestyle and other factors in Malawi, a very poor country with a predominantly rural-but rapidly growing urban-population, to identify high-risk populations and inform appropriate interventions...
January 19, 2018: Lancet Diabetes & Endocrinology
Sandra Zoni, Marie-Elise Verga, Michael Hauschild, Marie-Paule Aquarone-Vaucher, Teresa Gyuriga, Anne-Sylvie Ramelet, Andrew A Dwyer
PURPOSE: We aimed to evaluate patient self-management activities, patient perceptions of the therapeutic relationship and satisfaction with nurse-led consultations as part of a structured, pilot program transitioning young adults with type 1 diabetes (T1DM) to adult-oriented community-based practices. DESIGN AND METHODS: A descriptive, cross-sectional study of patients receiving nurse-led consultations. Patients provided sociodemographic/health information, glycated hemoglobin (HbA1c) measures and completed questionnaires assessing self-management (Revised Self-Care Inventory) and the therapeutic relationship (Caring Nurse-Patient Interaction - short scale)...
January 2018: Journal of Pediatric Nursing
Maria Ida Maiorino, Giuseppe Bellastella, Ofelia Casciano, Paolo Cirillo, Vittorio Simeon, Paolo Chiodini, Michela Petrizzo, Maurizio Gicchino, Ornella Romano, Paola Caruso, Dario Giugliano, Katherine Esposito
BACKGROUND: Type 1 diabetic patients have high instability of daily glucose levels. The aim of this study was to evaluate the long-term effects of continuous subcutaneous insulin infusion (CSII) therapy, compared with multiple daily injections of insulin (MDI), on glucose variability, in young type 1 diabetic patients transitioned to the adult diabetes care. METHODS: Patients aged 18-30 years and considered eligible for insulin pump therapy were included in the study...
January 5, 2018: Diabetes Technology & Therapeutics
Elizabeth O Buschur, Bethany Glick, Manmohan K Kamboj
Planning for the transition from pediatric to adult healthcare is broadly understood to be beneficial to the quality of care of patients with chronic illness. Due to the level of self-care that is necessary in the maintenance of most chronic diseases, it is important that pediatric settings can offer support during a time when adolescents are beginning to take more responsibility in all areas of their lives. Lack of supportive resources for adolescents with chronic conditions often results in both decreased access to care and impaired health and function likely leading to increased medical costs later...
October 2017: Translational Pediatrics
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
Amit Dias, Fredric Azariah, Public Health, Alex Cohen, Stewart Anderson, Jennifer Morse, Pim Cuijpers, Miriam Sequeira, M A Psychology, Vithoba Gaude, Salvino Soares, Vikram Patel, Charles F Reynolds
Because depression is a major source of the global burden of illness- related disability, developing effective strategies for reducing its incidence is an important public health priority, especially in low-income countries, where resources for treating depression are scarce. We describe in this report an intervention development project, funded by the US National Institute of Mental Health, to address "indicated" prevention of depression in older adults attending rural and urban primary care clinics in Goa, India...
June 2017: Contemporary Clinical Trials Communications
Evrim Kızıler, Dilek Yıldız, Berna Eren Fidancı
BACKGROUND: Today, more than 90% of adolescents with chronic conditions are surviving into adulthood and move pediatric to adult care with their chronic illness. It is important to gain autonomy and ensure readiness for adolescents/ young adults to use the adult health care system prior to the transfer of care. However, the lack of the transition readiness assessment tool which is validated, patient-centered and appropriate to developmental differences in pediatric care is seen a major obstacle for transition of care from pediatric to adult services...
October 17, 2017: Balkan Medical Journal
Kharis Burns, Kaye Farrell, Rickie Myszka, Kris Park, Deborah Jane Holmes-Walker
BACKGROUND: Management of Type 1 diabetes mellitus (T1DM) in youth with diabetes is complex and glycaemic control often deteriorates during this challenging period. We hypothesise that attendance at a youth-specific diabetes clinic reduces hospital admission rates and length of stay for diabetic ketoacidosis (DKA). AIMS: This study aimed to assess the impact of a youth specific diabetes service for youth with diabetes (YWD) on DKA admissions in two adjacent local health districts (LHDs)...
October 16, 2017: Internal Medicine Journal
Chee-Ruey Hsieh, Xuezheng Qin
Due to its fast economic growth and lifestyle changes, China is experiencing a rapid epidemiological transition from communicable to noncommunicable diseases (NCDs). Mental disorder such as depression is an important yet often neglected NCD and is becoming a growing cause of disability, suicides, and disease burden. This paper provides the first nationally representative estimate of the medical cost attributable to depression and depressive symptoms among the adult population in China. On the basis of the 2012 China Family Panel Studies survey, our results indicate that these mental health conditions have significant impacts on the individual medical expenditure, and they jointly contribute to 14...
October 8, 2017: Health Economics
Tristan M Snowsill, Jason Moore, Ruben E Mujica Mota, Jaime L Peters, Tracey L Jones-Hughes, Nicola J Huxley, Helen F Coelho, Marcela Haasova, Chris Cooper, Jenny A Lowe, Jo L Varley-Campbell, Louise Crathorne, Matt J Allwood, Rob Anderson
Background: Immunosuppression is required in kidney transplantation to prevent rejection and prolong graft survival. We conducted an economic evaluation to support England's National Institute for Health and Care Excellence in developing updated guidance on the use of immunosuppression, incorporating new immunosuppressive agents, and addressing changes in pricing and the evidence base. Methods: A discrete-time state transition model was developed to simulate adult kidney transplant patients over their lifetime...
July 1, 2017: Nephrology, Dialysis, Transplantation
Jacqueline B La Manna, Angeline Bushy, Denise Gammonley
Multimorbidity combined with geriatric syndromes in older adults with diabetes exacerbate their risks for poor post-discharge outcomes. The purpose of this study was to examine self-described hospital-to-home transition challenges encountered by older adults with a diagnosis of diabetes within the first 30 days following discharge. The qualitative responses for this paper emerged from a larger mixed methods study (n = 96) in which participants provided free responses specifying transition challenges during follow-up telephone interviews on the 7th day (n = 67) and 30th day (n = 55) post-discharge...
August 11, 2017: Geriatric Nursing
Meranda Nakhla, Lorraine E Bell, Sarah Wafa, Kaberi Dasgupta
OBJECTIVES: The transition from pediatric to adult care is a high-risk period for the emerging adult with diabetes. We aimed to determine adequacy of pediatric transition care structures and explore the pediatric diabetes care provider's perceptions of transition care. RESEARCH DESIGN AND METHODS: In-depth interviews with pediatric diabetes care providers from 12 diabetes centers in Quebec were conducted. We queried alignment with Got Transition's six core elements of healthcare transition, experiences, and barriers to transition care...
2017: BMJ Open Diabetes Research & Care
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
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
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