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Diabetes transition to adult care

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https://www.readbyqxmd.com/read/29100717/primary-care-physician-perspectives-on-basal-insulin-initiation-and-maintenance-in-patients-with-type-2-diabetes-mellitus
#1
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
https://www.readbyqxmd.com/read/29057368/intervention-development-for-the-indicated-prevention-of-depression-in-later-life-the-dil-protocol-in-goa-india
#2
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
https://www.readbyqxmd.com/read/29039345/validation-of-transition-readiness-assessment-questionaire-in-turkish-adolescents-with-diabetes
#3
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
https://www.readbyqxmd.com/read/29034986/access-to-a-youth-specific-service-for-young-adults-with-type-1-diabetes-mellitus-is-associated-with-decreased-hospital-length-of-stay-for-diabetic-ketoacidosis
#4
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
https://www.readbyqxmd.com/read/28990318/depression-hurts-depression-costs-the-medical-spending-attributable-to-depression-and-depressive-symptoms-in-china
#5
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
https://www.readbyqxmd.com/read/28873970/immunosuppressive-agents-in-adult-kidney-transplantation-in-the-national-health-service-a-model-based-economic-evaluation
#6
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
https://www.readbyqxmd.com/read/28807456/post-hospitalization-experiences-of-older-adults-diagnosed-with-diabetes-it-was-daunting
#7
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
https://www.readbyqxmd.com/read/28761657/improving-the-transition-from-pediatric-to-adult-diabetes-care-the-pediatric-care-provider-s-perspective-in-quebec-canada
#8
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
https://www.readbyqxmd.com/read/28691009/endoscopic-vs-microscopic-resection-of-sellar-lesions-a-matched-analysis-of-clinical-and-socioeconomic-outcomes
#9
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
#10
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
#11
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
#12
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
#13
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 health care transition (HCT) process. METHODS: Providers from the adult and pediatric endocrinology divisions at the University of Rochester Medical Center met monthly to customize and integrate the Six Core Elements (6CEs) of HCT into clinical workflows...
July 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
#14
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
#15
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
#16
Jessica S Pierce, Karen Aroian, Elizabeth Schifano, Amy Milkes, Tiani Schwindt, Anthony Gannon, Tim Wysocki
Objectives: 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. Methods: 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...
October 1, 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
#17
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
#18
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
#19
REVIEW
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
#20
RANDOMIZED CONTROLLED TRIAL
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
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