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Diabetes transition to adult care

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https://www.readbyqxmd.com/read/28338247/impact-of-diabetic-ketoacidosis-management-in-the-medical-intensive-care-unit-after-order-set-implementation
#1
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...
March 24, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28325798/management-of-inpatient-hyperglycemia-and-diabetes-in-older-adults
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28007779/health-care-transition-preparation-and-experiences-in-a-u-s-national-sample-of-young-adults-with-type-1-diabetes
#12
Katharine C Garvey, Nicole C Foster, Shivani Agarwal, Linda A DiMeglio, Barbara J Anderson, Sarah D Corathers, Marisa E Desimone, Ingrid M Libman, Sarah K Lyons, Anne L Peters, Jennifer K Raymond, Lori M Laffel
OBJECTIVE: Young adults with type 1 diabetes transitioning from pediatric to adult care are at risk for adverse outcomes. We developed a survey to evaluate transition experiences in two groups of young adults with type 1 diabetes, before (PEDS) and after (ADULT) transition to adult care. RESEARCH DESIGN AND METHODS: We fielded an electronic survey to young adults (18 to <30 years) at 60 T1D Exchange Clinic Registry centers. RESULTS: Surveys were completed by 602 young adults, 303 in the PEDS group (60% female, age 20 ± 2 years) and 299 in the ADULT group (62% female, age 24 ± 3 years)...
March 2017: Diabetes Care
https://www.readbyqxmd.com/read/27939878/components-of-interventions-that-improve-transitions-to-adult-care-for-adolescents-with-type-1-diabetes
#13
REVIEW
Alan T Schultz, Arlene Smaldone
Adolescents with type 1 diabetes struggle with glycemic control with decline further exacerbated by transfer from pediatric to adult care. The purpose of this systematic review/meta-analysis was to examine which components of transition programs are effective in improving outcomes following transfer. We searched six databases for studies that assessed the efficacy of a transition program on diabetes outcomes. Studies reporting hemoglobin A1c (HbA1c) or its change for the intervention versus control group pretransition and posttransition were pooled using a random effects meta-analysis model...
February 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/27889401/clinical-and-psychosocial-outcomes-of-a-structured-transition-program-among-young-adults-with-type-1-diabetes
#14
Elizabeth A Pyatak, Paola A Sequeira, Cheryl L P Vigen, Marc J Weigensberg, Jamie R Wood, Lucy Montoya, Valerie Ruelas, Anne L Peters
PURPOSE: We identified and treated young adults with type 1 diabetes who had been lost to follow-up during their transfer from pediatric to adult care, comparing their clinical, psychosocial, and health care utilization outcomes to participants receiving continuous care (CC) throughout the transition to adult care. METHODS: Individuals in their last year of pediatric care (CC group, n = 51) and individuals lost to follow-up in the transfer to adult care ("lapsed care" [LC] group, n = 24) were followed prospectively for 12 months...
February 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/27881054/transition-of-care-for-patients-with-diabetes
#15
Patricia Garnica
BACKGROUND: Diabetes is a common chronic condition among adults that can complicate the transition from the hospital to the community. Hospital readmission is an important contributor to total medical expenditures and is an emerging indicator of quality of care. Failure to acknowledge diabetes transition of care is associated with increased emergency department visits and 30-day readmissions. METHODS: Literature review of transition of care models, sample tools and processes are presented...
November 22, 2016: Current Diabetes Reviews
https://www.readbyqxmd.com/read/27812509/type-1-diabetes-addressing-the-transition-from-pediatric-to-adult-oriented-health-care
#16
Maureen Monaghan, Katherine Baumann
Adolescents and young adults with type 1 diabetes are at risk for poor health outcomes, including poor glycemic control, acute and chronic complications, and emergency department admissions. During this developmental period, adolescent and young adult patients also experience significant changes in living situation, education, and/or health care delivery, including transferring from pediatric to adult health care. In recent years, professional and advocacy organizations have proposed expert guidelines to improve the process of preparation for and transition to adult-oriented health care...
2016: Research and Reports in Endocrine Disorders
https://www.readbyqxmd.com/read/27692972/implementation-of-a-diabetes-transition-of-care-program
#17
Jeanne M Little, Janice A Odiaga, Carla Z Minutti
For adolescents with diabetes, ineffective health care transition to adult health services may result in suboptimal adherence to medical supervision, leading to poor glycemic control, increased diabetes complications, and hospitalization. Despite national recommendations, few youth receive the needed preparation to transition to adult health services. A data transition registry was created at a large Midwest urban academic medical center to identify patients 14 years and older with Type 1 diabetes. Thirty-nine patients with Type 1 diabetes were identified, and 33 were eligible to begin transition planning...
March 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/27622917/diabetes-control-and-adherence-in-adolescence
#18
Christy Foster, Jayne Bellando, Yu-Chi Annie Wang
Type 1 diabetes is a chronic disease that can lead to severe complications if poorly controlled. Adolescents are particularly vulnerable to worsening diabetes control due to changes in physiology, family dynamics, and social interactions. Good diabetes control requires following a regimen of frequent blood glucose checks, accurate carbohydrate counts, and compliance with insulin administration. Patients who are challenged in controlling their diabetes do tend to respond to behavioral interventions; however, the effect of the intervention wanes over time...
September 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27578432/perspectives-on-care-for-young-adults-with-type-1-diabetes-transitioning-from-pediatric-to-adult-health-systems-a-national-survey-of-pediatric-endocrinologists
#19
Shivani Agarwal, Katharine C Garvey, Jennifer K Raymond, Mark H Schutta
BACKGROUND: Healthcare transition from pediatric to adult care for young adults (YA) with type 1 diabetes (T1D) is associated with risk of adverse outcomes. Consensus recommendations exist from US professional societies on transition care for YA with T1D, but it is not known whether they have been widely adopted. We describe experiences, barriers, and provider characteristics associated with transition care in a national sample of pediatric endocrinologists. METHODS: US pediatric endocrinologists identified through the American Medical Association Physician Masterfile were sent an electronic survey...
August 31, 2016: Pediatric Diabetes
https://www.readbyqxmd.com/read/27567000/changes-in-the-quality-of-care-during-progress-from-stage-1-to-stage-2-of-meaningful-use
#20
David M Levine, Michael J Healey, Adam Wright, David W Bates, Jeffrey A Linder, Lipika Samal
Background: The Centers for Medicare and Medicaid Services (CMS) canceled Meaningful Use (MU), replacing it with Advancing Care Information, which preserves many MU elements. Therefore, transitioning from MU stage 1 to MU stage 2 has important implications for the new policy, yet the quality of care provided by physicians transitioning from MU1 to MU2 is unknown. Methods: Retrospective longitudinal evaluation of the quality of care delivered by outpatient physicians at an academic medical center in the transition between MU1 and MU2...
March 1, 2017: Journal of the American Medical Informatics Association: JAMIA
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