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Diabetics in long term care

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https://www.readbyqxmd.com/read/29221645/primary-care-led-weight-management-for-remission-of-type-2-diabetes-direct-an-open-label-cluster-randomised-trial
#1
Michael Ej Lean, Wilma S Leslie, Alison C Barnes, Naomi Brosnahan, George Thom, Louise McCombie, Carl Peters, Sviatlana Zhyzhneuskaya, Ahmad Al-Mrabeh, Kieren G Hollingsworth, Angela M Rodrigues, Lucia Rehackova, Ashley J Adamson, Falko F Sniehotta, John C Mathers, Hazel M Ross, Yvonne McIlvenna, Renae Stefanetti, Michael Trenell, Paul Welsh, Sharon Kean, Ian Ford, Alex McConnachie, Naveed Sattar, Roy Taylor
BACKGROUND: Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management within routine primary care would achieve remission of type 2 diabetes. METHODS: We did this open-label, cluster-randomised trial (DiRECT) at 49 primary care practices in Scotland and the Tyneside region of England. Practices were randomly assigned (1:1), via a computer-generated list, to provide either a weight management programme (intervention) or best-practice care by guidelines (control), with stratification for study site (Tyneside or Scotland) and practice list size (>5700 or ≤5700)...
December 4, 2017: Lancet
https://www.readbyqxmd.com/read/29217386/early-worsening-of-diabetic-retinopathy-after-rapid-improvement-of-blood-glucose-control-in-patients-with-diabetes
#2
REVIEW
S Feldman-Billard, É Larger, P Massin
AIM: To review the frequency, importance of and risk factors for "early worsening of diabetic retinopathy" (EWDR) after rapid improvement of blood glucose in patients with diabetes. METHODS: This was a systematic review of key references (PubMed 1980-2016) and the current international recommendations for the above-mentioned topics. RESULTS: EWDR has been described during intensive treatment (IT) in patients with uncontrolled type 1 or 2 diabetes, and after pancreas transplantation or bariatric surgery...
November 11, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/29216868/socio-demographic-determinants-and-effect-of-structured-personal-diabetes-care-a-19-year-follow-up-of-the-randomized-controlled-study-diabetes-care-in-general-practice-dcgp
#3
Andreas Heltberg, Volkert Siersma, John Sahl Andersen, Christina Ellervik, Henrik Brønnum-Hansen, Jakob Kragstrup, Niels de Fine Olivarius
BACKGROUND: We investigated how four aspects of socio-demography influence the effectiveness of an intervention with structured personal diabetes care on long-term outcomes. METHODS: The Diabetes Care in General Practice (DCGP) study is a cluster-randomized trial involving a population-based sample of 1381 patients with newly diagnosed type 2-diabetes mellitus. We investigated how education, employment, cohabitation status and residence influenced the effectiveness of 6 years of intervention with structured personal diabetes care, resembling present day recommendations...
December 8, 2017: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/29215660/-prioritization-of-non-recommended-clinical-activities-in-primary-care
#4
L García Mochon, A Olry de Labry Lima, C Bermudez-Tamayo
OBJECTIVE: To prioritize non-recommended clinical activities in Primary Care (PC), from "Do not do" recommendations listed by the Sociedad Española de Medicina de Familia y Comunitaria (Semfyc), according to expert consensus (physicians, nurses and pharmacists). METHODS: The consensus for the prioritization of non-recommended practices in PC was performed through an online procedure. We used as a base the list of "do not-do" recommendations of the SEMFYC. We asked the experts to prioritize practices that should be de-adopted in PC, based on four prioritization criteria: frequency of occurrence, cost of the activity, ease of disposal and damage caused, which were scored from one to five, according to their recommendation...
December 7, 2017: Anales del Sistema Sanitario de Navarra
https://www.readbyqxmd.com/read/29214306/seven-year-weight-trajectories-and-health-outcomes-in-the-longitudinal-assessment-of-bariatric-surgery-labs-study
#5
Anita P Courcoulas, Wendy C King, Steven H Belle, Paul Berk, David R Flum, Luis Garcia, William Gourash, Mary Horlick, James E Mitchell, Alfons Pomp, Walter J Pories, Jonathan Q Purnell, Ashima Singh, Konstantinos Spaniolas, Richard Thirlby, Bruce M Wolfe, Susan Z Yanovski
Importance: More information is needed about the durability of weight loss and health improvements after bariatric surgical procedures. Objective: To examine long-term weight change and health status following Roux-en-Y gastric bypass (RYGB) and laparoscopic adjustable gastric banding (LAGB). Design, Setting, and Participants: The Longitudinal Assessment of Bariatric Surgery (LABS) study is a multicenter observational cohort study at 10 US hospitals in 6 geographically diverse clinical centers...
December 6, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/29210010/management-of-diabetic-macular-edema-in-japan-a-review-and-expert-opinion
#6
REVIEW
Hiroko Terasaki, Yuichiro Ogura, Shigehiko Kitano, Taiji Sakamoto, Toshinori Murata, Akito Hirakata, Tatsuro Ishibashi
Diabetic retinopathy is a frequent cause of visual impairment in working-age adults (≥ 30 years) and in Japan is most commonly observed in those aged 50-69 years. Diabetic macular edema (DME) is one of the main causes of vision disturbance in diabetic retinopathy, which is a clinically significant microvascular complication of diabetes. Anti-vascular endothelial growth factor (VEGF) therapy is becoming the mainstay of treatment for DME. However, to achieve sustained long-term improvement in visual acuity, conventional laser photocoagulation, vitrectomy and steroid therapy are also expected to play a role in the treatment of DME...
December 5, 2017: Japanese Journal of Ophthalmology
https://www.readbyqxmd.com/read/29202256/long-term-mortality-of-critically-ill-patients-with-diabetes-who-survive-admission-to-the-intensive-care-unit
#7
Yasmine Ali Abdelhamid, Mark P Plummer, Mark E Finnis, Vishwanath Biradar, Shailesh Bihari, Palash Kar, Stewart Moodie, Michael Horowitz, Jonathan E Shaw, Liza K Phillips, Adam M Deane
OBJECTIVE: Long-term outcomes of critically ill patients with diabetes are unknown. Our objectives were to evaluate the effect of diabetes on both long-term survival rates and the average number of years of life lost for patients admitted to an intensive care unit who survived to hospital discharge. DESIGN AND PARTICIPANTS: A data linkage study evaluating all adult patients in South Australia between 2004 and 2011 who survived hospitalisation that required admission to a public hospital ICU...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29202033/synthetic-smart-gel-provides-glucose-responsive-insulin-delivery-in-diabetic-mice
#8
Akira Matsumoto, Miyako Tanaka, Hiroko Matsumoto, Kozue Ochi, Yuki Moro-Oka, Hirohito Kuwata, Hironori Yamada, Ibuki Shirakawa, Taiki Miyazawa, Hitoshi Ishii, Kazunori Kataoka, Yoshihiro Ogawa, Yuji Miyahara, Takayoshi Suganami
Although previous studies have attempted to create "electronics-free" insulin delivery systems using glucose oxidase and sugar-binding lectins as a glucose-sensing mechanism, no successful clinical translation has hitherto been made. These protein-based materials are intolerant of long-term use and storage because of their denaturing and/or cytotoxic properties. We provide a solution by designing a protein-free and totally synthetic material-based approach. Capitalizing on the sugar-responsive properties of boronic acid, we have established a synthetic polymer gel-based insulin delivery device confined within a single catheter, which exhibits an artificial pancreas-like function in vivo...
November 2017: Science Advances
https://www.readbyqxmd.com/read/29201147/evidence-for-current-recommendations-concerning-the-management-of-foot-health-for-people-with-chronic-long-term-conditions-a-systematic-review
#9
Katherine Edwards, Alan Borthwick, Louise McCulloch, Anthony Redmond, Rafael Pinedo-Villanueva, Daniel Prieto-Alhambra, Andrew Judge, Nigel Arden, Catherine Bowen
Background: Research focusing on management of foot health has become more evident over the past decade, especially related to chronic conditions such as diabetes. The level of methodological rigour across this body of work however is varied and outputs do not appear to have been developed or translated into clinical practice. The aim of this systematic review was to assess the latest guidelines, standards of care and current recommendations relative to people with chronic conditions to ascertain the level of supporting evidence concerning the management of foot health...
2017: Journal of Foot and Ankle Research
https://www.readbyqxmd.com/read/29198641/hemodialysis-self-management-intervention-randomized-trial-hed-smart-a-practical-low-intensity-intervention-to-improve-adherence-and-clinical-markers-in-patients-receiving-hemodialysis
#10
Konstadina Griva, Mooppil Nandakumar, Jo-An H Ng, Kevin F Y Lam, Hayley McBain, Stanton P Newman
BACKGROUND: Poor adherence to treatment is common in hemodialysis patients. However, effective interventions for adherence in this population are lacking. Small studies of behavioral interventions have yielded improvements, but clinical effectiveness and long-term effects are unclear. STUDY DESIGN: Multicenter parallel (1:1) design, blinded cluster-randomized controlled trial. SETTING & PARTICIPANTS: Patients undergoing maintenance hemodialysis enrolled in 14 dialysis centers...
November 30, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29197436/a-novel-evidence-based-periodontal-prognosis-model
#11
Troy McGowan, Kelly McGowan, Saso Ivanovski
OBJECTIVE: Patients with periodontal disease and the dental professionals responsible for their care want to know which teeth are expected to respond favorably to periodontal treatment and which teeth are likely to be lost in the short and long term. A number of different periodontal prognosis systems have been previously proposed but do not consider important patient-level factors, such as smoking and diabetic control, in the calculation of the expected outcome and often use subjective measures that introduce potential inaccuracies...
December 2017: Journal of Evidence-based Dental Practice
https://www.readbyqxmd.com/read/29193511/epidemiology-of-haemodialysis-patients-and-haemodialysis-performance-in-nauru
#12
Chia-Tien Hsu, Richard Leona, Ming-Ju Wu
AIM: There is limited literature on haemodialysis in island countries in the Central Pacific. The primary aim of this study was to report on the epidemiology of haemodialysis patients and haemodialysis performance in Nauru. METHODS: We obtained registry data from the haemodialysis unit in Nauru to calculate the incidence rate, prevalence, and survival probability of haemodialysis patients in Nauru. We also reviewed medical records from January 2015 to February 2017 to evaluate the haemodialysis performance in Nauru...
November 28, 2017: Nephrology
https://www.readbyqxmd.com/read/29192641/diabetes-or-hypertension-as-risk-indicators-for-missing-teeth-experience-an-exploratory-study-in-a-sample-of-mexican-adults
#13
V J Delgado-Pérez, R De La Rosa-Santillana, M L Márquez-Corona, L Ávila-Burgos, H Islas-Granillo, M Minaya-Sánchez, C E Medina-Solís, G Medina-SolIs
BACKGROUND: To determine an exploratory estimation of the strength of type 2 diabetes mellitus (T2DM) and hypertension diagnoses as risk indicators for missing teeth in a sample of Mexican adults. MATERIALS AND METHODS: A comparative cross-sectional study of sixty adult patients in a health center in Mexico included as dependent variable, the number of missing teeth (and having a functional dentition) and as independent variables, diagnoses for diabetes or hypertension, age, sex, maximum level of schooling, and tobacco use...
October 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29189999/nafld-nash-in-patients-with-type-2-diabetes-and-related-treatment-options
#14
REVIEW
M G Radaelli, F Martucci, S Perra, S Accornero, G Castoldi, G Lattuada, G Manzoni, G Perseghin
Type 2 diabetes may reduce life expectancy and patients' quality of life due to its micro- and macro-vascular complications and to the higher risk of several types of cancer. An emerging important factor is represented by the hepatic involvement; it is recognized that excessive hepatic fat accumulation represents a typical feature of diabetic patients and that it also plays an important pathogenic role. It is now evident that non-alcoholic fatty liver disease (NAFLD), generally perceived as a benign condition, may have on the contrary an important deleterious impact for diabetic patients increasing the risk to develop cardiovascular complications but also serious hepatic diseases, in particular non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma...
November 30, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29187944/improving-access-to-hba1c-in-sub-saharan-africa-ia3-cohort-cohort-profile
#15
Naby Balde, Alioune Camara, Joelle Sobngwi-Tambekou, Eric Vounsia Balti, Alain Tchatchoua, Leopold Fezeu, Serge Limen, Sylvie Ngamani, Suzanne Ngapout, Andre Pascal Kengne, Eugene Sobngwi
Introduction: Glycated haemoglobin (HbA1c) is the best surrogate of average blood glucose control in diabetic patients, and lowering HbA1c significantly reduces diabetes complications. Moreover, immediate feedback of HbA1c measurement to patients may improve control. However, HbA1c is unavailable in most parts of Africa, a continent with one of the highest burden of diabetes. To translate these evidences, we are conducting a multicentric project in 10 health care facilities in Guinea and Cameroon to evaluate the feasibility and one-year benefit of affordable HbA1c measurement with immediate feedback to patients on diabetes control and related outcomes...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29186165/disentangling-the-influence-of-living-place-and-socioeconomic-position-on-health-services-use-among-diabetes-patients-a-population-based-study
#16
Sébastien Lamy, Denis Ducros, Chloé Diméglio, Hélène Colineaux, Romain Fantin, Eloïse Berger, Pascale Grosclaude, Cyrille Delpierre, Béatrice Bouhanick
This research investigates the influence of place of residence and diabetic patient's socioeconomic position on their use of health services in a universal health care system. This retrospective cross-sectional population-based study is based on the joint use of the Health Insurance information systems, an ecological indicator of social deprivation and an indicator of potential spatial accessibility of healthcare provision in the Midi-Pyrénées region. Using French healthcare insurance population-based data on reimbursement of out-of-hospital care during the year 2012, we study the use of health services among patients aged 50 and over (n = 90,136)...
2017: PloS One
https://www.readbyqxmd.com/read/29183910/predictors-of-quality-of-life-and-other-patient-reported-outcomes-in-the-panorama-multinational-study-of-people-with-type-2-diabetes
#17
Clare Bradley, Eveline Eschwège, Pedro de Pablos-Velasco, Klaus G Parhofer, Dominique Simon, Hans Vandenberghe, Linda Gönder-Frederick
OBJECTIVE: PANORAMA, a nine-country cross-sectional type 2 diabetes study, investigated factors associated with quality of life (QoL), health status, and other patient-reported outcome measures (PROMs). RESEARCH DESIGN AND METHODS: Patients were randomly or consecutively selected from primary/secondary care. PROMs included the Audit of Diabetes-Dependent Quality of Life (ADDQoL) (generic QoL item and average weighted impact [AWI] scores), Diabetes Treatment Satisfaction Questionnaire (DTSQ) (patient- and physician-completed), Hypoglycemia Fear Survey-II worry subscale, and the EuroQoL-5 Dimension visual analog scale (EQ-VAS) measuring patient-reported health...
November 28, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29178923/guided-self-determination-young-versus-standard-care-in-the-treatment-of-young-females-with-type-1-diabetes-study-protocol-for-a-multicentre-randomized-controlled-trial
#18
Josephine Haas, Martina Persson, Anna Lena Brorsson, Eva Hagström Toft, Anna Lindholm Olinder
BACKGROUND: Female adolescents with type 1 diabetes mellitus (T1DM) have the most unsatisfactory glycaemic control of all age groups and report higher disease burden, poorer perceived health, and lower quality of life than their male counterparts. Females with T1DM face an excess risk of all-cause mortality compared with men with T1DM. New methods are needed to help and support young females with T1DM to manage their disease. A prerequisite for successful diabetes management is to offer individualized, person-centred care and support the patient's own motivation...
November 24, 2017: Trials
https://www.readbyqxmd.com/read/29174777/cardiac-surgery-outcomes-in-abdominal-solid-organ-transplant-recipients
#19
Takushi Kohmoto, Satoru Osaki, Dixon B Kaufman, Glen Leverson, Nilto DeOliveira, Shahab A Akhter, Susan Ulschmid, Lucian Lozonschi, Entela B Lushaj
BACKGROUND: Cardiovascular disease is a cause of morbidity and mortality in organ transplant recipients. Cardiac surgery after organ transplantation is not uncommon in this population. We evaluated 30-day outcomes and long-term survival of abdominal transplant recipients undergoing cardiac surgery at our institution. METHODS: In all, 138 patients with previous kidney, kidney-pancreas, and liver transplants underwent cardiac surgery from 2000 to 2016. Propensity score (ratio 1:3) matched 115 abdominal transplant with 345 patients undergoing cardiac surgery without a history of abdominal transplant...
November 23, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29171080/testosterone-therapy-for-sexual-dysfunction-in-men-with-type-2-diabetes-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#20
M Algeffari, C N Jayasena, P MacKeith, A Thapar, W S Dhillo, N Oliver
AIM: To evaluate the effectiveness of testosterone therapy on a range of sexual function domains in men with Type 2 diabetes. METHOD: Electronic databases were searched for studies investigating the effect of testosterone therapy on sexual function in men with Type 2 diabetes. All randomized controlled trials were considered for inclusion if they compared the efficacy of testosterone therapy with that of placebo and reported sexual function outcomes. Statistical analysis was performed using a random-effects model, and heterogeneity was expressed using the I(2) statistic...
November 24, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
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