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Type 2 diabetes, primary care

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https://www.readbyqxmd.com/read/28936586/role-of-structured-individual-patient-education-in-the-prevention-of-vascular-complications-in-newly-diagnosed-type-2-diabetes-the-individual-therapeutic-education-in-newly-diagnosed-type-2-diabetes-intend-randomized-controlled-trial
#1
Adriana Coppola, Livio Luzi, Tiziana Montalcini, Andrea Giustina, Carmine Gazzaruso
OBJECTIVE: Recent studies showed that a structured patient therapeutic education (PTE) may decrease both mortality and the development of diabetes complications. Nevertheless, no data are available in the literature on the impact of individual PTE on the complications in newly diagnosed type 2 diabetic patients. Aim of the present randomized controlled trial is to evaluate the impact of individual PTE on the occurrence of macrovascular complications in newly diagnosed type 2 diabetic patients when compared to usual care (UC) and group PTE...
September 21, 2017: Endocrine
https://www.readbyqxmd.com/read/28936150/prevalence-of-poor-glycemic-and-blood-pressure-control-and-pattern-of-drug-use-among-primary-health-care-outpatients-in-al-ahsa-saudi-arabia
#2
Promise M Emeka, Ahmed Al Mukalaf, Hussien Al Helal, Tahir M Khan, Mishial A Almukalf
OBJECTIVES: To assess drug use pattern and the effect on glycemic and blood pressure (BP) control in type 2 diabetes mellitus (T2DM) and hypertensive patients. Furthermore, to evaluate the duration of drug use and antecedence in diagnosis. METHODOLOGY: A cross-sectional study design, comprising interview/questionnaire targeting outpatients attending primary health centers in Al Ahsa was adopted. During the interview, their fasting blood glucose, weight, and height were measured, along with their BP...
July 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28932161/the-efficacy-of-a-diabetic-educational-program-and-predictors-of-compliance-of-patients-with-noninsulin-dependent-type-2-diabetes-mellitus-in-al-khobar-saudi-arabia
#3
Fatma M Mokabel, Shadia F Aboulazm, Hanan E Hassan, Mona F Al-Qahtani, Seham F Alrashedi, Fatma A Zainuddin
BACKGROUND: The concept of detection and management of diabetes mellitus at primary health-care centers is justified and widely practised in Saudi Arabia. The objective of this study was to assess the efficacy of diabetic educational programs for noninsulin-dependent (type 2) diabetes mellitus patients, and to determine the predictors of compliance. MATERIALS AND METHODS: A longitudinal experimental research design was adopted for this study and conducted at the diabetic outpatient clinic of King Fahd Hospital of the University, Al Khobar, Kingdom of Saudi Arabia...
September 2017: Journal of Family & Community Medicine
https://www.readbyqxmd.com/read/28931509/development-and-validation-of-qmortality-risk-prediction-algorithm-to-estimate-short-term-risk-of-death-and-assess-frailty-cohort-study
#4
Julia Hippisley-Cox, Carol Coupland
Objectives To derive and validate a risk prediction equation to estimate the short term risk of death, and to develop a classification method for frailty based on risk of death and risk of unplanned hospital admission.Design Prospective open cohort study.Participants Routinely collected data from 1436 general practices contributing data to QResearch in England between 2012 and 2016. 1079 practices were used to develop the scores and a separate set of 357 practices to validate the scores. 1.47 million patients aged 65-100 years were in the derivation cohort and 0...
September 20, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28928175/integrated-management-of-atrial-fibrillation-including-tailoring-of-anticoagulation-in-primary-care-study-design-of-the-all-in-cluster-randomised-trial
#5
Carline J van den Dries, Ruud Oudega, Arif Elvan, Frans H Rutten, Sjef J C M van de Leur, Henk J G Bilo, Arno W Hoes, Karel G M Moons, Geert-Jan Geersing
INTRODUCTION: In our ageing society, we are at the merge of an expected epidemic of atrial fibrillation (AF). AF management requires an integrated approach, including rate or rhythm control, stroke prevention with anticoagulation and treatment of comorbidities such as heart failure or type 2 diabetes. As such, primary care seems to be the logical healthcare setting for the chronic management of patients with AF. However, primary care has not yet played a dominant role in AF management, which has been in fact more fragmented between different healthcare providers...
September 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28925010/temporal-trends-in-quality-of-primary-care-for-patients-with-type-2-diabetes-mellitus-a-population-based-retrospective-cohort-study-after-implementation-of-a-quality-improvement-initiative
#6
Carlos K H Wong, Colman S C Fung, Esther Y T Yu, Eric Y F Wan, Anca K C Chan, Cindy L K Lam
BACKGROUND: This study examined whether temporal trends exist in treatment of patients with type 2 diabetes (T2D) and quality of diabetes care after implementation of quality improvement initiative in primary care setting. METHODS: We conducted a population-based retrospective cohort study of 202,284 patients with T2D who were routinely managed in primary care clinics. We examined the change over time and the variability between clinics in quality-of-care from Hospital Authority administrative data over a five-year period (2009-2013), and used multilevel logistic regression to adjust for patient and clinic characteristics...
September 19, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28923815/use-of-complementary-health-approaches-among-diverse-primary-care-patients-with-type-2-diabetes-and-association-with-cardiometabolic-outcomes-from-the-sf-bay-collaborative-research-network-sf-bay-crn
#7
Margaret A Handley, Judy Quan, Maria T Chao, Neda Ratanawongsa, Urmimala Sarkar, Sophia Emmons-Bell, Dean Schillinger
PURPOSE: To describe use of complementary health approaches (CHAs) among patients with type 2 diabetes, and independent associations between CHA use and Hemoglobin A1c (A1C) and lower-density lipoprotein (LDL) cholesterol. METHODS: Participants were enrolled onto the SMARTSteps Program, a diabetes self-management support program conducted between 2009 and 2013 in San Francisco. At the 6-month interview, CHA use in the prior 30 days was estimated using a 12-item validated instrument...
September 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28923165/cross-sectional-study-of-area-level-disadvantage-and-glycaemic-related-risk-in-community-health-service-users-in-the-southern-iml-research-simlr-cohort
#8
Roger Cross, Andrew Bonney, Darren J Mayne, Kathryn M Weston
Objectives The aim of the present study was to determine the association between area-level socioeconomic disadvantage and glycaemic-related risk in health service users in the Illawarra-Shoalhaven region of New South Wales, Australia.Methods HbA1c values recorded between 2010 and 2012 for non-pregnant individuals aged ≥18 years were extracted from the Southern.IML Research (SIMLR) database. Individuals were assigned quintiles of the Socioeconomic Indices for Australia (SEIFA) Index of Relative Socioeconomic Disadvantage (IRSD) according to their Statistical Area 1 of residence...
September 19, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28919055/antimicrobial-resistance-in-women-with-urinary-tract-infection-in-primary-care-no-relation-with-type-2-diabetes-mellitus
#9
Johanna E M Vinken, Helen E Mol, Theo J M Verheij, Sanne van Delft, Marion Kolader, Miquel B Ekkelenkamp, Guy E H M Rutten, Berna D L Broekhuizen
AIMS: To determine if type 2 diabetes mellitus (T2DM) is associated with the spectrum of uropathogens and antimicrobial resistance in urinary tract infections (UTI) in primary care. METHODS: A cross-sectional study in female outpatients ≥30 years with positive urine cultures. T2DM patients were 1:1 matched to controls by age group and general practitioner (GP). GPs were sent questionnaires for additional data. Uropathogens and resistance patterns were compared between patients with and without T2DM...
September 14, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28912194/assessing-oral-medication-adherence-among-patients-with-type-2-diabetes-mellitus-treated-with-polytherapy-in-a-developed-asian-community-a-cross-sectional-study
#10
Cia Sin Lee, Jane Hwee Mian Tan, Usha Sankari, Yi Ling Eileen Koh, Ngiap Chuan Tan
OBJECTIVES: The disease burden of type 2 diabetes mellitus (T2DM) is rising due to suboptimal glycaemic control leading to vascular complications. Medication adherence (MA) directly influences glycaemic control and clinical consequences. This study aimed to assess the MA of patients with T2DM and identify associated factors. DESIGN: Analysis of data from a cross-sectional survey and electronic medical records. SETTING: Primary care outpatient clinic in Singapore...
September 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28912193/effectiveness-of-a-multifactorial-intervention-based-on-an-application-for-smartphones-heart-healthy-walks-and-a-nutritional-workshop-in-patients-with-type-2-diabetes-mellitus-in-primary-care-emid-study-protocol-for-a-randomised-controlled-trial
#11
Rosario Alonso-Domínguez, Manuel A Gómez-Marcos, Maria C Patino-Alonso, Natalia Sánchez-Aguadero, Cristina Agudo-Conde, Carmen Castaño-Sánchez, Luis García-Ortiz, José I Recio-Rodríguez
INTRODUCTION: New information and communication technologies (ICTs) may promote lifestyle changes, but no adequate evidence is available on their combined effect of ICTs with multifactorial interventions aimed at improving diet and increasing physical activity in patients with type 2 diabetes mellitus (DM2). The primary objective of this study is to assess the effect of a multifactorial intervention to increase physical activity and adherence to Mediterranean diet in DM2. METHODS AND ANALYSIS: Study scope and population: The study will be conducted at 'La Alamedilla' primary care research unit in Salamanca (Spain)...
September 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28911977/screening-for-sexual-dissatisfaction-among-people-with-type-2-diabetes-in-primary-care
#12
Anne Bijlsma-Rutte, Annemarie M J Braamse, Patricia van Oppen, Frank J Snoek, Paul Enzlin, Peter Leusink, Giel Nijpels, Petra J M Elders
AIMS: The identification and discussion of sexual care needs in people with type 2 diabetes mellitus (T2DM) in primary care is currently insufficient. The objective of this study was to determine the prevalence of sexual dissatisfaction, sexual problems and need for help by using a screening instrument among people with T2DM in primary care. METHODS: Data were collected in 45 general practices in the Netherlands from January 2015 to February 2016. The Brief Sexual Symptom Checklist (BSSC) was used to screen among 40-75 year old men and women...
August 4, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28910237/effects-of-once-weekly-exenatide-on-cardiovascular-outcomes-in-type-2-diabetes
#13
Rury R Holman, M Angelyn Bethel, Robert J Mentz, Vivian P Thompson, Yuliya Lokhnygina, John B Buse, Juliana C Chan, Jasmine Choi, Stephanie M Gustavson, Nayyar Iqbal, Aldo P Maggioni, Steven P Marso, Peter Öhman, Neha J Pagidipati, Neil Poulter, Ambady Ramachandran, Bernard Zinman, Adrian F Hernandez
Background The cardiovascular effects of adding once-weekly treatment with exenatide to usual care in patients with type 2 diabetes are unknown. Methods We randomly assigned patients with type 2 diabetes, with or without previous cardiovascular disease, to receive subcutaneous injections of extended-release exenatide at a dose of 2 mg or matching placebo once weekly. The primary composite outcome was the first occurrence of death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke...
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28905434/decline-of-insulin-therapy-and-delays-in-insulin-initiation-in-people-with-uncontrolled-diabetes-mellitus
#14
N Hosomura, S Malmasi, D Timerman, V J Lei, H Zhang, L Chang, A Turchin
AIMS: To design and validate a natural language processing algorithm to identify insulin therapy decline from the text of physician notes, and to determine the prevalence of insulin therapy decline and its impact on insulin initiation. METHODS: We designed the algorithm using the publicly available natural language processing platform Canary. We evaluated the accuracy of the algorithm on 1501 randomly selected primary care physicians' notes from the electronic medical record system of a large academic medical centre...
September 14, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28905421/exercise-to-preserve-%C3%AE-cell-function-in-recent-onset-type-1-diabetes-mellitus-extod-a-randomized-controlled-pilot-trial
#15
P Narendran, N Jackson, A Daley, D Thompson, K Stokes, S Greenfield, M Charlton, M Curran, T P J Solomon, A Nouwen, S I Lee, A R Cooper, M Mostazir, R S Taylor, A Kennedy, R C Andrews
AIM: Residual β-cell function is present at the time of diagnosis with Type 1 diabetes. Preserving this β-cell function reduces complications. We hypothesized that exercise preserves β-cell function in Type 1 diabetes and undertook a pilot trial to address the key uncertainties in designing a definitive trial to test this hypothesis. METHODS: A randomized controlled pilot trial in adults aged 16-60 years diagnosed with Type 1 diabetes within the previous 3 months was undertaken...
September 14, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28902377/-implementation-of-the-national-guidelines-for-the-treatment-of-diabetes-mellitus-type-2-in-secondary-diabetes-centers
#16
Lydia Marahrens, Daniel Röck, Tjalf Ziemssen, Raimar Kern, Focke Ziemssen, Andreas Fritsche
Background The German National Disease Management Guideline (NVL) on treatment of Type 2 Diabetes recommends lowering of blood glucose in four therapy steps. There is little evidence, how NVL is implemented for the individual patients. Methods 810 patients in secondary diabetes centers were examined within the DiabCheck(OCTplus) trial. Data about the patient's health status (electronic medical record) were classified according to the NVL treatment steps. The degree of implementation was assessed for every person with diabetes type 2 (NCT02 311 504)...
September 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28899432/prevalence-and-associations-of-microalbuminuria-in-proteinuria-negative-patients-with-type-2-diabetes-in-two-regional-hospitals-in-cameroon-a-cross-sectional-study
#17
Nelsy T Efundem, Jules Clement N Assob, Vitalis F Feteh, Simeon-Pierre Choukem
BACKGROUND: Microalbuminuria (MA) is the earliest clinical evidence of diabetic nephropathy, but most patients in sub-Saharan Africa (SSA) only have access to much cheaper dipstick proteinuria as a means to screen for diabetic nephropathy. The aim of this study was to determine the prevalence and associations of MA among proteinuria-negative type 2 diabetic patients in a SSA setting. METHODS: In this cross-sectional study, patients with type 2 diabetes screened negative for dipstick proteinuria in a primary healthcare hospital were assessed...
September 12, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28898445/characterizing-adults-with-type-2-diabetes-mellitus-and-intellectual-disability-outcomes-of-a-case-finding-study
#18
L D Bryant, A M Russell, R E A Walwyn, A J Farrin, A Wright-Hughes, E H Graham, D Nagi, A Stansfield, J Birtwistle, S Meer, R A Ajjan, A O House
AIMS: To report the results of a case-finding study conducted during a feasibility trial of a supported self-management intervention for adults with mild to moderate intellectual disability and Type 2 diabetes mellitus, and to characterize the study sample in terms of diabetes control, health, and access to diabetes management services and support. METHODS: We conducted a cross-sectional case-finding study in the UK (March 2013 to June 2015), which recruited participants mainly through primary care settings...
September 12, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28895640/the-application-of-sudoscan-for-screening-diabetic-peripheral-neuropathy-in-chinese-population-screening-dpn-by-sudoscan
#19
Jiewen Jin, Weimin Wang, Tianwei Gu, Wei Chen, Jing Lu, Yan Bi, Dalong Zhu
Purpose Diabetic peripheral neuropathies are the common chronic complications of diabetes, but the diagnosis is insensitive by physical examination in busy outpatients. Here we evaluated the performance of SUDOSCAN in screening diabetic peripheral neuropathies in Chinese type 2 diabetic patients. Methods The study enrolled 180 patients for annually screening. All patients underwent neurological symptoms assessment, clinical examination, nerve conduction studies and cardiovascular autonomic reflex tests. SUDOSCAN was tested and evaluated with electrochemical skin conductance in hands and feet, asymmetry ratio in hands and feet and predicted cardiac neuropathy...
September 11, 2017: Experimental and Clinical Endocrinology & Diabetes
https://www.readbyqxmd.com/read/28895030/type-2-diabetes-and-cardiovascular-prevention-the-dogmas-disputed
#20
Dario Giugliano, Maria Ida Maiorino, Giuseppe Bellastella, Katherine Esposito
In randomized controlled trials (RCTs), more intensive glucose control in patients with type 2 diabetes leads to a modest (9%) reduction in major cardiovascular events (MACE), associated with a 20% reduction of kidney events and 13% reduction of eye events. The FDA issued guidance in 2008 led to the conduct of numerous cardiovascular outcomes (CVOT) trials to assess cardiovascular safety of new antihyperglycemic therapies in patients with type 2 diabetes. The results of these trials show that insulin glargine, three different dipeptidyl peptidase-4 (DPP-4) inhibitors (saxagliptin, alogliptin, and sitagliptin) and lixisenatide (a glucagon like peptide-1 receptor agonist) produce no significant difference in CVOT when compared with usual care or placebo...
September 11, 2017: Endocrine
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