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Type 2 diabetes, primary care

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https://www.readbyqxmd.com/read/28545518/design-and-rationale-of-the-odyssey-dm-dyslipidemia-trial-lipid-lowering-efficacy-and-safety-of-alirocumab-in-individuals-with-type-2-diabetes-and-mixed-dyslipidaemia-at-high-cardiovascular-risk
#1
Dirk Müller-Wieland, Lawrence A Leiter, Bertrand Cariou, Alexia Letierce, Helen M Colhoun, Stefano Del Prato, Robert R Henry, Francisco J Tinahones, Lisa Aurand, Jaman Maroni, Kausik K Ray, Maja Bujas-Bobanovic
BACKGROUND: Type 2 diabetes mellitus (T2DM) is often associated with mixed dyslipidaemia, where non-high-density lipoprotein cholesterol (non-HDL-C) levels may more closely align with cardiovascular risk than low-density lipoprotein cholesterol (LDL-C). We describe the design and rationale of the ODYSSEY DM-DYSLIPIDEMIA study that assesses the efficacy and safety of alirocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, versus lipid-lowering usual care in individuals with T2DM and mixed dyslipidaemia at high cardiovascular risk with non-HDL-C inadequately controlled despite maximally tolerated statin therapy...
May 25, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/28545493/three-approaches-to-glucose-monitoring-in-non-insulin-treated-diabetes-a-pragmatic-randomized-clinical-trial-protocol
#2
Laura A Young, John B Buse, Mark A Weaver, Maihan B Vu, April Reese, C Madeline Mitchell, Tamara Blakeney, Kimberlea Grimm, Jennifer Rees, Katrina E Donahue
BACKGROUND: For the nearly 75% of patients living with type 2 diabetes (T2DM) that do not use insulin, decisions regarding self-monitoring of blood glucose (SMBG) can be especially problematic. While in theory SMBG holds great promise for sparking favorable behavior change, it is a resource intensive activity without firmly established patient benefits. This study describes our study protocol to assess the impact of three different SMBG testing approaches on patient-centered outcomes in patients with non-insulin treated T2DM within a community-based, clinic setting...
May 25, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28544499/preventing-progression-from-gestational-diabetes-mellitus-to-diabetes-a-thought-filled-review
#3
REVIEW
Michal Kasher-Meron, Martin M Grajower
Women with a history of gestational diabetes (GDM) are at high risk for developing type 2 diabetes mellitus (T2DM). In studies with long periods of follow up, diabetes incidence of up to 70% has been reported. The appropriate follow up of women following a pregnancy complicated by GDM has not been studied. Published guidelines recommend that obstetrician/gynecologists, who are often the de facto primary care physicians for these otherwise healthy young women, make glucose monitoring in the post-partum period part of their annual examinations...
May 19, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28544171/effectiveness-of-shared-goal-setting-and-decision-making-to-achieve-treatment-targets-in-type-2-diabetes-patients-a-cluster-randomized-trial-optimal
#4
Henk Den Ouden, Rimke C Vos, Guy E H M Rutten
OBJECTIVE: About 20% of patients with type 2 diabetes achieve all their treatment targets. Shared decision making (SDM) using a support aid based on the 5-years results of the ADDITION study on multifactorial treatment, could increase this proportion. RESEARCH DESIGN AND METHODS: Cluster-randomized trial in 35 former ADDITION primary care practices. Practices were randomized to SDM or care as usual (1:1). Both ADDITION and non-ADDITION type 2 diabetes patients, 60-80 years, known with diabetes for 8-12 years, were included...
May 24, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/28539134/does-metformin-protect-against-osteoarthritis-an-electronic-health-record-cohort-study
#5
Lauren A Barnett, Kelvin P Jordan, John J Edwards, Danielle A van der Windt
BACKGROUND: Obesity is a major risk factor for osteoarthritis (OA) whilst there is some evidence that diabetes also increases risk. Metformin is a common oral treatment for those with diabetes. OBJECTIVE: The aim is to investigate whether metformin reduces the risk of OA. METHODS: This was a cohort study set within the Consultations in Primary Care Archive, with 3217 patients with type 2 diabetes. Patients at 13 general practices with recorded type 2 diabetes in the baseline period (2002-2003) and no prior record of OA were identified...
May 25, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28535926/the-impact-of-a-patient-web-communication-intervention-on-reaching-treatment-suggested-guidelines-for-chronic-diseases-a-randomized-controlled-trial
#6
Emma Glaser, Claude Richard, Marie-Thérèse Lussier
OBJECTIVE: Examine the impact of a PACE (Prepare, Ask, Check, Express) inspired web-based communication intervention alone or combined with a workshop on reaching treatment goals for patients suffering from chronic diseases (CDs), compared to usual care. METHODS: Three arm single-blind RCT in community primary care (PC) practices. PC practitioners (n=18) had a CD patient caseload, and practicing >5 years. Patients >40 years old, English speaking, computer literate, not reaching treatment goals for hypertension, type II diabetes, and/or dyslipidemia...
May 13, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28531197/a-narrative-systematic-review-of-factors-affecting-diabetes-prevention-in-primary-care-settings
#7
Josie Messina, Stephen Campbell, Rebecca Morris, Emily Eyles, Caroline Sanders
BACKGROUND: Type 2 diabetes is impacting millions of people globally; however, many future cases can be prevented through lifestyle changes and interventions. Primary care is an important setting for diabetes prevention, for at-risk populations, because it is a patient's primary point of contact with the health care system and professionals can provide lifestyle counselling and support, as well as monitoring health outcomes. These are all essential elements for diabetes prevention for at-risk adults...
2017: PloS One
https://www.readbyqxmd.com/read/28530380/diabetes-update-primary-care-of-patients-with-type-1-diabetes
#8
Beth Choby
The incidence and prevalence of type 1 diabetes (T1D) are increasing among white, black, Hispanic, and Asian individuals in the United States. Children often present with acute symptoms, including severe polyuria, polydipsia, weight loss, and ketonemia; adults may develop more gradual symptoms that initially appear similar to those of type 2 diabetes (T2D). Latent autoimmune diabetes of adults and maturity-onset diabetes of the young are conditions that may be confused with T1D, although they are actually more closely related to T2D...
May 2017: FP Essentials
https://www.readbyqxmd.com/read/28530263/utricular-hypofunction-in-patients-with-type-2-diabetes-mellitus
#9
K Jáuregui-Renaud, C Aranda-Moreno, A Herrera-Rangel
The aim of this study was to assess the function of the utricle and horizontal semicircular canals in patients with type 2 diabetes mellitus receiving primary health care, with/without a history of falls. 101 patients with type 2 diabetes mellitus, 34 to 84 years old (26 with and 75 without a history of falls) and 51 healthy volunteers (40-83 years old) accepted to participate. They denied having a history of dizziness, vertigo, unsteadiness, hearing loss or neurological disorders. None of them were seeking care due to sensory or balance decline...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28529546/disease-management-programs-for-patients-with-type-2-diabetes-mellitus-in-germany-a-longitudinal-population-based-descriptive-study
#10
Michael Mehring, Ewan Donnachie, Florian Cornelius Bonke, Christoph Werner, Antonius Schneider
BACKGROUND: The primary aim of the disease management program (DMP) for patients with diabetes mellitus type 2 is to improve the quality of health care and the treatment process. 12 years after its introduction in Germany, there is still no consensus as to whether DMP has been effective in reaching these goals. METHODS: A retrospective longitudinal population-based study between 2004 and 2015 were conducted to evaluate the DMP for type 2 diabetes in Bavaria using routinely collected patient medical records hold from the National Association of Statutory Health Insurance Physicians of Bavaria...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28528246/the-canadian-hypoglycemia-assessment-tool-program-insights-into-rates-and-implications-of-hypoglycemia-from-an-observational-study
#11
Ronnie Aronson, Ronald Goldenberg, Damir Boras, Rasmus Skovgaard, Harpreet Bajaj
OBJECTIVE: The true prevalence of hypoglycemia in insulin-treated patients with diabetes and its impact on patients, employers and healthcare providers is poorly appreciated owing to a paucity of real-world data. The global Hypoglycemia Assessment Tool (HAT) study addressed this issue, and here we report data from the Canadian cohort of patients. METHODS: This noninterventional, 6-month retrospective and 4-week prospective study enrolled patients aged ≥18 years receiving insulin treatment for >12 months from community endocrinology practices...
May 17, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28522450/lower-risk-of-heart-failure-and-death-in-patients-initiated-on-sglt-2-inhibitors-versus-other-glucose-lowering-drugs-the-cvd-real-study
#12
Mikhail Kosiborod, Matthew A Cavender, Alex Z Fu, John P Wilding, Kamlesh Khunti, Reinhard W Holl, Anna Norhammar, Kåre I Birkeland, Marit Jørgensen, Marcus Thuresson, Niki Arya, Johan Bodegård, Niklas Hammar, Peter Fenici
Background -Reduction in cardiovascular death and hospitalization for heart failure (HHF) was recently reported with the sodium-glucose co-transporter-2 inhibitor (SGLT-2i) empagliflozin in type 2 diabetes patients with atherosclerotic cardiovascular disease. We compared HHF and death in patients newly initiated on any SGLT-2i versus other glucose lowering drugs (oGLDs) in six countries to determine if these benefits are seen in real-world practice, and across SGLT-2i class. Methods -Data were collected via medical claims, primary care/hospital records and national registries from the US, Norway, Denmark, Sweden, Germany and the UK...
May 18, 2017: Circulation
https://www.readbyqxmd.com/read/28521859/-evaluation-of-primary-adherence-to-medications-in-patients-with-chronic-conditions-a-retrospective-cohort-study
#13
Francisco Emiliano Peper, Santiago Esteban, Sergio Adrian Terrasa
OBJECTIVES: To assess the proportion of members of a private health insurance at the Hospital Italiano de Buenos Aires with primary adherence to, 1) bisphosphonates for secondary prevention of osteoporotic fractures, 2) insulin and metformin in type 2 diabetes, and 3) tamoxifen in the context of treatment of breast cancer. DESIGN: Retrospective cohort study to determine the proportion of primary treatment adherence during 2012 and 2013. SITE: Hospital Italiano de Buenos Aires, Argentina...
May 15, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28521796/effects-of-nurse-telesupport-on-transition-between-specialized-and-primary-care-in-diabetic-patients-study-protocol-for-a-randomized-controlled-trial
#14
Ana Marina Moreira, Roberta Marobin, Dimitris Varvaki Rados, Camila Bergonsi de Farias, Sabrina Coelli, Bárbara Luiza Bernardi, Lívia de Almeida Faller, Laura Ferraz Dos Santos, Ana Maria Matzenbacher, Natan Katz, Erno Harzheim, Sandra Pinho Silveiro
BACKGROUND: According to the Global Diabetes Plan, a unified health system with preventive and educational strategies is essential to proper diabetes care and primary settings should be the main site of care. In Brazil, there is limited access to outpatient hospital diabetes services, while primary-care diabetes support is underutilized. Telemedicine can be a useful adjunct to support discharge of stable patients with type 2 diabetes to the primary care setting. In this paper, we present a randomized controlled trial (RCT) protocol designed to evaluate the effects of telehealth support for stable type 2 diabetes patients discharged from hospital outpatient diabetes clinics...
May 18, 2017: Trials
https://www.readbyqxmd.com/read/28520876/geographic-information-systems-mapping-of-diabetic-retinopathy-in-an-ocular-telemedicine-network
#15
Pooja D Jani, Lauren Forbes, Philip McDaniel, Anthony Viera, Seema Garg
Importance: Minimal information exists on the use of geographic information systems mapping for visualizing access barriers to eye care for patients with diabetes. Objective: To use geographic information systems mapping techniques to visualize (1) the locations of patients participating in the North Carolina Diabetic Retinopathy Telemedicine Network, (2) the locations of primary care clinicians and ophthalmologists across the state, and (3) the travel times associated with traveling to the 5 primary care clinics in our study...
May 18, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28520833/evaluation-of-diabetic-retinal-screening-and-factors-for-ophthalmology-referral-in-a-telemedicine-network
#16
Pooja D Jani, Lauren Forbes, Arkopal Choudhury, John S Preisser, Anthony J Viera, Seema Garg
Importance: Retinal telescreening for evaluation of diabetic retinopathy (DR) in the primary care setting may be useful in reaching rural and underserved patients. Objectives: To evaluate telemedicine retinal screenings for patients with type 1 or 2 diabetes and identify factors for ophthalmology referral in the North Carolina Diabetic Retinopathy Telemedicine Network. Design, Setting, and Participants: A preimplementation and postimplementation evaluation was conducted from January 6, 2014, to November 1, 2015, at 5 primary care clinics serving rural and underserved populations in North Carolina among 1787 adult patients with type 1 or 2 diabetes who received primary care at the clinics and obtained retinal telescreening to determine the presence and severity of DR...
May 18, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28514463/pediatric-psoriasis-comorbidity-screening-guidelines
#17
Emily Osier, Audrey S Wang, Megha M Tollefson, Kelly M Cordoro, Stephen R Daniels, Andrew Eichenfield, Joel M Gelfand, Alice B Gottlieb, Alexa B Kimball, Mark Lebwohl, Nehal N Mehta, Amy S Paller, Jeffrey B Schwimmer, Dennis M Styne, Abby S Van Voorhees, Wynnis L Tom, Lawrence F Eichenfield
Importance: Psoriasis is a complex inflammatory skin condition associated with serious medical comorbidities in adults, including obesity, hypertension, dyslipidemia, type 2 diabetes mellitus, psoriatic arthritis, nonalcoholic fatty liver disease, depression, anxiety, and decreased quality of life. Because psoriasis begins in childhood in almost one-third of patients, early identification of risk may be critical to minimizing effects on future health. Objective: To develop the first set of guidelines for comorbidity screening for patients with pediatric psoriasis based on current evidence...
May 17, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28511962/interventions-for-prevention-of-type-2-diabetes-in-relatives-a-systematic-review
#18
REVIEW
Elena Dimcheva Dimova, Andrea Rene Mary Mohan, Vivien Swanson, Josie M M Evans
The relatives and partners of people with type 2 diabetes are at increased risk of developing type 2 diabetes. This systematic review examines randomized controlled trials, written in English that tested an intervention, which aimed to modify behaviors known to delay or prevent type 2 diabetes, among the relatives or partners of people with type 2 diabetes. Study quality was assessed using the Cochrane Collaboration's tool for assessing risk of bias. Seven studies met the inclusion criteria. The majority of studies were at low risk of bias...
May 13, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28508013/self-reported-diagnosis-of-type-1-and-type-2-diabetes-and-lifestyle-change-among-uninsured-primary-care-patients
#19
Shannon Weaver, Jeanie Ashby, Akiko Kamimura
INTRODUCTION: The purpose of this study is to examine self-reported diagnosis of type 1 and type 2 diabetes and lifestyle change among uninsured primary care patients utilizing a free clinic. METHODS: Free clinic patients participated in a self-administered survey in May and June 2016. Patients with the following self-reported diagnoses were analyzed: type 2 diabetes only (n = 84), and type 1 diabetes only or both (n = 43). RESULTS: Participants who reported having type 2 diabetes only and/or were patients of the diabetes clinic were less likely to have modified diet and/or physical activity to manage diabetes compared to those with type 1 diabetes and/or those who were not patients of the diabetes clinic...
January 2017: Health Services Research and Managerial Epidemiology
https://www.readbyqxmd.com/read/28507433/effect-of-pharmaceutical-care-on-clinical-outcomes-of-outpatients-with-type-2-diabetes-mellitus
#20
Hua Shao, Guoming Chen, Chao Zhu, Yongfei Chen, Yamin Liu, Yuxing He, Hui Jin
BACKGROUND: In the People's Republic of China, outpatients have limited time with their physicians. Thus, compared to inpatients, outpatients have lower medication adherence and are less knowledgeable about their disease. OBJECTIVE: The objective of this study was to evaluate the effect of pharmaceutical care on clinical outcomes of outpatients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS: A randomized, controlled, prospective clinical trial was conducted recruiting a total of 240 T2DM outpatients from Zhongda Hospital, Southeast University...
2017: Patient Preference and Adherence
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