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Type 2 diabetes, primary care

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https://www.readbyqxmd.com/read/29138274/five-year-effectiveness-of-the-multidisciplinary-risk-assessment-and-management-program-for-primary-care-patients-with-type-2-diabetes-mellitus%C3%A2-ramp-dm-on-dm-related-complications-and-health-service-uses-a-population-based-and-propensity-matched-cohort-study
#1
Eric Yuk Fai Wan, Colman Siu Cheung Fung, Fang Fang Jiao, Esther Yee Tak Yu, Weng Yee Chin, Daniel Yee Tak Fong, Carlos King Ho Wong, Anca Ka Chun Chan, Karina Hiu Yen Chan, Ruby Lai Ping Kwok, Cindy Lo Kuen Lam
OBJECTIVE: To evaluate the 5-year effectiveness of a multidisciplinary Risk Assessment and Management Program for primary care patients with type 2 Diabetes Mellitus (RAMP-DM)‎. RESEARCH DESIGN AND METHODS: A 5-year prospective cohort study was conducted with 121,584 Chinese primary care patients with type 2 DM who were recruited between August 2009 and June 2011. Missing data were dealt with multiple imputations. After excluding patients with prior DM-related complications and one-to-one propensity score matching on all patient characteristics, 26,718 RAMP-DM participants and 26,718 matched usual-care patients were followed up for a median time of 4...
November 14, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29137017/prognostic-value-of-glucose-metabolism-for-non-st-segment-elevation-infarction-patients-with-diabetes-mellitus-and-single-concomitant-chronic-total-occlusion-following-primary-percutaneous-coronary-intervention
#2
Zhi Xing, Lei Zhang, Zhiqiang Liu, Pengyi He, Yuchun Yang, Muhuyati Wulasihan
Glucose metabolism status may play a predictive role in the severity of the complications among patients with type 2 diabetes mellitus (DM). However, few studies have focused on the prognostic value of glycosylated hemoglobin (HbA1c) and Homeostatic Model Assessment 2 for Insulin Resistance (HOMA2-IR) in patients with DM, non-ST-segment elevation infarction (NSTEMI), and single concomitant chronic total occlusion (CTO) following primary percutaneous coronary intervention (PCI). Short- and long-term prognostic value of HbA1c and HOMA2-IR in patients with DM with NSTEMI and single CTO who received primary percutaneous transluminal coronary intervention (pPCI)...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29129039/combined-diet-and-exercise-interventions-for-preventing-gestational-diabetes-mellitus
#3
REVIEW
Emily Shepherd, Judith C Gomersall, Joanna Tieu, Shanshan Han, Caroline A Crowther, Philippa Middleton
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with a wide range of adverse health consequences for women and their infants in the short and long term. With an increasing prevalence of GDM worldwide, there is an urgent need to assess strategies for GDM prevention, such as combined diet and exercise interventions. This is an update of a Cochrane review that was first published in 2015. OBJECTIVES: To assess the effects of diet interventions in combination with exercise interventions for pregnant women for preventing GDM, and associated adverse health consequences for the mother and her infant/child...
November 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29127341/classification-rule-for-5-year-cardiovascular-diseases-risk-using-decision-tree-in-primary-care-chinese-patients-with-type-2-diabetes-mellitus
#4
Eric Yuk Fai Wan, Daniel Yee Tak Fong, Colman Siu Cheung Fung, Esther Yee Tak Yu, Weng Yee Chin, Anca Ka Chun Chan, Cindy Lo Kuen Lam
Cardiovascular disease(CVD) is the leading cause of mortality among patients with type 2 diabetes mellitus(T2DM), and a risk classification model for CVD among primary care diabetic patients is pivotal for risk-based interventions and patient information. This study developed a simple tool for a 5-year CVD risk prediction for primary care Chinese patients with T2DM. A retrospective cohort study was conducted on 137,935 primary care Chinese T2DM patients aged 18-79 years without history of CVD between 1 January 2010 and 31 December 2010...
November 10, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29122782/study-protocol-for-the-cities-changing-diabetes-programme-a-global-mixed-methods-approach
#5
A David Napier, John J Nolan, Malene Bagger, Louise Hesseldal, Anna-Maria Volkmann
INTRODUCTION: Urban living has been shown to affect health in various ways. As the world is becoming more urbanised and almost two-thirds of people with diabetes now live in cities, research into the relationship between urban living, health and diabetes is key to improving the lives of many. The majority of people with diabetes have type 2 diabetes, a subset linked to overweight and obesity, decreased physical activity and unhealthy diets. Diabetes has significant consequences for those living with the condition as well as their families, relationships and wider society...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29122108/predictors-of-insulin-uptake-among-adults-with-type-2-diabetes-in-the-stepping-up-study
#6
Elizabeth Holmes-Truscott, John Furler, Irene Blackberry, David N O'Neal, Jane Speight
AIMS: We aimed to investigate predictors of insulin uptake, and change in insulin appraisals, among adults with type 2 diabetes mellitus (T2DM) who participated in the Stepping Up trial. METHODS: The Stepping Up model of care, supporting timely insulin initiation in primary care, was evaluated in a two-armed cluster-randomised controlled trial. Participants were 266 adults (mean±SD age 62±10years; 39% women) with T2DM (median (IQR) duration 8.5 (5, 13)years) from 74 primary care practices (Stepping Up intervention: 57%, control 43%)...
November 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29120361/variation-in-point-of-care-testing-of-hba1c-in-diabetes-care-in-general-practice
#7
Troels Kristensen, Frans Boch Waldorff, Jørgen Nexøe, Christian Volmar Skovsgaard, Kim Rose Olsen
Background: Point-of-care testing (POCT) of HbA1c may result in improved diabetic control, better patient outcomes, and enhanced clinical efficiency with fewer patient visits and subsequent reductions in costs. In 2008, the Danish regulators created a framework agreement regarding a new fee-for-service fee for the remuneration of POCT of HbA1c in general practice. According to secondary research, only the Capital Region of Denmark has allowed GPs to use this new incentive for POCT. The aim of this study is to use patient data to characterize patients with diabetes who have received POCT of HbA1c and analyze the variation in the use of POCT of HbA1c among patients with diabetes in Danish general practice...
November 9, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29120011/four-year-long-term-follow-up-of-diabetes-patients-after-implementation-of-the-chronic-care-model-in-primary-care-a-cross-sectional-study
#8
Corinne Chmiel, Irina Giewer, Anja Frei, Thomas Rosemann
AIMS: Implementing the Chronic Care Model (CCM) via involvement of specially trained practice nurses improves cardiovascular risk profiles and perception of care among type 2 diabetes patients in small primary care practices (PCPs) in the short term. Little is known about the long-term effects of this intervention. METHODS: Cross-sectional survey among the participants of the cluster randomised controlled CARAT trial (30 PCPs, 303 diabetes patients), 3 years after its completion...
November 9, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29113634/pharmacy-diabetes-management-of-a-veteran-population-in-a-long-term-care-setting-a-program-evaluation
#9
Forest Hansen, Hilary Teeples, Jordan Csati, Suzanne M Gillespie
BACKGROUND: The benefits of an outpatient pharmacy diabetes clinic has been established, with improved patient outcomes and reduced total costs of care. We describe the benefits of an inpatient clinical pharmacy diabetes service within a Department of Veterans Affairs long-term care facility. METHODS: Patients were referred to the pharmacy diabetes monitoring program between February 2016 and August 2016. During this time, clinical pharmacy specialists managed all pharmacotherapy relating to diabetes care as well as all fingerstick monitoring frequencies and laboratory monitoring to achieve a prespecified, patient-specific A1C goal...
November 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29103210/insulin-for-the-treatment-of-women-with-gestational-diabetes
#10
REVIEW
Julie Brown, Luke Grzeskowiak, Kathryn Williamson, Michelle R Downie, Caroline A Crowther
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with short- and long-term complications for the mother and her infant. Women who are unable to maintain their blood glucose concentration within pre-specified treatment targets with diet and lifestyle interventions will require anti-diabetic pharmacological therapies. This review explores the safety and effectiveness of insulin compared with oral anti-diabetic pharmacological therapies, non-pharmacological interventions and insulin regimens...
November 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29100717/primary-care-physician-perspectives-on-basal-insulin-initiation-and-maintenance-in-patients-with-type-2-diabetes-mellitus
#11
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/29099931/clinical-fractures-among-older-men-with-diabetes-are-mediated-by-diabetic-complications
#12
Richard H Lee, Richard Sloane, Carl Pieper, Kenneth W Lyles, Robert A Adler, Courtney Van Houtven, Joanne LaFleur, Cathleen Colón-Emeric
Introduction: Type 2 diabetes mellitus among older women has been associated with increased bone mineral density, but paradoxically increased fracture risk. Findings among older men have varied, and potential mechanisms have not been fully elucidated. Methods: Retrospective study of male Veterans 65-99 years of age who received primary care in the Veterans Health Administration (VHA) from 2000 to 2010, using administrative data from all 146 VHA medical centers linked to Centers for Medicare and Medicaid Services (CMS) Medicare fee-for-service data...
November 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29095564/a-risk-score-of-bmi-hba1c-and-triglycerides-predicts-future-glycemic-control-in-type-2-diabetes
#13
Dorijn Fl Hertroijs, Arianne Mj Elissen, Martijn Cgj Brouwers, Nicolaas C Schaper, Sebastian Köhler, Mirela C Popa, Stylianos Asteriadis, Steven H Hendriks, Henk J Bilo, Dirk Ruwaard
AIM: To identify, predict and validate distinct glycemic trajectories among patients with newly diagnosed type 2 diabetes treated in primary care, as a first step towards more effective patient-centred care. MATERIAL AND METHODS: We conducted a retrospective study on two cohorts using routinely collected individual patient data in primary care practices from two large Dutch diabetes patient registries. Participants included newly diagnosed, adult patients with type 2 diabetes between January 2006 and December 2014 (n = 10,528, development cohort; n = 3,777, validation cohort)...
November 2, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29094298/optimizing-glycemic-control-through-titration-of-insulin-glargine-100-u-ml-a-review-of-current-and-future-approaches-with-a-focus-on-asian-populations
#14
REVIEW
Chaicharn Deerochanawong, Shailendra Bajpai, I Made Pande Dwipayana, Zanariah Hussein, Maria Aileen Mabunay, Reynaldo Rosales, Shih-Tzer Tsai, Man Wo Tsang
Various data have demonstrated inadequate glycemic control amongst Asians with type 2 diabetes mellitus (T2DM), possibly on account of suboptimal titration of basal insulin-an issue which needs to be further examined. Here we review the available global and Asia-specific data on titration of basal insulin, with a focus on the use of insulin glargine 100 U/mL (Gla-100). We also discuss clinical evidence on the efficacy and safety of titrating Gla-100, different approaches to titration, including some of the latest technological advancements, and guidance on the titration of basal insulin from international and local Asian guidelines...
November 1, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29090381/diabetes-screening-among-antipsychotic-treated-adults-with-severe-mental-illness-in-an-integrated-delivery-system-a-retrospective-cohort-study
#15
Christina Mangurian, Dean Schillinger, John W Newcomer, Eric Vittinghoff, Susan Essock, Zheng Zhu, Wendy Dyer, Julie Schmittdiel
BACKGROUND: Severe mental illness (SMI) is associated with increased risk for type 2 diabetes, partly due to adverse metabolic effects of antipsychotic medications. In public health care settings, annual screening rates are 30%. We measured adherence to national diabetes screening guidelines for patients taking antipsychotic medications. OBJECTIVE: To estimate diabetes screening prevalence among patients with SMI within an integrated health care system, and to assess characteristics associated with lack of screening...
October 31, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29089913/diabetes-related-distress-and-depressive-symptoms-are-not-merely-negative-over-a-3-year-period-in-malaysian-adults-with-type-2-diabetes-mellitus-receiving-regular-primary-diabetes-care
#16
Boon-How Chew, Rimke C Vos, Rebecca K Stellato, Guy E H M Rutten
For people with type 2 diabetes mellitus (T2DM) the daily maintenance of physical and psychological health is challenging. However, the interrelatedness of these two health domains, and of diabetes-related distress (DRD) and depressive symptoms, in the Asian population is still poorly understood. DRD and depressive symptoms have important but distinct influences on diabetes self-care and disease control. Furthermore, the question of whether changes in DRD or depressive symptoms follow a more or less natural course or depend on disease and therapy-related factors is yet to be answered...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/29089247/factors-associated-with-non-adherence-among-type-2-diabetic-patients-in-primary-care-setting-in-eastern-bosnia-and-herzegovina
#17
Olga Horvat, Jelena Popržen, Ana Tomas, Milica Paut Kusturica, Zdenko Tomić, Ana Sabo
AIMS: The aims of this study were to assess patients' non-adherence and associated factors to antidiabetic medication in the primary care setting in the eastern part of Bosnia and Herzegovina (BiH). METHODS: We conducted a retrospective chart review of 323 patients with type 2 diabetes mellitus (T2DM) attending the primary health care center of the Foča municipality in eastern part of BiH and measured adherence to antidiabetic medication. Adherence was measured using a pill count method...
October 28, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/29081069/different-methods-and-settings-for-glucose-monitoring-for-gestational-diabetes-during-pregnancy
#18
REVIEW
Puvaneswary Raman, Emily Shepherd, Therese Dowswell, Philippa Middleton, Caroline A Crowther
BACKGROUND: Incidence of gestational diabetes mellitus (GDM) is increasing worldwide. Blood glucose monitoring plays a crucial part in maintaining glycaemic control in women with GDM and is generally recommended by healthcare professionals. There are several different methods for monitoring blood glucose which can be carried out in different settings (e.g. at home versus in hospital). OBJECTIVES: The objective of this review is to compare the effects of different methods and settings for glucose monitoring for women with GDM on maternal and fetal, neonatal, child and adult outcomes, and use and costs of health care...
October 29, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29080581/management-of-lipids-in-patients-with-diabetes
#19
REVIEW
Ngozi D Mbue, John E Mbue, Jane A Anderson
Abnormal lipids, sometimes referred to as diabetes dyslipidemia, is a common condition in patients with diabetes. With the increasing number of patients with abnormal lipids, especially those with type 2 diabetes, health care practitioners, including nurses, have to properly manage patients with diabetes as well as abnormal lipids. This article examines the pathophysiology of abnormal lipids, the management of abnormal lipids, and the lipid goals for patients with diabetes. Lastly, this article discusses pharmacologic and nonpharmacologic therapies and the role of primary care providers and nurses in the management of abnormal lipids...
December 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/29079252/effect-of-an-intensified-multifactorial-intervention-on-cardiovascular-outcomes-and-mortality-in-type-2-diabetes-j-doit3-an-open-label-randomised-controlled-trial
#20
Kohjiro Ueki, Takayoshi Sasako, Yukiko Okazaki, Masayuki Kato, Sumie Okahata, Hisayuki Katsuyama, Mikiko Haraguchi, Ai Morita, Ken Ohashi, Kazuo Hara, Atsushi Morise, Kazuo Izumi, Naoki Ishizuka, Yasuo Ohashi, Mitsuhiko Noda, Takashi Kadowaki
BACKGROUND: Limited evidence suggests that multifactorial interventions for control of glucose, blood pressure, and lipids reduce macrovascular complications and mortality in patients with type 2 diabetes. However, safe and effective treatment targets for these risk factors have not been determined for such interventions. METHODS: In this multicentre, open-label, randomised, parallel-group trial, undertaken at 81 clinical sites in Japan, we randomly assigned (1:1) patients with type 2 diabetes aged 45-69 years with hypertension, dyslipidaemia, or both, and an HbA1c of 6·9% (52·0 mmol/mol) or higher, to receive conventional therapy for glucose, blood pressure, and lipid control (targets: HbA1c <6·9% [52·0 mmol/mol], blood pressure <130/80 mm Hg, LDL cholesterol <120 mg/dL [or 100 mg/dL in patients with a history of coronary artery disease]) or intensive therapy (HbA1c <6·2% [44·3 mmol/mol], blood pressure <120/75 mm Hg, LDL cholesterol <80 mg/dL [or 70 mg/dL in patients with a history of coronary artery disease])...
October 24, 2017: Lancet Diabetes & Endocrinology
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