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Type 2 diabetes, primary care

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https://www.readbyqxmd.com/read/29775079/improved-glycemic-control-with-minimal-change-in-medication-regimen-complexity-in-a-pharmacist-endocrinologist-diabetes-intense-medical-management-dimm-tune-up-clinic
#1
Candis M Morello, Taylor Rotunno, John Khoan, Jan D Hirsch
BACKGROUND: Gaining glycemic control in patients with type 2 diabetes (T2D) usually requires more complicated medication regimens. Increased medication regimen complexity (MRC) negatively impacts adherence and clinical outcomes. OBJECTIVE: Compare MRC change in patients with uncontrolled T2D referred to a collaborative pharmacist-endocrinologist Diabetes Intense Medical Management (DIMM) clinic "tune up" model versus similar patients receiving usual primary care provider (PCP) care over 6 months...
May 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29773539/effectiveness-of-text-message-based-diabetes-self-management-support-programme-sms4bg-two-arm-parallel-randomised-controlled-trial
#2
Rosie Dobson, Robyn Whittaker, Yannan Jiang, Ralph Maddison, Matthew Shepherd, Catherine McNamara, Richard Cutfield, Manish Khanolkar, Rinki Murphy
OBJECTIVE: To determine the effectiveness of a theoretically based and individually tailored, text message based, diabetes self management support intervention (SMS4BG) in adults with poorly controlled diabetes. DESIGN: Nine month, two arm, parallel randomised controlled trial. SETTING: Primary and secondary healthcare services in New Zealand. PARTICIPANTS: 366 participants aged 16 years and over with poorly controlled type 1 or type 2 diabetes (HbA1c ≥65 mmol/mol or 8%) randomised between June 2015 and November 2016 (n=183 intervention, n=183 control)...
May 17, 2018: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29768945/pharmacist-impact-on-treatment-intensification-and-hemoglobin-a-1c-in-patients-with-type-2-diabetes-mellitus-at-an-academic-health-center
#3
Kevin Cowart, Karen Sando
BACKGROUND: Achievement of treatment goals for patients with type 2 diabetes mellitus (T2DM) is suboptimal. This is in part driven by a lack of treatment intensification when warranted, termed "clinical inertia." OBJECTIVES: To investigate time to treatment intensification and changes in A1C among pharmacist-physician managed (PPM) patients compared to usual medical care (UMC) in patients with T2DM. METHODS: Retrospective matched cohort study at 2 academic family medicine clinics...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29766565/a-retrospective-observational-study-of-people-with-type-1-diabetes-with-self-reported-severe-hypoglycaemia-reveals-high-level-of-ambulance-attendance-but-low-levels-of-therapy-change-and-specialist-intervention
#4
B C T Field, R Nayar, A Kilvert, M Baxter, J Hickey, M Cummings, S C Bain
AIM: To evaluate the impact of severe hypoglycaemia on NHS resources and overall glycaemic control in adults with Type 1 diabetes. METHODS: An observational, retrospective study of adults (aged ≥ 18 years) with Type 1 diabetes reporting one or more episodes of severe hypoglycaemia during the preceding 24 months in 10 NHS hospital diabetes centres in England and Wales. The primary outcome was healthcare resource utilization associated with severe hypoglycaemia...
May 15, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/29765224/statins-use-and-risk-of-new-onset-diabetes-in-hypertensive-patients-a-population-based-retrospective-cohort-study-in-yinzhou-district-ningbo-city-people-s-republic-of-china
#5
Hailong Li, Hongbo Lin, Houyu Zhao, Yang Xu, Yinchu Cheng, Peng Shen, Siyan Zhan
Background: Reports have suggested that statin use is associated with an increased incidence of type 2 diabetes mellitus (T2DM). Guidelines suggested that statins should be prescribed in hypertensive patients for primary prevention. However, there were very few studies on the risk of T2DM associated with statin use among patients with hypertension in mainland People's Republic of China. Purpose: To determine the association between statin use and new-onset diabetes mellitus among patients with hypertension in mainland People's Republic of China...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29764436/prevalence-and-incidence-of-complications-at-diagnosis-of-t2dm-and-during-follow-up-by-bmi-and-ethnicity-a-matched-case-control-analysis
#6
Ebenezer S Owusu Adjah, Srikanth Bellary, Wasim Hanif, Kiran Patel, Kamlesh Khunti, Sanjoy K Paul
AIMS: To estimate the risk of developing long-term major cardiovascular and renal complications in relation to levels of body mass index (BMI) in a population of White European (WE), African-Caribbean (AC), and South Asian (SA) patients with type 2 diabetes mellitus (T2DM). MATERIALS AND METHODS: Patients with new diagnosis of T2DM, aged ≥ 18 years from January 2000 (n = 69,436) and their age-sex-ethnicity matched non-diabetic controls (n = 272,190) were identified from UK primary care database...
May 15, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29764248/interprofessional-collaboration-and-the-care-and-management-of-type-2-diabetic-patients-in-the-middle-east-a-systematic-review
#7
J M Johnson, R Carragher
The World Health Organization has ranked the Middle East (ME) as the second most prevalent region globally for type 2 diabetes. Currently, treatment options initiated by physicians focus mainly on pharmaceuticals; however, lifestyle factors also have a tremendous impact on a patient's wellness or illness. A potential solution to this issue is to use an interprofessional team approach when caring for this patient population. The purpose of this systematic review is to look at the present literature involving the use of an interprofessional team approach to the care and maintenance of people with type 2 diabetes in the ME...
May 15, 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29763267/top-20-research-studies-of-2017-for-primary-care-physicians
#8
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29762737/postnatal-lifestyle-intervention-for-overweight-women-with-previous-gestational-diabetes-a-randomized-controlled-trial
#9
Valerie A Holmes, Claire R Draffin, Chris C Patterson, Loraine Francis, Joanne Irwin, Mae McConnell, Brid Farrell, Sarah F Brennan, Oonagh McSorley, Amy C Wotherspoon, Mark Davies, David R McCance
Background: Gestational diabetes mellitus (GDM) is associated with a 7-fold increased lifetime risk of type 2 diabetes. Excessive gestational weight gain and postpartum weight retention are established predictors of long-term obesity. Objective: To determine the impact of a postnatal lifestyle intervention programme for overweight women with previous gestational diabetes mellitus (PAIGE). Design: Postnatal overweight women with previous GDM participated in a multi-center randomized controlled trial between June 2013 and December 2014...
May 11, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29760272/physical-activity-assessment-and-counseling-in-quebec-family-medicine-groups
#10
Aurélie Baillot, Jean-Patrice Baillargeon, Alex Paré, Thomas G Poder, Christine Brown, Marie-France Langlois
OBJECTIVE: To determine how often primary health care providers (PHCPs) in family medicine groups (FMGs) assess physical activity (PA) levels, provide PA counseling (PAC), and refer patients to exercise professionals; to describe patients' PA levels, physical fitness, and satisfaction regarding their PA management in FMGs; to describe available PA materials in FMGs and PHCPs' PAC self-efficacy and PA knowledge; and to identify characteristics of patients and PHCPs that determine the assessment of PA and PAC provided by PHCPs...
May 2018: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29755756/treatment-choice-medication-adherence-and-glycemic-efficacy-in-people-with-type-2-diabetes-a-uk-clinical-practice-database-study
#11
Jason Gordon, Phil McEwan, Iskandar Idris, Marc Evans, Jorge Puelles
Objective: Using primary care data obtained from the UK Clinical Practice Research Datalink, this retrospective cohort study examined the relationships between medication adherence and clinical outcomes in patients with type 2 diabetes. Research design and methods: Data were extracted for patients treated between 2008 and 2016, and stratified by oral antihyperglycemic agent (OHA) line of therapy (mono, dual or triple therapy). Patients were monitored for up to 365 days; associations between medication possession ratio (MPR) and outcomes at 1 year (glycated hemoglobin A1c (HbA1c), weight and hypoglycemia incidence) were assessed using linear regression modeling and descriptive analyses...
2018: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/29754122/schizophrenia-and-type-2-diabetes-mellitus
#12
V Mamakou, A Thanopoulou, F Gonidakis, N Tentolouris, V Kontaxakis
Schizophrenia is associated with increased risk for type 2 diabetes mellitus, resulting in elevated cardiovascular risk and limited life expectancy, translated into a weighted average of 14.5 years of potential life lost and an overall weighted average life expectancy of 64.7 years. The exact prevalence of type 2 diabetes among people with schizophrenia varies across studies and ranges 2-5fold higher than in the general population, whereas the aetiology is complex and multifactorial. Besides common diabetogenic factors, applied similarly in the general population, such as obesity, hyperlipidemia, smoking, hypertension, poor diet and limited physical activity, the co-occurrence of schizophrenia and diabetes is also attributed to unique conditions...
January 2018: Psychiatrikē, Psychiatriki
https://www.readbyqxmd.com/read/29753353/cost-effectiveness-of-a-technology-facilitated-depression-care-management-adoption-model-in-safety-net-primary-care-patients-with-type-2-diabetes
#13
Joel W Hay, Pey-Jiuan Lee, Haomiao Jin, Jeffrey J Guterman, Sandra Gross-Schulman, Kathleen Ell, Shinyi Wu
BACKGROUND: The Diabetes-Depression Care-Management Adoption Trial is a translational study of safety-net primary care predominantly Hispanic/Latino patients with type 2 diabetes in collaboration with the Los Angeles County Department of Health Services. OBJECTIVES: To evaluate the cost-effectiveness of an information and communication technology (ICT)-facilitated depression care management program. METHODS: Cost-effectiveness of the ICT-facilitated care (TC) delivery model was evaluated relative to a usual care (UC) and a supported care (SC) model...
May 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29752345/randomized-outpatient-trial-of-single-and-dual-hormone-closed-loop-systems-that-adapt-to-exercise-using-wearable-sensors
#14
Jessica R Castle, Joseph El Youssef, Leah M Wilson, Ravi Reddy, Navid Resalat, Deborah Branigan, Katrina Ramsey, Joseph Leitschuh, Uma Rajhbeharrysingh, Brian Senf, Samuel M Sugerman, Virginia Gabo, Peter G Jacobs
OBJECTIVE: Automated insulin delivery is the new standard for type 1 diabetes, but exercise-related hypoglycemia remains a challenge. Our aim was to determine whether a dual-hormone closed-loop system using wearable sensors to detect exercise and adjust dosing to reduce exercise-related hypoglycemia would outperform other forms of closed-loop and open-loop therapy. RESEARCH DESIGN AND METHODS: Participants underwent four arms in randomized order: dual-hormone, single-hormone, predictive low glucose suspend, and continuation of current care over 4 outpatient days...
May 11, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29752222/the-berlin-declaration-a-call-to-improve-early-actions-related-to-type-2-diabetes-why-is-primary-care-important
#15
REVIEW
Kamlesh Khunti, James R Gavin, Andrew J M Boulton, Rick Blickstead, Margaret McGill, Antonio Ceriello, Itamar Raz, Shaukat Sadikot, David A Wood, Xavier Cos, Sanjay Kalra, Ashok Kumar Das, Cutberto Espinosa López
Diabetes is epidemic worldwide and places a huge burden on healthcare systems. The majority of the cost of type 2 diabetes (T2D) is related to hospitalization and the management of complications, and these also have a negative impact on the individual's quality of life. The Berlin Declaration is a global call for early action for the identification of high risk individuals, prevention of T2D and the prevention of complications in those with T2D, through prevention, early detection, early control and early access to the right multidisciplinary interventions...
May 8, 2018: Primary Care Diabetes
https://www.readbyqxmd.com/read/29747657/policies-and-clinical-practices-relating-to-the-management-of-gestational-diabetes-mellitus-in-the-public-health-sector-south-africa-a-qualitative-study
#16
Lorrein Shamiso Muhwava, Katherine Murphy, Christina Zarowsky, Naomi Levitt
BACKGROUND: Women with a prior gestational diabetes have an increased lifetime risk of developing type 2 diabetes. Although post-partum follow-up for GDM women is essential to prevent progression to type 2 diabetes, it is poorly attended. The need for health systems interventions to support postpartum follow-up for GDM women is evident, but there is little knowledge of actual current practice. The aim of this study was to explore current policies and clinical practices relating to antenatal and post-natal care for women with GDM in South Africa, as well as health sector stakeholders' perspectives on the barriers to -- and opportunities for -- delivering an integrated mother - baby health service that extends beyond the first week post-partum, to the infant's first year of life...
May 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29747575/assessing-treatment-fidelity-and-contamination-in-a-cluster-randomised-controlled-trial-of-motivational-interviewing-and-cognitive-behavioural-therapy-skills-in-type-2-diabetes
#17
Nicholas Magill, Helen Graves, Nicole de Zoysa, Kirsty Winkley, Stephanie Amiel, Emma Shuttlewood, Sabine Landau, Khalida Ismail
BACKGROUND: Competencies in psychological techniques delivered by primary care nurses to support diabetes self-management were compared between the intervention and control arms of a cluster randomised controlled trial as part of a process evaluation. The trial was pragmatic and designed to assess effectiveness. This article addresses the question of whether the care that was delivered in the intervention and control trial arms represented high fidelity treatment and attention control, respectively...
May 10, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29746972/onset-of-t2dm-after-gestational-diabetes-what-the-prevention-paradox-tells-us-about-risk
#18
Judith Bernstein, Emily Quinn, Omid Ameli, Myrita Craig, Timothy Heeren, Ronald Iverson, Brian Jack, Aviva Lee-Parritz, Lois Mccloskey
This study investigates the effect of severity of gestational diabetes (GDM) on likelihood of post-delivery glucose testing and early onset Type 2 diabetes (T2DM). We asked if clinical focus on relative risk (RR), i.e. greater probability of T2DM onset in a higher-severity group, contributes to missed opportunities for prevention among women with lower-severity GDM. A sample of 12,622 continuously-insured women with GDM (2006-2015) was drawn from a large national dataset (OptumLabs® Data Warehouse) and followed for 3-years post-delivery...
May 8, 2018: Preventive Medicine
https://www.readbyqxmd.com/read/29745915/association-of-diabetes-compensation-with-sleeping-habits-and-well-being-in-patients-with-diabetes-mellitus
#19
L Navasardyan, A Аvetisyan, M Simonyan, E Aghajanova
Recent data estimates that sleep deprivation and poor quality of night sleep have an impact on the incidence and prevalence of both obesity and type 2 diabetes, as well as cardiovascular events in all ages. The aim of this work is to evaluate the association between diabetes compensation and sleep quality and quantity, comparing patients with type 1 and type 2 diabetes, as well as to establish any potential connection with "screen" time, physical activity and well-being. For this reason 49 patients with type 1 (n=28) and type 2 DM (n=21) were investigated...
April 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29744539/community-based-pre-pregnancy-care-programme-improves-pregnancy-preparation-in-women-with-pregestational-diabetes
#20
Jennifer M Yamamoto, Deborah J F Hughes, Mark L Evans, Vithian Karunakaran, John D A Clark, Nicholas J Morrish, Gerry A Rayman, Peter H Winocour, Clare Hambling, Amanda W Harries, Michael J Sampson, Helen R Murphy
AIMS/HYPOTHESIS: Women with diabetes remain at increased risk of adverse pregnancy outcomes associated with poor pregnancy preparation. However, women with type 2 diabetes are less aware of and less likely to access pre-pregnancy care (PPC) compared with women with type 1 diabetes. We developed and evaluated a community-based PPC programme with the aim of improving pregnancy preparation in all women with pregestational diabetes. METHODS: This was a prospective cohort study comparing pregnancy preparation measures before and during/after the PPC intervention in women with pre-existing diabetes from 1 June 2013 to 28 February 2017...
May 9, 2018: Diabetologia
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