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Type 2 diabetes, primary care

Zahirah Tharek, Anis Safura Ramli, David Leonard Whitford, Zaliha Ismail, Maryam Mohd Zulkifli, Siti Khuzaimah Ahmad Sharoni, Asrul Akmal Shafie, Thevaraajan Jayaraman
BACKGROUND: Self-efficacy has been shown to be positively correlated with self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus. However, such evidence is lacking in the Malaysian primary care setting. The objectives of this study were to i) determine the levels of self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting ii) determine the relationship between self-efficacy, self-care behaviour and glycaemic control iii) determine the factors associated with glycaemic control...
March 9, 2018: BMC Family Practice
Antonio Rodriguez-Poncelas, Joan Barrot-de la-Puente, Gabriel Coll de Tuero, Carles López-Arpí, Bogdan Vlacho, Flora Lopéz-Simarro, Xavier Mundet Tudurí, Josep Franch-Nadal
AIM: The aim of this study was to assess glycaemic control and prescribing practices of antihyperglycaemic treatment in patients with diabetes mellitus type 2 aged 75 years or older. METHODS: We analysed data from health electronic records from 4,581 persons attended at primary healthcare centres of the Institut Català de la Salut (ICS), in the Girona Sud area of Catalonia, Spain, during 2013 and 2016. Variables such as age, gender, body mass index (BMI), diabetes duration, age at diabetes diagnosis, glycated haemoglobin (HbA1c), creatinine, glomerular filtrate rate and the albumin/creatinine ratio in urine were collected...
March 7, 2018: International Journal of Clinical Practice
Chris Manu, Elisabetta Lacopi, Benjamin Bouillet, Julien Vouillarmet, Raju Ahluwalia, Claas Lüdemann, José Luis Garcia-Klepzig, Marco Meloni, Víctor Rodriguez-Saenz De Buruaga, Juan Pedro Sánchez-Ríos, Mike Edmonds, Jan Apelqvist, Jose Luis Lazaro Martinez, Kristien Van Acker
OBJECTIVE: Diabetic foot ulceration (DFU) has the potential to deteriorate rapidly without prompt assessment and treatment. The aim of this study was to assess the referral patterns for DFU, from primary care to specialised diabetes foot care units. METHOD: A two-part, quantitative, online questionnaire was administered to GPs across four countries in Europe: France, the UK, Germany and Spain. The first part entailed a survey of GPs' perceptions of referrals for DFU...
March 2, 2018: Journal of Wound Care
Bahendeka Silver, Kaushik Ramaiya, Swai Babu Andrew, Otieno Fredrick, Sarita Bajaj, Sanjay Kalra, Bavuma M Charlotte, Karigire Claudine, Anthony Makhoba
A diagnosis of diabetes or hyperglycemia should be confirmed prior to ordering, dispensing, or administering insulin (A). Insulin is the primary treatment in all patients with type 1 diabetes mellitus (T1DM) (A). Typically, patients with T1DM will require initiation with multiple daily injections at the time of diagnosis. This is usually short-acting insulin or rapid-acting insulin analogue given 0 to 15 min before meals together with one or more daily separate injections of intermediate or long-acting insulin...
March 5, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Diana Sarfati, Melissa McLeod, James Stanley, Virginia Signal, Jeannine Stairmand, Jeremy Krebs, Anthony Dowell, William Leung, Cheryl Davies, Rebecca Grainger
BACKGROUND: Long-term conditions (LTCs) are the biggest contributor to health loss in New Zealand. The economic cost and burden on the health system is substantial and growing. Self-management strategies offer a potential way to reduce the pressure on health services. This study evaluates a comprehensive self-management programme (the BetaMe programme) delivered by mobile and web-based technologies for people with Type 2 diabetes (T2DM) and pre-diabetes. The primary aim of this study is to evaluate the effectiveness of the BetaMe programme versus usual care among primary care populations in improving the control of T2DM and pre-diabetes, as measured by change in HbA1c and weight over 12 months...
March 5, 2018: Trials
Rapat Eknithiset, Ratana Samrongthong, Ramesh Kumar
BACKGROUND: Globally, diabetes caused 4.6 million deaths during 2011 and burdened health care systems worldwide with $465 billion. The diabetes prevalence rate in Thailand has risen dramatically in recent years, from just 2.3% in 1991 to 6.9% in 2009. The objective of this study was to explore factors associated with knowledge, perception, and practice toward self-care among elderly type 2 diabetes mellitus patients aged 50-70 years. METHODS: A cross sectional study design was conducted by enrolling 140 aged people of both gender suffering from type 2 diabetes mellitus and registered at three clinics of Primary healthcare at Taladnoi, Horathep, and Khokyai, Saraburi, Thailand...
January 2018: Journal of Ayub Medical College, Abbottabad: JAMC
Emanuela Brusadelli, Alessandra Tomasich, Samantha Bruno, Alessia Romanazzi, Regina Dagani, Piero Porcelli
No abstract text is available yet for this article.
March 1, 2018: Psychotherapy and Psychosomatics
Khalid Al Khaja, Husain Ahmed Isa, Sindhan Veeramuthu, Reginald P Sequeira
OBJECTIVES: The aims of the study were to evaluate: a) the prevalence and types of potentially inappropriate prescribing in older adults with hypertension or diabetes mellitus and hypertension; and b) whether or not the differences in training of primary care physicians was associated with the PIP. MATERIALS AND METHODS: Primary care prescriptions issued by family physicians and general practitioners were audited using Screening Tools of Older Person's Prescriptions criteria (version 1) with 18 out of 65 applicable criteria...
March 1, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
Jane I Grove, Prarthana Thiagarajan, Stuart Astbury, Rebecca Harris, Toby Delahooke, I Neil Guha, Guruprasad P Aithal
BACKGROUND & AIMS: Chronic liver disease presents a major global public health challenge. Stratification of asymptomatic, at-risk patients in primary care using non-invasive methods has the potential to address this by identifying those likely to progress. We therefore evaluated variant alleles at loci associated with non-alcoholic fatty liver disease (NAFLD) as genetic determinants of substantial liver injury in patients with disease risk factors. METHODS: Levels of serum procollagen III (PIIINP), an established fibrosis and steatohepatitis marker, were determined in 467 people who had type 2 diabetes and/or BMI>27...
March 1, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Mathias Ried-Larsen, Christopher S MacDonald, Mette Y Johansen, Katrine B Hansen, Robin Christensen, Thomas P Almdal, Bente K Pedersen, Kristian Karstoft
The majority of T2D cases are preventable through a healthy lifestyle, leaving little room for questions that lifestyle should be the first line of defense in the fight against the development of T2D. However, when it comes to the clinical care of T2D, the potential efficacy of lifestyle is much less clear-cut, both in terms of impacting the pathological metabolic biomarkers of the disease, and long-term complications. A healthy diet, high leisure-time physical activity and exercise are considered to be cornerstones albeit adjunct to drug therapy in the management of T2D...
February 28, 2018: Diabetes/metabolism Research and Reviews
Signe T Andersen, Daniel R Witte, Else-Marie Dalsgaard, Henning Andersen, Peter Nawroth, Thomas Fleming, Troels M Jensen, Nanna B Finnerup, Troels S Jensen, Torsten Lauritzen, Eva L Feldman, Brian C Callaghan, Morten Charles
OBJECTIVE: To study incident diabetic polyneuropathy (DPN) prospectively during the first 13 years after a screening-based diagnosis of type 2 diabetes and determine the associated risk factors for the development of DPN. RESEARCH DESIGN AND METHODS: We assessed DPN longitudinally in the Danish arm of the Anglo-Danish-Dutch study of Intensive Treatment of Diabetes in Primary Care (ADDITION) using the Michigan Neuropathy Screening Instrument questionnaire (MNSIQ), defining DPN with scores ≥4...
February 27, 2018: Diabetes Care
Brian McMillan, Katherine Easton, Elizabeth Goyder, Brigitte Delaney, Priya Madhuvrata, Reem Abdelgalil, Caroline Mitchell
BACKGROUND: Despite the seven-fold increased risk of type 2 diabetes mellitus (T2DM) among females previously diagnosed with gestational diabetes (GD), annual rates of follow-up in primary care are low. There is a need to consider how to reduce the incidence of progression to T2DM among this high-risk group. AIM: To examine the views of females diagnosed with GD to ascertain how to improve primary care support postnatally, and the potential role of technology in reducing the risk of progression to T2DM...
February 26, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Samuel Seidu, Setor K Kunutsor, Xavier Cos, Syed Gillani, Kamlesh Khunti
BACKGROUND: Sodium-glucose co-transporter 2 (SGLT2) inhibitors may have renal protective effects in people with impaired kidney function. We assessed the use of SGLT2 inhibitors in people with type 2 diabetes with or without renal impairment [defined as estimated glomerular filtration rate (eGFR) of ≥30 and <60ml/min/1.73m2 and/or UACR>300 and ≤5000mg/g] by conducting a systematic review and meta-analysis of available studies. METHODS: Randomised controlled trials (RCTs) were identified from MEDLINE, EMABASE, Web of Science, the Cochrane Library, and search of bibliographies to March 2017...
February 23, 2018: Primary Care Diabetes
Ferozkhan Jadhakhan, Tom Marshall, Ronan Ryan, Paramjit Gill
BACKGROUND: The risk of chronic kidney disease (CKD) is known to be elevated in patients with diabetes mellitus but the risk of young adults aged 18 to 40 years with impaired glucose tolerance/impaired fasting glucose (IGT/IFG) developing CKD is not well characterised. Furthermore, progression of IGT/IFG to diabetes and subsequent CKD development is not well understood. METHODS: A retrospective cohort study was undertaken using The Health Improvement Network (THIN) database, a large dataset of electronic patient records...
February 26, 2018: BMC Nephrology
Nagy Mekhail, Ogi Visnjevac, Gerges Azer, Diana Sue Mehanny, Priya Agrawal, Victor Foorsov
To assess the efficacy of spinal cord stimulation (SCS) for each indication, one must critically assess each specific clinical outcome to identify outcomes that benefit from SCS therapy. To date, a comprehensive review of clinically relevant outcome-specific evidence regarding SCS has not been published. We aimed to assess all randomized controlled trials from the world literature for the purpose of evaluating the clinical outcome-specific efficacy of SCS for the following outcomes: perceived pain relief or change pain score, quality of life, functional status, psychological impact, analgesic medication utilization, patient satisfaction, and health care cost and utilization...
February 23, 2018: Regional Anesthesia and Pain Medicine
Patricia A Marin, James F Bena, Nancy M Albert
AIMS: To assess differences in hemoglobin A1c (HbA1c ) over time in diabetics treated by internal medicine physicians using the chronic care model (IMP-ancillary) or an advanced practice nurse (APN-IMP). METHODS: Retrospective, 2-group comparative design using administrative databases and matching of IMP-ancillary and APN-IMP subjects 2:1 based on patient age (±3years), gender and race. Subjects were diabetics treated ≥2 times during 2007-2010, had ≥1 follow-up visit 6-months from baseline and ≥2 HbA1c levels...
February 21, 2018: Primary Care Diabetes
Alvaro Sánchez, Carmen Silvestre, Natalia Campo, Gonzalo Grandes
AIMS: We assessed the effectiveness of a Type 2 diabetes mellitus (T2D) prevention programme in routine primary health care (PHC) in high-risk patients. METHODS: Phase IV cluster clinical trial involving 14 PHC centres in the Basque Health Service were randomised to the DE-PLAN educational healthy lifestyle promotion programme or standard care. All non-diabetic 45- to 70-year-old PHC attendees considered at high risk of T2D (FINDRISC ≥14 points) were eligible...
February 21, 2018: Diabetes Research and Clinical Practice
Katelyn Wassell, Josh Sullivan, Bryan Paul Jett, Jeffrey Zuber
PURPOSE: Results of a study to compare the impact of clinical pharmacy specialist (CPS) interventions with primary care physician (PCP) interventions in veterans with type 2 diabetes mellitus (T2D) in a rural setting are presented. METHODS: A retrospective analysis was performed examining veterans diagnosed with T2D with a glycosylated hemoglobin (HbA1c ) of ≥8% receiving treatment at a rural community-based outpatient clinic associated with the Memphis Veterans Affairs Medical Center...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
Damon Tanton, Mei Sheng Duh, Marie-Hélène Lafeuille, Patrick Lefebvre, Dominic Pilon, Maryia Zhdanava, Bruno Emond, Doreen Inman, Robert A Bailey
OBJECTIVE: Clinical trials and real-world studies reported that canagliflozin (CANA) improved HbA1c, blood pressure (BP), and weight in patients with type 2 diabetes mellitus (T2DM). This study examines if previous results hold regionally and within specific patient subgroups. METHODS: Adults with T2DM and ≥12 months of clinical activity before the first CANA prescription (index) were identified in electronic medical records (01/01/2012-02/15/2017) from a network of hospitals in Florida...
February 22, 2018: Current Medical Research and Opinion
Andreas Liebl, Viswanathan Mohan, Wenying Yang, Krzysztof Strojek, Sultan Linjawi
Since clinical experience with biphasic insulin aspart 30 (BIAsp 30) in type 2 diabetes mellitus (T2DM) was reviewed in 2012 after 10 years of use worldwide, additional studies have been published that highlight new aspects, including use in real-world populations. Evidence from 35 new studies confirms and builds upon previous work indicating that BIAsp 30 continues to have pharmacodynamic and clinical advantages over biphasic human insulin (BHI 30), including in real-world practice with unselected populations of patients...
February 21, 2018: Drugs in R&D
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