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Endocrinology diabetes internal medicine

Steven S Coughlin, Vahé Heboyan, Lovoria B Williams, Christos Hatzigeorgiou
Background: To determine the number of adult clinic patients seen for type 2 diabetes mellitus (T2DM) at an academic medical center and to examine characteristics of those who had or had not registered for a web portal. Methods: Electronic records were reviewed to identify web portal registration by patients treated for T2DM by age, sex, race and Hispanic ethnicity, and service (General Internal Medicine, Endocrinology). Results: A total of 1,401 patients with T2DM were seen in General Internal Medicine and Endocrinology outpatient clinics...
January 2018: Journal of hospital management and health policy
Amanda Rowlands, Alejandra Acosta-Gualandri, Jaime Guevara-Aguirre, Jean-Pierre Chanoine
Paediatric endocrinology and diabetes is a paediatric specialty with less common conditions and higher cost medicines. Access to medicines for our specialty in low and middle income countries remains limited. We analysed the content of the WHO (children and adults) and of all available national Model Lists of Essential Medicines (EMLs) for Mexico, the Caribbean, Central and South America from a paediatric endocrinology and diabetes standpoint. A master list of medicines deemed necessary in paediatric endocrinology and diabetes was established and compared with the WHO and national EMLs, taking into account the gross national income...
November 2016: BMJ Global Health
Shujie Hao, Ning Zhang, Anne Folta Fish, Xiaodan Yuan, Lin Liu, Fan Li, Zhaohui Fang, Qingqing Lou
AIMS: To evaluate the prevalence of hyperglycemia among inpatients in internal medicine, and specifically, to assess the glycemic management of inpatients in non-endocrinology departments in three large urban hospitals in China. METHODS: A multicenter observational study was conducted using electronic health records, and a survey of 1939 patients who were admitted to internal medicine units and followed until discharge. Those with previously diagnosed diabetes, newly diagnosed diabetes, or impaired fasting glucose were included...
August 2017: Current Medical Research and Opinion
V Morelli, A Scillitani, M Arosio, I Chiodini
Recently, the European Society of Endocrinology (ESE) published new guidelines on the management of adrenal incidentalomas. At the same time Lopez and coworkers published on the Annals of Internal Medicine an important study showing that even patients with non-functioning adrenal tumors have an increased risk of incident diabetes. In consideration of previous data and of the results of the study of Lopez and coworkers, some points emerge from the ESE Guidelines that deserve attention. Firstly, it must be observed that the term "autonomous cortisol secretion," introduced by the ESE Panel in the place of the commonly used "subclinical hypercortisolism," seems questionable, since the guidelines do not suggest determining the adrenocorticotroph hormone levels that could give the certain proof of a truly autonomous cortisol secretion...
March 2017: Journal of Endocrinological Investigation
Martin Ritt, Karl-Günter Gaßmann, Cornel Christian Sieber
Frailty is a major health burden in an aging society. It constitutes a clinical state of reduced physiological reserves that is associated with a diminished ability to withstand internal and external stressors. Frail patients have an increased risk for adverse clinical outcomes, such as mortality, readmission to hospital, institutionalization and falls. Of further clinical interest, frailty might be at least in part reversible in some patients and subject to preventive strategies. In daily clinical practice older patients with a complex health status, who are mostly frail or at least at risk of developing frailty, are frequently cared for by geriatricians...
October 2016: Zeitschrift Für Gerontologie und Geriatrie
Anthony Liccini, Theodore K Malmstrom
OBJECTIVES: Diabetes mellitus is associated with premature aging, and chronic diabetes is associated with significant physical and cognitive complications. We aimed to examine frailty and sarcopenia rates and 6-month health outcomes in a clinic-based sample of patients with diabetes. DESIGN: This study was an observational study. Participants were recruited from June 2014 to August 2014, and follow-up was conducted 6 months after day of screening. SETTING: Participants were recruited at outpatient endocrinology, geriatric, and internal medicine clinics affiliated with Saint Louis University in St...
September 1, 2016: Journal of the American Medical Directors Association
Catherine E Thomas, Elizabeth A Mauer, Alpana P Shukla, Samrat Rathi, Louis J Aronne
OBJECTIVE: To characterize the adoption of antiobesity pharmacotherapies, as compared with that of the newest antidiabetes pharmacotherapy, subtype 2 sodium-glucose transport protein inhibitors (SGLT2s), among prescribers in the United States. METHODS: A retrospective analysis of 2012 to 2015 data extracted from the IMS Health National Prescription Audit™ and Xponent™ assessed adoption rates of antiobesity pharmacotherapies and SGLT2s. RESULTS: The number of dispensed antidiabetes prescriptions was 15 times the number of dispensed antiobesity prescriptions...
September 2016: Obesity
Mahmud Badiei, Mitra Gharib, Mitra Zolfaghari, Rita Mojtahedzadeh
BACKGROUND: Training methods that enhance nurses' learning and retention will increase the quality of patient care. This study aimed to compare the effectiveness of electronic learning and educational booklet on the nurses' retention of diabetes updates. METHODS: In this controlled trial study, convenience sampling was used to select 123 nurses from the endocrinology and internal medicine wards of three hospitals affiliated to Tehran University of Medical Sciences (Tehran, Iran)...
2016: Medical Journal of the Islamic Republic of Iran
Ignacio Conget, Dídac Mauricio, Rafael Ortega, Bruno Detournay
OBJECTIVE: Several glucagon-like peptide-1 (GLP-1) receptor agonists (GLP-1Ra) have been made recently available in Spain for type 2 diabetes mellitus (DM2) treatment. There are no published data on the clinical and sociodemographic profile of patients initiating treatment with GLP-1Ra in Spain. Our objective was to understand these patients' characteristics in a real-world clinical practice setting. DESIGN: Cross-sectional observational study. SETTING: Spanish specialist outpatient clinics...
July 26, 2016: BMJ Open
Stephanie C Cox, Jade Au Tamatea, John V Conaglen, Marianne S Elston
BACKGROUND: Treatment options for Graves' disease (GD), namely anti-thyroid drugs (ATD), surgery or radioiodine (RAI), have not changed over the past two decades. There is no 'gold-standard' treatment for GD. AIMS: To assess whether the management of GD in New Zealand has changed since the previous 1991 New Zealand survey and compare current management with that of contemporary international studies. METHODS: We conducted an online survey of New Zealand physicians currently practising internal medicine, diabetes and/or endocrinology, using the cases and questions from the original European and 1991 New Zealand studies...
June 10, 2016: New Zealand Medical Journal
Maja Baretić, Ivana Kraljević, Ivana Pavlić Renar
The aim was to determine which adult type 1 diabetic patient receiving multiple daily injection therapy is the most appropriate candidate for insulin pump therapy, while taking into consideration limited insulin pump affordability in Croatia. A total of 145 type 1 diabetic patients (52% diagnosed in adult age) were monitored at the Department of Endocrinology, Clinical Department of Internal Medicine, Zagreb University Hospital Center from 2009 to 2014. Twenty-one patients started insulin pump therapy in adulthood (seven men and 14 women, median age 27)...
March 2016: Acta Clinica Croatica
Abraham Morgentaler, Michael Zitzmann, Abdulmaged M Traish, Anthony W Fox, T Hugh Jones, Mario Maggi, Stefan Arver, Antonio Aversa, Juliana C N Chan, Adrian S Dobs, Geoffrey I Hackett, Wayne J Hellstrom, Peter Lim, Bruno Lunenfeld, George Mskhalaya, Claude C Schulman, Luiz O Torres
To address widespread concerns regarding the medical condition of testosterone (T) deficiency (TD) (male hypogonadism) and its treatment with T therapy, an international expert consensus conference was convened in Prague, Czech Republic, on October 1, 2015. Experts included a broad range of medical specialties including urology, endocrinology, diabetology, internal medicine, and basic science research. A representative from the European Medicines Agency participated in a nonvoting capacity. Nine resolutions were debated, with unanimous approval: (1) TD is a well-established, clinically significant medical condition that negatively affects male sexuality, reproduction, general health, and quality of life; (2) symptoms and signs of TD occur as a result of low levels of T and may benefit from treatment regardless of whether there is an identified underlying etiology; (3) TD is a global public health concern; (4) T therapy for men with TD is effective, rational, and evidence based; (5) there is no T concentration threshold that reliably distinguishes those who will respond to treatment from those who will not; (6) there is no scientific basis for any age-specific recommendations against the use of T therapy in men; (7) the evidence does not support increased risks of cardiovascular events with T therapy; (8) the evidence does not support increased risk of prostate cancer with T therapy; and (9) the evidence supports a major research initiative to explore possible benefits of T therapy for cardiometabolic disease, including diabetes...
July 2016: Mayo Clinic Proceedings
J Feldkamp, M Schott, M Gogol, M Quinkler, M Blüher, S Diederich, M Reincke
POSITIVE RECOMMENDATIONS: A. After osteoporotic fractures in the elderly, as a rule specific antiosteoporotic therapy should be initiated. a. Osteoporosis as a disease of the elderly should be diagnosed and treated (recommendation of the German Society for Geriatrics). B. All patients with diabetes mellitus should complete a specific diabetes training program when antidiabetic drug medication is initiated. C. In Germany, all pregnant women should be advised to undertake iodine supplementation...
June 2016: Der Internist
Sophia Eilat-Tsanani, M Weingarten, M Ben-Ami, Mordechai Dayan, H Tabenkin
BACKGROUND: Teaching Internal Medicine is mainly hospital-based. Chronic diseases are treated mostly in community-based ambulatory care. This study describes our experience during the first year of teaching Internal Medicine in the community, with a focus on chronic disease management. METHODS: This was an observational study describing the content of clinical exposure and the feedback from students after a two-week clerkship in community health centers. RESULTS: Over a period of three months, 54 students spent two weeks in health centers singly or in pairs...
September 2015: Education for Health: Change in Training & Practice
Romeu Mendes, Nelson Sousa, António Almeida, Paulo Subtil, Fernando Guedes-Marques, Victor Machado Reis, José Luís Themudo-Barata
BACKGROUND: Physical activity is a cornerstone of type 2 diabetes treatment and control. AIM: We analysed and synthesised the guidelines and recommendations issued by scientific organisations, regarding exercise prescription for patients with type 2 diabetes. METHOD: A systematic bibliographic search in Pubmed, Web of Science and Scopus databases was conducted. Clinical guidelines from major international scientific organisations in the field of diabetology, endocrinology, cardiology, public health and sports medicine were also considered...
November 2016: British Journal of Sports Medicine
Liliane Hobeika, Kelly J Hunt, Benjamin A Neely, John M Arthur
BACKGROUND: Patients with diabetes and chronic kidney disease (CKD) without proteinuria are often believed to have a cause of CKD other than diabetes. It was hypothesized that if this is true, the rate of renal function decline should be similar among nonproteinuric patients with and without diabetes. METHODS: Patients seen in the nephrology, endocrinology and general internal medicine clinics at the Medical University of South Carolina (MUSC) between 2008 and 2012 with hypertension and diabetes were identified by ICD9 diagnosis codes...
December 2015: American Journal of the Medical Sciences
Nira Roopnarinesingh, Nancyellen Brennan, Claude Khan, Paul W Ladenson, Felicia Hill-Briggs, Rita Rastogi Kalyani
BACKGROUND: The republic of Trinidad and Tobago (T&T) is a middle income country with a comparatively high prevalence of diabetes mellitus (DM) compared to others in the Caribbean. To date, there have been no studies on health care professionals' (HCP) perspectives regarding the barriers to achieving optimal care of patients with DM in this country and few previous studies in the Caribbean, yet such perspectives are imperative to develop strategies that reduce the global burden of this disease...
September 19, 2015: BMC Health Services Research
Sonali Arora, Auras R Atreya, Adam M Bernstein, Reva Kleppel, Jennifer Friderici, Sarah Schramm, Tara Lagu, Michael B Rothberg
OBJECTIVES: Little is known about healthcare providers' knowledge of dietary evidence or about what dietary advice providers offer to patients. The objective of our study was to determine which diets providers recommended to patients and providers' beliefs about the evidence behind those recommendations. METHODS: This was a 22-question cross-sectional survey conducted between February 2013 and September 2013, in 45 ambulatory practices within two health systems...
September 2015: Southern Medical Journal
Zsuzsanna Kurti, Barbara D Lovasz, Michael D Mandel, Zoltan Csima, Petra A Golovics, Bence D Csako, Anna Mohas, Lorant Gönczi, Krisztina B Gecse, Lajos S Kiss, Miklos Szathmari, Peter L Lakatos
AIM: To analyze the incidence and possible risk factors in hospitalized patients treated with Clostridium difficile infection (CDI). METHODS: A total of 11751 patients were admitted to our clinic between 1 January 2010 and 1 May 2013. Two hundred and forty-seven inpatients were prospectively diagnosed with CDI. For the risk analysis a 1:3 matching was used. Data of 732 patients matched for age, sex, and inpatient care period and unit were compared to those of the CDI population...
June 7, 2015: World Journal of Gastroenterology: WJG
R Paul Robertson
The therapeutic potential of pancreatic islet allotransplantation, in which human donor islets are used, as a treatment for type 1 diabetes (T1D) has fascinated diabetes researchers and clinicians for decades. At the same time, the therapeutic potential of total pancreatectomy and islet autotransplantation (TPIAT) (in which one's own islets are used) as a preventive treatment for diabetes in patients who undergo total pancreatectomy for chronic, painful pancreatitis has received relatively less attention. This is ironic, since the latter has been much more effective than the former in terms of successful glucose management and duration of efficacy...
June 2015: Diabetes Care
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