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https://www.readbyqxmd.com/read/28923165/cross-sectional-study-of-area-level-disadvantage-and-glycaemic-related-risk-in-community-health-service-users-in-the-southern-iml-research-simlr-cohort
#1
Roger Cross, Andrew Bonney, Darren J Mayne, Kathryn M Weston
Objectives The aim of the present study was to determine the association between area-level socioeconomic disadvantage and glycaemic-related risk in health service users in the Illawarra-Shoalhaven region of New South Wales, Australia.Methods HbA1c values recorded between 2010 and 2012 for non-pregnant individuals aged ≥18 years were extracted from the Southern.IML Research (SIMLR) database. Individuals were assigned quintiles of the Socioeconomic Indices for Australia (SEIFA) Index of Relative Socioeconomic Disadvantage (IRSD) according to their Statistical Area 1 of residence...
September 19, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28918341/is-first-trimester-hba1c-useful-in-the-diagnosis-of-gestational-diabetes
#2
David Benaiges, Juana A Flores-Le Roux, Irene Marcelo, Laura Mañé, Marta Rodríguez, Xavier Navarro, Juan J Chillarón, Gemma Llauradó, Lucia Gortazar, Juan Pedro-Botet, Antonio Payà
AIMS: To evaluate the usefulness and efficacy of first-trimester HbA1c in the diagnosis of gestational diabetes (GDM). METHODS: Prospective observational of consecutive pregnant women. All women had a first-trimester HbA1c determination and GDM screening at 24-28weeks of pregnancy using a two-step approach. A ROC curve was drawn to determine the sensitivity and specificity of HbA1c in detecting GDM and a rule-in rule-out diagnostic algorithm was proposed. The cost of the proposed algorithm was calculated...
August 30, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28905721/using-a-cageside-device-for-testing-glycosylated-hemoglobin-in-cynomolgus-macaques-macaca-fascicularis
#3
Jessica M Johnston, Jolaine M Wilson, Abigail L Smith, John T Farrar, Michael J Kallan, Christin L Veeder
Nonhuman primates naturally develop type 2 diabetes mellitus and exhibit clinical features that are similar to those observed in humans, including obesity, insulin resistance, dyslipidemia, and pancreatic pathology. The glycosylated hemoglobin (HbA1C) test is the primary test used for diabetes management in humans because it reflects the average blood glucose levels over the previous 3 mo. The HbA1C results are a better predictor of potential risk of complications than are single or episodic measures of glucose levels...
January 1, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28905658/decision-support-for-diabetes-in-scotland-implementation-and-evaluation-of-a-clinical-decision-support-system
#4
Nicholas Conway, Karen A Adamson, Scott G Cunningham, Alistair Emslie Smith, Peter Nyberg, Blair H Smith, Ann Wales, Deborah J Wake
BACKGROUND: Automated clinical decision support systems (CDSS) are associated with improvements in health care delivery to those with long-term conditions, including diabetes. A CDSS was introduced to two Scottish regions (combined diabetes population ~30 000) via a national diabetes electronic health record. This study aims to describe users' reactions to the CDSS and to quantify impact on clinical processes and outcomes over two improvement cycles: December 2013 to February 2014 and August 2014 to November 2014...
September 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28893597/evaluation-of-a-provincial-intervention-to-reduce-redundant-hemoglobin-a1c-testing
#5
Irene Ma, Maggie Guo, Jeannine Viczko, Christopher Naugler
BACKGROUND: The Canadian Diabetes Association recommends testing most individuals with diabetes mellitus using HbA1c once every 3months. In Alberta, Canada, a provincial intervention to reduce inappropriate HbA1c test orders was implemented to align with this guideline, where only one HbA1c test request every 90days for most individuals can be processed. Here, we evaluated the provincial intervention to reduce redundant HbA1c testing in Alberta. METHODS: Total counts of all HbA1c tests ordered within Edmonton and Calgary, Alberta, were collected from the respective Laboratory Information Systems each month between January 2013 and December 2016...
September 8, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28879529/costs-and-treatment-pathways-for-type-2-diabetes-in-the-uk-a-mastermind-cohort-study
#6
Peter Eibich, Amelia Green, Andrew T Hattersley, Christopher Jennison, Mike Lonergan, Ewan R Pearson, Alastair M Gray
INTRODUCTION: Medication therapy for type 2 diabetes has become increasingly complex, and there are few reliable data on the current state of clinical practice. We report treatment pathways and associated costs of medication therapy for people with type 2 diabetes in the UK, their variability and changes over time. METHODS: Prescription and biomarker data for 7159 people with type 2 diabetes were extracted from the GoDARTS cohort study, covering the period 1989-2013...
September 6, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28872765/digital-therapy-in-diabetes
#7
REVIEW
Avivit Cahn, Amit Akirov, Itamar Raz
Diabetes care is largely dependent on patient self-management and empowerment, given that patients with diabetes must make numerous daily decisions of what to eat, when to exercise, and determine their insulin dose and timing if required. Additionally, patients and providers are generating vast amounts of data from many sources including electronic medical records, insulin pumps, sensors, glucometers, other wearables, as well as evolving genomic, proteomic, metabolomic and microbiomic data. Multiple digital tools and apps have been developed to assist patients to choose wisely, as well as enhance their compliance by employing motivational tools and incorporating incentives from social media and gaming techniques...
September 5, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/28871565/cost-effectiveness-analysis-of-sensor-augmented-insulin-pump-therapy-with-automated-insulin-suspension-versus-standard-insulin-pump-therapy-in-patients-with-type-1-diabetes-in-sweden
#8
Johan Jendle, Jayne Smith-Palmer, Alexis Delbaere, Simona de Portu, Natalie Papo, William Valentine, Stéphane Roze
INTRODUCTION: In Sweden an estimated 10,000 people with type 1 diabetes use continuous subcutaneous insulin infusion (CSII). Sensor-augmented pump therapy (SAP) is associated with higher acquisition costs but provides additional clinical benefits (e.g. reduced rate of hypoglycemic events) over and above that of CSII alone. The aim of the analysis was to assess the cost-effectiveness of SAP with automated insulin suspension relative to CSII alone in two different groups of patients with type 1 diabetes in Sweden...
September 4, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28840258/individualised-variable-interval-risk-based-screening-for-sight-threatening-diabetic-retinopathy-the-liverpool-risk-calculation-engine
#9
Antonio Eleuteri, Anthony C Fisher, Deborah M Broadbent, Marta García-Fiñana, Christopher P Cheyne, Amu Wang, Irene M Stratton, Mark Gabbay, Daniel Seddon, Simon P Harding
AIMS/HYPOTHESIS: Individualised variable-interval risk-based screening offers better targeting and improved cost-effectiveness in screening for diabetic retinopathy. We developed a generalisable risk calculation engine (RCE) to assign personalised intervals linked to local population characteristics, and explored differences in assignment compared with current practice. METHODS: Data from 5 years of photographic screening and primary care for people with diabetes, screen negative at the first of > 1 episode, were combined in a purpose-built near-real-time warehouse...
August 24, 2017: Diabetologia
https://www.readbyqxmd.com/read/28827235/assessing-the-potential-return-on-investment-of-the-proposed-uk-nhs-diabetes-prevention-programme-in-different-population-subgroups-an-economic-evaluation
#10
Chloe Thomas, Susi Sadler, Penny Breeze, Hazel Squires, Michael Gillett, Alan Brennan
OBJECTIVES: To evaluate potential return on investment of the National Health Service Diabetes Prevention Programme (NHS DPP) in England and estimate which population subgroups are likely to benefit most in terms of cost-effectiveness, cost-savings and health benefits. DESIGN: Economic analysis using the School for Public Health Research Diabetes Prevention Model. SETTING: England 2015-2016. POPULATION: Adults aged ≥16 with high risk of type 2 diabetes (HbA1c 6%-6...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28814583/does-use-of-point-of-care-testing-improve-cost-effectiveness-of-the-nhs-health-check-programme-in-the-primary-care-setting-a-cost-minimisation-analysis
#11
Austen El-Osta, Maria Woringer, Elena Pizzo, Talitha Verhoef, Claire Dickie, Melody Z Ni, Jeremy R Huddy, Michael Soljak, George B Hanna, Azeem Majeed
OBJECTIVE: To determine if use of point of care testing (POCT) is less costly than laboratory testing to the National Health Service (NHS) in delivering the NHS Health Check (NHSHC) programme in the primary care setting. DESIGN: Observational study and theoretical mathematical model with microcosting approach. SETTING: We collected data on NHSHC delivered at nine general practices (seven using POCT; two not using POCT). PARTICIPANTS: We recruited nine general practices offering NHSHC and a pathology services laboratory in the same area...
August 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28814128/effects-of-telemonitoring-on-glycaemic-control-and-healthcare-costs-in-type-2-diabetes-a-randomised-controlled-trial
#12
Robin Warren, Karen Carlisle, Gabor Mihala, Paul A Scuffham
Introduction This study examined the effect of a telehealth intervention on the control of type 2 diabetes and subsequent potential cost-savings to the health system. Methods This prospective randomised controlled trial randomised adults with type 2 diabetes to the intervention (diabetes program) or control (usual care) arm. Key eligibility criteria included an HbA1c level of at least 58 mmol/mol (7.5%) without severe or unstable comorbidities. All participants continued their usual healthcare, but participants in the intervention arm received additional diabetes care from a diabetes care coordinator via a home monitor that captured clinical measures...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28813636/using-systems-science-to-inform-population-health-strategies-in-local-health-departments-a-case-study-in-san-antonio-texas
#13
Yan Li, Norma A Padrón, Anil T Mangla, Pamela G Russo, Thomas Schlenker, José A Pagán
OBJECTIVES: Because of state and federal health care reform, local health departments play an increasingly prominent role leading and coordinating disease prevention programs in the United States. This case study shows how a local health department working in chronic disease prevention and management can use systems science and evidence-based decision making to inform program selection, implementation, and assessment; enhance engagement with local health systems and organizations; and possibly optimize health care delivery and population health...
September 2017: Public Health Reports
https://www.readbyqxmd.com/read/28801393/protocol-for-the-mwellcare-trial-a-multicentre-cluster-randomised-12-month-controlled-trial-to-compare-the-effectiveness-of-mwellcare-an-mhealth-system-for-an-integrated-management-of-patients-with-hypertension-and-diabetes-versus-enhanced-usual-care-in-india
#14
Dilip Jha, Priti Gupta, Vamadevan S Ajay, Devraj Jindal, Pablo Perel, David Prieto-Merino, Pramod Jacob, Jonathan Nyong, Vidya Venugopal, Kavita Singh, Shifalika Goenka, Ambuj Roy, Nikhil Tandon, Vikram Patel, Dorairaj Prabhakaran
INTRODUCTION: Rising burden of cardiovascular disease (CVD) and diabetes is a major challenge to the health system in India. Innovative approaches such as mobile phone technology (mHealth) for electronic decision support in delivering evidence-based and integrated care for hypertension, diabetes and comorbid depression have potential to transform the primary healthcare system. METHODS AND ANALYSIS: mWellcare trial is a multicentre, cluster randomised controlled trial evaluating the clinical and cost-effectiveness of a mHealth system and nurse managed care for people with hypertension and diabetes in rural India...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28747191/implementation-findings-from-a-hybrid-iii-implementation-effectiveness-trial-of-the-diabetes-prevention-program-dpp-in-the-veterans-health-administration-vha
#15
Laura J Damschroder, Caitlin M Reardon, Mona AuYoung, Tannaz Moin, Santanu K Datta, Jordan B Sparks, Matthew L Maciejewski, Nanette I Steinle, Jane E Weinreb, Maria Hughes, Lillian F Pinault, Xinran M Xiang, Charles Billington, Caroline R Richardson
BACKGROUND: The Diabetes Prevention Program (DPP) is an effective lifestyle intervention to reduce incidence of type 2 diabetes. However, there are gaps in knowledge about how to implement DPP. The aim of this study was to evaluate implementation of DPP via assessment of a clinical demonstration in the Veterans Health Administration (VHA). METHODS: A 12-month pragmatic clinical trial compared weight outcomes between the Veterans Affairs Diabetes Prevention Program (VA-DPP) and the usual care MOVE!® weight management program (MOVE!)...
July 26, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28745578/cost-effectiveness-of-g5-mobile-continuous-glucose-monitoring-cgm-device-compared-with-self-monitoring-of-blood-glucose-smbg-alone-for-people-with-type-1-diabetes-from-the-canadian-societal-perspective
#16
Shraddha Chaugule, Claudia Graham
AIMS: To evaluate the cost-effectiveness of real-time continuous glucose monitoring (CGM) compared to self-monitoring of blood glucose (SMBG) alone in people with type 1 diabetes (T1DM) using multiple daily injections (MDI) from the Canadian societal perspective. METHODS: The IMS CORE Diabetes Model (v.9.0) was used to assess the long-term (50 years) cost-effectiveness of real-time CGM (G5 Mobile CGM System; Dexcom, Inc., San Diego, CA) compared with SMBG alone for a cohort of adults with poorly-controlled T1DM...
July 26, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28745094/nich-at-its-best-for-diabetes-at-its-worst-texting-teens-and-their-caregivers-for-better-outcomes
#17
David V Wagner, Samantha A Barry, Maggie Stoeckel, Lena Teplitsky, Michael A Harris
BACKGROUND: There is growing evidence for the feasibility of text-based interventions for pediatric patients with type 1 diabetes (T1D). However, less is known regarding whether the use of personalized text messages with high-risk youth and their caregivers is associated with improvements in youth health. This study examines the use of diabetes-specific texts and associated health outcomes for participants of the Novel Interventions in Children's Healthcare (NICH) program. METHODS: Text messages sent to youth with T1D and their caregivers during NICH intervention were coded regarding diabetes relevance and adherence-related content...
May 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28745091/continuous-glucose-monitoring-use-in-type-1-diabetes-longitudinal-analysis-demonstrates-meaningful-improvements-in-hba1c-and-reductions-in-health-care-utilization
#18
Christopher G Parkin, Claudia Graham, John Smolskis
BACKGROUND: Real-time continuous glucose monitoring (rtCGM) improves glycemic control in type 1 diabetes (T1D) patients treated with continuous subcutaneous insulin infusion (CSII). However, the benefits of rtCGM in T1D patients treated with multiple daily insulin injection (MDI) therapy has not been well studied. We explored the effects of rtCGM versus self-monitoring of blood glucose (SMBG) on clinical outcomes within a large T1D population treated with either CSII or MDI therapy. METHODS: This retrospective, longitudinal analysis utilized datasets from T1D patients enrolled in a commercial health plan to assess changes in HbA1c in 187 naïve to rtCGM users and 6260 SMBG users...
May 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28730750/improving-type-2-diabetes-mellitus-glycaemic-outcomes-is-possible-without-spending-more-on-medication-lessons-from-the-uk-national-diabetes-audit
#19
Adrian H Heald, Mark Livingston, Nagaraj Malipatil, Michal Becher, Joyce Craig, Mike Stedman, Anthony A Fryer
OBJECTIVES: There is continuing discussion globally about how to optimise outcomes for type 2 diabetes (T2DM) patients. In the UK, national (NICE) guidance was updated in 2016 (NG28). We aimed to determine the factors at a GP practice level that relate to glycaemic control outcome. METHODS: Data was accessed from 4,050 GP practices (GPP) (50% of total) covering 1.6 million T2DM patients in the UK National Diabetes Audit 2013-14 and 2014-15. This reported T2DM population characteristics, services and outcomes, including % total glycaemic control (TGC) (at 67...
July 20, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28705184/prevalence-of-gestational-diabetes-mellitus-based-on-various-screening-strategies-in-western-kenya-a-prospective-comparison-of-point-of-care-diagnostic-methods
#20
Sonak D Pastakia, Benson Njuguna, Beryl Ajwang' Onyango, Sierra Washington, Astrid Christoffersen-Deb, Wycliffe K Kosgei, Ponnusamy Saravanan
BACKGROUND: Early diagnosis of gestational diabetes mellitus (GDM) is crucial to prevent short term delivery risks and long term effects such as cardiovascular and metabolic diseases in the mother and infant. Diagnosing GDM in Sub-Saharan Africa (SSA) however, remains sub-optimal due to associated logistical and cost barriers for resource-constrained populations. A cost-effective strategy to screen for GDM in such settings are therefore urgently required. We conducted this study to determine the prevalence of gestational diabetes mellitus (GDM) and assess utility of various GDM point of care (POC) screening strategies in a resource-constrained setting...
July 14, 2017: BMC Pregnancy and Childbirth
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