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https://www.readbyqxmd.com/read/28792170/consensus-on-basal-insulin-in-the-management-of-type-2-diabetes-which-when-and-how
#1
Samit Ghosal, Binayak Sinha, Anirban Majumder, Ashok Kumar Das, Awadhesh Kumar Singh, Biswajit Ghoshdastidar, Debasish Maji, Ghanshyam Goyal, Jagat Jyoti Mukherjee, Kalyan Kumar Gangopadhyay, Mathew John, Sanjay Chatterjee, Shalini Jaggi, Subir Ray, Sujoy Majumdar, Surendra Kumar Sharma
INTRODUCTION: Type 2 diabetes mellitus (T2DM) has attained epidemic proportions and continues to increase despite the availability of a number of oral antidiabetic medications and major advances made in insulin delivery since its discovery nearly a hundred years ago. One, amongst many other reasons responsible for the inability to achieve adequate glycaemic control in a substantial proportion of T2DM patients is the delayed initiation and inappropriate intensification of insulin treatment...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28754263/clinical-inertia-and-its-impact-on-treatment-intensification-in-people-with-type-2-diabetes-mellitus
#2
REVIEW
G Reach, V Pechtner, R Gentilella, A Corcos, A Ceriello
Many people with type 2 diabetes mellitus (T2DM) fail to achieve glycaemic control promptly after diagnosis and do not receive timely treatment intensification. This may be in part due to 'clinical inertia', defined as the failure of healthcare providers to initiate or intensify therapy when indicated. Physician-, patient- and healthcare-system-related factors all contribute to clinical inertia. However, decisions that appear to be clinical inertia may, in fact, be only 'apparent' clinical inertia and may reflect good clinical practice on behalf of the physician for a specific patient...
July 25, 2017: Diabetes & Metabolism
https://www.readbyqxmd.com/read/28712978/local-radiotherapy-intensification-for-locally-advanced-non-small-cell-lung-cancer-a-call-to-arms
#3
REVIEW
Noah S Kalman, Elisabeth Weiss, Paul R Walker, Julian G Rosenman
Chemoradiotherapy, the standard of care for locally advanced non-small-cell lung cancer (NSCLC), often fails to eradicate all known disease. Despite advances in chemotherapeutic regimens, locally advanced NSCLC remains a difficult disease to treat, and locoregional failure remains common. Improved radiographic detection can identify patients at significant risk of locoregional failure after definitive treatment, and newer methods of escalating locoregional treatment may allow for improvements in locoregional control with acceptable toxicity...
June 16, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28705697/overcoming-clinical-inertia-in-insulin-initiation-in-primary-care-for-patients-with-type-2-diabetes-24-month-follow-up-of-the-stepping-up-cluster-randomised-controlled-trial
#4
Jo-Anne Manski-Nankervis, John Furler, David O'Neal, Louise Ginnivan, Sharmala Thuraisingam, Irene Blackberry
AIM: To examine the two-year impact of Stepping Up, a general practice based model of care intervention for insulin initiation and titration in Australia. METHODS: 266 participants from 74 general practices participated in the Stepping Up cluster randomised controlled trial between 2012-2014. Control practices received training in the model of care on completion of the 12-month trial. Patients were followed for 24 months. Participant baseline characteristics, insulin and non-insulin medication use were summarised for each study group...
July 10, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28689692/patient-and-provider-factors-affecting-clinical-inertia-in-patients-with-type-2-diabetes-on-metformin-monotherapy
#5
Rohan Mahabaleshwarkar, Frank Gohs, Holly Mulder, Nick Wilkins, Andrea DeSantis, William E Anderson, Flavia Ejzykowicz, Swapnil Rajpathak, H James Norton
PURPOSE: Our aim was to determine the extent of clinical inertia and the associated patient and provider factors in patients with type 2 diabetes on metformin monotherapy (MM) at a large integrated health care system in the United States. METHODS: The study cohort included patients with type 2 diabetes aged 18 to 85 years, on MM between January 2009 and September 2013, who experienced MM failure (had an uncontrolled glycosylated hemoglobin [HbA1c] reading (≥8...
July 6, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28671150/emerging-trends-of-nosocomial-pneumonia-in-intensive-care-unit-of-a-tertiary-care-public-teaching-hospital-in-western-india
#6
Rakesh Bhadade, Minal Harde, Rosemarie deSouza, Ashwini More, Ramesh Bharmal
BACKGROUND: Nosocomial pneumonia poses great challenge to an intensivist. Detailed information about hospital-acquired pneumonia (HAP) and ventilator-acquired pneumonia (VAP) is crucial for prevention and optimal management, thus improving quality Intensive Care Unit (ICU) care. Hence, we aimed to study the current trend of nosocomial pneumonia in ICU. MATERIALS AND METHODS: It was a prospective observational cohort study, conducted in the ICU of a tertiary care teaching public hospital over a period of 18 months...
July 2017: Annals of African Medicine
https://www.readbyqxmd.com/read/28656746/therapeutic-inertia-in-patients-treated-with-two-or-more-antidiabetics-in-primary-care-factors-predicting-intensification-of-treatment
#7
Manel Mata-Cases, Josep Franch-Nadal, Jordi Real, Mònica Gratacòs, Flora López-Simarro, Kamlesh Khunti, Dídac Mauricio
AIMS: To determine the patterns and predictors of treatment intensification in patients with type 2 diabetes on ≥2 non-insulin antidiabetic drugs (NIADs) and inadequate glycemic control in primary care in Catalonia, Spain. MATERIAL AND METHODS: Retrospective analysis using electronic medical records from patients with HbA1c ≥7% and a first prescription for a new NIAD or insulin recorded from January 2010 to December 2014. Therapeutic inertia was defined as no intensification if HbA1c ≥8% at baseline or during follow-up...
June 28, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28648964/factors-associated-with-prolonged-inaction-in-the-hypoglycaemic-treatment-in-people-with-non-insulin-dependent-type-2-diabetes-and-elevated-glycated-haemoglobin-a-registry-based-cohort-study
#8
Geert Goderis, Bert Vaes, Marjan Van den Akker, Steven Elli, Chantal Mathieu, Frank Buntinx, Séverine Henrard
AIMS: To assess factors associated with Prolonged Inaction (PI) in insulin-naïve patients with Type 2 Diabetes Mellitus (T2DM). PI was defined as the absence of treatment initiation or intensification for ≥12 months despite HbA1c >7% (53mmol/mol). METHODS: A retrospective cohort study was conducted based on data from Intego, a Flemish General Practice registry. The study period ranged from January 1, 2006 to December 31, 2013. Patients with insulin therapy before the start of the study period were excluded from the analysis...
June 22, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28618915/coronary-artery-disease-risk-stratification-and-patient-selection-for-more-aggressive-secondary-prevention
#9
François Schiele, Fiona Ecarnot, Romain Chopard
In patients with stable coronary artery disease, clinical outcomes are predominantly characterized by the consequences of atherosclerosis on the myocardium, but also by complications of atherosclerosis, notably recurrent acute coronary syndrome or stroke. Secondary prevention therapy is therefore key in this patient population. Intensification of secondary prevention therapy is possible, at the price of a therapeutic risk or a high cost, therefore justifying careful selection of patients with a high residual risk and low therapeutic risk...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28574177/review-of-basal-plus-insulin-regimen-options-for-simpler-insulin-intensification-in-people-with-type-2-diabetes-mellitus
#10
REVIEW
D Raccah, D Huet, A Dib, F Joseph, B Landers, J Escalada, H Schmitt
AIMS: To identify simple insulin regimens for people with Type 2 diabetes mellitus that can be accepted and implemented earlier in primary and specialist care, taking into consideration each individual's needs and capabilities. METHODS: Using randomized clinical trials identified by a search of the PubMed database, as well as systematic reviews, meta-analyses and proof-of-concept studies, this review addresses topics of interest related to the progressive intensification of a basal insulin regimen to a basal-plus regimen (one basal insulin injection plus stepwise addition of one to three preprandial short-acting insulin injections/day) vs a basal-bolus regimen (basal insulin plus three short-acting insulin injections per day) in people with Type 2 diabetes...
September 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28573408/practical-recommendations-for-transitioning-patients-with-type-2-diabetes-from-hospital-to-home
#11
REVIEW
Amy C Donihi
PURPOSE OF REVIEW: The purpose of this review is to provide practical evidence-based recommendations for transitioning hospitalized patients with type 2 diabetes (T2DM) to home. RECENT FINDINGS: Hospitalized patients who have newly diagnosed or poorly controlled T2DM require initiation or intensification of their outpatient diabetes regimen. Potential barriers to medication access and continuity of care should be identified early in the hospitalization. Throughout hospitalization, patients should receive diabetes education focused on basic survival skills and tailored to learning needs...
July 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28555374/the-cisplatin-total-dose-and-concomitant-radiation-in-locoregionally-advanced-head-and-neck-cancer-any-recent-evidence-for-dose-efficacy
#12
REVIEW
Lindsay Carlsson, Scott V Bratman, Lillian L Siu, Anna Spreafico
Concurrent chemoradiotherapy (CRT) with high-dose (100 mg/m(2)), single-agent cisplatin is considered the standard of care for locoregionally advanced head and neck cancer (LAHNC). Poor compliance often due to significant treatment-related toxicities observed during CRT regimen has stimulated research efforts to examine for evidence of the optimal cumulative cisplatin dose and schedule. The findings from this systematic literature review demonstrate that there are insufficient prospective, randomized controlled data to determine the optimal total dose (and schedule) of cisplatin to administer concomitantly with radiotherapy in the treatment of LAHNC...
July 2017: Current Treatment Options in Oncology
https://www.readbyqxmd.com/read/28553609/choice-of-insulin-in-type-2-diabetes-a-southeast-asian-perspective
#13
Sanjay Kalra, Hong Quang Thai, Chaicharn Deerochanawong, Goh Su-Yen, Mafauzy Mohamed, Tint Swe Latt, Than Than Aye, Zafar Ahmed Latif, Prasad Katulanda, Touch Khun, Sum Satha, Vadsana Vongvandy
Southeast Asia faces a diabetes epidemic, which has created significant challenges for health care. The unique Asian diabetes phenotype, coupled with peculiar lifestyle, diet, and healthcare-seeking behavior, makes it imperative to develop clinical pathways and guidelines which address local needs and requirements. From an insulin-centric viewpoint, the preparations prescribed in such pathways should be effective, safe, well tolerated, nonintrusive, and suitable for the use in multiple clinical situations including initiation and intensification...
May 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28551769/clinical-course-and-end-of-life-care-in-patients-who-have-died-after-allogeneic-stem-cell-transplantation
#14
Christoph Busemann, Andreas Jülich, Britta Buchhold, Vanessa Schmidt, Laila Schneidewind, Daniel Pink, Christian Andreas Schmidt, Thomas Neumann, William H Krüger
PURPOSE: Allogeneic stem cell transplantation may cure approximately 50% of patients, however, a significant part of the other half might benefit from a high-quality palliative care medicine at the end of life. Somatic, psychic and spiritual needs of these patients may differ from those of patients suffering from incurable solid tumours and are not comprehensively evaluated so far. METHODS: To address this question, data from charts of 123 patients who have died after allogeneic stem cell transplantation were extracted...
May 27, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28500214/efficacy-of-the-telemedical-lifestyle-intervention-program-telipro-in-advanced-stages-of-type-2-diabetes-a-randomized-controlled-trial
#15
Kerstin Kempf, Bernd Altpeter, Janine Berger, Oliver Reuß, Matthias Fuchs, Michael Schneider, Babette Gärtner, Katja Niedermeier, Stephan Martin
OBJECTIVE: Lifestyle interventions are the foundation of treatment in newly diagnosed type 2 diabetes. However, their therapeutic potential in advanced disease stages is unknown. We evaluated the efficacy of the Telemedical Lifestyle intervention Program (TeLiPro) in improving metabolic control in advanced-stage type 2 diabetes. RESEARCH DESIGN AND METHODS: In this single-blind, active comparator, intervention study, patients with type 2 diabetes (with glycated hemoglobin [HbA1c] ≥7...
July 2017: Diabetes Care
https://www.readbyqxmd.com/read/28490797/action-on-diabetic-macular-oedema-achieving-optimal-patient-management-in-treating-visual-impairment-due-to-diabetic-eye-disease
#16
R Gale, P H Scanlon, M Evans, F Ghanchi, Y Yang, G Silvestri, M Freeman, A Maisey, J Napier
This paper identifies best practice recommendations for managing diabetes and sight-threatening diabetic eye disease. The authors provide an update for ophthalmologists and allied healthcare professionals on key aspects of diabetes management, supported by a review of the pertinent literature, and recommend practice principles for optimal patient management in treating visual impairment due to diabetic eye disease. In people with diabetes, early optimal glycaemic control reduces the long-term risk of both microvascular and macrovascular complications...
May 2017: Eye
https://www.readbyqxmd.com/read/28475268/prospective-evaluation-of-quality-of-life-in-children-treated-in-ukall-2003-for-acute-lymphoblastic-leukaemia-a-cohort-study
#17
C Eiser, C B Stride, A Vora, N Goulden, C Mitchell, G Buck, M Adams, M E M Jenney
BACKGROUND: Health-related quality of life (HRQoL) from diagnosis until end of treatment for children with acute lymphoblastic leukaemia was investigated, examining effects of age, gender, risk-stratified treatment regimen, and therapy intensity (one vs. two 'delayed intensifications' [DIs]). METHOD: In a multi-centre prospective study, parents reported their child's generic and disease-specific HRQoL and their own care-giving burden at five time points. From 1,428 eligible patients, 874 parents completed questionnaires at least once during treatment...
May 5, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/28460836/the-role-of-meat-in-strategies-to-achieve-a-sustainable-diet-lower-in-greenhouse-gas-emissions-a-review
#18
REVIEW
John J Hyland, Maeve Henchion, Mary McCarthy, Sinéad N McCarthy
Food consumption is responsible for a considerable proportion of greenhouse gas emissions (GHGE). Hence, individual food choices have the potential to substantially influence both public health and the environment. Meat and animal products are relatively high in GHGE and therefore targeted in efforts to reduce dietary emissions. This review first highlights the complexities regarding sustainability in terms of meat consumption and thereafter discusses possible strategies that could be implemented to mitigate its climatic impact...
April 21, 2017: Meat Science
https://www.readbyqxmd.com/read/28459925/effect-of-a-community-health-worker-intervention-among-latinos-with-poorly-controlled-type-2-diabetes-the-miami-healthy-heart-initiative-randomized-clinical-trial
#19
Olveen Carrasquillo, Cynthia Lebron, Yisel Alonzo, Hua Li, Aileen Chang, Sonjia Kenya
Importance: Community health worker (CHW) intervention is a promising approach to address type 2 diabetes among Latinos. However, evidence from randomized clinical studies is limited. Objective: To compare a CHW intervention with enhanced usual care. Design, Setting, and Participants: This 52-week, single-blind, randomized clinical trial included 300 Latino adults aged 18 to 65 years who were treated in 2 public hospital outpatient clinics in Miami-Dade County, Florida, from July 1, 2010, through October 31, 2013...
July 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28457028/consensus-on-insulin-dose-and-titration-algorithms-in-ambulatory-care-of-type-2-diabetes-in-india
#20
Rajiv Kovil, Manoj Chawla, Rajesh Rajput, A K Singh, Binayak Sinha, Samit Ghosal, Piya Ballani, Sunil Gupta, Snehal Tanna, S M Bandukwala, Tejas Shah, Vijay Negalur, Anil Bhoraskar, S R Aravind, Abdul H Zargar, Jothydev Kesavadev, Ashok Kumar Das
INSTRUCTION: Insulin is the oldest of the currently available treatment options in Type 2 diabetes mellitus (T2DM) and is considered as the most effective glucose lowering agent. Despite this, decision on starting insulin therapy is often delayed in India as well as worldwide due to various barriers at both patient and physician levels. Appropriate insulin dosing and titration is also critical to the successful achievement of tight glycaemic control. OBJECTIVE: To provide simple and easily implementable guidelines to primary care physicians on appropriate insulin dosing and titration of various insulin regimens for both initiation and intensification...
February 2017: Journal of the Association of Physicians of India
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