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Diabetes care delivery

Cathy Liu, Jade Lodge, Christopher Flatley, Alexander Gooi, Cameron Ward, Karen Eagleson, Sailesh Kumar
OBJECTIVE: To determine obstetric, intrapartum and perinatal outcomes for pregnancies with isolated fetal congenital heart defects (CHD). METHODS: This was a retrospective cohort study of women that delivered an infant with an isolated major CHD between January 2010 and April 2017 at a major Australian perinatal centre. The study cohort was compared with a cohort of women with infants without CHD. Cardiac abnormalities were broadly subdivided into the following five categories using the International Classification of Diseases Tenth Revision (ICD-10) as a guide - transposition of the great arteries (TGA), septal defects, right heart lesions (RHL), left heart lesions (LHL) and "other"...
March 16, 2018: Journal of Maternal-fetal & Neonatal Medicine
P Karen Simmavong, Loretta M Hillier, Robert J Petrella
Health eSteps is a pragmatic, evidence-based lifestyle prescription program aimed at reducing the rates of chronic disease, in particular, type 2 diabetes. A process evaluation was completed to assess the feasibility of the implementation of HealtheSteps in primary care and community-based settings across Canada. Key informant interviews (program providers and participants) were conducted to identify facilitators and barriers to implementation and opportunities for future program adaptation and improvement...
March 1, 2018: Health Promotion Practice
Karen Broekhuizen, David Simmons, Roland Devlieger, André van Assche, Goele Jans, Sander Galjaard, Rosa Corcoy, Juan M Adelantado, Fidelma Dunne, Gernot Desoye, Jürgen Harreiter, Alexandra Kautzky-Willer, Peter Damm, Elisabeth R Mathiesen, Dorte M Jensen, Liselotte L Andersen, Annunziata Lapolla, Maria G Dalfra, Alessandra Bertolotto, Ewa Wender-Ozegowska, Agnieszka Zawiejska, David Hill, Frank J Snoek, Judith G M Jelsma, Judith E Bosmans, Mireille N M van Poppel, Johanna M van Dongen
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with perinatal health risks to both mother and offspring, and represents a large economic burden. The DALI study is a multicenter randomized controlled trial, undertaken to add to the knowledge base on the effectiveness of interventions for pregnant women at increased risk for GDM. The purpose of this study was to evaluate the cost-effectiveness of the healthy eating and/or physical activity promotion intervention compared to usual care among pregnant women at increased risk of GDM from a societal perspective...
March 14, 2018: International Journal of Behavioral Nutrition and Physical Activity
Líliam Barbosa Silva, Sônia Maria Soares, Patrícia Aparecida Barbosa Silva, Joseph Fabiano Guimarães Santos, Lívia Carvalho Viana Miranda, Raquel Melgaço Santos
OBJECTIVE: to evaluate the quality of care provided to older people with diabetes mellitus and/or hypertension in the Primary Health Care (PHC) according to the Chronic Care Model (CCM) and identify associations with care outcomes. METHOD: cross-sectional study involving 105 older people with diabetes mellitus and/or hypertension. The Patient Assessment of Chronic Illness Care (PACIC) questionnaire was used to evaluate the quality of care. The total score was compared with care outcomes that included biochemical parameters, body mass index, pressure levels and quality of life...
March 8, 2018: Revista Latino-americana de Enfermagem
Rajesh Kumari, Venus Dalal, Garima Kachhawa, Ipshita Sahoo, Rajesh Khadgawat, Reeta Mahey, Vidushi Kulshrestha, Perumal Vanamail, J B Sharma, Neerja Bhatla, Alka Kriplani
Background: Gestational diabetes mellitus (GDM) is defined as a carbohydrate intolerance first diagnosed in pregnancy and may be associated with adverse maternal and perinatal outcome. Aim: The aim of the study was to determine the maternal and perinatal outcome in GDM during pregnancy. Materials and Methods: It is a retrospective analysis of women diagnosed with GDM who got antenatal care and delivered in our hospital in previous 5 years...
January 2018: Indian Journal of Endocrinology and Metabolism
Annie Dude, Charlotte M Niznik, Emily D Szmuilowicz, Alan M Peaceman, Lynn M Yee
Achieving maternal euglycemia in women with pregestational and gestational diabetes mellitus is critical to decreasing the risk of neonatal hypoglycemia, as maternal blood glucose levels around the time of delivery are directly related to the risk of hypoglycemia in the neonate. Many institutions use continuous insulin and glucose infusions during the intrapartum period, although practices are widely variable. At Northwestern Memorial Hospital, the "Management of the Perinatal Patient with Diabetes" policy and protocol was developed to improve consistency of management while also allowing individualization appropriate for the patient's specific diabetic needs...
March 13, 2018: American Journal of Perinatology
Asanka Jayawardane, Malitha Patabendige, Dulani Samaranayake, Medini Boteju, Shamalka Dahanayake, Ruvini Perera, Sumudu Jayasinghe, Dakshila Galappatti, C N Wijeyaratne
AIM: To study case mix, risk factors, adverse outcomes and associations of hyperglycemia in pregnancy in a cohort of Sri Lankans. METHODS: Prospective observational study, from April 2011-October 2015 at a tertiary care referral center, Colombo, Sri Lanka. Data from first trimester to delivery of HIP was analyzed. Three subgroups were defined: Diabetes in pregnancy (DIP), Hyperglycemia in early Pregnancy (HIEP) [<24 weeks] and Gestational diabetes (GDM) [>24 weeks]...
March 8, 2018: Diabetes Research and Clinical Practice
Katja Vince, Tamara Poljičanin, Marko Brkić, Urelija Rodin, Ratko Matijević
AIMS: The aim of this study was to determine the prevalence of diabetes among women 5 years after having gestational diabetes during pregnancy. Also, we sought to determine whether women who develop diabetes after GD during pregnancy differ from women who do not develop diabetes after GD during pregnancy. METHODS: This longitudinal study was performed using data from medical birth certificates and CroDiab diabetes registry. Women burdened with gestational diabetes in Croatia in 2011 were followed up until year 2016...
March 5, 2018: Primary Care Diabetes
Laura Schummers, Jennifer A Hutcheon, Michele R Hacker, Tyler J VanderWeele, Paige L Williams, Thomas A McElrath, Sonia Hernandez-Diaz
BACKGROUND: First deliveries in women older than 35, 40, or 45 are at increased risk for adverse pregnancy outcomes compared with those in younger women. However, specific relationships between each additional year of maternal age and pregnancy risks remain unclear, and absolute risks at each maternal age are not known. METHODS: Using a population-based cohort of nulliparous women in British Columbia, Canada, from 2004-2014 (n=203,414), We examined relationships between maternal age (modeled flexibly to allow curvilinear shapes) and pregnancy outcomes using logistic regression...
March 6, 2018: Epidemiology
Liv Guro Engen Hanem, Solhild Stridsklev, Pétur B Júlíusson, Øyvind Salvesen, Mathieu Roelants, Sven M Carlsen, Rønnaug Ødegård, Eszter Vanky
Context: Metformin is used in pregnancy in women with gestational diabetes mellitus, polycystic ovary syndrome (PCOS) and obesity. Metformin passes the placenta. Objective: To explore the effects of metformin use in PCOS pregnancies on offspring growth to 4 years of age. Design: Follow-up study of two randomized, double blind, placebo-controlled trials. Setting: Secondary care centers. Eleven public hospitals in Norway...
February 27, 2018: Journal of Clinical Endocrinology and Metabolism
Kathy L Rush, Linda Hatt, Robert Janke, Lindsay Burton, Matthew Ferrier, Meghan Tetrault
OBJECTIVE: The virtual delivery of patient education and other forms of telehealth have been proposed as alternatives to providing needed care for patients with chronic diseases. The purpose of this systematic review was to compare the efficacy of virtual education delivery on patient outcomes compared with usual care. METHODS: The review examined citations from 3 databases, MEDLINE, CINAHL, and EMBASE using the search words telehealth, chronic disease, patient education, and related concepts...
February 15, 2018: Patient Education and Counseling
Matthias David, Katrin Alexandra Scherer, Wolfgang Henrich, Jürgen Breckenkamp
Objectives: Does the incidence and/or indication(s) for emergency cesarean section differ if the pregnant woman has an immigrant background (IB)? Does a lack of language proficiency (communication problems) and a low acculturation level result in a longer decision-to-delivery interval (D-D interval)? Are neonates born to women with IB by emergency cesarean section in a poorer condition post delivery? Patient cohorts and method: Standardized interviews were carried out before or immediately after delivery in three Berlin obstetric hospitals...
February 2018: Geburtshilfe und Frauenheilkunde
Linda Penn, Angela Rodrigues, Anna Haste, Marta M Marques, Kirsten Budig, Kirby Sainsbury, Ruth Bell, Vera Araújo-Soares, Martin White, Carolyn Summerbell, Elizabeth Goyder, Alan Brennan, Ashley J Adamson, Falko F Sniehotta
OBJECTIVES: Evaluation of the demonstrator phase and first wave roll-out of the National Health Service (NHS) Diabetes Prevention Programme (DPP) in England. To examine: (1) intervention design, provision and fidelity assessment procedures; (2) risk assessment and recruitment pathways and (3) data collection for monitoring and evaluation. To provide recommendations informing decision makers on programme quality, improvements and future evaluation. DESIGN: We reviewed programme documents, mapping against the NHS DPP specification and National Institute for Health and Care Excellence (NICE) public health guideline: Type 2 diabetes (T2D) prevention in people at high risk (PH38), conducted qualitative research using individual interviews and focus group discussions with stakeholders and examined recruitment, fidelity and data collection procedures...
February 21, 2018: BMJ Open
Kingshuk Pal, Charlotte Dack, Jamie Ross, Susan Michie, Carl May, Fiona Stevenson, Andrew Farmer, Lucy Yardley, Maria Barnard, Elizabeth Murray
BACKGROUND: The prevalence of type 2 diabetes is increasing globally, and health services in many countries are struggling with the morbidity, mortality, and costs associated with the complications of this long-term condition. Diabetes self-management education (DSME) and behavioral support can reduce the risks of developing diabetes-related complications and improve glycemic control. However, their uptake is low. Digital health interventions (DHI) can provide sustained support and may overcome challenges associated with attending diabetes self-management sessions...
January 29, 2018: Journal of Medical Internet Research
Naricha Chirakalwasan, Somvang Amnakkittikul, Ekasitt Wanitcharoenkul, Suranut Charoensri, Sunee Saetung, Suwannee Chanprasertyothin, La-Or Chailurkit, Panyu Panburana, Sommart Bumrungphuet, Ammarin Takkinstian, Sirimon Reutrakul
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is associated with gestational diabetes mellitus (GDM). This study assessed the effects of continuous positive airway pressure (CPAP) in obese pregnant females with GDM and OSA. METHODS: A randomized controlled trial was conducted (April 2014 - June 2016). Obese females at 24 to 34 weeks gestation and with diet-controlled GDM were screened for OSA. Those with OSA were randomly assigned to receive 2 weeks nightly CPAP or be part of a waitlist control group...
February 13, 2018: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
Liz Glidewell, Thomas A Willis, Duncan Petty, Rebecca Lawton, Rosemary R C McEachan, Emma Ingleson, Peter Heudtlass, Andrew Davies, Tony Jamieson, Cheryl Hunter, Suzanne Hartley, Kara Gray-Burrows, Susan Clamp, Paul Carder, Sarah Alderson, Amanda J Farrin, Robbie Foy
BACKGROUND: Interpreting evaluations of complex interventions can be difficult without sufficient description of key intervention content. We aimed to develop an implementation package for primary care which could be delivered using typically available resources and could be adapted to target determinants of behaviour for each of four quality indicators: diabetes control, blood pressure control, anticoagulation for atrial fibrillation and risky prescribing. We describe the development and prospective verification of behaviour change techniques (BCTs) embedded within the adaptable implementation packages...
February 17, 2018: Implementation Science: IS
Hayley McBain, Frederique Lamontagne-Godwin, Mark Haddad, Alan Simpson, Jacqui Chapman, Julia Jones, Chris Flood, Kathleen Mulligan
OBJECTIVES: To establish healthcare professionals' (HCPs) views about clinical roles, and the barriers and enablers to delivery of diabetes care for people with severe mental illness (SMI). DESIGN: Cross-sectional, postal and online survey. SETTING: Trusts within the National Health Service, mental health and diabetes charities, and professional bodies. PARTICIPANTS: HCPs who care for people with type 2 diabetes mellitus (T2DM) and/or SMI in the UK...
February 15, 2018: BMJ Open
Dana Vitner, Kristin Harris, Cynthia Maxwell, M D Farine
BACKGROUND: Obesity in pregnancy has become one of the most important challenges in obstetrical care given its prevalence and potential adverse impact on both mother and fetus. The primary objective of this descriptive review is to identify common themes and distinctions within the current recommendations for maternal obesity in the most updated version of four published national guidelines. METHODS: We reviewed the following guidelines for obesity in pregnancy: American College of Obstetricians and Gynecologists (ACOG) 2015, Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG) 2013, Royal College of Obstetrics and Gynecology (RCOG) 2010, and Society of Obstetrics and Gynecologists of Canada (SOGC) 2010...
February 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
Helen Lloyd, Hannah Wheat, Jane Horrell, Thavapriya Sugavanam, Benjamin Fosh, Jose M Valderas, James Close
BACKGROUND: Patient-reported measure (PRM) questionnaires were originally used in research to measure outcomes of intervention studies. They have now evolved into a diverse family of tools measuring a range of constructs including quality of life and experiences of care. Current health and social care policy increasingly advocates their use for embedding the patient voice into service redesign through new models of care such as person-centered coordinated care (P3C). If chosen carefully and used efficiently, these tools can help improve care delivery through a variety of novel ways, including system-level feedback for health care management and commissioning...
February 14, 2018: Journal of Medical Internet Research
Marie-Ève Beauregard, Sylvie Provost, Raynald Pineault, Dominique Grimard, José Pérez, Michel Fournier
INTRODUCTION: In 2011, the Agence de la santé et des services sociaux de Montréal (ASSSM), in partnership with the region's Centres de santé et de services sociaux (CSSS), coordinated the implementation of a program on cardiometabolic risk based on the Chronic Care Model. The program, intended for patients suffering from diabetes or hypertension, involved a series of individual follow-up appointments, group classes and exercise sessions. Our study assesses the impact on patient health outcomes of variations in the implementation of some aspects of the program among the six CSSSs taking part in the study...
February 2018: Health Promotion and Chronic Disease Prevention in Canada
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