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Diabetes care delivery

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https://www.readbyqxmd.com/read/28100562/healthcare-organisation-and-delivery-for-people-with-dementia-and-comorbidity-a-qualitative-study-exploring-the-views-of-patients-carers-and-professionals
#1
Frances Bunn, Anne-Marie Burn, Louise Robinson, Marie Poole, Greta Rait, Carol Brayne, Johan Schoeman, Sam Norton, Claire Goodman
OBJECTIVES: People living with dementia (PLWD) have a high prevalence of comorbidty. The aim of this study was to explore the impact of dementia on access to non-dementia services and identify ways of improving service delivery for this population. DESIGN: Qualitative study involving interviews and focus groups. Thematic content analysis was informed by theories of continuity of care and access to care. SETTING: Primary and secondary care in the South and North East of England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28099208/the-upside-down-world-of-diabetes-care-medical-economics-and-what-we-might-do-to-improve-it
#2
David M Harlan, Irl B Hirsch
PURPOSE OF REVIEW: Increasingly over the past generation, the American healthcare delivery system has received consistently poor marks with regard to public health outcomes and costs. This review by two seasoned diabetes care providers is intended to shed light on the fundamental flaws we believe to underlie that poor performance, and suggest options for better outcomes and cost efficiencies. RECENT FINDINGS: Despite major advances in diabetes management medications and tools, overall public health with regard to diabetes outcomes remains poor...
January 17, 2017: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/28093900/who-is-responsible-for-metabolic-screening-for-mental-health-clients-taking-antipsychotic-medications
#3
Tamara Ward, Dianne Wynaden, Karen Heslop
Metabolic syndrome is common in mental health consumer populations, and is linked to cardiovascular disease, stroke and diabetes. Metabolic screening is a way of recognising consumers who are at risk of developing metabolic syndrome but internationally screening rates remain low. A retrospective audit was completed at one Australian public mental health service on the case files of 100 randomly selected consumers to determine nurses level of compliance with metabolic screening policies over a 12 month period...
January 17, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28091441/process-and-outcome-measures-of-quality-of-care-at-the-diabetes-outpatient-clinic-university-college-hospital-ibadan
#4
J O Adeleye, M A Kuti
OBJECTIVE: The study aims to assess the quality of care provided at a diabetes outpatient clinic of a tertiary hospital in Nigeria using quality indicators approved by the National Diabetes Quality Improvement Alliance (NDQIA). MATERIALS AND METHODS: The medical records of patients who had visited the clinic at least two times within a 12 months period preceding the index visit were reviewed during a 5 month period. Process measure indicators, approved by the NDQIA (evaluating the functioning of the clinic) and outcome measures, published by the American Diabetes Association, (evaluating the health status of the attending patients) were retrieved from the medical records...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28076991/type-2-diabetes-mellitus-does-prenatal-care-affect-outcomes-suggested-running-head-treatment-of-t2dm-and-perinatal-outcomes
#5
Allison J Allen, Jonathan M Snowden, Bernard Lau, Yvonne Cheng, Aaron B Caughey
OBJECTIVE: To determine if prenatal care affects adverse perinatal outcomes in pregnant women with Type-2 Diabetes Mellitus. STUDY DESIGN: This was a retrospective cohort study of pregnant women with pregestational diabetes mellitus pregnancies in the state of California between 1997 and 2006, using vital statistics data linked to birth certificates. Women were stratified by time of presentation to care and we compared those who presented in the first trimester, third trimester, and those who had no prenatal care prior to delivery...
January 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28075695/lessons-from-launching-the-diabetes-prevention-program-in-a-large-integrated-health-care-delivery-system-a-case-study
#6
Colin D Rehm, Melinda E Marquez, Elizabeth Spurrell-Huss, Nicole Hollingsworth, Amanda S Parsons
There is urgent need for health systems to prevent diabetes. To date, few health systems have implemented the evidence-based Diabetes Prevention Program (DPP), and the few that have mostly partnered with community-based organizations to implement the program. Given the recent decision by the Centers for Medicare & Medicaid Services to reimburse for diabetes prevention, there is likely much interest in how such programs can be implemented within large health systems or how community partnerships can be expanded to support DPP implementation...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28065256/a-newborn-infant-with-oxygen-desaturation-during-sleep
#7
Ashley Deschamp, Ameet Daftary
The patient is a 1-week-old boy born at 37+2 weeks' gestational age through spontaneous vaginal delivery. The pregnancy was complicated by maternal gestational diabetes mellitus and pre-eclampsia. The Apgar score was 9 at both 1 minute and 5 minutes after birth. Because of hypoglycemia at delivery that required IV dextrose, he was admitted to the local neonatal intensive care unit. His blood glucose levels quickly stabilized, dextrose administration was discontinued, and the patient began breast-feeding. On day 2 of life, the patient began having intermittent oxygen desaturation, with oxygen saturation as measured by pulse oximetry down to 70% while sleeping; he was transferred to a tertiary-care NICU for further management...
January 2017: Chest
https://www.readbyqxmd.com/read/28061319/brief-computer-delivered-intervention-to-increase-parental-monitoring-in-families-of-african-american-adolescents-with-type-1-diabetes-a-randomized-controlled-trial
#8
Deborah A Ellis, April Idalski Carcone, Steven J Ondersma, Sylvie Naar-King, Bassem Dekelbab, Kathleen Moltz
BACKGROUND: African American adolescents with type 1 diabetes (T1D) are at elevated risk for poor diabetes management and metabolic control. Parental supervision and monitoring of adolescent diabetes management have been shown to promote better diabetes management among adolescents, but parents typically decrease their oversight during the transition to independent diabetes care. INTRODUCTION: The purpose of the study was to conduct a randomized clinical trial to test the feasibility and efficacy of a three-session, computer-delivered motivational intervention (The 3Ms) to promote increased parental monitoring among primary caregivers of young African American adolescents with T1D...
January 6, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28056933/study-protocol-for-movediabetes-a-trial-to-promote-physical-activity-for-adults-with-type-2-diabetes-in-primary-health-care-in-oman
#9
Thamra S Alghafri, Saud M Alharthi, Yahya M Al-Farsi, Angela M Craigie, Maureen Mcleod, Annie S Anderson
BACKGROUND: Benefits of physical activity in the management of diabetes are well documented. However, evidence on the effectiveness of interventions integrating physical activity in diabetes care is sparse especially in the countries of the Gulf Cooperation Council. The results from this study will increase our understanding of the use of multi-component interventions aimed at increasing physical activity levels in inactive adults with type 2 diabetes in primary health care in Oman. METHODS/DESIGN: The study is a one year 1:1 cluster randomized controlled trial of the MOVEdiabetes programme (intervention) versus usual care in eight primary health care centres in Oman...
January 6, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28056894/study-protocol-the-norfolk-diabetes-prevention-study-ndps-a-46%C3%A2-month-multi-centre-randomised-controlled-parallel-group-trial-of-a-lifestyle-intervention-with-or-without-additional-support-from-lay-lifestyle-mentors-with-type-2-diabetes-to-prevent-transition
#10
Melanie Pascale, Nikki Murray, Max Bachmann, Garry Barton, Allan Clark, Amanda Howe, Colin Greaves, Mike Sampson
BACKGROUND: This 7 year NIHR programme [2011-2018] tests the primary hypothesis that the NDPS diet and physical activity intervention will reduce the risk of transition to type 2 diabetes (T2DM) in groups at high risk of Type 2 diabetes. The NDPS programme recognizes the need to reduce intervention costs through group delivery and the use of lay mentors with T2DM, the realities of normal primary care, and the complexity of the current glycaemic categorisation of T2DM risk. METHODS: NDPS identifies people at highest risk of T2DM on the databases of 135 general practices in the East of England for further screening with ab fasting plasma glucose and glycosylated haemoglobin [HbA1c]...
January 6, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28053673/diagnostic-protocol-for-gestational-diabetes-mellitus-gdm-iadpsg-ada-2011-influence-on-the-occurrence-of-gdm-and-mild-gestational-hyperglycemia-mgh-and-on-the-perinatal-outcomes
#11
Mariana Pinto Sirimarco, Helena Maciel Guerra, Eduardo Guimarães Lisboa, Joice Monalisa Vernini, Bianca Nicolosi Cassetari, Roberto Antonio de Araujo Costa, Marilza Vieira Cunha Rudge, Iracema de Mattos Paranhos Calderon
BACKGROUND: In August 2011, the Specialized Center for Diabetes and Pregnancy of the Botucatu Medical School/Unesp adopted a new diagnostic protocol for gestational diabetes mellitus, recommended by the American Diabetes Association and the International Association of the Diabetes and Pregnancy Study Group. The glycemic profile was evaluated using the 75-g oral glucose tolerance test (OGTT) used to diagnose mild gestational hyperglycemia, recognized and treated in our department as gestational diabetes mellitus...
2017: Diabetology & Metabolic Syndrome
https://www.readbyqxmd.com/read/28043961/stakeholder-engagement-in-diabetes-self-management-patient-preference-for-peer-support-and-other-insights
#12
Bethany M Kwan, Bonnie Jortberg, Meredith K Warman, Ilima Kane, Robyn Wearner, Romona Koren, Thomas Carrigan, Vincent Martinez, Donald E Nease
BACKGROUND: Self-management support (SMS) for patients with diabetes can improve adherence to treatment, mitigate disease-related distress, and improve health outcomes. Translating this evidence into real-world practice is needed, as it is not clear which SMS models are acceptable to patients, and feasible and sustainable for primary care practices. OBJECTIVE: To use the Boot Camp Translation (BCT) method to engage patient, practice, community resource and research stakeholders in translation of evidence about SMS and diabetes distress into mutually acceptable care models and to inform patient-centred outcomes research (PCOR)...
January 1, 2017: Family Practice
https://www.readbyqxmd.com/read/28040612/association-of-obstructive-sleep-apnea-with-adverse-pregnancy-related-outcomes-in-military-hospitals
#13
Dennis L Spence, Rhonda C Allen, Monica A Lutgendorf, Virginia R Gary, John D Richard, Sara C Gonzalez
BACKGROUND: Obstructive sleep apnea (OSA) is associated with significant morbidity and mortality in non-obstetrical and obstetrical patients. OBJECTIVES: To estimate the prevalence of OSA and its relationship with pregnancy-related complications in a general obstetric population of Department of Defense beneficiaries receiving direct-care at military treatment facilities. STUDY DESIGN: A retrospective cohort study of all women (N=305,001) who gave birth at a military treatment facility from 2008 to 2014...
December 14, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28026897/pregnancy-outcome-of-gestational-diabetes-mellitus-using-a-structured-model-of-care-wings-project-wings-10
#14
Ram Uma, Balaji Bhavadharini, Harish Ranjani, Manni Mohanraj Mahalakshmi, Ranjit Mohan Anjana, Ranjit Unnikrishnan, Arivudainambi Kayal, Belma Malanda, Anne Belton, Viswanathan Mohan
AIM: To evaluate the impact of a structured model of care (MOC) prepared for resource-constrained settings, on the pregnancy outcomes of Asian Indian women with gestational diabetes mellitus (GDM). METHODS: Pregnant women were screened under the Women in India with GDM Strategy (WINGS) MOC for GDM using the International Association of Diabetes and Pregnancy Study Groups criteria. Women with GDM went through a structured MOC that included medical nutrition therapy (MNT), regular physical activity (PA); and insulin when indicated...
December 27, 2016: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/28024825/automated-diabetic-retinopathy-image-assessment-software-diagnostic-accuracy-and-cost-effectiveness-compared-with-human-graders
#15
Adnan Tufail, Caroline Rudisill, Catherine Egan, Venediktos V Kapetanakis, Sebastian Salas-Vega, Christopher G Owen, Aaron Lee, Vern Louw, John Anderson, Gerald Liew, Louis Bolter, Sowmya Srinivas, Muneeswar Nittala, SriniVas Sadda, Paul Taylor, Alicja R Rudnicka
OBJECTIVE: With the increasing prevalence of diabetes, annual screening for diabetic retinopathy (DR) by expert human grading of retinal images is challenging. Automated DR image assessment systems (ARIAS) may provide clinically effective and cost-effective detection of retinopathy. We aimed to determine whether ARIAS can be safely introduced into DR screening pathways to replace human graders. DESIGN: Observational measurement comparison study of human graders following a national screening program for DR versus ARIAS...
December 23, 2016: Ophthalmology
https://www.readbyqxmd.com/read/28007348/home-use-of-a-bihormonal-bionic-pancreas-versus-insulin-pump-therapy-in-adults-with-type-1-diabetes-a-multicentre-randomised-crossover-trial
#16
Firas H El-Khatib, Courtney Balliro, Mallory A Hillard, Kendra L Magyar, Laya Ekhlaspour, Manasi Sinha, Debbie Mondesir, Aryan Esmaeili, Celia Hartigan, Michael J Thompson, Samir Malkani, J Paul Lock, David M Harlan, Paula Clinton, Eliana Frank, Darrell M Wilson, Daniel DeSalvo, Lisa Norlander, Trang Ly, Bruce A Buckingham, Jamie Diner, Milana Dezube, Laura A Young, April Goley, M Sue Kirkman, John B Buse, Hui Zheng, Rajendranath R Selagamsetty, Edward R Damiano, Steven J Russell
BACKGROUND: The safety and effectiveness of a continuous, day-and-night automated glycaemic control system using insulin and glucagon has not been shown in a free-living, home-use setting. We aimed to assess whether bihormonal bionic pancreas initialised only with body mass can safely reduce mean glycaemia and hypoglycaemia in adults with type 1 diabetes who were living at home and participating in their normal daily routines without restrictions on diet or physical activity. METHODS: We did a random-order crossover study in volunteers at least 18 years old who had type 1 diabetes and lived within a 30 min drive of four sites in the USA...
December 20, 2016: Lancet
https://www.readbyqxmd.com/read/28003248/development-of-a-smartphone-enabled-hypertension-and-diabetes-mellitus-management-package-to-facilitate-evidence-based-care-delivery-in-primary-healthcare-facilities-in-india-the-mpower-heart-project
#17
Vamadevan S Ajay, Devraj Jindal, Ambuj Roy, Vidya Venugopal, Rakshit Sharma, Abha Pawar, Sanjay Kinra, Nikhil Tandon, Dorairaj Prabhakaran
BACKGROUND: The high burden of undetected and undertreated hypertension and diabetes mellitus is a major health challenge worldwide. The mPower Heart Project aimed to develop and test a feasible and scalable intervention for hypertension and diabetes mellitus by task-sharing with the use of a mobile phone-based clinical decision support system at Community Health Centers in Himachal Pradesh, India. METHODS AND RESULTS: The development of the intervention and mobile phone-based clinical decision support system was carried out using mixed methods in five Community Health Centers...
December 21, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27994487/the-experiences-of-prepregnancy-care-for-women-with-type-2-diabetes-mellitus-a-meta-synthesis
#18
Rita Forde, Evridiki E Patelarou, Angus Forbes
BACKGROUND: Diabetes is one of the most common medical conditions affecting pregnancy and is associated with a number of adverse fetal, infant, and maternal outcomes. These adverse outcomes can be avoided or minimized with appropriate prepregnancy care (PPC). However, the uptake of PPC is limited in women with type 2 diabetes mellitus (T2DM). The reasons for poor uptake are multifactorial, reflecting both women's understanding of pregnancy risks, and limitations in care delivery. METHODS: A systematic literature review with meta-synthesis was undertaken to identify qualitative studies exploring experiences of PPC for women with T2DM incorporating the views of women with T2DM and health care professionals (HCPs)...
2016: International Journal of Women's Health
https://www.readbyqxmd.com/read/27993166/the-effect-of-community-groups-and-mobile-phone-messages-on-the-prevention-and-control-of-diabetes-in-rural-bangladesh-study-protocol-for-a-three-arm-cluster-randomised-controlled-trial
#19
Edward Fottrell, Hannah Jennings, Abdul Kuddus, Naveed Ahmed, Joanna Morrison, Kohenour Akter, Sanjit Kumar Shaha, Badrun Nahar, Tasmin Nahar, Hassan Haghparast-Bidgoli, A K Azad Khan, Anthony Costello, Kishwar Azad
BACKGROUND: Increasing rates of type 2 diabetes mellitus place a substantial burden on health care services, communities, families and individuals living with the disease or at risk of developing it. Estimates of the combined prevalence of intermediate hyperglycaemia and diabetes in Bangladesh vary, and can be as high as 30% of the adult population. Despite such high prevalence, awareness and control of diabetes and its risk factors are limited. Prevention and control of diabetes and its complications demand increased awareness and action of individuals and communities, with positive influences on behaviours and lifestyle choices...
December 19, 2016: Trials
https://www.readbyqxmd.com/read/27984105/photothermally-triggered-on-demand-insulin-release-from-reduced-graphene-oxide-modified-hydrogels
#20
Florina Teodorescu, Yavuz Oz, Gurvan Quéniat, Amar Abderrahmani, Rana Sanyal, Amitav Sanyal, Rabah Boukherroub, Sabine Szunerits
On-demand delivery of therapeutics plays an essential role in simplifying and improving patient care. The high loading capacity of reduced graphene oxide (rGO) for drugs has made this matrix of particular interest for its hybridization with therapeutics. In this work, we describe the formulation of rGO impregnated poly(ethylene glycol) dimethacrylate based hydrogels (PEGDMA-rGO) and their efficient loading with insulin. Near-infrared (NIR) light induced heating of the PEGDMA-rGO hydrogels allows for highly efficient insulin release...
October 27, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
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