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Diabetes care delivery

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https://www.readbyqxmd.com/read/28350939/the-advancing-role-of-neuromodulation-for-the-management-of-chronic-treatment-refractory-pain
#1
Mohammed F Shamji, Cecile De Vos, Ashwini Sharan
Neuropathic pain is a common cause of disability and health care utilization. While judicious pharmacotherapy and management of comorbid psychological distress can provide for improved quality of life, some patients with treatment-refractory disease require more invasive therapies. Spinal cord stimulation can provide for improvement in pain and decrease in medication utilization, with level 1 evidence supporting its use across various pain etiologies including persistent postoperative neuropathic pain, complex regional pain syndrome, chronic inoperable limb ischemia, treatment refractory angina, and painful diabetic neuropathy...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28345030/wearable-disposable-sweat-based-glucose-monitoring-device-with-multistage-transdermal-drug-delivery-module
#2
Hyunjae Lee, Changyeong Song, Yong Seok Hong, Min Sung Kim, Hye Rim Cho, Taegyu Kang, Kwangsoo Shin, Seung Hong Choi, Taeghwan Hyeon, Dae-Hyeong Kim
Electrochemical analysis of sweat using soft bioelectronics on human skin provides a new route for noninvasive glucose monitoring without painful blood collection. However, sweat-based glucose sensing still faces many challenges, such as difficulty in sweat collection, activity variation of glucose oxidase due to lactic acid secretion and ambient temperature changes, and delamination of the enzyme when exposed to mechanical friction and skin deformation. Precise point-of-care therapy in response to the measured glucose levels is still very challenging...
March 2017: Science Advances
https://www.readbyqxmd.com/read/28334581/a-gap-analysis-needs-assessment-tool-to-drive-a-care-delivery-and-research-agenda-for-integration-of-care-and-sharing-of-best-practices-across-a-health-system
#3
Sherita Hill Golden, Daniel Hager, Lois J Gould, Nestoras Mathioudakis, Peter J Pronovost
BACKGROUND: In a complex health system, it is important to establish a systematic and data-driven approach to identifying needs. The Diabetes Clinical Community (DCC) of Johns Hopkins Medicine's Armstrong Institute for Patient Safety and Quality developed a gap analysis tool and process to establish the system's current state of inpatient diabetes care. METHODS: The collectively developed tool assessed the following areas: program infrastructure; protocols, policies, and order sets; patient and health care professional education; and automated data access...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28320788/effectiveness-of-chronic-care-models-for-the-management-of-type-2-diabetes-mellitus-in-europe-a-systematic-review-and-meta-analysis
#4
Brenda W C Bongaerts, Karsten Müssig, Johan Wens, Caroline Lang, Peter Schwarz, Michael Roden, Wolfgang Rathmann
OBJECTIVES: We evaluated the effectiveness of European chronic care programmes for type 2 diabetes mellitus (characterised by integrative care and a multicomponent framework for enhancing healthcare delivery), compared with usual diabetes care. DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, Embase, CENTRAL and CINAHL from January 2000 to July 2015. ELIGIBILITY CRITERIA: Randomised controlled trials focussing on (1) adults with type 2 diabetes, (2) multifaceted diabetes care interventions specifically designed for type 2 diabetes and delivered in primary or secondary care, targeting patient, physician and healthcare organisation and (3) usual diabetes care as the control intervention...
March 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28319006/high-rates-of-severe-hypoglycemia-among-african-american-patients-with-diabetes-the-surveillance-prevention-and-management-of-diabetes-mellitus-supreme-dm-network
#5
Andrew J Karter, Kasia J Lipska, Patrick J O'Connor, Jennifer Y Liu, Howard H Moffet, Emily B Schroeder, Jean M Lawrence, Gregory A Nichols, Katherine M Newton, Ram D Pathak, Jay Desai, Beth Waitzfelder, Melissa G Butler, Abraham Thomas, John F Steiner
AIMS: Seven-year surveillance study (2005-2011) to evaluate race/ethnic differences in the trends in rates of severe hypoglycemia (SH) in a population of insured, at-risk adults with diabetes. METHODS: SH events were identified via any primary or principal diagnosis from emergency department or inpatient encounters among African American, Asian, Latino and White adult diabetes patients treated with insulin or secretagogues (Sulfonylureas or Meglitinides), receiving care from integrated healthcare delivery systems across the United States...
February 21, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28318091/insulin-responsive-glucagon-delivery-for-prevention-of-hypoglycemia
#6
Jicheng Yu, Yuqi Zhang, Wujin Sun, Anna R Kahkoska, Jinqiang Wang, John B Buse, Zhen Gu
Hypoglycemia, the state of abnormally low blood glucose level, is an acute complication of insulin and sulfonylurea therapy in diabetes management. Frequent insulin dosing and boluses during daily diabetes care leads to an increased risk of dangerously low glucose levels, which can cause behavioral and cognitive disturbance, seizure, coma, and even death. This study reports an insulin-responsive glucagon delivery method based on a microneedle (MN)-array patch for the prevention of hypoglycemia. The controlled release of glucagon is achieved in response to elevated insulin concentration by taking advantage of the specific interaction between insulin aptamer and target insulin...
March 20, 2017: Small
https://www.readbyqxmd.com/read/28303255/active-use-of-electronic-health-records-ehrs-and-personal-health-records-phrs-for-epidemiologic-research-sample-representativeness-and-nonresponse-bias-in-a-study-of-women-during-pregnancy
#7
Julie K Bower, Claire E Bollinger, Randi E Foraker, Darryl B Hood, Abigail B Shoben, Albert M Lai
INTRODUCTION: With the growing use of electronic medical records, electronic health records (EHRs), and personal health records (PHRs) for health care delivery, new opportunities have arisen for population health researchers. Our objective was to characterize PHR users and examine sample representativeness and nonresponse bias in a study of pregnant women recruited via the PHR. DESIGN: Demographic characteristics were examined for PHR users and nonusers. Enrolled study participants (responders, n=187) were then compared with nonresponders and a representative sample of the target population...
2017: EGEMS
https://www.readbyqxmd.com/read/28302210/-risk-factors-for-neonatal-pulmonary-hemorrhage-in-the-neonatal-intensive-care-unit-of-a-municipal-hospital
#8
Jie Fan, Ming-Yan Hei, Xi-Lin Huang, Xiao-Ping Li
OBJECTIVE: To investigate the risk factors for neonatal pulmonary hemorrhage (NPH) in the neonatal intensive care unit (NICU) of a municipal hospital, and to provide a basis for the early identification and treatment of NPH. METHODS: A total of 112 neonates who were admitted to the NICU of Shaoyang Central Hospital of Hunan Province and diagnosed with NPH were enrolled as the case group. A nested case-control method was used to select, as a control group (n=224), the neonates who underwent the treatment with an assisted mechanical ventilator and did not experience pulmonary hemorrhage...
March 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28298369/metabolic-syndrome-in-finnish-women-7%C3%A2-years-after-a-gestational-diabetes-prevention-trial
#9
Jatta Puhkala, Jani Raitanen, Päivi Kolu, Pipsa Tuominen, Pauliina Husu, Riitta Luoto
BACKGROUND: Risk for developing metabolic syndrome (MeS) after delivery is high among women with gestational diabetes mellitus (GDM), but little is known about development of MeS among women with risk factors for GDM during pregnancy. In the present study, we studied the prevalence of MeS 7 years postpartum among women with GDM risk factors during pregnancy, women with early GDM diagnosis and women without GDM risk factors. We also analysed the early pregnancy risk factors associated with MeS...
March 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28298226/addressing-the-double-burden-of-diabetes-and-tuberculosis-lessons-from-kyrgyzstan
#10
Jolene Skordis-Worrall, Jeff Round, Matthias Arnold, Aida Abdraimova, Baktygul Akkazieva, David Beran
BACKGROUND: The incidence of diabetes and tuberculosis co-morbidity is rising, yet little work has been done to understand potential implications for health systems, healthcare providers and individuals. Kyrgyzstan is a priority country for tuberculosis control and has a 5% prevalence of diabetes in adults, with many health system challenges for both conditions. METHODS: Patient exit interviews collected data on demographic and socio-economic characteristics, health spending and care seeking for people with diabetes, tuberculosis and both diabetes and tuberculosis...
March 15, 2017: Globalization and Health
https://www.readbyqxmd.com/read/28282465/are-community-based-nurse-led-self-management-support-interventions-effective-in-chronic-patients-results-of-a-systematic-review-and-meta-analysis
#11
Azzurra Massimi, Corrado De Vito, Ilaria Brufola, Alice Corsaro, Carolina Marzuillo, Giuseppe Migliara, Maria Luisa Rega, Walter Ricciardi, Paolo Villari, Gianfranco Damiani
The expansion of primary care and community-based service delivery systems is intended to meet emerging needs, reduce the costs of hospital-based ambulatory care and prevent avoidable hospital use by the provision of more appropriate care. Great emphasis has been placed on the role of self-management in the complex process of care of patient with long-term conditions. Several studies have determined that nurses, among the health professionals, are more recommended to promote health and deliver preventive programs within the primary care context...
2017: PloS One
https://www.readbyqxmd.com/read/28280744/glycemic-excursions-in-type-1-diabetes-in-pregnancy-a-semiparametric-statistical-approach-to-identify-sensitive-time-points-during-gestation
#12
Resmi Gupta, Jane Khoury, Mekibib Altaye, Lawrence Dolan, Rhonda D Szczesniak
Aim. To examine the gestational glycemic profile and identify specific times during pregnancy that variability in glucose levels, measured by change in velocity and acceleration/deceleration of blood glucose fluctuations, is associated with delivery of a large-for-gestational-age (LGA) baby, in women with type 1 diabetes. Methods. Retrospective analysis of capillary blood glucose levels measured multiple times daily throughout gestation in women with type 1 diabetes was performed using semiparametric mixed models...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28277365/association-of-group-prenatal-care-with-gestational-weight-gain
#13
Michelle A Kominiarek, Amy Crockett, Sarah Covington-Kolb, Melissa Simon, William A Grobman
OBJECTIVE: To compare gestational weight gain among women in group prenatal care with that of women in individual prenatal care. METHODS: In this retrospective cohort study, women who participated in group prenatal care from 2009 to 2015 and whose body mass indexes (BMIs) and gestational weight gain were recorded were matched with the next two women who had the same payer type, were within 2-kg/m prepregnancy BMI and 2-week gestational age at delivery, and had received individual prenatal care...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28267235/red-blood-cells-for-glucose-responsive-insulin-delivery
#14
Chao Wang, Yanqi Ye, Wujin Sun, Jicheng Yu, Jingqiang Wang, David S Lawrence, John B Buse, Zhen Gu
Glucose-responsive delivery of insulin mimicking the function of pancreatic β-cells to achieve meticulous control of blood glucose (BG) would revolutionize diabetes care. Here the authors report the development of a new glucose-responsive insulin delivery system based on the potential interaction between the glucose derivative-modified insulin (Glc-Insulin) and glucose transporters on erythrocytes (or red blood cells, RBCs) membrane. After being conjugated with the glucosamine, insulin can efficiently bind to RBC membranes...
March 7, 2017: Advanced Materials
https://www.readbyqxmd.com/read/28265579/the-next-frontier-in-communication-and-the-eclippse-study-bridging-the-linguistic-divide-in-secure-messaging
#15
REVIEW
Dean Schillinger, Danielle McNamara, Scott Crossley, Courtney Lyles, Howard H Moffet, Urmimala Sarkar, Nicholas Duran, Jill Allen, Jennifer Liu, Danielle Oryn, Neda Ratanawongsa, Andrew J Karter
Health systems are heavily promoting patient portals. However, limited health literacy (HL) can restrict online communication via secure messaging (SM) because patients' literacy skills must be sufficient to convey and comprehend content while clinicians must encourage and elicit communication from patients and match patients' literacy level. This paper describes the Employing Computational Linguistics to Improve Patient-Provider Secure Email (ECLIPPSE) study, an interdisciplinary effort bringing together scientists in communication, computational linguistics, and health services to employ computational linguistic methods to (1) create a novel Linguistic Complexity Profile (LCP) to characterize communications of patients and clinicians and demonstrate its validity and (2) examine whether providers accommodate communication needs of patients with limited HL by tailoring their SM responses...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28259852/supporting-the-management-of-type-2-diabetes-with-pharmacist-led-reviews-an-observational-analysis
#16
Tim Langran, Nithya Nanda, Attia Bataveljic, Javier Gonzalez-Durio
OBJECTIVE: Describe and assess the impact of a pharmacist-led patient review programme on the management and control of type 2 diabetes (T2D). DESIGN: Uncontrolled prospective cohort study with before and after intervention data collection. SETTING: General practices within NHS Slough Clinical Commissioning Group (CCG). PARTICIPANTS: 5910 patients with T2D. INTERVENTIONS: Pharmacists reviewed 5910 patients and worked with general practice teams to schedule any of the 9 key care processes recommended by the National Institute for Health and Care Excellence (NICE) that the patients were lacking, to optimise medication and to make other interventions such as providing lifestyle advice...
March 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28251633/outcome-of-pregnancy-in-women-diagnosed-with-idiopathic-polyhydramnios
#17
Sarwat Khan, Jennifer Donnelly
INTRODUCTION: Polyhydramnios is present in approximately 2% of pregnancies and it has been associated with a variety of adverse pregnancy outcomes. OBJECTIVES: The aim of our study was to evaluate the association between polyhydramnios and adverse pregnancy outcomes. METHODS: This was a retrospective case control study of 288 singleton pregnancies delivered in the Rotunda Hospital, Dublin, between 2013 and 2014. Polyhydramnios was defined as: (i) amniotic fluid index (AFI) ≥ 25 cm; (ii) maximal vertical pocket (MVP) of ≥8 cm; and (iii) a gestational age-specific threshold for AFI...
February 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28247543/improving-diabetes-care-for-people-with-intellectual-disabilities-a-qualitative-study-exploring-the-perceptions-and-experiences-of-professionals-in-diabetes-and-intellectual-disability-services
#18
M Brown, L Taggart, T Karatzias, M Truesdale, R Walley, R Northway, S Macrae, M Carey, M Davies
BACKGROUND: Globally, diabetes is increasing with concerns about the impact on outcomes, including premature death and the costs associated with managing the condition. Research indicates that adults with intellectual disabilities (ID) are two to three times more likely to develop diabetes; however, there has been limited focus on diabetes service utilisation in this population. The aim of this study is to explore the perceptions and experiences of diabetes and ID practitioners. METHODS: A series of 1:1 semi-structured interviews were undertaken in one Scottish health service area...
February 28, 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28246144/population-trends-in-the-10-year-incidence-and-prevalence-of-diabetic-retinopathy-in-the-uk-a-cohort-study-in-the-clinical-practice-research-datalink-2004-2014
#19
Rohini Mathur, Krishnan Bhaskaran, Emma Edwards, Helen Lee, Nishi Chaturvedi, Liam Smeeth, Ian Douglas
OBJECTIVES: To describe trends in the incidence and prevalence of diabetic retinopathy (DR) in the UK by diabetes type, age, sex, ethnicity, deprivation, region and calendar year. DESIGN: Cohort study using the Clinical Practice Research Datalink (CPRD). SETTING: UK primary care. PARTICIPANTS: 7.7 million patients ≥12 contributing to the CPRD from 2004 to 2014. PRIMARY AND SECONDARY OUTCOME MEASURES: Age-standardised prevalence and incidence of diabetes, DR and severe DR (requiring photocoagulation) by calendar year and population subgroup...
February 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28230457/comparative-effectiveness-of-rapid-acting-insulins-in-adults-with-diabetes
#20
Patrick N Racsa, Yunus Meah, Jeffrey J Ellis, Kimberly R Saverno
BACKGROUND: Although there are a variety of insulin products and new delivery modalities available, the absence of direct clinical and economic comparisons can make treatment planning and formulary decision making difficult. Direct comparisons between insulin aspart and insulin lispro from a large heterogeneous population are not available. OBJECTIVE: To assess differences in clinical outcomes, medication adherence, utilization, and total health care costs between aspart and lispro and vial versus pen modalities for administering these short-acting insulin analogs...
March 2017: Journal of Managed Care & Specialty Pharmacy
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