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Diabetes Mellitus care

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https://www.readbyqxmd.com/read/28230459/estimated-cost-effectiveness-cost-benefit-and-risk-reduction-associated-with-an-endocrinologist-pharmacist-diabetes-intense-medical-management-tune-up-clinic
#1
Jan D Hirsch, Mark Bounthavong, Anisa Arjmand, David R Ha, Christine L Cadiz, Andrew Zimmerman, Heather Ourth, Anthony P Morreale, Steven V Edelman, Candis M Morello
BACKGROUND: In 2012 U.S. diabetes costs were estimated to be $245 billion, with $176 billion related to direct diabetes treatment and associated complications. Although a few studies have reported positive glycemic and economic benefits for diabetes patients treated under primary care physician (PCP)-pharmacist collaborative practice models, no studies have evaluated the cost-effectiveness of an endocrinologist-pharmacist collaborative practice model treating complex diabetes patients versus usual PCP care for similar patients...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230446/economic-impact-of-treatment-duration-and-persistence-with-basal-insulin-in-previously-insulin-naive-users
#2
Samaneh Kalirai, Ran Duan, Dongju Liu, Beverly L Reed
BACKGROUND: Although insulin is a well-established therapy that is associated with improved clinical outcomes, adherence and persistence with insulin regimens are poor in patients with type 2 diabetes mellitus (T2DM). Diabetes-related health care costs and the impact of insulin persistence patterns on these health care costs have been previously studied; however, these aspects of insulin therapy have limited data beyond the first year of use and have not been characterized among patients previously naive to basal insulin...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230312/five-year-cost-effectiveness-of-patient-empowerment-programme-pep-for-type-2-diabetes-mellitus-in-primary-care
#3
J X Lian, Sarah M McGhee, C So, J Chau, Carlos Kh Wong, William Cw Wong, Cindy Lk Lam
This study evaluated the short-term cost-effectiveness of the Patient Empowerment Programme (PEP) for diabetes mellitus in Hong Kong. Propensity score matching was used to select a matched group of PEP and non-PEP subjects. A societal perspective was adopted to estimate the cost of PEP. The outcome measures were the cumulative incidence of all-cause mortality and diabetic complication over a five-year follow-up and the number needed to treat (NNT) to avoid one event. The incremental cost-effectiveness ratio (ICER) of cost per event avoided was calculated using the PEP cost per subject multiplied by the NNT...
February 23, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28228865/identification-of-beta-cell-dysfunction-at-the-pre-symptomatic-stage-of-diabetes-mellitus-by-novel-analytical-system-liquid-biopsy-measurements-in-femtograms
#4
REVIEW
Kurt Krapfenbauer
BACKGROUND: Diabetes mellitus is produced and progresses as a consequence of complex and gradual processes, in which a variety of alterations of the endocrine pancreas, are involved and which mainly result in beta cell failure. Those molecular alterations can be found in the bloodstream, which suggests that we could quantify specific biomarkers in plasma or serum by very sensitive methods before the onset diabetes mellitus is diagnosed. However, classical methods of protein analysis such as electrophoresis, Western blot, ELISA, and liquid chromatography are generally time-consuming, lab-intensive, and not sensitive enough to detect such alteration in a pre-symptomatic state of the disease...
December 2017: EPMA Journal
https://www.readbyqxmd.com/read/28226036/development-of-a-booklet-on-insulin-therapy-for-children-with-diabetes-mellitus-type-1
#5
Denizielle de Jesus Moreira Moura, Nádya Dos Santos Moura, Luciana Catunda Gomes de Menezes, Ariane Alves Barros, Maria Vilani Cavalcante Guedes
Objective: to describe the process of developing of an educational booklet on insulin therapy for children with diabetes mellitus type 1. Method: methodological approach, in which the following steps were carried out: selecting of the content and type of technology to be developed (for this step, an integrative review, an analysis of the comments of blogs about Diabetes Mellitus type 1 and interviews with the children were performed), creation of images, formatting and layout composition...
January 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/28224127/early-diagnosis-and-surgical-treatment-for-necrotizing-fasciitis-a-multicenter-study
#6
Evangelos P Misiakos, George Bagias, Iordanis Papadopoulos, Nickolaos Danias, Paul Patapis, Nickolaos Machairas, Theodore Karatzas, Nickolaos Arkadopoulos, Konstantinos Toutouzas, Nickolaos Alexakis, Manousos N Konstantoulakis, George Zografos, Vasilis Smyrniotis, Gregory Kouraklis, Anastasios Machairas
BACKGROUND: Necrotizing fasciitis (NF) is a group of relatively rare infections, usually caused by two or more pathogens. It affects the skin and subcutaneous tissues of lower and upper limbs, perineal area (Fournier's gangrene), and the abdominal wall. Early diagnosis and aggressive surgical management are of high significance for the management of this potentially lethal disease. METHODS: We conducted a retrospective study in patients who presented, during the last decade, at four University Surgical Departments in the area of Athens, Greece, with an admission diagnosis of NF...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28223446/management-of-nonalcoholic-fatty-liver-disease-in-patients-with-type-2-diabetes-a-call-to-action
#7
REVIEW
Fernando Bril, Kenneth Cusi
Traditionally a disease of hepatologists, nonalcoholic fatty liver disease (NAFLD) has recently become a major concern for a broad spectrum of health care providers. Endocrinologists and those caring for patients with type 2 diabetes mellitus (T2DM) are at center stage, as T2DM appears to worsen the course of NAFLD and the liver disease makes diabetes management more challenging. However, the nature of this relationship remains incompletely understood. Although the increasing prevalence of NAFLD is frequently attributed to the epidemic of obesity and is often oversimplified as the "hepatic manifestation of the metabolic syndrome," it is a much more complex disease process that may also be observed in nonobese individuals and in patients without clinical manifestations of the metabolic syndrome...
March 2017: Diabetes Care
https://www.readbyqxmd.com/read/28220976/evaluation-of-a-new-hemoglobin-a1c-analyzer-for-point-of-care-testing
#8
Rui Zhou, Wei Wang, Zhi-Xin Song, Qing Tong, Qing-Tao Wang
BACKGROUND: There has been an increasing desire for the use of point-of-care testing (POCT) by both primary care clinicians and patients. This study aimed to evaluate the performance of a new POCT analyzer for hemoglobin A1c (HbA1c) testing. METHODS: We assessed the accuracy, precision, and linearity of the POCT HbA1c analyzer (A1C EZ 2.0) with the Tosoh G8 Analyzer as comparative instrument, following the Clinical and Laboratory Standards Institute (CLSI) protocols...
February 21, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28218263/non-alcoholic-fatty-liver-disease-an-emerging-driving-force-in-chronic-kidney-disease
#9
REVIEW
Giovanni Targher, Christopher D Byrne
Non-alcoholic fatty liver disease (NAFLD) is caused by an accumulation of fat in the liver; the condition can progress over time to increase the risk of developing cirrhosis, end-stage liver disease and hepatocellular carcinoma. The prevalence of NAFLD is increasing rapidly owing to the global epidemics of obesity and type 2 diabetes mellitus (T2DM), and NAFLD has been predicted to become the most important indication for liver transplantation over the next decade. It is now increasingly clear that NAFLD not only affects the liver but can also increase the risk of developing extra-hepatic diseases, including T2DM, cardiovascular disease and chronic kidney disease (CKD), which have a considerable impact on health-care resources...
February 20, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28217598/five-year-comparison-of-diabetic-control-between-community-diabetic-center-and-primary-health-care-centers
#10
Mazen S Ferwana, Abdulaziz Alshamlan, Wedad Al Madani, Bader Al Khateeb, Amen Bawazir
CONTEXT: Hyperglycemia is the most important factor for development of complications. A high level of hemoglobin A1c (HbA1c) is linked with such complications of diabetes. AIMS: The aim of this study was to compare diabetic care between community diabetic center (CDC) and primary health centers. SETTINGS AND DESIGN: This was a retrospective cohort study conducted at King Abdulaziz Medical City for National Guard Health Affairs at Riyadh, Saudi Arabia...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217523/safe-and-pragmatic-use-of-sodium-glucose-co-transporter-2-inhibitors-in-type-2-diabetes-mellitus-south-asian-federation-of-endocrine-societies-consensus-statement
#11
REVIEW
Sanjay Kalra, Sujoy Ghosh, A H Aamir, Md Tofail Ahmed, Mohammod Feroz Amin, Sarita Bajaj, Manash P Baruah, Uditha Bulugahapitiya, A K Das, Mimi Giri, Sonali Gunatilake, Saeed A Mahar, Md Faruque Pathan, Nazmul Kabir Qureshi, S Abbas Raza, Rakesh Sahay, Santosh Shakya, Dina Shreshta, Noel Somasundaram, Manilka Sumanatilleke, A G Unnikrishnan, Achini Madushani Wijesinghe
Diabetes prevalence shows a continuous increasing trend in South Asia. Although well-established treatment modalities exist for type 2 diabetes mellitus (T2DM) management, they are limited by their side effect profile. Sodium-glucose co-transporter 2 inhibitors (SGLT2i) with their novel insulin-independent renal action provide improved glycemic control, supplemented by reduction in weight and blood pressure, and cardiovascular safety. Based on the clinical outcomes with SGLT2i in patients with T2DM, treatment strategies that make a "good clinical sense" are desirable...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28217520/elevated-glycated-hemoglobin-predicts-macrosomia-among-asian-indian-pregnant-women-wings-9
#12
Balaji Bhavadharini, Manni Mohanraj Mahalakshmi, Mohan Deepa, Ranjani Harish, Belma Malanda, Arivudainambi Kayal, Anne Belton, Ponnusamy Saravanan, Unnikrishnan Ranjit, Ram Uma, Ranjit Mohan Anjana, Viswanathan Mohan
AIM: The aim of this study was to determine the optimal glycated hemoglobin (HbA1c) cut point for diagnosis of gestational diabetes mellitus (GDM) and to evaluate the usefulness of HbA1c as a prognostic indicator for adverse pregnancy outcomes. METHODS: HbA1c estimations were carried out in 1459 pregnant women attending antenatal care centers in urban and rural Tamil Nadu in South India. An oral glucose tolerance test was carried out using 75 g anhydrous glucose, and GDM was diagnosed using the International Association of the Diabetes and Pregnancy Study Groups criteria...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28217499/factors-associated-with-high-stress-levels-in-adults-with-diabetes-mellitus-attending-a-tertiary-diabetes-care-center-chennai-tamil-nadu-india
#13
Muthappan Sendhilkumar, Jaya Prasad Tripathy, Anthony D Harries, Amol R Dongre, Mohan Deepa, Ashok Vidyulatha, Subramanian Poongothai, Ulaganathan Venkatesan, Ranjit Mohan Anjana, Viswanathan Mohan
OBJECTIVE: We aimed to determine perceived stress levels among adults aged >20 years with type 2 diabetes mellitus (DM) in a tertiary care diabetes center, Chennai, Tamil Nadu, India, assess their association with sociodemographic and clinical characteristics and assess the possible risk factors for stress and coping strategies. METHODS: A mixed-methods (triangulation design) study with quantitative methodology (survey) and qualitative methodology (interviews) was carried out...
January 2017: Indian Journal of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28216809/healing-ulcers-and-preventing-their-recurrences-in-the-diabetic-foot
#14
S Raja Sabapathy, Madhu Periasamy
Fifteen percent of people with diabetes develop an ulcer in the course of their lifetime. Eighty-five percent of the major amputations in diabetes mellitus are preceded by an ulcer. Management of ulcers and preventing their recurrence is important for the quality of life of the individual and reducing the cost of care of treatment. The main causative factors of ulceration are neuropathy, vasculopathy and limited joint mobility. Altered bio-mechanics due to the deformities secondary to neuropathy and limited joint mobility leads to focal points of increased pressure, which compromises circulation leading to ulcers...
September 2016: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/28215423/chads2-score-predicts-postoperative-atrial-fibrillation-in-patients-undergoing-elective-pulmonary-lobectomy
#15
Svetlana Kotova, Mansen Wang, Katie Lothrop, Gary Grunkemeier, Heather E Merry, John R Handy
BACKGROUND: Postoperative atrial fibrillation (PAF) affects 12% to 17% of patients undergoing lobectomy and is associated with increased morbidity. CHADS2 (congestive heart failure history, hypertension history, age ≥75 years, diabetes mellitus history, and stroke or transient ischemic attack symptoms previously) is used to predict stroke risk in patients with existing AF. It also has been shown also to predict new-onset PAF. Our objective was to determine whether CHADS2 can predict PAF in patients undergoing lobectomy...
February 16, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28213828/screening-for-non-alcoholic-fatty-liver-disease-in-children-and-adolescents-with-type-1-diabetes-mellitus-a-cross-sectional-analysis
#16
Sebastian Kummer, Dirk Klee, Gerald Kircheis, Michael Friedt, Joerg Schaper, Dieter Häussinger, Ertan Mayatepek, Thomas Meissner
: The liver is intensely involved in glucose metabolism and is thereby closely related to diabetes pathophysiology. Adult patients with type 1 diabetes mellitus (DM) are at an increased risk for non-alcoholic fatty liver disease (NAFLD). Here, we studied the prevalence of NAFLD in a cohort of children and adolescents with type 1 DM in a tertiary care paediatric diabetes centre in Germany. We screened 93 children and adolescents with type 1 DM using ultrasound, laboratory investigations, and liver stiffness measurements (Fibroscan® [FS] and acoustic radiation force imaging [ARFI])...
February 17, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/28213597/retrospective-examination-of-lipid-lowering-treatment-patterns-in-a-real-world-high-risk-cohort-in-the-uk-in-2014-comparison-with-the-national-institute-for-health-and-care-excellence-nice-2014-lipid-modification-guidelines
#17
Dylan L Steen, Irfan Khan, David Ansell, Robert J Sanchez, Kausik K Ray
BACKGROUND: In 2014, guidelines from the National Institute for Health and Care Excellence (NICE) provided updated recommendations on lipid-modifying therapy (LMT). We assessed clinical practice contemporaneous to release of these guidelines in a UK general practice setting for secondary and high-risk primary-prevention populations, and extrapolated the findings to UK nation level. METHODS: Patients from The Health Improvement Network database with the following criteria were included: lipid profile in 2014 (index date); ≥20 years of age; ≥2 years representation in database prior to index; ≥1 statin indication either for atherosclerotic cardiovascular disease (ASCVD) or the non-ASCVD conditions high-risk diabetes mellitus and/or chronic kidney disease...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28212974/costs-and-outcomes-of-increasing-access-to-bariatric-surgery-cohort-study-and-cost-effectiveness-analysis-using-electronic-health-records
#18
Martin C Gulliford, Judith Charlton, Toby Prevost, Helen Booth, Alison Fildes, Mark Ashworth, Peter Littlejohns, Marcus Reddy, Omar Khan, Caroline Rudisill
OBJECTIVES: To estimate costs and outcomes of increasing access to bariatric surgery in obese adults and in population subgroups of age, sex, deprivation, comorbidity, and obesity category. METHODS: A cohort study was conducted using primary care electronic health records, with linked hospital utilization data, for 3,045 participants who underwent bariatric surgery and 247,537 participants who did not undergo bariatric surgery. Epidemiological analyses informed a probabilistic Markov model to compare bariatric surgery, including equal proportions with adjustable gastric banding, gastric bypass, and sleeve gastrectomy, with standard nonsurgical management of obesity...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28211609/comparison-of-body-mass-index-at-diagnosis-of-diabetes-in-a-multiethnic-population-a-case-control-study-with-matched-non-diabetic-controls
#19
Sanjoy K Paul, Ebenezer S Owusu Adjah, Mayukh Samanta, Kiran Patel, Srikanth Bellary, Wasim Hanif, Kamlesh Khunti
AIMS: To investigate the probability of developing type 2 diabetes mellitus (T2DM) at different body mass index compared to matched non-diabetic controls in a multi-ethnic population. MATERIALS AND METHODS: Case-control study of 90,367 patients with incident diabetes and 362,548 age-sex-ethnicity matched controls from UK primary care. Probability of developing T2DM was estimated. RESULTS: Case and control patients were 56 years old at index and 56% were male...
February 17, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28210870/diabetes-related-burden-and-distress-in-people-with-diabetes-mellitus-at-primary-care-level-in-germany
#20
N Kuniss, T Rechtacek, C Kloos, U A Müller, J Roth, K Burghardt, G Kramer
AIMS: The importance of diabetes-related distress for the treatment of diabetes is emphasised in national and international guidelines recommending routinely screening for psychosocial problems. Data of investigations regarding diabetes-related distress on primary care are rare in Germany though most people with diabetes are treated without insulin therapy at primary care level. METHODS: Three hundred and forty-five people with diabetes mellitus type 2 (DM2, n = 336, 229 without and 107 with insulin therapy) and type 1 (DM1, n = 9) were interviewed with the PAID questionnaire in the period from 1 October 2015 to 31 December 2015 in a general practice...
February 16, 2017: Acta Diabetologica
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