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management of diabetes in primary care

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https://www.readbyqxmd.com/read/28341364/decreased-access-to-bariatric-care-an-analysis-of-referral-practices-to-bariatric-specialists
#1
John A Primomo, Tanyaradzwa Kajese, Garth Davis, Robert Davis, Shinil Shah, Maddie Orsak, Christina Morrison
BACKGROUND: Substantial evidence reveals tolerability and co-morbid disease resolution after bariatric surgery; however, few physicians refer morbidly obese patients for bariatric consultation. OBJECTIVE: To evaluate morbidly obese patient access to bariatric surgical consultation. SETTING: A multidisciplinary, private, bariatric center of excellence. METHODS: Patient surveyed in person regarding preconsultation co-morbidities, physician discussion and support for bariatric surgery, and physician referral practices...
November 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28338247/impact-of-diabetic-ketoacidosis-management-in-the-medical-intensive-care-unit-after-order-set-implementation
#2
Benjamin Laliberte, Siu Yan Amy Yeung, Jeffrey P Gonzales
OBJECTIVE: To determine the rate of compliance to the 2006 and 2009 ADA DKA guidelines in the medical intensive care unit (MICU) at a large academic medical centre after the implementation of a computerised DKA order set and protocol. METHODS: Retrospective chart review of adult patients with DKA admitted to the MICU. Results of pre-order set (PRE) were compared to those of data post-order set (POST). The primary outcome was a composite administration of intravenous fluid resuscitation in the first 24 h, insulin bolus and initial insulin infusion rate...
March 24, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28337055/diabetic-retinopathy-knowledge-awareness-and-practices-of-physicians-in-primary-care-centers-in-riyadh-saudi-arabia
#3
Raghad Al Rasheed, Fadwa Al Adel
PURPOSE: Diabetic retinopathy (DR) is a serious cause of irreversible blindness and is the most common complication of diabetes. Annual fundus examination for diabetics aids in the prevention of blindness and allows intervening at a timely manner. As primary care physicians (PCP) are the main providers for diabetic care in Saudi Arabia, we aim to evaluate the current knowledge and awareness, and to assess practices among PCP regarding DR. METHODS: We conducted a cross-sectional study covering 46 randomly selected primary-care centers in Riyadh during October 2015...
January 2017: Saudi Journal of Ophthalmology: Official Journal of the Saudi Ophthalmological Society
https://www.readbyqxmd.com/read/28336505/internet-based-self-management-support-for-patients-with-well-controlled-type-2-diabetes-a-real-life-study
#4
Huberta E Hart, Inge Etm Geilen, Elke de Leeuw, Guy Ehm Rutten, Rimke C Vos
BACKGROUND: Little attention has been paid to self-management support of patients with well-controlled type 2 diabetes mellitus (T2DM). Most studies evaluated the addition of self-management support to regular diabetes care, but self-management as an alternative for part of regular diabetes care has hardly been studied. In this study, we offered patients with well-controlled T2DM the opportunity to perform the 3 quarterly monitoring sessions at home using an Internet-based self-management program, resulting in online personalized advice...
March 23, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28335809/poor-uptake-of-an-online-intervention-in-a-cluster-randomised-controlled-trial-of-online-diabetes-education-for-rural-general-practitioners
#5
Christine L Paul, Leon Piterman, Jonathan E Shaw, Catherine Kirby, Kristy L Forshaw, Jennifer Robinson, Isaraporn Thepwongsa, Robert W Sanson-Fisher
BACKGROUND: In Australia, rural and remote communities have high rates of diabetes-related death and hospitalisation. General practitioners (GPs) play a major role in diabetes detection and management. Education of GPs could optimise diabetes management and improve patient outcomes at a population level. The study aimed to describe the uptake of a continuing medical education intervention for rural GPs and its impact on the viability of a cluster randomised controlled trial of the effects of continuing medical education on whole-town diabetes monitoring and control...
March 23, 2017: Trials
https://www.readbyqxmd.com/read/28330453/a-systematic-review-of-primary-care-models-for-non-communicable-disease-interventions-in-sub-saharan-africa
#6
Jennifer Kane, Megan Landes, Christopher Carroll, Amy Nolen, Sumeet Sodhi
BACKGROUND: Chronic diseases, primarily cardiovascular disease, respiratory disease, diabetes and cancer, are the leading cause of death and disability worldwide. In sub-Saharan Africa (SSA), where communicable disease prevalence still outweighs that of non-communicable disease (NCDs), rates of NCDs are rapidly rising and evidence for primary healthcare approaches for these emerging NCDs is needed. METHODS: A systematic review and evidence synthesis of primary care approaches for chronic disease in SSA...
March 23, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28330385/health-effectiveness-of-community-health-workers-as-a-diabetes-self-management-intervention
#7
Judith Aponte, Tranice D Jackson, Katarzyna Wyka, Cyril Ikechi
OBJECTIVE: To evaluate the health effectiveness of community health workers among three groups (intervention, attentional control and control groups) of Hispanic adults with uncontrolled (HbA1c >8%) type 2 diabetes mellitus. METHODS: This was a randomized clinical trial involving 180 English- and Spanish-speaking Hispanic individuals with uncontrolled type 2 diabetes mellitus, 40-74 years of age, who received diabetes care at an outpatient, public, urban hospital...
March 1, 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/28327875/compliance-with-the-prescription-of-antihypertensive-medications-and-blood-pressure-control-in-primary-care
#8
Mayra Faria Novello, Maria Luiza Garcia Rosa, Ranier Tagarro Ferreira, Icaro Gusmão Nunes, Antonio José Lagoeiro Jorge, Dayse Mary da Silva Correia, Wolney de Andrade Martins, Evandro Tinoco Mesquita
Background: Hypertension is the most prevalent risk factor for cardiovascular disease, and its proper control can prevent the high morbidity and mortality associated with this disease. Objective: To assess the degree of compliance of antihypertensive prescriptions with the VI Brazilian Guidelines on Hypertension and the blood pressure control rate in primary care. Methods: Cross-sectional study conducted between August 2011 and November 2012, including 332 adults ≥ 45 years registered in the Family Doctor Program in Niteroi and selected randomly...
February 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28327157/factors-influencing-implementation-of-a-patient-decision-aid-in-a-developing-country-an-exploratory-study
#9
Wen Ting Tong, Yew Kong Lee, Chirk Jenn Ng, Ping Yein Lee
BACKGROUND: Most studies on barriers and facilitators to implementation of patient decision aids (PDAs) are conducted in the west; hence, the findings may not be transferable to developing countries. This study aims to use a locally developed insulin PDA as an exemplar to explore the barriers and facilitators to implementing PDAs in Malaysia, an upper middle-income country in Asia. METHODS: Qualitative methodology was adopted. Nine in-depth interviews (IDIs) and three focus group discussions (FGDs) were conducted with policymakers (n = 6), medical officers (n = 13), diabetes educators (n = 5) and a nurse, who were involved in insulin initiation management at an academic primary care clinic...
March 21, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28324867/blood-glucose-levels-and-glycaemic-burden-in-76-341-patients-attending-primary-care-bittersweet-findings-from-a-9-year-cohort-study
#10
Melinda J Carrington, Neale Cohen, Joshua F Wiley
AIMS: Diabetes care is principally applied in the primary care setting whereby we examined trends in glycaemic levels and goals and estimated avoidable glycaemic burden. METHODS: We retrieved glycated haemoglobin (HbA1C) results and glucose-lowering prescription records from a patient-based medical database during 2005-2013. There were 275,480 available HbA1C measurements from 76,341 individuals managed by 960 general practitioners from 321 clinics across Australia...
February 27, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28323533/success-in-weight-management-among-patients-with-type-2-diabetes-do-perceived-autonomy-support-autonomous-motivation-and-self-care-competence-play-a-role
#11
Anne M Koponen, Nina Simonsen, Sakari B Suominen
Based on self-determination theory (SDT), this study investigated whether the three central SDT variables-perceived autonomy support (from a physician), autonomous motivation and self-care competence-were associated with success in weight management (SWM) among primary care patients with type 2 diabetes when the effect of other important life-context factors was controlled for. Patients participated in a mail survey in 2011. Those who had tried to change their health behavior during the past two years in order to lose weight, either with or without success (n = 1433, mean age 63 years, 50% men), were included in this study...
March 21, 2017: Behavioral Medicine
https://www.readbyqxmd.com/read/28322884/cardiovascular-disease-screening-in-general-practice-general-practitioner-recording-of-common-risk-factors
#12
Lyle R Turner, Flavia Cicuttini, Christopher Pearce, Danielle Mazza
The assessment and screening of individual risk factors for cardiovascular disease (CVD) is a critical component of CVD prevention strategies in general practice (GP). This study sought to examine current CVD risk factor recording as recommended by Australian guidelines for the management of absolute cardiovascular disease risk. A retrospective analysis of routine GP data from 149,306 GP patients aged 45years and above in eastern Melbourne was conducted. Data were collected from GP clinics located throughout inner east Melbourne from July 2011 to September 2014 through the Melbourne East Monash General Practice Database...
March 16, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28321314/obesity-paradox-and-mortality-in-adults-with-and-without-incident-type-2-diabetes-a-matched-population-level-cohort-study
#13
Ellena Badrick, Matthew Sperrin, Iain E Buchan, Andrew G Renehan
OBJECTIVE: Among adults with type 2 diabetes (T2D), several (but not all) studies show that being overweight (body mass index (BMI): 25.0-29.9 kg/m(2)) or obese I (BMI: 30.0-34.9 kg/m(2)) near the time of diagnosis, is unexpectedly associated with reduced all-cause mortality compared with normal weight-the obesity paradox. We addressed whether this observation is causal (eg, a true protective effect); due to confounding (including effect modification); or due to selection ('collider') bias...
2017: BMJ Open Diabetes Research & Care
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
#14
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/28320325/-was-that-a-success-or-not-a-success-a-qualitative-study-of-health-professionals-perspectives-on-support-for-people-with-long-term-conditions
#15
John Owens, Vikki A Entwistle, Alan Cribb, Zoë C Skea, Simon Christmas, Heather Morgan, Ian S Watt
BACKGROUND: Support for self-management (SSM) is a prominent strand of health policy internationally, particularly for primary care. It is often discussed and evaluated in terms of patients' knowledge, skills and confidence, health-related behaviours, disease control or risk reduction, and service use and costs. However, these goals are limited, both as guides to professional practice and as indicators of its quality. In order to better understand what it means to support self-management well, we examined health professionals' views of success in their work with people with long-term conditions...
March 20, 2017: BMC Family Practice
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
#16
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/28318938/diabetes-nurse-case-management-in-a-canadian-tertiary-care-setting-results-of-a-randomized-controlled-trial
#17
Danni Li, Tom Elliott, Gerri Klein, Ehud Ur, Tricia S Tang
OBJECTIVES: To examine the effects of a 6-month nurse case manager (NCM) intervention compared to standard care (SC) on glycemic control and diabetes distress in a Canadian tertiary-care setting. METHODS: We recruited 140 adults with type 2 diabetes and glycated hemoglobin (A1C) levels >8% (64 mmol/mol) from 2 tertiary care facilities and randomized them to: 1) a 6-month NCM intervention in addition to SC or 2) SC by the primary endocrinologists. Assessments were conducted at baseline and at 6 months...
March 17, 2017: Canadian Journal of Diabetes
https://www.readbyqxmd.com/read/28316316/colonic-diverticulosis-and-diverticulitis-in-renal-transplant-recipients-management-and-long-term-outcomes
#18
Ahmet Rencuzogullari, Gokhan Ozuner, Sinan Binboga, Erman Aytac, Venkatesh Krishnamurthi, Emre Gorgun
Data regarding management of colonic diverticulitis in renal transplant recipients (RTRs) are limited. This study aims to identify prevalence, risk factors, and outcomes in RTRs with colonic diverticulosis and diverticulitis. Between January 2004 and December 2013, all patients who underwent kidney transplantation were analyzed. Among all RTSs, patients who had a pretransplant colonoscopic diagnosis of diverticulosis and patients with a proven attack of diverticulitis were included in our analysis. There were 1578 RTRs with a mean age of 50 ± 14 years at the time of transplantation...
March 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28314499/bringing-global-health-home-the-case-of-global-to-local-in-king-county-washington
#19
EDITORIAL
Adam Taylor, Fareeha Siddiqui
The article describes the experience of testing successful global health interventions in the cities of SeaTac and Tukwila, Washington-2 very diverse, underserved communities outside of Seattle that experience significant health disparities compared with surrounding areas in King County. Topics covered include an overview of the partnership that established Global to Local, the process of engaging Seattle-based global health institutions in identifying global health strategies to test, identifying communities experiencing health disparities that might benefit from global health-inspired interventions, engaging those local communities to understand the perceived drivers of poor health outcomes, tailoring global interventions to the local context, launching programs, and the successes and challenges that have emerged throughout this process...
November 2016: Annals of Global Health
https://www.readbyqxmd.com/read/28306609/when-peers-count-the-effects-on-integrated-type-ii-diabetes-care-of-communication-within-general-practitioner-only-subgroups-in-interprofessional-primary-care-teams
#20
Amelia Compagni, Patrizio Armeni, Stefano Tasselli
BACKGROUND: Primary care teams (hereafter referred to as primary care units [PCUs]) composed of general practitioners (GPs), nurses, and specialist doctors have recently been established in the Italian context, with the main aim of improving integrated care for chronic diseases. PURPOSES: The aim of the study was to assess whether the increased professional diversity of PCUs has resulted in an improvement in the integrated care of type II diabetes and to identify a potential mechanism mediating this effect...
March 16, 2017: Health Care Management Review
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