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Inpatient diabetes management

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https://www.readbyqxmd.com/read/28511417/effectiveness-of-a-four-week-diet-regimen-exercise-and-psychological-intervention-for-weight-loss
#1
Tobias Weinreich, Hans-Peter Filz, Ursula Gresser, Barbara M Richartz
INTRODUCTION: Obesity is accompanied by restriction in the quality of life and an increased risk of morbidity and mortality. Cardiovascular, orthopedic, and metabolic disorders are among the possible consequences. In the management of obesity, a combination therapy that includes dietary, exercise, and behaviour modules has proven its worth. AIM: To evaluate the effect of weight-associated parameters, circulation associated parameters, glucose metabolism, body composition and life quality changes within a four-week inpatient rehabilitation program...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28507433/effect-of-pharmaceutical-care-on-clinical-outcomes-of-outpatients-with-type-2-diabetes-mellitus
#2
Hua Shao, Guoming Chen, Chao Zhu, Yongfei Chen, Yamin Liu, Yuxing He, Hui Jin
BACKGROUND: In the People's Republic of China, outpatients have limited time with their physicians. Thus, compared to inpatients, outpatients have lower medication adherence and are less knowledgeable about their disease. OBJECTIVE: The objective of this study was to evaluate the effect of pharmaceutical care on clinical outcomes of outpatients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS: A randomized, controlled, prospective clinical trial was conducted recruiting a total of 240 T2DM outpatients from Zhongda Hospital, Southeast University...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28504012/inpatient-glycemic-management-in-internal-medicine-an-observational-multicenter-study-in-nanjing-china
#3
Shujie Hao, Ning Zhang, Anne Folta Fish, Xiaodan Yuan, Lin Liu, Fan Li, Zhaohui Fang, Qingqing Lou
Aims To evaluate the prevalence of hyperglycemia among inpatients in internal medicine, and specifically, to assess the glycemic management of inpatients in non-endocrinology departments in three large urban hospitals in China. Methods A multicenter observational study was conducted using electronic health records, and a survey of 1939 patients who were admitted to internal medicine units and followed until discharge. Those with previously diagnosed diabetes, newly diagnosed diabetes, or impaired fasting glucose were included...
May 13, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28477328/can-chronic-disease-be-managed-through-integrated-care-cost-effectively-evidence-from-a-systematic-review
#4
J Cronin, A Murphy, E Savage
BACKGROUND: The increase in demand for integrated care models to manage chronic disease is a challenge for the Irish health system, which is traditionally organised around the acute hospital services. Implementing integrated care programmes requires significant investment, and thus, their economic impact requires consideration. AIMS: This paper updates the previous evidence on the cost-effectiveness of integrated care programmes to support the development of a cost-effective integrated care programme for chronic disease management...
May 5, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28458523/results-of-a-pilot-study-of-patient-to-patient-education-strategy-on-self-management-among-glycemic-uncontrolled-patients-with-diabetes
#5
Yingying Xiang, Pingyan Luo, Xueqin Cai, Yuqin Tang, Zhongming Wu
OBJECTIVES: The purpose of this study was to assess the efficacy and practicability of patient-to-patient (PTP) education strategy on glycemic control among patients with type 2 diabetes mellitus. METHODS: Eligible subjects from outpatient clinic were recruited and randomized to either intervention group or control group. Inpatients with poor outcomes and complications acted as mentors to share their experience with the intervention group in three tailored classes...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28455681/multidimensional-improvements-induced-by-an-intensive-obesity-inpatients-rehabilitation-programme
#6
Francesca Giordano, Michela Berteotti, Simona Budui, Nicole Calgaro, Laura Franceschini, Federica Gilli, Marina Masiero, Guido Raschellà, Sabrina Salvetti, Micol Taddei, Federico Schena, Luca Busetto
PURPOSE: To analyse the short-term effectiveness of an intensive multidimensional inpatient programme specifically developed for patients with severe obesity. METHODS: A multidisciplinary team managed a 3-week residential programme characterised by the integration of nutritional and physical rehabilitation with psychological and educational intervention. All patients consecutively admitted in 10 months were analysed at admission and discharge for changes in the following domains: anthropometry (weight, body mass index (BMI), waist and neck circumferences), cardiovascular risk factors (glycaemia, HbA1c, lipid profile, blood pressure), quality of life, eating behaviour, and physical performance (VO2peak by incremental cycle ergometer test, 6-min walking test (6MWT), chair stands test)...
April 28, 2017: Eating and Weight Disorders: EWD
https://www.readbyqxmd.com/read/28455179/nonelective-primary-total-hip-arthroplasty-the-effect-of-discharge-destination-on-postdischarge-outcomes
#7
Chirag K Shah, Aakash Keswani, Debbie Chi, Alex Sher, Karl M Koenig, Calin S Moucha
BACKGROUND: Medicare has enacted a mandatory bundled payment program for primary total joint arthroplasty that includes nonelective primary total hip arthroplasty (THA). Efficient postacute care management has been identified as an opportunity to improve value for patients. We aimed to identify risk factors for and compare rates of complications by discharge destination and then use those factors to risk-stratify non-elective THA patients. METHODS: Patients who underwent nonelective primary THA from 2011 to 2014 were identified in the American College of Surgeons National Surgical Quality Improvement Program database and categorized into those discharged to skilled nursing facility or inpatient rehabilitation facility vs home self-managed/home health (HHH)...
March 30, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28437321/medical-expenditures-associated-with-diabetes-among-youth-with-medicaid-coverage
#8
Sundar S Shrestha, Ping Zhang, Theodore J Thompson, Edward W Gregg, Ann Albright, Giuseppina Imperatore
BACKGROUND: Information on diabetes-related excess medical expenditures for youth is important to understand the magnitude of financial burden and to plan the health care resources needed for managing diabetes. However, diabetes-related excess medical expenditures for youth covered by Medicaid program have not been investigated recently. OBJECTIVE: To estimate excess diabetes-related medical expenditures among youth aged below 20 years enrolled in Medicaid programs in the United States...
April 21, 2017: Medical Care
https://www.readbyqxmd.com/read/28429611/consensus-statement-on-inpatient-use-of-continuous-glucose-monitoring
#9
Amisha Wallia, Guillermo E Umpierrez, Robert J Rushakoff, David C Klonoff, Daniel J Rubin, Sherita Hill Golden, Curtiss B Cook, Bithika Thompson
In June 2016, Diabetes Technology Society convened a panel of US experts in inpatient diabetes management to discuss the current and potential role of continuous glucose monitoring (CGM) in the hospital. This discussion combined with a literature review was a follow-up to a meeting, which took place in May 2015. The panel reviewed evidence on use of CGM in 3 potential inpatient scenarios: (1) the intensive care unit (ICU), (2) non-ICU, and (3) transitioning outpatient CGM use into the hospital setting. Panel members agreed that data from limited studies and theoretical considerations suggested that use of CGM in the hospital had the potential to improve patient clinical outcomes, and in particular reduction of hypoglycemia...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28358229/intractable-acute-pain-related-to-fluoroquinolone-induced-peripheral-neuropathy
#10
Matthew Dukewich, Arash Danesh, Chiemeka Onyima, Anita Gupta
Fluoroquinolones are widely prescribed antibiotics, used for various infectious etiologies. These antibiotics carry the possibility of the serious adverse effect of peripheral neuropathy, with a true incidence not known owing to its rare existence. Recently, the Food and Drug Administration (FDA) has required alterations to drug labels to highlight this adverse effect of fluoroquinolones. This is a case report of a single patient at an inpatient neurology service at an urban academic medical center in the United States...
March 30, 2017: Journal of Pain & Palliative Care Pharmacotherapy
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
#11
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/28333367/community-paramedicine-applied-in-a-rural-community
#12
Kevin J Bennett, Matt W Yuen, Melinda A Merrell
RESEARCH OBJECTIVE: Abbeville County Emergency Management Services (ACEMS) began a community paramedicine (CP) program to utilize trained paramedics to serve patients who frequently use the emergency department (ED) and have 1 or more of the following diagnoses: hypertension, diabetes, chronic heart failure, asthma, and chronic obstructive pulmonary disease. The objective of this study was to determine if the CP program reduced ED visits in Abbeville while improving patient outcomes. DESIGN: A pre/posttest with a comparison group study design was used to evaluate the CP program...
March 23, 2017: Journal of Rural Health
https://www.readbyqxmd.com/read/28325798/management-of-inpatient-hyperglycemia-and-diabetes-in-older-adults
#13
Guillermo E Umpierrez, Francisco J Pasquel
Adults aged 65 years and older are the fastest growing segment of the U.S. population, and their number is expected to double to 89 million between 2010 and 2050. The prevalence of diabetes in hospitalized adults aged 65-75 years and over 80 years of age has been estimated to be 20% and 40%, respectively. Similar to general populations, the presence of hyperglycemia and diabetes in elderly patients is associated with increased risk of hospital complications, longer length of stay, and increased mortality compared with subjects with normoglycemia...
April 2017: Diabetes Care
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
#14
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...
May 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28315826/early-invasive-strategy-and-in-hospital-survival-among-diabetics-with-non-st-elevation-acute-coronary-syndromes-a-contemporary-national-insight
#15
Ahmed N Mahmoud, Islam Y Elgendy, Hend Mansoor, Xuerong Wen, Mohammad K Mojadidi, Anthony A Bavry, R David Anderson
BACKGROUND: There are limited data on the merits of an early invasive strategy in diabetics with non-ST-elevation acute coronary syndrome, with unclear influence of this strategy on survival. The aim of this study was to evaluate the in-hospital survival of diabetics with non-ST-elevation acute coronary syndrome treated with an early invasive strategy compared with an initial conservative strategy. METHODS AND RESULTS: The National Inpatient Sample database, years 2012-2013, was queried for diabetics with a primary diagnosis of non-ST-elevation acute coronary syndrome defined as either non-ST-elevation myocardial infarction or unstable angina (unstable angina)...
March 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28290224/inpatient-continuous-glucose-monitoring-and-glycemic-outcomes
#16
David L Levitt, Kristi D Silver, Elias K Spanakis
Continuous glucose monitoring (CGM) is commonly used in the outpatient setting to improve diabetes management. CGM can provide real-time glucose trends, detecting hyperglycemia and hypoglycemia before the onset of clinical symptoms. In 2011, at the time the Endocrine Society CGM guidelines were published, the society did not recommend inpatient CGM as its efficacy and safety were unknown. While many studies have subsequently evaluated inpatient CGM accuracy and reliability, glycemic outcome studies have not been widely published...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28274344/the-prevalence-of-diabetes-mellitus-and-abnormal-glucose-metabolism-in-the-inpatient-psychiatric-setting-a-systematic-review-and-meta-analysis
#17
REVIEW
Emmert Roberts, Leah Jones, Alexandra Blackman, Thomas Dewhurst, Faith Matcham, Carol Kan, Omar Mustafa, Toral Thomas, Najma Siddiqi, Khalida Ismail, Hermione Price
OBJECTIVE: To systematically determine the prevalence of diabetes mellitus (DM), impaired fasting glucose (IFG), and impaired glucose tolerance (IGT) in psychiatric inpatients and explore the impact of patient and study variables on prevalence estimates. METHOD: We searched EMBASE, PsychINFO, Medline and CENTRAL from database inception until 1st December 2015. We included studies of any design reporting prevalence of abnormal glucose metabolism in any adult psychiatric inpatients...
March 2017: General Hospital Psychiatry
https://www.readbyqxmd.com/read/28271422/the-obesity-epidemic-in-the-veterans-health-administration-prevalence-among-key-populations-of-women-and-men-veterans
#18
Jessica Y Breland, Ciaran S Phibbs, Katherine J Hoggatt, Donna L Washington, Jimmy Lee, Sally Haskell, Uchenna S Uchendu, Fay S Saechao, Laurie C Zephyrin, Susan M Frayne
BACKGROUND: Most US adults are overweight or obese. Understanding differences in obesity prevalence across subpopulations could facilitate the development and dissemination of weight management services. OBJECTIVES: To inform Veterans Health Administration (VHA) weight management initiatives, we describe obesity prevalence among subpopulations of VHA patients. DESIGN: Cross-sectional descriptive analyses of fiscal year 2014 (FY2014) national VHA administrative and clinical data, stratified by gender...
April 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28238154/the-gestio-protocol-experience-safety-of-a-standardized-order-set-for-subcutaneous-insulin-regimen-in-elderly-hospitalized-patients
#19
Alessandro Franchin, Alberto Maran, Daniela Bruttomesso, Maria L Corradin, Francesco Rossi, Federica Zanatta, Gian-Maria Barbato, Nicola Sicolo, Enzo Manzato
BACKGROUNDS: In non-critical hospitalized patients with diabetes mellitus, guidelines suggest subcutaneous insulin therapy with basal-bolus regimen, even in old and vulnerable inpatients. AIM: To evaluate safety, efficacy, and benefit on clinical management of the GesTIO protocol, a set of subcutaneous insulin administration rules, in old and vulnerable non-ICU inpatients. METHODS: Retrospective, observational study. Patients admitted to Geriatric Clinic of Padua were studied...
February 25, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28225312/perspectives-on-learning-and-clinical-practice-improvement-for-diabetes-in-the-hospital-a-review-of-educational-interventions-for-providers
#20
Ariana Pichardo-Lowden, Paul Haidet, Guillermo E Umpierrez
OBJECTIVE: The management of inpatient hyperglycemia and diabetes requires expertise among many health-care providers. There is limited evidence about how education for healthcare providers can result in optimization of clinical outcomes. The purpose of this critical review of the literature is to examine methods and outcomes related to educational interventions regarding the management of diabetes and dysglycemia in the hospital setting. This report provides recommendations to advance learning, curricular planning, and clinical practice...
May 2017: Endocrine Practice
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