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Inpatient diabetes management

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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
#1
Ariana Pichardo-Lowden, Paul Haidet, Guillermo E Umpierrez
BACKGROUND: The management inpatient hyperglycemia and diabetes requires expertise among many healthcare 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...
February 22, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28196524/financial-barriers-and-adverse-clinical-outcomes-among-patients-with-cardiovascular-related-chronic-diseases-a-cohort-study
#2
David J T Campbell, Braden J Manns, Robert G Weaver, Brenda R Hemmelgarn, Kathryn M King-Shier, Claudia Sanmartin
BACKGROUND: Some patients with cardiovascular-related chronic diseases such as diabetes and heart disease report financial barriers to achieving optimal health. Previous surveys report that the perception of having a financial barrier is associated with self-reported adverse clinical outcomes. We sought to confirm these findings using linked survey and administrative data to determine, among patients with cardiovascular-related chronic diseases, if there is an association between perceived financial barriers and the outcomes of: (1) disease-related hospitalizations, (2) all-cause mortality and (3) inpatient healthcare costs...
February 15, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28153000/effectiveness-of-the-cardiac-diabetes-transcare-program-protocol-for-a-randomised-controlled-trial
#3
Chiung-Jung Jo Wu, John J Atherton, Richard J MacIsaac, Mary Courtney, Anne M Chang, David R Thompson, Karam Kostner, Andrew I MacIsaac, Michael d'Emden, Nick Graves, Steven M McPhail
BACKGROUND: This paper presents a protocol for a randomised controlled trial of the Cardiac-Diabetes Transcare program which is a transitional care, multi-modal self-management program for patients with acute coronary syndrome comorbid with type 2 diabetes. Prior research has indicated people hospitalised with dual cardiac and diabetes diagnoses are at an elevated risk of hospital readmissions, morbidity and mortality. The primary aim of this study is to evaluate the effectiveness (and cost-effectiveness) of a Cardiac-Diabetes Transcare intervention program on 6-month readmission rate in comparison to usual care...
February 2, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28128542/management-of-ambulatory-day-case-endovascular-procedures-for-peripheral-arterial-disease
#4
Alexandra Hauguel, Blandine Maurel, Nicolas Bague, Flora Vulcain-Gouailler, Alain Costargent, Philippe Chaillou, Yann Gouëffic
BACKGROUND: Thanks to exceptional improvements in technological developments and vascular teams' expertise, endovascular repair of peripheral arterial disease (PAD) has drastically increased these past decades. Incidence of PAD rising, pressure to reduce costs and patient's empowerment make outpatient endovascular procedures for PAD an attractive alternative to conventional hospitalization. This review describes outpatient endovascular procedures for PAD in the literature. METHODS: We used PRISMA guidelines and Medline to conduct this systematic review...
January 27, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28123754/resource-use-associated-with-type-2-diabetes-in-africa-the-middle-east-south-asia-eurasia-and-turkey-results-from-the-international-diabetes-management-practice-study-idmps
#5
Juan J Gagliardino, Petar K Atanasov, Juliana C N Chan, Jean C Mbanya, Marina V Shestakova, Prisca Leguet-Dinville, Lieven Annemans
OBJECTIVE: Type 2 diabetes (T2D) and its complications form a global healthcare burden but the exact impact in some geographical regions is still not well documented. We describe the healthcare resource usage (HRU) associated with T2D in Africa, the Middle East, South Asia, Eurasia and Turkey. RESEARCH DESIGN AND METHODS: In the fifth wave of the International Diabetes Management Practices Study (IDMPS; 2011-2012), we collected self-reported and physician-reported cross-sectional data from 8156 patients from 18 countries across 5 regions, including different types of HRU in the previous 3-6 months...
2017: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/28118124/role-of-the-diabetes-educator-in-inpatient-diabetes-management
#6
(no author information available yet)
It is the position of American Association of Diabetes Educators (AADE) that all inpatient interdisciplinary teams include a diabetes educator to lead or support improvement efforts that affect patients hospitalized with diabetes or hyperglycemia. This not only encompasses patient and family education but education of interdisciplinary team members and achievement of diabetes-related organizational quality metrics and performance outcomes.
February 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28107252/multimorbidity-and-the-risk-of-all-cause-30-day-readmission-in-the-setting-of-multidisciplinary-management-of-chronic-heart-failure-a-retrospective-analysis-of-830-hospitalized-patients-in-australia
#7
Joshua F Wiley, Yih-Kai Chan, Yasmin Ahamed, Jocasta Ball, Melinda J Carrington, Barbara Riegel, Simon Stewart
BACKGROUND: Multimorbidity has an adverse effect on health outcomes in hospitalized individuals with chronic heart failure (CHF), but the modulating effect of multidisciplinary management is unknown. OBJECTIVE: The aim of this study was to test the hypothesis that increasing morbidity would independently predict an increasing risk of 30-day readmission despite multidisciplinary management of CHF. METHODS: We studied patients hospitalized for any reason with heart failure receiving nurse-led, postdischarge multidisciplinary management...
January 20, 2017: Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28094135/diabetes-prevention-program-translation-in-the-veterans-health-administration
#8
Tannaz Moin, Laura J Damschroder, Mona AuYoung, Matthew L Maciejewski, Santanu K Datta, Jane E Weinreb, Nanette I Steinle, Charles Billington, Maria Hughes, Fatima Makki, Robert G Holleman, H Myra Kim, Amy S Jeffreys, Linda S Kinsinger, Jennifer A Burns, Caroline R Richardson
INTRODUCTION: This clinical demonstration trial compared the effectiveness of the Veterans Affairs Diabetes Prevention Program (VA-DPP) with an evidence-based usual care weight management program (MOVE!(®)) in the Veterans Health Administration health system. DESIGN: Prospective, pragmatic, non-randomized comparative effectiveness study of two behavioral weight management interventions. SETTING/PARTICIPANTS: Obese/overweight Veterans with prediabetes were recruited from three geographically diverse VA sites between 2012 and 2014...
January 13, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28067472/efficacy-of-basal-bolus-insulin-regimens-in-the-inpatient-management-of-non-critically-ill-patients-with-type-2-diabetes-a-systematic-review-and-meta-analysis
#9
REVIEW
Merete B Christensen, Anders Gotfredsen, Kirsten Nørgaard
BACKGROUND: Hyperglycemia during hospitalization is associated with increased rates of complications and longer hospital stays. Various insulin regimens are used in the inpatient diabetes management of non-critically ill patients. We aimed to assess the efficacy and safety of basal-bolus insulin therapy (BBI) by summarizing evidence from studies of BBI versus sliding scale insulin therapy (SSI) in the management of hospitalized non-critically ill type 2 diabetes patients. METHODS: We searched MEDLINE, EMBASE, Scopus and the Cochrane Library for studies comparing BBI therapy with SSI therapy in hospitalized non-critically ill patients with type 2 diabetes...
January 9, 2017: Diabetes/metabolism Research and Reviews
https://www.readbyqxmd.com/read/28034481/complications-following-outpatient-total-joint-arthroplasty-an-analysis-of-a-national-database
#10
P Maxwell Courtney, Anthony J Boniello, Richard A Berger
BACKGROUND: As outpatient total hip (THA) and knee arthroplasties (TKA) increase in popularity, concerns exist about the safety of discharging patients home the same day. The purpose of this study is to determine the complications associated with outpatient total joint arthroplasty (TJA) and to identify high-risk patients who should be excluded from these protocols. METHODS: We queried the American College of Surgeons-National Surgical Quality Improvement Program database for all patients who underwent primary TKA or THA from 2011 to 2014...
December 14, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28031946/hyperglycemia-during-the-immediate-period-following-liver-transplantation
#11
K Tuesday Werner, Patricia A Mackey, Janna C Castro, Elizabeth J Carey, Harini A Chakkera, Curtiss B Cook
AIM: High blood glucose levels in the hospital are common among transplant recipients. METHODS: Retrospective analysis, stratified by diagnosis of pretransplant diabetes mellitus (DM). RESULTS: Of 346 patients, 96 had pretransplant DM (insulin, n = 60; no insulin, n = 36) and 250 did not. Patients with pretransplant DM had higher inpatient mean glucose levels and more hyperglycemia and hypoglycemia (all p < 0.01). For patients without pretransplant DM, the need for insulin at discharge increased 23% for every 5-year age increase (odds ratio: 1...
March 2016: Future Science OA
https://www.readbyqxmd.com/read/28017586/operative-variables-are-better-predictors-of-postdischarge-infections-and-unplanned-readmissions-in-vascular-surgery-patients-than-patient-characteristics
#12
Caitlin W Hicks, Michael Bronsert, Karl E Hammermeister, William G Henderson, Douglas R Gibula, James H Black, Natalia O Glebova
OBJECTIVE: Although postoperative readmissions are frequent in vascular surgery patients, the reasons for these readmissions are not well characterized, and effective approaches to their reduction are unknown. Our aim was to analyze the reasons for vascular surgery readmissions and to report potential areas for focused efforts aimed at readmission reduction. METHODS: The 2012 to 2013 American College of Surgeons National Quality Improvement Program (ACS NSQIP) data set was queried for vascular surgery patients...
December 22, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28012724/the-evaluation-of-comorbidities-relative-to-length-of-stay-for-total-joint-arthroplasty-patients
#13
Jakub Sikora-Klak, Andrew Gupta, Christopher Bergum, Bradley Zarling, David C Markel
BACKGROUND: The ability to identify those at risk for longer inpatient stay helps providers with postoperative planning and patient expectations. Decreasing length of stay (LOS) in the future will be determined by appropriate patient selection, risk stratification, and preoperative patient optimization. The purpose of this study was to identify factors that place patients at risk for extended postoperative LOSs. METHODS: The study cohort included 2009 primary total knee arthroplasty (TKA) patients and 905 total hip arthroplasty (THA) patients...
November 16, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27994438/comorbidity-and-health-care-visit-burden-in-working-age-commercially-insured-patients-with-diabetic-macular-edema
#14
Szilárd Kiss, Hitesh S Chandwani, Ashley L Cole, Vaishali D Patel, Orsolya E Lunacsek, Pravin U Dugel
PURPOSE: To examine the comorbidity profile and update estimates of health care resource utilization for commercially insured, working-age adults with diabetic macular edema (DME) relative to a matched comparison group of diabetic adults without DME. Additional comparisons were made in the subgroup of pseudophakic patients. PATIENTS AND METHODS: A retrospective matched-cohort study of commercially insured diabetic adults aged 18-63 years was conducted using medical and outpatient pharmacy claims (July 1, 2008-June 30, 2013)...
2016: Clinical Ophthalmology
https://www.readbyqxmd.com/read/27967230/pathophysiology-and-management-of-hypoglycemia-in-end-stage-renal-disease-patients-a-review
#15
Roma Y Gianchandani, Shristi Neupane, Jennifer J Iyengar, Michael Heung
OBJECTIVE: This review focuses on hypoglycemia in patients with end stage renal disease (ESRD). It discusses pathophysiology of glucose metabolism in the kidney, the impact of dialysis on glucose and insulin metabolism and the challenges of glucose monitoring in ESRD. The clinical relevance of these changes are reviewed in relation to altered blood glucose targets and modification of antidiabetes therapy to prevent hypoglycemia. Based on current data and guidelines, recommendations for the outpatient and inpatient setting are provided for diabetes management in ESRD...
December 14, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27967226/use-of-a-computer-guided-glucose-management-system-to-improve-glycemic-control-and-address-national-quality-measures-a-7-year-retrospective-observational-study-at-a-tertiary-care-teaching-hospital
#16
Robert J Tanenberg, Sandra Hardee, Caitlin Rothermel, Almond J Drake
Objectives Inpatient hyperglycemia, hypoglycemia, and glucose variability are associated with increased mortality. The use of electronic Glucose Management Systems (eGMS) to guide intravenous (IV) insulin infusion have been found to significantly improve blood glucose (BG) control. This retrospective observational study evaluated the 7-year (1/2009-12/2015) impact of the EndoTool(®) eGMS in intensive and intermediate units at Vidant Medical Center, a 900-bed tertiary teaching hospital. Methods Patients assigned to eGMS had indications for IV insulin infusion, including uncontrolled diabetes, stress hyperglycemia, and/or post-operative BG levels >140 mg/dL...
December 14, 2016: Endocrine Practice
https://www.readbyqxmd.com/read/27928991/mortality-in-patients-with-diabetes-mellitus-and-addison-s-disease-a-nationwide-matched-observational-cohort-study
#17
Dimitrios Chantzichristos, Anders Persson, Björn Eliasson, Mervete Miftaraj, Stefan Franzén, Ragnhildur Bergthorsdottir, Soffia Gudbjörnsdottir, Ann-Marie Svensson, Gudmundur Johannsson
OBJECTIVE: Our hypothesis was that patients with diabetes mellitus obtain an additional risk of death if they develop Addison's disease (AD). DESIGN AND METHODS: Nationwide, matched, observational cohort study cross-referencing the Swedish National Diabetes Register with Inpatient, Cancer and Cause of Death Registers in patients with diabetes (type 1 and 2) and AD and matched controls with diabetes. Clinical characteristics at baseline, overall, and cause-specific mortality were assessed...
January 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27913984/basal-insulin-persistence-associated-factors-and-outcomes-after-treatment-initiation-a-retrospective-database-study-among-people-with-type-2-diabetes-mellitus-in-japan
#18
Irene Hadjiyianni, Urvi Desai, Shuichi Suzuki, Jasmina I Ivanova, Dachuang Cao, Noam Y Kirson, Dai Chida, Caroline Enloe, Howard G Birnbaum, Magaly Perez-Nieves
INTRODUCTION: The objective of this study was to assess basal insulin persistence, associated factors, and economic outcomes for insulin-naïve people with type 2 diabetes mellitus (T2DM) in Japan. METHODS: People aged at least 18 years with T2DM with first claim for basal insulin between May 2006 and April 2013 (index date), no insulin use before index date, and continuous insurance coverage for 6 months before (baseline) and 12 months after index date were selected from the Japan Medical Center Database...
February 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/27903117/risk-factors-associated-with-the-surgical-management-of-craniopharyngiomas-in-pediatric-patients-analysis-of-1961-patients-from-a-national-registry-database
#19
Joshua Bakhsheshian, Diana L Jin, Ki-Eun Chang, Ben A Strickland, Dan A Donoho, Steven Cen, William J Mack, Frank Attenello, Eisha A Christian, Gabriel Zada
OBJECTIVE Patient demographic characteristics, hospital volume, and admission status have been shown to impact surgical outcomes of sellar region tumors in adults; however, the data available following the resection of craniopharyngiomas in the pediatric population remain limited. The authors sought to identify potential risk factors associated with outcomes following surgical management of pediatric craniopharyngiomas. METHODS The Nationwide Inpatient Sample database and Kids' Inpatient Database were analyzed to include admissions for pediatric patients (≤ 18 years) who underwent a transcranial or transsphenoidal craniotomy for resection of a craniopharyngioma...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27864954/prevalence-of-comorbidity-and-associated-risk-factors-in-adults-with-atopic-dermatitis
#20
A Egeberg, Y M F Andersen, G H Gislason, L Skov, J P Thyssen
BACKGROUND: Atopic dermatitis (AD) is a common chronic skin disorder, which may persist into adulthood; however, the prevalence of comorbidities in patients with AD is not well characterized. AD is considered a systemic disorder like psoriasis, which has raised a need for data on the comorbidity profile of patients with AD, to assess the potential risks, benefits, and complications in management of patients with AD. We described the occurrence of medical and psychiatric comorbidities and associated risk factors in adults with AD compared with psoriasis and the general population...
November 16, 2016: Allergy
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