Practical Diabetes最新文献

{"title":"Who owns health data anyway?","authors":"Louise R Curtis","doi":"10.1002/pdi.2472","DOIUrl":"https://doi.org/10.1002/pdi.2472","url":null,"abstract":"Data driven technologies have revolutionised the management of diabetes allowing people to take a greater role in their care; however, use of such systems creates tremendous quantities of data. We have become accustomed to the sharing of data within the health care professional relationship. For example, someone with type 1 diabetes who experiences hypoglycaemia may explore their glucose profile with their diabetes specialist team. This is acceptable to both parties as there is an implicit trust underpinned by confidentiality and a shared goal. What happens when a third party with their own business interest is introduced to that relationship? Who owns that data? There is an increasingly insistent call for people to take control of ‘their’ data framed as the right of ownership with quotes such as ‘Who owns the data owns the future’ becoming well-worn clichés where the alternatives include the risk of exploitation by ‘surveillance capitalism’.1 Health data is far more than that held in clinical records with collective health data being greater than the sum of its parts. All data can be seen as health data with an estimated 80–90% generated outside of the clinical setting.2 From grocery shopping to sleep habits, walking speed to typing speed, patient-generated health data (PGHD) combines all factors that can reflect an individual's health. Despite the concept of personal ownership of one's data coming into the public awareness following the Cambridge Analytica scandal,3 there has been a proliferation and ubiquity in data intensive software generating PGHD such as health and wellness apps, heart rate wrist monitors and nutrition programmes. This ‘self- tracking’ is marketed as a means to gain self-awareness and improved wellbeing.4 It has been shown that motion data from a smartphone can predict behaviour and mental state of the user,5 so how much more might the tremendous volume of data from continuous glucose monitoring, bolus advisors and insulin requirements in a hybrid closed-loop system predict? Cross reference this with an online calendar, geolocation, spending patterns, sleep and menstrual cycle and you gain an in-depth understanding into someone's life beyond the remit of their diabetes care. Ensuring that the collection, use and access of these data meets the expectations of the public is essential to maintain the professional relationship.6 From the perspective of UK law, health data does not have an extensive system of specific rules like those that govern intellectual property. Arguably, even if this were developed, the advantages of a property framework to govern health information may be limited. The monetary value of one person's data points is likely to be insignificant as value lies in collective data from a population. It is also unclear whether legal ownership would provide patients access to the data economy. Perhaps more pertinently from a health perspective is whether legal ownership of health data would enhance self-care and ","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital enabled learning for people with diabetes post <scp>COVID</scp>‐19 pandemic","authors":"Joan RS McDowell, Salma Mehar, Raj S Chandok, Wendy A Watson","doi":"10.1002/pdi.2477","DOIUrl":"https://doi.org/10.1002/pdi.2477","url":null,"abstract":"Abstract The COVID‐19 pandemic was the catalyst for a rapid increase in digital learning for people with diabetes. This paper aims to discuss the research on digital learning and the impact and synergy of COVID‐19 on health inequalities, and present some digital educational resources. Copyright © 2023 John Wiley &amp; Sons.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135639065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting gestational diabetes mellitus by first trimester HbA1c: a retrospective study in women with moderate to severe obesity","authors":"J. Balani, S. Hyer, Antoinette Johnson, H. Shehata","doi":"10.1002/pdi.2466","DOIUrl":"https://doi.org/10.1002/pdi.2466","url":null,"abstract":"This study aimed to investigate the utility of first trimester HbA1c in predicting gestational diabetes mellitus (GDM) in obese women with Grade II–III obesity. HbA1c was measured during the first trimester in 160 obese women. A 75g oral glucose tolerance test (OGTT) was performed between 24–28 weeks gestation and GDM diagnosed by WHO criteria.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"10 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86756060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health literacy, self‐management and glycaemic control in persons living with type 2 diabetes mellitus: a cross‐sectional study","authors":"Tiffany Lori Nugent, A. Galea, R. Sammut","doi":"10.1002/pdi.2467","DOIUrl":"https://doi.org/10.1002/pdi.2467","url":null,"abstract":"Aims. The aim of this study was to explore the relationship between health literacy and diabetes self‐management and control among adults living with type 2 diabetes.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"48 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76911298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of asking about wellbeing in a diabetes foot clinic","authors":"C. Bewsey","doi":"10.1002/pdi.2465","DOIUrl":"https://doi.org/10.1002/pdi.2465","url":null,"abstract":"The onset of diabetes foot complications signals a new stage of diabetes progression. Amputation may be the result of such difficulties and can impact upon all aspects of a person's life such as mobility, independence, relationships, and possible loss of earning potential, all likely triggers of distress.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"15 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74727899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing diabetes and dementia, a challenging duo: a scoping review","authors":"Florence Sharkey, V. Coates","doi":"10.1002/pdi.2469","DOIUrl":"https://doi.org/10.1002/pdi.2469","url":null,"abstract":"This paper aims to describe experiences and challenges when managing diabetes along with dementia from the perspectives of those living with these conditions, their informal carers and health care professionals.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"98 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78017791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Action4Diabetes: a non‐profit organisation bridging the type 1 diabetes gap in Southeast Asia","authors":"Sze May Ng","doi":"10.1002/pdi.2463","DOIUrl":"https://doi.org/10.1002/pdi.2463","url":null,"abstract":"Global incidence and challenges of type 1 diabetes Type 1 diabetes (T1D) is a chronic disease that affects millions of people around the world. The International Diabetes Federation (IDF) reports that the global incidence of T1D is estimated to be around 15 cases per 100,000 population per year.1 There has been a global increase in the incidence of T1D over the past few decades, particularly in children under the age of five. The reasons for this increase in incidence are not well understood, but it is thought to be due to a combination of genetic and environmental factors. In the UK, around 400,000 people are affected by T1D and life expectancy is reduced in people with T1D.2 Diabetes remains a leading cause of blindness in people of working age, the leading cause of renal failure and second most common cause of lower limb amputation. While the condition can be managed with proper treatment and care, those living in low-middle income countries (LMICs) often lack access to the necessary resources, resulting in poor health outcomes for many living with T1D.1 In LMICs, T1D is often diagnosed late due to limited access to health care services and diagnostic tools. This delay in diagnosis can result in high mortality rates from diabetic ketoacidosis (DKA). Once diagnosed, managing T1D in LMICs can be a challenge. The cost of insulin and other medications can be prohibitively expensive, and many people do not have access to blood glucose monitoring devices, blood glucose strips or other essential diabetes supplies. As a result, many people with T1D in these countries must rely on inadequate treatment options putting their health at risk of lifelong complications such as nerve damage, blindness, and kidney failure.3","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"51 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88962604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Highlights from the Diabetes UK Professional Conference 2023","authors":"K. Bishop","doi":"10.1002/pdi.2470","DOIUrl":"https://doi.org/10.1002/pdi.2470","url":null,"abstract":"The Diabetes UK Professional Conference 2023 saw health care professionals from around the world arrive in Liverpool for the three‐day event. The programme saw experts in all aspects of diabetes sharing their skills and knowledge, allowing attendees to develop their own practice, as well as providing tantalising insights into the future of diabetes care. Dr Katherine Bishop reports on some of the highlights from the conference.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"1 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91397019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fear in diabetes","authors":"R. Hillson","doi":"10.1002/pdi.2462","DOIUrl":"https://doi.org/10.1002/pdi.2462","url":null,"abstract":"T woman touched the snake’s flickering tongue. She was fascinated, and completely unafraid. Indeed, she kept asking to touch the poisonous snakes too, and they had to stop her picking up the tarantula. She found the haunted house funny and scared one of the ‘monsters’ by poking it in the head. The fearless subject of these unusual experiments is SM who has Urbach-Wiethe disease. This condition includes bilateral destruction of the amygdala. ‘SM provides a rare glimpse into the adverse consequences of living life without the amygdala. For SM, the consequences have been severe. Her behavior, time and time again, leads her back to the very situations she should be avoiding, highlighting the indispensable role that the amygdala plays in promoting survival by compelling the organism away from danger. Indeed, it appears that without the amygdala, the evolutionary value of fear is lost.’1","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"5 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89340754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of menstrual hormonal fluctuations on the glycaemic control in women with type 1 diabetes mellitus","authors":"C. Milionis, I. Ilias, E. Venaki, E. Koukkou","doi":"10.1002/pdi.2468","DOIUrl":"https://doi.org/10.1002/pdi.2468","url":null,"abstract":"Information on physiological processes that affect insulin action and glycaemia is of paramount importance in the treatment of type 1 diabetes mellitus because optimal blood glucose control can prevent or decelerate microvascular complications. In insulin‐deficient premenopausal women, sensitivity to exogenous insulin seems to be lower during ovulation and in the luteal phase compared to the follicular phase. This difference directly affects glucose management. The risk for hyperglycaemia is oftentimes higher in the second half of the catamenial cycle, while hypoglycaemic events may occur more often in the follicular phase. Ovarian steroids (oestradiol and progesterone) are probable modulating factors in insulin action. Rising oestradiol during midcycle and high progesterone in the secretory phase of the menstrual cycle may contribute to insulin resistance. The underlying physiological mechanisms are largely unknown. It is possible that progesterone enhances gluconeogenesis in the liver and oestradiol binds to insulin and its receptor, thereby increasing resistance to insulin. These actions remain to be clarified. Additional factors related to the catamenial cycle may also facilitate variability in insulin sensitivity. The presence of glycaemic changes during the menstrual cycle is not consistent among premenopausal women with type 1 diabetes. The variability of blood glucose throughout the menstrual cycle should be considered when adjusting insulin dosage in susceptible subjects. Copyright © 2023 John Wiley & Sons.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"44 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74839202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}