Practical Diabetes最新文献

{"title":"Adding psychology to the diabetes service ‘new patient’ pathway: an evaluation","authors":"J. Heath","doi":"10.1002/pdi.2458","DOIUrl":"https://doi.org/10.1002/pdi.2458","url":null,"abstract":"Promotion of psychology as an integrated aspect of the diabetes team has been encouraged, with the aims of: reducing stigma felt by service users accessing this aspect of the multidisciplinary team, allowing for a biopsychosocial overview of patient care, and timely advising on appropriate signposting and onwards referral where necessary. To this end, a new care pathway was trialled, with psychology appointments offered as the third step in a new nurse‐ and dietitian‐led clinic structure.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"29 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88931745","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":"Improving diabetes care in Ealing, London: an analysis of the NDA and diabetes‐related admissions data during first year of COVID‐19","authors":"Raj Chandok, Ken Baynes, Maurice Birnbaum, G. Vanterpool, Adamma Okwu, Kanchan Bains, Diljit Sidhu, Mini Dhatt, S. Mehar, B. Chitra","doi":"10.1002/pdi.2437","DOIUrl":"https://doi.org/10.1002/pdi.2437","url":null,"abstract":"In this paper, we present and analyse National Diabetes Audit (NDA) and diabetes‐related emergency admissions data in Ealing during the period 1 January 2020 to 31 March 2021. Care for diabetes and other long‐term conditions was disrupted and significantly impacted during this initial period of the COVID‐19 pandemic.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"11 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72514835","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":"Identifying patients with diabetes in a day‐case systemic anti‐cancer therapy population: the Belfast Regional Oncology Centre experience","authors":"Adam Waterworth, A. Hamilton, P. Johnston, A. Todd, Grainne M. Connolly, A. Nugent, P. Scullin, S. McKenna, S. Lawless, H. Wallace, I. Wallace","doi":"10.1002/pdi.2456","DOIUrl":"https://doi.org/10.1002/pdi.2456","url":null,"abstract":"Patients undergoing systemic anti‐cancer treatment (SACT) often receive short courses of high dose steroids which may cause hyperglycaemia and potentially impact negatively on clinical outcomes. In this study we aimed to ascertain the prevalence of diabetes in a day‐case SACT cohort and secondly to compare practical methods of identifying patients with diabetes in a busy oncology service.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"70 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88137677","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 weather's no joke for people living with diabetes","authors":"M. Greener","doi":"10.1002/pdi.2459","DOIUrl":"https://doi.org/10.1002/pdi.2459","url":null,"abstract":"Climate change – presaging heat waves and cold snaps – along with drivers for global warming are likely to affect the epidemiology and management of diabetes, warns Mark Greener in his examination here of the published evidence to date.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"55 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76908912","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":"An eye opener: improving attendance rates of retinopathy screening within the paediatric diabetes clinic","authors":"M. Wolverson, P. O’Hare, V. Patel","doi":"10.1002/pdi.2433","DOIUrl":"https://doi.org/10.1002/pdi.2433","url":null,"abstract":"Aims: To audit eye screening attendance rates in children pre and post implementation of a screening service offered on the same day as their diabetes clinic appointment and to identify characteristics of non‐attenders.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"49 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90677207","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":"Diabetes Care for You: leadership, followership, partnership","authors":"David Lipscomb, E. Rezazadeh, Jane Rowney","doi":"10.1002/pdi.2436","DOIUrl":"https://doi.org/10.1002/pdi.2436","url":null,"abstract":"The 2022 Mary MacKinnon lecture reminds us of some of the history of the development of out of hospital specialist diabetes services in the United Kingdom. There have been multiple clarion calls across the years to collaborate, share information and values and break down traditional boundaries in the pursuit of improved patient care and outcomes. Along with this, we note the roles of clinical and managerial leadership, followership and partnership in working together with people living with diabetes to co‐produce a model of diabetes care and then to ensure through good stewardship of shared resources that the expectations of that change are delivered for our population. We go on to discuss how the Diabetes Care for You team has continued to innovate and provide care during the pandemic and conclude with a vision of the future and a challenge for decision makers to put the needs of the population at the forefront of future planning. Copyright © 2023 John Wiley & Sons.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"117 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86807938","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":"Promising outcomes from latest landmark diabetes trials: tirzepatide and finerenone in the spotlight","authors":"Lakshmi Sankaran, L. Curtis","doi":"10.1002/pdi.2432","DOIUrl":"https://doi.org/10.1002/pdi.2432","url":null,"abstract":"SURPASS trials The incretin hormones, glucose-dependent insulinotropic polypeptide (GIP) and glucagon line peptide 1 (GLP-1), are responsible for the increased insulin secretion from oral, as compared to intravenous, glucose administration which increases the amount of glucose ingested – known as the ‘incretin effect’. Incretins also slow down the digestion of food so that glucose from your meals takes longer to be absorbed, and thereby appetite is reduced with resulting weight loss. This has been exploited therapeutically by GLP-1 receptor agonists and dipeptidyl peptidase (DPP4) inhibitors. SURPASS is an array of double-blind, randomised phase 3 trials studying tirzepatide, a novel dual GIP and GLP-1 receptor agonist, a weekly subcutaneous injection in people with type 2 diabetes. The preceding 2018 phase 2 trials showed supportive results leading to much anticipation for this ‘twincretin’. Each trial included four arms of 5mg, 10mg and 15mg tirzepatide and placebo. The primary endpoint was mean change in HbA1c along with secondary outcomes of change in body weight and achieving target HbA1c. SURPASS-11 investigated tirzepatide monotherapy in 478 participants with a short duration of diabetes across 40 weeks (mean baseline HbA1c 63mmol/mol [7.9%], age 54, diabetes duration 4.7years, BMI 31.9kg/m2). HbA1c reductions were 21mmol/mol (1.9%), 21mmol/mol (1.9%) and 23mmol/mol (2%) with 5mg, 10mg and 15mg tirzepatide respectively. A dose dependent weight loss of 7–9.2kg was seen. SURPASS-22 was a 40-week head-to-head study of tirzepatide vs injectable semaglutide in 1879 people with a mean diabetes duration of 8.6 years. Tirzepatide showed improved outcomes with a 23–27mmol/mol (2.1–2.5%) vs 21mmol/mol (1.9%) HbA1c reduction and weight reductions of 7.6–11.2kg vs 5.7kg. Comparatively, the best weight loss seen in the phase 3 semaglutide SUSTAIN-7 trials was 6.5kg (mean baseline 95.2kg, duration of diabetes 7.4 years) and 20mmol/mol (1.8%) HbA1c drop. SURPASS-33 compared tirzepatide against the basal insulin degludec in 1444 participants taking metformin with or without an SGLT2 inhibitor. After 52 weeks, all three tirzepatide arms had decreased bodyweight (-7.5kg to -12.9kg), whereas insulin patients’ bodyweight increased by 2.3kg. Mean tirzepatide HbA1c reduction was 21–25mmol/mol(1.9–2.3%) vs 14mmol/mol (1.3%). The SURPASS-MRI sub-study4 involved participants with non-alcoholic fatty liver disease. Liver fat content was measured by MRI-proton density fat fraction with an absolute reduction of 8.1% in the pooled 10mg and 15mg tirzepatide groups vs 3.4% with insulin degludec. SURPASS-45 recruited a high cardiovascular risk cohort (87% had a previous event), who had lived with diabetes for a median of 10.5 years and mean HbA1c 69.7mmol/L (8.5%) despite multiple oral antihyperglycaemics. In a head-to-head 52-week trial vs insulin glargine U100, 5mg, 10mg and 15mg doses of tirzepatide led to HbA1c reductions of 24mmol/mol (2.2%), 26mmol/mol (2.4%) and 2","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"50 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85288926","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":"Impact of using fasting plasma glucose and HbA1c instead of OGTT as a screening tool for gestational diabetes: a retrospective study","authors":"Hannah Cooke, Stephen Craig, H. Kahal, F. Talbot, K. Lonnen","doi":"10.1002/pdi.2434","DOIUrl":"https://doi.org/10.1002/pdi.2434","url":null,"abstract":"Aims: To examine the impact of using the Royal College of Obstetricians and Gynaecologists (RCOG) COVID‐19 Gestational Diabetes (GDM) criteria on identifying women with GDM.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"48 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84869457","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 inequalities and diabetes","authors":"A. Kilvert, C. Fox","doi":"10.1002/pdi.2435","DOIUrl":"https://doi.org/10.1002/pdi.2435","url":null,"abstract":"Inequalities in health care exist in many countries in the world. In 2008 the then UK Secretary of State for Health commissioned the Marmot review, ‘Fair Society, Healthy Lives’, to propose strategies to address health inequalities in the UK. Most of Marmot's proposals were not acted upon and in 2020, 10 years after the initial recommendations were published, Marmot found that there had been no improvement and some things were worse.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"46 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76328859","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":"Chronic kidney disease awareness and updates on the management of diabetic kidney disease","authors":"Wigdan Hamza, J. Burton","doi":"10.1002/pdi.2454","DOIUrl":"https://doi.org/10.1002/pdi.2454","url":null,"abstract":"The prevalence of chronic kidney disease (CKD) is rising worldwide and is a major contributor to morbidity and mortality. It is estimated to affect over 800 million people globally.","PeriodicalId":20309,"journal":{"name":"Practical Diabetes","volume":"17 1","pages":""},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87514084","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}