Diabetes Spectrum最新文献

{"title":"Feasibility Study to Assess the Incorporation of the Diabetes Distress Assessment System and Diabetes Distress Scale Into a Veterans Administration Diabetes Clinic Practice.","authors":"Beth D Greck, Paula Geigle, Mara Vitolins","doi":"10.2337/ds24-0070","DOIUrl":"10.2337/ds24-0070","url":null,"abstract":"<p><strong>Objective: </strong>Diabetes affects nearly 25% of the Veterans Health Administration population, and a diagnosis of diabetes has been reported to increase distress in patients. This study aimed to assess the feasibility of incorporating a diabetes distress (DD) screening program in a Veterans Administration (VA) diabetes clinic and identifying opportunities for intervention.</p><p><strong>Research design and methods: </strong>Veterans diagnosed with diabetes attending appointments with the clinical pharmacist practitioner in the endocrinology diabetes clinic were asked to participate. Veterans diagnosed with cognitive impairment and/or unable to answer multi-part questions were excluded. Veterans who agreed to participate were asked to complete the two-question Diabetes Distress Scale (DDS2) screening tool and then complete the Type 1 Diabetes Distress Scale (T1-DDS) or the Type 2 Diabetes Distress Assessment System (T2-DDAS), if indicated.</p><p><strong>Results: </strong>Eighty-seven veterans were identified to complete the DD2S, and 58 (67%) agreed. The mean DDS2 score was 3.2 ± 1.3. Twenty of the 32 participants (67%) who were then offered the T1-DDS or T2-DDAS completed it. A majority of those with a score indicating at least moderate distress accepted a referral to a Whole Health health coach for follow-up.</p><p><strong>Conclusion: </strong>Veterans were interested in completing the DD2S and the T1-DDS or T2-DDAS. This feasibility study was conducted to develop a foundation for larger trials to identify the optimal approach to identifying DD and providing proper referrals for interventions to address it. Successful integration of DD screening into daily clinical practice in VA clinics could improve diabetes care for veterans.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 3","pages":"274-278"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357195/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Insulin Dosage After the Addition of Tirzepatide Compared With Semaglutide or Dulaglutide in Patients With Type 2 Diabetes.","authors":"Delaney B McKone, Karolyn S Duprey, Hayley M Hall, Abigail Leonhard, Aric Schadler, Kristina W Naseman","doi":"10.2337/ds24-0035","DOIUrl":"10.2337/ds24-0035","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate insulin dose requirements after the addition of the dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide 1 (GLP-1) receptor agonist tirzepatide compared with the GLP-1 receptor agonists injectable semaglutide and dulaglutide in people with type 2 diabetes.</p><p><strong>Research design and methods: </strong>This was a retrospective cohort study using chart review of electronic health records to identify patients from a single academic medical center with type 2 diabetes who were initiated on tirzepatide, injectable semaglutide, or dulaglutide from 1 July 2021 to 31 May 2023 while on concomitant insulin therapy (basal with or without bolus or premixed insulin).</p><p><strong>Results: </strong>A total of 135 patients were included in the study. The median percentage change in insulin requirement was 0% at 4-6 weeks (<i>P</i> = 0.286), -16.67% at 3 months (<i>P</i> <0.001), -51.03% at 6 months (<i>P</i> <0.001), and -58.33% at 12 months (<i>P</i> = 0.013) for the tirzepatide group (<i>n</i> = 45) and 0% at 4-6 weeks, 3 months, and 6 months and -12.50% at 12 months in the combined dulaglutide and semaglutide group (<i>n</i> = 90). Mean change in weight at 6 months was -8.5813 kg in the tirzepatide group and -3.4111 kg in the dulaglutide and semaglutide group (<i>P</i> <0.001). The most commonly reported adverse events in the tirzepatide group were decreased appetite, nausea, and vomiting.</p><p><strong>Conclusion: </strong>In patients with type 2 diabetes who were also on insulin, tirzepatide led to significantly lower insulin requirements after 3, 6, and 12 months of use compared with dulaglutide and semaglutide. Tirzepatide also led to significantly more weight loss compared with dulaglutide and semaglutide and yielded a larger decrease in A1C overall without increasing side effects.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 3","pages":"266-273"},"PeriodicalIF":0.0,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes and Glucose Management in People on Hemodialysis.","authors":"Shubham Agarwal, Julia K Mader, Giuliana Arevalo, Sreekant Avula, Efren Chavez, Lance A Sloan, Rodolfo J Galindo","doi":"10.2337/dsi24-0015","DOIUrl":"10.2337/dsi24-0015","url":null,"abstract":"<p><p>Diabetes is a major cause of end-stage kidney disease (ESKD). Glycemic management is challenging in this population, and A1C, commonly used for monitoring glycemic control, is unreliable. Continuous glucose monitoring indices can be used for glycemic monitoring in people with ESKD. Dipeptidyl peptidase 4 inhibitors, incretin mimetic agents (glucagon-like peptide 1 and glucose-dependent insulinotropic peptide receptor agonists), and insulin using an automated insulin delivery system are preferred to manage diabetes in people with ESKD on hemodialysis.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"7-18"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Interconnected Complexity of Diabetes and Depression.","authors":"Elizabeth A Beverly, Jeffrey S Gonzalez","doi":"10.2337/dsi24-0014","DOIUrl":"10.2337/dsi24-0014","url":null,"abstract":"<p><p>Diabetes and depression have a bidirectional relationship, with negative impacts on glycemia, self-care, long-term complications, quality of life, and mortality. This review highlights key aspects of the interconnected and complex relationship between diabetes and depression, including how it affects health outcomes, depression duration and recurrence, age-specific manifestations, and recommendations for screening and nonpharmacological treatment.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"23-31"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autonomous Artificial Intelligence for Diabetic Eye Disease Testing Improves Access and Equity in the Pediatric and Adult Populations: The Johns Hopkins Medicine Experience.","authors":"T Y Alvin Liu, Risa M Wolf","doi":"10.2337/dsi24-0016","DOIUrl":"10.2337/dsi24-0016","url":null,"abstract":"<p><p>This article discusses the implementation and impact of autonomous artificial intelligence (AI) systems for diabetic eye disease testing at the Johns Hopkins Medicine health system, highlighting improvements in screening rates, access to care, and health equity for underserved populations. The AI technology has been effective in both adult and pediatric populations and has reduced disparities and increased follow-up with eye care professionals. While considering the challenges and successes of this approach, this article also highlights the potential long-term impact of AI systems in improving visual health outcomes for people with diabetes in diverse health care settings.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"19-22"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"About Lance A. Sloan: Guest Editor.","authors":"","doi":"10.2337/ds25-ge01","DOIUrl":"10.2337/ds25-ge01","url":null,"abstract":"","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Sincere Thank You to the Reviewers of <i>Diabetes Spectrum</i>.","authors":"","doi":"10.2337/ds25-en01","DOIUrl":"10.2337/ds25-en01","url":null,"abstract":"","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes in Special Populations.","authors":"Lance A Sloan","doi":"10.2337/dsi24-0018","DOIUrl":"10.2337/dsi24-0018","url":null,"abstract":"","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 1","pages":"4-5"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Use of a Simulation in Pediatric Type 1 Diabetes Sick-Day Education for Patients and Caregivers.","authors":"Hailee L Delsart, Sarah D Corathers, Catherine Fox, Gary L Geis, Patrick W Brady, Emily D Smith, Eric S Kirkendall, Kathleen E Walsh","doi":"10.2337/ds24-0049","DOIUrl":"10.2337/ds24-0049","url":null,"abstract":"<p><strong>Objective: </strong>Management of type 1 diabetes during illness confers risk for serious harm because sick days happen infrequently, management is complex and multistep, and errors can result in diabetic ketoacidosis and hospitalization. Simulation offers a safe, experiential learning environment in which to practice skills with the goal of identifying and closing knowledge gaps. We hypothesized that simulation of sick-day scenarios with patients and caregivers via video conference could be used to assess knowledge of sick-day management for type 1 diabetes and determine the availability of necessary supplies at home.</p><p><strong>Research design and methods: </strong>Our study included development of performance-based, scripted sick-day scenarios; selection and training of content experts as simulation facilitators; piloting and iterative revision of scenarios; and implementation of simulation sessions. Five distinct scenarios were created for either insulin injections or continuous insulin pump therapy. Each participant was block randomized to receive three of the five scenarios. Participant performance was measured by categorizing actions as most desired, less desired, or incorrect.</p><p><strong>Results: </strong>Ten caregivers and two young adults with type 1 diabetes participated in 12 simulations, representing 14 individuals with type 1 diabetes. The most common category of less desired and incorrect processes chosen by participants was ketone management.</p><p><strong>Conclusion: </strong>Simulation-based training for sick-day management is a feasible, interactive form of education for people with type 1 diabetes and caregivers. Video conferences allowed firsthand observation of supplies and resources available to families at home. Participant understanding of sick-day management will inform future interventions to address challenges with ketone management and recognition of diabetes technology issues when caring for an ill child with type 1 diabetes.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 2","pages":"171-179"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12078990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"They Did Not Anticipate Anybody Living a Full Life\": Perspectives on Aging With Type 1 Diabetes.","authors":"Allyson S Hughes, Kashif Uddin, Meghan Krupar, Erika VanDyke, Heather L Stuckey-Peyrot","doi":"10.2337/ds24-0045","DOIUrl":"10.2337/ds24-0045","url":null,"abstract":"<p><p>People with type 1 diabetes are living longer and, by 2030, one-fifth of the U.S. population will be older adults ≥65 years of age. This qualitative study addressed the scarcity of research on the experiences of aging people with type 1 diabetes. Nineteen older adults (mean age 65.63 ± 6.27 years, mean duration of diabetes 36.97 ± 18.94 years) were interviewed about their disease management challenges and gaps in available resources. Identified themes included positive and negative changes over the life span resulting from <i>1</i>) diabetes-related psychological health, <i>2</i>) hypoglycemia unawareness, and <i>3</i>) health care barriers. Responses also suggested that a lack of support may lead to poorer health outcomes and greater diabetes distress. Additional research is needed to better understand these issues and to inform the creation or tailoring of public policies to support older adults with type 1 diabetes.</p>","PeriodicalId":39737,"journal":{"name":"Diabetes Spectrum","volume":"38 3","pages":"259-265"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}