Primary Care Diabetes最新文献

{"title":"Beyond diagnosis: Investigating factors influencing health-related quality of life in older people with type 2 diabetes in Slovenia","authors":"Matic Mihevc ,&nbsp;Tina Virtič Potočnik ,&nbsp;Črt Zavrnik ,&nbsp;Marija Petek Šter ,&nbsp;Zalika Klemenc-Ketiš ,&nbsp;Antonija Poplas Susič","doi":"10.1016/j.pcd.2024.01.010","DOIUrl":"10.1016/j.pcd.2024.01.010","url":null,"abstract":"<div><h3>Aims</h3><p>To examine the present state of health-related quality of life (HRQOL) among elderly individuals with type 2 diabetes (T2D) receiving integrated care and identify risk factors associated with low HRQOL.</p></div><div><h3>Methods</h3><p>A multi-centre cross-sectional survey among elderly individuals with T2D, treated in Slovenian urban and rural primary care settings was performed. HRQOL was investigated using EuroQol 5-dimension (EQ-5D) questionnaire and Appraisal of Diabetes Scale (ADS). Furthermore, socio-demographic, clinical, and laboratory data were collected. Low HRQOL was defined as EQ-5D utility score &lt;10%. Statistical analysis was performed using univariate and multivariate binary logistic regression statistics.</p></div><div><h3>Results</h3><p>Examining 358 people with median age of 72 (range 65–98) years and with a mean EQ-5D utility score of 0.80, the study found that lower HRQOL correlated with older age, higher body mass index (BMI), lower education, elevated depressive symptoms, increased challenges across all EQ-5D dimensions, and less favourable appraisal of diabetes. When considering age, gender, education, and HbA1c, the main predictors of low HRQOL were BMI (OR 1.35, 95% CI 1.04–1.76, p = 0.025) and ADS score (OR 1.63, 95% CI 1.13–2.35, p = 0.009).</p></div><div><h3>Conclusions</h3><p>To improve HRQOL, integrated care models should consider interventions that target mental health, obesity prevention, chronic pain management, diabetes education, self-management, and treatment plan personalisation.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 2","pages":"Pages 157-162"},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000111/pdfft?md5=ebcc2f0c82a2f4765703883fbe5d70ff&pid=1-s2.0-S1751991824000111-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139699180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multicausal analysis of mortality due to diabetes mellitus in Spain, 2016-2018","authors":"Fernando Álvarez-Guisasola ,&nbsp;José A. Quesada ,&nbsp;Adriana López-Pineda ,&nbsp;Rauf Nouni García ,&nbsp;Concepción Carratalá-Munuera ,&nbsp;Vicente F. Gil-Guillén ,&nbsp;Domingo Orozco-Beltrán","doi":"10.1016/j.pcd.2024.01.013","DOIUrl":"10.1016/j.pcd.2024.01.013","url":null,"abstract":"<div><h3>Objectives</h3><p>This study aimed to assess multicausal mortality due to diabetes from 2016–2018 in Spain. Specific objectives were to quantify the occurrence of diabetes as an underlying cause or as any registered cause on the death certificate.</p></div><div><h3>Materials and methods</h3><p>A cross-sectional descriptive study taking a multicausal approach.</p></div><div><h3>Results</h3><p>Diabetes appears as an underlying cause of 2.3% of total deaths in Spain, and as any cause in 6.2%. In patients in whom Diabetes appears as an underlying cause on the death certificates, the 15 most frequent immediate causes are cardiovascular diseases in men(prevalence ratio 1,59)and women (PR1,31). In men, the causes associated with diabetes as any cause were skin diseases(prevalence ratio 1.33), followed by endocrine diseases(prevalence ratio 1.26)and genitourinary diseases (prevalence ratio1.14). In women, the causes associated with the presence of diabetes as any cause were endocrine (prevalence ratio 1.13)and genitourinary (prevalence ratio 1.04)diseases.</p></div><div><h3>Conclusions</h3><p>In patients in whom diabetes appears as an underlying cause on the death certificates, the 15 most frequent immediate causes are cardiovascular diseases. In men, the causes associated with the presence of diabetes as any cause of death are skin, endocrine and genitourinary diseases. In women, the causes associated with diabetes as any cause are endocrine and genitourinary.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 2","pages":"Pages 138-145"},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000251/pdfft?md5=9e29f559c18b12f142ebe6ceb57afe07&pid=1-s2.0-S1751991824000251-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139704310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of GLP-1 receptor agonists on the degree of liver fibrosis and CRP in non-alcoholic fatty liver disease and non-alcoholic steatohepatitis: A systematic review and meta-analysis","authors":"Lixuan Fang ,&nbsp;Jine Li ,&nbsp;Haixia Zeng ,&nbsp;Jianping Liu","doi":"10.1016/j.pcd.2024.03.005","DOIUrl":"10.1016/j.pcd.2024.03.005","url":null,"abstract":"<div><h3>Background</h3><p>Based on the rapidly growing global burden of non-alcoholic fatty liver disease (NAFLD) or steatohepatitis (NASH), in order to evaluate the efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in the treatment of NAFLD or NASH this paper presents a systematic review and meta-analysis of randomized controlled trials(RCTs).</p></div><div><h3>Methods</h3><p>In this systematic review and meta-analysis, We searched PubMed, Medline, Web of Science and The Cochrane Library databases. All randomized controlled trials involving GLP-1RAs and NAFLD or NASH were collected since the database was established. A meta-analysis of proportions was done with the generalised linear mixed model. Continuous variables were represented by Mean and Standard Deviation (SD), and binary variable were represented by Relative Risk (RR) and 95% Confidence Interval (CI) as effect indicators. The research results were presented by Revman 5.4. This study is registered with PROSPERO (CRD42023390735).</p></div><div><h3>Finding</h3><p>We included 16 placebo-controlled or active drug-controlled randomized controlled trials (involving 2178 patients) that used liraglutide, exenatide, dulaglutide, or semaglutie in the treatment of NAFLD or NASH, as measured by liver biopsy or imaging techniques. This study found that the effect of GLP-1RAs on histologic resolution of NASH with no worsening of liver fibrosis (n=2 RCTs; WMD:4.08, 95%CI 2.54–6.56, p &lt; 0.00001) has statistically significant. At the same time, GLP-1RAs affected CRP (n = 7 RCTs; WMD:−0.41, 95% CI-0.78 to −0.04, p =0.002) and other serological indicators were significantly improved.</p></div><div><h3>Conclusion</h3><p>This study evaluated the efficacy of GLP-1RAs in patients with NAFLD and NASH. These results suggest that GLP-1RAs may be a potential and viable therapeutic approach as a targeted agent to intervene in disease progression of NAFLD and NASH.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 3","pages":"Pages 268-276"},"PeriodicalIF":2.9,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes mellitus as a cause of premature death in small areas of Spain by socioeconomic level from 2016 to 2020: A multiple-cause approach","authors":"José A. Quesada ,&nbsp;Adriana López-Pineda ,&nbsp;Domingo Orozco-Beltrán ,&nbsp;Concepción Carratalá-Munuera ,&nbsp;Xavier Barber-Vallés ,&nbsp;Vicente F. Gil-Guillén ,&nbsp;Rauf Nouni-García ,&nbsp;Álvaro Carbonell- Soliva","doi":"10.1016/j.pcd.2024.03.004","DOIUrl":"10.1016/j.pcd.2024.03.004","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to assess premature mortality due to Diabetes in small areas of Spain between 2016 and 2020, and its relationship with socioeconomic level and the immediate cause of death. As a secondary objective, we evaluated the effect of the Covid 19 pandemic.</p></div><div><h3>Methods</h3><p>This was an ecological study of premature mortality due to Diabetes from 2016 to 2020, with a focus on small areas. All deaths in people under 75 years of age due to Diabetes as the underlying cause were included</p></div><div><h3>Results</h3><p>The final sample comprised 7382 premature deaths in 5967 census tracts. Women living in census tracts with an high level of deprivation(RR=2.40) were at a significantly higher risk. Mortality from Diabetes increased with deprivation, especially people aged 0–54(RR=2.40). People with an immediate cause of death related to a circulatory disease, living in census tracts with an high level of deprivation(RR=3.86) was associated with a significantly greater risk of death with underlying Diabetes. When a disease of the circulatory system was recorded as the immediate cause of death, being 65–74 years (RR=71.01) was associated with a significantly higher risk of premature mortality.</p></div><div><h3>Conclusions</h3><p>Living in geographic areas with higher levels of socioeconomic deprivation is associated with a higher risk of premature death from Diabetes in Spain. This relationship has a greater impact on women, people under 54 years, and people at risk of death caused directly by diseases of the circulatory system. Premature mortality due to diabetes saw a modest increase in 2020.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 3","pages":"Pages 356-361"},"PeriodicalIF":2.9,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000640/pdfft?md5=0eada56575c52d5bc9741ac2050692cc&pid=1-s2.0-S1751991824000640-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compliance with eye and foot preventive care in people with self-reported diabetes in Latin America and the Caribbean: Pooled, cross-sectional analysis of nine national surveys","authors":"Rodrigo M. Carrillo-Larco ,&nbsp;Wilmer Cristobal Guzman-Vilca ,&nbsp;Jithin Sam Varghese ,&nbsp;Francisco J. Pasquel ,&nbsp;Roberta Caixeta ,&nbsp;Carmen Antini ,&nbsp;Antonio Bernabé-Ortiz","doi":"10.1016/j.pcd.2024.03.001","DOIUrl":"10.1016/j.pcd.2024.03.001","url":null,"abstract":"<div><h3>Aims</h3><p>To estimate the proportion of people with self-reported diabetes receiving eye and foot examinations in Latin America and the Caribbean (LAC).</p></div><div><h3>Methods</h3><p>Cross-sectional analysis of national health surveys in nine countries. Adults aged 25–64 years with self-reported diabetes. We quantified the proportion who reported having an eye examination in the last two years or a foot examination in the last year. We fitted multilevel Poisson regressions to assess socio-demographic (age and sex) and clinical (oral hypoglycemic medication and insulin treatment) variables associated with having had examinations.</p></div><div><h3>Results</h3><p>There were 7435 people with self-reported diabetes included in the analysis. In three countries (Chile [64%; 95% CI: 56%-71%], British Virgin Islands [58%; 95% CI: 51%-65%], and Brazil [54%; 95% CI: 50%-58%]), &gt;50% of people with diabetes reported having had an eye examination in the last two years. Fewer participants (&lt;50% across all countries) reported having had a foot examination in the last year, with Ecuador having the lowest proportion (12%; 95% CI: 8%-17%). Older people, and those taking oral medication or insulin, were more likely to have eye/foot examinations.</p></div><div><h3>Conclusions</h3><p>The proportion of eye and foot examinations in people with self-reported diabetes across nine countries in LAC is low.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 3","pages":"Pages 374-379"},"PeriodicalIF":2.9,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of diabetes shared care program on metabolic indicators of people with type 2 diabetes: A systematic review and meta-analysis","authors":"Ya-Hui Yang ,&nbsp;Kuan-Han Lin ,&nbsp;Shu-Nu Chang-Lee ,&nbsp;Jiun-Yi Wang","doi":"10.1016/j.pcd.2024.03.003","DOIUrl":"10.1016/j.pcd.2024.03.003","url":null,"abstract":"<div><h3>Aims</h3><p>To explore the effectiveness of the Taiwanese Diabetes Shared Care Program (DSCP) on improving the metabolic indicators of people with type 2 diabetes.</p></div><div><h3>Methods</h3><p>Relevant studies published between January 2002 and August 2021 were retrieved from Chinese- and English-language electronic databases, including PubMed, MEDLINE, CINAHL, ProQuest, Cochrane Library, Airiti Library, and Taiwan Periodical Literature System. After screening, studies that met inclusion criteria were included in the literature review. RevMan 5.4 was employed for a meta-analysis.</p></div><div><h3>Results</h3><p>Ten studies published between 2007 and 2021 were included in the systematic review, with nine of them contributing to the meta-analysis. In total, 1506 and 1388 participants were classified into DSCP and non-DSCP groups, respectively, for the meta-analysis. The results revealed that the DSCP significantly improved glycated hemoglobin levels (mean difference [MD]: −0.50, 95% Confidence Interval [CI]: −0.83 to −0.17) and body weights (MD: −0.83, 95% CI: −1.29 to −0.38) within 1-year follow-up. However, it did not show significant improvement in other metabolic indicators.</p></div><div><h3>Conclusions</h3><p>Taiwanese DSCP led to improvements in glycated hemoglobin levels and body weights among people with type 2 diabetes. This study suggests that people with diabetes and health-care institutions should consider participating in the DSCP.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 3","pages":"Pages 257-267"},"PeriodicalIF":2.9,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000664/pdfft?md5=4734f4f4b184aa8c59f58a1a56fbe7df&pid=1-s2.0-S1751991824000664-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digitising diabetes education for a safer Ramadan: Design, delivery, and evaluation of massive open online courses in Ramadan-focused diabetes education","authors":"Scott C. Mackenzie ,&nbsp;Jane Dickson ,&nbsp;Salma Mehar ,&nbsp;Barakatun Nisak Mohd Yusof ,&nbsp;Adhari Alselmi ,&nbsp;Bilal Aksi ,&nbsp;Mats Stage Baxter ,&nbsp;Alex Bickerton ,&nbsp;Harnovdeep Singh Bharaj ,&nbsp;Nicholas Conway ,&nbsp;Kirsten M. Cumming ,&nbsp;Lee-Ling Lim ,&nbsp;Nader Lessan ,&nbsp;Nazim Ghouri ,&nbsp;Tracey T. Flax ,&nbsp;Hibbah A. Osei-Kwasi ,&nbsp;Michelle ES Teo ,&nbsp;Salman Waqar ,&nbsp;Mohamed Hassanein ,&nbsp;Deborah J. Wake","doi":"10.1016/j.pcd.2024.03.002","DOIUrl":"10.1016/j.pcd.2024.03.002","url":null,"abstract":"<div><h3>Aims</h3><p>Ramadan-focused diabetes education is critical to facilitate safer Ramadan fasting amongst Muslim people living with diabetes. We present the design, delivery, and evaluation of two parallel massive open online courses (MOOCs) in Ramadan-focused diabetes education for people with diabetes and HCPs.</p></div><div><h3>Methods</h3><p>Two Ramadan-focused diabetes education MOOCs were developed and delivered for Ramadan 2023: one for HCPs in English, and another for people with diabetes in English, Arabic and Malay. A user-centred iterative design process was adopted, informed by user feedback from a 2022 pilot MOOC. Evaluation comprised a mixed-methods evaluation of pre- and post-course user surveys.</p></div><div><h3>Results</h3><p>The platform was utilised by people with diabetes and their family, friends and healthcare professionals. Overall, a total of 1531 users registered for the platform from 50 countries, 809 started a course with a 48% subsequent completion rate among course starters. Qualitative analysis showed users found the course a user-friendly and authoritative information source. In the HCP MOOC, users reported improved post-MOOC Ramadan awareness, associated diabetes knowledge and ability to assess and advise patients in relation to their diabetes during Ramadan (p&lt;0.01).</p></div><div><h3>Conclusions</h3><p>We demonstrate the potential of MOOCs to deliver culturally tailored, high-quality, scalable, multilingual Ramadan-focused diabetes education to HCPs and people with diabetes.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 3","pages":"Pages 340-346"},"PeriodicalIF":2.9,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000652/pdfft?md5=fbaec7cbb2599cff73eb976d305eb76e&pid=1-s2.0-S1751991824000652-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140141330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic status and the effect of prolonged pandemic confinement on anthropometric and glycaemic outcomes in adults with type 2 diabetes mellitus","authors":"Chandana Wijeweera ,&nbsp;Ummul Muhfaza ,&nbsp;Reginald V. Lord ,&nbsp;Peter Petocz ,&nbsp;Juliana Chen ,&nbsp;Veronica Preda","doi":"10.1016/j.pcd.2024.02.002","DOIUrl":"10.1016/j.pcd.2024.02.002","url":null,"abstract":"<div><h3>Aim</h3><p>This systematic review and meta-analysis aimed to investigate the impact of COVID19 lockdown on the anthropometric and glycaemic outcomes of adults with type 2 diabetes mellitus (T2DM) and assess whether socioeconomic status (SES) was relevant to these changes.</p></div><div><h3>Methods</h3><p>A search of three databases was conducted. Meta-analyses using random effects models were undertaken to combine anthropometric and glycaemic measures pre- and post-confinement. Subgroup analyses according to SES were also conducted.</p></div><div><h3>Results</h3><p>This systematic review of 19 articles demonstrated that prolonged pandemic-related confinement is associated with a deterioration in both anthropometric and glycaemic outcomes among adults with T2DM. Furthermore, SES was found to be relevant to these changes. Specifically, BMI (kg/m²) showed an increase in mean difference of 0.72 (95% CI; 0.13, 1.31; p&lt;0.05) between pre and post lockdown cohorts. High income countries displayed a greater increase in BMI compared to their lower middle-income counterparts. Regarding, fasting blood glucose (FBG), a statistically significant difference was observed in the upper middle-income group (mean difference: 5.10; 95% CI: 2.92, 7.27), and high-income group (mean difference: 6.03; 95% CI: 0.04, 12.02). There were no significant changes to weight, waist circumference, or HbA1C over the lockdown period.</p></div><div><h3>Conclusion</h3><p>Our findings suggest adults with T2DM may have received less effective care over the lockdown period, particularly in high income countries. Clinics and care providers may need to adopt more intensive contact and treatment plans in the post lockdown period to prevent lasting impacts on disease progression and metabolic sequelae.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 3","pages":"Pages 308-318"},"PeriodicalIF":2.9,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000366/pdfft?md5=55414982e8b8266dcc406ee87cb39970&pid=1-s2.0-S1751991824000366-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beliefs, practices, perceptions and motivations of healthcare professionals on medication deprescribing during end-of-life care: A systematic review","authors":"Elizabeth Hickman ,&nbsp;Abdullah Almaqhawi,&nbsp;Clare Gillies ,&nbsp;Kamlesh Khunti ,&nbsp;Samuel Seidu","doi":"10.1016/j.pcd.2024.02.006","DOIUrl":"10.1016/j.pcd.2024.02.006","url":null,"abstract":"<div><h3>Aim</h3><p>Conduct a systematic review to investigate current beliefs, practices, perceptions, and motivations towards deprescribing practices from the healthcare professional perspective in older adults residing in long term care facilities with cardiometabolic conditions, using a narrative approach.</p></div><div><h3>Methods</h3><p>Studies were identified using a literature search of MEDLINE, CINAHL and Web of Science from inception to June 2023 Two reviewers (EH and AA) independently extracted data from each selected study using a standardised self-developed data extraction proforma. Studies reviewed included cross-sectional and observational studies. Data was extracted on baseline characteristics, motivations and beliefs and was discussed using a narrative approach.</p></div><div><h3>Results</h3><p>Eight studies were identified for inclusion. Deprescribing approaches included complete withdrawal, dose reduction, or switching to an alternative medication, for at least one preventive medication. Most healthcare professionals were willing to initiate deprescribing strategies and stated the importance of such interventions, however many felt inexperienced and lacked the required knowledge to feel comfortable doing so.</p></div><div><h3>Conclusion</h3><p>Deprescribing is a key strategy when managing older people with cardiometabolic and multiple long term conditions (MLTC). Overall, HCPs including specialists, were happy to explore deprescribing strategies if provided with the relevant training and development to do so. Barriers that still exist include communication and consultation skills, a lack of evidence-based guidance and trust based policies, and a lack of MDT communications and involvement.</p><p>Systematic Review Registration: PROSPERO CRD42022335106</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 3","pages":"Pages 249-256"},"PeriodicalIF":2.9,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000408/pdfft?md5=401424bad17fce203b1d8b78e2c10250&pid=1-s2.0-S1751991824000408-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140041218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternal caffeine, coffee and cola drink intake and the risk of gestational diabetes – Kuopio Birth Cohort","authors":"Anni Kukkonen ,&nbsp;Sari Hantunen ,&nbsp;Ari Voutilainen ,&nbsp;Anu Ruusunen ,&nbsp;Lauri Uusitalo ,&nbsp;Katri Backman ,&nbsp;Raimo Voutilainen ,&nbsp;Markku Pasanen ,&nbsp;Pirkka V. Kirjavainen ,&nbsp;Leea Keski-Nisula","doi":"10.1016/j.pcd.2024.02.005","DOIUrl":"10.1016/j.pcd.2024.02.005","url":null,"abstract":"<div><h3>Aims</h3><p>Coffee intake is associated with a decreased risk of type 2 diabetes among non-pregnant people. We aimed to investigate the association between caffeine, coffee and cola drink intake in early pregnancy and the risk of gestational diabetes (GDM).</p></div><div><h3>Methods</h3><p>Kuopio Birth Cohort (KuBiCo) is a prospective cohort study including pregnant women who were followed at the prenatal clinics in outpatient healthcare centers and gave birth in Kuopio University Hospital, Finland (n=2214). Maternal diet during the first trimester of pregnancy was assessed using a 160-item food frequency questionnaire. GDM was diagnosed by oral glucose tolerance test according to the Finnish national guidelines mainly between 24 and 28 gestational weeks.</p></div><div><h3>Results</h3><p>Women with moderate coffee intake in the first trimester were less likely diagnosed with GDM than women without coffee intake in an age-adjusted model (OR 0.87; 95% CI 0.76–0.99; p = 0.03), but the association was attenuated in multi-adjusted models (p = 0.11). No association was found between caffeine intake and GDM. One third (32.4%) of pregnant women consumed caffeine over the recommendation (&gt; 200 mg/d). Women who consumed cola drinks more than the median (33.3 mL/d) had an increased risk of GDM (OR 1.29; 95% CI 1.02–1.63, p = 0.037) in multi-adjusted model compared to those who consumed less.</p></div><div><h3>Conclusions</h3><p>Caffeine intake during the first trimester of pregnancy was not associated with the risk of GDM but a minor non-significant decrease was seen with moderate coffee intake. Although the average consumption of cola drinks was low in the KuBiCo cohort, higher consumption was associated with an increased risk of GDM. Further studies are needed to evaluate the safe amount of coffee during pregnancy, since the recommended caffeine intake was exceeded in almost half of the coffee drinkers.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 3","pages":"Pages 362-367"},"PeriodicalIF":2.9,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000391/pdfft?md5=ff5bd1a9af6959acf7c2ebe8b93dcf58&pid=1-s2.0-S1751991824000391-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139998654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}