Primary Care Diabetes最新文献

{"title":"Continuity of care across sectors in patients with type 2 diabetes: A nationwide register study in Denmark","authors":"Anne Sofie Baymler Lundberg ,&nbsp;Claus Høstrup Vestergaard ,&nbsp;Annelli Sandbæk ,&nbsp;Anders Prior","doi":"10.1016/j.pcd.2025.02.004","DOIUrl":"10.1016/j.pcd.2025.02.004","url":null,"abstract":"<div><h3>Aims</h3><div>Our aims were to describe health care utilisation patterns across sectors in patients with type 2 diabetes(T2D), and to identify patient characteristics associated with low continuity of care.</div></div><div><h3>Methods</h3><div>A nationwide register-based cohort study including all Danish citizens recorded with a diagnosis of T2 diabetes in 2017. The outcome was continuity of care as measured by three different indices: the Continuity of Care Index (COCI), the Usual Provider of Care Index (UPC), and the Sequential Continuity Index (SECON).</div></div><div><h3>Results</h3><div>The median of patients with T2D had 75 % of their contacts to their usual health care provider. The strongest association with low continuity of care was the number of comorbidities, showing a dose response trend. Other patient characteristics associated with low continuity of care were duration of T2 diabetes (&gt;10.3 years), lower age group (40–49 years), having a high education level (&gt;15 years) and having a cancer comorbidity.</div></div><div><h3>Conclusions</h3><div>Our study was the first step to flag patients at potential risk of fragmented care due to many transitions between providers. This is of importance for the general practitioners, who are the coordinators of the patients with T2D and their various health conditions and contacts.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 261-269"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434654","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":"The promise of tirzepatide: A narrative review of metabolic benefits","authors":"Sara Sokary,&nbsp;Hiba Bawadi","doi":"10.1016/j.pcd.2025.03.008","DOIUrl":"10.1016/j.pcd.2025.03.008","url":null,"abstract":"<div><div>Obesity and type 2 diabetes mellites (T2DM) are intertwined epidemics that continue to pose significant challenges to global public health. We aim to review the available evidence on the metabolic effects of tirzepatide, focusing on weight loss and maintenance of lost weight, body composition alterations, appetite regulation, glycemic control, and lipid profile modulation. Tirzepatide administration for 72 weeks elicited significant weight reduction ranging from 5 % to 20.9 % across different trials in a dose-dependent manner. Furthermore, limited evidence showed that lost body weight may be primarily due to fat mass reduction. Tirzepatide also significantly decreased food intake, reduced overall appetite scores and increased fasting visual analog scale scores for satiety and fullness across different clinical trials. Moreover, tirzepatide exhibited favorable effects on glycemic control, with notable reductions in HbA1c levels ranging from 20.4 mmol/mol with the 5 mg dose to 28.2 mmol/mol with the 15 mg dose, following treatment durations lasting 40–52 weeks. Additionally, tirzepatide exerts a beneficial impact on lipid profile parameters, including reductions in total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels, while increasing high-density lipoprotein cholesterol concentrations. Despite its efficacy, tirzepatide is associated with gastrointestinal adverse effects, which requires dose escalation strategies to enhance tolerability. Mild to moderate adverse events are commonly reported at higher doses, with discontinuation rates ranging from 4 % to 10 % across different dosages. In conclusion, tirzepatide has shown multifaceted metabolic effects, along with manageable adverse profiles, which makes it a promising therapeutic agent for addressing both obesity and T2DM. However, further long-term randomized controlled trials are warranted to reveal long-term efficacy and safety outcomes, particularly in diverse patient populations.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 229-237"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921560","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":"Barriers to glucagon use in patients with type 1 diabetes","authors":"Emma Mason,&nbsp;Kagan E. Karakus,&nbsp;Halis K. Akturk","doi":"10.1016/j.pcd.2025.03.004","DOIUrl":"10.1016/j.pcd.2025.03.004","url":null,"abstract":"<div><div>Glucagon use has been shown to be low in severe hypoglycemia events among adults with type 1 diabetes. In this study, we aimed to explore the barriers to using glucagon. We surveyed 576 adults with type 1 diabetes and demonstrated the barriers in using glucagon and speculated possible solutions.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 341-343"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695021","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 a community intervention program on healthy lifestyles (PREDICOL) among adults with prediabetes in two Latin American cities: A quasi-experimental study","authors":"Yenifer Diaz Montes ,&nbsp;Luis A. Anillo Arrieta ,&nbsp;Juan Jose Espitia De La Hoz ,&nbsp;Tania Acosta-Vergara ,&nbsp;Jorge Acosta-Reyes ,&nbsp;Karen C. Flórez Lozano ,&nbsp;Rafael Tuesca Molina ,&nbsp;Pablo Aschner ,&nbsp;Sandra Rodríguez Acosta ,&nbsp;Noël C. Barengo","doi":"10.1016/j.pcd.2025.03.010","DOIUrl":"10.1016/j.pcd.2025.03.010","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to measure the impact of a community-based lifestyle modification intervention program on the Health-Related Quality of Life (HRQoL) of adults with prediabetes in two Latin American cities.</div></div><div><h3>Methods</h3><div>A quasi-experimental study was conducted with participants aged 30 and above in two Colombian cities between 2018 and 2022. The glycemic status of study participants was determined through the administration of an oral glucose tolerance test. Individuals exhibiting impaired glucose tolerance (IGT) were selected for inclusion in the intervention program. Of the 146 individuals identified with IGT, 91 completed the one-year intervention protocol. HRQoL was assessed utilizing the EQ-5D-3L questionnaire, both before and after the intervention. Logistic regression models were used to calculate the odds ratios (OR) and 95 % confidence intervals (CI), while classification models based on machine learning algorithms were utilized to identify factors associated with favorable changes in health-related quality of life (HRQoL).</div></div><div><h3>Results</h3><div>In Bogotá D.C., a significant improvement in HRQoL was documented (pre-intervention: 0.69 ± 0.17; post-intervention: 0.76 ± 0.16), attaining the threshold for clinically meaningful change (0.06<strong>).</strong> No changes in HRQoL were observed in the study participants. Logistic regression analysis revealed that the improvement in HRQoL was statistically significantly associated with sex (OR 8.75; 95 % CI 1.91–40.03), age (OR 11.61; 95 % CI 1.44–93.44), place of residence (OR 29.31; 95 % CI 5.26–163.54), and weight loss (OR 5.56; 95 % CI 1.15–26.76). According to the XGBoost model, return to normal glycemic status emerged as the most important variable for improvements in HRQoL.</div></div><div><h3>Conclusion</h3><div>Gender, age, place of residence, weight loss, and return to normoglycemic status were identified as significant predictors in lifestyle modification to improve HRQoL among participants at high risk of developing type 2 diabetes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 277-287"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756974","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":"Deprescribing of preventive medications in palliative care patients living with multiple long-term conditions in their final 12 months of life: A retrospective cohort Clinical Practice Research Datalink study","authors":"Elizabeth Hickman ,&nbsp;Clare Gillies ,&nbsp;Kamlesh Khunti ,&nbsp;Samuel Seidu","doi":"10.1016/j.pcd.2025.03.005","DOIUrl":"10.1016/j.pcd.2025.03.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the patterns and trends associated with deprescribing of preventive medications in the final 12 months of life in palliative patients living with multiple long-term conditions using the Clinical Practice Research Datalink.</div></div><div><h3>Participants</h3><div>All patients with a medcode/readcode for palliative care assigned to their profile with a medcode/readcode for a cardiometabolic condition. All patients were on therapeutic interventions for their condition/s.</div></div><div><h3>Primary and secondary outcome measures</h3><div>the trends of medication deprescribing of preventive medications in the final twelve months of life in those known to be end-of-life.</div></div><div><h3>Results</h3><div>Preventive medication deprescribing was only observed in a very small cohort of patients. The findings were consistent across all six medication groups tested. Deprescribing was observed in a range of 2–60 patients with the most deprescribing efforts being associated with antihypertensive medications (n = 177), and antiplatelet medications (n = 70), and antihyperglycaemic medications (n = 10).</div></div><div><h3>Conclusions</h3><div>Deprescribing practices are not commonplace in patients with a known end-of-life designation with low patient numbers (range 2–60) undergoing the intervention, thus potentially reducing the quality of life in these patients final twelve months of life.</div></div><div><h3>CPRD ID</h3><div>#22_002253, linkage request 2914</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 288-295"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665441","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":"Comparing quality of diabetes care between immigrants and non-immigrants within dimensions of marginalization: A population-based cohort study","authors":"Shadia Adekunte ,&nbsp;Yu Qing Bai ,&nbsp;Gillian L. Booth ,&nbsp;Ghazal Fazli ,&nbsp;Calvin Ke ,&nbsp;Lorraine L. Lipscombe ,&nbsp;Sarah M. Mah ,&nbsp;Laura C. Rosella ,&nbsp;Walter P. Wodchis ,&nbsp;Baiju R. Shah","doi":"10.1016/j.pcd.2025.02.007","DOIUrl":"10.1016/j.pcd.2025.02.007","url":null,"abstract":"<div><h3>Aims</h3><div>Immigrants in western countries face an increased risk of developing diabetes and have been shown to receive lower quality of diabetes care. However, it is uncertain whether this disparity in care persists when comparing immigrants and non-immigrants with similar levels of marginalization with respect to the social determinants of health.</div></div><div><h3>Methods</h3><div>Using population-based healthcare administrative data linked to immigration and neighbourhood census data, we conducted a retrospective cohort study of all people aged ≥ 40 years with diabetes in Ontario, Canada on 1 April 2019. Process measures (testing for HbA1c, LDL-cholesterol and urine albumin-creatinine ratio; eye examinations; and appropriate prescriptions) and outcome measures (achieving guideline-recommended targets for laboratory tests) over the following year were ascertained. They were compared between immigrants and non-immigrants overall and within the highest and lowest quintiles of three measures of marginalization: material deprivation, residential instability and dependency.</div></div><div><h3>Results</h3><div>There were 1,449,589 people with diabetes included in the study (22.6 % immigrants). Immigrants were less likely than non-immigrants to achieve many of the process quality indicators and were less likely to achieve both HbA1c and LDL-cholesterol targets. These findings were similar when stratified within the highest and lowest quintiles of material deprivation, residential instability and dependency.</div></div><div><h3>Conclusions</h3><div>Even within similar levels of marginalization, immigrants were less likely to achieve many quality indicators for diabetes care than non-immigrants. This finding suggests that the gap in quality of care between immigrants and non-immigrants is not simply due to differences in these social determinants of health, and highlights the intersecting impact of immigration and marginalization. However, the disparities were relatively small, so the greater issue is the overall low achievement of these quality indicators among all people with diabetes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 296-301"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143473393","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":"Intermittent fasting versus continuous caloric restriction for glycemic control and weight loss in type 2 diabetes: A traditional review","authors":"Hairya Ajaykumar Lakhani ,&nbsp;Deepanwita Biswas ,&nbsp;Mahima Kuruvila ,&nbsp;Manisha Sai Chava ,&nbsp;Kshitij Raj ,&nbsp;Joel Thomas Varghese ,&nbsp;N.L. Swathi","doi":"10.1016/j.pcd.2025.02.006","DOIUrl":"10.1016/j.pcd.2025.02.006","url":null,"abstract":"<div><div>Type 2 Diabetes Mellitus (T2DM) represents a major global health issue, with its incidence anticipated to increase markedly in the forthcoming decades. Efficient non-pharmacological therapies, especially dietary approaches, are essential for regulating glycemic control and facilitating weight reduction. Intermittent Fasting (IF) and Continuous Caloric Restriction (CCR) are two well researched methodologies, but their relative effectiveness and enduring advantages continue to be topics of active discussion. This review systematically assesses and contrasts the impacts of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic regulation and weight reduction in persons with type 2 diabetes mellitus (T2DM), highlighting their short-term and long-term effects, safety profiles, and adherence rates. A thorough literature analysis was performed utilizing PubMed and Google Scholar, concentrating on papers published from 2000 to 2024. The review encompassed randomized controlled trials and observational studies that investigated the effects of intermittent fasting (IF) and continuous calorie restriction (CCR) on glycemic indicators (HbA1c, fasting glucose) and body weight. IF shown substantial short-term advantages, encompassing marked decreases in HbA1c levels, fasting glucose, and body weight. Mechanistic discoveries emphasized better insulin sensitivity, augmented fat metabolism, and autophagy as key aspects. In contrast, CCR was linked to enduring metabolic enhancements, including decreased visceral fat and improved insulin sensitivity. Nevertheless, both dietary approaches demonstrated constraints.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 203-213"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505856","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":"The perspectives of healthcare professionals in providing care to women with GDM in high-income nations: A qualitative systematic review","authors":"Mary-Ellen Hooper ,&nbsp;Ella Kurz ,&nbsp;Cathy Knight-Agarwal ,&nbsp;Mary-Jessimine Bushell ,&nbsp;Elyse Ladbrook ,&nbsp;Deborah Davis","doi":"10.1016/j.pcd.2024.11.005","DOIUrl":"10.1016/j.pcd.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Gestational Diabetes Mellitus (GDM) represents a growing challenge worldwide, with significant risks to both women and their babies that extend beyond the duration of the pregnancy and immediate post-partum period. Healthcare professionals (HCPs) play important roles in the screening, diagnosis, treatment and management of women with GDM.</div></div><div><h3>Methods</h3><div>For this qualitative systematic review, a comprehensive search strategy explored the electronic databases Web of Science, CINAHL, Medline, and Scopus, as well as the reference lists of the included papers, for primary studies investigating the experiences, perspectives and practices of HCPs providing care to women with GDM in high-income healthcare settings. Studies were assessed with the Crowe Critical Appraisal Tool, and findings were synthesised using the approach described by Thomas and Harden.</div></div><div><h3>Results</h3><div>This review included 33 articles - 26 qualitative and seven mixed method studies, representing ten high-income nations. The total number of HCP participants represented across the studies is 989. This figure is constituted by medical professionals (n = 226), nurses and midwives (n = 583), allied health (n = 40) and other or not numerically specified HCPs (n = 140). From 149 findings, four major themes and 10 subthemes were constructed. The four major themes are: multidisciplinary collaboration; healthcare practice; organizational factors; and working with women.</div></div><div><h3>Discussion and conclusion</h3><div>There are barriers to providing optimal care to women with GDM. Including, time and resource constraints, a lack of consensus in practice guidelines, and variable multidisciplinary collaboration. Moving forward, there needs to be a focus on more explicit guidelines, multidisciplinary collaboration, and appropriate resources to support HCPs in providing care to women to manage the short-term and longer-term risks that are associated with a pregnancy affected by GDM.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 246-260"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505996","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":"Editorial Board and Aims & Scopes","authors":"","doi":"10.1016/S1751-9918(25)00090-7","DOIUrl":"10.1016/S1751-9918(25)00090-7","url":null,"abstract":"","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages ii-iii"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921612","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":"Social isolation, loneliness, and incidence of type 2 diabetes mellitus: A systematic review and meta-analysis","authors":"Maheen Asif ,&nbsp;Aliza Asif ,&nbsp;Ummi Aiman Rahman ,&nbsp;Hafsa Ajmal ,&nbsp;Uzair Jafar ,&nbsp;Oshaz Fatima","doi":"10.1016/j.pcd.2025.03.006","DOIUrl":"10.1016/j.pcd.2025.03.006","url":null,"abstract":"<div><h3>Objective</h3><div>Social isolation and loneliness are forms of social disconnection that have been linked to increased risk of many metabolic disorders, including Type 2 Diabetes Mellitus (T2DM). However, evidence to support this relation is lacking. This study aims to investigate the association between social isolation, loneliness, and the incidence risk of T2DM.</div></div><div><h3>Methods</h3><div>We searched various electronic databases including MEDLINE (via PubMed), Embase, the Cochrane Library, and Google scholar to retrieve qualitative studies comparing the incidence of T2DM in patients with social isolation or loneliness. We performed statistical analysis on RevMan 5.4 using the random effect model.</div></div><div><h3>Results</h3><div>Loneliness was associated with a significantly increased incidence of T2DM (OR: 1.44; 95 % CI: 1.19–1.73; P:0.0001), with high heterogeneity (I² = 95 %). Sensitivity analysis indicated potential variability due to differences in loneliness measurements. Social isolation also showed a significant association with T2DM (OR: 1.88; 95 % CI: 1.38–2.58; P:&lt;0.0001) with high heterogeneity (I² = 98 %).</div></div><div><h3>Conclusion</h3><div>In conclusion, we found social isolation and loneliness are independently associated with a higher incidence of T2DM. These findings underscore the need to address psychosocial elements like social isolation and loneliness in the management of T2DM. However, further studies with larger sample sizes, longer follow-up durations, and uniform criteria is warranted to better understand the association between social isolation, loneliness and T2DM.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 221-228"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675055","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}