Primary Care Diabetes最新文献

{"title":"Development and validation of a new questionnaire for the assessment of patients with diabetic foot disease: The Diabetic Foot Questionnaire (DiaFootQ)","authors":"María Ruiz-Muñoz ,&nbsp;Raúl Fernández-Torres ,&nbsp;Cynthia Formosa ,&nbsp;Alfred Gatt ,&nbsp;Alberto José Pérez-Panero ,&nbsp;Ana Juana Pérez-Belloso ,&nbsp;Francisco Javier Martínez-Barrios ,&nbsp;Manuel González-Sánchez","doi":"10.1016/j.pcd.2024.07.002","DOIUrl":"10.1016/j.pcd.2024.07.002","url":null,"abstract":"<div><h3>Background</h3><p>The epidemiology data and global burden of diabetic foot disease underscores the need for effective prevention strategies, which requires an early diagnosis. Patient-reported outcome measures are instruments based on a simple format, which favours their application. Currently, there is an absence of instruments with a broad enough scope to capture the diverse aspects involved in diabetic foot disease.</p></div><div><h3>Objectives</h3><p>To develop a questionnaire for the assessment of patients with diabetic foot disease and carry out an analysis of its validity and reliability.</p></div><div><h3>Methods</h3><p>The study was developed in two stages. Stage 1: the Delphi Panel was composed of 22 experts. The questionnaire is made up of 25 questions selected, after three rounds, from an initial sample of 68 questions. Stage 2: A validation study was performed. With a sample of 273 subjects, an exploratory factor analysis and an analysis of internal consistency, items response, and validity were carried out using the Diabetes Quality of Life, SF-12v2, Foot Function Index and EuroQol EQ5D questionnaires. Measurements of error and sensitivity to change were also analyzed.</p></div><div><h3>Results</h3><p>A 25-item questionnaire (DiaFootQ) was developed. It comprised two dimensions: 1) lifestyle and function; and 2) footwear and foot self-care. Sample (n=273) mean age was 69.77 years (±11.08). The internal consistency of DiafootQ was α=0.916, and item response values were ICC=0.862–0.998. External validity correlation levels ranged from r=0.386 to r=0.888.</p></div><div><h3>Conclusion</h3><p>DiaFootQ was developed. Integrating the main aspects involved in diabetic foot disease could help to detect more accurately the risk or severity of these patients. DiaFootQ is a well-structured, valid, and reliable tool whose use should be promoted in clinical and research settings.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824001566/pdfft?md5=ab53b52469da71d372919a94742e4565&pid=1-s2.0-S1751991824001566-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763605","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":"Physicians’ stigmatizing attitudes about individuals with type 2 diabetes: Associations with communication practices and perceived barriers to care","authors":"Brooke L. Bennett ,&nbsp;Rebecca M. Puhl","doi":"10.1016/j.pcd.2024.07.001","DOIUrl":"10.1016/j.pcd.2024.07.001","url":null,"abstract":"<div><h3>Aims</h3><p>The stigma of type 2 diabetes (T2D) has received growing attention in the healthcare setting. However, there has been almost no research examining how healthcare professional biases about diabetes relate to patient care. This cross-sectional study examined how physicians’ self-reported biases, stereotypes, and attributions about diabetes and obesity were related to their patient care practices.</p><p><em>Methods:</em><span><span> Physicians treating T2D, specializing in internal medicine or </span>endocrinology (n=205), completed a battery of online questionnaires.</span></p><p><em>Results:</em> Physicians who attributed poor patient compliance as the primary barrier to provision of diabetes care had worse perceptions of individuals with T2D and were less likely to use person-centered approaches with their patients. Physicians’ stigmatizing attitudes about T2D were associated with less use of person-first language, while more positive perceptions of individuals with T2D were associated with greater use of motivational interviewing. Weight-related stigma was associated with less use of person-centered approaches to care and less confidence in their ability to provide care.</p><p><em>Conclusions:</em></p><p>Findings reiterate the associations between weight stigma and poorer physician communication and suggest that similar patterns occur in the provision of care for individuals with T2D. Physicians who treat T2D may benefit from stigma reduction interventions for both diabetes and weight-related stigmas.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141763635","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":"Prevalence and characteristics of chronic kidney disease in people with type 2 diabetes mellitus in the Autonomous Community of Aragon","authors":"","doi":"10.1016/j.pcd.2024.06.006","DOIUrl":"10.1016/j.pcd.2024.06.006","url":null,"abstract":"<div><h3>Aims</h3><p><span>The main objective in this study was to determine the prevalence of Chronic Kidney Disease<span> (CKD) in people with Type 2 Diabetes Mellitus (T2DM) in the Autonomous Community (AC) of Aragon (Spain) and to detect whether or not there is under-registration in the </span></span>patient's history. As a secundary objetive, it was proposed to study the most relevant demographic and clinical characteristics of people with CKD.</p></div><div><h3>Methods</h3><p>Observational and retrospective real world data study of the population over 18 years of age with a diagnosis of T2DM, between January 2017 and December 2021. A descriptive analysis of qualitative and quantitative variables, and a comparison using the parametric Student's t-test or the non-parametric Mann-Whitney U-test between both groups was performed.</p></div><div><h3>Results</h3><p><span>The prevalence of T2DM was 8.07 % and that of CKD 31.4 %, with an under-reporting of 47 %. The main risk factor associated with CKD was arterial hypertension (p&lt;0.001), followed by dyslipidemia<span> (p&lt;0.001). The main treatment used for diabetes control was metformin, both in patients with and without CKD (p&lt;0.001). A total of 56.81 % of people with T2DM and CKD did not undergo annual monitoring of their </span></span>renal function<span> (glomerular filtration rate) or determination of albuminuria.</span></p></div><div><h3>Conclusions</h3><p>The prevalence of CKD increases in patients with T2DM (31.4 %), and in almost half of patients the diagnosis is not registered (47 %). This under-reporting delays the implementation of measures needed to prevent CKD progression.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592504","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":"Adherence and persistence among people with type 2 diabetes newly initiating oral semaglutide versus DPP-4is in a US real-world setting","authors":"","doi":"10.1016/j.pcd.2024.06.013","DOIUrl":"10.1016/j.pcd.2024.06.013","url":null,"abstract":"<div><h3>Aims</h3><p>To investigate real-world treatment adherence and persistence in people with type 2 diabetes newly initiating oral semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), or a dipeptidyl peptidase-4 inhibitor (DPP-4i).</p></div><div><h3>Methods</h3><p>This retrospective cohort study used the Merative™ MarketScan® Commercial and Medicare databases. Index date was the first fill for the cohort medication. Adherence was defined as proportion of days covered (PDC) over the 12-month post-index period (‘adherent’ = ≥0.8). Persistence was number of days until discontinuation, based on a 45-day gap. Results were compared between cohorts using inverse probability treatment weighting.</p></div><div><h3>Results</h3><p>Oral semaglutide (n=5485) and DPP-4i (n=4980) cohorts had similar percentages of people who were adherent (PDC ≥0.8; 41.6 % vs. 42.9 %; P = 0.182) and persistent for ≥9 months (45.0 % vs. 46.3 %; P = 0.185). The DPP-4i cohort used significantly more anti-diabetic medication (ADM) classes over the post-index period (mean±SD: 2.6±1.0 vs. 2.9±1.1, P &lt; 0.001), with 23.2 % filling a GLP-1 RA in the post-period.</p></div><div><h3>Conclusions</h3><p>Adherence and persistence were similar between cohorts. However, there are potential benefits to prescribing oral semaglutide over DPP-4is, including reduced need for additional ADM.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824001268/pdfft?md5=eb91da8b2f7eccf007c40b1b4af61eb3&pid=1-s2.0-S1751991824001268-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141592503","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":"Diet quality, community food access, and glycemic control among nulliparous individuals with diabetes","authors":"","doi":"10.1016/j.pcd.2024.06.011","DOIUrl":"10.1016/j.pcd.2024.06.011","url":null,"abstract":"<div><p>Better diet quality regardless of community food access was associated with a higher likelihood of glycemic control in early pregnancy among nulliparous individuals with pregestational diabetes. These findings highlight the need for interventions that address nutrition insecurity for pregnant individuals living with diabetes.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824001244/pdfft?md5=9c9d34b1d2ac3020e9c68467cba080df&pid=1-s2.0-S1751991824001244-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556304","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":"Clinical practice recommendations for management of Diabetes Mellitus in Arab region: An expert consensus statement from Arab Diabetes Forum (ADF)","authors":"","doi":"10.1016/j.pcd.2024.06.003","DOIUrl":"10.1016/j.pcd.2024.06.003","url":null,"abstract":"<div><p>Prevalence of diabetes in Arab region has significantly increased, resulting in a significant economic burden on healthcare systems. This surge can be attributed to obesity, rapid urbanization, changing dietary habits, and sedentary lifestyles. The Arab Diabetes Forum (ADF) has established localized recommendations to tackle the region's rising diabetes prevalence. The recommendations, which incorporate worldwide best practices, seek to enhance the quality of treatment for people with diabetes by raising knowledge and adherence among healthcare providers. The guidelines include comprehensive recommendations for screening, diagnosing, and treating type 1 and type 2 diabetes in children and adults for better overall health results.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824001207/pdfft?md5=2dbdcb053445b67dfa79edebb978a164&pid=1-s2.0-S1751991824001207-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494713","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":"Charcot neuroarthropathy in diabetic patients in Texas","authors":"","doi":"10.1016/j.pcd.2024.06.012","DOIUrl":"10.1016/j.pcd.2024.06.012","url":null,"abstract":"<div><h3>Aims</h3><p>Charcot neuroarthropathy (CN) is a complex disease of the bone and joints that can lead to serious and life-threatening complications. This study investigates epidemiologic trends in diabetic CN in Texas and the impact of age on these values.</p></div><div><h3>Methods</h3><p><span>A retrospective analysis was conducted using the Texas Department of State Health Services Hospital Discharge Data Public Use Data File. Using </span>International Classification of Diseases, Ninth (ICD-9) and Tenth (ICD-10) Revision codes, we identified patients with diabetes and Charcot ankle or foot. Data extracted included diagnoses, race, and gender. Population rates were estimated using census data, calculated per 1000 population and standardized by age.</p></div><div><h3>Results</h3><p>Overall and age-standardized rates of CN increased each year from 2006 to 2016, except for a downward trend from 2014 to 2016. Poisson regression revealed significant increases in the incidence rate ratio compared to 2006 for each year from 2008 to 2016. When age group is included, all years except 2007 show a significant increase relative to 2006, and all age groups have increased rates relative to ages 18–44. Major and minor amputations in patients with CN have increased.</p></div><div><h3>Conclusions</h3><p>The increasing rates of CN and amputations highlight the need for further research and standardized strategies for diagnosis and management.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474118","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":"A machine learning tool for identifying patients with newly diagnosed diabetes in primary care","authors":"","doi":"10.1016/j.pcd.2024.06.010","DOIUrl":"10.1016/j.pcd.2024.06.010","url":null,"abstract":"<div><h3>Background and aim</h3><p>It is crucial to identify a diabetes diagnosis early. Create a predictive model utilizing machine learning (ML) to identify new cases of diabetes in primary health care (PHC).</p></div><div><h3>Methods</h3><p>A case-control study utilizing data on PHC visits for sex-, age, and PHC-matched controls. Stochastic gradient boosting was used to construct a model for predicting cases of diabetes based on diagnostic codes from PHC consultations during the year before index (diagnosis) date and number of consultations. Variable importance was estimated using the normalized relative influence (NRI) score. Risks of having diabetes were calculated using odds ratios of marginal effects (OR_ME). Four groups by age and sex were studied, age-groups 35–64 years and ≥ 65 years in men and women, respectively.</p></div><div><h3>Results</h3><p>The most important predictive factors were hypertension with NRI 21.4–29.7 %, and obesity 4.8–15.2 %. The NRI for other top ten diagnoses and administrative codes generally ranged 1.0–4.2 %.</p></div><div><h3>Conclusions</h3><p>Our data confirm the known risk patterns for predicting a new diagnosis of diabetes, and the need to test blood glucose frequently. To assess the full potential of ML for risk prediction purposes in clinical practice, future studies could include clinical data on life-style patterns, laboratory tests and prescribed medication.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824001232/pdfft?md5=45c46752d01aa4e253b12cd36692b632&pid=1-s2.0-S1751991824001232-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474117","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":"Comment on: Association between polyunsaturated fatty acids and progression among patients with diabetic kidney disease","authors":"","doi":"10.1016/j.pcd.2024.06.009","DOIUrl":"10.1016/j.pcd.2024.06.009","url":null,"abstract":"","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474119","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(24)00082-2","DOIUrl":"https://doi.org/10.1016/S1751-9918(24)00082-2","url":null,"abstract":"","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000822/pdfft?md5=7d3871f1dbd0963189cac6daba85c4d5&pid=1-s2.0-S1751991824000822-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141083336","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}