Primary Care Diabetes最新文献

{"title":"Effect of switch from flash glucose monitoring to flash glucose monitoring with real-time alarms on hypoglycaemia in people with type 1 diabetes mellitus","authors":"A. Gutiérrez-Pastor ,&nbsp;JA Quesada ,&nbsp;MM Soler-Martínez ,&nbsp;C. Carratalá Munuera ,&nbsp;FJ Pomares-Gómez","doi":"10.1016/j.pcd.2024.04.003","DOIUrl":"10.1016/j.pcd.2024.04.003","url":null,"abstract":"<div><p>We aimed to evaluate the utility of the FreeStyle Libre 2 device for reducing time below range level 1 and level 2 compared with the Freestyle Libre device (without alarms) in people with type 1 diabetes mellitus. We conducted longitudinal observational follow-up study of a cohort of 100 people with type 1 diabetes mellitus who had switched from FreeStyle Libre to FreeStyle Libre 2 as part of routine clinical practice. Three months after switching to FreeStyle Libre 2, compared with results with FreeStyle Libre, there were a significant improvements in time below range level 1 (p = 0.02) and level 2 (p &lt;0.001), time in range (p &lt;0.001), time above range level 1 (p = 0.002), glucose management indicator (p= 0.04) and mean glucose (p= 0.04) during follow-up. Furthermore there was a significant direct association between age and change in TIR with a coefficient of 0.23, and a significant inverse association between age and change in TAR-1 with a coefficient of 0.11. Switching to a flash glucose monitoring system with alarms improves time below range, time in range and coefficient of variation in people with type 1 diabetes mellitus.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000755/pdfft?md5=c81c87931ccf5b926a28dfda3e1b6b6d&pid=1-s2.0-S1751991824000755-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140857705","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":"The association between depressive symptoms and executive function in type 1 diabetes population: A scoping review","authors":"Chawisa Dandamrongrak ,&nbsp;Kaitlyn Rechenberg ,&nbsp;Jumpee Granger ,&nbsp;Ayesha Johnson ,&nbsp;Kailei Yan ,&nbsp;Jennifer Kue","doi":"10.1016/j.pcd.2024.04.001","DOIUrl":"10.1016/j.pcd.2024.04.001","url":null,"abstract":"<div><h3>Purpose</h3><p>The purpose of this study was to explore the existing literature on the relationship between depressive symptoms and executive function in patients with type 1 diabetes (T1DM) across the lifespan.</p></div><div><h3>Methods</h3><p>The scoping review followed the PRISMA protocol by using three databases: PubMed, CINAHL, and PsycINFO on May 14, 2023. Primary research that included reported executive function and the association with depressive symptoms was included in the review.</p></div><div><h3>Results</h3><p>Of 1470 de-duplicated publications identified, nine articles were included in the review. Five studies evaluated the T1DM population, while four studies evaluated T1DM and type 2 diabetes (T2DM) as an aggregate result. Three studies indicated an association between depressive symptoms and executive function in adults with T1DM, and four studies indicated an association between depressive symptoms and executive function in adults with either T1DM or T2DM. In general, participants who reported depressive symptoms also exhibited poor executive function. However, two studies did not find an association between depressive symptoms and executive function.</p></div><div><h3>Conclusion</h3><p>In summary, the seven studies in this review suggest that individuals with T1DM who report depressive symptoms are at a higher risk of poor executive function; a clear association between depressive symptoms and executive function in individuals with T1DM remains inconclusive. There is a need to explore this relationship in the future.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140758613","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":"Fish skin grafts versus standard of care on wound healing of chronic diabetic foot ulcers: A systematic review and meta-analysis","authors":"Maria Ruiz-Muñoz,&nbsp;Francisco-Javier Martinez-Barrios,&nbsp;Pablo Cervera-Garvi,&nbsp;Eva Lopezosa-Reca,&nbsp;Ana J. Marchena-Rodriguez","doi":"10.1016/j.pcd.2024.03.008","DOIUrl":"10.1016/j.pcd.2024.03.008","url":null,"abstract":"<div><h3>Introduction</h3><p>This study will explore the effectiveness of fish skin grafts (FSG) in ulcer healing in diabetic foot disease compared to standard of care (SOC).</p></div><div><h3>Methods</h3><p>The systematic review and meta-analysis were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standard. The electronic databases of PubMed, EMBASE, and Web of Science (WoS) internet were searched for the outcome rate of complete ulcer healing. The risk of bias assessment was conducted using the tool recommended by the Cochrane Collaboration. Statistical analysis included the individual and combined result of the studies, heterogeneity test, the effect size, sensitivity analysis, and publication bias tests.</p></div><div><h3>Results</h3><p>Five randomised controlled trials (RCTs) with a total of 411 patients were included in this study. This meta-analysis showed a higher rate of complete ulcer healing in groups receiving fish skin grafts (OR = 3.34, 95% CI 2.14–5.20, p &lt; 0.01, I² = 0%) compared to control groups.</p></div><div><h3>Conclusion</h3><p>Fish skin grafts have been shown to be more effective for achieving complete ulcer healing compared to current conventional treatments in diabetic foot disease.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S175199182400072X/pdfft?md5=75a5e7518d71811beefb61caa7511e47&pid=1-s2.0-S175199182400072X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140797079","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":"Impact of Ramadan fasting on lipid profile, uric acid, and HbA1c in CKD: A systematic review and meta-analysis","authors":"Ali Ashkbari ,&nbsp;Hossein-Ali Nikbakht ,&nbsp;Saeid Amirkhanlou ,&nbsp;Ghazaleh Elahi ,&nbsp;Marjan Salahi ,&nbsp;Sareh Ebrahimi ,&nbsp;Saeed Golfiroozi ,&nbsp;Seyed Ahmad Hosseini ,&nbsp;Mousa Ghelichi-Ghojogh","doi":"10.1016/j.pcd.2024.03.007","DOIUrl":"10.1016/j.pcd.2024.03.007","url":null,"abstract":"<div><p>Studies have shown that fasting during Ramadan has different effects on circulating levels of several biochemical markers. This study aims to conduct a comprehensive evaluation of studies related to the effect of fasting in the holy month of Ramadan on lipid profile, uric acid, and HbA1c in CKD patients. Studies were systematically searched and collected from three databases (PubMed, Scopus, and Web of Science). After screening, the quality and risk of bias assessment of the selected articles were evaluated. Study heterogeneity was assessed using the Cochrane test and I² statistic. In case of any heterogeneity random effects model with the inverse-variance method was applied. All analyses were performed using STATA software version 16. Four observational studies were included in this study. The results of this meta-analysis were that cholesterol (Weighted mean differences (WMD):0.21 with 95% CI:-0.09–0.51 (P-value=:0.18)), LDL (WMD:0.06 with 95% CI −0.24–0.36 (P-value:0.69)), triglyceride (WMD:0.05 with 95% CI:-0.25–0.35 (P-value:0.73)) had not-significant increase. Uric acid (WMD: −0.11 with 95% CI: −0.42–0.21 (P-value:0.51)) and HbA1c (WMD: −0.22 with 95% CI: −0.79–0.36 (P-value: 0.46)) show a non-significant decrease. The results of the analyses did not report significant changes in the lipid profile, uric acid, and HbA1c in CKD patients after Ramadan fasting.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140767574","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 multimodal approach using fundus images and text meta-data in a machine learning classifier with embeddings to predict years with self-reported diabetes – An exploratory analysis","authors":"Rodrigo M. Carrillo-Larco ,&nbsp;Gusseppe Bravo-Rocca ,&nbsp;Manuel Castillo-Cara ,&nbsp;Xiaolin Xu ,&nbsp;Antonio Bernabe-Ortiz","doi":"10.1016/j.pcd.2024.04.002","DOIUrl":"10.1016/j.pcd.2024.04.002","url":null,"abstract":"<div><h3>Aims</h3><p>Machine learning models can use image and text data to predict the number of years since diabetes diagnosis; such model can be applied to new patients to predict, approximately, how long the new patient may have lived with diabetes unknowingly. We aimed to develop a model to predict self-reported diabetes duration.</p></div><div><h3>Methods</h3><p>We used the Brazilian Multilabel Ophthalmological Dataset. Unit of analysis was the fundus image and its meta-data, regardless of the patient. We included people 40 + years and fundus images without diabetic retinopathy. Fundus images and meta-data (sex, age, comorbidities and taking insulin) were passed to the MedCLIP model to extract the embedding representation. The embedding representation was passed to an Extra Tree Classifier to predict: 0–4, 5–9, 10–14 and 15 + years with self-reported diabetes.</p></div><div><h3>Results</h3><p>There were 988 images from 563 people (mean age = 67 years; 64 % were women). Overall, the F1 score was 57 %. The group 15 + years of self-reported diabetes had the highest precision (64 %) and F1 score (63 %), while the highest recall (69 %) was observed in the group 0–4 years. The proportion of correctly classified observations was 55 % for the group 0–4 years, 51 % for 5–9 years, 58 % for 10–14 years, and 64 % for 15 + years with self-reported diabetes.</p></div><div><h3>Conclusions</h3><p>The machine learning model had acceptable accuracy and F1 score, and correctly classified more than half of the patients according to diabetes duration. Using large foundational models to extract image and text embeddings seems a feasible and efficient approach to predict years living with self-reported diabetes.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140782140","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":"Willingness of people with type 2 diabetes to engage in healthy eating, physical activity and medication taking","authors":"Martina Ambrož ,&nbsp;Sieta T. de Vries ,&nbsp;Goya Buitenhuis ,&nbsp;Julia Frost ,&nbsp;Petra Denig","doi":"10.1016/j.pcd.2024.03.006","DOIUrl":"10.1016/j.pcd.2024.03.006","url":null,"abstract":"<div><h3>Aim</h3><p>To assess the willingness of people with type 2 diabetes (T2D) to engage in healthy eating, physical activity and medication taking, and explore associated patient factors.</p></div><div><h3>Methods</h3><p>Online survey among recently diagnosed T2D patients recruited in the Netherlands and the United Kingdom (UK). Patient factors included general factors and behaviour-specific beliefs. Logistic regression analyses and explorative comparisons were conducted.</p></div><div><h3>Results</h3><p>Overall, 48% of 67 patients were willing to engage in all three management options, whereas 6% were not willing to follow any of them. 73% were willing to manage T2D with healthy eating, 73% with physical activity, and 72% with medication. Country of recruitment was significantly associated with willingness for healthy eating, with higher willingness among Dutch participants. Beliefs surrounding capability, opportunity, and motivation were significantly associated with willingness to engage in physical activity and medication taking. Many beliefs were similar regardless of willingness but those willing to engage in physical activity perceived less barriers and those willing to take medication had more positive and less negative outcome beliefs than those not willing.</p></div><div><h3>Conclusions</h3><p>Willingness to engage in all management options was limited among recently diagnosed patients, and partly associated with behaviour-specific patient beliefs.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000706/pdfft?md5=d7145b4568ba9faa11b894efeae29a42&pid=1-s2.0-S1751991824000706-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140776507","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":"Methods, rationale, and design for a remote pharmacist and navigator-driven disease management program to improve guideline-directed medical therapy in patients with type 2 diabetes at elevated cardiovascular and/or kidney risk","authors":"Alexander J. Blood ,&nbsp;Lee-Shing Chang ,&nbsp;Caitlin Colling ,&nbsp;Gretchen Stern ,&nbsp;Daniel Gabovitch ,&nbsp;Guinevere Feldman ,&nbsp;Asma Adan ,&nbsp;Fanta Waterman ,&nbsp;Emily Durden ,&nbsp;Carol Hamersky ,&nbsp;Joshua Noone ,&nbsp;Samuel J. Aronson ,&nbsp;Paul Liberatore ,&nbsp;Thomas A. Gaziano ,&nbsp;Lina S. Matta ,&nbsp;Jorge Plutzky ,&nbsp;Christopher P. Cannon ,&nbsp;Deborah J. Wexler ,&nbsp;Benjamin M. Scirica","doi":"10.1016/j.pcd.2024.01.005","DOIUrl":"10.1016/j.pcd.2024.01.005","url":null,"abstract":"<div><h3>Aim</h3><p>Describe the rationale for and design of Diabetes Remote Intervention to improVe use of Evidence-based medications (DRIVE), a remote medication management program designed to initiate and titrate guideline-directed medical therapy (GDMT) in patients with type 2 diabetes (T2D) at elevated cardiovascular (CV) and/or kidney risk by leveraging non-physician providers.</p></div><div><h3>Methods</h3><p>An electronic health record based algorithm is used to identify patients with T2D and either established atherosclerotic CV disease (ASCVD), high risk for ASCVD, chronic kidney disease, and/or heart failure within our health system. Patients are invited to participate and randomly assigned to either simultaneous education and medication management, or a period of education prior to medication management. Patient navigators (trained, non-licensed staff) are the primary points of contact while a pharmacist or nurse practitioner reviews and authorizes each medication initiation and titration under an institution-approved collaborative drug therapy management protocol with supervision from a cardiologist and/or endocrinologist. Patient engagement is managed through software to support communication, automation, workflow, and standardization.</p></div><div><h3>Conclusion</h3><p>We are testing a remote, navigator-driven, pharmacist-led, and physician-overseen management strategy to optimize GDMT for T2D as a population-level strategy to close the gap between guidelines and clinical practice for patients with T2D at elevated CV and/or kidney risk.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000056/pdfft?md5=35e2466e6c655d9882f55828dafb99c8&pid=1-s2.0-S1751991824000056-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139667885","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":"Reliability and validity of the Turkish version of the problem areas in diabetes (PAID) survey: Results from diabetes MILES – Turkey","authors":"Dilara Karşıdağ Altıkardeş ,&nbsp;Giesje Nefs ,&nbsp;Hülya Hacışahinoğulları ,&nbsp;Tom Smeets ,&nbsp;Frans Pouwer","doi":"10.1016/j.pcd.2024.01.001","DOIUrl":"10.1016/j.pcd.2024.01.001","url":null,"abstract":"<div><h3>Background and Aims</h3><p>To 1) assess the reliability and validity of the Turkish version of the Problem Areas in Diabetes (PAID), PAID-5 and PAID-1 survey among Turkish adults with type 1 or type 2 diabetes, 2) estimate the level of elevated diabetes-specific distress (DD), and 3) determine the demographic and clinical correlates of DD-symptom severity.</p></div><div><h3>Methods and Results</h3><p>From 2017–2019, 252 adults with type 1(<em>n</em> = 80) (T1DM) or type 2 diabetes (<em>n</em><span><span> = 172) (T2DM) self-reported demographic factors, DD(PAID) and related psychological and clinical questionnaires. We examined PAID internal consistency, structural and </span>convergent validity<span>. Associations of measures with DD were explored with hierarchical linear regression analysis<span><span>. PCA yielded a 3-factor solution for PAID-20 and a 2-factor solution for PAID-5. Cronbach’s α for PAID/PAID-5 subscales ranged from 0.63–0.90. All PAID versions correlated most strongly to BIPQ and HFS. The prevalence of elevated distress (PAID-20 ≥33) was 40% in T1DM and 15% in </span>T2DM. DD severity was significantly positively associated (</span></span></span><em>p</em><span> &lt; 0.01) with more negative diabetes perceptions (BIPQ) and type 1 diabetes.</span></p></div><div><h3>Conclusions</h3><p>The Turkish translation of the PAID and its short forms appeared to have satisfactory psychometric properties. Elevated diabetes distress was more common in T1DM.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139463384","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":"Trends in the prevalence of gestational diabetes in Catalonia from 2010 to 2019","authors":"Berta Soldevila ,&nbsp;Lourdes Alarcón ,&nbsp;Bogdan Vlacho ,&nbsp;Jordi Real ,&nbsp;Marta Hernández ,&nbsp;Xavier Cos ,&nbsp;Josep Franch-Nadal ,&nbsp;Dídac Mauricio","doi":"10.1016/j.pcd.2023.12.007","DOIUrl":"10.1016/j.pcd.2023.12.007","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Gestational diabetes mellitus (GDM) is globally increasing due to changes in risk factors such as gestational age, obesity, and socioeconomic status (SES). This study examined trends of GDM prevalence over ten years using a real-world </span>Primary Health Care database from Catalonia (Spain). Methods: A retrospective analysis of pregnant women screened for GDM was conducted, using clinical and SES data from the SIDIAP database. Results: Among 221,806 women studied from 2010 to 2019,17,587 had GDM, equating to a 7.9% prevalence (95% CI 7.8–8.04). GDM subjects were older (33.5 ± 5.1 vs. 31.2 ± 5.6 years; p &lt; 0.001) and had higher </span>BMI<span> (29.2 ± 5.1 vs .27.8 ± 4.8 kg/m²; p &lt; 0.001) than non-GDM individuals. Overall GDM prevalence remained unchanged throughout the study, although an increase was observed in younger women (below 20 years: 1.28% [95% CI 0.59–2.42] in 2010 to 2.22% [95% CI 0.96–4.33] in 2019, p = 0.02; ages 20–25.9 years: 3.62% [95% CI 3.12–4.17] in 2010 to 4.63% [95% CI 3.88–5.48)] in 2019, p = 0.02). Age, BMI ≥ 25 kg/m2, deprived SES, and previous hypertension and dyslipidaemia were positively associated with GDM.</span></p></div><div><h3>Conclusions</h3><p>This study offers insights into GDM prevalence in Catalonia (Spain),showing overall stability except for a rising trend among younger women.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139471073","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 assessment of quality of care of patients with type 2 diabetes mellitus in a population-based cohort in the District of Landeck in Austria","authors":"Veronika Haslwanter ,&nbsp;Ursula Rochau ,&nbsp;Lára R. Hallsson ,&nbsp;Uwe Siebert ,&nbsp;Hans-Robert Schönherr ,&nbsp;Monika Lechleitner ,&nbsp;Willi Oberaigner","doi":"10.1016/j.pcd.2024.01.011","DOIUrl":"10.1016/j.pcd.2024.01.011","url":null,"abstract":"<div><h3>Introduction</h3><p>Structured diabetes care based on evidence-based guidelines is one of the main strategies to improve glycemic control and to reduce long-term complications in diabetes mellitus.</p></div><div><h3>Methods</h3><p>This study is based on the “Diabetes-Landeck Cohort”, a population-based cohort of patients with diabetes mellitus type 2 (T2DM). We assessed the quality of diabetes care and compared it between three groups of care units, that is, general practitioners (GP), diabetes specialists in private practice (DSPP), and hospitals (HOSP).</p></div><div><h3>Results</h3><p>The total study population comprised 1616 patients with T2DM, including 378 patients of GP, 281 of DSPP, and 957 from HOSP. We identified statistically significant differences: DSPP showed the highest percentage of structured training, sufficient training, eye examinations and foot examinations. The group HOSP showed the highest proportion for increased HbA1c≥ 7.5 and almost all long-term complications surveyed, that is, nephropathy (23.2%), neuropathy (14.4%), diabetic foot (5.1%), and cerebrovascular diseases (10.9%).</p></div><div><h3>Conclusion</h3><p>This population-based cohort study on patients with T2DM in Austria showed significant differences in important quality-of-care process and outcome parameters across different groups of care units. Future research should also include prediction modeling for early warning and monitoring systems as well as adjustment for patient characteristics and duration and severity of disease.</p></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1751991824000123/pdfft?md5=521bc30c72a21dde7a72bef3d41580f0&pid=1-s2.0-S1751991824000123-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139713602","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}