Primary Care Diabetes最新文献

{"title":"Managing type 1 diabetes at work – A qualitative meta-synthesis","authors":"Emma Victoria Shiel ,&nbsp;Steve Hemingway ,&nbsp;Rajeeb Kumar Sah ,&nbsp;Kim Burton","doi":"10.1016/j.pcd.2025.06.009","DOIUrl":"10.1016/j.pcd.2025.06.009","url":null,"abstract":"<div><h3>Aims</h3><div>To interpret the available qualitative research findings on people’s experiences of managing type 1 diabetes at work.</div></div><div><h3>Methods</h3><div>A qualitative meta-synthesis was conducted using constant comparative methods, reciprocal analysis, and a line of argument synthesis, which were expressed narratively.</div></div><div><h3>Results</h3><div>The study included thirteen articles, revealing a complex relationship between type 1 diabetes and work. People with type one diabetes want minimal interference in their daily routines while balancing health and work responsibilities. The concept of 'containment' emerged as a key strategy, where self-management is integrated alongside work demands. However, this approach may inadvertently lead to psychosocial conflicts and detrimental health outcomes.</div></div><div><h3>Conclusions</h3><div>The findings highlight the importance of creating supportive and empowering workplaces to reduce the tensions between type one diabetes and work. Enabling people with type one diabetes to self-manage effectively while maintaining autonomy requires support that both fosters self-management and avoids isolation. This sort of supportive and empowering work environment for workers with type one diabetes could contribute to facilitating [re]entry and retention in the workforce. This synthesis adds to contemporary knowledge, particularly in qualitative areas, yet further study is needed to identify specific actions that can create more accommodating workplaces for people with type one diabetes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 426-433"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593292","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":"Pattern of semaglutide prescription in a real-world Canadian patient cohort","authors":"Armin Farahvash ,&nbsp;Michelle CM Lee ,&nbsp;Rahul Jain ,&nbsp;Liisa Jaakkimainen","doi":"10.1016/j.pcd.2025.06.006","DOIUrl":"10.1016/j.pcd.2025.06.006","url":null,"abstract":"<div><h3>Aims</h3><div>Despite the growing interest in the broad applications of semaglutide, real-world data on its use in weight-loss is limited. This study aims to explore the pattern of semaglutide prescriptions in a Canadian family medicine practice.</div></div><div><h3>Methods</h3><div>This retrospective study included patients ≥ 18 years who were enrolled in Sunnybrook Academic Family practice in Toronto, Canada and prescribed semaglutide between January 2018 and April 2024. Baseline demographics, weight measurements up to 16 months, and prescription details were collected. Descriptive statistics was used to illustrate the patterns of semaglutide prescription.</div></div><div><h3>Results</h3><div>Of 9930 enrolled patients, 368 (3.71 %) were prescribed semaglutide and 335 used it. Mean age was 57.7 ± 14.1 years and 63.3 % were female. Mean BMI was 36.6 ± 7.84 kg/m². Semaglutide was discontinued due to side effects in 11 (3.3 %) within one month and 27 (8.1 %) at any time. There was an increasing trend in semaglutide prescriptions from 2018 to 2023. There were increasing semaglutide prescriptions for weight-loss, and prescriptions by family physicians compared to specialists. Follow up measurements showed a mean weight-loss of 7.5 % in 212 patients.</div></div><div><h3>Conclusions</h3><div>In an Ontario academic family practice, semaglutide is being more frequently prescribed in the primary care setting, particularly for weight loss.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 512-516"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499983","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 metabolic risk factors control among adults with type 2 diabetes: A comparative study of 2018 and 2021","authors":"Fereshteh Baygi,&nbsp;Peter Haastrup,&nbsp;Helene Støttrup Andersen,&nbsp;Sonja Wehberg,&nbsp;Jens Søndergaard","doi":"10.1016/j.pcd.2025.06.008","DOIUrl":"10.1016/j.pcd.2025.06.008","url":null,"abstract":"<div><h3>Aims</h3><div>This study aims to analyze recent trends in managing major metabolic risk factors among type 2 diabetes patients (T2D) over time.</div></div><div><h3>Methods</h3><div>We used data from the Danish Adult Diabetes Registry (DVDD) on health indicators in 2018 and 2021. Information about medication was found using Danish National Prescription Registry (DNPR). Cut points for abnormal values of the included health indicators were identified from the revised National Cholesterol Education Program Adult Treatment Panel III criteria. Correspondingly, reached target levels were defined. A logistic regression model based on generalized estimating equations was fitted to evaluate the difference between 2018 and 2021.</div></div><div><h3>Results</h3><div>We included 24,343 and 18,027 observations in 2018 and 2021, respectively. Longitudinal analyses showed statistically significant improvement in Low density lipoprotein, Blood pressure, triglycerides, and Glycated hemoglobin control overtime. The use of glucose-lowering and lipid-lowering medications, and antihypertensive medication increased. Obesity declined significantly overtime. Subgroup analyses highlighted improvement in metabolic control across age groups, with TG control declining in T2D patients over 60 years.</div></div><div><h3>Conclusions</h3><div>We found statistically significant improvement in metabolic risk factor control and medication use over time. Despite progress in managing LDL, BP, and HbA1c, challenges remain in Blood pressure and triglycerides control.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 486-496"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562494","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":"Cognitive impairment is associated with poor diabetic foot ulcer outcomes","authors":"Christopher Girgis ,&nbsp;Stephanie Behme ,&nbsp;Crystal Holmes ,&nbsp;Sari Priesand ,&nbsp;Evan L. Reynolds ,&nbsp;Jihyun Park ,&nbsp;Pearl G. Lee ,&nbsp;Brian M. Schmidt","doi":"10.1016/j.pcd.2025.07.008","DOIUrl":"10.1016/j.pcd.2025.07.008","url":null,"abstract":"<div><h3>Background</h3><div>Up to one-third of individuals with diabetes develop diabetic foot ulcers (DFU), and cognitive impairment affects up to 34 % of this population. This study evaluates the impact of cognitive impairment on ulcer outcomes.</div></div><div><h3>Methods</h3><div>This six-year retrospective study analyzed ICD-9/10 codes from a large tertiary health system. Eligible patients had DFU and at least six months of follow-up. Exclusions were made for those without an ulcer and not seen by a podiatrist. For the cohort without cognitive impairment, patients were excluded if they screened positive for cognitive impairment or dementia in the five years prior to diagnosis. Clinical outcomes were assessed using the Wound, Ischemic, Foot Infection classification, focusing on healing rates, time to healing, amputation events, and hospital admissions. Logistic regression determined associations between cognitive impairment and DFU outcomes.</div></div><div><h3>Results</h3><div>Of 631 charts reviewed, 123 patients were included: 56 with cognitive impairment (mean age 71.9) and 67 without (mean age 58). Healing rates at six months were lower for those with cognitive impairment (39 % vs. 72 %, p &lt; 0.001). They had higher rates of major amputations (17.8 % vs. 5.9 %, odds ratio 4.5, p &lt; 0.05) and foot-related admissions (p = 0.01).</div></div><div><h3>Conclusions</h3><div>Individuals with DFU and cognitive impairment were at higher risk of major amputation, foot-related admissions, and nonhealing, underscoring the need for targeted interventions.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 527-532"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755529","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":"Response to comment on “Comment on characteristics of metabolic inflammatory syndrome among inpatients with type 2 diabetes: A cross-sectional study in China”","authors":"Mengjuan Xue,&nbsp;Bin Lu","doi":"10.1016/j.pcd.2025.07.006","DOIUrl":"10.1016/j.pcd.2025.07.006","url":null,"abstract":"<div><div>This manuscript addresses several comments raised by Dr. Liao on metabolic inflammatory syndrome (MIS) in type 2 diabetes inpatients. It explains the limitations including selection bias in the study population, lack of exploration of molecular mechanisms, and discrepancies in dyslipidemia findings.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 554-555"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144755530","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":"Achieving meaningful reduction of HgbA1c in pediatric type 1 diabetes requires an individualized approach","authors":"Andrew Kanouse ,&nbsp;Joanna S. Fishbein ,&nbsp;Parissa Salemi","doi":"10.1016/j.pcd.2025.07.005","DOIUrl":"10.1016/j.pcd.2025.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>Individuals with diabetes often have difficulty attaining a goal hemoglobin A1c &lt; 7.0 %. Diabetes care is multifactorial, including medications, education, and lifestyle intervention. Individuals with a hemoglobin A1c (HgbA1c) <u>&gt;</u> 10 % are especially at risk for complications. The aim of this study was to evaluate the association of technological interventions [continuous glucose monitors (CGM) and/or continuous subcutaneous insulin infusion devices (CSII, i.e. insulin pumps)] and frequency of clinic visits with improvement of HgbA1c values in children with type 1 diabetes (T1D) who have a HgbA1c <u>&gt;</u> 10 %.</div></div><div><h3>Research design and methods</h3><div>A chart review was performed for patients with T1D who had a HgbA1c &gt; 10 % and a diagnosis of T1D for greater than 1 year between 2018 and 2019 analyzing demographic data, treatment modality, and frequency of visits to determine if a clinically meaningful HgbA1c reduction (&gt;0.5 %) was achieved.</div></div><div><h3>Results</h3><div>One hundred and forty-seven children were evaluated. Altogether, 9 children (53 %) with CGM only, 18 (64 %) with CSII only, and 14 (78 %) with combination use achieved a clinically significant reduction as compared to 50 (60 %) with no technology. When evaluating number of visits, 41 children (61 %) with 1–2 visits, 40 (60 %) with 3, 19 (70 %) with 4, and 5 (50 %) with 5–6 achieved reduction.</div></div><div><h3>Conclusions</h3><div>These results show that while either use of technology or increased clinic visits may improve the ability to achieve meaningful HgbA1c reductions, this may not be true for all patients. While some patients may need numerous clinic visits, others may be able to make dramatic changes with only two visits. Similarly, while some may benefit from CGM use alone, others may improve their HgbA1c with a CSII or no technology. Given the intricacies of diabetes care, this data supports that patients would likely benefit from a tailored treatment plan catered to their individual needs to best optimize their HgbA1c.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 522-526"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692793","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":"Comment on ‘Characteristics of metabolic inflammatory syndrome among inpatients with type 2 diabetes: A cross-sectional study in China’","authors":"Mao Liao","doi":"10.1016/j.pcd.2025.04.003","DOIUrl":"10.1016/j.pcd.2025.04.003","url":null,"abstract":"<div><div><span><span>This commentary critically evaluates the cross - sectional study by Li et al. on metabolic inflammatory syndrome (MIS) in type 2 diabetes (T2D) inpatients. It points out limitations including selection bias in the study population, lack of exploration of molecular mechanisms, and discrepancies in </span>dyslipidemia findings. Additionally, it proposes </span>prospective cohort studies<span> and specific research directions to enhance the understanding of MIS as a risk factor for coronary heart disease and improve its clinical relevance.</span></div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 552-553"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061385","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":"Impact of a primary care-based mobile health intervention to ‘sit less and move more’ on HbA1c, blood pressure, and other clinical outcomes in office employees with type 2 diabetes: A randomized controlled trial","authors":"Francesc Alòs ,&nbsp;Ma Àngels Colomer ,&nbsp;Judit Bort-Roig ,&nbsp;Carlos Martin-Cantera ,&nbsp;Alicia Minaya ,&nbsp;Ignasi Saigí ,&nbsp;Miquel Sitjar-Suñer ,&nbsp;Anna Puig-Ribera","doi":"10.1016/j.pcd.2025.05.010","DOIUrl":"10.1016/j.pcd.2025.05.010","url":null,"abstract":"<div><h3>Background</h3><div>Type 2 diabetes (T2D) is a prevalent and costly disease, with sedentary behaviour and physical inactivity as modifiable contributors. Mobile health (mHealth) applications provide complementary strategies for T2D management, but their impact on clinical outcomes remains unclear.</div></div><div><h3>Objective</h3><div>This study evaluated the efficacy of an mHealth programme promoting “sit less and move more” at work, prescribed in clinical practice, on clinical and cardiovascular risk factors in office employees with T2D.</div></div><div><h3>Methods</h3><div>A randomized controlled trial compared usual care (n = 25) with a 13-week mHealth intervention (n = 29) using the Walk@Work-App and web-based tools. Outcomes included HbA1c, glycemia, lipid profile, domain-specific sedentary behaviour (Workforce Sitting Questionnaire), objective physical activity and sedentary behaviour (ActivPal), blood pressure, and BMI at baseline, 6, and 12 months.</div></div><div><h3>Results</h3><div>Compared to the control group and at 12 months, the intervention group showed a significant reduction in HbA1c (p &lt; 0.05), systolic and diastolic blood pressure (p &lt; 0.05). Sitting time decreased during leisure activities while watching TV (p = 0.0052) and using electronic devices (p = 0.0397). The number of sedentary breaks and time spent in sedentary bouts &lt;20 min/day increased (p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>An mHealth programme effectively reduced sedentary behaviour, improved HbA1c and blood pressure, serving as a cost-effective lifestyle intervention for adults with T2D.</div></div><div><h3>Trial registration</h3><div>ClinicalTrials.gov NCT04092738.<span><span>https://clinicaltrials.gov/ct2/show/NCT04092738</span><svg><path></path></svg></span></div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 434-445"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144268296","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":"Racial and ethnic differences in prescribing antihyperglycemic medications to persons with type 2 diabetes: An all of us cohort study","authors":"Veronica J. Brady ,&nbsp;Samuel Akyirem ,&nbsp;Nikhil Padhye","doi":"10.1016/j.pcd.2025.05.011","DOIUrl":"10.1016/j.pcd.2025.05.011","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to determine prescribing patterns for newer antihyperglycemic agents among racial and ethnic minorities with type 2 diabetes (T2DM) using the All of Us study data.</div></div><div><h3>Methods</h3><div><span>We conducted a cross-sectional analysis of electronic health records (EHR) data obtained from the All of Us research study data. We included data from 20,016 persons with </span>T2DM. Participants were eligible for the study if they were 18 years or older, living with T2DM, and had complete data on all variables of interest.</div></div><div><h3>Results</h3><div>Participants in the study were more likely to be &gt; 55 years of age, identify as female, and non-Hispanic White. Nearly half of the participants were married or partnered and had a household income of less than $35,000 annually. Most participants had hypertension and obesity. Non-Hispanic Blacks had 14 % less odds of having a current or previous prescription of SGLT-2i and 28 % lower odds of receiving a prescription for a GLP-1RA.</div></div><div><h3>Conclusions</h3><div>Despite known benefits to mitigating the risk for cardiorenal complications related to diabetes, there continue to be disparities in the prescribing of newer antihyperglycemic medications for racial and ethnic minorities.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 504-511"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217986","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 primary care guide to the screening and pharmacologic management of chronic kidney disease in people living with type 2 diabetes","authors":"Eugene E. Wright ,&nbsp;Ana Cebrian ,&nbsp;Daniel Ngui","doi":"10.1016/j.pcd.2025.05.005","DOIUrl":"10.1016/j.pcd.2025.05.005","url":null,"abstract":"<div><div>This paper reports the expert opinions and recommendations made by primary care physicians (PCPs) to optimize screening and management of chronic kidney disease (CKD) associated with diabetes and presents algorithms to provide a practical and simplified guide for PCPs. Individuals living with type 2 diabetes (T2D) should be screened early and at regular intervals for CKD using both estimated glomerular filtration rate and urinary albumin-to-creatinine ratio testing. The risk of CKD assessed using the Kidney Disease: Improving Global Outcomes heatmap should be reviewed at least annually to optimize treatment to slow progression of CKD. Lifestyle modifications form the foundation of reducing CKD risk in individuals with T2D. A pillared approach to pharmacotherapy (renin–angiotensin system inhibitors, sodium-glucose cotransporter 2 inhibitors, a nonsteroidal mineralocorticoid receptor antagonist [finerenone], and glucagon-like peptide-1 receptor agonists) is recommended in individuals with CKD and T2D.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 411-421"},"PeriodicalIF":2.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922522","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}