Diabetes epidemiology and management最新文献

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Severe hypoglycemia and falls in older adults with diabetes: The Diabetes & Aging Study 老年糖尿病患者的严重低血糖和跌倒:糖尿病与衰老研究
Diabetes epidemiology and management Pub Date : 2023-10-01 DOI: 10.1016/j.deman.2023.100162
Howard H. Moffet , Elbert S. Huang , Jennifer Y. Liu , Melissa M. Parker , Kasia J. Lipska , Neda Laiteerapong , Richard W. Grant , Alexandra K. Lee , Andrew J. Karter
{"title":"Severe hypoglycemia and falls in older adults with diabetes: The Diabetes & Aging Study","authors":"Howard H. Moffet ,&nbsp;Elbert S. Huang ,&nbsp;Jennifer Y. Liu ,&nbsp;Melissa M. Parker ,&nbsp;Kasia J. Lipska ,&nbsp;Neda Laiteerapong ,&nbsp;Richard W. Grant ,&nbsp;Alexandra K. Lee ,&nbsp;Andrew J. Karter","doi":"10.1016/j.deman.2023.100162","DOIUrl":"10.1016/j.deman.2023.100162","url":null,"abstract":"<div><h3>Objective</h3><p>To estimate rates of severe hypoglycemia and falls among older adults with diabetes and evaluate their association.</p></div><div><h3>Research Design and Methods</h3><p>Survey in an age-stratified, random sample adults with diabetes age 65–100 years; respondents were asked about severe hypoglycemia (requiring assistance) and falls in the past 12 months. Prevalence ratios (adjusted for age, sex, race/ethnicity) estimated the increased risk of falls associated with severe hypoglycemia.</p></div><div><h3>Results</h3><p>Among 2,158 survey respondents, 79 (3.7%) reported severe hypoglycemia, of whom 68 (86.1%) had no ED visit or hospitalization for hypoglycemia. Falls were reported by 847 (39.2%), of whom 745 (88.0%) had no fall documented in outpatient or inpatient records. Severe hypoglycemia was associated with a 70% greater prevalence of falls (adjusted prevalence ratio = 1.7 (95% CI, 1.3–2.2)).</p></div><div><h3>Conclusion</h3><p>While clinical documentation of events likely reflects severity or care-seeking behavior, severe hypoglycemia and falls are common, under-reported life-threatening events.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100162"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44648644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of telomere attrition on diabetes mellitus and its complications 端粒磨损对糖尿病及其并发症的影响
Diabetes epidemiology and management Pub Date : 2023-10-01 DOI: 10.1016/j.deman.2023.100174
Venkata Chaithanya , Janardanan Kumar , Kakithakara Vajravelu Leela , Ria Murugesan , Matcha Angelin , Abhishek Satheesan
{"title":"Impact of telomere attrition on diabetes mellitus and its complications","authors":"Venkata Chaithanya ,&nbsp;Janardanan Kumar ,&nbsp;Kakithakara Vajravelu Leela ,&nbsp;Ria Murugesan ,&nbsp;Matcha Angelin ,&nbsp;Abhishek Satheesan","doi":"10.1016/j.deman.2023.100174","DOIUrl":"10.1016/j.deman.2023.100174","url":null,"abstract":"<div><p>Diabetes mellitus is a chronic metabolic condition marked by persistent hyperglycemia. It is a major issue of public health with wide-ranging effects. Telomeres are protective caps at chromosome ends, essential for preserving genomic stability and cellular integrity. Research highlights the complex link between diabetes and telomere biology and the potential interactions between the two. This review aims to present a summary of the relationship between diabetes and telomeres, highlighting significant discoveries and probable underlying mechanisms. Telomere shortening in those with diabetes and those at risk of getting the condition provides evidence that telomere dysfunction is linked to diabetes. It is said that telomere attrition, which is influenced by elements such as oxidative stress, inflammation, insulin resistance, and hyperglycemia, plays a major role in the pathophysiology of diabetes. Diabetes Mellitus's hallmark symptoms are chronic inflammation and oxidative stress, accelerating telomere shortening <em>via</em> pro-inflammatory cytokines production and reactive oxygen species, respectively. Telomere dysfunction is enhanced further by the long-term effects of insulin resistance and hyperglycemia. The onset of diabetic comorbidities such as cardiovascular disease, nephropathy, retinopathy, and neuropathy has also been linked to telomere shortening. Understanding how telomeres contribute to these issues may offer new therapeutic ideas. Diabetes and its consequences may be treated with telomere-targeted medicines, such as telomerase activators, telomerase gene therapy, and treatments that target telomere-associated proteins. However, more investigation is required to assess these strategies' security, effectiveness, and long-term impacts.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100174"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43578196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prescriptions of newer glucose regulating agents in older hospitalized patients with type 2 diabetes A retrospective cohort study 老年住院2型糖尿病患者新型血糖调节剂处方的回顾性队列研究
Diabetes epidemiology and management Pub Date : 2023-10-01 DOI: 10.1016/j.deman.2023.100157
Drs. Merel L.J.M. Janssen , Dr. Carolien M.J. van der Linden , Dr. Maarten J. Deenen , Dr. Petra E. Spies , Drs. Anne Jacobs
{"title":"Prescriptions of newer glucose regulating agents in older hospitalized patients with type 2 diabetes A retrospective cohort study","authors":"Drs. Merel L.J.M. Janssen ,&nbsp;Dr. Carolien M.J. van der Linden ,&nbsp;Dr. Maarten J. Deenen ,&nbsp;Dr. Petra E. Spies ,&nbsp;Drs. Anne Jacobs","doi":"10.1016/j.deman.2023.100157","DOIUrl":"10.1016/j.deman.2023.100157","url":null,"abstract":"<div><h3>Aims</h3><p>GLP-1-analogues, DPP4-inhibitors, and SGLT2-inhibitors have become available to treat type 2 diabetes. The extent to which these glucose regulating agents (GRA) are prescribed to older patients is unknown.</p></div><div><h3>Methods</h3><p>We performed a retrospective observational cohort study including all clinical admissions of patients with one or more prescriptions for non-insulin GRA between 2017 and 2021. We analyzed prescription trends and differences in prescription prevalences for frail and non-frail older patients, as well as older (≥ 70 years) versus younger patients.</p></div><div><h3>Results</h3><p>In total 11.5% of admissions had one prescription or more of newer GRA; GLP-1-analogues 1.6%, DPP4-inhibitors 7.3% and SGLT2-inhibitors 2.3%. Total prescription prevalence increased from 8.4% to 16.3% (<em>p</em> &lt; 0.001). Prescription prevalence was 11.1% (<em>N</em> = 129) in admissions of frail patients versus 14.6% (<em>N</em> = 344) of non-frail patients (<em>p</em> = 0.005) and 15.0% in admissions of younger patients versus 11.5% of older patients (<em>p</em> &lt; 0.001).</p></div><div><h3>Conclusions</h3><p>Prescription prevalence of newer GRA in clinical admissions of older patients (≥ 70 years) increased from 2017 to 2021. Prevalence was lower in admissions of frail and older patients, possibly because they are undertreated due to a lack of clear recommendations for older patients in guidelines and underrepresentation in clinical trials.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100157"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44071705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes 2型糖尿病患者血压和控制与微血管功能障碍的关系
Diabetes epidemiology and management Pub Date : 2023-10-01 DOI: 10.1016/j.deman.2023.100160
Charles F. Hayfron-Benjamin , Theresa Ruby Quartey-Papafio , Tracy Amo-Nyarko , Ewuradwoa A Antwi , Patience Vormatu , Melody Kwatemah Agyei-Fedieley , Kwaku Amponsah Obeng
{"title":"Relationships of blood pressure and control with microvascular dysfunction in type 2 diabetes","authors":"Charles F. Hayfron-Benjamin ,&nbsp;Theresa Ruby Quartey-Papafio ,&nbsp;Tracy Amo-Nyarko ,&nbsp;Ewuradwoa A Antwi ,&nbsp;Patience Vormatu ,&nbsp;Melody Kwatemah Agyei-Fedieley ,&nbsp;Kwaku Amponsah Obeng","doi":"10.1016/j.deman.2023.100160","DOIUrl":"10.1016/j.deman.2023.100160","url":null,"abstract":"<div><h3>Background</h3><p>In type 2 diabetes mellitus (T2D), cardiovascular risk factors including glycemic control differentially affect various microcirculatory beds. To date, studies comparing the impact of blood pressure (BP) on various microvascular beds in T2D are limited. We assessed the associations of BP and its control with neural, renal, and retinal microvascular dysfunction.</p></div><div><h3>Methods</h3><p>This was a cross-sectional study among 403 adults with T2D. Microvascular dysfunction was based on nephropathy (albumin-creatinine ratio ≥ 30 mg/g), neuropathy (vibration perception threshold ≥ 25 V and/or Diabetic Neuropathy Symptom score &gt; 1), and retinopathy (based on retinal photography). Logistic regression was used to examine the associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction with adjustments for age, sex, diabetes duration, smoking pack years, HbA1c concentration, total cholesterol concentration, and BMI.</p></div><div><h3>Results</h3><p>The mean age (± SD), proportion of females, and proportion of hypertensives were 56.35 (± 9.91) years, 75.7%, and 49.1%, respectively. In a fully adjusted model, hypertension was significantly associated with neuropathy [odds ratio 3.44, 95% confidence interval 1.96–6.04, <em>P</em> &lt; 0.001] and nephropathy [2.05 (1.09–3.85), 0.026] but not for retinopathy [0.98 (0.42–2.31), 0.970]. Increasing Z-score systolic BP was significantly associated with nephropathy [1.43 (1.05–1.97), 0.025] but not for neuropathy [1.28 (0.98–1.67), 0.075] or retinopathy [1.27 (0.84–1.91), 0.261]. Increasing Z-score diastolic BP was significantly associated with nephropathy [1.81 (1.32 – 2.49), &lt; 0.001] but not retinopathy [1.38 (0.92–2.05), 0.120] or neuropathy [0.86 (0.67–1.10), 0.230].</p></div><div><h3>Conclusion</h3><p>Our study shows varying strengths of associations of hypertension, systolic BP, and diastolic BP with microvascular dysfunction in different microcirculatory beds. Hypertension prevention and/or control may be valuable in the prevention/treatment of microvascular disease, especially nephropathy, and neuropathy.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100160"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46591625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Factors influencing adherence towards oral hypoglycaemic agents- A cross-sectional study among patients with Type II Diabetes Mellitus 影响口服降糖药依从性的因素- 2型糖尿病患者的横断面研究
Diabetes epidemiology and management Pub Date : 2023-10-01 DOI: 10.1016/j.deman.2023.100163
Abhilash P , Delisha Josvita Dsouza , Sradha S , Nandakumar UP , Shuaib Ahmed MA , Reshma Kolar , Sharad Chand
{"title":"Factors influencing adherence towards oral hypoglycaemic agents- A cross-sectional study among patients with Type II Diabetes Mellitus","authors":"Abhilash P ,&nbsp;Delisha Josvita Dsouza ,&nbsp;Sradha S ,&nbsp;Nandakumar UP ,&nbsp;Shuaib Ahmed MA ,&nbsp;Reshma Kolar ,&nbsp;Sharad Chand","doi":"10.1016/j.deman.2023.100163","DOIUrl":"10.1016/j.deman.2023.100163","url":null,"abstract":"<div><h3>Aims</h3><p>The present study was conducted to assess the level of medication adherence and factors affecting adherence among Type-2 Diabetes Mellitus (T2DM) patients.</p></div><div><h3>Methods</h3><p>A prospective cross-sectional study was carried out among T2DM patients who were presented to the outpatient department of general medicine. A well-designed data collection form was used to gather information pertaining to various socio-demographic and medical variables. A previously validated and translated 8-item self-reported questionnaire was used to assess the level of medication adherence. Data was analysed using SPSS Version 29.0.</p></div><div><h3>Results</h3><p>Among the total 369 subjects enrolled, a majority were found to be males, and the mean age of the population was observed as 56.84 ± 11.32. A total of 125 (33.8%) subjects were found to be within the category of high adherence, 161 (43.6%) subjects were found to have moderate level of adherence and 83 (22.4%) had low level of adherence. On analysis, various medical variables were found to have a statistically significant association with medication adherence.</p></div><div><h3>Conclusion</h3><p>The findings of the present study would form the basis for all the future implications including education intervention programmes to improve the level of adherence towards anti-diabetic medications, which ultimately results in better health outcomes.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100163"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43544546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bullous diabeticorum 大疱的diabeticorum
Diabetes epidemiology and management Pub Date : 2023-10-01 DOI: 10.1016/j.deman.2023.100152
Rawan Alharbi, Ibtihal Abdulaal
{"title":"Bullous diabeticorum","authors":"Rawan Alharbi,&nbsp;Ibtihal Abdulaal","doi":"10.1016/j.deman.2023.100152","DOIUrl":"https://doi.org/10.1016/j.deman.2023.100152","url":null,"abstract":"<div><p>Bullous Diabeticorum is a skin condition that occurs rarely in diabetic patients. It is a specific type of skin lesions characterized by non-inflammatory blisters that heals spontaneously. It is usually found in long standing diabetic patients with poor glycemic control, although the relationship between BD and blood glucose level in diabetic patients remains unclear. It frequently goes undiagnosed because it resembles other vesicobullous illnesses. Few published articles reported such cases. This case report describes a rare case of Saudi female patient presented to the clinic with a well demarcated erythematic fluid-filled lesion. Based on medical history and clinical examination diagnosis of diabetic bullae was made. We present this case to shed light on the rare occurrence of Bullous Diabeticorum in diabetic patients, to highlight the role of interprofessional team in its management and to improve the patients’ outcome.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100152"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49765971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence of nonalcoholic fatty liver disease in type 2 diabetes mellitus patients from the Eastern region of India 印度东部地区2型糖尿病患者非酒精性脂肪肝患病率
Diabetes epidemiology and management Pub Date : 2023-10-01 DOI: 10.1016/j.deman.2023.100161
Anirban Sinha , Biswabandhu Bankura
{"title":"Prevalence of nonalcoholic fatty liver disease in type 2 diabetes mellitus patients from the Eastern region of India","authors":"Anirban Sinha ,&nbsp;Biswabandhu Bankura","doi":"10.1016/j.deman.2023.100161","DOIUrl":"10.1016/j.deman.2023.100161","url":null,"abstract":"<div><h3>Objective</h3><p>The risk of nonalcoholic fatty liver disease (NAFLD) is increased significantly in individuals having Type 2 diabetes mellitus (T2DM) and the presence of T2DM enormously drives NAFLD progression. However, in clinical practice, it is overlooked despite the significant clinical effects of NAFLD in T2DM. Our study aimed to estimate the prevalence of NAFLD in T2DM patients from the eastern region of India.</p></div><div><h3>Methods</h3><p>This cross-sectional study assessed 132 T2DM patients for NAFLD. Anthropometry and lipid estimations were done in all the individuals. Hepatic fibrosis was diagnosed by transient elastography (TE) using a TOUCH 502 Fiber Scanner using M‑probe. A fibrosis score ≥ 11 kgpascals (kPa) was used to define advanced fibrosis (F3).</p></div><div><h3>Results</h3><p>Overall prevalence of NAFLD in T2DM patients was 57% (75/132 subjects) and the prevalence is higher in males (54.6%). Results showed that approximately 26% of patients with NAFLD will develop into NASH, among them 37.3% developed mild to moderate steatosis and 26.6% developed severe steatosis.</p></div><div><h3>Conclusion</h3><p>The prevalence of NAFLD is high in the eastern region of India, need for early diagnosis and treatment of NAFLD in T2DM. The use of TE with other serum markers can be helpful for the diagnosis of advanced fibrosis.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100161"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43847580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
The impact of diabetes on sarcopenia in community-dwelling older adults in India: key findings from the longitudinal ageing study in India (LASI) 糖尿病对印度社区老年人少肌症的影响:印度纵向老龄化研究的关键发现
Diabetes epidemiology and management Pub Date : 2023-10-01 DOI: 10.1016/j.deman.2023.100158
Sayani Das
{"title":"The impact of diabetes on sarcopenia in community-dwelling older adults in India: key findings from the longitudinal ageing study in India (LASI)","authors":"Sayani Das","doi":"10.1016/j.deman.2023.100158","DOIUrl":"10.1016/j.deman.2023.100158","url":null,"abstract":"<div><h3>Background</h3><p>Diabetes has become a major public health issue in India, and understanding its impact on skeletal muscle health is crucial for addressing the elevated risk of sarcopenia among individuals with diabetes. While the association between diabetes and sarcopenia has been extensively studied worldwide, there is a notable lack of research focusing on this relationship within the Indian community-dwelling geriatric population. Therefore, this study aimed to explore the influence of diabetes on sarcopenia among older adults living in community settings in India.</p></div><div><h3>Methodology</h3><p>The study used data from the Longitudinal Aging Study in India (LASI), Wave 1 (2017–18). It was focused on older adults aged 60 years and above living in community settings in India, including both males and females. This study followed the Asian Working Group on Sarcopenia (2019) guidelines, utilizing a screening tool that assessed sarcopenia through muscle (handgrip) strength, physical performance, and appendicular skeletal muscle mass (ASM). The presence of diabetes was determined through a self-reported approach, where participants disclosed their diabetes diagnosis as provided by healthcare professionals. To examine the association between diabetes and sarcopenia, the study utilized logistic regression analysis to calculate the adjusted odds ratio (AOR) and corresponding 95% confidence interval (CI).</p></div><div><h3>Results</h3><p>Present study included 27,241 individuals, with sarcopenia prevalent in 27.0% of participants. 3.4% had both sarcopenia and diabetes, 23.5% had sarcopenia only, 11.7% had diabetes only, and 61.3% had neither. After adjusting for confounding variables, participants with diabetes had a significantly higher odds ratio of 1.14 (95% CI 1.06–1.26, <em>p</em> &lt; 0.001) for sarcopenia.</p></div><div><h3>Conclusions</h3><p>The study established that diabetes is a risk factor for sarcopenia in older adults living in India. Early identification and management are essential to mitigate sarcopenia, emphasizing the importance of addressing both conditions in healthcare.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100158"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48735290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characteristics of people with optimally-managed type 1 diabetes 最佳管理1型糖尿病患者的特征
Diabetes epidemiology and management Pub Date : 2023-10-01 DOI: 10.1016/j.deman.2023.100153
Gijsbert Stoet , Richard IG Holt
{"title":"Characteristics of people with optimally-managed type 1 diabetes","authors":"Gijsbert Stoet ,&nbsp;Richard IG Holt","doi":"10.1016/j.deman.2023.100153","DOIUrl":"10.1016/j.deman.2023.100153","url":null,"abstract":"<div><h3>Objective</h3><p>The aim is to describe the characteristics of people with type 1 diabetes who are meeting all seven glycemic targets set by international consensus.</p></div><div><h3>Research Design &amp; Methods</h3><p>We analyzed continuous glucose monitoring (CGM) data from 497 participants (aged 18-70 yrs). Time-in-range, time above and below range, co-efficient of variability, and glucose management indicator (GMI) were combined with demographic data, insulin delivery, and exercise.</p></div><div><h3>Results</h3><p>While 68% of participants achieved a GMI below 7% (53 mmol/mol), 39% met all seven glycemic targets. Older people and those of White ethnicity were more likely to meet these targets. Men and women were equally likely to meet all targets, although men were more likely to experience hypoglycemia while women were more likely to experience hyperglycemia. Hybrid-closed loop (HCL) system users were more likely to meet all targets than people using a standard pump or multiple daily injections.</p></div><div><h3>Conclusions</h3><p>Only 56% of those with a GMI below 7% (53 mmol/mol) met all seven targets, illustrating how glycemic management involves more than GMI/HbA<sub>1c</sub> lowering alone, which has implications for estimates of optimally managed participants in the wider population of people with type 1 diabetes. Demographic inequalities were prevalent. Using a HCL system clearly facilitated the achievement of glycemic targets.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100153"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43923721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Endocrinologists’ use of patient-reported outcome measures in the care of people with diabetes: A qualitative study 内分泌学家在糖尿病患者护理中使用患者报告的结果测量:一项定性研究
Diabetes epidemiology and management Pub Date : 2023-10-01 DOI: 10.1016/j.deman.2023.100159
B.K. Nielsen , M.D. Terkildsen , A.L. Jensen , M.Z. Pedersen , M.R. Hollesen , K. Lomborg
{"title":"Endocrinologists’ use of patient-reported outcome measures in the care of people with diabetes: A qualitative study","authors":"B.K. Nielsen ,&nbsp;M.D. Terkildsen ,&nbsp;A.L. Jensen ,&nbsp;M.Z. Pedersen ,&nbsp;M.R. Hollesen ,&nbsp;K. Lomborg","doi":"10.1016/j.deman.2023.100159","DOIUrl":"10.1016/j.deman.2023.100159","url":null,"abstract":"<div><h3>Aims</h3><p>DiabetesFlex Care is a patient-reported outcome (PRO)-based telehealth service for adults with type 1 diabetes, intended to enable patient perspectives in consultations. The study aimed to explore endocrinologists' experiences of using PRO to support dialog in diabetes consultations.</p></div><div><h3>Methods</h3><p>Thematic analysis was conducted on data from participant observations and semi-structured interviews with 13 endocrinologists engaging in DiabetesFlex consultations at a Danish hospital-based diabetes clinic.</p></div><div><h3>Results</h3><p>Two themes were extracted: 'Perceiving PRO as ambiguous information' and 'Integrating PRO in the care for people with diabetes'. Endocrinologists perceived PRO as situational information with variable quality and validity, depending on patient competencies and commitment. Therefore, endocrinologists used different approaches to integrate PRO in their efforts to improve care for the individual patient. The study also showed that patients’ PRO-responses were rarely discussed among endocrinologists.</p></div><div><h3>Conclusion</h3><p>Endocrinologists experienced both potentials and challenges in using PRO to support diabetes consultations. To optimize DiabetesFlex Care and similar PRO-based diabetes consultations, a culture should be built up where clinicians share experiences to improve the quality and solve PRO-related problems in consultations.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"12 ","pages":"Article 100159"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43191252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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