Practical diabetes international : the journal for diabetes care teams worldwide最新文献

{"title":"Insulinoma in a patient with type 2 diabetes","authors":"A. Munir, Sl Toh, V. Arutchelvam","doi":"10.1002/PDI.1599","DOIUrl":"https://doi.org/10.1002/PDI.1599","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"50 3","pages":"226-226"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1599","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025615","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}

{"title":"NICE inpatient diabetes foot disease guidance","authors":"S. Benbow, V. Chikthimmah, R. Cooke","doi":"10.1002/PDI.1592","DOIUrl":"https://doi.org/10.1002/PDI.1592","url":null,"abstract":"the individual and to the NHS. With a lifetime risk of 15% of developing a foot ulcer, foot ulcers preceding 80% of amputations and diabetes being the most common cause of non-traumatic limb amputation, it is a significant problem. Prolonged length of hospital inpatient stays and increased bed occupancy (the most common diabetes reason for admission in the recent National Diabetes Inpatient Audit)1 contribute to the financial cost of this complication. The recent publication of the National Institute for Health and Clinical Excellence (NICE) clinical guideline (CG) on the ‘Inpatient Management of Diabetic Foot Problems’ (CG 119)2 comes seven years after the previous NICE guideline which concentrated on the community and outpatient prevention and management of foot disease.3 ‘Putting Feet First’,4 guidance on commissioning specialist services for the prevention and management of foot disease in hospitals, was the catalyst for this topic to be developed by NICE under the short guidelines programme. The variation in clinical management of diabetes inpatients with foot disease was, however, of particular relevance in its acceptance as a CG topic. The short guidelines review a narrower clinical area than the full guidelines (in this case, six review questions were addressed) but are developed in a shorter period of time. Therefore prevention of foot disease is not covered with regard to the general inpatient diabetes population which is a missed opportunity. The NICE review of evidence and consequent recommendations just published will nevertheless provide a distinct advantage over other guidelines, by being NICE ‘badged’, and will provide further impetus to getting much needed recognition within the NHS for the problem of diabetes foot disease, particularly in the current financial climate.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"34 3","pages":"202-203"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1592","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025205","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}

{"title":"The safe use of insulin e-learning module: successful roll out of a teaching programme for all working in diabetes","authors":"J. James, H. Atkins, I. Sturgess, R. Malik, G. Rayman, A. Morton, R. Hillson, R. Gregory","doi":"10.1002/PDI.1595","DOIUrl":"https://doi.org/10.1002/PDI.1595","url":null,"abstract":"Insulin is often used in the management of hyperglycaemia but prescribing and management errors are common. A UK audit revealed 3881 wrong dose incidents and six deaths over six years (National Patient Safety Agency 2010, NPSA). The NPSA and NHS Diabetes launched a tri-phase education initiative in June 2010, aimed at reducing error and including rapid response reports sent to all hospital and community trusts, written supporting information and recommendations, and access to an e-learning module and assessment. \u0000 \u0000 \u0000 \u0000The aim of this project was to improve all health care professionals' (HCPs') knowledge in the safe use of insulin through e-learning. \u0000 \u0000 \u0000 \u0000A safer use of insulin e-learning module commissioned by NHS Diabetes and the NPSA was developed by a hospital trust and piloted by multidisciplinary HCPs from UK hospital and community settings. Developers used established web-based contacts to promote access. Reminders were sent to those not completing within three months. The number, type, workplace location and percentage of those accessing and completing the module were audited weekly to assess uptake. \u0000 \u0000 \u0000 \u0000Eight-month data revealed 31 089 registrations from a wide range of HCPs with 64% (n=19 947) completing. Workplace data showed that more than half of completers worked in secondary care (59%), 22% in primary care, and 19% in community settings. Early data show positive learner feedback. \u0000 \u0000 \u0000 \u0000E-learning provides an accessible method of education delivery to large multidisciplinary populations; module efficacy can be audited through collection and comparison of locally and nationally reported insulin errors. Copyright © 2011 John Wiley & Sons.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"13 1","pages":"209-211"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025316","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}

{"title":"A multidisciplinary paediatric diabetes health care team: perspectives on adolescent care","authors":"J. Spencer, H. Cooper","doi":"10.1002/PDI.1596","DOIUrl":"https://doi.org/10.1002/PDI.1596","url":null,"abstract":"This paper focuses on a qualitative study of the experiences of a multidisciplinary health care team caring for adolescents with type 1 diabetes in a hospital in the North West of England. \u0000 \u0000 \u0000 \u0000It builds upon previous research which has explored the lived experiences of young people and their parents/guardians with the aim of better understanding blood glucose control in this age group. \u0000 \u0000 \u0000 \u0000Findings emphasise lack of human resources, the importance of effective team working, and the need for meaningful education which acknowledges adolescents' unique and complex social worlds. \u0000 \u0000 \u0000 \u0000Given these findings we are now developing a computer-based ‘Adolescent Diabetes Needs Assessment Tool’ (ADNAT study), with a view to individualising self-directed education and support. Copyright © 2011 John Wiley & Sons.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"65 3","pages":"212-215"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1596","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025334","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}

{"title":"The new NHS Diabetes guidelines on the perioperative management of people with diabetes","authors":"K. Dhatariya, A. Kilvert","doi":"10.1002/PDI.1591","DOIUrl":"https://doi.org/10.1002/PDI.1591","url":null,"abstract":"much of what we do in our profession has been determined by evidence from large, long-term intervention trials. These provide a strong evidence base for recommending person specific targets for HbA1c, blood pressure and lipids. However, as diabetes specialists we also have an important role in ensuring that the condition is well managed during hospital admission and in this area there is very limited evidence on which to base recommendations. The incidence of diabetes is rising exponentially and as a consequence the number of inpatients with diabetes is also rising. Attention is therefore focusing on inpatient care, with recognition that this is frequently suboptimal. The 2010 National Inpatient Audit reports a mean diabetes prevalence of 15% (range 6.6–24.3%) among inpatients in acute hospitals.1 The audit shows that patients with diabetes experience high levels of medication and management errors and increased length of stay.1,2 Guidelines for the management of inpatients with diabetes are needed to standardise and improve care across the UK. Surgery in people with diabetes is a neglected area, with surgeons and anaesthetists often happy with the idea of ‘permissive hyperglycaemia’, assuming that short (or even long) term hyperglycaemia is less likely to do the patient harm than a hypoglycaemic episode while under anaesthetic. However, recent data from the US have demonstrated that people with diabetes undergoing surgery have an almost 50% greater chance of postoperative mortality than those with normal glucose tolerance and have adverse consequences in all measures of postoperative morbidity.3 Furthermore, people with preoperative hyperglycaemia, who were not previously known to have diabetes, had a risk of perioperative death up to 12 times that of people without diabetes, rising to 40 times if the hyperglycaemia persisted postoperatively.3 These are powerful data and if you could tell your surgical colleagues that you could reduce their perioperative mortality by 12-fold without them even putting knife to skin, you would probably get their attention fairly swiftly.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"5 1","pages":"200-201"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1591","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025183","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}

{"title":"Obstructive sleep apnoea and type 2 diabetes: Whose disease is it anyway?","authors":"S. Choudhury, S. Taheri","doi":"10.1002/PDI.1589","DOIUrl":"https://doi.org/10.1002/PDI.1589","url":null,"abstract":"a pioneering study of OSA, reportedthat OSA affected 2–4% of the general population in 1993. Morerecent reports, taking into accountthe increased prevalence of obesity,estimate that up to 17% of adultshave OSA. Importantly, OSA is com-mon in patients with type 2 diabetesmellitus (T2DM). This prevalencevaries depending on the populationand setting of the study but rangesfrom 20% to as much as 80%. While obesity is an importantcontributor to OSA, less than 50% ofOSA is attributable to obesity. Otherfactors which are also important inOSA include age (older individuals),gender (men greater than women),ethnicity (African Americans andHispanics), and craniofacial abnor-malities. OSA has been associatedwith polycystic ovarian syndrome,hypothyroidism, and less commonendocrine conditions such asacromegaly. Smoking and alcoholconsumption can exacerbate OSA.Several gene polymorphisms havebeen associated with OSA in linewith a complex genetic condition.Obesity is a common risk factor forboth diabetes and OSA. However,emerging evidence suggests a rela-tionship between OSA and diabetesindependent of obesity.OSA belongs to a spectrum ofbreathing disorders during sleep(sleep-disordered breathing) thatrange from simple snoring to com-plete cessation of breathing. OSA ischaracterised by frequent abnormalpauses in breathing during sleep.These pauses are obstructive innature and occur despite respiratoryeffort by the patient. OSA is associ-ated with repetitive blood oxygendesaturation because of lack of air-flow into the lungs. Obstructiveevents during sleep are associatedwith arousals that are often unno-ticed by the patient. These arousalsresult in fragmented sleep thatcauses excessive daytime sleepiness(EDS). This increases the risk ofroad and workplace accidents. Thesymptoms of OSA include snoring,witnessed breath-holds, gasping andchoking, fatigue, reduced alertness,nocturia, morning headaches, refluxoesophagitis, poor memory, lowmood and genderual dysfunction.Some of these symptoms are alsoseen in poorly controlled diabetes,resulting in the possibility of OSAbeing forgotten in patients with dia-betes. Severe OSA can be potentiallylife threatening if left untreated,resulting in heart failure and arryth-mias. There is increasing evidencelinking OSA to vascular, metabolic,haematological and genetic markersassociated with increased risk for cardiovascular disease. Identifying patients with OSA inthe diabetes clinic tends not to occurbecause of lack of awareness of therelationship between the two condi-tions. OSA questionnaires are notvery useful either, because they havenot been designed for the diabetespopulation. Also, diabetes patientsmay not specifically report sleepi-ness. Potential indicators of OSA indiabetes patients include frequentheadaches, acid reflux disease,impotence, poor glycaemic control,and uncontrolled hypertension.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"69 2","pages":"183"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025107","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}

{"title":"Development and validation of a diabetes knowledge questionnaire","authors":"C. Eigenmann, T. Skinner, R. Colagiuri","doi":"10.1002/PDI.1586","DOIUrl":"https://doi.org/10.1002/PDI.1586","url":null,"abstract":"An Australian National Consensus Position on Outcomes and Indicators for Diabetes \u0000Education identified knowledge and understanding as the outcomes most directly \u0000affected by diabetes education. A subsequent literature review failed to identify a \u0000validated, suitable questionnaire for measuring knowledge. Consequently, we aimed to \u0000develop a minimum diabetes knowledge questionnaire (DKQ) suitable for people with \u0000both type 1 and type 2 diabetes. Content validity was established through literature review, Delphi survey of 52 \u0000opinion leaders and a workshop of Australian Diabetes Educators (n ≥300). The resulting \u0000instrument was tested for internal consistency on 129 and for reliability on 57 people with \u0000type 1 and type 2 diabetes, respectively. The final questionnaire contains: 12 multiple choice questions common to type 1 and \u0000type 2 diabetes, e.g. normal blood glucose levels, complications, diet, exercise, selfmonitoring \u0000of blood glucose, annual check-ups, support services, and sick-days; two \u0000questions for people on oral medication/insulin only; and one question (sick-days) for \u0000people with type 1 diabetes only. For the first 12 questions, the internal consistency was good (Cronbach’s α=0.73); \u0000with the additional item for type 1 diabetes, the internal consistency was slightly better \u0000(α=0.79) as it was with the additional items for people on medication/insulin (α=0.76). No \u0000particular item seemed to adversely affect the overall consistency of the questionnaire. Comparing test-retest pilots, total scores showed good reliability with no evidence of \u0000change over time (t=1.73; df=56; p \u0000 \u0000The DKQ is now ready to use for evaluating knowledge outcomes of diabetes \u0000education.","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"68 9","pages":"166-170"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1586","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025041","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}

{"title":"Pleural effusion caused by pioglitazone: case report","authors":"A. Munir, S. Kalathil, S. Nag","doi":"10.1002/PDI.1583","DOIUrl":"https://doi.org/10.1002/PDI.1583","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"42 2","pages":"160"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1583","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025462","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}

{"title":"An unusual cause for deterioration of glycaemia in diabetes","authors":"A. Nayak, V. Baskar","doi":"10.1002/PDI.1584","DOIUrl":"https://doi.org/10.1002/PDI.1584","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"41 1","pages":"163-163"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1584","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025477","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}

{"title":"Could glucose self‐monitoring become the preferred tool for screening and monitoring glucose control in cystic fibrosis?","authors":"C. Mclachlan, R. Beach, Richard Laing, G. Frazer, H. Lunt, T. Cawood","doi":"10.1002/PDI.1587","DOIUrl":"https://doi.org/10.1002/PDI.1587","url":null,"abstract":"","PeriodicalId":92116,"journal":{"name":"Practical diabetes international : the journal for diabetes care teams worldwide","volume":"56 3","pages":"173-176"},"PeriodicalIF":0.0,"publicationDate":"2011-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/PDI.1587","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"51025054","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}