Canadian journal of diabetes最新文献

{"title":"What is the Effectiveness of Type 2 Diabetes Related Patient Decision Aids? Secondary Analysis of a Systematic Review.","authors":"Sandhya Goge, Christopher Tran, Krystina B Lewis, Meg Carley, Carol Bennett, Dawn Stacey","doi":"10.1016/j.jcjd.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.jcjd.2025.02.003","url":null,"abstract":"<p><strong>Introduction: </strong>Patient decision aids (PtDAs) are evidence-based interventions to help people faced with difficult healthcare decisions. Little is known about their effectiveness in people facing diabetes related decisions.</p><p><strong>Methods: </strong>Secondary analysis of RCTs from 2024 Cochrane review of PtDAs, comparing decisions aids on diabetes screening, prevention or treatment to usual care (e.g., patient education, no intervention). Two reviewers independently screened citations, extracted data and assessed study quality.</p><p><strong>Primary outcomes: </strong>quality of the decision and decision-making process. Meta-analyses were conducted for similar outcome measures.</p><p><strong>Results: </strong>Of 209 RCTs, 11 eligible studies evaluated diabetes PtDAs for treatment (n=7), screening (n=3) and prevention (n=1). Common decisions were about diabetes treatment intensification (n=4) and statin initiation (n=3), in people with type 2 diabetes. Compared to usual care, PtDA group reported increased knowledge (MD 16.06, 95%CI 8.38 to23.75) and clearer values (MD -7.43, 95%CI -13.23 to -1.63) and no difference in accurate risk perceptions. After removing high risk of bias studies, PtDAs led to fewer patients feeling uninformed about their options (MD -6.38; 95%CI -9.58 to -3.19) and more participants starting new medications (RR 1.65, 95%CI 1.06 to 2.56). Six studies measured adherence to a chosen option: one reported greater adherence while another reported lower adherence in PtDA versus usual care and remaining four reported no difference.</p><p><strong>Conclusion: </strong>Patients given PtDAs can improve their knowledge, feel informed and clearer about their values, while being more likely to start new medications. Future research can strengthen certainty of these findings and explore PtDAs use within chronic disease.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426809","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":"Exercise training for people with diabetes-related foot ulcers - a systematic review of glycaemia, fitness, and wound healing outcomes.","authors":"Callum J Baker, Vivienne Chuter, Magali Brousseau-Foley, Danqing Min, Angela Searle, Stephen M Twigg, Nathan A Johnson","doi":"10.1016/j.jcjd.2025.02.002","DOIUrl":"https://doi.org/10.1016/j.jcjd.2025.02.002","url":null,"abstract":"<p><strong>Background: </strong>Regular physical activity is a key, patient-centred therapy for people with diabetes to manage their glycaemia. The International Working Group on the Diabetic Foot (IWGDF) recommends optimisation of glycaemic control for people with/at risk of diabetes-related foot ulcer (DFU), however people with DFU are commonly instructed by clinicians to avoid physical activity so as not to worsen the ulcer. The effects of exercise on glycaemia, fitness, and wound healing in people with active DFU are not clear.</p><p><strong>Objective: </strong>To examine the effects of regular exercise (training) on glycaemia, cardiorespiratory fitness, and muscular strength, metabolic health, and ulcer healing in adults with diabetes and an active foot ulcer.</p><p><strong>Method: </strong>Online databases and reference lists of included studies were searched from earliest records to December 2023. Studies involving adult populations with DFU and incorporating interventions of exercise training were included. Data were extracted independently by two reviewers.</p><p><strong>Results: </strong>Of the 5,592 studies screened eight studies were included with a total of 213 participants. Exercise interventions involved foot range of movement exercises and/or aerobic and/or resistance type exercise. No studies reported on cardiorespiratory fitness or anthropometry and limited data were available for glycaemic and muscular strength outcomes. Interpretation of data on safety, wound healing, and adherence to exercise were limited due to inconsistent reporting.</p><p><strong>Conclusions: </strong>Despite some data that exercise may have a positive impact on wound healing, evidence regarding its benefits and safety is significantly lacking, despite metabolic (particularly glycaemic) and fitness outcomes being core to the rationale for exercise therapy in diabetes. Given the importance of exercise in current management guidelines for diabetes, and the plausibility of positive health effects of exercise training for people with DFU, there is a need for research to move from foot focused to person-centred outcomes to better inform the implementation of exercise therapy for people with DFU.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426807","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":"Exercise and Glycemic Management in Females and Women with Diabetes: The Role of Sex and Gender Across the Lifespan.","authors":"Tricia M Peters, Anne-Sophie Brazeau, Lia Bally, Alexa Govette, Elsa Heyman, Mary E Jung, Céline I Laesser, Élodie Lespagnol, Jessica E Logan, Zeinab Momeni, Tawnya Perry, Meryem K Talbo, Anne Bonhoure, Jenna A P Sim, Jasmin von Zezschwitz, Dessi P Zaharieva, Jenna B Gillen, Jane E Yardley","doi":"10.1016/j.jcjd.2025.02.001","DOIUrl":"https://doi.org/10.1016/j.jcjd.2025.02.001","url":null,"abstract":"","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426804","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":"High Prevalence and Common Forms of Maturity-Onset Diabetes of the Young in Greenland.","authors":"Anne Cathrine Baun Thuesen, Marie Balslev Backe, Genís Garcia-Erill, Mikkel Schubert, Kristian Ebbesen Hanghøj, Ida Moltke, Anders Albrechtsen, Niels Grarup, Anette Prior Gjesing, Marit Eika Jørgensen, Torben Hansen, Michael Lynge Pedersen","doi":"10.1016/j.jcjd.2025.01.002","DOIUrl":"https://doi.org/10.1016/j.jcjd.2025.01.002","url":null,"abstract":"<p><strong>Objectives: </strong>Population studies have identified common genetic variants contributing substantially to the burden of diabetes in Greenland. However, handling of suspected monogenic diabetes in diabetes clinics in Greenland has not been described. We aimed to describe the referral rate, prevalence, and genetic causes of clinically identified monogenic diabetes in Greenland.</p><p><strong>Methods: </strong>All diabetes patients in Greenland referred for genetic testing due to suspected monogenic diabetes between 2014-2022 were tallied. Targeted short read sequencing and Sanger sequencing of probands and their family members were used to screen for potentially deleterious variants in the Maturity-Onset Diabetes of the Young (MODY) genes GCK, HNF1A, HNF1B, and HNF4A. Clinical data were extracted from the electronic medical records and whole genome sequencing was performed for families with potentially deleterious variants for genetic ancestry analysis.</p><p><strong>Results: </strong>Over the study period, 58 probands were referred for genetic testing, equivalent to 0.1% of the population. Five variants were identified: GCK p.F133L, GCK p.D205E, HNF1A c.1108G>T, HNF1B p.Q182*, HNF4A -178A>G. These variants were found in 11 probands and 19 family members, equivalent to a population prevalence of monogenic diabetes of 0.05%. Local ancestry analysis revealed that all the variants were found exclusively in Inuit haplotypes, despite all individuals being admixed with both Inuit and European genetic ancestry.</p><p><strong>Conclusions: </strong>We show that the rate of referral and prevalence of monogenic diabetes is substantially higher in Greenland than in other populations and that both rare and more common population-specific variants of Inuit genetic ancestry contribute to the high prevalence.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075698","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":"Endocrinologists' Acceptability and Implementation of Glycated Hemoglobin Targets Among Adults With Type 1 Diabetes.","authors":"Sanchit Kaushal, Patience Fakembe, Ilana J Halperin, Gillian A Hawker, Alanna Weisman","doi":"10.1016/j.jcjd.2024.12.005","DOIUrl":"10.1016/j.jcjd.2024.12.005","url":null,"abstract":"<p><strong>Objectives: </strong>Attainment of the glycated hemoglobin (A1C) target of ≤7.0% is consistently low among those living with type 1 diabetes (T1D). We evaluated endocrinologists' acceptability and implementation of A1C targets.</p><p><strong>Methods: </strong>All 309 adult endocrinologists in Ontario were invited to complete an online questionnaire between October 31, 2023 and January 16, 2024. The questionnaire consisted of 4 sections: 1) acceptability of the A1C target of ≤7.0%, evaluated by agreement with statements pertaining to the 7 domains of the Theoretical Framework of Acceptability; 2) endocrinologists' perceptions of patient attainment of A1C targets, frequency of setting and discussing A1C targets, common targets used, and open-ended questions regarding A1C targets; 3) influence of patients' characteristics on selecting individualized A1C targets different from 7.0%; and 4) respondents' characteristics.</p><p><strong>Results: </strong>One hundred forty-eight endocrinologists (48%) completed the questionnaire. Endocrinologists agreed that the A1C target of ≤7.0% is important (87% agreed or strongly agreed) and the correct threshold (75% agreed or strongly agreed). However, endocrinologists overestimated A1C target attainment among their own patients and recognized the A1C target of <7.0% may be unrealistic for patients, difficult to achieve, and could cause patient distress. Patients' psychosocial characteristics (such as mental health disorders) and use of technologies (such as continuous glucose monitors and automated insulin delivery systems) emerged as important, yet previously underemphasized factors when selecting individualized A1C targets.</p><p><strong>Conclusions: </strong>Endocrinologists endorsed the A1C target of ≤7.0%, but simultaneously expressed concerns regarding its feasibility. Future studies should evaluate how this discrepancy may impact physician discussions and counselling regarding A1C targets.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018327","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":"Critical Insights on Promoting Self-management in Adults With Type 2 Diabetes: Development and Validation of the Glucose Monitoring Impact Scale.","authors":"Saad Khan, Fatima Naveed, Ayesha Khan, Rizwan Ahmad, Faraz Arshad","doi":"10.1016/j.jcjd.2024.12.007","DOIUrl":"10.1016/j.jcjd.2024.12.007","url":null,"abstract":"","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143018323","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":"Type 1 Diabetes: Evaluating a Transition Care Model From Pediatric to Adult Care at the McGill University Health Centre.","authors":"Samantha Jacobson, Isabella Albanese, Jonathan-Raphaël Stetco, Natasha Garfield","doi":"10.1016/j.jcjd.2024.12.001","DOIUrl":"10.1016/j.jcjd.2024.12.001","url":null,"abstract":"<p><strong>Objective: </strong>Our aim in this study was to describe a type 1 diabetes mellitus (T1DM) transition care model by assessing clinic attendance, glycemic management, and diabetes-related hospitalizations.</p><p><strong>Methods: </strong>This work is a descriptive, longitudinal, single-centre study of patients with T1DM, who were 18 to 25 years of age and referred to our transition clinic from 2012 to 2021 (N=179).</p><p><strong>Results: </strong>Our data analysis demonstrates an average clinic attendance rate of 79% and mean time between last pediatric and first adult visit of 6.9±5.8 months. Glycated hemoglobin levels at last pediatric visit, first transition visit, and last transition visit were 8.92±1.84%, 9.03±1.84%, and 8.47±1.74%, respectively. There was no change in frequency of diabetes-related hospitalizations after transfer to transition clinic.</p><p><strong>Conclusions: </strong>Youth attending our transition clinic had high clinic attendance and improved glycemic management at their last transition visit compared with the last pediatric visit without an increase in diabetes-related hospitalizations. This work highlights the potential importance of comprehensive support in addressing psychosocial and lifestyle challenges during the critical transition period from pediatric to adult care.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901230","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 Impact of Resistance Training and Diabetes Education on Physical Functioning, Frailty Status, and Glycemia in Older Adults With Short- and Long-Duration Type 2 Diabetes: A Secondary Analysis of the Band-Frail Study.","authors":"Amy M Thomson, Isaac C Cull, Logan E Peskett, Danielle R Bouchard, Martin Sénéchal","doi":"10.1016/j.jcjd.2024.12.002","DOIUrl":"10.1016/j.jcjd.2024.12.002","url":null,"abstract":"<p><strong>Objectives: </strong>Diabetes duration is an underappreciated risk factor in type 2 diabetes (T2DM) management that can increase the risk of complications and potentially decrease the effectiveness of lifestyle interventions. However, it is unclear whether T2DM duration impacts the efficacy of an elastic band resistance training intervention for older adults living with comorbid T2DM and frailty. In this analysis we aimed to investigate and better understand the impact of a 16-week elastic band resistance training and diabetes education intervention on physical functioning, glycemia, and frailty in older adults of different T2DM durations.</p><p><strong>Methods: </strong>This secondary analysis of the Band-Frail Study includes 130 adults (≥65 years) living with T2DM and pre-frailty/frailty who completed 16 weeks of elastic band resistance training and diabetes education. Participants were categorized as: 1) short-duration T2DM (<10 years) and 2) long-duration T2DM (>10 years). Outcome measures included physical functioning (Short Physical Performance Battery), glycemia (A1C), and frailty (Fried Frailty Scale).</p><p><strong>Results: </strong>Participants in both the short- and long-duration T2DM groups improved in physical functioning and frailty status postintervention (p<0.05). The long-duration group improved A1C significantly more than the short-duration group (p=0.03).</p><p><strong>Conclusions: </strong>Our findings suggest that older adults, irrespective of T2DM duration, improve physical functioning and frailty status after 16 weeks of elastic band resistance training and diabetes education, and that longer duration T2DM is associated with greater improvements in A1C.</p>","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901234","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":"Possible Drug Interaction Between Elexacaftor-Tezacaftor-Ivacaftor and Repaglinide in an Adult With Cystic Fibrosis-related Diabetes.","authors":"Mirna Gerges, Meredith Chiasson, Carly Nichols, Nancy Morrison, Barna De","doi":"10.1016/j.jcjd.2024.12.003","DOIUrl":"10.1016/j.jcjd.2024.12.003","url":null,"abstract":"","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901232","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":"Switching From Open-source to Commercial Advanced Automated Insulin Delivery System: Glucose Management and Patient Perspective in an Adult Living With Type 1 Diabetes.","authors":"Maha Lebbar, Anne Bonhoure, Rémi Rabasa-Lhoret, Zekai Wu","doi":"10.1016/j.jcjd.2024.12.004","DOIUrl":"10.1016/j.jcjd.2024.12.004","url":null,"abstract":"","PeriodicalId":93918,"journal":{"name":"Canadian journal of diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901233","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}