Primary care diabetes最新文献

{"title":"Using glucometers to assess lifestyle-mediated prediabetes remission in health examinations for students and workers.","authors":"Olaf Chresten Jensen, Nailet Delgado Mujica, Bishal Gyawali, Finn Gyntelberg","doi":"10.1016/j.pcd.2025.05.008","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.05.008","url":null,"abstract":"<p><p>One-third to one-half of seafarers and other transport workers have prediabetes. The initiative described herein aims to incorporate glucometer tests into the routine health examinations and offers a structured 16-week intervention plan. Gold-standard diagnostic techniques such as A1c testing are often excluded from routine health examinations, which leads to missed opportunities to prevent diabetes. Using affordable glucometer technology, by comparison, would enable early diagnosis and the initiation of prediabetes remission coaching programmes. Regularly monitoring fitness and dietary health plans, along with the self-monitoring of blood glucose, is both feasible and beneficial for long-term health management.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176382","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 German Diabetes Risk Score (GDRS) in action: Bridging risk stratification with cognitive behavioral lifestyle counseling.","authors":"Riza Amalia, Ronal Surya Aditya, Rizka Apriani, Salmiati","doi":"10.1016/j.pcd.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.05.009","url":null,"abstract":"<p><p>Type 2 diabetes mellitus is a growing global health challenge, particularly in low- and middle-income countries. The recent study by Seidel-Jacobs et al. highlights the effectiveness of the German Diabetes Risk Score (GDRS) in enhancing lifestyle counseling and shared decision-making in primary care. This letter emphasizes the importance of integrating risk assessment tools with cognitive behavioral therapy (CBT) approaches in counseling to address both behavior and the underlying negative thought patterns that contribute to diabetes risk. Adapting such models to diverse populations, especially in regions like Southeast Asia, could improve early intervention and diabetes prevention efforts globally.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145208","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 frequency of neuropathy and predictive parameters in prediabetic cases from Turkiye.","authors":"Baris Emekdas, Canan Celebi, Batuhan Cakmak, Soner Duman, Ilgin Yildirim Simsir","doi":"10.1016/j.pcd.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.05.007","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetic sensorimotor peripheral neuropathy causes patients to have foot injuries without realizing it. This condition may progress to diabetic foot ulcer; infections can include osteomyelitis and lower limb amputations. Managing diabetes and screening diabetic neuropathy is crucial to reducing patient mortality, quality of life, functionality, and the cost burden of complications to the healthcare system. We aim to contribute to the literature by comparing diagnostic methods and examining parameters that can predict neuropathy early.</p><p><strong>Material and methods: </strong>A total of 108 patients with a neuropathy score Douleur Neuropathique-4 (DN-4) above 4, 54 with known diabetes, and 54 with prediabetes were included. Fasting plasma glucose, oral glucose tolerance test, hemoglobin A1c (HbA1c), LDL-cholesterol, HDL-cholesterol, triglyceride, uric acid, vitamin B12, folic acid, creatinine, and complete urinalysis was performed on 108 patients included. Afterward, a monofilament test, tuning fork test, and electromyography were performed by the neurologist to prove neuropathy.</p><p><strong>Results: </strong>The frequency of neuropathy in the prediabetes group was found to be 0.40 ± 0.49 % using EMG. This rate is 0.71 ± 0.45 % for diabetic neuropathy. The difference is statistically significant (p = 0.001) in the prediabetic group, the neuropathy score (DN-4 score) was 5.1 ± 0.9, the tuning fork test positivity was 0.18 ± 0.39, and p = 0.001 was statistically significant compared to the diabetic group. Also, in the monofilament test, the rate of neuropathy in the prediabetes group was again statistically significant with 0.68 ± 0.47 (p = 0.027). Total cholesterol (185.1 ± 21.8, p = 0.003), high uric acid (5.11 ± 1.27, p = 0.003), and low folic acid (4.5 ± 1.05, p = 0.026) are found to be statistically significant between diabetic and prediabetic groups.</p><p><strong>Discussion and conclusion: </strong>In diagnosing neuropathy, monofilament, and diapason testing can be used in the clinical setting, and they have been found to be successful tests in the diagnosis of neuropathy. Also, our analysis indicates the relationship between low folic acid, high total cholesterol/uric acid levels, and prediabetic neuropathy. The role of intervening blood levels of those factors with medications in preventing neuropathy is unclear. We recommend further investigating all the patient's dietary habits to find possible risk factors, as well as investigating patients with low folic acid and high total cholesterol/ uric acid levels much more cautiously.</p><p><strong>Recommendation: </strong>Neuropathy should be screened in prediabetic and diabetic patients, and possible risk factors should be assessed periodically.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096113","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 association between ethnicity and complications in individuals with early-onset type 2 diabetes: A systematic review.","authors":"Jonathan Goldney, Eka Melson, Ansh Verma, Kamlesh Khunti, Francesco Zaccardi, Melanie J Davies, Samuel Seidu","doi":"10.1016/j.pcd.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.05.006","url":null,"abstract":"<p><p>It remains unclear whether the prevalence and incidence of complications varies with ethnicity in individuals with early-onset type 2 diabetes. We undertook a systematic review to investigate. We identified sparse published data, with no clear findings. More prospective studies are needed. Epidemiological studies should routinely stratify by ethnicity.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082883","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":"Impact on diabetes-related health outcomes using a digitally-enabled diabetes self-management platform in Somerset, UK: An interrupted time-series analysis.","authors":"Mats Baxter, Nicholas Conway, Alex Bickerton, Scott Cunningham, Scott C MacKenzie, Jane Dickson, Doogie Brodie, Christopher Sainsbury, Deborah J Wake","doi":"10.1016/j.pcd.2025.05.003","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>The MyWay Diabetes (MWD) digital platform aims to improve diabetes management through personalised access to health records, structured education, and other self-management features.</p><p><strong>Purpose: </strong>We aimed to assess health outcomes in MWD users with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) over 6 years of use.</p><p><strong>Methods: </strong>An interrupted time-series analysis in MWD users with T1DM or T2DM in Somerset, UK, compared pre- and post-MWD registration trends to estimate differences in health outcomes (HbA1c, blood pressure, lipids, BMI, weight). Generalised estimating equations modelling adjusted for participant baseline characteristics and identified significant predictors.</p><p><strong>Results: </strong>A total of 7207 people (T1DM: n = 750 (52.3 % female, mean age 51.2 (SD15.8)), T2DM: n = 6457 (58.1 % male, mean age 64.7 (SD12.0))) were included in the analysis. The study showed some health outcomes improved significantly for T2DM between pre- and post-MWD registration. HbA1c reduced by 8.6 mmol/mol at 24 months post-MWD registration, with greatest improvements observed in users who were younger, had shorter diabetes durations and who were frequent MWD users. All health outcomes for T1DM were unchanged.</p><p><strong>Conclusion: </strong>The large HbA1c reduction for T2DM is notable for a scalable digitally-enabled self-management intervention and adds to the evidence base for digital interventions for diabetes self-management.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082826","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":"Effectiveness of AI-driven interventions in glycemic control: A systematic review and meta-analysis of randomized controlled trials.","authors":"Khadija Elmotia, Oumaima Abouyaala, Soukaina Bougrine, Moulay Laarbi Ouahidi","doi":"10.1016/j.pcd.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.05.004","url":null,"abstract":"<p><p>This systematic review aims to assess the effectiveness of AI-Driven Decision Support Systems in improving glycemic control, measured by Time in Range (TIR) and HbA1c levels, in patients with diabetes. Included studies were randomized controlled trials (RCTs) that evaluated AI interventions in diabetes management. Exclusion criteria included non-English studies, non-peer-reviewed articles. Studies were identified by searching electronic databases including PubMed, EMBASE, and Cochrane Library up to December 2024. Risk of bias was assessed using the Cochrane Risk of Bias tool for RCTs. Results were synthesized using a random-effects meta-analysis model. The review included 17 RCTs with a total of 3381 participants in the intervention group and 3176 in the control group. AI interventions were found to significantly improve TIR and reduce HbA1c levels. The meta-analysis for TIR yielded a mean difference of 0.54 (95 % CI: 0.05-1.03), and for HbA1c a standardized mean difference of -0.91 (95 % CI: -1.23 to -0.58). Evidence was limited by high heterogeneity (I² > 90 % for both outcomes) and indications of publication bias, which may overestimate the effectiveness reported. Despite limitations, the results support the potential of AI interventions in enhancing diabetes management, though variability in effectiveness suggests the need for personalized approaches.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144002267","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":"Evaluating risk stratification according to Type 2 diabetes guidelines in primary care - Insights from the Danish DIAGRAM project.","authors":"Morten H Charles, Karoline Schousboe, Tanja Thybo, Esben Krogh Hall-Andersen, Søren Tang Knudsen","doi":"10.1016/j.pcd.2025.05.002","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.05.002","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate how Danish General Practitioners (GPs) apply Type 2 diabetes guideline recommendations for risk stratification and management across patient subgroups defined by existing chronic kidney disease (CKD), heart failure (HF), cardiovascular disease (CVD), or elevated risk of incident CVD.</p><p><strong>Methods: </strong>131 GPs responded to a questionnaire on guideline usage and reviewed randomised patient electronic medical records (EMRs), noting demographics, treatment, comorbidities, and presence of six prespecified CVD risk factors. Patients without comorbidities but with ≥ 3 risk factors were deemed at Higher CVD Risk. When missing data prevented allocation to risk groups, CVD risk was Undefined.</p><p><strong>Results: </strong>Of 1964 EMRs meeting inclusion criteria, 641 (33 %) had ≥ 1 cardiorenal comorbidity. Of 1307 without comorbidities, 513 (26 %) were at Higher CVD Risk; risk was Undefined for 668 (34 %). Organ-protective antihyperglycaemic agents were used in 1114/1964 (57 %), and more frequently (61-68 %) across comorbidity subgroups, while CVD risk group status did not correlate with guideline-directed organ-protective treatment. Finally, whereas GPs allocated 379 (19 %) patients to CKD, 596 (30 %) EMRs included laboratory data suggesting presence of CKD.</p><p><strong>Conclusions: </strong>Organ-protective treatment patterns suggest that GPs distinguish patients by comorbidity status but find guideline-defined CVD risk challenging to apply. Additionally, CKD may be underdiagnosed in T2D patients.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063774","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":"Validity and reliability of the Turkish version of the type 1 diabetes distress scale.","authors":"Tuğba Bi Lgehan, Elif Gencer Şendur, Özlem Canbolat, Emre Dünder, William H Polonsky","doi":"10.1016/j.pcd.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.05.001","url":null,"abstract":"<p><strong>Aims: </strong>This study aimed to examine the psychometric properties of the Turkish version of the Type 1 Diabetes Distress Scale METHODS: This methodological, descriptive, and correlational study was conducted with 292 individuals diagnosed with Type 1 diabetes. Data were collected between January 2024 and August 2024 using the \"Information Form for Individuals with Diabetes,\" the \"Type 1 Diabetes Distress Scale,\" and the \"Patient Health Questionnaire.\" The linguistic validity and content validity of the scale were evaluated, with content validity assessed using the Davis technique. The psychometric properties of the scale were analyzed through exploratory and confirmatory factor analyses, internal consistency reliability, test-retest reliability, and parallel-form reliability.</p><p><strong>Results: </strong>The Turkish version of the Type 1 Diabetes Distress Scale consists of 21 items and two subdimensions (Factor 1: Concerns About Diabetes Management; Factor 2: Social Diabetes Perception and Pressure). The two-factor structure explained 66 % of the total variance. The overall Cronbach's alpha coefficient for the scale was 0.96. Test-retest reliability analysis revealed a high, positive, and statistically significant correlation (r = 0.995, p < 0.05).</p><p><strong>Conclusions: </strong>The questionnaire was demonstrated to be a valid and reliable instrument for evaluating diabetes distress in patients with type 1 diabetes.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035270","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 association between Ramadan, pre-Ramadan diabetes education (PRE) and metabolic parameters in people with type 2 diabetes: A longitudinal study using routine primary care data.","authors":"Siham Bouchareb, Peter P Harms, Mohamed Hassanein, Giel Nijpels, Petra J M Elders","doi":"10.1016/j.pcd.2025.04.002","DOIUrl":"https://doi.org/10.1016/j.pcd.2025.04.002","url":null,"abstract":"<p><strong>Aims: </strong>To assess the impact of Ramadan and pre-Ramadan diabetes education (PRE) on metabolic parameters in people with type 2 diabetes (T2D). Additionally, we described the proportion of Ramadan-related adverse events.</p><p><strong>Methods: </strong>A retrospective longitudinal study utilising Dutch routine primary care data from 133 people with T2D who participated in a PRE session. Linear Generalized Estimating Equations models were used to assess the association of metabolic parameters with Ramadan and PRE. We analysed free-text notes and a questionnaire to identify Ramadan-related adverse events.</p><p><strong>Results: </strong>Ramadan was associated with modest reductions in HbA1c (β -1.07 mmol/mol; p = 0.07), systolic blood pressure (β -1.89 mmHg; p = 0.04), weight (β -0.81 kg; p < 0.01), BMI (β -0.29 kg/m²; p < 0.01), and a slight increase in triglycerides (β 0.27 mmol/l; p = 0.04) compared to non-Ramadan periods. PRE demonstrated no significant impact on metabolic parameters. The number of medical notes regarding Ramadan was small, with the mentioning of some physical complaints and medication errors.</p><p><strong>Conclusions: </strong>In our study, Ramadan is associated with temporary and marginal metabolic improvements in people with T2D. A single PRE session had no substantial impact on metabolic control. Healthcare professionals should more often discuss Ramadan and medication adjustments with their patients.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048867","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":"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":"https://doi.org/10.1016/j.pcd.2025.04.003","url":null,"abstract":"<p><p>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 dyslipidemia findings. Additionally, it proposes prospective cohort studies and specific research directions to enhance the understanding of MIS as a risk factor for coronary heart disease and improve its clinical relevance.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061385","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}