Primary care diabetes最新文献

{"title":"The effect of COVID-19 pandemic on new-onset adult diabetes and its one-year follow-up.","authors":"Elif Ece Doğan, Nubar Rasulova, Fatima Bayramova, Hülya Hacisahinoğulları, Gülşah Yenidünya Yalın, Özlem Soyluk Selçukbiricik, Nurdan Gül, Ayşe Kubat Üzüm, Kubilay Karşıdağ, İlhan Satman","doi":"10.1016/j.pcd.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.pcd.2024.11.004","url":null,"abstract":"<p><strong>Aims: </strong>Bidirectional detrimental relationships between COVID-19 infection and diabetes have been described globally. However, new-onset diabetes in adults and its follow-up during the pandemic have not been sufficiently investigated. In this study, new-onset autoimmune and type 2 diabetes cases during the pandemic were compared to those before the pandemic, and the clinical course of new-onset diabetes during the pandemic was examined.</p><p><strong>Methods: </strong>In this single-center retrospective cohort study, clinical and laboratory characteristics of new-onset diabetes patients before the pandemic (n = 161) and during the pandemic (n = 144) were evaluated between March 2018 and March 2022.</p><p><strong>Results: </strong>A 1.85-fold increase in new-onset adult diabetes cases was observed during the pandemic compared to pre-pandemic period (p = 0.010), while the proportion of autoimmune and type 2 diabetes (T2D) did not change. During the pandemic, there was a 6.2-fold increase in autoimmune diabetes presented with DKA (p = 0.003). Insulin was preferred 1.7 times more frequently as initial treatment during the pandemic (p = 0.014), and mean HbA1c (p = 0.003) and C-peptide (p = 0.010) were higher. Clinical and laboratory data did not differ between PCR (+) and PCR (-) patients. At one-year follow-up, while only HbA1c decreased in the autoimmune diabetes; in T2D group fasting glucose, HbA1c, C-peptide, and lipid profile were significantly improved.</p><p><strong>Conclusions: </strong>The pandemic led to increased new-onset adult diabetes presented with DKA. However, clinical and laboratory features were similar between PCR positive and negative cases. PCR-confirmed COVID-19 may not adversely affect the medium-term clinical course of new diabetes in adults.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142831552","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":"Risk factors for mortality among people with diabetes in Spain: The DIMORTES study.","authors":"Elena Caride-Miana, Domingo Orozco-Beltrán, Jose Antonio Quesada, Jose Joaquin Mira-Solves","doi":"10.1016/j.pcd.2024.11.002","DOIUrl":"https://doi.org/10.1016/j.pcd.2024.11.002","url":null,"abstract":"<p><strong>Introduction: </strong>Diabetes mellitus (DM) is a common chronic disease with an increasing global prevalence.</p><p><strong>Objectives: </strong>The objective of this study was to analyse all-cause mortality and its associated factors in people with DM in Spain.</p><p><strong>Methods: </strong>We conducted a population-based retrospective study based on the 2011/2012 Spanish National Health Survey and the Spanish national death register, with six years of follow-up. The response variable was all-cause mortality, and explanatory variables included sociodemographic characteristics, health characteristics, use of health services, and lifestyle habits.</p><p><strong>Results: </strong>Of the 14,784 respondents aged over 40 years, 1781 (12.0 %) had a diagnosis of DM. There were 350 deaths during follow-up (19.7 % cumulative incidence of all-cause mortality). The most common comorbidities in people with DM included overweight and obesity (68.7 %), hypertension (60.9 %) and hypercholesterolemia (51.4 %). The main factors associated with mortality were a diagnosis of chronic obstructive pulmonary disease (Hazard Ratio (HR) 1.43 95 % CI 1.01-2.03); hospital admission in the last year (HR 1.52, 95 % CI 1.15-2.01); depressive disorder (HR 1.53, 95 % CI 1.05-2.23); and smoking (HR 1.84, 95 % CI 1.11-3.05). The association between mortality and history of acute myocardial infarction was time dependent, strengthening considerably over the follow-up period.</p><p><strong>Conclusion: </strong>Among people with DM, there are significant associations between mortality and concomitant chronic respiratory disease, depressive disorder, hospital admission in the last year, and smoking. Greater efforts are required in the detection and management of these comorbidities in DM owing to their implication in mortality risk.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142809022","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":"Association between periodontal disease and gestational diabetes: Systematic review and meta-analysis.","authors":"Juan Manuel García-Martos, Francisco Javier Valverde-Bolívar, María Teresa Campillo-López, Miguel Delgado-Rodríguez","doi":"10.1016/j.pcd.2024.11.003","DOIUrl":"https://doi.org/10.1016/j.pcd.2024.11.003","url":null,"abstract":"<p><strong>Aim: </strong>Periodontal disease (PD) can aggravate insulin resistance during pregnancy and trigger the development of gestational diabetes mellitus (GDM).</p><p><strong>Methods: </strong>A systematic review and meta-analysis was carried out. Two researchers carried out a literature search using internet databases. Studies that met the inclusion criteria were selected. OR was used as the measure of association. The fixed effects model was applied, and due to the presence of heterogeneity, the DerSimonian and Laird random effects model was applied. The level of significance was p < 0.05. The presence of biases was assessed using the Egger test and the funnel plot.</p><p><strong>Results: </strong>Of the 176 articles found, 11 were included. 2032 pregnant women were analyzed, of which 572 developed GDM. It was found that PD was a risk factor for developing GDM when all studies were assessed (OR=1.83 95 % CI 1.25-2.69, p < 0.0017) and when analyzing only those that included an adjusted OR (OR= 1.83 95 % CI 1.31-2.56, p < 0.004).</p><p><strong>Conclusions: </strong>PD poses a high risk of suffering from GDM. The development of oral health programs in women who wish to conceive is essential to improve metabolic control and reduce obstetric and perinatal complications.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776023","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":"Diabetic myonecrosis: A rare complication of long-standing diabetes mellitus.","authors":"Rosamaria Dias, Ovie Enaohwo, Richard Felli, Aman Garg, Meet Shah, Kathleen Beebe","doi":"10.1016/j.pcd.2024.11.001","DOIUrl":"https://doi.org/10.1016/j.pcd.2024.11.001","url":null,"abstract":"<p><strong>Background: </strong>Diabetes mellitus is a rapidly growing health illness worldwide and its incidence is expected to continue rising. Various complications have been cited including retinopathy, nephropathy, peripheral artery disease and ulceration among others. However, rarer complications such as diabetic myonecrosis are limited in literature. This case report demonstrates the presentation of this complication to allow for earlier detection and treatment by providers.</p><p><strong>Case report: </strong>This case highlights a 49-year-old man with an extensive past medical history inclusive of diabetes mellitus type 2, who presented with acute onset left thigh pain and swelling. On presentation, the patient has an HbA1c of 8 % and hyperpigmented spots were noted bilaterally on the lower extremities. Initial management was centered around infectious etiologies and management which failed to improve his symptoms. Further work-up included a negative lower extremity duplex ultrasound and a CT scan showing a hypodense lesion in the left lower extremity. Following unsuccessful drainage of the lesion to assess for a possible abscess, MRI of the lower extremities showed bilateral myositis and myonecrosis centered in the left vastus medialis.</p><p><strong>Conclusion: </strong>This case report highlights a rare complication of diabetes mellitus known as diabetic myonecrosis (DMN). The gold-standard diagnostic tool is a muscle biopsy, however, sensitive imaging like MRI and clinical context are sufficient for a diagnosis. Supportive care centered around pain management remains the standard of care. While this remains as a diagnosis of exclusion, early identification may decrease the number of unnecessary treatments and should remain as a differential in patients with this presentation.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741819","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":"Trends in type 2 diabetes medication use and guideline adherence in Belgian primary care (2019-2023).","authors":"Willem Raat, Pavlos Mamouris, Chantal Mathieu, Geert Goderis, Bert Vaes","doi":"10.1016/j.pcd.2024.10.007","DOIUrl":"https://doi.org/10.1016/j.pcd.2024.10.007","url":null,"abstract":"<p><strong>Aims: </strong>To assess the prevalence of atherosclerotic cardiovascular disease (ASCVD), heart failure (HF), and chronic kidney disease (CKD) among patients with type 2 diabetes (T2D) in Belgium. To analyze trends in medication use and adherence to guidelines from 2019 to 2023.</p><p><strong>Methods: </strong>We conducted a retrospective cross-sectional analysis using data from the Intego primary care database, encompassing records from 431 general practitioners. We identified adults with T2D through diagnostic codes and glycated hemoglobin levels and analyzed subgroups with ASCVD, HF, and CKD for trends in medication use, particularly SGLT2 inhibitors (SGLT2-i) and GLP-1 receptor agonists (GLP-1).</p><p><strong>Results: </strong>The T2D population increased from 20,766 in 2019 to 21,764 in 2023. The prevalence of ASCVD, HF, and CKD among T2D patients slightly increased to 27 %, 6.7 %, and 23.7 % by 2023 (from 25.2 %, 4.9 % and 21.5 % respectively). Medication prescription trends showed a tripling of SGLT2-i and GLP-1 prescribing in the study period to 6.2 % and 11.5 % respectively. Despite these increases, only 7.5 % of eligible patients received these medications as of 2023.</p><p><strong>Conclusion: </strong>The study highlights a growing burden of ASCVD, HF, and CKD among T2D patients in Belgium and an increase in the use of guideline-recommended medications. However, there remains a substantial gap in the optimal use of these therapies, indicating a need for improved implementation of clinical guidelines in primary care.</p>","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564783","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":"Sleep well, but be active. Effect of sleep and sedentariness on incidence of diabetes.","authors":"Keyuan Liu, P. Marques-Vidal","doi":"10.1093/eurjpc/zwad125.106","DOIUrl":"https://doi.org/10.1093/eurjpc/zwad125.106","url":null,"abstract":"AIMS\u0000We aimed to determine the individual effect of long/short sleep and of inactivity on diabetes risk using data from a population-based prospective study in Switzerland.\u0000\u0000\u0000METHODS\u0000Prospective study with a median (min-max) follow-up of 9 (2.4-11.5) years. Incident diabetes was defined based on 1) fasting plasma glucose (FPG), 2) glycated hemoglobin (HbA1c), or 3) any diagnostic criterion (FPG, HbA1c or medical diagnosis). Sleep and sedentary levels were assessed by questionnaire. Sleep was categorized into short (<7 h/day), adequate (7-9 h/day) and long (>9 h/day).\u0000\u0000\u0000RESULTS\u0000Data from 3355 participants (57.6% women, mean age years 56.6 ± 10.3) was analyzed. There were 136, 110 and 142 incident cases of diabetes defined by FPG, HbA1c or any criterion, respectively. Participants who developed diabetes had a higher sedentariness but no differences were found regarding sleep duration. Similar results were obtained after adjusting for age, gender, education, smoking and body mass index: hazard ratio (95% confidence interval) for sedentariness 1.61 (1.11-2.35), 1.40 (0.93-2.12) and 1.39 (1.04-1.87) for diabetes defined by FPG, HbA1c or any diagnostic criterion, respectively.\u0000\u0000\u0000CONCLUSION\u0000Being sedentary, but not being a long or a short sleeper, increases the risk of developing diabetes.","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42061845","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 Effectiveness of Enhanced Primary Healthcare (EnPHC) interventions on Type 2 diabetes management in Malaysia: Difference-in-differences (DID) analysis.","authors":"M. Husin, X. Teh, S. M. Ong, Y. Lim, Swee Hung Ang, C. Chan, M. Lim, S. Shanmugam, Noraziani Khamis, Faeiz Syezri Adzmin Jaafar, Norliza Ibrahim, N. Nasir, D. Kusuma, A. Wagner, D. Ross-Degnan, R. Atun, S. Sivasampu","doi":"10.21203/RS.3.RS-154502/V1","DOIUrl":"https://doi.org/10.21203/RS.3.RS-154502/V1","url":null,"abstract":"AIMS\u0000To evaluate the effectiveness of the Enhanced Primary Healthcare (EnPHC) interventions on process of care and intermediate clinical outcomes among type 2 diabetes patients.\u0000\u0000\u0000METHODS\u0000This was a quasi-experimental controlled study conducted in 20 intervention and 20 control public primary care clinics in Malaysia from November 2016 to June 2019. Type 2 diabetes patients aged 30 years and above were selected via systematic random sampling. Outcomes include process of care and intermediate clinical outcomes. Difference-in-differences analyses was conducted.\u0000\u0000\u0000RESULTS\u0000We reviewed 12,017 medical records of patients with type 2 diabetes. Seven process of care measures improved: HbA1c tests (odds ratio (OR) 3.31, 95% CI 2.13, 5.13); lipid test (OR 4.59, 95% CI 2.64, 7.97), LDL (OR 4.33, 95% CI 2.16, 8.70), and urine albumin (OR 1.99, 95% CI 1.12, 3.55) tests; BMI measured (OR 15.80, 95% CI 4.78, 52.24); cardiovascular risk assessment (OR 174.65, 95% CI 16.84, 1810.80); and exercise counselling (OR 1.18, 95% CI 1.04, 1.33). We found no statistically significant changes in intermediate clinical outcomes (i.e. HbA1c, LDL, HDL and BP control).\u0000\u0000\u0000CONCLUSIONS\u0000EnPHC interventions was successful in enhancing the quality of care, in terms of process of care, by changing healthcare providers behaviour.","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45092402","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 restricted diet with a plate in patients with type 2 diabetes: A randomized controlled trial.","authors":"Yongwen Zhang, Huanhuan Han, Lanfang Lanfang","doi":"10.22541/au.160552637.79851951/v1","DOIUrl":"https://doi.org/10.22541/au.160552637.79851951/v1","url":null,"abstract":"BACKGROUND\u0000In view of the complexity of dietary and nutritional education for most patients with type 2 diabetes mellitus (T2DM), a simplified approach called the \"restricted diet with a plate\" or \"plate model\" is recommended.\u0000\u0000\u0000PURPOSE\u0000To evaluate whether the plate model can effectively improve glycemic control and cardiovascular risk markers in type 2 diabetes mellitus (T2DM), while reducing the time devoted to education and avoiding weight gain.\u0000\u0000\u0000METHODS\u0000The study was a randomized, multicenter, controlled study, conducted between October 2018 and October 2019, among patients with T2DM living in Nanjing. The study included 419 participants who were randomly divided into a plate group and a counting group. The plate model included three components: a low-literacy, color leaflet containing the explanation and composition of the plate model, health education, and medical visits. Patients in the counting group received health education, group medical visits, and a paper booklet containing traditional carbohydrate counting education. Primary outcomes were glycemic control and weight.\u0000\u0000\u0000RESULTS\u0000Participants in the plate model reduced HbA1c by 0.7% in the first three months, and reduced to a greater extent at six months (1.44%), but this was not sustained, and HbA1c increased slightly over the following six months. Fasting plasma glucose (FPG) and 2-h postprandial glucose (2hPG) values were significantly reduced at the endpoint in the plate model (9.25 ± 1.72% vs. 7.44 ± 0.88%, P = 0.008; 12.07 ± 2.94 vs. 8.35 ± 1.99%; P = 0.004); however, the 2hPG values decreased most significantly. Total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels decreased significantly in the plate group, which occurred at six months and lasted for 12 months. In the first three months, the average weight loss in the plate group was 1.2 kg/month (95% CI 0.92-1.48), and in the fourth to twelfth months, the average weight gain was 0.21 kg/month (95% CI 0.08-0.34). There was significant difference in education time between the groups (17.3 ± 4.42 vs. 38.6 ± 12.63; P < 0.001).\u0000\u0000\u0000CONCLUSIONS\u0000The plate model is at least as effective as the counting model over the short term for glycemic control and perhaps even better for weight and lipid control. Plate model has the potential to improve education of those with low health literacy by reducing reading demands.","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42015834","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":"Progression of pregnancy induced diabetes mellitus to type two diabetes mellitus, an ambidirectional cohort study.","authors":"B. Feleke, Teferi Elfu Feleke, M. Kassahun, Wondemu Gebrekirose Adane, Desalegn Achenefe, Abere Genetu, Azezu Asres Nigussie, Hailemariam Awoke Engedaw","doi":"10.21203/rs.3.rs-30572/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-30572/v1","url":null,"abstract":"INTRODUCTION\u0000Diabetes mellitus (DM) is a metabolic disorder characterized by elevated level of blood glucose. It affects more than 422 million people globally. In resource limited settings, the progression of gestational diabetes (GDM) to DM was not well investigated and this research work was conducted to estimate the incidence of DM after GDM and their predictors in resource limited settings.\u0000\u0000\u0000METHODS\u0000A retrospective and prospective cohort studies were used from January 2010 until December 2019. The data were collected using patients chart review, interview and collecting blood sample. Initially, baseline data were collected from GDM and GDM free women and update data were collected every 3 month. Clinical nurses were used to extract the necessary data from medical charts and to collect the data using patient interview. Laboratory technologists were used to measure the blood glucose level of the study participants. The study was conducted in pregnant women presenting themselves in the referral hospitals of Amhara regional state. The sample size was calculated using Epi-info software. Descriptive statistics were used to describe the profile of study participants. Kaplan Meier survival curve and life-table were used to estimate the survivals of study participants. Incidence density was used to estimate the incidence of DM. Cox regression was used to identify the predictors DM.\u0000\u0000\u0000RESULTS\u0000A total of 4892 women were followed giving for the response rate of 88.62%. The mean age of study participants at the start of the study was 28.34 years with standard deviation [SD] ±7.48 years. DM was associated with gestational diabetes mellitus [AHR (adjusted hazard ratio); 2.53, 95% CI: 2.14-2.99], frequency of breastfeeding [AHR; 0.72, 95% CI: 0.69-0.74], age [AHR; 1.04, 95% CI: 1.03-1.05], parity [AHR; 1.14, 95% CI: 1.07-1.21], regular physical exercise [AHR; 0.45, 95% CI: 0.37-0.55], family history of DM [AHR; 2.04, 95% CI: 1.76-2.37], stillbirth [AHR; 1.67: 95% CI: 1.34-2.07], abortion [AHR; 2.64, 95% CI: 2.25-3.09].\u0000\u0000\u0000CONCLUSION\u0000The progression of GDM to DM was very high and special follow up should be implemented for women with a history of abortion, stillbirth, and family history of DM.","PeriodicalId":94177,"journal":{"name":"Primary care diabetes","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42002517","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}