Canadian Journal of Diabetes最新文献

{"title":"Screening and Management Recommendations for Type 2 Diabetes in Women With Breast Cancer","authors":"Laura Scott MD ,&nbsp;Lan-Linh Truong MD ,&nbsp;Robyn L. Houlden MD ,&nbsp;Don Thiwanka Wijeratne MD","doi":"10.1016/j.jcjd.2023.07.008","DOIUrl":"10.1016/j.jcjd.2023.07.008","url":null,"abstract":"<div><p><span><span>Breast cancer increases the risk of type 2 diabetes 1.07- to 4.27-fold, depending on patient and treatment characteristics, such as postmenopausal status, hormone therapy, and treatment with </span>adjuvant chemotherapy. We evaluated the current evidence and considered the role of increased screening for type 2 diabetes in this at-risk population. This narrative review was conducted using Embase and MEDLINE databases. Keywords including diabetes and breast cancer were used. Articles were limited to those published in English between 2000 and 2022. It appears that the increased risk of diabetes begins at or just after breast cancer diagnosis, and remains elevated for at least 10 to 15 years, with greatest risk in the first 2 years after diagnosis. Subsets of patients with breast cancer appear to be at higher risk of developing type 2 diabetes, including those who were treated with adjuvant chemotherapy or hormone therapy. Further investigation is needed to develop specific screening recommendations for this population. If screening is performed with a </span>glycated hemoglobin test during breast cancer treatment, then hemoglobin should be measured at the same time given the association of breast cancer therapy with anemia. Presence of breast cancer should not be a major factor when choosing among available antihyperglycemic agents. Overall, patients with breast cancer appear to be at an increased risk of developing type 2 diabetes. This increased risk suggests the need for further investigation to develop specific screening recommendations for this at-risk population.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10338608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reasons for Hospitalization Among Australians With Type 1 or Type 2 Diabetes and COVID-19","authors":"Dunya Tomic MBBS (Hons) ,&nbsp;Jonathan E. Shaw MD ,&nbsp;Dianna J. Magliano PhD","doi":"10.1016/j.jcjd.2023.09.002","DOIUrl":"10.1016/j.jcjd.2023.09.002","url":null,"abstract":"<div><h3>Objective</h3><p>Our aim in this study was to determine the reasons for hospitalization in Australian people with diabetes who contract COVID-19.</p></div><div><h3>Methods</h3><p>All COVID-19 cases reported to the Victorian Department of Health and linked hospitalization data were assessed. We determined reasons for acute (0 to 30 days) and postacute (31 to 365 days) hospitalization among those with type 1 or type 2 diabetes and COVID-19, compared to those with COVID-19 and no diabetes, and to admissions before the COVID-19 pandemic.</p></div><div><h3>Results</h3><p>A total of 13,302 Australians with type 1 or type 2 diabetes were hospitalized in the state of Victoria in the 12 months after COVID-19 diagnosis. Respiratory diseases accounted for 40% of acute admissions among those with diabetes. Viral pneumonia was the leading cause of acute hospitalization among those with diabetes and constituted a larger proportion of admissions in those with compared to those without diabetes (adjusted prevalence ratio 1.87, 95% confidence interval 1.76 to 1.99). The distribution of postacute hospitalizations among those with diabetes aligned with that of people with diabetes before the COVID-19 pandemic.</p></div><div><h3>Conclusions</h3><p>Respiratory diseases are the leading cause of acute hospitalization in those with type 1 or type 2 diabetes and COVID-19. The reasons for postacute hospitalization resemble those in people with diabetes and no COVID-19. We reinforce the importance of community management of people with diabetes in the ongoing pandemic.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41149603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Attainment of Glycemic Targets Among Adults With Type 1 and Type 2 Diabetes in Canada: A Cross-sectional Study Using Primary and Specialty Care Electronic Medical Record Data","authors":"Alanna Weisman MD, PhD ,&nbsp;Ruth Brown PhD ,&nbsp;Lisa Chu PhD ,&nbsp;Ronnie Aronson MD ,&nbsp;Bruce A. Perkins MD, MPH","doi":"10.1016/j.jcjd.2023.09.001","DOIUrl":"10.1016/j.jcjd.2023.09.001","url":null,"abstract":"<div><h3>Objective</h3><p>Using a new database combining primary and specialty care electronic medical record (EMR) data in Canada, we determined attainment of glycemic targets and associated predictors among adults with diabetes.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional observational study combining primary and specialty care EMR data in Canada. Adults with diabetes whose primary care provider contributed to the National Diabetes Repository or who were assessed at a diabetes specialty clinic (LMC Diabetes and Endocrinology) between July 3, 2015, and June 30, 2019, were included. Diabetes type was categorized as type 2 diabetes (T2D) not prescribed insulin, T2D prescribed insulin, and type 1 diabetes (T1D). Covariates were age, sex, income quintile, province, rural/urban location, estimated glomerular filtration rate, medications, and insulin pump use. Associations between predictors and the outcome (glycated hemoglobin [A1C] of ≤7.0%) were assessed by multivariable logistic regressions.</p></div><div><h3>Results</h3><p>Among 122,106 adults, consisting of 91,366 with T2D not prescribed insulin, 25,131 with T2D prescribed insulin, and 5,609 with T1D, attainment of an A1C of ≤7.0% was 60%, 25%, and 23%, respectively. Proportions with an A1C of ≤7.5% and ≤8.0% were 75% and 84% for those with T2D not prescribed insulin, 41% and 57% for those with T2D prescribed insulin, and 37% and 53% for those with T1D. Highest vs lowest income quintile was associated with greater odds of meeting the A1C target (adjusted odds ratio [95% confidence interval] for each diabetes category: 1.15 [1.10 to 1.21], 1.21 [1.10 to 1.33], and 1.29 [1.04 to 1.60], respectively). Individuals in Alberta and Manitoba had less antihyperglycemic medication use and attainment of A1C target than other provinces.</p></div><div><h3>Conclusions</h3><p>Attainment of glycemic targets among adults with diabetes was poor and differed by income and geographic location, which must be addressed in national diabetes strategies.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1499267123002174/pdfft?md5=4ae2e688b4236038a935b3ad5619bb4f&pid=1-s2.0-S1499267123002174-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10338555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Sex and Gender on Metabolic Syndrome in Adults: A Retrospective Cohort Study From the Canadian Primary Care Sentinel Surveillance Network","authors":"Rubee Dev PhD, MPH ,&nbsp;Hassan Behlouli PhD ,&nbsp;Monica Parry NP-Adult, PhD, FAAN ,&nbsp;Valeria Raparelli MD, PhD ,&nbsp;Colleen M. Norris MScN, PhD ,&nbsp;Louise Pilote MD, MPH, PhD, FRCPC ,&nbsp;GOING-FWD Consortium","doi":"10.1016/j.jcjd.2023.08.008","DOIUrl":"10.1016/j.jcjd.2023.08.008","url":null,"abstract":"<div><h3>Objective</h3><p><span>Metabolic syndrome (MetS), a cluster of 5 interconnected factors, is the main contributor to cardiovascular disease. Although sex- and gender-related elements have been linked to MetS and its components, this association has not been explored among Canadians with or without MetS. In this study, we aimed to identify </span>sex and gender differences in characteristics of MetS in the Canadian population.</p></div><div><h3>Methods</h3><p><span>This retrospective cohort study used data from the Canadian </span>Primary Care<span> Sentinel Surveillance Network (CPCSSN) database. The CPCSSN contains de-identified electronic health records<span> of &gt;1.5 million Canadians (2010–2019). Individuals 35 to 75 years of age who had a primary care encounter formed the study sample (N=37,813). Multiple logistic regression models were used to estimate adjusted odds ratios for sex and gender differences among Canadians with and without MetS, which was the primary outcome variable.</span></span></p></div><div><h3>Results</h3><p>The estimated prevalence of MetS was 41.9%. The risk of developing MetS was significantly lower among females compared with males (odds ratio 0.73, 95% confidence interval 0.70 to 0.76). However, the risk was higher in females who used antidepressants (odds ratio 1.53, 95% confidence interval 1.42 to 1.65). An equal distribution of deprivation indexes was observed between males and females with MetS, with risk slightly higher for those with material deprivation. Females were found to be the most socially deprived.</p></div><div><h3>Conclusions</h3><p>This study provides important sex- and gender-specific differences in MetS among Canadians. Targeting sex- and gender-specific risk factors could assist in reversing the trend of adverse cardiovascular outcomes associated with MetS.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10306855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining a Childhood Type 1 Diabetes Cohort, Clinical Practice Measures, and Outcomes Within Administrative Data in British Columbia","authors":"Danya Fox MD, MPH ,&nbsp;Qian Zhang MPH ,&nbsp;Nazrul Islam PhD ,&nbsp;Leo Chen MSc ,&nbsp;Joseph Leung MD, MPH ,&nbsp;Jeffrey Bone PhD ,&nbsp;Shazhan Amed MD, MScPH","doi":"10.1016/j.jcjd.2023.08.007","DOIUrl":"10.1016/j.jcjd.2023.08.007","url":null,"abstract":"<div><h3>Objective</h3><p>We used administrative data to 1) establish a cohort of individuals with childhood-onset type 1 diabetes (T1D) in British Columbia (BC), and 2) define T1D-related clinical practice measures.</p></div><div><h3>Methods</h3><p>We applied a validated diabetes case–finding definition and differentiating algorithm to linked administrative data (1992–1993 to 2019–2020). Cases were removed when they did not meet inclusion criteria for childhood-onset T1D. Clinical practice measures were defined based on clinical practice guidelines.</p></div><div><h3>Results</h3><p>We developed an administrative cohort that included 5,901 individuals with childhood-diagnosed T1D between April 1, 1996, and March 31, 2020. The mean age was 22.31 (standard deviation 8.21) years. Clinical practice measures derived included diabetes outpatient visits (N=4,935) and glycated hemoglobin<span><span> tests (N=4,935), and screening for thyroid function (N=4,457), </span>retinopathy<span> (N=1,602), and nephropathy (N=2,369).</span></span></p></div><div><h3>Conclusions</h3><p>We established an administrative cohort of ∼6,000 individuals with childhood-onset T1D with 20⁺ years of follow-up data that can be used to describe the association between clinical practice measures and clinical outcomes.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10314830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Type 1 and Type 2 Diabetes Care in the Hemodialysis Unit: A Quality-improvement Initiative Throughout the COVID-19 Pandemic","authors":"Shaily Brahmbhatt BSc ,&nbsp;Amanda Mikalachki RN, CDE ,&nbsp;Julie Ann Lawrence NP ,&nbsp;Lindsay Blackwell Pharm ,&nbsp;Paulina Bleah NP ,&nbsp;Yumna Khan RD ,&nbsp;Tsan-Hua Tung BSc ,&nbsp;Kathy Austin RN ,&nbsp;Laura Craig RD ,&nbsp;Kristin K. Clemens MD, MSc ,&nbsp;TEAM CARE Investigators","doi":"10.1016/j.jcjd.2023.07.010","DOIUrl":"10.1016/j.jcjd.2023.07.010","url":null,"abstract":"<div><h3>Objective</h3><p>People living with diabetes mellitus (DM) and chronic kidney disease can have difficulty attending multiple appointments to receive DM care. We developed and studied the utility of a DM outreach program to offer in the hemodialysis (HD) unit.</p></div><div><h3>Methods</h3><p>We conducted a quality improvement project in a satellite HD unit in London, Ontario, Canada, between August 1, 2019, and July 31, 2022. We assessed for baseline gaps in DM care among those with DM, performed root-cause analysis with key stakeholders to identify critical drivers of gaps, and conceptualized a certified diabetes educator–led outreach program to offer in the HD unit. We aimed to improve DM self-monitoring, hypo- and hyperglycemia, and DM-related screening. We used run and control charts to track outcome measures over time and modified our outreach program iteratively.</p></div><div><h3>Results</h3><p>Fifty-eight persons with DM receiving HD participated in our program. Support spanned multiple waves of the COVID-19 pandemic. With 4 tests of change, we observed improvement in DM self-monitoring with a modest decline in self-reported hyperglycemia. There were no adverse consequences, and satisfaction with our program was high.</p></div><div><h3>Conclusions</h3><p>Although we did not meet all measures of success during the pandemic, outreach DM support in the HD unit appeared to improve self-monitoring and self-reported hyperglycemia. Similar programs could be modified and implemented in other centres.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10539158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Testing 3 Digital Health Platforms to Improve Mental Health Outcomes in Adults With Type 1 Diabetes: A Pilot Trial","authors":"Tricia S. Tang PhD, RPsych ,&nbsp;Sorayya Seddigh BSc ,&nbsp;Eashan Halbe BSc ,&nbsp;Anthony T. Vesco PhD","doi":"10.1016/j.jcjd.2023.08.006","DOIUrl":"10.1016/j.jcjd.2023.08.006","url":null,"abstract":"<div><h3>Objective</h3><p>Our aim in this study was to examine the potential impact of a 3-pronged digital health<span> pilot intervention (TRIFECTA) on diabetes distress and depressive symptoms among adults with type 1 diabetes (T1D) in British Columbia.</span></p></div><div><h3>Methods</h3><p>We recruited 60 adults with T1D (mean age 38.9±15.1 years, 75% female, 77% Caucasian) who participated in the 6-month pilot intervention involving 3 digital health platforms: monthly, provider-led, group-based sessions over Zoom (virtual huddles); a WhatsApp peer texting group; and a web-based “Ask-the-expert” portal. Assessments were conducted at baseline and 6 months and measured diabetes distress (T1D Diabetes Distress Scale), depressive symptoms (9-item Personal Health Questionnaire), and TRIFECTA engagement metrics.</p></div><div><h3>Results</h3><p>Participation in TRIFECTA was associated with significant reductions in Overall Distress (p=0.011) and 4 distress subscales: Powerlessness (p=0.006), Management Distress (p=0.001), Hypoglycemia Distress (p=0.029), and Eating Distress (p&lt;0.001). A higher number of virtual huddles attended predicted lower Overall Distress (p=0.019) and Family/Friends Distress (p=0.023). A higher number of “Ask-the-expert” posts viewed predicted lower Overall Distress (p=0.046), whereas a higher number of WhatsApp messages posted predicted lower Management Distress (p=0.006). Furthermore, engagement in all 3 metrics was a predictor for lower Negative Social Perceptions Distress (p&lt;0.05). No associations were seen in other distress subscales or for depressive symptoms.</p></div><div><h3>Conclusions</h3><p>Participation in TRIFECTA was linked to reduced diabetes distress levels, but not depressive symptoms, in a platform-dependent manner. This study provides promising pilot data for a subsequent large-scale and fully powered randomized controlled trial.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10250790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impaired cardiovagal activity as a link between hyperglycemia and arterial stiffness in type-2 diabetes mellitus patients among Eastern Indian population: A cross-sectional study.","authors":"Nibedita Priyadarsini, Devineni Likhitha, Madumathy Ramachandran, Kishore Kumar Behera","doi":"10.1016/j.jcjd.2023.12.003","DOIUrl":"https://doi.org/10.1016/j.jcjd.2023.12.003","url":null,"abstract":"<h3>Introduction</h3><p>Cardiac autonomic neuropathy (CAN) is one of the most common yet overlooked complications in Type- 2 Diabetes mellitus (T2DM). The T2DM patients with CAN show a fivefold increase in Cardiovascular morbidity and mortality. The presence of CAN in T2DM could potentially lead to arterial stiffness. However, there is sparse data available to prove this association between autonomic dysfunction and arterial stiffness in T2DM.</p><h3>Methods</h3><p>We recruited 80 T2DM patients and 74 healthy controls. Heart rate variability (HRV) was done to assess autonomic function. The assessment of arterial stiffness was done by measuring brachial Pulse wave velocity (baPWV) and Augmentation index (AI).</p><h3>Results</h3><p>The time domain parameters were significantly decreased (<em>P</em>&lt;0.001) and frequency domain parameters like total power and HFnu were found to be significantly reduced in T2DM patients (<em>P</em>&lt;0.001). The baPWV and AI were significantly higher in T2DM compared to healthy controls (<em>P</em>&lt;0.001). We observed a moderate correlation between SDNN and baPWV (r= -0.437, <em>P</em> 0.002) and AI (r= -0.403, <em>P</em> 0.002). The multiple linear regression model shows an association between SDNN and arterial stiffness parameters like baPWV and AI which was statistically significant (p&lt;0.05) in the fully adjusted model which includes the conventional risk factors for atherosclerosis.</p><h3>Conclusion</h3><p>The impaired cardiovagal activity is an independent risk factor for the development of arterial stiffness. Incorporation of HRV test into diabetes management protocol will have potential benefits of identifying the patients at high risk of developing cardiovascular events. Hence, preventive measures can be taken at the earliest to improve patient outcomes.</p>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139022368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Type 2 Diabetes in the Multiethnic Cohort","authors":"Gertraud Maskarinec MD, PhD ,&nbsp;Bruce S. Kristal PhD ,&nbsp;Lynne R. Wilkens DrPH ,&nbsp;Gino Quintal BS ,&nbsp;David Bogumil PhD ,&nbsp;Veronica W. Setiawan PhD ,&nbsp;Loïc Le Marchand MD, PhD","doi":"10.1016/j.jcjd.2023.06.004","DOIUrl":"10.1016/j.jcjd.2023.06.004","url":null,"abstract":"<div><h3>Objectives</h3><p>In this report, we investigated the association between established risk factors and type 2 diabetes (T2D) across 5 distinct ethnic groups and explored differences according to T2D definition within the Multiethnic Cohort (MEC) Study.</p></div><div><h3>Methods</h3><p>Using the full MEC, with participants in Hawaii and Los Angeles (N=172,230), we applied Cox regression<span><span> to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). All participants completed questionnaires asking about demographics, anthropometrics, lifestyle factors, and regular diet. T2D status was determined from self-reported diagnosis/medication and Medicare claims. We assessed the associations between well-established risk factors and T2D in the full cohort, after stratification by ethnic group, according to the T2D definition, and in a </span>biorepository subset. Effect modification by ethnicity was evaluated using Wald’s tests.</span></p></div><div><h3>Results</h3><p>Overall, 46,500 (27%) participants had an incident T2D diagnosis after a mean follow-up of 17.1±6.9 years. All predictors were significantly associated with T2D: overweight (HR=1.74), obesity (HR=2.90), red meat intake (HR=1.15), short (HR=1.04) and long (HR=1.08) sleep duration, and smoking (HR=1.26) predicted a significantly higher T2D incidence, whereas coffee (HR=0.90) and alcohol (HR=0.78) consumption, physical activity (HR=0.89), and diet quality (HR=0.96) were associated with lower T2D incidence. The strength of these associations was similar across ethnic groups with noteworthy disparities for overweight/obesity, physical activity, alcohol intake, coffee consumption, and diet quality.</p></div><div><h3>Conclusions</h3><p>These findings confirm the importance of known risk factors for T2D across ethnic groups, but small differences were detected that may contribute to disparate incidence rates in some ethnic groups, especially for obesity and physical activity.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9943127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Perspectives on Virtual Care for Diabetes Management in the Era of COVID-19","authors":"Paul Beamish MD ,&nbsp;Kylie McNeill PhD ,&nbsp;Amel Arnaout MD ,&nbsp;Janine Malcolm MD","doi":"10.1016/j.jcjd.2023.07.001","DOIUrl":"10.1016/j.jcjd.2023.07.001","url":null,"abstract":"<div><h3>Objective</h3><p>The aim of this study was to characterize patient perspectives on the quality of diabetes care at The Ottawa Hospital Endocrinology and Metabolism multidisciplinary clinic delivered virtually during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>An online survey was developed to collect quantitative and qualitative data on patients’ experiences with virtual diabetes clinic visits between March 2020 and April 2021.</p></div><div><h3>Results</h3><p>A total of 333 patients were included in this study; 45% were female and had a mean age of 60 years. Seventy-nine percent were born in Canada and 87% identified as Caucasian. Thirty-six percent were treated for type 1 diabetes and 62% for type 2 diabetes. Eighty-seven percent of virtual visits occurred by phone, with 12% of these on Zoom. Overall, 83% were “very satisfied” or “satisfied” with their virtual care experience. Most respondents perceived all treatment-related factors to be equally well addressed virtually as in person, except for physical examination. Auxiliary factors like travel, cost, and time spent were rated more favourably with virtual care. Qualitative findings provided further contextualization and identified gaps in virtual care delivery. For future visits, 44% wanted in-person visits only as needed, 36% wanted a hybrid of in-person and virtual appointments, and 11% preferred in-person appointments only.</p></div><div><h3>Conclusions</h3><p>Patients perceive that virtual care provides high-fidelity diabetes management while reducing their pandemic risks as well as minimizing travel and time associated with in-person care. Virtual care is an important medium for diabetes care delivery that should be used according to patient preference and intermixed with in-person appointments.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9940800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}