Improving Glycemic Control When “Usual” Diabetes Care Is Not Enough

2011 ◽  
Vol 171 (22) ◽  
pp. 1999 ◽  
Author(s):  
Ralph Gonzales
Keyword(s):  
Glycemic Control ◽  
Diabetes Care

scholarly journals Diabetes Care, Glycemic Control, Complications, and Concomitant Autoimmune Diseases in Children with Type 1 Diabetes in Turkey: A Multicenter Study

2013 ◽  
Vol 5 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Gökşen Şimşek Damla ◽  
Aycan Zehra ◽  
Özen Samim ◽  
Çetinkaya Semra ◽  
Kara Cengiz ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Autoimmune Diseases ◽  
Multicenter Study ◽  
Diabetes Care

scholarly journals Response to Comment on Lacy et al. Long-term Glycemic Control and Dementia Risk in Type 1 Diabetes. Diabetes Care 2018;41:2339–2345

Diabetes Care ◽  
2019 ◽  
Vol 42 (4) ◽  
pp. e69-e69
Author(s):  
Mary E. Lacy ◽  
Paola Gilsanz ◽  
Andrew J. Karter ◽  
Charles P. Quesenberry ◽  
Mark J. Pletcher ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Diabetes Care ◽  
Dementia Risk

scholarly journals Testing an audit and feedback-based intervention to improve glycemic control after transfer to adult diabetes care: protocol for a quasi-experimental pre-post design with a control group

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Rayzel Shulman ◽  
Ian Zenlea ◽  
Baiju R. Shah ◽  
Cheril Clarson ◽  
Jennifer Harrington ◽  
...  
Keyword(s):  
Young Adults ◽  
Glycemic Control ◽  
Diabetes Care ◽  
Audit And Feedback ◽  
System Level ◽  
Pediatric Diabetes ◽  
Patient Reported ◽  
Quasi Experimental ◽  
Adult Diabetes

Abstract Background When young adults transfer from pediatric to adult diabetes care they are at risk for deterioration of glycemic control, putting them at an increased risk of developing both acute and chronic complications. Despite increased awareness of these risks, there are gaps in care delivery during this vulnerable time and variability in the implementation of recommended transition practice. Audit and feedback (AF) interventions have a positive but variable effect on implementation of best practices. An expert group identified specific suggestions for optimizing the effectiveness of AF interventions. We aim to test an AF-based intervention incorporating these specific suggestions to improve transition practices and glycemic control in the first year after transfer from pediatric to adult diabetes care. Methods This is a pragmatic quasi-experimental study; a series of three cohort studies (pre-implementation, early-implementation, and post-implementation) to compare the baseline adjusted hemoglobin A1c (HbA1c) in the 12 months after the final pediatric visit in five pediatric diabetes centres within the Ontario Pediatric Diabetes Network in Ontario, Canada. The intervention includes three components: 1) centre-level feedback reports compiling data from chart abstraction, linked provincial administrative datasets, and patient-reported experience measures; 2) webinars for facilitated conversations/coaching about the feedback; and 3) online repository of curated transition resources for providers. The primary outcome will be analyzed using a multivariable linear regression model. We will conduct a qualitative process evaluation to understand intervention fidelity and to provide insight into the mechanisms of action of our results. Discussion There is a need to develop an innovative system-level approach to improve outcomes and the quality of care for young adults with type 1 diabetes during the vulnerable time when they transfer to adult care. Our research team, a collaboration of health services, implementation science, and quality improvement researchers, are designing, implementing, and evaluating an AF-based intervention using recommendations about how to optimize effectiveness. This knowledge will be generalizable to other care networks that aim to deliver uniformly high-quality care in diverse care settings. Trial registration ClinicalTrials.gov NCT03781973. Registered 13 December 2018. Date of enrolment of the first participant to the trial: June 1, 2019.

Sign in / Sign up

Export Citation Format

Share Document