Complex diabetes screening guidelines for high-risk adolescent Aboriginal Australians: a barrier to implementation in primary health care

2019 ◽  
Vol 25 (5) ◽  
pp. 501
Author(s):  
Andreana Manifold ◽  
David Atkinson ◽  
Julia V. Marley ◽  
Lydia Scott ◽  
Gavin Cleland ◽  
...  
Keyword(s):  
Point Of Care ◽  
Glycated Haemoglobin ◽  
Aboriginal Australians ◽  
Aboriginal Community ◽  
Screening Guidelines ◽  
Retrospective Audit ◽  
Screening Algorithm ◽  
Targeted Screening ◽  
Complex Diabetes

The aim of this study is to ascertain whether a simplified screening algorithm incorporating glycated haemoglobin (HbA1c) tests increases type 2 diabetes (T2D) screening in 10- to 14-year-old Aboriginal Australians presenting to primary healthcare (PHC) services. The study involved a 6-month pilot of a locally developed evidence-based screening algorithm in a remote Western Australian Kimberley town. A retrospective audit of electronic health records for the pilot period (27 June–26 December 2016) and a 6-month period before the screening algorithm was introduced (1 October 2015–31 March 2016) was conducted. Interviews were held with 30 PHC staff at participating PHC services, an Aboriginal Community Controlled Health Service (ACCHS) and a hospital-based general practice service. During the pilot, significantly more patients received an initial T2D screening test at the ACCHS (28/130 (22%) v. 50/139 (36%), P = 0.011), but there was no change at the hospital (0.02% v. 0.02%, P = 0.615). Staff feedback suggested measures to improve screening; these include simple guidelines, targeted screening, patient and staff education, point-of-care HbA1c tests and a whole-of-clinic approach to implementation. Implementing a screening algorithm for young-onset diabetes in Aboriginal Australians is challenging, but practical measures can be taken to improve screening.

scholarly journals Use of the Bayer DCA 2000+ for the measurement of glycated haemoglobin in a remote Australian Aboriginal community

2003 ◽  
Vol 40 (5) ◽  
pp. 566-568 ◽  
Author(s):  
T Shemesh ◽  
LS Piers ◽  
K O'Dea
Keyword(s):  
Glycaemic Control ◽  
High Performance ◽  
Glycated Haemoglobin ◽  
Remote Communities ◽  
Community Based ◽  
Aboriginal Community ◽  
Good Glycaemic Control ◽  
Australian Aboriginal Community ◽  
Sensitivity Specificity

Background: Good glycaemic control in type 2 diabetes can reduce both morbidity and mortality, and monitoring of glycated haemoglobin A1c (HbA1c) is currently recommended for this purpose. Methods: Haemoglobin A1c can be measured using the portable Bayer DCA 2000+. As part of a community-based screening project for chronic diseases, subjects with impaired fasting glucose concentrations or diabetes had their HbA1c concentration measured on the analyser. HbA1c measurements were also made in a laboratory using cation-exchange high-performance liquid chromatography. Results were then compared to those obtained in the field. HbA1c values were loge transformed to obtain a normal distribution. Results: Mean (95% confidence interval) HbA1c measured on the DCA 2000+ ( n = 39) was 6.3% (5.8, 6.9%), while that measured in the laboratory was 6.5% (6.0, 7.0%). The correlation coefficient ( r) between the measurements was 0.96 ( P < 0.01). Bland-Altman analysis revealed that the DCA 2000+ estimate of HbA1c could be used interchangeably with that from the laboratory (mean bias = 0.1%, limits of agreement - 1.1, 0.8%). The sensitivity, specificity and positive predictive value of the DCA 2000+ estimate of HbA1c using a cut-off value of <7% for adequate glycaemic control, were all 100%. Conclusions: The DCA 2000+ may be used to measure HbA1c in remote communities.

Abstract # P-1: Use of Type 2 Diabetes Screening Guidelines in Primary Care: Concordance Between Physician Survey and Medical Records

2016 ◽  
Vol 22 ◽  
pp. 14
Author(s):  
Michelle Mocarski ◽  
Sandhya Mehta ◽  
Karin Gillespie ◽  
Tami Wisniewski ◽  
K.M. Venkat Narayan ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Medical Records ◽  
Physician Survey ◽  
Diabetes Screening ◽  
Screening Guidelines

scholarly journals A Pathway to Precision Medicine for Aboriginal Australians: A Study Protocol

2021 ◽  
Vol 4 (2) ◽  
pp. 42
Author(s):  
Yeu-Yao Cheng ◽  
Jack Nunn ◽  
John Skinner ◽  
Boe Rambaldini ◽  
Tiffany Boughtwood ◽  
...  
Keyword(s):  
Precision Medicine ◽  
Study Protocol ◽  
Torres Strait Islander ◽  
Genomic Data ◽  
Phase Iii ◽  
Community Members ◽  
Aboriginal Australians ◽  
Aboriginal Community ◽  
Potential Use ◽  
Fair Access

(1) Background: Genomic precision medicine (PM) utilises people’s genomic data to inform the delivery of preventive and therapeutic health care. PM has not been well-established for use with people of Aboriginal and Torres Strait Islander ancestry due to the paucity of genomic data from these communities. We report the development of a new protocol using co-design methods to enhance the potential use of PM for Aboriginal Australians. (2) Methods: This iterative qualitative study consists of five main phases. Phase-I will ensure appropriate governance of the project and establishment of a Project Advisory Committee. Following an initial consultation with the Aboriginal community, Phase-II will invite community members to participate in co-design workshops. In Phase-III, the Chief Investigators will participate in co-design workshops and document generated ideas. The notes shall be analysed thematically in Phase-IV with Aboriginal community representatives, and the summary will be disseminated to the communities. In Phase-V, we will evaluate the co-design process and adapt our protocol for the use in partnership with other communities. (3) Discussion: This study protocol represents a crucial first step to ensure that PM research is relevant and acceptable to Aboriginal Australians. Without fair access to PM, the gap in health outcome between Aboriginal and non-Aboriginal Australians will continue to widen.

A comparison of the periodontal status in patients with type 2 diabetes based on glycated haemoglobin levels and other risk factors

2015 ◽  
Vol 60 (1) ◽  
pp. 156-161 ◽  
Author(s):  
Magdalena Kiedrowicz ◽  
Elżbieta Dembowska ◽  
Jadwiga Banach ◽  
Krzysztof Safranow ◽  
Sławomir Pynka
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Glycated Haemoglobin ◽  
Periodontal Status

scholarly journals Cognitive Impairment in People with Diabetes-Related Foot Ulceration

2021 ◽  
Vol 10 (13) ◽  
pp. 2808
Author(s):  
Ranita Siru ◽  
Melanie S. Burkhardt ◽  
Wendy A. Davis ◽  
Jonathan Hiew ◽  
Laurens Manning ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cognitive Impairment ◽  
Sex Education ◽  
Foot Ulcer ◽  
Screening Tests ◽  
Community Settings ◽  
Foot Ulceration ◽  
Complex Diabetes ◽  
State Examination

Aims: To determine whether there is an excess of cognitive impairment in patients with type 2 diabetes and foot ulceration. Methods: 55 patients with type 2 diabetes and foot ulcers attending Multidisciplinary Diabetes Foot Ulcer clinics (MDFU cohort) were compared with 56 patients with type 2 diabetes attending Complex Diabetes clinics (CDC cohort) using commonly used screening tests for cognitive impairment (Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MOCA)), as well as foot self-care, mood and health literacy. MMSE was also compared between the MDFU cohort and a historical community-based cohort of patients with type 2 diabetes (FDS2 cohort). Results: Median MMSE scores were the same in all three groups (28/30). Median MOCA scores did not differ between the MDFU and CDC cohorts (25/30). There were no significant differences in the percentages of patients with MMSE ≤ 24 or MOCA ≤ 25 between MDFU and CDC cohorts (3.6% versus 10.7%, p = 0.27 and 56.4% versus 51.8%, p = 0.71, respectively), findings that did not change after adjustment for age, sex, education, diabetes duration, and random blood glucose. Conclusions: Using conventionally applied instruments, patients with type 2 diabetes and foot ulceration have similar cognition compared with patients without, from either hospital-based clinic or community settings.

Type 2 diabetes self-management: spirituality, coping and responsibility

2021 ◽  
Vol 26 (8) ◽  
pp. 743-760
Author(s):  
Natasha Duke
Keyword(s):  
Type 2 Diabetes ◽  
Health Beliefs ◽  
Diabetes Management ◽  
Coping Styles ◽  
Glycated Haemoglobin ◽  
Self Management ◽  
Living Situation ◽  
Care Plans ◽  
Interpretive Method

Background In England, although The National Institute of Health and Care Excellence recommends that patients’ religious beliefs should be incorporated into individual healthcare plans, these components are often neglected in diabetes management care plans. A literature review identified a paucity of research regarding how the spirituality of British people may influence their approach to their self-management of type 2 diabetes (T2D). Aims To explore how the spirituality of a small group of adults with T2D, living in England, influenced their coping strategies and self-management of diet and exercise. Methods Biographic Narrative Interpretive Method of two interviews per participant and thematic analysis for data interrogation ( n = 8). Data as glycated haemoglobin, living situation, age, length of time since T2D diagnosis, body mass index and diabetic medicines contextualised the interview data. Results Participants’ spirituality, health beliefs, coping and sense of responsibility for T2D self-management overlapped in complex layers. Three themes were generated: (a) spirituality influences expectations in life; (b) beliefs influence coping styles of diabetes self-management; and (c) responsibility influences diabetes self-management. A model was created to assist nurses in addressing these components. Conclusion Nurses should consider how patients’ self-management of T2D may be influenced by their spirituality, health beliefs, coping and sense of responsibility.

scholarly journals Effect of Vitamin C on Blood Glucose & Serum Lipids in Type 2 Diabetes Patients

KYAMC Journal ◽  
2017 ◽  
Vol 4 (1) ◽  
pp. 337-340 ◽  
Author(s):  
Ronjon Kumer Nath ◽  
Marufa Akhter ◽  
Kali Rani Sarker ◽  
Md Rezwanur Rahman ◽  
Shahela Sultana Chowdhury ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Vitamin C ◽  
Serum Lipids ◽  
Vascular Complications ◽  
Density Lipoprotein ◽  
Glycated Haemoglobin ◽  
Antioxidant Vitamin ◽  
Daily Consumption

Background & objectives: The prevalence of diabetes is rising at an alarming sign through out the world & is one of the major metabolic disorders that cause micro & macro-vascular complications. Dyslipidaemia is considered as risk factor for cardiovascular disease & it is higher risk in diabetes subjects than normal. The control of glycemic & lipid profile status can reduced the risk of micro & macro-vascular complications. As vitamin C is anti oxidant vitamins so we aimed to evaluate the beneficial effects of its on blood glucose & serum lipids in T2DM patients.Materials & methods: A total of 46 patients with T2DM were included in this study. They received 1000 mg of vitamin C for eight weeks. Fasting blood sugar (FBS), triglyceride (TG), total cholesterol (TC), low & high density lipoprotein (LDL & HDL) and glycated haemoglobin (HbA1c) were measured before & after vitamin consumption and the results were analyzed.Results: A significant decrease in TG, TC, LDL, and HbA1c was seen in the group supplemented with 1000 mg vitamin C. In case of FBG & HDL there was no significant difference.Interpretation & conclusions: Our results indicate that daily consumption of 1000 mg supplementary antioxidant vitamin-C may be beneficial in decreasing glycemic status and lipids in patients with type 2 diabetes and thus reducing the risk of complications.KYAMC Journal Vol. 4, No.-1, July 2013, Page 337-340

scholarly journals The Effects of Almonds on Gut Microbiota, Glycometabolism, and Inflammatory Markers in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3377
Author(s):  
Omorogieva Ojo ◽  
Xiao-Hua Wang ◽  
Osarhumwese Osaretin Ojo ◽  
Amanda Rodrigues Amorim Adegboye
Keyword(s):  
Systematic Review ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Gut Microbiota ◽  
Inflammatory Markers ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Glycated Haemoglobin ◽  
Postprandial Blood Glucose

The use of nutritional interventions for managing diabetes is one of the effective strategies aimed at reducing the global prevalence of the condition, which is on the rise. Almonds are the most consumed tree nut and they are known to be rich sources of protein, monounsaturated fatty acids, essential minerals, and dietary fibre. Therefore, the aim of this review was to evaluate the effects of almonds on gut microbiota, glycometabolism, and inflammatory parameters in patients with type 2 diabetes. Methods: This systematic review and meta-analysis was carried out according to the preferred reporting items for systematic review and meta-analysis (PRISMA). EBSCOhost, which encompasses the Health Sciences Research Databases; Google Scholar; EMBASE; and the reference lists of articles were searched based on population, intervention, control, outcome, and study (PICOS) framework. Searches were carried out from database inception until 1 August 2021 based on medical subject headings (MesH) and synonyms. The meta-analysis was carried out with the Review Manager (RevMan) 5.3 software. Results: Nine randomised studies were included in the systematic review and eight were used for the meta-analysis. The results would suggest that almond-based diets have significant effects in promoting the growth of short-chain fatty acid (SCFA)-producing gut microbiota. Furthermore, the meta-analysis showed that almond-based diets were effective in significantly lowering (p < 0.05) glycated haemoglobin (HbA1c) levels and body mass index (BMI) in patients with type 2 diabetes. However, it was also found that the effects of almonds were not significant (p > 0.05) in relation to fasting blood glucose, 2 h postprandial blood glucose, inflammatory markers (C-reactive protein and Tumour necrosis factor α, TNF-α), glucagon-like peptide-1 (GLP-1), homeostatic model assessment of insulin resistance (HOMA–IR), and fasting insulin. The biological mechanisms responsible for the outcomes observed in this review in relation to reduction in HbA1c and BMI may be based on the nutrient composition of almonds and the biological effects, including the high fibre content and the low glycaemic index profile. Conclusion: The findings of this systematic review and meta-analysis have shown that almond-based diets may be effective in promoting short-chain fatty acid-producing bacteria and lowering glycated haemoglobin and body mass index in patients with type 2 diabetes compared with control. However, the effects of almonds were not significant (p > 0.05) with respect to fasting blood glucose, 2 h postprandial blood glucose, inflammatory markers (C-reactive protein and TNF-α), GLP-1, HOMA–IR, and fasting insulin.

scholarly journals New clusters of type 2 diabetes mellitus and their outcomes: relation between pharmacological treatment and previous cardiovascular events

2021 ◽  
Vol 31 (Supplement_2) ◽  
Author(s):  
Claudio Santos ◽  
Sonia Brito-Costa ◽  
Luis Margalho ◽  
Pedro Monteiro
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pharmacological Treatment ◽  
Cardiovascular Events ◽  
Glycated Haemoglobin ◽  
Research Unit ◽  
Clinical Research Unit ◽  
History Of

Abstract Background Type 2 Diabetes Mellitus (T2DM) is the most common form of diabetes in adults, with 90% to 95% of cases. This study aims to establish clusters and have knowledge about the relationship between previous cardiovascular events and pharmacological treatment for T2DM. Methods 191 participants (EG) with T2DM with the average of 70.3 years (SD = 8.3) and 36 with pre-diabetes (CG) with an average of 62 years (SD = 10.3) who participated in clinical trials at Clinical Research Unit in Cardiology of Coimbra Hospital and Universitary Centre without cognitive difficulties, were divided in 5 different clusters. These were established based on six different variables: body mass index (BMI), age of each individual, age at diagnosis of DMT2, glycated haemoglobin value (HbA1c), homeostatic model that estimates the function of β cells (HOMA2-B) and insulin resistance (HOMA2-IR). Results Cluster 1 presented pre-diabetic individuals (15.9%), while diabetic individuals were divided into clusters 2 (1.8%), 3 (17.6%), 4 (21.1%) and 5 (43.6%). Regarding the study of the prevalence of previous cardiovascular events, the majority of individuals present in the different clusters had history of acute myocardial infarction (AMI). As for the prevalence of pharmacological treatment for DMT2, it was found that metformin was the most used drug. It was observed a relationship between previous AMI and metformin administration in clusters 3 (P = 0.0027; P &lt; 0.05) and 5 (P = 0.0059; P &lt; 0.05). Conclusions It was possible to create different clusters in a sample of the Portuguese population and to observe the existence of dependency relationships between different previous cardiovascular events and pharmacological treatment.

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