scholarly journals Care for Patients with Type 2 Diabetes in a Random Sample of Community Family Practices in Ontario, Canada

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Gina Agarwal ◽  
Janusz Kaczorowski ◽  
Steve Hanna
Keyword(s):  
Best Practices ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Management Strategies ◽  
Chart Audit ◽  
Pressure Reading ◽  
International Data ◽  
One Year ◽  
Control And Management

Objective. Diabetes care is an important part of family practice. Previous work indicates that diabetes management is variable. This study aimed to examine diabetes care according to best practices in one part of Ontario. Design and Participants. A retrospective chart audit of 96 charts from 18 physicians was conducted to examine charts regarding diabetes care during a one-year period. Setting. Grimsby, Ontario. Main Outcome Measures. Glycemic screening, control and management strategies, documentation and counselling for lifestyle habits, prevalence of comorbidities, screening for hypertension, hyperlipidemia, and use of appropriate recommended preventive medications in the charts were examined. Results. Mean A1c was within target (less than or equal to 7.00) in 76% of patients (ICC = −0.02), at least 4 readings per annum were taken in 75% of patients (ICC = 0.006). Nearly 2/3 of patients had been counselled about diet, more than 1/2 on exercise, and nearly all (90%) were on medication. Nearly all patients had a documented blood pressure reading and lipid profile. Over half (60%) had a record of their weight and/or BMI. Conclusion. Although room for improvement exists, diabetes targets were mainly reached according to recognized best practices, in keeping with international data on attainment of diabetes targets.

scholarly journals Involvement of dietitians in diabetes care, results from a secondary care hospital in Greece

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Zoe Pafili ◽  
Sophia Samara ◽  
Charilaos Dimosthenopoulos ◽  
Olga Gkortzi
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Care ◽  
Secondary Care ◽  
Diabetes Management ◽  
Nutrition Therapy ◽  
Dietary Advice ◽  
Diabetes Diagnosis ◽  
Diabetes Patients

AbstractIntroductionAccording to diabetes care standards nutrition therapy should be an integral part of diabetes management, and all individuals with diabetes should be referred to a registered dietitian for nutrition therapy at—or soon after—diagnosis and for ongoing follow-up. There is limited international data that indicate that a large percentage of people with diabetes have not received structured diabetes education and have not visited a dietitian. The aim of this study was to assess the involvement of dietitians in diabetes care in Greece.Materials and MethodsAll adult diabetic patients admitted to a secondary care general hospital in Greece during 30 consecutive days were included in the study. Patients admitted in the ICU, CICU, day clinics and hemodialysis patients were excluded. Data were obtained by personal interviews using a 40 item questionnaire which included 10 questions regarding number of visits to dietitians for diabetes management, whether patients were referred by their doctors or sought dietary advice by their own, reasons for visiting a dietitian, goal achievement and patient satisfaction.ResultsIn total 124 patients (68 males and 56 females) with diabetes were admitted to the hospital during the study period (4 type 1, 114 type 2 and 6 pregnancy diabetes). Data were obtained from 3 (22.8 ± 6 yrs, 26.1 ± 5.7kg/m2,8.3 ± 5.9 yrs with diabetes),105 (76.6 ± 11.3 yrs, 28.0 ± 5.3 kg/m2, 12.8 ± 9.3 yrs with diabetes), and 5 (32.6 ± 4.4 yrs, 28.5 ± 4.0 kg/m2) patients with type 1, type 2 and pregnancy diabetes respectively. Two out of 3 type 1 diabetes and 1 out of 5 patients with pregnancy diabetes interviewed reported to have been referred to a dietitian by their doctor. Only 5.7% (6 patients) of type 2 diabetes patients reported to have been referred to a dietitian by their doctor and another 5.7% have visited a dietitian on their own initiative. Five out of 6 referrals were at diabetes diagnosis. The number of encounters with a dietitian ranged from 1 to 24 with patients seeking to loose weight having the greater number of encounters. Of type 2 diabetes patients 94.3% did not receive lifestyle advice before commencing diabetes medication whereas 25% did not receive any dietary advice by any health professional even after starting medication.ConclusionsIn our cohort the majority of diabetes patients had not received dietary counseling by a dietitian, whereas about one fourth of type 2 diabetes patients had not received any dietary advice.

scholarly journals Integrated personalized diabetes management goes Europe: A multi-disciplinary approach to innovating type 2 diabetes care in Europe

2020 ◽  
Author(s):  
Allan Jones ◽  
Jakob Eyvind Bardram ◽  
Per Bækgaard ◽  
Claus Lundgaard Cramer-Petersen ◽  
Timothy Skinner ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Care ◽  
Diabetes Management

scholarly journals Therapy in type 2 diabetes: A logical empiricism - based approach

2014 ◽  
Vol 02 (02) ◽  
pp. 109-111
Author(s):  
Sanjay Kalra ◽  
Yashdeep Gupta
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Logical Empiricism ◽  
Ongoing Debate ◽  
The Family ◽  
Important People

AbstractThere is ongoing debate about the relevance of the ‘guideline approach,” vis-a-vis the “pathophysiologic approach” in the management of diabetes. However, it is disheartening to note that both these stands neglects the most important people involved in diabetes management: The person with diabetes, the family, and the treating physician. We discuss a logical empiricism based approach for diabetes care in this brief communication.

scholarly journals Comment on Tay et al. A Very Low-Carbohydrate, Low–Saturated Fat Diet for Type 2 Diabetes Management: A Randomized Trial. Diabetes Care 2014;37:2909–2918

Diabetes Care ◽  
2015 ◽  
Vol 38 (4) ◽  
pp. e64-e64
Author(s):  
Maria Ida Maiorino ◽  
Michela Petrizzo ◽  
Giuseppe Bellastella ◽  
Dario Giugliano ◽  
Katherine Esposito
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Trial ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Saturated Fat ◽  
Low Carbohydrate

Self-management, health service use and information seeking for diabetes care among recent immigrants in Toronto

2012 ◽  
Vol 33 (1) ◽  
pp. 12-18
Author(s):  
I Hyman ◽  
D Patychuk ◽  
Q Zaidi ◽  
D Kljujic ◽  
YB Shakya ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Care ◽  
Information Seeking ◽  
Service Use ◽  
Management Practices ◽  
Management Strategies ◽  
Self Management ◽  
Health Services Use ◽  
Recent Immigrants

Introduction Our objective was to explore self-management practices, health services use and information-seeking for type 2 diabetes care among adult men and women from four recent immigrant communities in Toronto. Methods A structured questionnaire was adapted for the Canadian context and translated into 4 languages. A total of 184 participants with type 2 diabetes—130 recent immigrants and 54 Canadian-born—were recruited in both community and hospital settings. Results Recent immigrants were significantly less likely than the Canadian-born group to perform regular blood glucose and foot checks and significantly more likely than the Canadian-born group to be non-smokers, participate in regular physical activity and reduce dietary fat. Recent immigrants were significantly less likely than the Canadian-born group to use a specialist, alternative provider and dietician and less likely to report using dieticians, nurses and diabetes organizations as sources of diabetes-related information. Important differences were observed by sex and country of origin. Conclusion Findings suggest that diabetes prevention and management strategies for recent immigrants must address linguistic, financial, informational and systemic barriers to information and care.

scholarly journals An Expert Opinion on “Glycemic Happiness”: Delineating the Concept and Determinant Factors for Persons with Type 2 Diabetes Mellitus

2021 ◽  
Vol 11 (3) ◽  
pp. 543-560 ◽  
Author(s):  
Sanjay Kalra ◽  
Ashok Kumar Das ◽  
Gagan Priya ◽  
Ameya Joshi ◽  
Hitesh Punyani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Expert Opinion ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Psychological Impact ◽  
Psychological Outcomes ◽  
Psychosocial Burden

The importance of the psychological impact of diabetes is globally well-documented. Evidence suggests that there is a high level of psychosocial burden of diabetes in India. Moreover, there is a lack of relevant knowledge among the patients and caregivers regarding the psychological impact of diabetes and how to cope with it, as compared to the majority of other countries. “Happiness of the patient” is an essential component of diabetes management, which potentially affects the treatment outcome, treatment adherence, self-care, and lifelong management of diabetes. Although several validated tools and scales exist for measuring psychological outcomes both in patients and physicians, tools to assess “happiness in diabetes care” are still lacking. With this background, an expert group meeting was held in India in September 2019, involving nine expert diabetologists and endocrinologists across the country to discuss the concept of “glycemic happiness”. This article summarizes the expert opinion on the factors affecting psychological outcomes in diabetes, introduces the concept of glycemic happiness, describes available scales and tools to measure general happiness, and delineates the five sets of questionnaires developed with questions that may help correlate with “glycemic happiness”. The questionnaires are based on a five-point Likert method. The experts also discussed and decided upon the study design for a proposed observational survey to assess glycemic happiness of persons with type 2 diabetes mellitus (T2DM) based on the developed five sets of questionnaires. Given the huge burden of diabetes in India, the introduction of the concept of glycemic happiness will help in the optimization of diabetes care in the country.

Pleiotropic effects of type 2 diabetes management strategies on renal risk factors

2015 ◽  
Vol 3 (5) ◽  
pp. 367-381 ◽  
Author(s):  
Marcel H A Muskiet ◽  
Lennart Tonneijck ◽  
Mark M Smits ◽  
Mark H H Kramer ◽  
Hiddo J Lambers Heerspink ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Diabetes Management ◽  
Management Strategies ◽  
Pleiotropic Effects

scholarly journals Overview of In-Hospital Diabetes Management: Audit of Patients Attending a Rural Hospital in Queensland, Australia

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A429-A429
Author(s):  
Sarah X M Goh ◽  
Jun Kwei Ng ◽  
On Sze Yun ◽  
Holly Gibbons ◽  
Anis Zand Irani
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Diabetes Type 2 ◽  
Diabetes Type ◽  
Australian Institute ◽  
Clinical Records ◽  
Improve Diabetes Care

Abstract Context: The Australian Institute of Health and Welfare (AIHW) health survey in 2018 demonstrated that mortality rates from diabetes in remote and very remote areas were twice as high compared to those in the urban regions. Moreover, diabetic patients in the lowest socioeconomic areas were more than twice as likely to die from the disease and its associated complications than those living in the highest socioeconomic areas (77 and 33 per 10,000 respectively) [1]. These health disparities prompted a closer look into the quality of local inpatient diabetes management in order to identify the changes required to improve diabetes care in a rural community. Methods: A retrospective audit assessing all adult patients (aged over 18) with diabetes between August and October 2019 who attended treatment in one rural health centre in Queensland, Australia was conducted. Information was obtained from paper based patient records, especially the state-wide insulin subcutaneous order and blood glucose chart. Results: There were 122 diabetic inpatients during the study period. 9 were excluded due to poor documentation on the details of diabetes or insulin management. Men comprised 62% (n = 75) of the patients and the chronicity of diabetes in the majority of the patients was either unknown or undocumented (n = 90). Type 2 diabetes represented 87% (n = 106) of the hospitalisations. There were 64 hospitalisations with diabetes or diabetic related complications as the principal diagnoses. Among these, 7% (n = 8) were due to diabetic ketoacidosis (DKA), hyperosmolar hyperglycaemic state (HHS) or severe hyperglycaemia with ketosis, while 2 patients (1.7%) presented with hypoglycaemia. The majority (32%, n = 36) of the diabetic related complications were due to an underlying infection. Throughout inpatient stay, half (50.4%, n = 57) of the patients experienced one or more hyperglycaemic episodes and 14% (n = 16) experienced at least one hypoglycaemic events. The prevalence of inappropriate management of hyperglycaemia during this period was observed to be 21%. This was due to prescription errors i.e. usual insulin not prescribed (n = 7), erroneous insulin type (n = 3) and unsigned order (n = 4). Persistent hyperglycaemia, defined locally by blood glucose level (BGL) > 12 mmol/L was not managed ideally in 10 patients due to either lack of communication between staffs and physicians or failure to make changes when notifications were relayed. Patients were followed up until the discharge phase. Nearly half (41.8%, n = 51) of the patients were found to have no clearly documented follow up plans albeit the limitations of paper based clinical records should be taken into account. Conclusion: The management of diabetes in the rural communities can be challenging. Communication between the different layers of healthcare providers is imperative to ensure hyperglycaemia among hospitalised patients is not mismanaged. Clear documentation of insulin doses and BGL levels on paper records as well as regular education and shared clinical experience on insulin titration in response to abnormal BGL levels by clinicians are strategies to improve diabetes care. Reference: 1. Australian Institute of Health and Welfare. 2021. Diabetes, Type 2 Diabetes - Australian Institute Of Health And Welfare. [online] Available at: <https://www.aihw.gov.au/reports/diabetes/diabetes/contents/hospital-care-for-diabetes/type-2-diabetes> [Accessed 6 January 2021].

scholarly journals DPARD: rationale, design and initial results from the Dutch national diabetes registry

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jessica C. G. Bak ◽  
Dick Mul ◽  
Erik H. Serné ◽  
Harold W. de Valk ◽  
Theo C. J. Sas ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Care ◽  
Diabetes Management ◽  
Management Strategies ◽  
Clinical Information ◽  
Past Century ◽  
Hospital Data ◽  
Diabetes Registry ◽  
Quality Of Diabetes Care

Abstract Background Treatment of diabetes mellitus has majorly improved over the past century, however, the disease burden is high and its prevalence still expanding. Further insight in the diabetes population is imperative to improve the quality of diabetes care by enhancement of knowledge-based diabetes management strategies. To this end, in 2017 a Dutch nationwide consortium of diabetologists, paediatric endocrinologists, and diabetes patients has founded a national outpatient diabetes care registry named Dutch Pediatric and Adult Registry of Diabetes (DPARD). We aim to describe the implementation of DPARD and to provide an overview of the characteristics of patients included during the first 2 years. Methods For the DPARD cohort with long-term follow-up of observational nature, hospital data are gathered directly from electronic health records and securely transferred and stored. DPARD provides weekly updated clinical information on the diabetes population care on a hospital-level benchmarked against the national average. Results Between November 2017 and January 2020, 20,857 patients were included from 8 (11%) Dutch hospitals with a level of care distribution representative of all diabetic outpatients in the Netherlands. Among patients with known diabetes type, 41% had type 1 diabetes, 51% type 2 diabetes, and 8% had diabetes due to other causes. Characteristics of the total patient population were similar to patients with unknown diabetes classification. HbA1c levels decreased over the years, while BMI levels showed an increase over time. Conclusions The national DPARD registry aims to facilitate investigation of prevalence and long-term outcomes of Dutch outpatients with diabetes mellitus and their treatment, thus allowing for quality improvement of diabetes care as well as allowing for comparison of diabetes care on an international level.

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