The Effects of Disease Management on Glycemic Control and Adherence to American Diabetes Association Guidelines in an Air Force Population

2001 ◽  
Author(s):  
Lauren Franklin
Keyword(s):  
Glycemic Control ◽  
Disease Management ◽  
Air Force ◽  
American Diabetes Association

American Diabetes Association Framework for Glycemic Control in Older Adults: Implications for Risk of Hospitalization and Mortality

Diabetes Care ◽  
2021 ◽  
pp. dc203045
Author(s):  
Mary R. Rooney ◽  
Olive Tang ◽  
Justin B. Echouffo Tcheugui ◽  
Pamela L. Lutsey ◽  
Morgan E. Grams ◽  
...  
Keyword(s):  
Older Adults ◽  
Glycemic Control ◽  
American Diabetes Association

Proposed Mechanisms of Blood Flow Restriction Exercise for the Improvement of Type 1 Diabetes Pathologies

Diabetology ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 176-189
Author(s):  
Morgan T. Jones ◽  
Elroy J. Aguiar ◽  
Lee J. Winchester
Keyword(s):  
Blood Flow ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Resistance Exercise ◽  
American Diabetes Association ◽  
Blood Flow Restriction ◽  
Clinical Population ◽  
Muscular System ◽  
Flow Restriction

Individuals with type 1 diabetes suffer from impaired angiogenesis, decreased capillarization, and higher fatigability that influence their muscular system beyond the detriments caused by decreased glycemic control. In order to combat exacerbations of these effects, the American Diabetes Association recommends that individuals with type 1 diabetes participate in regular resistance exercise. However, traditional resistance exercise only induces hypertrophy when loads of ≥65% of an individual’s one repetition maximum are used. Combining blood flow restriction with resistance exercise may serve as a more efficient means for stimulating anabolic pathways that result in increased protein synthesis and angiogenesis at lower loads, while also promoting better glycemic control. The purpose of this paper is to provide a review on the literature surrounding the benefits of resistance exercise, specifically for individuals with type 1 diabetes, and postulate potential effects of combining resistance exercise with blood flow restriction in this clinical population.

scholarly journals American Association of Clinical Endocrinologists and American Diabetes Association Consensus Statement on Inpatient Glycemic Control

Diabetes Care ◽  
2009 ◽  
Vol 32 (6) ◽  
pp. 1119-1131 ◽  
Author(s):  
E. S. Moghissi ◽  
M. T. Korytkowski ◽  
M. DiNardo ◽  
D. Einhorn ◽  
R. Hellman ◽  
...  
Keyword(s):  
Glycemic Control ◽  
American Diabetes Association ◽  
Consensus Statement ◽  
American Association

scholarly journals Teleassistance for Patients With Type 1 Diabetes During the COVID-19 Pandemic: Results of a Pilot Study (Preprint)

2020 ◽  
Author(s):  
Martina Parise ◽  
Linda Tartaglione ◽  
Antonio Cutruzzolà ◽  
Maria Ida Maiorino ◽  
Katherine Esposito ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Disease Management ◽  
Health Care Providers ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Care Providers ◽  
Virtual Visits

BACKGROUND Telemedicine use in chronic disease management has markedly increased during health emergencies due to COVID-19. Diabetes and technologies supporting diabetes care, including glucose monitoring devices, software analyzing glucose data, and insulin delivering systems, would facilitate remote and structured disease management. Indeed, most of the currently available technologies to store and transfer web-based data to be shared with health care providers. OBJECTIVE During the COVID-19 pandemic, we provided our patients the opportunity to manage their diabetes remotely by implementing technology. Therefore, this study aimed to evaluate the effectiveness of 2 virtual visits on glycemic control parameters among patients with type 1 diabetes (T1D) during the lockdown period. METHODS This prospective observational study included T1D patients who completed 2 virtual visits during the lockdown period. The glucose outcomes that reflected the benefits of the virtual consultation were time in range (TIR), time above range, time below range, mean daily glucose, glucose management indicator (GMI), and glycemic variability. This metric was generated using specific computer programs that automatically upload data from the devices used to monitor blood or interstitial glucose levels. If needed, we changed the ongoing treatment at the first virtual visit. RESULTS Among 209 eligible patients with T1D, 166 completed 2 virtual visits, 35 failed to download glucose data, and 8 declined the visit. Among the patients not included in the study, we observed a significantly lower proportion of continuous glucose monitoring (CGM) and continuous subcutaneous insulin infusion (CSII) users (n=7/43, 16% vs n=155/166, 93.4% and n=9/43, 21% vs n=128/166, 77.1%, respectively; <i>P</i>&lt;.001) compared to patients who completed the study. TIR significantly increased from the first (62%, SD 18%) to the second (65%, SD 16%) virtual visit (<i>P</i>=.02); this increase was more marked among patients using the traditional meter (n=11; baseline TIR=55%, SD 17% and follow-up TIR=66%, SD 13%; <i>P</i>=.01) than among those using CGM, and in those with a baseline GMI of ≥7.5% (n=46; baseline TIR=45%, SD 15% and follow-up TIR=53%, SD 18%; <i>P</i>&lt;.001) than in those with a GMI of &lt;7.5% (n=120; baseline TIR=68%, SD 15% and follow-up TIR=69%, SD 15%; <i>P</i>=.98). The only variable independently associated with TIR was the change of ongoing therapy. The unstandardized beta coefficient (B) and 95% CI were 5 (95% CI 0.7-8.0) (<i>P</i>=.02). The type of glucose monitoring device and insulin delivery systems did not influence glucometric parameters. CONCLUSIONS These findings indicate that the structured virtual visits help maintain and improve glycemic control in situations where in-person visits are not feasible.

scholarly journals Glycated Hemoglobin Levels in Patients with Decompensated Cirrhosis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Jeffrey Nadelson ◽  
Sanjaya K. Satapathy ◽  
Satheesh Nair
Keyword(s):  
Glycemic Control ◽  
American Diabetes Association ◽  
Independent Predictor ◽  
Decompensated Cirrhosis ◽  
University Of Tennessee ◽  
Glucose Levels ◽  
Reliable Predictor ◽  
Group A ◽  
Group B ◽  
Hba1c Levels

Introduction. Aim of this study is to determine if HbA1c levels are a reliable predictor of glycemic control in patients with decompensated cirrhosis.Methods. 200 unique patients referred for liver transplantation at University of Tennessee/Methodist University Transplant Institute with a HbA1c result were included. Three glucose levels prior to the “measured” A1c (MA1c) were input into an HbA1c calculator from the American Diabetes Association website to determine the “calculated” A1c (CA1c). The differences between MA1c and CA1c levels were computed. Patients were divided into three groups: group A, difference of <0.5; group B, 0.51–1.5; and group C, >1.5.Results. 97 (49%) patients had hemoglobin A1c of less than 5%. Discordance between calculated and measured HbA1c of >0.5% was seen in 47% (n=94). Higher level of discordance of greater than >1.5 was in 12% of patients (n=24). Hemoglobin was an independent predictor for higher discordance (odds ratio 0.77 95%, CI 0.60–0.99, andpvalue 0.04). HbA1c was an independent predictor of occurrence of HCC (OR 2.69 955, CI 1.38–5.43, andpvalue 0.008).Conclusion. HbA1c is not a reliable predictor of glycemic control in patients with decompensated cirrhosis, especially in those with severe anemia.

scholarly journals Glycemic Control of Type 2 Diabetic Patients Managed in Tertiary Care Internal Medicine Clinics Using HbA1c

2013 ◽  
Vol 3 (1) ◽  
pp. 23-28
Author(s):  
Helal S. Alenezi ◽  
Mubasher Kharal ◽  
Muhammad Yousuf ◽  
Yousef Al Saleh ◽  
Salih Bin Salih
Keyword(s):  
Internal Medicine ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
American Diabetes Association ◽  
Diabetic Control ◽  
Hypoglycemic Agents ◽  
Oral Hypoglycemic Agents

Background /Objective: The aim was to assess the glycemic control in patients with type 2 diabetes mellitus using American Diabetes Association HbA1c definition of good control of ≤ 7.0%. Methods: This retrospective study conducted in internal medicine outpatient clinics at King Abdulaziz Medical City in Riyadh, Kingdom of Saudi Arabia. All patients with type 2 diabetes mellitus attending the clinic from August 2005 to January 2006 were evaluated. Patients with HbA1c measured regularly and under anti-diabetic therapy were included in the study. Last measured HbA1c was used to evaluate diabetic control. Results: Data for 968 (81.5%) patients out of 1188 were available for analysis. Only 211 (21.8%) patients had their HbA1c within the American Diabetes Association recommended target of HbA1c ≤ 7%. Mean HbA1c was 8.98%. Patients were stratified into groups of good (HbA1c £ 7%), average (HbA1c 7.1% - 9.9%) and poor diabetic control (HbA1c ≥ 10%) included 21.8%, 46.2% and 32.0% of the study population, respectively. Mean HbA1c in patients on diabetic diet only, oral hypoglycemic agents, insulin, and oral hypoglycemic agents plus insulin was 7.62%, 8.67%, 8.92% and 9.70%, respectively. Conclusion: Majority of patients in our study did not meet the American Diabetes Association recommended target HbA1c for type 2 diabetes mellitus. Causes for this failure need to be assessed in Saudi type 2 diabetes mellitus population.

Interinstitutional Variation in Glycohemoglobin Monitoring and Glycemic Control of Diabetic Patients

2001 ◽  
Vol 125 (2) ◽  
pp. 191-197
Author(s):  
Paul N. Valenstein ◽  
Molly K. Walsh ◽  
Alex A. Pappas ◽  
Peter J. Howanitz
Keyword(s):  
Glycemic Control ◽  
Hba1c Level ◽  
American Diabetes Association ◽  
Hemoglobin A1c ◽  
Institutional Factors ◽  
Diabetic Patients ◽  
Factors Associated ◽  
Monitoring Frequency ◽  
Frequent Monitoring ◽  
Hba1c Levels

Abstract Objectives.—To compare how frequently institutions monitor glycohemoglobin in diabetic patients, the level of glycemic control achieved and to identify institutional factors associated with higher rates of monitoring and lower glycohemoglobin levels. Methods.—A total of 212 institutions retrospectively abstracted laboratory and outpatient records of up to 30 diabetic patients who had initial glycohemoglobin monitoring performed in their laboratories. Data from a cohort of 5586 diabetic patients and 17 365 assays were analyzed. Results.—Overall, 31.3% of patients underwent glycohemoglobin monitoring at least quarterly, the frequency recommended by the American Diabetes Association (ADA) to stabilize patients at target hemoglobin A1c (HbA1c) levels. A total of 64.9% of patients were monitored at least semiannually, the ADA recommendation for patients with stable diabetes in glycemic control (final HbA1c level &lt;7%). When we compared the top and bottom deciles of the 212 institutions, there was more than an eightfold difference in the proportion of patients monitored at least quarterly and more than a twofold difference in the proportion of patients monitored at least semiannually. Glycemic control was assessed by examining the value of the last glycohemoglobin determination on record after at least 8 months of management. For all 5586 diabetic patients, the median value of the last HbA1c assay was 7.4%. Comparing the top and bottom deciles, there was almost a fourfold difference among institutions in the proportion of diabetic patients in glycemic control. The use of reminders to order glycohemoglobin monitoring was associated with higher rates of semiannual monitoring (P &lt; .05) and tighter glycemic control (P &lt; .05). In addition, patients who were monitored more frequently experienced glycohemoglobin reductions of greater magnitude (P &lt; .001). The presence of diabetes clinics and the use of rapid methods for testing glycohemoglobin were not associated with monitoring frequency or glycohemoglobin levels. Conclusions.—There is wide interinstitutional variation in the frequency with which diabetic patients are monitored and the level of glycemic control achieved. The use of prompting systems to remind providers to order glycohemoglobin monitoring was associated with more frequent monitoring and superior glycemic control.

A Novel Approach for Mental Health Disease Management: The Air Force Medical Service's Interdisciplinary Model

2003 ◽  
Vol 6 (3) ◽  
pp. 179-188 ◽  
Author(s):  
Christine N. Runyan ◽  
Vincent P. Fonseca ◽  
John G. Meyer ◽  
Mark S. Oordt ◽  
G. Wayne Talcott
Keyword(s):  
Mental Health ◽  
Disease Management ◽  
Air Force ◽  
Novel Approach
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