scholarly journals Dietary Intake and Health Status of Elderly Patients with Type 2 Diabetes Mellitus: Cross-Sectional Study Using a Mobile App in Primary Care (Preprint)

2021 ◽  
Author(s):  
Joane Diomara Coleone ◽  
Ericles Andrei Bellei ◽  
Mateus Klein Roman ◽  
Vanessa Ramos Kirsten ◽  
Ana Carolina Bertoletti De Marchi
Keyword(s):  
Primary Care ◽  
Health Status ◽  
Dietary Intake ◽  
Health Professionals ◽  
Mobile App ◽  
Sugary Drinks ◽  
Fried Foods ◽  
History Of ◽  
Recommended Guidelines

BACKGROUND Healthy dietary intake reduces the risk of complications of diabetes mellitus. Using assessment methods helps to understand these circumstances, and an electronic application may optimize this practice. OBJECTIVE In this study, we aim to (1) assess the dietary intake and health status of elderly patients with T2DM from primary care; (2) use a mobile app as a tool for data collection and analysis in the context of primary care; and (3) verify the perceptions of multidisciplinary health professionals regarding the app use. METHODS First, we developed a mobile app comprising the questions of the Food and Nutrition Surveillance System (SISVAN) of Brazil, which includes a food frequency questionnaire of food categories with a recall of the previous 7 days. Thereafter, we used the app to collect data on the health status and dietary intake of 154 participants, aged 60-96 years, diagnosed with type 2 diabetes and under treatment in primary care centers in the northern region of Rio Grande do Sul, Brazil. We also collected participants’ demographic, anthropometric, biochemical, and lifestyle variables. The associations between the dietary intake and other variables were tested using the Chi-square test with a 5% significance level. Regarding the app, we assessed usability and acceptance with 20 health professionals. RESULTS Between August and December 2018, participants had an intake in line with recommended guidelines for raw salads (57.1%), fruits (76.6%), milk products (68.2%), fried foods (72.7%), savory biscuits (60.4%), cookies or sweets (72.1%), and sugary drinks (92.9%) Meanwhile, the consumption not in line with the guidelines was for beans (59.7%), pulses and cooked vegetables (73.4%), and processed meat products (59.7%). There were statistically significant differences in meeting the recommended guidelines among participants of different genders (P=.006 and P=.035 for the intake of fried foods and sugary drinks, respectively), place of residence (P=.034 for the intake of cookies and sweets), family history of diabetes (P<.001 for the intake of beans), physical activity engagement (P=.003 for the intake fresh fruits), history of smoking (P=.001 for the intake of raw salads), and presence of coronary diseases (P=.050 for the intake of pulses and cooked vegetables). The assessment of usability resulted in a mean score of 71.75 points. Similarly, the assessment of the 15 acceptance questions revealed high scores and the qualitative questions revealed positive perceptions. CONCLUSIONS We found that most participants comply with recommended intake guidelines for 7 out of 10 categories of SISVAN guidelines. However, most participants were overweight and had nutritional and clinical disorders, which justifies further investigations in this population. The app was well-rated by health professionals and considered a useful and promising tool in collecting and analyzing data in primary care settings. CLINICALTRIAL

scholarly journals Dietary Intake and Health Status of Elderly Patients With Type 2 Diabetes Mellitus: Cross-sectional Study Using a Mobile App in Primary Care

10.2196/27454 ◽  
2021 ◽  
Vol 5 (8) ◽  
pp. e27454
Author(s):  
Joane Diomara Coleone ◽  
Ericles Andrei Bellei ◽  
Mateus Klein Roman ◽  
Vanessa Ramos Kirsten ◽  
Ana Carolina Bertoletti De Marchi
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Health Status ◽  
Dietary Intake ◽  
Health Professionals ◽  
Mobile App ◽  
Sugary Drinks ◽  
Fried Foods ◽  
History Of ◽  
Recommended Guidelines

Background Healthy dietary intake reduces the risk of complications of diabetes mellitus. Using assessment methods helps to understand these circumstances, and an electronic application may optimize this practice. Objective In this study, we aimed to (1) assess the dietary intake and health status of elderly patients with type 2 diabetes mellitus (T2DM) in primary care, (2) use a mobile app as a tool for data collection and analysis in the context of primary care, and (3) verify the perceptions of multidisciplinary health professionals regarding app use. Methods First, we developed a mobile app comprised of the questions of the Food and Nutrition Surveillance System (SISVAN) of Brazil, which includes a food frequency questionnaire of food categories with a recall of the previous 7 days. Thereafter, we used the app to collect data on the health status and dietary intake of 154 participants, aged 60-96 years, diagnosed with T2DM, and under treatment in primary care centers in the northern region of Rio Grande do Sul, Brazil. We also collected participants’ demographic, anthropometric, biochemical, and lifestyle variables. The associations between dietary intake and other variables were tested using chi-square tests with a 5% significance level. Regarding the app, we assessed usability and acceptance with 20 health professionals. Results Between August 2018 and December 2018, participants had an intake in line with recommended guidelines for raw salads (57.1%), fruits (76.6%), milk products (68.2%), fried foods (72.7%), savory biscuits (60.4%), cookies or sweets (72.1%), and sugary drinks (92.9%) Meanwhile, the consumption of beans (59.7%), pulses and cooked vegetables (73.4%), and processed meat products (59.7%) was not in line with the guidelines. There were statistically significant differences in meeting the recommended guidelines among participants of different genders (P=.006 and P=.035 for the intake of fried foods and sugary drinks, respectively), place of residence (P=.034 for the intake of cookies and sweets), family history of diabetes (P<.001 for the intake of beans), physical activity engagement (P=.003 for the intake fresh fruits), history of smoking (P=.001 for the intake of raw salads), and presence of coronary disease (P=.050 for the intake of pulses and cooked vegetables). The assessment of usability resulted in a mean score of 71.75 points. Similarly, the assessment of the 15 acceptance questions revealed high scores, and the qualitative questions revealed positive perceptions. Conclusions We identified that most participants complied with recommended intake guidelines for 7 of 10 categories in the SISVAN guidelines. However, most participants were overweight and had nutritional and clinical disorders, which justifies further investigations in this population. The app was well-rated by health professionals and considered a useful and promising tool for collecting and analyzing data in primary care settings.

AMERICAN COLLEGE OF PHYSICIANS SPEAKS OUT

PEDIATRICS ◽  
1994 ◽  
Vol 93 (2) ◽  
pp. 351-1-351-1
Keyword(s):  
Primary Care ◽  
Health Status ◽  
Acute Care ◽  
Health Professionals ◽  
Preventive Services ◽  
High Technology ◽  
Professional Society ◽  
Health Coverage ◽  
Substandard Care

As a professional society of physicians whose goal is excellence in medicine, we see a system failing all who are a part of it—patients, physicians and other health professionals, purchasers, and insurers. Most of the problems have been well documented: over 35 million Americans without health coverage, excessive utilization of high technology coexisting with substandard care, astonishing increases in spending without commensurate gains in health status, acute care promoted at the expense of preventive services and technology-based care at the expense of primary care.

scholarly journals Dietary intake and anthropometric indices in Mexican medical students, stratified by family history of Type 2 Diabetes

2020 ◽  
Vol 24 (4) ◽  
pp. 374
Author(s):  
Gabriela Vazquez-Marroquin ◽  
Rebeca G. Elguezabal-Rodelo ◽  
Leonardo M. Porchia ◽  
Enrique Torres-Rasgado ◽  
Ricardo Pérez-Fuentes ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Medical Students ◽  
Family History ◽  
Dietary Intake ◽  
Anthropometric Indices ◽  
History Of ◽  
De Medicina ◽  
Diabetes Tipo 2

Introducción: Nuestro objetivo fue evaluar la ingesta dietética y los índices antropométricos en estudiantes de medicina con historia familiar positiva de diabetes tipo 2 (FH-T2D)(+) y sin antecedentes familiares FH-T2D(-).Material y métodos: 144 estudiantes fueron analizados en este estudio transversal y observacional realizado durante el año escolar 2017-2018 mediante entrevistas y un diario de alimentos de 7 días. Los participantes se caracterizaron antropométricamente. Se calculó el ínidce cintura-cadera (WHR) y el índice cintura-altura (WHtR), el área muscular corregida de la mitad del brazo (MAMA), el índice de grasa del brazo (FAI) así como el pliegue cutáneo tricipital (TSF).Resultados:El 79,2% (95%CI: 72,5- 85,8) tenían FH-T2D. El IMC fue significativamente mayor en los participantes con FH-T2D que en aquellos sin FH-T2D (23,7 ± 3,8 v 25,0 ± 3,7, respectivamente, p <0,05). No se determinaron diferencias significativas en los índices basados en la distribución de grasa central (WHtR y WHR), la distribución periférica (FAI y TSF) o la masa muscular (MAMA), cuando se estratificó por FH-T2D. Al comparar la ingesta dietética de participantes con y sin FH-T2D, respectivamente, observamos un consumo bajo / ninguno de leguminosas [30% (95%CI: 21,4-38,2) frente a 23% (95%CI: 8,2-38,5)], dietas altas en proteínas [38,6% (95%CI: 29,7-47,5) frente a 46,7% (95%CI: 28,8-64,5)], bajas en carbohidratos [84,2% (95%CI: 77,5-90,9) frente a 83,3% (95%CI: 70,0-96,7)], y la ingesta de energía insuficiente [64% (95%CI: 55,2-72,8) frente a 56,7% (95%CI: 38,9-74,4)], donde las alteraciones en el patrón de la dieta fueron más perjudiciales para el grupo FH-T2D(+). Los participantes con FH-T2D consumieron al final del día [60% (95%CI: 50,6-68,6) frente a 54% (95%CI: 35,5-71,2)].Conclusiones: Aunque hubo diferencias mínimas significativas con el consumo por categorías de alimentos, aquellos estudiantes con FH-T2D presentaron un patrón dietético deficiente, poco variado y desequilibrado con un consumo de energía principalmente por la noche. Estos factores, si se prolongan, podrían aumentar el riesgo de desarrollar diabetes tipo 2.

scholarly journals Influenza Vaccination in Coronavirus Times: Intention to Be Vaccinated by Primary Care Professionals in Central Catalonia (VAGCOVID)

2021 ◽  
Author(s):  
Raquel Muñoz-Miralles ◽  
Anna Bonet-Esteve ◽  
Anna Rufas Cebollero ◽  
Xavier Pelegrin Cruz ◽  
Josep Vidal Alaball
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Health Professionals ◽  
Online Survey ◽  
Health Workers ◽  
Cross Sectional ◽  
History Of ◽  
Primary Care Professionals

Abstract BackgroundInfluenza vaccination is the main measure of prevention against the epidemic flu, which annually produces a significant increase in the pressure on healthcare systems, in addition to influencing the absenteeism of health workers. Although it is recommended that health professionals be vaccinated, their vaccination coverage is low. The lack of knowledge about the evolution of influenza in the context of the SARS-CoV-2 coronavirus pandemic led to the continued recommendation of influenza vaccination to people at risk and to professionals. The aim of the study is to determine the intention to vaccinate against seasonal flu of health professionals in the 2020-21 campaign in the context of the SARS-CoV-2 pandemic, and to analyse the factors that influence it.MethodsCross-sectional study through a structured online survey aimed at Primary Care professionals in the region of central Catalonia.ResultsA total of 610 participants responded to the survey, 65.7% of whom intended to be vaccinated against the flu in this campaign and 11.1% did not yet know or did not answer. The intention to be vaccinated against flu is associated with the professional category, the years of professional practice, the fact of making face-to-face guards, and the perception of the risk of suffering from flu. It is also related to a history of influenza vaccination in the previous year and to having been vaccinated on another occasion. The profile of professionals who intend to be vaccinated against flu includes professionals with a history of vaccination, who were on duty and perceived that their staff were at risk of becoming ill with flu.ConclusionsDuring the SARS-CoV-2 pandemic, many professionals show a clear intention to get vaccinated against the flu, but there are still some who doubt it. In order to improve influenza vaccination coverage among health professionals, it is necessary to design strategies aimed at professionals who are hesitant or reluctant to vaccination.

scholarly journals Characteristics of men and women with diabetes

2021 ◽  
Author(s):  
Enza Gucciardi ◽  
Shirley Chi-Tyan Wang ◽  
Lisa Amaral ◽  
Donna E. Stewart
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Diabetes Education ◽  
Primary Care Providers ◽  
Self Management ◽  
Care Providers ◽  
Family History Of Diabetes ◽  
Men And Women ◽  
History Of

OBJECTIVE To determine whether men and women with type 2 diabetes have different psychosocial, behavioural, and clinical characteristics at the time of their first visit to a diabetes education centre. DESIGN A questionnaire on psychosocial and behavioural characteristics was administered at participants’ first appointments. Clinical and disease-related data were collected from their medical records. Bivariate analyses (χ2 test, t test, and Mann-Whitney test) were conducted to examine differences between men and women on the various characteristics. SETTING Two diabetes education centres in the greater Toronto area in Ontario. PARTICIPANTS A total of 275 men and women with type 2 diabetes. RESULTS Women were more likely to have a family history of diabetes, previous diabetes education, and higher expectations of the benefits of self-management. Women reported higher levels of social support from their diabetes health care team than men did, and had more depressive symptoms, higher body mass, and higher levels of high-density lipoprotein cholesterol than men did. CONCLUSION The results of this study provide evidence that diabetes prevention, care, and education need to be targeted to men and women differently. Primary care providers should encourage men to attend diabetes self-management education sessions and emphasize the benefits of self-care. Primary care providers should promote regular diabetes screening and primary prevention to women, particularly women with a family history of diabetes or a high body mass index; emphasize the importance of weight management for those with and without diabetes; and screen diabetic women for depressive symptoms.

scholarly journals Understanding the nutrition care needs of patients newly diagnosed with type 2 diabetes: a need for open communication and patient-focussed consultations

2016 ◽  
Vol 22 (5) ◽  
pp. 416 ◽  
Author(s):  
Lauren Ball ◽  
Ruth Davmor ◽  
Michael Leveritt ◽  
Ben Desbrow ◽  
Carolyn Ehrlich ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Dietary Intake ◽  
Health Professionals ◽  
Dietary Change ◽  
Newly Diagnosed ◽  
Care Needs ◽  
Open Communication ◽  
Nutrition Care ◽  
Primary Health

Patients who are newly diagnosed with type 2 diabetes mellitus (T2DM) commonly attempt to modify their dietary intake after receiving nutrition care from primary health professionals. Yet, adherence to dietary recommendations is rarely sustained and factors influencing adherence are poorly understood. This study explored T2DM patients’ experiences of dietary change and their views on how primary health professionals can best support long-term maintenance of dietary change. A purposive sample of 10 individuals recently diagnosed with T2DM participated in three individual semi-structured qualitative telephone interviews: at baseline, then at 3 and 6 months after recruitment. Interview questions were modified from the initial interview in order to investigate emerging findings. A two-step data analysis process occurred through content analysis of individual interviews and meta-synthesis of findings over time. Participants initially made wide-ranging attempts to improve dietary behaviours, but most experienced negative emotions from the restraint required to maintain a healthy diet. Participants felt confused by the conflicting advice received from health professionals and other sources such as friends, family, internet and diabetes organisations. Participants frequently reported feeling rushed and not heard in consultations, resulting in limited ongoing engagement with primary healthcare services. These findings suggest that there is opportunity for primary health professionals to enhance the dietary support provided to patients by: acknowledging the challenges of sustained improvements in dietary intake; open communication; and investing in patient relationships through more patient-focussed consultations.

scholarly journals Characteristics of men and women with diabetes

2021 ◽  
Author(s):  
Enza Gucciardi ◽  
Shirley Chi-Tyan Wang ◽  
Lisa Amaral ◽  
Donna E. Stewart
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Diabetes Education ◽  
Primary Care Providers ◽  
Self Management ◽  
Care Providers ◽  
Family History Of Diabetes ◽  
Men And Women ◽  
History Of

OBJECTIVE To determine whether men and women with type 2 diabetes have different psychosocial, behavioural, and clinical characteristics at the time of their first visit to a diabetes education centre. DESIGN A questionnaire on psychosocial and behavioural characteristics was administered at participants’ first appointments. Clinical and disease-related data were collected from their medical records. Bivariate analyses (χ2 test, t test, and Mann-Whitney test) were conducted to examine differences between men and women on the various characteristics. SETTING Two diabetes education centres in the greater Toronto area in Ontario. PARTICIPANTS A total of 275 men and women with type 2 diabetes. RESULTS Women were more likely to have a family history of diabetes, previous diabetes education, and higher expectations of the benefits of self-management. Women reported higher levels of social support from their diabetes health care team than men did, and had more depressive symptoms, higher body mass, and higher levels of high-density lipoprotein cholesterol than men did. CONCLUSION The results of this study provide evidence that diabetes prevention, care, and education need to be targeted to men and women differently. Primary care providers should encourage men to attend diabetes self-management education sessions and emphasize the benefits of self-care. Primary care providers should promote regular diabetes screening and primary prevention to women, particularly women with a family history of diabetes or a high body mass index; emphasize the importance of weight management for those with and without diabetes; and screen diabetic women for depressive symptoms.

scholarly journals Preconception care for women with type 1 or type 2 diabetes mellitus: a mixed-methods study exploring uptake of preconception care

2017 ◽  
Vol 21 (14) ◽  
pp. 1-130 ◽  
Author(s):  
Sarah Earle ◽  
Anisah Tariq ◽  
Carol Komaromy ◽  
Cathy E Lloyd ◽  
M Ali Karamat ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Health Professionals ◽  
Preconception Care ◽  
Qualitative Interviews ◽  
Childbearing Age ◽  
Pregnancy Planning

BackgroundDiabetes mellitus is a global health problem and one of the most common medical conditions in pregnancy. A wide range of modifiable risk factors are associated with diabetes mellitus in pregnancy, and it is widely acknowledged that preconception care (PCC) is beneficial for women with pre-existing diabetes mellitus. However, uptake of PCC services is low.ObjectivesTo systematically review qualitative research on PCC for women with pre-existing diabetes mellitus of childbearing age, identify facilitators of and barriers to uptake of PCC and establish themes and gaps in knowledge. Through qualitative interviews explore views on the provision of, and facilitators of and barriers to the uptake of, PCC.DesignMixed methods encompassing a systematic review and qualitative interviews.SettingTwo secondary care sites and 11 primary care sites.ParticipantsWomen of childbearing age with pre-existing type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) of white British or Pakistani origin.InterventionsNone.AnalysisA narrative synthesis of the literature using thematic analysis and a thematic analysis of the qualitative interview data using the method of constant comparison.ResultsEighteen qualitative studies were included in the systematic review and a quality appraisal was carried out using relevant criteria for qualitative research appraisal, including a narrative summary of study quality. Twelve interviews with women with pre-existing T1DM or T2DM were carried out. This fell short of the original aim of interviewing 48 women owing to challenges in recruitment, especially in primary care. A synthesis of these data shows that uptake of PCC is influenced by a range of factors, including the complexity of pregnancy planning, the skill and expertise of health professionals who provide care to women with diabetes mellitus, the role of health professionals in the delivery of PCC, and the quality of relationships between women and health professionals.LimitationsOwing to significant challenges with recruitment of participants, particularly in primary care, 12 interviews with women with pre-existing T1DM or T2DM were carried out, which fell short of the a priori sample size.ConclusionsReconceptualising PCC to place greater emphasis on pregnancy planning, fertility and contraception would lower some of the existing barriers to uptake of care. It is important to clarify who is responsible for the delivery of PCC to women with pre-existing diabetes mellitus and to ensure that the correct expertise is available so that opportunities for advice giving are maximised. Relationships between women and health professionals should be based on a partnership approach that encourages mutual trust and respect, focusing on positive change rather than negative outcomes.Future workFurther research is needed to investigate the views and experiences of stakeholders that commission, design and deliver PCC services for women with pre-existing diabetes mellitus; to explore experiences of women from minority or ethnically diverse backgrounds; to investigate the role of family support in contraception, pregnancy planning and PCC; and to investigate the management of diabetes mellitus in neonatal care and its role in breastfeeding.Study registrationThis study is registered as PROSPERO CRD42014015592 and ISRCTN12983949.FundingThe National Institute for Health Research Health Technology Assessment programme.

scholarly journals Variability in the Control of Type 2 Diabetes in Primary Care and Its Association with Hospital Admissions for Vascular Events. The APNA Study.

2021 ◽  
Author(s):  
Sara Guillen-Aguinaga ◽  
Luis Forga ◽  
Antonio Brugos-Larumbe ◽  
Francisco Guillen-Grima ◽  
Laura Guillen-Aguinaga ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Low Income ◽  
Hospital Admissions ◽  
Cox Regression ◽  
Vascular Events ◽  
Primary Care Health ◽  
Hba1c Control ◽  
History Of

Type 2 diabetes (T2D) is associated with increased cardiovascular morbidity, mortality, and hospital admissions. There is variability in clinical practice. The objectives are to analyze the variability in the control of Blood Pressure (BP), HbA1c, and LDL-C in T2D patients and its influence on admissions due to cardiovascular events (CVE) Methods: We analyzed the electronic records in Primary Care Health centers in Navarra (Spain) and hospital admission for CVE. We follow 480637 people from 2012 to 2016. We calculated indicators of control of patients with T2D for each year, percentage with: HbA1c &amp;lt; 7%; HbA1c &amp;gt;= 9%; BP &amp;lt;140/90 mmHg; LDL-C &amp;lt;100 mg/dl. We used logistic and Cox regression. Results: Patients in the best control GP practices cluster are 2.5 times more likely to have HbA1c &amp;lt;7% [OR: 2.46 (95% CI: 2.29-3.64)]. Poor HbA1c control &ge; 9% is more likely in the worst control cluster [OR: 1.73 (95% CI:1.63-1.83)]. The probability of admission for CVE increases with age, being male, low income, obesity, history of CVE, having HbA1c &ge; 9%, and belonging to a GP practice in the cluster of HbA1C &ge; 9% worst control. In contrast, it decreases in patients with HbA1c &amp;lt;7%, BP&amp;lt;140/90 mmHg and LDL &amp;lt;100 mg/dl.

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