This randomized clinical trial compared the effects of Ganoderma lucidum and kombucha mushrooms on glycemic control in patients with type 2 diabetes. After the intervention, there were significant differences among the G. lucidum, kombucha mushroom, and control groups in fasting blood glucose, 2-hour postprandial glucose, and A1C. In the G. lucidum and kombucha mushroom groups, these measures all decreased significantly from baseline to after the intervention. The use of both G. lucidum and kombucha mushrooms was effective in the glycemic control, and there was no significant difference in effectiveness between the two. Further studies of different doses and longer follow-up periods may clarify the best use of these substances.

This study explored the immediate concerns of people at the time of type 2 diabetes diagnosis by comparing perspectives from 18 adults with a recent diagnosis and eight clinicians. Four key themes emerged: 1) concerns about diabetes and its management, 2) communication challenges at diagnosis, 3) inconsistent identification of concerns, and 4) discrepancies between clinicians’ actions and patients’ satisfaction. The findings highlight the need for improved communication, longer consultations, and personalized support during diagnosis to enhance patient satisfaction and engagement in care.

This article describes and evaluates a multipronged strategy to expand use of the Diabetes Prevention Program (DPP) and diabetes self-management education and support (DSMES) services across a large academic health system. Strategies included streamlining referral processes, embedding diabetes educators in primary care, leveraging consistent leadership messaging, and building partnerships with community organizations. These interventions led to substantial increases in referrals, with 10.8% of 4,397 patients enrolling in DPP and 35.9% of 10,210 enrolling in DSMES. Coordinated, multilevel interventions can effectively increase engagement in these underutilized, evidence-based diabetes care programs.

This article describes a pharmacist-led deprescribing initiative to reduce the incidence of inappropriate rapid-acting insulin use among admitted older adults at an acute care community hospital. Inappropriate use was defined as at least one episode of severe hypoglycemia (blood glucose <40 mg/dL) within 24 hours of insulin lispro administration, two or more episodes of hypoglycemia (blood glucose <70 but >40 mg/dL) within 24 hours of insulin lispro administration, or five or more held administrations of insulin lispro because of euglycemia in a 48-hour period. The initiative led to a 66% observed relative reduction of inappropriate rapid-acting insulin use over 7 months.

Quality Improvement Success Stories are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of Clinical Diabetes. The following article describes an initiative to improve the rate of lipid profile screening in youth with type 2 diabetes at a tertiary children’s hospital in Southern California.

Glucagon-like peptide 1 (GLP-1) receptor agonists are prescribed as an adjunct to diet and exercise for the management of type 2 diabetes, yet adherence to healthy nutrition and physical activity is often suboptimal. As the use of these agents continues to rise, there are some concerns about the negative aspects of associated weight loss, including loss of muscle mass. This article highlights the benefits of healthy nutrition and physical activity for type 2 diabetes management irrespective of GLP-1 receptor agonist use or associated weight loss, identifies barriers to healthy nutrition and physical activity, and provides guidance for primary care clinicians to further educate and advise their patients on these important topics when initiating GLP-1 receptor agonist treatment.

This article provides an overview for primary care physicians of recently published evidence-based clinical practice guidelines for managing the risks of atherosclerotic cardiovascular disease and chronic kidney disease in people with type 2 diabetes. The authors also share practical guidance and example case studies on how to initiate effective communication with patients to mitigate these risks.

Youth with type 2 diabetes are at a higher risk of adverse pregnancy outcomes than their adult counterparts, and addressing contraception in this population at puberty onset is strongly recommended. This retrospective study at an academic pediatric type 2 diabetes clinic found that 30% of youth achieved the primary composite outcome of documented preconception and contraceptive counseling, contraception prescription, and gynecology referral. Only 1.4% of youth aged 12–21 years had documented preconception counseling, and 27% had documented contraception counseling. By comparison, 18% of adults with preexisting diabetes at the same academic campus met the primary outcome. Adults had a higher rate of preconception counseling (14%), but a lower rate of contraception counseling (4%). This study identifies major gaps in preconception counseling and contraception education for youth with type 2 diabetes.

Quality Improvement Success Stories are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of Clinical Diabetes. The following article describes a quality improvement project to improve screenings rates for diabetic kidney disease at a Veterans Affairs health system in Northeast Ohio.