Diabetes Care Research Articles

Racial and Ethnic Differences in Diabetes Care Quality in A National Sample of Cancer Survivors Relative to Non-Cancer Controls.

Among cancer survivors, diabetes is associated with greater morbidity and mortality. The objective of this study is to describe racial/ethnic disparities in diabetes care quality (DCQ) among cancer survivors compared to non-cancer controls. We used Medical Expenditure Panel Survey Household Component data (2010-2018). Black, non-Hispanic White (NHW), and Hispanic respondents diagnosed with diabetes and cancer were frequency matched 1:5 to non-cancer controls. Multivariable logistic regression estimated associations for specific indices and overall DCQ by race/ethnicity stratified by cancer site/status in partially adjusted (not controlling for socioeconomic indicators) and fully adjusted models. The final sample of 4775 included cancer survivors (n = 907 all cancers; n = 401 breast; n = 167 colon; n = 339 prostate) and non-cancer controls (n = 3868) matched by age, race/ethnicity, and year. In partially adjusted models, Black (adjusted odds ratio, AOR) 0.67 [95% CI 0.54-0.83]) and Hispanic (AOR 0.68 [95% CI 0.54-0.87]) non-cancer controls had significant disparities for overall DCQ compared to NHWs. Among cancer survivors, DCQ disparities for Black (AOR 0.62, [95% CI 0.4-0.96]) and Hispanics (AOR 0.60, [95% CI 0.38-0.97]) were identified. Among prostate cancer survivors, DCQ disparities were identified for Blacks (AOR 0.38; [95% CI 0.20-0.72]) and Hispanics (AOR 0.39; [95% CI 0.17-0.89]) compared to NHWs. Racial disparities among Black controls and Black prostate cancer survivors remained significant in fully adjusted models. Diabetes care disparities are evident among cancer survivors and salient among non-cancer controls. Strategies to promote health equity should target specific care indices among survivors and emphasize equitable DCQ strategies among Black and Hispanic communities.

Structured diabetes care routines in cardiac rehabilitation are associated with increased diabetes detection and improved treatment after myocardial infarction: a nationwide observational study

BackgroundDespite the detrimental impact of abnormal glucose metabolism on cardiovascular prognosis after myocardial infarction (MI), diabetes is both underdiagnosed and undertreated. We investigated associations between structured diabetes care routines in cardiac rehabilitation (CR) and detection and treatment of diabetes at one-year post-MI.MethodsCenter-level data was derived from the Perfect-CR survey, which evaluated work routines applied at Swedish CR centers (n = 76). Work routines involving diabetes care included: (1) routine assessment of fasting glucose and/or HbA1c, (2) routine use of oral glucose tolerance test (OGTT), (3) having regular case rounds with diabetologists, and (4) whether glucose-lowering medication was adjusted by CR physicians. Patient-level data was obtained from the national MI registry SWEDEHEART (n = 7601, 76% male, mean age 62.6 years) and included all post-MI patients irrespective of diabetes diagnosis. Using mixed-effects regression we estimated differences between patients exposed versus. not exposed to the four above-mentioned diabetes care routines. Outcomes were newly detected diabetes and the proportion of patients receiving oral glucose-lowering medication at one-year post-MI.ResultsRoutine assessment of fasting glucose/HbA1c was performed at 63.2% (n = 48) of the centers, while 38.2% (n = 29) reported using OGTT for detecting glucose abnormalities. Glucose-lowering medication adjusted by CR physicians (n = 13, 17.1%) or regular case rounds with diabetologists (n = 7, 9.2%) were less frequently reported. In total, 4.0% of all patients (n = 304) were diagnosed with diabetes during follow-up and 17.9% (n = 1361) were on oral glucose-lowering treatment one-year post-MI. Routine use of OGTT was associated with a higher rate of newly detected diabetes at one-year (risk ratio [95% confidence interval]: 1.62 [1.26, 1.98], p = 0.0007). At one-year a higher proportion of patients were receiving oral glucose-lowering medication at centers using OGTT (1.22 [1.07, 1.37], p = 0.0046) and where such medication was adjusted by CR physicians (1.31 [1.06, 1.56], p = 0.0155). Compared to having none of the structured diabetes care routines, the more routines implemented the higher the rate of newly detected diabetes (from 0 routines: 2.7% to 4 routines: 6.3%; p for trend = 0.0014).ConclusionsHaving structured routines for diabetes care implemented within CR can improve detection and treatment of diabetes post-MI. A cluster-randomized trial is warranted to ascertain causality.

Assessing compliance with national guidelines in diabetes care: A study leveraging data from south Africa's National Health Laboratory Service (NHLS).

Diabetes is a major global health issue. We evaluated compliance to laboratory-based management guidelines for diabetes (type 1 and 2), essential for effective treatment and reducing diabetes-related morbidity and mortality. Our study utilized South Africa's National Health Laboratory Services (NHLS) data, focusing on patients from birth to age 80 years who underwent initial diabetes laboratory testing between January 1, 2012-January 1, 2016. Patients were categorized into type 1 (<30 years) or type 2 (≥30-80 years) diabetes based on age at first diabetes test. National diabetes guidelines recommend blood glucose to be checked every three-six months post laboratory-diagnosis. We employed a sharp regression discontinuity design to estimate the effect of a laboratory-diagnosis of diabetes on the likelihood of having a follow-up laboratory test 24 months post-diagnosis. Among patients with type 2 diabetes, the probability of a diabetes follow-up laboratory test within 24 months was 52.4% for patients presenting above the diabetes diagnosis threshold vs 31.1% for those presenting below. Although the likelihood of repeat testing rose with higher HbA1c and glucose levels, at the diagnostic threshold there was no clinically meaningful difference (risk difference: -2.2%, 95% CI: -3.3%, -1.2%). These results were consistent among patients with type 1 diabetes, those living with and without HIV, and healthcare setting. In a national laboratory cohort, diabetes laboratory-diagnosis did not lead to increased monitoring as recommended in national guidelines. Strategies to improve patient education, healthcare provider communication, and healthcare system support are essential to enhance guideline compliance and overall diabetes management.

Various Diabetes Management Activities: A Comprehensive Overview

Diabetes management is a multifaceted process crucial for preventing complications and improving the quality of life for individuals with diabetes. This comprehensive review explores various aspects of diabetes management, including education, self-monitoring, medication adherence, dietary management, physical activity, psychological support, and technological innovations. Diabetes self-management education (DSME) forms the foundation of effective care, equipping patients with the knowledge and skills necessary for optimal self-care. Self-monitoring of blood glucose (SMBG) and continuous glucose monitoring (CGM) are essential for tracking and adjusting treatment plans. Medication management, including insulin therapy and oral medications, is vital for maintaining glycemic control, while personalized dietary plans and regular physical activity contribute to overall health. Psychological support and motivational strategies are crucial for addressing the emotional burden of diabetes and sustaining long-term self-care. Technological advancements, such as digital health tools and artificial pancreas systems, enhance diabetes management by providing real-time data and facilitating remote consultations. This review underscores the importance of an integrated approach to diabetes care, combining education, self-monitoring, medication management, lifestyle modifications, psychological support, and technological innovations to achieve better health outcomes and improve patient well-being. Keywords: Diabetes Management, Diabetes Self-Management Education, Insulin Therapy, Oral Medications.

GLP-1 receptor agonists and their role in managing type 2 diabetes

There are three components to diabetes care. These are prevention, treatment and management. Linda Nazarko explains how nurses are increasingly adopting a holistic model of diabetes care. Until recently the focus in diabetes care was on managing blood glucose – a glucocentric view. This is changing to a more holistic model aimed at prevention, treatment and management through lifestyle interventions as well as medication. An estimated 5 million people in the UK are living with diabetes, most have type 2 diabetes which is associated with obesity. Type 2 diabetes can be prevented, treated with diet and weight loss, or managed with medication. The number of people with diabetes has reached epidemic proportions. To manage diabetes well and reduce complications of poorly managed diabetes, management of the condition can no longer be restricted to endocrinologists and diabetes specialist nurses. This article provides guidance on how glucagon-like peptide-1 receptor agonists can be used in the management of type 2 diabetes.

Analytics of the Cost Effectiveness and Real-Time Health Risk Assessments for Pharmacy-Based Preventive Health Services

More patient-centered care and participation in managing chronic illnesses are features of the modern pharmacist's task, which has evolved substantially in recent years. Still, the issue of whether or not pharmacists are cost-effective in diabetes care persists. Cost-effectiveness analyses (CEA) have emerged as a crucial tool when making informed decisions about healthcare delivery. Patients' present health status, past medical history (personal and family), and lifestyle variables influencing their health are all part of a health risk assessment (HRA). Hence, this study proposed a Cost-Effectiveness Analysis of Pharmacy-based Preventive Health Services (CEA-PBPHS) model for real-time health risk assessment. Nowadays, medical professionals place a greater emphasis on preventative health care. This research aims to examine the potential impact of risk assessment tools on males past due for a physical examination and evaluate the return on investment (ROI) for community pharmacists who provide this service for free. More cost-efficient or cost-saving than conventional treatment is pharmacist engagement in diabetes management due to better glucose control, higher patient compliances, and lower risks of medication-related issues. The experimental outcomes demonstrate that the suggested CEA-PBPHS model increases the health risk assessment ratio by 98.9%, the personalized health service ratio by 97.5% and the cost-effectiveness analysis ratio by 98.3% compared to other existing models.

Perceptions of adults with type 1 diabetes toward diabetes-specific quality of life measures: a survey-based qualitative exploration

BackgroundDiabetes-specific quality of life (QoL) questionnaires are commonly used to assess the impact of diabetes and its management on an individual’s quality of life. While several valid and reliable measures of diabetes-specific QoL exist, there is no consensus on which to use and in what setting. Furthermore, there is limited evidence of their acceptability to people with diabetes. Our aim was to explore perceptions of adults with type 1 diabetes (T1D) toward five diabetes-specific QoL measures.MethodsAdults (aged 18 + years) with T1D living in Australia or the United Kingdom (UK) were eligible to take part in ‘YourSAY: QoL’, an online cross-sectional survey. Recruitment involved study promotion on diabetes-related websites and social media, as well as direct invitation of people with T1D via a hospital client list (UK only). In random order, participants completed five diabetes-specific QoL measures: Audit of Diabetes-Dependent Quality of Life (ADDQoL-19); Diabetes Care Profile: Social and Personal Factors subscale (DCP); DAWN Impact of Diabetes Profile (DIDP); Diabetes-Specific Quality of Life Scale: Burden Subscale (DSQoLS); Diabetes Quality of Life Questionnaire (Diabetes QOL-Q). They were invited to provide feedback on each questionnaire in the form of a brief free-text response. Responses were analysed using inductive, thematic template analysis.ResultsOf the N = 1,946 adults with T1D who completed the survey, 20% (UK: n = 216, Australia: n = 168) provided qualitative responses about ≥ 1 measure. All measures received both positive and negative feedback, across four themes: (1) clarity and ease of completion, e.g., difficulty isolating impact of diabetes, dislike of hypothetical questions, and preference for ‘not applicable’ response options; (2) relevance and comprehensiveness, e.g., inclusion of a wide range of aspects of life to improve personal relevance; (3) length and repetition, e.g., length to be balanced against respondent burden; (4) framing and tone, e.g., preference for respectful language and avoidance of extremes.ConclusionsThese findings suggest opportunities to improve the relevance and acceptability of existing diabetes-specific QoL measures, and offer considerations for developing new measures, which need to be better informed by the preferences of people living with diabetes.

Factors Associated With Satisfaction With Diabetes Care Among Patients Attending Public Diabetic Clinics in Dar es Salaam, Tanzania: A Cross‐Sectional Study

ABSTRACTBackgroundDiabetes is a major public health problem worldwide, currently affecting more than 537 million people. The disease is associated with high morbidity and mortality rates. Modern diabetes care has evolved toward more patient‐centered approaches, emphasizing individualized treatment plans and targets. This study sought to assess the level of satisfaction with diabetes care and related factors among patients attending public diabetes clinics in Dar es Salaam, Tanzania.MethodsThis descriptive cross‐sectional study used a simple random sampling method to recruit 423 diabetic patients from May to October 2023. Data collection was conducted using a structured questionnaire administered by an interviewer. The collected data were coded and analyzed using Statistical Package for the Social Sciences (SPSS) version 25.ResultsThe mean (±SD) age of participants was 58.7 (±11.68) years. About half (51.1%) of participants reported being satisfied with the diabetes care provided, 26.2% were very satisfied, and 22.7% were dissatisfied. Participants who usually spend 1–3 h pursuing services at the facilities had 0.40 less odds of being dissatisfied with diabetes care offered at the clinics compared to those who spend more than 3 h on each attendance (adjusted odds ratio [adjusted OR] 0.40, 95% confidence interval [CI] 0.21–0.76, p = 0.005). For each one‐unit increase in the communication subscale score, the likelihood of satisfaction (as opposed to being very satisfied) increased (adjusted OR 1.23, 95% CI 1.09–1.38, p = 0.001). Each one‐unit increase in the accessibility subscale score increased the probability of satisfaction (adjusted OR 1.12, 95% CI 1.02–1.24, p = 0.023) and decreased the probability of dissatisfaction (adjusted OR 0.85, 95% CI 0.76–0.95, p = 0.004).ConclusionThese findings highlight the importance of effective communication and accessibility in improving patient satisfaction with diabetes care in public clinics. Health facilities and allied stakeholders should engage in continual capacity building among healthcare providers. Furthermore, other studies should be conducted at different levels of health facilities across the country to capture new insights on the satisfaction of homogenous sub‐groups of patients.

In Situ Triggered Self-Contraction Bioactive Microgel Assembly Accelerates Diabetic Skin Wound Healing by Activating Mechanotransduction and Biochemical Pathway.

Chronic nonhealing skin wounds, characterized by reduced tissue contractility and inhibited wound cell survival under hyperglycemia and hypoxia, present a significant challenge in diabetic care. Here, an advanced self-contraction bioactive core-shell microgel assembly with robust tissue-adhesion (SMART-EXO) is introduced to expedite diabetic wound healing. The SMART-EXO dressing exhibits strong, reversible adhesion to damaged tissue due to abundant hydrogen and dynamic coordination bonds. Additionally, the core-shell microgel components and dynamic coordination bonds provide moderate rigidity, customizable self-contraction, and an interlinked porous architecture. The triggered in situ self-contraction of the SMART-EXO dressing enables active, tunable wound contraction, activating mechanotransduction in the skin and promoting the optimal fibroblast-to-myofibroblast conversion, collagen synthesis, and angiogenesis. Concurrently, the triggered contraction of SMART-EXO facilitates efficient loading and on-demand release of bioactive exosomes, contributing to re-epithelialization and wound microenvironment regulation in diabetic mice. RNA-seq results reveal the activation of critical signaling pathways associated with mechanosensing and exosome regulation, highlighting the combined biomechanical and biochemical mechanisms. These findings underscore SMART-EXO as a versatile, adaptable solution to the complex challenges of diabetic wound care.

A mobile serious game about diabetes self-management: Design and evaluation

Type 2 Diabetes Mellitus (T2DM) is a chronic condition that requires ongoing self-management and education. In recent years, there has been a growing interest in utilizing mobile serious games as a tool for patient education and engagement. This article presents the development of DiaPo, a mobile serious game designed to improve self-management education for patients with T2DM. DiaPo integrates gamification techniques to increase patient engagement and motivation while providing essential information about disease management. The development of DiaPo followed a structured design process, utilizing the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) educational system. This systematic approach allowed for the integration of best practices in educational game design and diabetes care. The development team consisted of experts in medical informatics, game design, and diabetes care, ensuring a multidisciplinary approach to the game's creation. The game's narrative focuses on a T2DM patient who earns positive points for making healthy lifestyle choices and negative points for poor ones. This gamified approach aims to reinforce positive behaviors and provide immediate feedback on negative ones. Interactive animations confirm or deny options selected by the player, further enhancing the learning experience. DiaPo offers a flexible and adaptable platform suitable for diverse audiences, promoting inclusiveness and accessibility in T2DM education. DiaPo represents a novel approach to self-management education for patients with T2DM, utilizing gamification techniques and a multidisciplinary design process to create an engaging and informative mobile serious game. By promoting inclusiveness and accessibility, DiaPo has the potential to empower patients with T2DM to take an active role in their disease management. As the field of mobile serious games continues to evolve, DiaPo stands as a promising tool for improving T2DM education and patient outcomes.

The use of Telehealth in Managing Diabetes

The rising prevalence of diabetes, particularly type 2, has put enormous strain on worldwide healthcare systems. Telehealth is becoming an increasingly important aspect of modern healthcare, and it offers a viable approach to improve diabetes management by improving patient outcomes, access to care, and medication compliance. This study investigates the use of telehealth technologies in diabetes management, focussing on their benefits, problems, and future potential. Telehealth can help to overcome geographical boundaries, provide regular monitoring, and deliver personalised care. However, it has limits, such as discrepancies in technology access and data security. Understanding these aspects is critical to optimising telehealth’s role in diabetes care. Keywords: Telehealth, Diabetes Management, Type 2 Diabetes, Remote Patient Monitoring, Healthcare Access.

Improving Type 2 Diabetes Care with Extended-Release Metformin: Real-Life Insights from a Physician Educational Program.

Compared to Immediate-Release (IR) metformin, Extended-Release (ER) metformin reduces side effects and pill burden while improving adherence; however, there is little real-life data on patient satisfaction with this innovative formulation to guide physicians toward a more holistic approach. Our goal is to train general practitioners on holistic patient management, with the aim of increasing patient satisfaction and treatment adherence, reducing side effects, and improving quality of life in patients with poor tolerance to metformin-IR. We designed an educational program for physicians called SlowDiab, aimed at establishing a holistic patient approach. In this context, adult patients with T2DM who experienced gastrointestinal discomfort with metformin-IR were enrolled and switched to metformin- ER. Data on glycemic control were collected at baseline and 2 months after switching. A survey was carried out on patients to assess their level of satisfaction. In 69 enrolled patients (mean (min-max) age, 68.2 (41-90)), side effects decreased after switching from 61.8% to 16.2% (p < 0.01), and the mean perceived burden of adverse events on a scale of 1 to 10 also decreased (6.17 vs. 3.82; p < 0.05). Among patients previously intolerant to metformin-IR, 74.3% reported no longer experiencing any side effects after the switch. The mean number of tablets taken daily (2.28 vs. 1.66; p < 0.01) and mean plasma glycated hemoglobin (HbA1c) values (7.0% vs. 6.7%; p < 0.05) decreased, while 93.8% of patients were satisfied with the treatment change. Moreover, 84.2% reported an improvement in glycemic control after the switch. In a real-life setting, an educational program for general practitioners confirmed that metformin ER reduces side effects and improves pill burden, therapeutic adherence, and patient satisfaction compared to metformin IR.

Artificial intelligence-driven transformations in diabetes care: a comprehensive literature review.

Artificial intelligence (AI) has been applied in healthcare for diagnosis, treatments, disease management, and for studying underlying mechanisms and disease complications in diseases like diabetes and metabolic disorders. This review is a comprehensive overview of various applications of AI in the healthcare system for managing diabetes. A literature search was conducted on PubMed to locate studies integrating AI in the diagnosis, treatment, management and prevention of diabetes. As diabetes is now considered a pandemic now so employing AI and machine learning approaches can be applied to limit diabetes in areas with higher prevalence. Machine learning algorithms can visualize big datasets, and make predictions. AI-powered mobile apps and the closed-loop system automated glucose monitoring and insulin delivery can lower the burden on insulin. AI can help identify disease markers and potential risk factors as well. While promising, AI's integration in the medical field is still challenging due to privacy, data security, bias, and transparency. Overall, AI's potential can be harnessed for better patient outcomes through personalized treatment.

An Overview of Diabetes Types, Management of Type 1 Diabetes, and its Impact

Diabetes mellitus, a complex, and growing global health challenge, manifests in various forms, each with distinct causes, progression, and management strategies. This review provides a comprehensive overview of diabetes types, with a particular focus on the management of Type 1 Diabetes (T1D) and its profound impact on individuals’ lives. T1D, an autoimmune disorder that typically arises in childhood or adolescence, necessitates lifelong insulin therapy due to the destruction of insulin-producing beta cells in the pancreas. The review explores the classification of diabetes, highlighting the differences in etiology, pathophysiology, and management across the major types: Type 1 Diabetes, Type 2 Diabetes, Gestational Diabetes Mellitus, and other specific forms of diabetes. The management of T1D involves a multifaceted approach, including advanced insulin delivery systems, continuous glucose monitoring technologies, and lifestyle modifications. Despite advancements in diabetes care, T1D significantly impacts individuals’ physical health, psychological well-being, and social life. The relentless demands of managing T1D, coupled with the risk of acute complications such as hypoglycemia and diabetic ketoacidosis, contribute to physical and emotional strain. Additionally, the disease’s social and lifestyle implications, including the stigma associated with chronic illness, further complicate the lived experience of those with T1D. This review underscores the importance of integrated care approaches that address both the physical and psychological aspects of T1D, aiming to enhance the quality of life for affected individuals. Keywords: Diabetes, Type 1 Diabetes, Impact, Individuals’ Lives

Impact of a diabetic retinal exam screening program on quality measure gaps at a family medicine practice

BackgroundDiabetic retinopathy is a common complication in people with diabetes, and annual screening is recommended by the American Diabetes Association. This annual exam is also a Health Effectiveness Data and Information Set quality measure. Barriers such as lack of access to healthcare or cost of specialist visits may impact the number of patients who receive these exams. ObjectiveThe objective of this study is to describe the impact of a diabetic retinal exam screening program at a rural family medicine center on the number of quality measure gaps resolved. Practice descriptionThis study occurred at a rural family medicine center in southwestern Pennsylvania with a medically underserved patient population. A pharmacist at the site holds board certifications in Advanced Diabetes Management and as a Diabetes Care and Education Specialist and manages diabetes through a collaborative practice agreement. Practice innovationA regional Medicaid plan provided a list of patients with a quality measure gap for an annual diabetic retinal exam and loaned a RetinaVue 700 Imager to take retinal photos. After screening eligible patients via phone, retinal exams were administered by student pharmacists and medical assistants to consenting patients over the course of 9 days. Images were then sent to an ophthalmologist to be interpreted. Evaluation methodsThe rate of quality measure gaps closed and satisfaction survey results are reported using descriptive statistics. ResultsA total of 61 patients were included in the analysis. This program closed quality measure gaps for 11 (18.0%) patients who were able to receive an in-office eye exam. ConclusionThis pilot project shows that offering in-office diabetic retinal exams may be an effective strategy to close quality measure gaps and provide access to screening among a medically underserved population.

Effects of Monochromatic Infrared Light on Painful Diabetic Polyneuropathy: Randomized Controlled Trial

Purpose: To evaluate the effect of 890 nm Monochromatic Infrared Light (MIR) associated with a physical therapy protocol on pain in individuals with diabetic Distal Symmetric Polyneuropathy.Methods: Randomized, parallel, double-blind controlled trial conducted with individuals randomly allocated into two groups: an experimental group (EG) with the application of 890 nm MIR associated with physical therapy and a control group that received the same treatment protocol without MIR application. Both groups underwent 18 treatment sessions and were followed up for 10 weeks. Pain assessment took place at four times using the instruments: Leeds Assessment of Neuropathic Symptoms and Signs, Douleur Neuropathique 4, and Brief Pain Inventory. Descriptive, inferential statistics and probabilistic estimates of the magnitude of the intervention's effect on neuropathic pain were used in data analysis (5% significance level).Results: A total of 144 patients were allocated to groups. Lower levels of pain were observed for the EG after 6 weeks of intervention (p < .001) and 30 days after the intervention ended (p < .001). Pain intensity was lower and sleep quality improved (p < .001) for the experiment group, especially in people with severe pain.Conclusions: 890 nm MIR associated with a physical therapy protocol alleviated pain in people with Diabetic Painful Polyneuropathy after 6 weeks of follow-up, showing to be a promising alternative for the control of neuropathic pain due to diabetes mellitus.Clinical Implications: 890 nm MIR improves Painful Diabetic Polyneuropathy patient care due to relief of neuropathic pain.

Assessing Nurses’ Knowledge of Diabetic Foot Care

Tunisia in particular is experiencing an alarming rise in the prevalence of type 2 diabetes. Given that nurses are the first people involved in foot care and education for people with diabetes, it would be useful to carry out our work with a view to improving the quality of foot care for people with diabetes. This is an exhaustive descriptive cross-sectional quantitative study carried out between August 2023 and October 2023 in two university hospitals of Sousse and in the regional hospital of Gafsa. A total of 149 copies with valid answers were collected. In 62.4% of cases, the nurses surveyed reported that they did not have podiatrists working with them on their departments, 26.2% had podiatrists occasionally and 11.4% continuously. This proves that continuing training is essential in all areas of healthcare, to reinforce current knowledge.

The Effect of Iron Deficiency Anemia on Hemoglobin Glycation in Diabetics and Non-diabetics.

Background Iron deficiency anemia (IDA) is the most prevalent form of nutritional anemia worldwide, affecting a substantial portion of the population. It has significant negative effects on health and the economy, especially in poorer nations, and is more prevalent than anemia alone. Although hemoglobin A1c (HbA1c) is frequently used to track long-term glycemic management, several variables, including iron deficiency, might affect its values.For proper diabetic care, it is essential to comprehend this link. The purpose of this study is to evaluate the impact of IDA on HbA1c levels in individuals with and without diabetes. Materials and methods A hospital-based cross-sectional study was conducted at Shri B. M. Patil Medical College, BLDE (Deemed to be University). Group 1 consists of diabetic patients with IDA, Group 2 consists of diabetic patients without IDA, and Group 3 consists of non-diabetics with IDA. A total of 108 patients were involved in the study. A complete hemogram, anemia profile, and HbA1c values were also a part of the data-gathering process. IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York) was used for the statistical analysis, with a significance level of p < 0.05. Results The study found no significant changes in the mean age, gender distribution,hypertension prevalence, weight, height, pulse rate, or blood pressure across the groups. Group 2 exhibited considerably higher hemoglobin levels than Groups 1 and3. Group 1 showed substantially higher mean blood sugar and HbA1c levelsthan Group 3 (p < 0.05). Diabetic individuals had higher HbA1c levels than non-diabetic individuals, with the greatest levels found in diabetic patients with IDA. Conclusion This study found that IDA had a significant influence on HbA1c levels in diabetic patients, indicating that iron deficiency should be addressed when interpreting HbA1c levels in these individuals. These findings underscore the need for more study to better understand the processes behind this connection and the consequences for clinical management.

Developing Self-Management in Type 1 Diabetes at Secondary Schools: Who Is Responsible? A Qualitative Study.

Occupational therapists have the proven capacity to improve outcomes for young adults who are self-managing Type 1 diabetes (T1D). There is insufficient understanding of adolescents' experiences of developing responsibility for diabetes self-management (DSM). To investigate adolescents' perceptions of sharing responsibility for T1D management at school. This study had a descriptive qualitative design and used semistructured interviews and thematic analysis. It is the second phase of a mixed-methods study with a sequential explanatory design that investigated mechanisms of responsibility-sharing at school. Secondary school in Australia. Purposive sample of adolescents (age 15-16 yr) with T1D (N = 11). Adolescents approached the complex occupation of school-based DSM primarily in partnership with their parents, with each adolescent having unique responsibilities while sharing others. Health care professionals and teachers reportedly had minimal involvement. Adolescents described owning most DSM tasks, with their perceptions of building independence limiting the sharing of this responsibility. A heightened sense of risk meant that adolescents were likely to communicate with others in cases of errant blood glucose readings. Current processes commonly resulted in reduced school participation. Adolescents valued working responsively and interdependently with their parents to manage T1D at school, which aligns with the occupational therapy model of co-occupation. Effective responsibility-sharing depends on clear, frequent, autonomy-supportive, team-based communications. Our results showed that patterns of communication for determining school-based DSM processes were fragmented and risk focused, with limited adolescent involvement, resulting in strategies that led to students at times being excluded from school activities. Plain-Language Summary: This is the first study to use an occupational lens to examine the way in which adolescents share their responsibility for diabetes care at school. Diabetes self-management in secondary schools occurs more often when adolescents work interdependently with their parents to manage their diabetes. Adolescent involvement in formal school processes and a clearer allocation of team roles and responsibilities would better support health-promoting habits and school participation.

Health literacy and diabetes information preferences among Chinese immigrants: An Australian cross-sectional study.

Explore Australian-Chinese immigrants' health literacy and preferences and engagement with translated diabetes self-management patient education materials. The cross-sectional survey was conducted with Australian-Chinese immigrants at risk or with type 2 diabetes recruited via health services, and diabetes and community organisations. The survey had three parts: (1) diabetes screening; (2) sociodemographic information, clinical characteristics and preferences for translated materials; and (3) Functional, Communicative and Critical Health Literacy (FCCHL) Scale. Of 381 participants, 54.3% reported diabetes (n = 207), the remainder pre-diabetes or at risk (45.7%, n = 174); 34.1% male; mean age 64.1 years. Average total health literacy (FCCHL) scores were 35.3/56 (SD = 8.7). Participants with greater English proficiency reported higher health literacy (p < 0.001). This pattern also existed for functional (p < 0.001), communicative (p = 0.007) and critical (p = 0.041) health literacy subdomains. Health literacy scores did not differ significantly based on years of residence in Australia (all p > 0.05). Although the majority of participants (75.6%, N = 288) were willing to receive translated diabetes information, only a small proportion (19.7%, N = 75) reporting receiving such materials. There is a clear need for co-designed diabetes patient education materials that meet the needs and adequately reach Australian-Chinese immigrants. In particular, these materials must support people with limited English-language proficiency. This study highlights important considerations for nurses seeking to improve diabetes care for Chinese immigrants when incorporating patient education materials as part of their nursing education.