DM Management Research Articles

Joint Action JACARDI: a context analysis on CVDs and diabetes policies and practices

Abstract Issue/problem Non-communicable diseases are the leading cause of death and disability in Europe, with 63 million people living with cardiovascular diseases (CVDs) and 32 million with diabetes (DM) in 2019. The EU-co-funded Joint Action on CVDs and diabetes (JACARDI), with 76 partners from 21 countries, aims to reduce CVDs and DM burden at European level through 142 pilot projects. Description of the problem For an effective and tailored pilots’ implementation, a preliminary step is to assess the current state of strategies and services for CVDs and DM prevention and management in Europe. We adopt the Gap Analysis methodology aiming to evaluate the gap between the current and the ideal state, the latter defined according to scientific evidence, best-practices, guidelines, and expert’s opinions. For this purpose, 12 questionnaires, one for CVDs and one for DM for six different thematic areas, were developed through a participatory approach that fostered the collaboration between the scientific coordination team and the project members. Results Questionnaires were sent to National Focal Points for health covering 29 European countries. We anticipate receiving responses from each country covering aspects related to the legal and strategic framework, the intersectoral and equity-oriented approaches, the funding and the service delivery and capacity for CVDs and DM. This information will be collected across each of the six thematic areas corresponding to six technical Work Packages (WP): health literacy, data, screening, integrated-care pathways, patients self-management, labour participation. The survey will be completed by June 2024, and results by WP and country will be presented. Lessons The context analysis, based on the Gap Analysis methodology, allows to identify gaps between the current and ideal state in CVDs and DM prevention and management. This will guide JACARDI’s pilots to address gaps and serve as a roadmap to inform European policy-makers. Key messages • The context analysis will provide an invaluable overview of the current European state of CVDs and DM prevention and management. • The context analysis will support JACARDI’s pilots in addressing identified gaps and policy-makers in shaping public health responses.

Prevalence of diabetes mellitus-related complications and their impact on health-related quality of life in Singapore.

One in three Singaporeans is at risk of developing DM (DM) in their lifetime. The majority of those with DM experience other comorbidities that often affect the course of their DM. This study explored: (a) the prevalence of DM-related complications, (b) their sociodemographic correlates, and (c) their association with health-related quality of life (HRQOL). Participants with DM (n = 387) were recruited from a population-based survey. Type 2 DM was self-reported as diagnosed by a doctor. The DM-related complications and comorbidities were assessed using the DM knowledge questionnaire and chronic conditions checklist. Short-Form health survey was used to examined HRQOL. Multiple logistic regressions were performed to examine the association between DM-related complications and sociodemographic factors and body mass index. Multiple linear regressions examined the association of complications with HRQOL. Approximately 31.6% of the participants had DM-related complications. The top three complications were nephropathy (54.4%), neuropathy (42.2%) and retinopathy (40.8%). Younger participants (aged 18-49 years) and those with higher education were less likely to develop DM-related complications. Physical HRQOL was adversely affected in participants with any chronic condition, DM for 4-9 years, DM-related neuropathy, lower leg/foot ulcers and gangrene. Mental HRQOL was adversely affected by gangrene. Younger participants had better physical HRQOL. Physical HRQOL is adversely affected when individuals develop DM-related complications. Understanding the sociodemographic corelates of DM-related complications could aid clinicians in identifying and assisting at-risk populations to prevent adverse outcomes. Educating individuals on the risk of developing DM-related complications could encourage better DM management.

8122 CGM use and its Impact on Diabetes Self-Management Behaviors: Insights from a Pilot Study Paving the Way for Targeted Interventions in Specialty Clinic

Abstract Disclosure: K.M. St. Jean: None. P. Underwood: None. R. Longo: None. J. Keels: None. J. Upadhyay: None. Introduction: Continuous glucose monitor (CGM) use is increasing. While the relationship between CGM use and improved diabetes (DM) clinical outcomes is well known (lower hemoglobin A1c (A1c), reduced hypoglycemia events), the mechanisms underlying this association are unknown. Further, the factors that contribute to successful CGM use by patients and whether CGM use influences diabetes self-management behavior (DMB) change are still undetermined. Objective: To understand the extent to which personal CGM use influences DMB versus user-blind CGM. In addition, patient satisfaction and provider perspective were evaluated during the study. Methodology: A pilot-randomized control trial (RCT) was conducted on 30 patients (15 libre-professional CGM and 15 libre 2 CGM). Adults (18-80y) with an ICD-10 diagnosis of DM within the past 12 months, A1c >8% measured within the past 6 months, stable weight within the past 3 months (BMI ± 2 units), able to speak, read, and write English, and a negative pregnancy test for women of childbearing age seen in the Lahey Endocrine Clinic were included.Exclusion criteria included evidence of personal CGM device use prior to the trial, addition of new oral or injectable hypoglycemic agents within 3 months of trial start, current or anticipated acute use of steroids, pregnancy, medical conditions that, per investigator determination, make it unsafe to target A1c <8%, severe psychiatric illness, homeless, current substance abuse, vision or hearing impairment that may affect the use of CGM. All participants were given information on how to incorporate the CGM into daily DM management and general diabetes self-management education (DSME). DMB was measured using the Diabetes Self Care Inventory-Revised scale, which was provided at visit 1 (baseline), visit 2 (2 weeks), and visit 3 (3-6 months). Additional outcome variables, including Diabetes Distress, sleep quality, exercise habits, and nutrition, were obtained. A1c was measured at baseline and at the end of visit 3. Provider satisfaction with patient CGM use was also evaluated using a newly developed provider satisfaction survey. Results: This study remains active for enrollment. Thus far, 14 patients have been recruited (7 in Libre 2 arm and 7 in Libre Pro User blind arm). Based on initial results, personal-CGM use supports improved diabetes self-care. Further, improvements in A1c, glucose time in target range, and lower rates of hypoglycemia are evident in all CGM users. Further, 100% of the providers felt that CGM use by their patients was very effective and helped their clinical decision-making during the visit. Providers did not feel that reviewing CGM data prolonged their visit. Conclusion: This pilot suggests that personal CGM use improves diabetes self-management behavior and reaffirms that CGM use in patients with poorly controlled diabetes is associated with improved DM clinical outcomes. Presentation: 6/3/2024

The Prevalence and Determinants of Anxiety and Depressive Symptoms in Patients with Type II Diabetes Mellitus in Mogadishu, Somalia: A Cross-Sectional Study.

This study aims to determine the prevalence of depression, anxiety, and stress among TIIDM patients in Mogadishu, Somalia, and identify predicting factors, as there is limited research on these disorders in Somalia. A hospital-based cross-sectional study was conducted on adult patients with TIIDM from November 2023 to January 2024 at Erdogan Hospital, in the capital city of Somalia. A total of 360 participants were recruited using the systematic sampling technique. Data was collected using questionnaires on sociodemographic, clinical and behavioral characteristics. The depression, anxiety, and stress scale (DASS-21) questionnaire was used to assess symptoms of depression, anxiety, and stress. Bivariate and multivariate logistic regression analyses were performed to identify variables predicted by the outcome variables. Out of the 360 participants included in this study, 44.7%, 55.0%, and 30.3% had depression, anxiety, and stress symptoms, respectively. A lack of regular exercise (AOR = 1.79; 95% CI: 1.14-2.79) and an illness duration of 4-7 years (AOR = 1.94; 95% CI: 1.16-3.23) were statistically associated with depression. Being female (AOR = 2.07; 95% CI: 1.31-3.28), having ≥9 children (AOR = 1.94; 95% CI: 1.07-3.53), and a lack of regular exercise (AOR = 1.57; 95% CI: 1.01-2.45) were statistically associated with anxiety. A lack of regular exercise (AOR = 2.07; 95% CI: 1.31-3.28), having DM complications (AOR = 2.14; 95% CI: 1.01-4.54), an illness duration of 4-7 years (AOR = 2.22; 95% CI: 1.25-3.94), and DM management non-compliance (AOR = 2.74; 95% CI: 1.20-6.26) were statistically associated with stress. This study found that TIIDM patients had moderately high rates of depression, anxiety, and stress symptoms, with a lack of physical activity associated with increased odds of depression, anxiety, and stress symptoms. Healthcare workers should screen for psychological symptoms, provide interventions, monitor sedentary patients, and encourage adherence to treatment and physical exercise to reduce mental health burden.

Bibliometric analysis of the applicability of artificial intelligence in the integrated management of medical waste

The integrated management of medical waste (MD) is a crucial challenge for public health and the environment, aggravated in recent times by population growth and the emergence of pandemics. In this context, the implementation of innovative technologies such as Artificial Intelligence (AI) presents itself as a promising solution. These technological tools can facilitate the identification, classification and tracking of DMs, thus optimizing their collection, treatment and final disposal in an efficient and sustainable manner. For this purpose, it was established to analyze the scientific production related to the integrated management of medical waste and the applicability of Artificial Intelligence. The Scopus database was used during the period 2017 - 2024 based on the PRISMA 2020 methodology. The behavior of the studies presented 9 nodes representing 116 publications. For the co-occurrence of keywords, five clusters and 56 selected keywords were found, which corroborates the importance of the study. However, the application of emerging technologies in combination with comprehensive approaches can significantly contribute to improve DM management, from an adaptive, resilient, and inclusive approach.

Self-Efficacy Improvement in Diabetes Mellitus Patients After Implementing Discharge Planning Based on Diabetes Self Care Management Education in Inpatient Room, dr. Haryoto Hospital, Lumajang

Diabetes (DM) is a chronic disease and is characterized by high blood sugar (glucose) levels, diabetes that is not well controlled, can cause various complications that endanger the patient. One of the pillars of DM management is health education. Health education can increase the self-efficacy of patients so that diabetes management can be optimized. Diabetes Self Management Education (DSME) is a diabetes management education and support program that can be a place for diabetes patients to get education, support development and maintain the behavior of diabetes patients. The management that will be implemented is implementing DSME-based discharge planning and measuring self-efficacy before and after the intervention. The design of this scientific paper uses a case study design. The subjects used were two patients with diabetes mellitus. Data analysis was carried out using descriptive analysis. Self-efficacy in (Mrs. S) patients who were given DSME-based charge planning increased from an initial self-efficacy score of 58 in the low category to 87 in the high category, Meanwhile the self-efficacy of (Mrs. P) patients who were given charge planning not based on DSME experienced a difference from the initial self-efficacy score of 54 in the low category to 59 in the low category. There is a change in self-efficacy in diabetes mellitus patients (Mrs.S) after implementing DSME-based discharge planning and there was no change in self-efficacy in diabetes mellitus patients (Mrs.P) who applied non-DSME-based discharge planning inpatient RSUD. dr. Haryoto Lumajang.

Effectiveness of Diabetes Mellitus Management Training On Health Cadres

The highest prevalence of DM based on diagnosis and symptoms was in the 55-64 year age group, namely 5.5%. Knowledge about DM disease is very necessary for sufferers so that the risk of complications can be minimized. This study aims to analyze the effectiveness of DM management training in preventing DM complications in Kalipare Village, Malang Regency. This research used a Quasi Experimental design carried out in Kalipare Village, Malang Regency. The population of this study was all Kalipare Village Health Cadres totaling 30 people. The research sample was 30 Health Cadres. The sampling technique uses Total Sampling. The independent variable in this research is DM management training while the dependent variable is prevention of DM complications. Data was collected using questionnaires, skills observation and analyzed using the Mann-Whitney test. There is a significant difference with a significance of 0.000 (< 0.05). (p < 0.05) between the treatment group and the control group regarding the results of knowledge and observation of DM management skills after treatment, which means that there is effectiveness of DM management training in preventing DM complications. The more effective the DM management training given to health cadre participants, the better the prevention of DM complications will be.

Impact of systematic diabetes screening on peri-operative infections in patients undergoing cardiac surgery

Detection of high glycated hemoglobin (A1c) is associated with worse postoperative outcomes, including predisposition to develop systemic and local infectious events. Diabetes and infectious Outcomes in Cardiac Surgery (DOCS) study is a retrospective case–control study aimed to assess in DM and non-DM cardiac surgery patients if a new screening and management model, consisting of systematic A1c evaluation followed by a specialized DM consult, could reduce perioperative infections and 30-days mortality. Effective July 2021, all patients admitted to the cardiac surgery of IRCCS ISMETT were tested for A1c. According to the new protocol, glucose values of patients with A1c ≥ 6% or with known diabetes were monitored. The diabetes team was activated to manage therapy daily until discharge or provide indications for the diagnostic-therapeutic process. Propensity score was used to match 573 patients managed according to the new protocol (the Screen+ Group) to 573 patients admitted before July 2021 and subjected to the traditional management (Screen−). Perioperative prevalence of infections from any cause, including surgical wound infections (SWI), was significantly lower in the Screen+ as compared with the Screen− matched patients (66 [11%] vs. 103 [18%] p = 0.003). No significant difference was observed in 30-day mortality. A1c analysis identified undiagnosed DM in 12% of patients without known metabolic conditions. In a population of patients undergoing cardiac surgery, systematic A1c evaluation at admission followed by specialist DM management reduces perioperative infectious complications, including SWI. Furthermore, A1c screening for patients undergoing cardiac surgery unmasks unknown DM and enhances risk stratification.

Pelatihan Peningkatan Kualitas Sumber Daya Manusia di Era Digital pada UMKM

This community service activity is carried out with the aim of increasing knowledge and skills in human resource management (HR) in MSME (Micro, Small and Medium Enterprises) companies. HR Management Training in the Digital Era is a training program designed to equip HR professionals with relevant and up-to-date skills in managing human resources in the digital era. This kind of training is designed to prepare HR professionals to face the challenges arising from the ongoing digital transformation. The method of implementing this activity is carried out using a material presentation model and followed by discussion activities. This training activity was attended by 16 MSME scale business actors from Badung district, Bali. From the results of the training, it was concluded that several weaknesses were found in MSME businesses, especially in DM management, such as lack of digital skills, uncertainty about change, lack of access to digital resources, inability to compete with large companies and data security and privacy.

Integrated Management for Patients with Diabetes Mellitus: A Literature Review

Background: Many factors contribute to DM, such as age, heredity, high-calorie meals, an unhealthy lifestyle, obesity, and stress. Inadequate glycemic control contributes to elevated blood glucose levels and potential complications. However, many people of DM had unmet proper DM management regularly due to many factors.Objective: This study reviewed published articles about integrated management for people with DM through three databases.Methods: We identified 1902 articles, and 13 articles were selected for full-text analysis.Results: We found that in integrated DM management for patients with DM, they highly recommend to monitoring their blood glucose, doing exercise, dietary plan, coping strategy, and continuous health education were the most effective DM management strategies to lowering HbA1c levels.Conclusion: Nurses as healthcare providers should engage with people with DM to ensure they have good knowledge and understanding of how to maintain their disease.

Current scientific evidence for why periodontitis should be included in diabetes management.

This Perspective provides a brief summary of the scientific evidence for the two-way links between periodontal diseases and hyperglycemia (diabetes mellitus [DM] and pre-DM). It delivers in a nutshell current scientific evidence for manifestations of hyperglycemia on periodontal health status and effects of periodontal diseases on blood glucose levels and in turn incidence, progression, and complications of diabetes. Of outmost importance is presentation of scientific evidence for the potential of routine periodontal treatment to lower blood glucose levels, providing a novel, economical tool in DM management. Non-surgical periodontal treatment ("deep cleaning") can be provided by dental hygienists or dentists in general dental offices, although severe cases should be referred to specialists. Such therapy can decrease the costs of DM care and other health care costs for people with DM. The great importance of a healthy oral cavity free of infection and subsequent inflammation - especially periodontitis that if untreated will cause loosening and eventually loss of affected teeth - has largely gone unnoticed by the medical community as the health care curricula are largely void of content regarding the bi-directional links between oral health and systemic health, despite elevation of blood glucose levels being an integral part of the general systemic inflammation response. The importance of keeping disease-free, natural teeth for proper biting and chewing, smiling, self-esteem, and pain avoidance cannot be overestimated. Medical and dental professionals are strongly encouraged to collaborate in patient-centered care for their mutual patients with - or at risk for - hyperglycemia.

Perception and Educational Needs in the Self-Management Type 2 Diabetes Mellitus Patients: A Phenomenological Study Based on Local Wisdom

Lack of knowledge, misperceptions, and the absence of a diabetes management culture pose challenges to providing social support, particularly within families. This is a qualitative phenomenological study aimed at identifying factors contributing to self-management, unearthing the influence of a patrilineal culture, and uncovering the educational needs for local wisdom-based diabetes mellitus self-management in type 2 patients. Data were collected through in-depth interviews and analyzed thematically. The study population consisted of type 2 diabetes mellitus patients living within patrilineal families. The sample size was 10 female individuals aged between 40 and 60 years. The duration of type 2 DM ranged from 6 to 15 years. Four themes emerged from the research: (1) Insufficiency in self-management, (2) Beliefs and perceptions about type 2 diabetes mellitus, (3) The influence of patrilineal families on self-management, and (4) The need for the development of educational programs for self-management type 2 DM management rooted in local culture. According to the results, people with Type 2 Diabetes Mellitus may not be capable of managing their health. Though there are many different opinions and views regarding Type 2 DM, there are frequently gaps in our knowledge. The management of diabetes is greatly impacted by patrilineal family systems. Participants express a significant need for educational programs that are culturally sensitive and improve their ability to control their diabetes.

The Implications of the Pandemic with Covid-19 in the Glycemic Control of People with Type 2 Diabetes.

The COVID-19 lockdown influenced the glycemic control and other metabolic parameters in people with type 1 and 2 diabetes mellitus. To study the effects of COVID-19 lockdown on glycemic control in people with type 2 diabetes mellitus (T2DM). Our study group included 120 Romanian people with T2DM from both urban and rural areas. We employed a structured questionnaire with multiple-choice to collect data about DM management during lockdown, the interaction with their diabetologist, the access to treatment, and what other factors influenced their DM management during the lockdown. We did not observe an increase of numbers of hyper or hypoglycemia during the restriction period in people with T2DM. The number of glycemic imbalances was higher in people treated with insulin than those with oral antidiabetics (OAD) (p=0.003, X2=8.91). Regarding the causes of imbalances, we did not obtain a significant difference during the restriction period, neither between patients following treatment with insulin nor with OAD. On the contrary, we observed that only 26.7% of people with T2DM managed to maintain their weight or lost weight vs 73.3% patients who gained several extra kg (p<0.001, X2=52.26). The findings of this study have demonstrated that in people with T2DM, the COVID-19 lockdown determines better glycemic control among patients treated with OAD compared to those treated with insulin therapy. Anxiety, stress, and emotions were the main reasons that led to the increase in glycemic values of these patients. Also, most patients have gained weight either due to lack of physical activity or due to stress.

Роль самоконтроля гликемии у подростков с сахарным диабетом 1-го типа: клинический разбор

Type 1 diabetes mellitus (dm) is a disease characterized by chronic hyperglycemia and the development and progression of severe microvascular complications. The results of the AdVAnce, Accord and VAdT large-scale research studies have definitely proved that glycemic control plays a role in prevention of the dm microvascular complications. A number of studies have shown that glycemic variability parameters play a separate role in prediction of diabetic retinopathy, nephropathy and cardiovascular complications. Adolescents with type 1 dm are characterized by the labile disease course and the tendency to develop hypoglycemia and ketoacidosis. modern approach to type 1 dm management, especially in adolescents, includes the need for mandatory self-monitoring of blood glucose (BG). Adolescents with type 1 dm are unable to achieve target glucose levels themselves at home without BG monitoring. Glycemic control in type 1 dm should be accurate, simple and convenient, allowing patients to adjust insulin therapy for dm on their own. Selection of BG monitor is one of the main aspects of self-monitoring of BG. From the doctor's point of view, compliance with accuracy standards is the most important criterion for choosing the glucose meter, while from the patient’s perspective it is convenience and ease of use. With improvements in technology, the accuracy of BG measurement increases, the self-monitoring of BG procedure gets simpler, which results in higher adherence to treatment and treatment efficacy. It is impossible to achieve and maintain target BG levels without active full-fledged participation of patient with type 1 dm, self-monitoring of BG using the advanced, accurate and convenient for patient glucose meter, such as contour Plus one.

Evaluation of the knowledge and practice of family physicians in the management of diabetes mellitus type 2 in Iran

BackgroundThe increasing prevalence and occurrence of type 2 diabetes has made it a widespread epidemic. Being the first line of care, family doctors can play an essential role in this field. The knowledge of these doctors about how to deal with the prevention, diagnosis, and correct treatment of patients is fundamental in reducing the burden of this disease in the community. In this study, we decided to evaluate the knowledge and practice of family doctors in Shiraz-Iran and its related factors in managing Diabetes.MethodThis analytical cross-sectional study was conducted among family doctors of two primary healthcare centers, Shahadai Wal-Fajr Health Center and the Enghlab Health Center in Shiraz, Iran, from March 2021 to August 2021. A researcher-designed diabetes questionnaire consisting of 21 items and a data collection form including demographic information and other related factors was used in this study. An interviewer asked the questions from participants at their workplace and completed the questionnaires. The data were analyzed by SPSS-20 software. A linear regression test was used to investigate the factors affecting the questionnaire score. A one-way ANOVA test was used to compare questionnaire scores among multiple groups.ResultsOn average, the participants obtained 62.5% of the total score. The average scores for each question in the screening, the diagnosis, and the treatment sections were 0.5 ± 0.28, 0.65 ± 0.2, and 0.66 ± 0.17, respectively. Physicians’ knowledge about the blood sugar threshold for diagnosing Diabetes was suboptimal, and 81.9, 47, 43 correctly mentioned the FBS, 2hrpp BS, and HbA1c threshold, respectively. Although 95% knew the first line medication but 33.6% prescribed 2nd or 3rd medication for DM treatment. Only 43% knew the goal of therapy. Sixty-three doctors (42%) have not registered any referrals for newly diagnosed uncomplicated diabetic patients, and 37.6% referred these new DM cases to an internist or endocrinologist at the first visit. Microvascular complication screening, such as testing for microalbuminuria and ophthalmologist consultation reported by 32. 89% and 8% of physicians, respectively. Years since graduation was the determining factor of the knowledge level of doctors in this study. Regarding the preferred education method, most participants selected the workshop method as the preferred training method. Virtual education was ranked as the second preferred educational method.ConclusionThe knowledge and practice of general family doctors were lower than the optimal level in diabetes screening, diagnosis, and treatment. In the treatment of patients, the knowledge of most of the physicians was appropriate in the early stages of treatment, such as determining the time to start the medication and the first line of treatment, but in the follow-up and more advanced treatment, the knowledge and performance of the doctors were less than expected. They prefer to refer patients to higher levels in the healthcare system. Recently graduated physicians had better knowledge and approach to DM management. Therefore, effective periodic training should be conducted as soon as possible to address this pitfall and improve the quality of care. Workshops and virtual education were the most preferred education methods from the participants’ points of view. So, it is suggested that these methods be used as the first training methods. Implementing the specialty training program for family medicine (which has been started in our country for a few years) is the best final solution. In addition, A clinical guideline should be designed for family physicians highlighting these physicians’ roles in the management of Diabetes.

Mindfull Eating To Increase Self Compassion Pada Pasien Diabetes Mellitus Tipe II

Type 2 diabetes mellitus is a chronic disease that is currently growing rapidly in society. The main target of diabetes management is to prevent complications and maintain a good quality of life. To achieve this target, sufferers need sufficient knowledge about DM management so that they are motivated and do it in the right way. Diet management plays an important role in stabilizing blood glucose. Mindful eating is a diet method that involves enjoying food without coercion so that sufferers can appreciate themselves more and the impact can improve the quality of life. This community service are carried out to increase the knowledge and ability of diabetes sufferers in carrying out diet management at home. The activities ini community services are providing education and skills training on how to carry out diet management using the mainstream eating method. The results of community service activities, show that participants have good understanding and abilities, high enthusiasm, interest in participating with great focus, and a strong commitment to implementing them in everyday life.

THU006 Exploring Primary Care Resident Perspectives On Diabetes Education In Training

Abstract Disclosure: N. Francis: None. S. Cardillo: None. D.R. Nandiwada: None. Background: The training residents gain in Family Medicine (FM) and Internal Medicine (IM) residency programs provide a critical foundation for their knowledge in diabetes (DM) management. It is one of the most common diagnoses physicians-in-training will encounter in their residency training programs and in clinical settings. However, a 2012 study compared diabetes care in resident clinics versus private physicians and found significant decrease in patient satisfaction (56.5% vs. 71.3%) in resident clinics. A 2020 study surveying primary care (PC) residency program directors showed that most FM and IM residency training programs focus on the core diabetes care and management topics with much less focus on emerging topics, such as 2nd generation insulin analogs and digital health technologies. The purpose of our survey was to better assess current resident perceptions and attitudes towards their DM education and their perceived comfort level in comprehensive DM counseling, evaluation, and management. Methods: A 12 item survey was designed using the Qualtrics program. The survey link was sent via email to IM- PC and FM residents at a major academic medical center. Data was collected from September 13th, 2022 to present. The survey included a combination of multiple choice, Likert scale and ranking questions. Results: 14 residents responded to the survey to date with the majority (71%) belonging to the IM-PC group and the remainder (29%) family medicine. Residents felt most comfortable managing diabetes related complications and counseling on foot and eye care and hypoglycemia. Respondents reported being most uncomfortable in prescribing non-insulin medication (50%) and initiating an insulin regimen (43%) and less comfortable counseling patients on continuous glucose monitoring systems (83%) and insulin administration (66%). While majority of residents (72%) found their DM curriculum clinically relevant, 85% of residents reported there was not enough time allotted. Respondents felt a more longitudinal lecture series, with increased access to treatment frameworks and on-site feedback on their DM counseling and care would best supplement their DM curriculum. Conclusion: This survey data explores specific areas that residents have identified as being least comfortable and also expresses what they identified as the most preferable ways to modify and design an educational intervention. This information allows for tailored curricular intervention highlighting diabetes technologies, insulin and non-insulin prescribing practice in a longitudinal lecture style format that provides access to DM treatment frameworks and incorporates direct on-site feedback to the residents. This provides evidence for the development of a novel clinically integrated DM curriculum. Presentation: Thursday, June 15, 2023

EFEKTIFITAS HIPNOTERAPI LIMA JARI MELALUI BERSYUKUR DALAM PENGENDALIAN KADAR GULA DARAH DM TIPE 2

Diabetes mellitus is a group of metabolic syndrome diseases with hyperglycemia characteristics that occur due to abnormalities in insulin secretion, insulin resistance, or both. About 50% of Type-2 DM patients experiencing undiagnosed depression is quite concerning because it will hinder DM management and allow negative thoughts to arise so it is important to activate gratitude through five-finger hypnotherapy. The purpose of the study was to determine the effectiveness of five-finger hypnotherapy through gratitude in controlling blood sugar levels of Type-2 Diabetes Mellitus patients. This type of research uses quasi-experimental design with a nonequivalent control group design model. The sample was divided into two, namely the intervention group of 23 people was given five-finger hypnotherapy therapy treatment with gratitude and the control group of 22 people was only given five-finger hypnotherapy therapy treatment taken with purposive sampling techniques. Bivariate analysis using Wilconxon test and Mann-Whitney test. As a result, there was a difference in pre-test and post-test blood sugar levels where the p-value of the Wilcoxon test in the intervention group was 0.022 and the control group was 0.008. In conclusion, the effectiveness of five-finger hypnotherapy through gratitude in controlling blood sugar levels was a decrease in KGD 27.31 mg / dl in the intervention group and an addition of KGD 19.14 mg / dl in the control group.

Роль контроля гликемии у больных сахарным диабетом 2-го типа

It is well-known that patients with type 1 and 2 diabetes mellitus are at high risk of complications of micro- and macrovascular disease. Furthermore, the relationship between elevated blood glucose levels and microvascular complications is likely to be direct and is generally specific for diabetes. However, the correlation with macrovascular risk is more complex, multifactorial and not limited to hyperglycemia only. The paper considers the relationship between the macro- and microvascular damage to the target organs associated with DM and cardiovascular risk. The review of studies focused on assessing the effectiveness of blood glucose level reduction in type 2 diabetes mellitus in the context of cardiovascular safety is provided. Advanced DM treatment methods are discussed. Special attention is paid to self-monitoring of blood glucose as one of the most important factors of the DM management and prevention of complications.

Gambaran Pengetahuan dan Perilaku Pasien dan Keluarga Tentang Manajemen DM Tipe 2

Diabetes mellitus is a chronic disease caused by heredity and/or lack of insulin production by the pancreas, or due to ineffective insulin function thereby increasing the concentration of glucose in the blood, which ultimately damages various body systems, especially blood vessels and nerves. Worldwide there are approximately 224 million cases of diabetes with 1.5 million mortality rates and an estimated one in eleven people in the world has diabetes. The four pillars of DM management which discuss DM education, DM diet, DM physical exercise and DM treatment. To find out the knowledge and behavior of patients and families about type 2 DM management. In this study, secondary data was used by analyzing previous journals and journal searches using the Google search engine. Scholar It is known based on three journals the results of patient and family knowledge levels about DM management, regarding DM education in the good category with results (73.3%) patient knowledge about diet is in the good category with results (83.8%), while knowledge about physical exercise get good category results (77.5%) and less knowledge (60.0%) and less knowledge about drugs. (61.3%) and good knowledge (90.0%). Behavioral adherence to education, diet, physical activity, adherence to taking medication in type 2 DM patients is still a lot of disobedience. Knowledge and behavior of patients and families have in common in discussing the four pillars of DM management which discuss DM education, DM diet, DM physical exercise and DM treatment.