Understanding Of Diabetes Management Research Articles

Diabetes in residential aged care: Pharmacological management and concordance with clinical guidelines.

Existing studies have highlighted suboptimal diabetes management in residential aged care facilities (RACFs). However, understanding of diabetes management in Australian metropolitan RACFs has been limited. This retrospective cohort study aimed to explore the pharmacological management of diabetes in 25 RACFs in Sydney Australia and assess concordance with clinical practice guidelines (CPGs). Data from 231 permanent RACF residents aged ≥65 years and over with type 2 diabetes mellitus over the period from 1 July 2016 to 31 December 2019 were used. Concordance was measured by assessing the medications and medical history data for each individual resident for concordance with evidence-based CPGs. Multivariable logistic regression was used to estimate the effect of resident characteristics on concordance with CPGs. Of the 231 residents with diabetes, 87 (38%) were not taking any antidiabetic medication. Pharmacological management inconsistent with CPG recommendations was observed for 73 (32%) residents, with the most common reason for non-concordance being the use of medications with significant adverse effects in older adults (47, 2%). Residents with hypertension or other heart diseases in addition to their diabetes had greater odds of their diabetes management being non-concordant with CPGs (OR = 2.84 95% CI = 1.54, 5.3 and OR = 2.64, 95% CI = 1.07, 6.41, respectively). Pharmacological diabetes management in metropolitan Australian RACFs is suboptimal, with a high prevalence of inconsistency with CPGs (32%) observed. Additionally, having hypertension or heart diseases significantly increased the possibility of non-concordance among diabetic RACF residents. Further investigation into the underlying relationships with comorbidities is required to develop better strategies.

Feasibility and acceptability of a tailored health coaching intervention to improve type 2 diabetes self-management in Saudi Arabia: a mixed-methods randomised feasibility trial

BackgroundAround one-third of the population of Saudi Arabia have been diagnosed with type 2 diabetes, a condition often requiring lifestyle changes. Personalised health coaching, a strategy developed to assist individuals...

Evaluation of Interprofessional Delivery of Diabetes Medication Management Training Among Family Medicine Residents.

Diabetes-related care makes up approximately 24% of outpatient clinic visits. Therefore, confidence and understanding of diabetes management is necessary for family medicine residents. We developed a combined lecture and simulation lab curriculum utilizing a registered nurse and pharmacist to deliver education to 20 family medicine learners. Pre and post surveys of the educational material were completed in 2 sections including one gauging medical knowledge and a second part gauging level of comfort. Of the learners who participated, fourteen completed the pre-post surveys. Most (53%) respondents improved their scores, while 20% scored the same 27% scored worse. The overall average score increased 57% to 70% and improvement was statistically significant (P < .05). All learners improved confidence by at least 1 point. An interprofessional team utilizing a lecture curriculum focusing on providing education on effective prescribing, medication safety profiles, and resource availability, showed improvement in confidence but mixed knowledge benefit. Further modifications to the curriculum may yield further educational gains.

Antidiabetic Potential of Commonly Available Fruit Plants in Bangladesh: Updates on Prospective Phytochemicals and Their Reported MoAs.

Diabetes mellitus is a life-threatening disorder affecting people of all ages and adversely disrupts their daily functions. Despite the availability of numerous synthetic-antidiabetic medications and insulin, the demand for the development of novel antidiabetic medications is increasing due to the adverse effects and growth of resistance to commercial drugs in the long-term usage. Hence, antidiabetic phytochemicals isolated from fruit plants can be a very nifty option to develop life-saving novel antidiabetic therapeutics, employing several pathways and MoAs (mechanism of actions). This review focuses on the antidiabetic potential of commonly available Bangladeshi fruits and other plant parts, such as seeds, fruit peals, leaves, and roots, along with isolated phytochemicals from these phytosources based on lab findings and mechanism of actions. Several fruits, such as orange, lemon, amla, tamarind, and others, can produce remarkable antidiabetic actions and can be dietary alternatives to antidiabetic therapies. Besides, isolated phytochemicals from these plants, such as swertisin, quercetin, rutin, naringenin, and other prospective phytochemicals, also demonstrated their candidacy for further exploration to be established as antidiabetic leads. Thus, it can be considered that fruits are one of the most valuable gifts of plants packed with a wide spectrum of bioactive phytochemicals and are widely consumed as dietary items and medicinal therapies in different civilizations and cultures. This review will provide a better understanding of diabetes management by consuming fruits and other plant parts as well as deliver innovative hints for the researchers to develop novel drugs from these plant parts and/or their phytochemicals.

\u201cI try the one that they say is good.\u201d - factors influencing choice of health care provider and pathways to diabetes care for Syrian refugees in Lebanon

BackgroundNavigating health systems in host countries can be a challenge for refugees, particularly in a multi-provider system such as Lebanon. Syrian refugees in Lebanon face a high burden of Non-Communicable Diseases (NCDs) including diabetes mellitus. Evidence on how refugees navigate the health system is essential to improve provision of NCD services. We conducted a qualitative study amongst Syrian diabetes patients visiting Médecins Sans Frontières (MSF) clinics in one urban and one rural setting in Lebanon to explore factors influencing choice of and pathways to diabetes care.MethodsIn-depth interviews were conducted with male and female adult participants with DM type 1 or type 2 who were receiving treatment at MSF clinics. Participants were recruited using convenience sampling. Interviews were conducted in Arabic and directly transcribed and translated into English. Data were coded in NVivo and analyzed using an inductive thematic approach.ResultsA total of 29 in-depth interviews were conducted with 13 men and 16 women. Knowledge and understanding of diabetes management differed among participants. Syrian refugees in Lebanon gathered information about health services for diabetes largely from social networks of family and peers rather than through formal means. Pathways to care included different combinations of providers such as clinics, pharmacists and informal providers.ConclusionsSyrian refugees with diabetes in Lebanon face considerable challenges in navigating the health care system due to their vulnerable status and limited knowledge of the host country systems. To ensure access to care for diabetes, efforts need to be made to support patients’ orientation in the Lebanese health system.

Pharmacy Students as Volunteer Medical Staff for American Diabetes Association Summer Camp

For children living with a diagnosis of diabetes, com-munity support and education about proper disease management are critical for the mental and physical health of the child and their family. The experiences offered at summer camps hosted by the American Diabetes Association address both of these needs for the pediatric diabetes community. These camps provide children with the opportunity to participate in a traditional camp experience—swimming, rock climbing, tubing, and more—while giving parents peace of mind in the knowledge that their child’s diabetes will be closely monitored by a team of health care professionals. During my time as volunteer medical staff at the American Diabetes Association’s Camp John Warvel, I was given the unique opportunity to put into practice the topics taught in my pharmacy curriculum in a hands-on learning environment. As part of the camp medical staff, I was responsible for adjusting insulin doses, checking blood sugar levels, and treating episodes of low or high blood sugar. While campers were given the opportunity to make friends and learn about how to manage their diabetes, I was able to supplement areas of my education with real-world applications of content from my clinical courses. Camp John Warvel is a prime example of the incredible benefit that a service-learning experience can have for a student, particularly in a health care profession. I left Camp John Warvel with a rejuvenated passion for my profession that helped sustain me through my remaining years of school. I returned to my classes at Purdue with improved retention of my diabetes knowledge after using that information in a hands-on setting. My campers went home having formed lifelong friendships and a better understanding of diabetes management, with their eyes excitedly set on coming back to camp again next year.

Relationships Between Family History and Self-Reported Diabetes Status and Alzheimer’s Disease Warning Signs

Abstract Objectives To determine whether familial history is linked for Alzheimer's disease (AD) and diabetes, and examine if a relationship exists between years since diagnosis and understanding of diabetes management and blood glucose testing. Methods Adults aged fifty and older were asked to complete a survey that included family history of diabetes and AD. The survey asked respondents to self-identify diabetes status, their understanding of diabetes management, and the frequency of their blood sugar monitoring. Surveys were distributed in person and online via social media and email. Data were entered into SPSS 26, and Pearson correlations were run to determine whether a significant relationship was present between the variables of interest. Results There was not a significant relationship between the number of blood relatives with AD and the number of relatives with diabetes (r = 0.140, P = 0.226), but a weak between the total number of relatives with diabetes and self-reported diabetes status (r = 0.278, P = 0.003). While there was not a significant relationship between years since diabetes diagnosis and self-rated understanding of diabetes management (r = 0.197, P = 0.325), there was a strong relationship between years since diagnosis and total number of blood sugar tests taken per week (r = 0.565, P = 0.004). Conclusions The relationship between number of relatives with diabetes and having diabetes oneself is in line with previous research. Additionally, while diabetics monitor their blood sugar more closely as time goes by, Future efforts are needed to inform diabetics about best practices for blood glucose management. Funding Sources None.

A Qualitative Evaluation of Patient Experiences With Group Medical and Individual Education Appointments for Type 2 Diabetes Management in Saskatchewan, Canada.

The purpose of this study was to capture information on patient experiences and perspectives of group medical appointments (GMAs) and compare them to those attending individual appointments (IAs) with the diabetes education team (usual care) for managing type 2 diabetes. Adults (N = 18; 61% male; 83% 50-70 years old ) with type 2 diabetes (or prediabetes) living in rural Saskatchewan were recruited to complete a semistructured interview on their experiences with GMAs or IAs. To be eligible to participate, individuals must have attended at least 2 GMAs or 2 IAs. Transcripts were coded and analyzed using content analysis. Overall, participants spoke highly of their respective appointment type. Results indicated that both appointment types positively influenced understanding of diabetes management, with the most notable difference being greater understanding of stress management in the GMAs. Participants identified several positive aspects of each appointment type, which included convenience, supportive and enjoyable, and informative for GMAs and time and tailored information for IAs. Participants provided some suggestions to improve diabetes related-care for their respective appointment type. Participants of GMAs and IAs for type 2 diabetes each reported unique strengths to their respective care plan and reported benefiting from their care.

Effectiveness of a Community Health Worker-Led Diabetes Intervention among Older and Younger Latino Participants: Results from a Randomized Controlled Trial.

Diabetes management for older Latino adults is complex, given a higher incidence of multiple coexisting medical conditions and psychosocial barriers to self-management. Community health workers (CHWs) may be effective in reducing these barriers. The REACH Detroit CHW randomized controlled intervention studies with Latino/as with diabetes found improvements in self-management behaviors and glucose control after participating in a CHW-led intervention. Using data from the REACH Detroit Partnership′s cohort 3, this study used descriptive statistics and multiple linear regression analyses to evaluate whether the six-month CHW intervention had a greater effect on older Latino/as (ages 55 and older) than younger participants between baseline and post-intervention follow-up at six months. There were significant intervention effects by age group that varied by outcome. Compared to a control group that received enhanced usual care, there were statistically significant intervention effects demonstrating greater self-efficacy scores 1.27 (0.23, 2.32); p < 0.05, and reductions in HbA1c 1.02 (−1.96, −0.07); p < 0.05, among older participants in the CHW intervention, and increases in diabetes support 0.74 (0.34, 1.13); p < 0.001; and understanding of diabetes management 0.39 (0.08, 0.70); p < 0.01 among younger participants.

Assessment of a Dietary Consultation Model for Effective Diabetes Care in Saudi Population using Partial Least Squares Estimation

The relationship between dietary habits and diabetes has not been studied efficiently in Saudi Arabia and the available diabetes risk models does not focus much on diet, nor do they capture the overall dietary behaviors. The purpose of this research was to test empirically the hypothesised dietary consultation model that has been proposed for more effective diabetes care. This exploratory study was conducted on type 2 diabetic Saudi patients visiting the Primary Health Care Centres in Almajmaah city. The data comprising 350 patients were collected from 5 th February – 24 th April, 2017 through systematic sampling technique using direct investigation method. Data was collected through four questionnaires. Composite scores were extracted for all variables under study and analysed by Partial Least Squares-Structural Equation Modelling approach using SmartPLS 3.2.6 software. Evaluation of formative outer and inner model relationships validated the hypothesised dietary consultation model. Power of study, coefficient of determination, effect size, total effects, and model fit index further validated the findings. The validated dietary consultation model facilitates a new healthcare paradigm which can give a better understanding of diabetes management at stakeholder and individual level. Healthcare givers should pay special emphasis on diabetics’ diabetes mellitus knowledge, dietary knowledge, and dietary attitude, as these factors influence each other, dietary practices and HbA1c. Healthcare givers can use this model alone or by integrating it with available diabetes risk models to carry out the dietary assessment of type 2 diabetics.

Higher body mass index and lower intake of dairy products predict poor glycaemic control among Type 2 Diabetes patients in Malaysia.

This cross-sectional study was designed to determine factors contributing to glyceamic control in order to provide better understanding of diabetes management among Type 2 Diabetes patients. A pre-tested structured questionnaire was used to obtain information on socio-demographic and medical history. As a proxy measure for glycaemic control, glycosylated haemoglobin (HbA1c) was obtained as secondary data from the medical reports. Perceived self-care barrier on diabetes management, diet knowledge and skills, and diet quality were assessed using pretested instruments. With a response rate of 80.3%, 155 subjects were recruited for the study. Mean HbA1c level of the subjects was 9.02 ± 2.25% with more than 70% not able to achieve acceptable level in accordance to WHO recommendation. Diet quality of the subjects was unsatisfactory especially for vegetables, fruits, fish and legumes as well as from the milk and dairy products group. Higher body mass index (BMI), poorer medication compliance, lower diet knowledge and skill scores and lower intake of milk and dairy products contributed significantly on poor glycaemic control. In conclusion, while perceived self-care barriers and diet quality failed to predict HbA1c, good knowledge and skill ability, together with appropriate BMI and adequate intake of dairy products should be emphasized to optimize glycaemic control among type 2 diabetes patients.

Continuous Glucose Monitoring: A Perspective on Its Past, Present, and Future Applications for Diabetes Management.

The transition from urinary glucose measurement to more sophisticated self-monitoring of blood glucose (SMBG) systems in the 1970s and 1980s dramatically changed the approach to and understanding of diabetes management (1). Innovations in the design and technology of portable blood glucose meters have become integral to the success of intensive treatment of both type 1 and type 2 diabetes, and the outcome of this treatment has led to a tremendous decrease in the development of long-term micro- and macrovascular complications (2–4). However, intensive insulin therapy has its limitations, including increased frequency of hypoglycemia and the need for frequent SMBG testing. In the past decade, continuous glucose monitoring (CGM) technology has evolved into a novel tool to support diabetes management. Unlike conventional glucose meters, which provide a snapshot of the blood glucose value at the time of testing, CGM provides semi-continuous information about glucose levels. It does this indirectly, by extrapolating blood glucose levels from interstitial fluid glucose via an algorithm. Importantly, CGM allows users to make decisions regarding their day-to-day diabetes management using real-time glucose trends. Along with this information, CGM systems provide customizable hypo- and hyperglycemia alarms and display trends of the rate of change of glucose levels. Most recently, CGM systems have been integrated with insulin pumps and are being used in artificial pancreas clinical trials. In this article, we discuss the clinical benefits of CGM; its challenges, including accuracy and user experience; and its present and future role in the management of diabetes. Numerous studies have explored whether sustained use of CGM offers clinical benefits in individuals with diabetes. Randomized, multicenter clinical trials have shown improved glycemic control in adults with type 1 diabetes using CGM compared to those using SMBG and a reduction in the time spent in hypoglycemia with concomitant improvement in A1C …

Do People with Type 2 Diabetes Think They are Unhealthy?: A Cross-Sectional Study in Celaya, Mexico.

Background:Type 2 diabetes is a chronic disease that presents a significant burden on health care systems in many countries. With the rise of obesity, the incidence of Type 2 diabetes has also been steadily increasing. A healthy lifestyle and understanding of diabetes management are important factors for delaying the onset of comorbidities associated with Type 2 diabetes. The objective of this study was to evaluate the self-perception of health in individuals with Type 2 diabetes as it relates to BMI status, which has important implications for the implementation of preventive programs.Methods:A cross-sectional lifestyle survey was implemented in the region of Celaya, Guanajuato, Mexico, targeting 100 participants diagnosed with Type 2 diabetes. Anthropometric measurements and participant characteristics were also obtained. Fisher’s exact test was used to determine if the proportions of lifestyles perceptions differed by BMI status.Results:Participants had a mean age of 56.12 ± 10.26, a mean BMI of 29.13 ± 5.48 kg/m2, were mostly married (67.0%), and female (70.0%). None of the normal weight participants perceived themselves as unhealthy. 95% of overweight/obese participants perceived themselves to be healthy, despite a diagnosis of diabetes and being overweight/obese, while only 5% perceived themselves to be unhealthy. However, these differences in the perceptions of health classified by BMI status were not statistically significant (p = 0.42).Conclusion:Our findings indicate that overweight and obese persons with Type 2 diabetes in Celaya, Mexico may have misperceptions about their own health, even though these findings were not statistically significant. These preliminary data highlight the importance of implementing prevention and educational programs among those with diabetes, in order to combat health misperceptions and raise awareness about the dangers of diabetes and obesity. Furthermore, more research with larger sample sizes is needed in order to fully understand the effects of perception of health on actual health.

Translating Research into Practice: Impact of an Interprofessional Diabetes Education Model on Patient Health Outcomes

Background: Patient education programs encouraging diabetes self-management can improve clinical outcomes and lessen diabetes complications. This study implemented an innovative interprofessional student-led diabetes self-management and health promotion program for an underserved population and demonstrated an improvement in participant clinical outcomes and students’ understanding of interprofessional aspects of diabetes care.Methods and Findings: This community-based program was implemented at two sites that serve medically underserved individuals. Students from five health career professions led educational sessions designed to demonstrate critical components of diabetes self-management. The six-month longitudinal program covered topics within the Alphabet Strategy, including Advice, Blood pressure, Cholesterol, Diabetes control, Dental care, Diet, Eye care, Foot care, and Guardian drugs. Participants completed surveys evaluating diabetes knowledge, understanding of diabetes care, and health behaviours. Clinical values were collected before and after the program. Student surveys assessed their understanding of diabetes self-management. Upon completion of the program, all assessments were repeated to determine if there were improvements in outcomes. Thirty-eight participants and thirty students completed the study. There were significant improvements in participants’ diabetes knowledge, understanding of diabetes management, and clinical outcomes. There were significant improvements in the students’ ability to educate patients about foot care, eye care, and guardian drugs, as well as increased awareness of the role of each health profession in diabetes care.Conclusions: This interprofessional health promotion model showed significant improvements in patient and student outcomes. This innovative student-led program could be implemented in other settings and for the management of other chronic diseases.

Treat-to-target trials in diabetes.

Treat-to-target is a therapeutic concept that considers well defined and specific physiologic targets as aims in controlling the pathophysiology of the disease. It has been widely used in diseases that pathophysiology includes, chronic metabolic and physiological disturbances, namely rheumatic conditions, vascular medicine and diabetes. In diabetes, the availability of “gold-standard” quantitative measures like fasting plasma glucose and glycated hemoglobin make the application of treat-to-target trials especially pertinent. Treatment modalities which have used single therapeutic agents or combinations or in combination with a variety of titration algorithms and implementation protocols have broadened our understanding of diabetes management with specific reference to insulin initiation and maintenance. Treat-to-target trials have been used to investigate a wide variety of questions including efficacy, safety, effect of treatment on comorbidities and patient satisfaction, ideal mechanisms to implement insulin initiation etc. A more generalized acceptance and implementation of treat-to-target trials may finally revolutionize diabetes management by combining aspects of individual care with standard treatment protocols.

Health Education in Diabetic Population: Current Practice and Future Challenges

The aim of this review is to discuss the role of health education, self-management and mult idisciplinary ap- proach and how they can improve to produce a framework for better practice. Diabetes is a growing problem in all over the world. It is associated with severe co mp lications if it is not adequately controlled. Diabetes patients need to develop a range of competencies that allo w them to take greater control over the treat ment of their disease. This requires education that promotes health whilst respecting individuals' self-perceived needs and voluntary choices. However, such concept is not new in the field of diabetes; health professionals are still struggling with how to ad minister it successfully. Diabetic patients can be educated toward greater autonomy, but all health professionals are not ready to work in partnership with them. Th is review indicates that there are number of important changes which need to be taken. There is a need to gain better understanding of diabetes management and theoretical principles underlying patient empowerment and education. In order to achieve better outcomes and effective health care services, collaboration of different health care professional working in different setup is required.

Evaluation of a student-led interprofessional innovative health promotion model for an underserved population with diabetes: A pilot project

Interprofessional education seeks to encourage different health professions to interact and learn together during their training process which will eventually lead to collaborative healthcare practices and improved care for patients. This study determined whether student understanding of diabetes management and the role of health professionals in diabetes care improved after the implementation of an interprofessional health promotion program. Sixty-three students from five health professions led six educational sessions concentrating on critical components of diabetes management. The longitudinal program covered topics within the Alphabet Strategy (A–G). Students were surveyed to determine their understanding of diabetes management. Data were gathered at the beginning of the study and its conclusion. Forty-seven students completed the program and the pre- and post-survey. There were significant improvements in students' knowledge of diabetes care, understanding of the roles of healthcare professionals and ability to work with other healthcare professionals. Nineteen patients completed the study. There were no significant differences in patients' diabetes knowledge, understanding of diabetes care and clinical outcomes. This study acknowledged the potential value of an interprofessional team approach to care. This innovative model could be applied to other practice settings and used for the management of other chronic diseases.