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 Clinical Diabetes Journal current issueнет даты
Clinical Diabetes Journal current issue

 
 
1. Timely News and Notes for Primary Care Providers from the American Diabetes AssociationЧт, 29 июл[−]
Автор(?)
Нет описания

2. Learning and Improvement: From “Me” to “We”Чт, 29 июл[−]
Автор(?)
Нет описания

3. T1D Exchange Quality Improvement Collaborative: A Learning Health System to Improve Outcomes for All People With Type 1 DiabetesЧт, 29 июл[−]
Автор(?)
Нет описания

4. Quality Improvement in Diabetes Care: A Review of Initiatives and Outcomes in the T1D Exchange Quality Improvement CollaborativeЧт, 29 июл[−]
Автор(?)
Despite immense strides in therapeutic advances, clinical outcomes continue to be less than ideal for people with type 1 diabetes. This discrepancy has prompted an outpouring of quality improvement (QI) initiatives to address the medical, psychosocial, and health equity challenges that complicate ideal type 1 diabetes care and outcomes. This article reviews a framework for QI in diabetes care that guided the development of the T1D Exchange Quality Improvement Collaborative to improve care delivery and health outcomes in type 1 diabetes. Evaluation of the methodology, outcomes, and knowledge gained from these initiatives will highlight the importance of continued QI initiatives in diabetes care.

5. Multi-Clinic Quality Improvement Initiative Increases Continuous Glucose Monitoring Use Among Adolescents and Young Adults With Type 1 DiabetesЧт, 29 июл[−]
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Continuous glucose monitoring (CGM) use is associated with improved A1C outcomes and quality of life in adolescents and young adults with diabetes; however, CGM uptake is low. This article reports on a quality improvement (QI) initiative of the T1D Exchange Quality Improvement Collaborative to increase CGM use among patients in this age-group. Ten centers participated in developing a key driver diagram and center-specific interventions that resulted in an increase in CGM use from 34 to 55% in adolescents and young adults over 19–22 months. Sites that performed QI tests of change and documented their interventions had the highest increases in CGM uptake, demonstrating that QI methodology and sharing of learnings can increase CGM uptake.

6. Increasing Insulin Pump Use Among 12- to 26-Year-Olds With Type 1 Diabetes: Results From the T1D Exchange Quality Improvement CollaborativeЧт, 29 июл[−]
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Insulin pump therapy in pediatric type 1 diabetes has been associated with better glycemic control than multiple daily injections. However, insulin pump use remains limited. This article describes an initiative from the T1D Exchange Quality Improvement Collaborative aimed at increasing insulin pump use in patients aged 12–26 years with type 1 diabetes from a baseline of 45% in May 2018 to >50% by February 2020. Interventions developed by participating centers included increasing in-person and telehealth education about insulin pump technology, creating and distributing tools to assist in informed decision-making, facilitating insulin pump insurance approval and onboarding processes, and improving clinic staff knowledge about insulin pumps. These efforts yielded a 13% improvement in pump use among the five participating centers, from 45 to 58% over 22 months.

7. Inequities in Health Outcomes in Children and Adults With Type 1 Diabetes: Data From the T1D Exchange Quality Improvement CollaborativeЧт, 29 июл[−]
Автор(?)
Health care inequities among racial and ethnic groups remain prevalent. For people with type 1 diabetes who require increased medical access and care, disparities are seen in access to care and health outcomes. This article reports on a study by the T1D Exchange Quality Improvement Collaborative evaluating differences in A1C, diabetic ketoacidosis (DKA), severe hypoglycemia, and technology use among racial and ethnic groups. In a diverse cohort of nearly 20,000 children and adults with type 1 diabetes, A1C was found to differ significantly among racial and ethnic groups. Non-Hispanic Blacks had higher rates of DKA and severe hypoglycemia and the lowest rate of technology use. These results underscore the crucial need to study and overcome the barriers that lead to inequities in the care and outcomes of people with type 1 diabetes.

8. Type 1 Diabetes Management With Technology: Patterns of Utilization and Effects on Glucose Control Using Real-World EvidenceЧт, 29 июл[−]
Автор(?)
This retrospective cohort study evaluated diabetes device utilization and the effectiveness of these devices for newly diagnosed type 1 diabetes. Investigators examined the use of continuous glucose monitoring (CGM) systems, self-monitoring of blood glucose (SMBG), continuous subcutaneous insulin infusion (CSII), and multiple daily injection (MDI) insulin regimens and their effects on A1C. The researchers identified 6,250 patients with type 1 diabetes, of whom 32% used CGM and 37.1% used CSII. A higher adoption rate of either CGM or CSII in newly diagnosed type 1 diabetes was noted among White patients and those with private health insurance. CGM users had lower A1C levels than nonusers (P= 0.039), whereas no difference was noted between CSII users and nonusers (P= 0.057). Furthermore, CGM use combined with CSII yielded lower A1C than MDI regimens plus SMBG (P

9. Effect of Diabetes-Trained Nurse Practitioners on Glycemic Outcomes: Their Suggested Use in Busy Primary Care PracticesЧт, 29 июл[−]
Автор(?)
A Federally Qualified Health Center received ongoing external support for half-time salaries for two nurse practitioners to treat people with poorly controlled diabetes (A1C >9.0%) in the clinic’s diabetes program using approved detailed treatment protocols. Patients were treated for 1 year and graduated from this program if their A1C fell to <7.5%. Ninety-one percent graduated, and treatment was deemed to have failed in 9% who did not achieve an A1C <7.5% by the end of the year of treatment. The suggestion is made to assign a specially trained diabetes nurse or physician assistant to serve many primary care providers at important clinical junctures to improve diabetes outcomes throughout busy primary care practices.

10. Evaluation of Clinical Outcomes With the V-Go Wearable Insulin Delivery Device in Patients With Type 2 DiabetesЧт, 29 июл[−]
Автор(?)
Uncontrolled type 2 diabetes can lead to a multitude of health complications. Insulin therapy is recommended when patients are unable to reach their A1C goal with oral or noninsulin injectable diabetes medications. This study evaluated the clinical benefits of switching from multiple daily insulin injections to a wearable insulin delivery device (V-Go). A retrospective chart review was conducted on 44 patients who received prescriptions for the V-Go at two family medicine offices. Investigators found a significant reduction in A1C and daily insulin requirements with no impact on weight or BMI.

11. Identifying Potential Intervention Points for Acute Hypoglycemic Events in Patients With Type 2 Diabetes Using Retrospective Clinical DataЧт, 29 июл[−]
Автор(?)
This retrospective study examined changes in medication orders as a risk factor for future acute hypoglycemic events. The investigators identified factors associated with acute hypoglycemic events resulting in emergency department visits or inpatient admissions. Non-Hispanic Black race, chronic kidney disease, insulin at baseline, and nonprivate insurance were associated with higher risk of an acute hypoglycemic event, whereas age, sex, and A1C were not. After adjustment for other risk factors, changes in insulin orders after A1C measurement were associated with a 1.5 times higher risk of an acute hypoglycemia (adjusted hazard ratio 1.48, 95% CI 1.08–2.03). These results further understanding of risk factors and clinical processes relevant to predicting and preventing acute hypoglycemia.

12. Flat Oral Glucose Tolerance Test During Pregnancy: Maternal Characteristics and Risk for Adverse OutcomesЧт, 29 июл[−]
Автор(?)
Flat oral glucose tolerance test (OGTT) curve is characterized by low glucose levels, seemingly nonresponsive to glucose load. Few studies have explored flat OGTT during pregnancy and have yielded conflicting results, some suggesting risk for fetal growth restriction. This study evaluated the characteristics and perinatal outcomes of women with a flat OGTT during pregnancy. We found that a flat OGTT curve occurs in younger, leaner pregnant women. Also, flat OGTT curve was significantly associated with a male fetus and higher levels of pregnancy-associated plasma protein A at the first-trimester screening. Although flat OGTT can possibly reflect some degree of hyperinsulinemia, it is generally not associated with adverse maternal or neonatal outcomes.

13. Expanding Flash Continuous Glucose Monitoring Technology to a Broader PopulationЧт, 29 июл[−]
Автор(?)
Нет описания

14. Pregestational Diabetes and Family PlanningЧт, 29 июл[−]
Автор(?)
Нет описания

15. Good to Know: Type 1 DiabetesЧт, 29 июл[−]
Нет описания

16. FinerenoneЧт, 29 июл[−]
Автор(?)
Нет описания

17. A Pediatric Case of Abrupt-Onset, Autoantibody-Negative Diabetes With Marked Insulin Resistance Concomitant With COVID-19Чт, 29 июл[−]
Автор(?)
Нет описания


 
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