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Diabetes management
About: Diabetes management is a research topic. Over the lifetime, 6060 publications have been published within this topic receiving 164670 citations.
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TL;DR: It is demonstrated that Chinese men and women with type 2 diabetes following an integrated intervention program including diabetes education, frequent blood glucose monitoring and daily use of a diabetes-specific meal replacement, can achieve significant improvements in glycemic control and markers of cardiovascular health.
Abstract: This study evaluated a structured and integrated intervention program on diabetes management in individuals with type 2 diabetes in Shanghai, China. Men and women with type 2 diabetes and body mass index > 23 kg/m 2 were randomized into a 24-week, prospective, randomized clinical trial. The Reference Group (n=50) received diabetes education including diet and physical activity instruction only; the Intervention Group (n=100) received more intensive intervention, including diabetes education with frequent blood glucose monitoring, nutritional counseling, meal plans with diabetes-specific nutritional meal replacement, and weekly progress updates with study staff. Major study assessments were obtained at baseline, and after 12 and/or 24 weeks of intervention. The Intervention Group improved fasting blood glucose, insulin, systolic and diastolic blood pressures compared to Reference Group (p<0.05). Importantly, HbA1c was lower (p<0.001) in the Intervention Group at 12 weeks (0.6 ± 0.1%) and 24 weeks (-0.8 ± 0.1%). Weight loss was modest, but significant differences were observed between groups (p<0.05). Weight change from baseline after 12 and 24 weeks was -2.8 ± 0.2% and -3.7 ± 0.3%, respectively, in the Intervention Group vs -1.8 ± 0.4% and -2.5 ± 0.4% in the Reference Group. Additionally, waist and hip circumferences and waist:hip ratio decreased in the Intervention compared to the Reference Group (p<0.05). In conclusion, this study demonstrates that Chinese men and women with type 2 diabetes following an integrated intervention program including diabetes education, frequent blood glucose monitoring and daily use of a diabetes-specific meal replacement, can achieve significant improvements in glycemic control and markers of cardiovascular health.
65 citations
01 Jan 2012
TL;DR: Non-severe nocturnal hypoglycemic events (NSNHEs) are associated with a substantial impact on diabetes management, sleep quality, and next-day functioning, and potential limitations in this study include recall and selection bias.
Abstract: Objectives: Non-severe nocturnal hypoglycemic events (NSNHEs) may have a major impact on patients. The objective was to determine how NSNHEs affect diabetes management, sleep quality, functioning, and to assess if these impacts differ by diabetes type or country.
65 citations
TL;DR: Having better provider-patient communication, having social support, and having higher self-efficacy was associated with performing diabetes self-care behaviors; and these behaviors were directly linked to lipid control.
Abstract: Self-care is a crucial component of diabetes management. But comprehensive behavior change frameworks are needed to provide guidance for the design, implementation, and evaluation of diabetes self-care programs in diverse populations. We tested the Information–Motivation–Behavioral Skills (IMB) model in a sample of Chinese adults with Type 2 diabetes. A cross-sectional study of 222 Chinese adults with type 2 diabetes was conducted in a primary care center. We collected information on demographics, provider-patient communication (knowledge), social support (motivation), self-efficacy (behavioral skills), and diabetes self-care (behavior). The values of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were also obtained. Measured variable path analyses were used to the IMB framework. Provider-patient communication (β = 0.12, p = .037), and social support (β = 0.19, p = .007) and self-efficacy (β = 0.41, p < .001) were independent, direct predictors of diabetes self-care behavior. Diabetes self-care behaviors had a direct effect on TC/HDL-C (β = −0.31, p < .001) and LDL-C/HDL-C (β = −0.30, p < .001). Consistent with the IMB model, having better provider-patient communication, having social support, and having higher self-efficacy was associated with performing diabetes self-care behaviors; and these behaviors were directly linked to lipid control. The findings indicate that diabetes education programs should including strategies enhancing patients’ knowledge, motivation and behavioral skills to effect behavior change.
65 citations
TL;DR: This study demonstrated that a clinical pharmacist can effectively care for patients with diabetes referred by their primary care provider because of poor glycemic control.
Abstract: BACKGROUNDPharmacists' responsibilities in caring for patients with diabetes mellitus are expanding. However, few data are available to support pharmacists optimizing therapy and improving outcomes in these patients.OBJECTIVETo determine the effect of a clinical pharmacist—directed diabetes management clinic on glycemic control and cardiovascular and renal parameters in patients with type 2 diabetes.METHODSA nonrandomized, prospective study was conducted in 70 Veterans Affairs patients. Patients met with the pharmacist every 6–8 weeks for approximately 30 minutes for education, medication counseling, monitoring, and management. The primary endpoint was the impact of 9–12 months of participation in the clinic on glycosylated hemoglobin (HbA1C). Secondarily, we evaluated body weight, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides, systolic and diastolic blood pressure, and level of microalbuminuria. All comparisons were made using a paired...
65 citations
TL;DR: In this paper, the impact of rapid-turnaround HbA1c results on providers' clinical decision-making and on follow-up HC levels was assessed, and the authors found that the more favorable followup HC profile in the rapid HC group occurs independently of the decision to intensify therapy, suggesting the involvement of other factors such as enhanced provider and patient motivation.
Abstract: OBJECTIVE: To assess the impact of rapid-turnaround HbA1c results on providers9 clinical decision-making and on follow-up HbA1c levels. RESEARCH DESIGN AND METHODS: The research design was a randomized clinical trial in which rapid HbA1c results were made available to providers on even days of the month (rapid, n = 575), but delayed by 24 h on odd days (conventional, n = 563). Adjustment of therapy for patients with type 2 diabetes was considered appropriate if therapy was intensified for HbA1c values >7% or not intensified for HbA1c values 7% (67 vs. 63%, P = 0.33). For both groups, intensification was greatest for patients on insulin (51%) compared with patients on oral agents (35%) and diet alone (14%) (P 7%, rapid HbA1c results had a favorable impact on follow-up HbA1c independent of the decision to intensify therapy (P = 0.03). CONCLUSIONS: Availability of rapid HbA1c determinations appears to facilitate diabetes management. The more favorable follow-up HbA1c profile in the rapid HbA1c group occurs independently of the decision to intensify therapy, suggesting the involvement of other factors such as enhanced provider and/or patient motivation.
65 citations