Diabetes management

About: Diabetes management is a research topic. Over the lifetime, 6060 publications have been published within this topic receiving 164670 citations.

Severe hypoglycaemia leading to hospital admission in type 2 diabetic patients aged 80 years or older.

Abstract: Aim: Evidence is mounting that hypoglycaemia among elderly diabetic patients is a very real and costly concern. Objective of this study was to determine the incidence and risk factors for developing severe hypoglycaemia leading to hospital admission, among type 2 diabetic subjects aged 80 years or older. Methods: Hypoglycaemia was defined as a symptomatic event requiring treatment with i.v. glucose and confirmed by a blood glucose determination < 50 mg/dl. Results: During a eight-year period severe hypoglycaemia was identified in 99 subjects. These patients were found to have a reduced cognitive ability, a heavy burden of comorbid disease and a HbA1c values of 5.9 %. Of the hypoglycaemic episodes, 76 occurred in patients taking glibenclamide. Diabetes therapy was prescribed by general practitioners in 85 of them. Only 26 patients performed regular home blood glucose self-monitoring. Conclusion: Severe hypoglycaemia is a serious and not uncommon metabolic emergency among patients with type 2 diabetes aged 80 years or older; it is more frequent in patients with considerable comorbidity undergoing aggressive diabetes management and in users of a long-acting sulphonylurea. In elderly subject, each patient's risk for hypoglycaemia should be considered and therapy should be individualized accordingly; in our opinion, a great number of episodes may be avoided by teaching the principles of blood glucose monitoring and involving general practitioners in outpatients management of diabetes mellitus.

Examining Knowledge, Attitudes, and Beliefs About Depression Among Latino Adults With Type 2 Diabetes

Abstract: PURPOSE The purpose of this study was to explore knowledge, attitudes, and beliefs about depression among Latinos with type 2 diabetes. METHODS Eight 90-minute focus groups were conducted, each moderated by a bilingual, bicultural woman. Participants included 45 self-identified Latino adults with diabetes. Discussion topics included diabetes management, perceived control, emotional barriers, conceptualization of depression, and help-seeking behavior. Themes pertinent to depression and emotional health were identified using a combined deductive/inductive approach and an iterative process of consensus coding. RESULTS Participants' mean age was 40 years, 44% were male, and most were born in Mexico. The mean time with diabetes was 6.5 years. The primary theme identified was the bidirectional relationship between emotional health and diabetes. Diagnosis of diabetes led to feelings of hopelessness and upset, while difficulty with diabetes management led to feelings of anxiety and depression. Participants felt that being "stressed out" or sad directly affected their blood sugar. Participants described factors that influence the relationship between emotions and diabetes, including family and societal stressors, and they reported little discussion of depression with providers. Depression and emotional health are closely associated with diabetes in the minds of these Latino adults. It is important to ask patients with diabetes about their emotional health, to screen for depression, and to elicit preferences about treatment when indicated.

A survey study on diabetes management and complication status in primary care setting in Thailand.

Abstract: Objective: Healthcare service in Thailand is stratified into three levels with different facilities of care. This cross-sectional survey study described diabetes management, diabetes control, and late complication status among patients managed in urban primary health care clinics. Material and method: Thirty-seven primary health care units were randomly selected. Each unit enrolled up to 30 patients having been managed in the unit for at least one year. The patients were interviewed, and the medical records such as demographic data, management practice, glycemic control, and complications were retrospectively reviewed for a period of one year. All data were entered in the case record forms, transferred into a database by electronic scanning, and analyzed by SAS version 6.12. One thousand and seventy-eight patients, including 300 males and 778 females, were recruited in the present study. Result: Their mean + SD of age, onset age, and diabetes duration were 58.2 + 11.3, 52.2 + 11.4 and 6.2 + 4.0 years, respectively. Six percent of the patients were type 1, and 94% were type 2 diabetes. Two-thirds of the patients engaged in diabetes education > 5 days during the previous year. Monitoring of glycemic control was largely by measurement of fasting plasma glucose (FPG) in the unit. Determination of hemoglobin A 1c (HbA 1c ), total cholesterol, triglyceride, HDL-cholesterol, serum creatinine, urinary protein, and microalbuminuria were observed in 0.7, 17.4, 11.7, 6.9, 38.2, 33.0, and 0.9% of the patients, respectively. Mean + SD of FPG was 8.3 + 2.7 mmol/l, and HbA 1c was 8.6 + 1.9%. The percentage of patients with FPG < 6.7 mmol/1 and HbA 1c < 7% were 28.7 and 19.6%, respectively. An annual eye and foot examination was performed in 21.5% and 45% of the patients, respectively. The prevalence of late complications included retinopathy (13.6%), proteinuria (17.0%), end stage renal failure (0.1%), peripheral neuropathy (34%), acute foot ulcer/gangrene (1.2%), healed foot ulcer (6.9%), stroke (1.9%), and myocardial infarction (0.7%). Conclusion: The present study results demonstrated that necessary, routine assessments were not regularly practiced by caregivers in primary care units. In addition, peripheral neuropathy was the most common observed complication and this might explain the high rate of foot ulcers in this cohort.

Improvement of Insulin Injection Technique: Examination of Current Issues and Recommendations.

Abstract: PurposeCorrect insulin injection technique is a crucial aspect of diabetes management. The purpose of this article is (1) to outline the medical literature, including patient-based studies and surveys, surrounding the type of issues and problems that patients encounter with injectable insulin therapy and the degree to which correct insulin technique is being applied and (2) to review the latest recommendations for insulin injection technique and discuss the key aspects that diabetes educators and other health care professionals should be communicating to their patients to ensure that injection technique is optimized.ConclusionsExamination of the literature and multiple patient surveys demonstrates that patients continue to have many issues with insulin injection technique, highlighting the pressing need for effective patient education. In addition, many patients are not using insulin pen devices correctly. Widespread lack of injection site rotation and reuse of needles have resulted in high rates of lipoh...