Diabetes management

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

Exercise and glucose metabolism in persons with diabetes mellitus: perspectives on the role for continuous glucose monitoring.

Abstract: Exercise causes profound changes in glucose homeostasis. For people with type 1 diabetes, aerobic exercise usually causes blood glucose concentration to drop rapidly, while anaerobic exercise may cause it to rise, thereby making glycemic control challenging. Having the capacity to know their glucose levels and the direction of change during exercise increases self-efficacy in these persons who are prone to hypo- and hyperglycemia. For people with type 2 diabetes, learning first hand that regular exercise improves glucose levels may be a motivating factor in getting them to be more active. Continuous glucose monitoring is a potentially useful adjunct to diabetes management for the active person with either forms of diabetes. This review aims to guide the reader to use this technology to its maximum advantage by providing an overview of technical features, performance characteristics, and clinical utility, all balanced against the limitations that may be more prominent during physical activity.

Pharmacist Impact on Clinical Outcomes in a Diabetes Disease Management Program via Collaborative Practice

Abstract: BACKGROUNDClinical outcomes resulting from pharmaceutical care have been incompletely addressed in the diabetes population. We conducted a retrospective study evaluating clinical outcomes in a diabetes disease management program in which clinical pharmacists possessed collaborative practice agreements.OBJECTIVETo evaluate changes in clinical outcomes for patients enrolled in a pharmacist-coordinated diabetes management program.METHODSMedical records of 157 patients enrolled in the diabetes management program between June 2003 and April 2004 were retrospectively reviewed. Data collection included baseline and follow-up values for hemoglobin A1C (A1C) and lipids as well as frequency of adherence to preventive care, including annual foot and eye examinations and daily aspirin therapy.RESULTSFor patients with both baseline and follow-up data, the mean A1C reduction was 1.6% (n = 109; p < 0.001). For patients with an initial A1C of ≥8.5%, the mean reduction was 2.7% (n = 57; p < 0.001). The percentage of patie...

System and methods for improved diabetes data management and use employing wireless connectivity between patients and healthcare providers and repository of diabetes management information

Abstract: Methods, devices and a system for disease management are provided that employ diagnostic testing devices (e.g., blood glucose meters) and medication delivery devices (e.g., insulin delivery devices) for providing data to a repository in real-time and automatically. Repository data can be analyzed to determine such information as actual test strip use, patient health parameters to outside prescribed ranges, testing and medication delivery compliance, patient profiles or stakeholders to receive promotional items or incentives, and so on. Connected meters and medication delivery devices and repository data analysis are also employed to associate a diagnostic test to a mealtime based on timing of a therapeutic intervention performed by an individual.

Empowering patients with diabetes : a qualitative primary care study focusing on South Asians in Leicester, UK

Abstract: Results. Interviews were conducted with 15 South Asian and 5 white patients. We identified both similar and culturally specific elements within the experience, attitudes and barriers in the two ethnic groups. High regard for education, particularly in South Asians, was associated with a positive attitude to empowerment through knowledge, but also sometimes led to low motivation to become partners in diabetes management. High prevalence of diabetes and strong family networks meant that families were an important source of knowledge for South Asians and that these patients generally had good emotional support. Practical considerations such as the need for a convenient venue for educational initiatives were common to both ethnic groups, but some cultural preferences were also identified, for example for appropriate language provision and separate gender sessions. Conclusions. Educational initiatives aimed at promoting self-management in chronic diseases such as diabetes need to be designed with an awareness of the complexity of social and cultural experiences and attitudes in target communities.

Where is the patient in diabetes performance measures? The case for including patient-centered and self-management measures.

Abstract: OBJECTIVE —Health policies are important determinants of clinician and patient behavior, and an important policy issue is what items are included in healthcare quality and performance measures. There is consensus that patient-centered care and self-management support are essential evidence-based components of good diabetes care. However, most major diabetes performance measures such as the National Committee for Quality Assurance (NCQA)/American Diabetes Association (ADA) Provider Recognition Program indexes have not included self-management or psychosocial items. RESEARCH DESIGN AND METHODS AND RESULTS —We review the case for and propose a set of patient-centered, self-management indicators to be included as a standard part of diabetes quality indicators. The proposed indicators include: patient self-management goal(s), measures of health behaviors (e.g., healthy eating, medication taking, physical activity, and smoking status), quality of life, and patient-centered collaborative care. We discuss the evidence and the concerns about patient-report measures and summarize successful incorporation of such patient-centered measures in other countries and by the American Association of Diabetes Educators (AADE). CONCLUSIONS —The adage that “what gets measured, gets done” applies to diabetes management and many other areas of healthcare. Inclusion of the proposed indicators in national diabetes performance measures would be consistent with Institute of Medicine (IOM), ADA, Centers for Disease Control (CDC), Diabetes Attitudes, Wishes, and Needs (DAWN), AADE, and Society of Behavioral Medicine (SBM) recommendations. Such action would enhance both the priority and delivery of quality, patient-centered care, and diabetes self-management support.