Type 2 Diabetes in High-risk Youth: Improving Identification and Interventions in Community Health with a Decade of Quality Improvement Efforts

IF 1.2 4区医学 Q4 HEALTH POLICY & SERVICES Journal of Health Care for the Poor and Underserved Pub Date : 2023-11-01 DOI:10.1353/hpu.2023.a912723

Kathy A. Love-Osborne, Haley Ringwood, Jessica F. Wallace, J. Sheeder, S. Knierim

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Abstract

Abstract:Introduction. This manuscript describes quality improvement interventions with aims (1) to increase identification and follow-up testing of youth with prediabetes and type 2 diabetes (T2D) and (2) to improve outcomes for youth with prediabetes and low-range T2D (HbA1c 6.5–6.9%). Methods. Interventions included (a) dissemination of evidence-based guidelines and (b) creation of in-house weight management (WM) programs and programs to increase prediabetes follow-up testing and T2D self-management. Data from the electronic health record are presented. Results. Between 2009–2020, T2D screening for obese youth increased from 24% to 76%. Two WM programs served 2,726 unique youth for 11,110 billable visits. Youth with prediabetes seen in WM clinic had a lower risk of developing T2D if they attended three or more visits. Teaching self-monitoring blood glucose showed promise for improving HbA1c outcomes in youth with low-range T2D. Conclusions. Interventions have increased identification, access to preventive services, and treatment for youth with prediabetes and T2D.

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高危青少年中的 2 型糖尿病：通过十年的质量改进努力，提高社区卫生的识别和干预能力

摘要：导言。本手稿介绍了质量改进干预措施，旨在（1）增加对患有糖尿病前期和 2 型糖尿病（T2D）的青少年的识别和跟踪检测；（2）改善患有糖尿病前期和低范围 T2D（HbA1c 6.5-6.9%）的青少年的治疗效果。方法。干预措施包括：(a) 宣传循证指南；(b) 制定内部体重管理 (WM) 计划和方案，以增加糖尿病前期跟踪检测和 T2D 自我管理。本文介绍了电子健康记录中的数据。结果。2009-2020年间，肥胖青少年的T2D筛查率从24%上升到76%。两项 WM 计划共为 2726 名青少年提供了服务，计费就诊次数达 11110 次。在 WM 诊所就诊的糖尿病前期青少年如果就诊三次或三次以上，患 T2D 的风险较低。教授自我监测血糖的方法有望改善低水平 T2D 青少年的 HbA1c 结果。结论。干预措施增加了对糖尿病前期和 T2D 青少年的识别、预防服务和治疗。

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来源期刊

Journal of Health Care for the Poor and Underserved Multiple-

CiteScore

2.00

自引率

7.10%

发文量

154

期刊介绍： The journal has as its goal the dissemination of information on the health of, and health care for, low income and other medically underserved communities to health care practitioners, policy makers, and community leaders who are in a position to effect meaningful change. Issues dealt with include access to, quality of, and cost of health care.