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Multidisciplinary Diabetes Management and Education Strategies in the Inpatient Rehabilitation Setting. 住院康复治疗中的多学科糖尿病管理和教育策略。
Q3 Medicine Pub Date : 2024-08-15 eCollection Date: 2024-01-01 DOI: 10.2337/dsi24-0012
Christopher L Greer, Joshua J Neumiller

People with diabetes receiving inpatient rehabilitation have multiple unique care needs. Although the condition, event, or disability resulting in admission to an inpatient rehabilitation facility (IRF) may not have a causal relationship with chronic conditions such as diabetes, the condition precipitating referral to IRF care may increase a person's risk for worsening cardiometabolic disease. Furthermore, diabetes management in the IRF setting may be complicated by stress hyperglycemia from illness and/or drug-induced hyperglycemia from the use of glucocorticoids or other offending medications. The availability of a multidisciplinary team of clinicians and therapists in the IRF setting holds great opportunity for development of robust diabetes care and education programs to optimize therapy, teach or reinforce diabetes self-management survival skills, and facilitate safe transitions of care to individuals' next setting of care.

接受住院康复治疗的糖尿病患者有多种独特的护理需求。虽然导致患者入住住院康复机构(IRF)的病症、事件或残疾可能与糖尿病等慢性疾病没有因果关系,但促使患者转入 IRF 护理的病症可能会增加患者心血管代谢疾病恶化的风险。此外,IRF 环境中的糖尿病管理可能会因疾病引起的应激性高血糖和/或使用糖皮质激素或其他违规药物引起的药物性高血糖而变得复杂。在 IRF 环境中,临床医生和治疗师组成的多学科团队为制定强有力的糖尿病护理和教育计划提供了巨大的机会,以优化治疗、教授或加强糖尿病自我管理生存技能,并促进护理安全过渡到个人的下一个护理环境。
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引用次数: 0
Managing Type 1 Diabetes in an Inpatient Child Psychiatric Care Setting. 在儿童精神科住院治疗环境中管理 1 型糖尿病。
Q3 Medicine Pub Date : 2024-08-15 eCollection Date: 2024-01-01 DOI: 10.2337/dsi24-0008
Amanda L Olinger, Shilpa Sachdeva, Ann M Manzardo, Sharon E Cain

Individuals with diabetes are at increased risk for psychological, behavioral, and social problems. Comorbid mental illness and diabetes present a unique set of challenges for people with diabetes and their health care providers, particularly in an inpatient setting. Psychiatric symptoms before admission may affect type 1 diabetes management, and mental status and behavior can affect individuals' ability to cooperate with treatment while they are inpatients. This article describes a clinical protocol to manage type 1 diabetes and maximize patient safety in an acute inpatient child psychiatric unit.

糖尿病患者出现心理、行为和社会问题的风险增加。合并精神疾病和糖尿病会给糖尿病患者及其医疗服务提供者带来一系列独特的挑战,尤其是在住院环境中。入院前的精神症状可能会影响 1 型糖尿病的治疗,而住院期间的精神状态和行为也会影响患者配合治疗的能力。本文介绍了在儿童精神科急诊住院病房中管理 1 型糖尿病并最大限度保障患者安全的临床方案。
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引用次数: 0
Standardizing Diabetes Care in Colorado Schools: Nearly Two Decades of Success. 科罗拉多州学校糖尿病护理标准化:近二十年的成功经验。
Q3 Medicine Pub Date : 2024-08-15 eCollection Date: 2024-01-01 DOI: 10.2337/dsi24-0011
G Todd Alonso, Andrea Houk, Pamela Brunner Nii, Dianne Chorny, Kathleen Patrick, Leah Wyckoff

Since 2005, a group of stakeholders in Colorado has collaborated to improve diabetes management in schools and childcare centers by standardizing care and embedding local expertise to support school personnel in this task. This effort has included the development of toolkits for parents, school nurses, and other health care providers; the establishment of a diabetes resource nurses program; and annually updated guidelines titled Standards of Care for Diabetes Management in the School Setting & Licensed Child Care Facilities. This collaboration has fundamentally changed how school nurses and staff in Colorado care for students with diabetes.

自 2005 年以来,科罗拉多州的一个利益相关者团体一直在合作,通过标准化护理和植入当地专业知识来支持学校工作人员完成这项任务,从而改善学校和托儿所的糖尿病管理。这项工作包括为家长、学校护士和其他医疗保健提供者开发工具包;建立糖尿病资源护士计划;以及每年更新名为《学校环境和持证托儿所糖尿病管理护理标准》的指南。这项合作从根本上改变了科罗拉多州学校护士和教职员工护理糖尿病学生的方式。
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引用次数: 0
Diabetes Care at Summer Camps. 夏令营中的糖尿病护理。
Q3 Medicine Pub Date : 2024-08-15 eCollection Date: 2024-01-01 DOI: 10.2337/dsi24-0010
Lowell R Schmeltz, Nader Kasim

Attending summer camp can be a rewarding experience for children with type 1 diabetes and an opportunity for them to build their confidence and diabetes self-management skills. Diabetes camps are built to cater to the medical needs of children with diabetes. With proper communication, education, and resources, traditional summer camps can provide the same benefits.

参加夏令营对 1 型糖尿病患儿来说是一次有益的经历,也是他们建立自信和掌握糖尿病自我管理技能的机会。糖尿病夏令营旨在满足糖尿病儿童的医疗需求。通过适当的沟通、教育和资源,传统夏令营也能带来同样的益处。
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引用次数: 0
Diabetes in Diverse Settings. 不同环境中的糖尿病。
Q3 Medicine Pub Date : 2024-08-15 eCollection Date: 2024-01-01 DOI: 10.2337/dsi24-0013
Ryan J McDonough
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引用次数: 0
Considerations to Better Meet the Needs of People Living With Diabetes While in Prison or Detention. 更好地满足监狱或拘留所中糖尿病患者需求的考虑因素。
Q3 Medicine Pub Date : 2024-08-15 eCollection Date: 2024-01-01 DOI: 10.2337/dsi24-0009
Jennifer L West, Rebecca A Ballard, John P May

Diabetes care within prison walls offers challenges and opportunities for both health care providers and individuals living with diabetes. To meet the challenges, providers and patients work together to manage diabetes within the limitations imposed by imprisonment. Upon release, patients face new challenges, as they transition from incarceration into the community.

监狱内的糖尿病护理为医疗服务提供者和糖尿病患者带来了挑战和机遇。为了应对挑战,医疗服务提供者和患者共同努力,在监禁所带来的限制条件下控制糖尿病。获释后,患者从监禁中过渡到社区生活,面临着新的挑战。
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引用次数: 0
About Ryan J. McDonough: Guest Editor. 关于 Ryan J. McDonough:客座编辑。
Q3 Medicine Pub Date : 2024-08-15 eCollection Date: 2024-01-01 DOI: 10.2337/ds24-ge03
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引用次数: 0
Correlates of Self-Reported Executive Function Impairment Among Medicaid Beneficiaries With Type 2 Diabetes 2 型糖尿病医疗补助受益人自述执行功能受损的相关因素
Q3 Medicine Pub Date : 2024-07-10 DOI: 10.2337/ds23-0067
David Von Nordheim, Cynthia Herrick, N. Verdecias, Rachel Garg, Matthew W Kreuter, Amy McQueen
Executive function (EF) impairment is associated with poorer outcomes for individuals with type 2 diabetes. Previous research has identified risk factors for EF impairment, but many of these are also associated with type 2 diabetes. To address this issue, this study identified relevant variables from the literature and compared their association with EF in a sample of people with type 2 diabetes. Adult members of a Medicaid health plan diagnosed with type 2 diabetes were enrolled in a social needs intervention trial. Using baseline data from the trial, bivariate and multivariable regression analyses examined associations between EF and demographic, health, and psychosocial factors. When controlling for other factors, we identified six significant correlates of EF impairment: age (β = 0.10), education (college vs. no college; β = −0.38), depression symptoms (β = 0.18), comorbidity burden (β = 0.21), diabetes-related distress (β = 0.14), and future time orientation (β = −0.13). Our analysis identified several factors associated with greater EF impairment, which may interfere with diabetes self-management. Providers should consider these factors when prescribing treatments and determine whether additional resources or accommodations are warranted.
执行功能(EF)受损与 2 型糖尿病患者较差的预后有关。以往的研究已经确定了导致执行功能受损的风险因素,但其中许多因素也与 2 型糖尿病有关。为了解决这个问题,本研究从文献中找出了相关变量,并在 2 型糖尿病患者样本中比较了这些变量与 EF 的关系。 医疗补助健康计划中被诊断出患有 2 型糖尿病的成人成员参加了一项社会需求干预试验。利用试验的基线数据,我们进行了双变量和多变量回归分析,研究了EF与人口、健康和社会心理因素之间的关系。 在控制其他因素的情况下,我们发现了六个与 EF 损伤显著相关的因素:年龄(β = 0.10)、教育程度(大学与非大学;β = -0.38)、抑郁症状(β = 0.18)、合并症负担(β = 0.21)、糖尿病相关困扰(β = 0.14)和未来时间取向(β = -0.13)。 我们的分析确定了与更大的 EF 损伤相关的几个因素,这些因素可能会干扰糖尿病的自我管理。医生在开具治疗处方时应考虑这些因素,并确定是否需要额外的资源或调整。
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引用次数: 0
Patient Satisfaction and Clinical Experience With the Tandem t:slim X2 With Control-IQ Technology Advanced Hybrid Closed-Loop Insulin Delivery System 采用 Control-IQ 技术的 Tandem t:slim X2 高级混合闭环胰岛素输送系统的患者满意度和临床体验
Q3 Medicine Pub Date : 2024-07-05 DOI: 10.2337/ds23-0057
Lisa T. Meade, Adriane B. Marino, Madison A. Barrier, Madison H. Wilson
The purpose of this study was to assess patient satisfaction and clinical experience with the t:slim X2 with Control-IQ Technology automated insulin delivery system. This descriptive study used a retrospective electronic health record review of all individuals trained on the Control-IQ system between December 2019 and April 2022 in one adult endocrinology practice. A total of 99 patients using the Control-IQ system for at least 3 months completed the glucose monitoring satisfaction survey (GMSS). The primary outcome was overall satisfaction with the system as measured by the GMSS. Secondary outcomes included changes in A1C from baseline at 3, 6, and 12 months, the association between GMSS scores and A1C levels, and the use of the system’s sleep activity feature to achieve lower A1C levels. The overall satisfaction score for patients using the system was 4.0 ± 0.6 (possible score range 1–5). A1C decreased by 0.6% 3 months, 0.7% at 6 months, and 0.8% at 12 months. Participants with A1C levels ≤7% did not experience greater satisfaction compared to those with higher A1C levels. Participants using the Control-IQ system reported a high rate of overall satisfaction and experienced significant reductions from baseline A1C at 3, 6, and 12 months.
本研究旨在评估患者对带有 Control-IQ 技术的 t:slim X2 胰岛素自动给药系统的满意度和临床经验。 这项描述性研究采用回顾性电子健康记录审查的方式,对一家成人内分泌科诊所在 2019 年 12 月至 2022 年 4 月期间接受过 Control-IQ 系统培训的所有人员进行了审查。共有 99 名使用 Control-IQ 系统至少 3 个月的患者完成了血糖监测满意度调查 (GMSS)。主要结果是通过 GMSS 测定的对该系统的总体满意度。次要结果包括 3 个月、6 个月和 12 个月时 A1C 与基线相比的变化、GMSS 分数与 A1C 水平之间的关联,以及使用该系统的睡眠活动功能达到较低 A1C 水平的情况。 使用该系统的患者总体满意度为 4.0 ± 0.6(评分范围为 1-5)。3 个月后,A1C 下降了 0.6%,6 个月后下降了 0.7%,12 个月后下降了 0.8%。与 A1C 水平较高的参与者相比,A1C 水平≤7% 的参与者并没有获得更高的满意度。 使用 Control-IQ 系统的参与者总体满意度较高,3 个月、6 个月和 12 个月时的 A1C 与基线相比均有显著下降。
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引用次数: 0
“A Wake-Up Call”: A Mixed-Methods Analysis of Barriers to Type 2 Diabetes Prevention After Gestational Diabetes Mellitus "警钟长鸣":妊娠糖尿病后 2 型糖尿病预防障碍的混合方法分析
Q3 Medicine Pub Date : 2024-05-03 DOI: 10.2337/ds23-0072
Julia D. DiTosto, Maria V Gomez-Roas, C. Niznik, Brittney R. Williams, W. Grobman, Lynn M. Yee
Individuals who have gestational diabetes mellitus (GDM) are advised to engage in physical activity and healthy eating behaviors in the postpartum period to prevent type 2 diabetes. We aimed to understand individual perspectives on incorporating such lifestyle choices during the first postpartum year. This was a mixed-methods analysis of data from individuals with GDM who completed surveys and in-depth interviews at 4–12 weeks and 11–13 months postpartum as part of their participation in a feasibility randomized controlled trial on postpartum patient navigation. Participant attitudes were elicited with surveys (structured items with Likert-scale responses) and interviews that focused on barriers to postpartum type 2 diabetes prevention. We used a concurrent, triangulation design to jointly analyze survey data alongside interview data. Of 40 participants, 39 provided data about their type 2 diabetes prevention activities. Interview themes triangulated with survey results to yield consistent insights about attitudes regarding physical activity and healthy eating. The majority of participants reported that caring for a new baby and family responsibilities made it much harder to be physically active; fewer participants identified cost of exercise, accessing a safe area to exercise, or breastfeeding as barriers. The most common barriers to healthy eating included caring for a new baby, family responsibilities, and work/school schedules. Although proximity and transportation to healthy food sources were uncommon barriers, when they did occur, they were experienced as major burdens. Individuals who had GDM reported many barriers to implementing recommended postpartum lifestyle choices. Recognizing these unique needs may enhance provision of guidance for type 2 diabetes prevention postpartum.
我们建议妊娠糖尿病(GDM)患者在产后进行体育锻炼并养成健康的饮食习惯,以预防 2 型糖尿病。我们的目的是了解个人对在产后第一年选择这种生活方式的看法。 这项研究采用混合方法对 GDM 患者的数据进行了分析,这些患者在产后 4-12 周和 11-13 个月时填写了调查问卷并进行了深入访谈,这是他们参与产后患者指导可行性随机对照试验的一部分。我们通过调查(采用李克特量表回答的结构化项目)和访谈了解了参与者的态度,访谈的重点是产后预防 2 型糖尿病的障碍。我们采用了并行三角测量设计,将调查数据与访谈数据一起进行联合分析。 在 40 位参与者中,有 39 位提供了有关其 2 型糖尿病预防活动的数据。访谈主题与调查结果进行了三角测量,得出了有关体育锻炼和健康饮食态度的一致见解。大多数参与者表示,照顾新生儿和家庭责任使他们更难进行体育锻炼;较少参与者认为运动成本、获得安全的运动场所或母乳喂养是障碍。最常见的健康饮食障碍包括照顾新生儿、家庭责任以及工作/学业时间安排。虽然就近获得健康食品和交通是不常见的障碍,但当这些障碍出现时,它们就会成为主要的负担。 患有 GDM 的人表示,在实施建议的产后生活方式选择时会遇到很多障碍。认识到这些独特的需求可以加强对产后预防 2 型糖尿病的指导。
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Diabetes Spectrum
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