Diabetes Spectrum最新文献

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.

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.

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.

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.

Objective: This study aimed to assess the need for practice-wide quality improvement to support evidence-based type 2 diabetes screening for women with a history of gestational diabetes mellitus (GDM) receiving primary care. We sought to add the diagnosis of GDM to the problem list of women who did not have it at baseline.

Research design and methods: We identified all women in our practice with a history of GDM diagnosed between 2002 and 2023, quantified the proportion with GDM documented in their problem list, and examined patient- and clinician-level factors associated with having GDM appropriately documented at baseline.

Results: We identified 203 women with GDM receiving primary care within internal medicine. Of the 203 women, 73 (35.0%) did not have GDM documented in their problem list. Of those without GDM included on the problem list, 52% were overdue for type 2 diabetes screening compared with 41% of those with GDM documented before our intervention. We found race, parity, and previous abnormal glycemic laboratory test results to be highly predictive of whether the history of GDM was on patients' problem list. Upon completion of our intervention, we successfully achieved a 100% documentation rate for GDM diagnosis for women who previously lacked documentation in their problem list.

Conclusion: This work paves the way for targeted interventions aimed at improving care for women with a history of GDM, including delivery of interventions and education to prevent the onset of an appropriate clinical screening for type 2 diabetes.