Clinical Diabetes最新文献

This qualitative study explored the self-management behaviors, challenges, motivations, and information needs of low-income people with type 2 diabetes. Four themes emerged: 1) low-income adults are navigating behavioral modification amid challenges; 2) low-income adults need comprehensive and personalized education for proficient self-management; 3) digital health tools are desirable; and 4) fear, support, and health aspirations drive self-management engagement. The findings of this study underscore the need for improved clinician awareness of evidence-based diabetes education and support programs, and for innovative approaches to bridge the gap between low-income patients' educational needs and their access to such services.

This study explored the immediate concerns of people at the time of type 2 diabetes diagnosis by comparing perspectives from 18 adults with a recent diagnosis and eight clinicians. Four key themes emerged: 1) concerns about diabetes and its management, 2) communication challenges at diagnosis, 3) inconsistent identification of concerns, and 4) discrepancies between clinicians' actions and patients' satisfaction. The findings highlight the need for improved communication, longer consultations, and personalized support during diagnosis to enhance patient satisfaction and engagement in care.

This article describes and evaluates a multipronged strategy to expand use of the Diabetes Prevention Program (DPP) and diabetes self-management education and support (DSMES) services across a large academic health system. Strategies included streamlining referral processes, embedding diabetes educators in primary care, leveraging consistent leadership messaging, and building partnerships with community organizations. These interventions led to substantial increases in referrals, with 10.8% of 4,397 patients enrolling in DPP and 35.9% of 10,210 enrolling in DSMES. Coordinated, multilevel interventions can effectively increase engagement in these underutilized, evidence-based diabetes care programs.

This article describes a pharmacist-led deprescribing initiative to reduce the incidence of inappropriate rapid-acting insulin use among admitted older adults at an acute care community hospital. Inappropriate use was defined as at least one episode of severe hypoglycemia (blood glucose <40 mg/dL) within 24 hours of insulin lispro administration, two or more episodes of hypoglycemia (blood glucose <70 but >40 mg/dL) within 24 hours of insulin lispro administration, or five or more held administrations of insulin lispro because of euglycemia in a 48-hour period. The initiative led to a 66% observed relative reduction of inappropriate rapid-acting insulin use over 7 months.

Quality Improvement Success Stories are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of Clinical Diabetes. The following article describes an initiative to improve the rate of lipid profile screening in youth with type 2 diabetes at a tertiary children's hospital in Southern California.

Optimal management of hyperglycemia during illness has been hindered by a lack of comprehensive sick-day guidance, particularly for adults with diabetes. Managing glycemia can be challenging during illness because of adaptive counterregulatory hormonal changes, acute stress of illness, altered dietary intake, and effects of medications. People with diabetes may be at risk for severe hypoglycemia and hyperglycemic crisis during illness unless mitigated by close monitoring and medication adjustment. This article provides practical guidance to health care professionals and people with diabetes for safe glycemic management during illness, including considerations for insulin and noninsulin medications, use of insulin technologies, prevention of hypoglycemia and ketoacidosis, steroid use, and pregnancy.

Quality Improvement Success Stories are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of Clinical Diabetes. The following article describes an initiative to reduce the incidence of diabetic ketoacidosis in children with type 1 diabetes at high risk for complications.