Nuha A. ElSayed, R. Bannuru, G. Bakris, Joan Bardsley, Ian H. de Boer, Robert A. Gabbay, Janet Gockerman, Rozalina G. McCoy, Elaine McCracken, Joshua J. Neumiller, Scott J. Pilla, Connie M. Rhee
More than one-third of people with diabetes develop diabetic kidney disease (DKD), which substantially increases risks of kidney failure, cardiovascular disease (CVD), hypoglycemia, death, and other adverse health outcomes. A multifaceted approach incorporating self-management education, lifestyle optimization, pharmacological intervention, CVD prevention, and psychosocial support is crucial to mitigate the onset and progression of DKD. The American Diabetes Association convened an expert panel to develop the DKD Prevention Model presented herein. This model addresses prevention and treatment, including screening guidelines, diagnostic tools, and management approaches; comprehensive, holistic interventions; well-defined roles for interdisciplinary health care professionals; community engagement; and future directions for research and policy.
{"title":"Diabetic Kidney Disease Prevention Care Model Development","authors":"Nuha A. ElSayed, R. Bannuru, G. Bakris, Joan Bardsley, Ian H. de Boer, Robert A. Gabbay, Janet Gockerman, Rozalina G. McCoy, Elaine McCracken, Joshua J. Neumiller, Scott J. Pilla, Connie M. Rhee","doi":"10.2337/cd23-0063","DOIUrl":"https://doi.org/10.2337/cd23-0063","url":null,"abstract":"More than one-third of people with diabetes develop diabetic kidney disease (DKD), which substantially increases risks of kidney failure, cardiovascular disease (CVD), hypoglycemia, death, and other adverse health outcomes. A multifaceted approach incorporating self-management education, lifestyle optimization, pharmacological intervention, CVD prevention, and psychosocial support is crucial to mitigate the onset and progression of DKD. The American Diabetes Association convened an expert panel to develop the DKD Prevention Model presented herein. This model addresses prevention and treatment, including screening guidelines, diagnostic tools, and management approaches; comprehensive, holistic interventions; well-defined roles for interdisciplinary health care professionals; community engagement; and future directions for research and policy.","PeriodicalId":39894,"journal":{"name":"Clinical Diabetes","volume":"65 46","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138594889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicole M. Ehrhardt, V. Aroda, Rodolfo J. Galindo, Anne L. Peters, Jay H. Shubrook
{"title":"Use of Continuous Glucose Monitoring and Glucagon-Like Peptide 1 Receptor Agonist Therapy to Achieve Individualized Treatment Goals in Insulin-Treated People With Type 2 Diabetes: A Case Series and Expert Opinion","authors":"Nicole M. Ehrhardt, V. Aroda, Rodolfo J. Galindo, Anne L. Peters, Jay H. Shubrook","doi":"10.2337/cd23-0047","DOIUrl":"https://doi.org/10.2337/cd23-0047","url":null,"abstract":"","PeriodicalId":39894,"journal":{"name":"Clinical Diabetes","volume":"12 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138601457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Donislecel: First Cellular Therapy to Treat Patients With Brittle Type 1 Diabetes","authors":"Ojashwi Giri, J. Goldman","doi":"10.2337/cd23-0091","DOIUrl":"https://doi.org/10.2337/cd23-0091","url":null,"abstract":"","PeriodicalId":39894,"journal":{"name":"Clinical Diabetes","volume":"35 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139215951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. E. Caballero, Nuha A. ElSayed, S. Golden, R. Bannuru, Brigid Gregg
“Implicit bias,” also called “unconscious bias,” refers to associations outside of conscious awareness that adversely affect one’s perception of a person or group. Awareness of implicit bias has been increasing in the realm of diabetes care. Here, the authors highlight several types of unconscious bias on the part of clinicians and patients, including biases based on race, ethnicity, and obesity. They discuss how these biases can negatively affect patient-centered clinical interactions and diabetes care delivery, and they recommend implementation of evidence-based interventions and other health system policy approaches to reduce the potential impact of such biases in health care settings.
{"title":"Implicit or Unconscious Bias in Diabetes Care","authors":"A. E. Caballero, Nuha A. ElSayed, S. Golden, R. Bannuru, Brigid Gregg","doi":"10.2337/cd23-0048","DOIUrl":"https://doi.org/10.2337/cd23-0048","url":null,"abstract":"“Implicit bias,” also called “unconscious bias,” refers to associations outside of conscious awareness that adversely affect one’s perception of a person or group. Awareness of implicit bias has been increasing in the realm of diabetes care. Here, the authors highlight several types of unconscious bias on the part of clinicians and patients, including biases based on race, ethnicity, and obesity. They discuss how these biases can negatively affect patient-centered clinical interactions and diabetes care delivery, and they recommend implementation of evidence-based interventions and other health system policy approaches to reduce the potential impact of such biases in health care settings.","PeriodicalId":39894,"journal":{"name":"Clinical Diabetes","volume":"38 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139266648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Autumn Stewart-Lynch, Rebekah Meyers, Dina Sidig, Sea-oh McConville, Lindsay Heiple
The American Diabetes Association advises clinicians of the potential for insulin overbasalization in the management of type 2 diabetes. Described as the titration of basal insulin beyond an appropriate dose, overbasalization increases risks for adverse effects such as hypoglycemia and weight gain without achieving the glycemic targets needed to optimally manage the disease. There is a need to determine the prevalence of and clinical factors that can lead to overbasalization. This study aimed to assess the prevalence of and characterize the patient variables associated with overbasalization in a family medicine practice.
{"title":"Quantifying and Characterizing the Presence of Insulin Overbasalization in a Family Medicine Practice","authors":"Autumn Stewart-Lynch, Rebekah Meyers, Dina Sidig, Sea-oh McConville, Lindsay Heiple","doi":"10.2337/cd23-0044","DOIUrl":"https://doi.org/10.2337/cd23-0044","url":null,"abstract":"The American Diabetes Association advises clinicians of the potential for insulin overbasalization in the management of type 2 diabetes. Described as the titration of basal insulin beyond an appropriate dose, overbasalization increases risks for adverse effects such as hypoglycemia and weight gain without achieving the glycemic targets needed to optimally manage the disease. There is a need to determine the prevalence of and clinical factors that can lead to overbasalization. This study aimed to assess the prevalence of and characterize the patient variables associated with overbasalization in a family medicine practice.","PeriodicalId":39894,"journal":{"name":"Clinical Diabetes","volume":"5 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135136729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Priya Prahalad, Holly Hardison, Ori Odugbesan, Sarah Lyons, Mohammed Alwazeer, Anna Neyman, Brian Miyazaki, Kristina Cossen, Susan Hsieh, Donna Eng, Alissa Roberts, Mark A. Clements, Osagie Ebekozien
The American Diabetes Association’s Standards of Care in Diabetes recommends the use of diabetes technology such as continuous glucose monitoring systems and insulin pumps for people living with type 1 diabetes. Unfortunately, there are multiple barriers to uptake of these devices, including local diabetes center practices. This study aimed to examine overall change and center-to-center variation in uptake of diabetes technology across 21 pediatric centers in the T1D Exchange Quality Improvement Collaborative. It found an overall increase in diabetes technology use for most centers from 2021 to 2022 with significant variation.
{"title":"Benchmarking Diabetes Technology Use Among 21 U.S. Pediatric Diabetes Centers","authors":"Priya Prahalad, Holly Hardison, Ori Odugbesan, Sarah Lyons, Mohammed Alwazeer, Anna Neyman, Brian Miyazaki, Kristina Cossen, Susan Hsieh, Donna Eng, Alissa Roberts, Mark A. Clements, Osagie Ebekozien","doi":"10.2337/cd23-0052","DOIUrl":"https://doi.org/10.2337/cd23-0052","url":null,"abstract":"The American Diabetes Association’s Standards of Care in Diabetes recommends the use of diabetes technology such as continuous glucose monitoring systems and insulin pumps for people living with type 1 diabetes. Unfortunately, there are multiple barriers to uptake of these devices, including local diabetes center practices. This study aimed to examine overall change and center-to-center variation in uptake of diabetes technology across 21 pediatric centers in the T1D Exchange Quality Improvement Collaborative. It found an overall increase in diabetes technology use for most centers from 2021 to 2022 with significant variation.","PeriodicalId":39894,"journal":{"name":"Clinical Diabetes","volume":"17 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135271129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ori Odugbesan, Trevon Wright, Nana-Hawa Yayah Jones, Selorm Dei-Tutu, Mary Pat Gallagher, Emily DeWit, Roberto E. Izquierdo, Marisa Desimone, Nicole Rioles, Osagie Ebekozien
Social determinants of health (SDOH) are strongly associated with outcomes for people with type 1 diabetes. Six centers in the T1D Exchange Quality Improvement Collaborative applied quality improvement principles to design iterative Plan-Do-Study-Act cycles to develop and expand interventions to improve SDOH screening rates. The interventions tested include staff training, a social risk index, an electronic health record patient-facing portal, partnerships with community organizations, and referrals to community resources. All centers were successful in improving SDOH screening rates, with individual site improvements ranging from 41 to 70% and overall screening across the six centers increasing from a baseline of 1% to 70% in 27 months.
{"title":"Increasing Social Determinants of Health Screening Rates Among Six Endocrinology Centers Across the United States: Results From the T1D Exchange Quality Improvement Collaborative","authors":"Ori Odugbesan, Trevon Wright, Nana-Hawa Yayah Jones, Selorm Dei-Tutu, Mary Pat Gallagher, Emily DeWit, Roberto E. Izquierdo, Marisa Desimone, Nicole Rioles, Osagie Ebekozien","doi":"10.2337/cd23-0060","DOIUrl":"https://doi.org/10.2337/cd23-0060","url":null,"abstract":"Social determinants of health (SDOH) are strongly associated with outcomes for people with type 1 diabetes. Six centers in the T1D Exchange Quality Improvement Collaborative applied quality improvement principles to design iterative Plan-Do-Study-Act cycles to develop and expand interventions to improve SDOH screening rates. The interventions tested include staff training, a social risk index, an electronic health record patient-facing portal, partnerships with community organizations, and referrals to community resources. All centers were successful in improving SDOH screening rates, with individual site improvements ranging from 41 to 70% and overall screening across the six centers increasing from a baseline of 1% to 70% in 27 months.","PeriodicalId":39894,"journal":{"name":"Clinical Diabetes","volume":"148 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135870886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephanie Zilberman, Jovana Vidovic, Nay Min Tun, Thwe Thwe Tun, Alfred Leong, David Conner
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 a Brooklyn. N.Y. hospital’s initiative to reduce high A1C rates among its patients.
{"title":"New York Presbyterian-Brooklyn Methodist Hospital’s Quality Improvement Project to Targeting High A1C Levels","authors":"Stephanie Zilberman, Jovana Vidovic, Nay Min Tun, Thwe Thwe Tun, Alfred Leong, David Conner","doi":"10.2337/cd22-0109","DOIUrl":"https://doi.org/10.2337/cd22-0109","url":null,"abstract":"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 a Brooklyn. N.Y. hospital’s initiative to reduce high A1C rates among its patients.","PeriodicalId":39894,"journal":{"name":"Clinical Diabetes","volume":"59 3","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136022539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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