Primary Care Diabetes最新文献_第10页

Association between insurance status and prevalence of diabetic retinopathy in patients with diabetes in the United States from 2011 to 2020 2011年至2020年美国糖尿病患者的保险状况与糖尿病视网膜病变患病率之间的关系

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-02-01 DOI: 10.1016/j.pcd.2024.12.007

Jordan Khorsandi , Daniel Kraversky , Jack Martinyan , Prashant Parekh , Grettel Castro , Noël Barengo

Aim

To determine whether an association exists between health insurance and diabetic retinopathy (DR) prevalence in adults with diabetes.

Methods

An analytical cross-sectional study was conducted utilizing the National Health and Nutrition Examination Survey database. 4530 Patients aged ≥ 18 with diabetes from 2011 to 2020 with various insurance types (no insurance, private, Medicare, Medicaid, or other) were evaluated for prevalence of DR, including covariates. Unadjusted and adjusted logistic regression analysis were conducted to calculate odds ratios (OR) and 95 % confidence intervals (CI).

Results

There was no significant association between insurance status and DR prevalence when adjusting for confounders. OR for DR in patients without insurance, Medicare, Medicaid, or other insurance compared to those with private insurance were 1.13 (95 % CI 0.74–1.71), 0.78 (95 % CI 0.54–1.13), 1.20 (95 % CI 0.80–1.81), and 0.81 (95 % CI 0.47–1.37) respectively. However, factors like age ≥ 65 and use of diabetes medication were associated with reduced DR prevalence.

Conclusion

Although insurance status alone does not have an association with the prevalence of DR, this study highlights several confounding variables that potentially influence previously reported associations between insurance status and DR.

目的：确定健康保险与成人糖尿病视网膜病变（DR）患病率之间是否存在关联。方法：利用国家健康与营养检查调查数据库进行分析性横断面研究。4530例年龄≥ 18岁的2011 - 2020年各种保险类型（无保险、私人、医疗保险、医疗补助或其他）的糖尿病患者进行了DR患病率评估，包括协变量。进行未校正和校正logistic回归分析，计算优势比（OR）和95% %置信区间（CI）。结果：在调整混杂因素后，保险状况与DR患病率之间没有显著关联。无保险、医疗保险、医疗补助或其他保险的患者与有私人保险的患者相比，DR的OR分别为1.13（95 % CI 0.74-1.71）、0.78（95 % CI 0.54-1.13）、1.20（95 % CI 0.80-1.81）和0.81（95 % CI 0.47-1.37）。然而，年龄≥ 65岁和使用糖尿病药物等因素与DR患病率降低有关。结论：虽然保险状况本身与DR患病率没有关联，但本研究强调了几个可能影响先前报道的保险状况与DR之间关联的混杂变量。

{"title":"Association between insurance status and prevalence of diabetic retinopathy in patients with diabetes in the United States from 2011 to 2020","authors":"Jordan Khorsandi , Daniel Kraversky , Jack Martinyan , Prashant Parekh , Grettel Castro , Noël Barengo","doi":"10.1016/j.pcd.2024.12.007","DOIUrl":"10.1016/j.pcd.2024.12.007","url":null,"abstract":"<div><h3>Aim</h3><div>To determine whether an association exists between health insurance and diabetic retinopathy (DR) prevalence in adults with diabetes.</div></div><div><h3>Methods</h3><div>An analytical cross-sectional study was conducted utilizing the National Health and Nutrition Examination Survey database. 4530 Patients aged ≥ 18 with diabetes from 2011 to 2020 with various insurance types (no insurance, private, Medicare, Medicaid, or other) were evaluated for prevalence of DR, including covariates. Unadjusted and adjusted logistic regression analysis were conducted to calculate odds ratios (OR) and 95 % confidence intervals (CI).</div></div><div><h3>Results</h3><div>There was no significant association between insurance status and DR prevalence when adjusting for confounders. OR for DR in patients without insurance, Medicare, Medicaid, or other insurance compared to those with private insurance were 1.13 (95 % CI 0.74–1.71), 0.78 (95 % CI 0.54–1.13), 1.20 (95 % CI 0.80–1.81), and 0.81 (95 % CI 0.47–1.37) respectively. However, factors like age ≥ 65 and use of diabetes medication were associated with reduced DR prevalence.</div></div><div><h3>Conclusion</h3><div>Although insurance status alone does not have an association with the prevalence of DR, this study highlights several confounding variables that potentially influence previously reported associations between insurance status and DR.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 1","pages":"Pages 46-52"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial Board and Aims & Scopes 编辑委员会和目标与范围

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-02-01 DOI: 10.1016/S1751-9918(25)00013-0

引用次数: 0

Assessment of healthcare utilization in diabetes patients according to foot risk level 糖尿病患者足部危险程度对医疗保健利用的评价。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-02-01 DOI: 10.1016/j.pcd.2024.12.005

Cristina Blaya Fernández , Alba Gracia-Sánchez , Sara Zúnica-García , Esther Chicharro-Luna

Aims

To quantify healthcare service utilization over the past two years according to the foot risk level in patients with type 2 diabetes (T2DM).

Methodology

A descriptive observational study was conducted in a Primary Care Nursing consultation, evaluating patients with T2DM through examination and collection of sociodemographic and clinical data.

Results

A total of 153 patients were included. The prevalence of underdiagnosis was 71.2 % for neuropathy and 59.5 % for peripheral arterial disease. Patients with a high foot risk level had more consultations in PC Nursing for foot-related issues (2022 y 2023; p=<0.001). The number of hospitalization days in 2022 was also higher in patients with a high foot risk. Patients with diagnosed neuropathy consistently utilized healthcare services more frequently than those with undiagnosed or no neuropathy across most categories.

Conclusion

Patients with a high foot risk level consume more healthcare resources. Early detection and management of diabetic foot is crucial to avoid underdiagnosis, optimize resource use, and prevent serious complications.

目的：根据2型糖尿病（T2DM）患者足部风险水平，量化过去两年的医疗保健服务利用情况。方法：在初级保健护理咨询中进行了一项描述性观察研究，通过检查和收集社会人口学和临床数据来评估2型糖尿病患者。结果：共纳入153例患者。神经病变的漏诊率为71.2%，外周动脉疾病为59.5%。高足部风险水平的患者在PC护理中有更多的足部相关问题咨询(2022 - 2023；p=结论：足部危险程度高的患者消耗更多的医疗资源。糖尿病足的早期发现和管理对于避免漏诊、优化资源利用和预防严重并发症至关重要。

{"title":"Assessment of healthcare utilization in diabetes patients according to foot risk level","authors":"Cristina Blaya Fernández , Alba Gracia-Sánchez , Sara Zúnica-García , Esther Chicharro-Luna","doi":"10.1016/j.pcd.2024.12.005","DOIUrl":"10.1016/j.pcd.2024.12.005","url":null,"abstract":"<div><h3>Aims</h3><div>To quantify healthcare service utilization over the past two years according to the foot risk level in patients with type 2 diabetes (T2DM).</div></div><div><h3>Methodology</h3><div>A descriptive observational study was conducted in a Primary Care Nursing consultation, evaluating patients with T2DM through examination and collection of sociodemographic and clinical data.</div></div><div><h3>Results</h3><div>A total of 153 patients were included. The prevalence of underdiagnosis was 71.2 % for neuropathy and 59.5 % for peripheral arterial disease. Patients with a high foot risk level had more consultations in PC Nursing for foot-related issues (2022 y 2023; p=<0.001). The number of hospitalization days in 2022 was also higher in patients with a high foot risk. Patients with diagnosed neuropathy consistently utilized healthcare services more frequently than those with undiagnosed or no neuropathy across most categories.</div></div><div><h3>Conclusion</h3><div>Patients with a high foot risk level consume more healthcare resources. Early detection and management of diabetic foot is crucial to avoid underdiagnosis, optimize resource use, and prevent serious complications.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 1","pages":"Pages 53-60"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142901553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incidence and factors associated with new depressive episodes in adults with newly treated type 2 diabetes: A cohort study 新治疗的成人2型糖尿病患者新发抑郁发作的发生率和相关因素：一项队列研究

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-02-01 DOI: 10.1016/j.pcd.2024.12.001

Jessica Kuntz, Candace Necyk, Scot H. Simpson

Aims

Several methods are available to help identify people with depression; however, there is little guidance on when to start screening. This study estimated the incidence of new depressive episodes and identified factors associated with onset in adults with newly treated type 2 diabetes.

Methods

Administrative health data from Alberta, Canada was used to identify people starting metformin between April 2011 and March 2015. People with a history of depression before metformin initiation were excluded. Person-time analysis was used to calculate the incidence rate of new depressive episodes over the next 3 years, stratified by sex, age, and year. Multivariable logistic regression was used to identify factors independently associated with a new depressive episode.

Results

42,694 adults initiated metformin; mean age 56 years, 38 % female. A new depressive episode occurred in 2752 (6 %) individuals, mean time to onset was 1.4 years and overall incidence rate was 22.3/1000 person-years. Factors associated with a new depressive episode were female sex, younger age, previous mental health conditions, frequent healthcare utilization, and multiple comorbid conditions.

Conclusions

Screening for depression should begin within 1–2 years of metformin initiation and focus on females, those < 55 years old, those with a history of mental health conditions, and those with multiple comorbid conditions.

目的：有几种方法可以帮助识别抑郁症患者；然而，关于何时开始筛查的指导很少。本研究估计了新治疗的2型糖尿病成人患者新发抑郁发作的发生率，并确定了与发病相关的因素。方法：采用加拿大艾伯塔省的行政卫生数据，确定2011年4月至2015年3月期间开始使用二甲双胍的人群。在开始使用二甲双胍之前有抑郁史的人被排除在外。根据性别、年龄和年份，采用人-时间分析计算未来3年内新发抑郁发作的发生率。使用多变量逻辑回归来确定与新抑郁发作独立相关的因素。结果：42,694名成人开始使用二甲双胍；平均年龄56岁，38% %女性。2752人（6 %）出现新的抑郁发作，平均发病时间为1.4年，总发病率为22.3/1000人年。与新发抑郁发作相关的因素为女性、年龄较小、既往精神健康状况、频繁的医疗保健利用和多种合并症。结论：抑郁症筛查应在开始服用二甲双胍1-2年内开始，并以女性为重点

{"title":"Incidence and factors associated with new depressive episodes in adults with newly treated type 2 diabetes: A cohort study","authors":"Jessica Kuntz, Candace Necyk, Scot H. Simpson","doi":"10.1016/j.pcd.2024.12.001","DOIUrl":"10.1016/j.pcd.2024.12.001","url":null,"abstract":"<div><h3>Aims</h3><div>Several methods are available to help identify people with depression; however, there is little guidance on when to start screening. This study estimated the incidence of new depressive episodes and identified factors associated with onset in adults with newly treated type 2 diabetes.</div></div><div><h3>Methods</h3><div>Administrative health data from Alberta, Canada was used to identify people starting metformin between April 2011 and March 2015. People with a history of depression before metformin initiation were excluded. Person-time analysis was used to calculate the incidence rate of new depressive episodes over the next 3 years, stratified by sex, age, and year. Multivariable logistic regression was used to identify factors independently associated with a new depressive episode.</div></div><div><h3>Results</h3><div>42,694 adults initiated metformin; mean age 56 years, 38 % female. A new depressive episode occurred in 2752 (6 %) individuals, mean time to onset was 1.4 years and overall incidence rate was 22.3/1000 person-years. Factors associated with a new depressive episode were female sex, younger age, previous mental health conditions, frequent healthcare utilization, and multiple comorbid conditions.</div></div><div><h3>Conclusions</h3><div>Screening for depression should begin within 1–2 years of metformin initiation and focus on females, those < 55 years old, those with a history of mental health conditions, and those with multiple comorbid conditions.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 1","pages":"Pages 21-28"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Glycemic and weight control in people with type 2 diabetes: A real-world observational study in primary care 2型糖尿病患者血糖和体重控制：一项现实世界初级保健观察性研究

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-02-01 DOI: 10.1016/j.pcd.2024.12.002

D Orozco-Beltran , M Mata-Cases , S Artola-Menéndez , F Álvarez-Guisasola , AM Cebrián-Cuenca , A Pérez , DIAMOND2 Study Coordinating Group. On behalf of the study investigators

Aims

To analyze glycemic and bodyweight control in people with type 2 diabetes mellitus (T2DM), and prescribing patterns in primary care.

Methods

We reviewed the electronic medical records of 5009 randomly selected T2DM patients, from 70 health centers in Spain. We analyzed results by age group and presence/absence of obesity. All data were collected in 2022.

Results

Regarding treatment, 13.2 % of the sample were on lifestyle therapy only, 76.5 % received metformin, 37.6 % SGLT2 inhibitors, 32.2 % DPP-4 inhibitors, 12.2 % GLP-1 agonists, 18.9 % insulin, 6.5 % sulfonylureas, and 1.3 % glitazones. Glycated Hemoglobin (HbA1c) was below 7 % in 57.7 % of patients, and 62.3 % met their individualized HbA1c targets. Overall, 42 % of the population was obese (45.6 % of women vs 39.1 % of men; p = 0.001). Obesity rates decreased with age in both sexes. We found no association between obesity and poor glycemic control (HbA1c<7 %) (43,5 % vs 41,4 %; p = 0,17).

Conclusions

In 2022, over 60 % of people with T2DM treated by family doctors in Spain met their individualized glycemic control targets, but only one in three had good glycemic control without obesity. The use of drugs with cardiorenal benefits (particularly SGLT2 inhibitors) is higher than previous published data in our setting.

目的：分析2型糖尿病（T2DM）患者的血糖和体重控制，以及初级保健的处方模式。方法：我们回顾了5009名随机选择的T2DM患者的电子病历，这些患者来自西班牙70个卫生中心。我们按年龄组和有无肥胖来分析结果。所有数据于2022年收集。结果：在治疗方面，13.2 %的样本只接受生活方式治疗，76.5 %的样本接受二甲双胍、37.6% %的SGLT2抑制剂、32.2% %的DPP-4抑制剂、12.2 %的GLP-1激动剂、18.9% %的胰岛素、6.5 %的磺脲类药物和1.3 %的格列酮。57.7% %的患者糖化血红蛋白（HbA1c）低于7 %，62.3% %的患者达到个体化HbA1c目标。总体而言，42% %的人口肥胖(女性为45.6% %，男性为39.1% %； = 0.001页)。无论男女，肥胖率都随着年龄的增长而下降。我们发现肥胖和血糖控制不良（hba1）之间没有关联。结论：2022年，西班牙家庭医生治疗的2型糖尿病患者中，超过60% %达到了他们的个体化血糖控制目标，但只有三分之一的人血糖控制良好，没有肥胖。在我们的研究中，对心肾有益的药物（尤其是SGLT2抑制剂）的使用高于之前发表的数据。

{"title":"Glycemic and weight control in people with type 2 diabetes: A real-world observational study in primary care","authors":"D Orozco-Beltran , M Mata-Cases , S Artola-Menéndez , F Álvarez-Guisasola , AM Cebrián-Cuenca , A Pérez , DIAMOND2 Study Coordinating Group. On behalf of the study investigators","doi":"10.1016/j.pcd.2024.12.002","DOIUrl":"10.1016/j.pcd.2024.12.002","url":null,"abstract":"<div><h3>Aims</h3><div>To analyze glycemic and bodyweight control in people with type 2 diabetes mellitus (T2DM), and prescribing patterns in primary care.</div></div><div><h3>Methods</h3><div>We reviewed the electronic medical records of 5009 randomly selected T2DM patients, from 70 health centers in Spain. We analyzed results by age group and presence/absence of obesity. All data were collected in 2022.</div></div><div><h3>Results</h3><div>Regarding treatment, 13.2 % of the sample were on lifestyle therapy only, 76.5 % received metformin, 37.6 % SGLT2 inhibitors, 32.2 % DPP-4 inhibitors, 12.2 % GLP-1 agonists, 18.9 % insulin, 6.5 % sulfonylureas, and 1.3 % glitazones. Glycated Hemoglobin (HbA1c) was below 7 % in 57.7 % of patients, and 62.3 % met their individualized HbA1c targets. Overall, 42 % of the population was obese (45.6 % of women vs 39.1 % of men; p = 0.001). Obesity rates decreased with age in both sexes. We found no association between obesity and poor glycemic control (HbA1c<7 %) (43,5 % vs 41,4 %; p = 0,17).</div></div><div><h3>Conclusions</h3><div>In 2022, over 60 % of people with T2DM treated by family doctors in Spain met their individualized glycemic control targets, but only one in three had good glycemic control without obesity. The use of drugs with cardiorenal benefits (particularly SGLT2 inhibitors) is higher than previous published data in our setting.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 1","pages":"Pages 7-14"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diabetic myonecrosis: A rare complication of long-standing diabetes mellitus 糖尿病肌坏死：长期糖尿病的罕见并发症。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-02-01 DOI: 10.1016/j.pcd.2024.11.001

Rosamaria Dias , Ovie Enaohwo , Richard Felli , Aman Garg , Meet Shah , Kathleen Beebe

Background

Diabetes mellitus is a rapidly growing health illness worldwide and its incidence is expected to continue rising. Various complications have been cited including retinopathy, nephropathy, peripheral artery disease and ulceration among others. However, rarer complications such as diabetic myonecrosis are limited in literature. This case report demonstrates the presentation of this complication to allow for earlier detection and treatment by providers.

Case report

This case highlights a 49-year-old man with an extensive past medical history inclusive of diabetes mellitus type 2, who presented with acute onset left thigh pain and swelling. On presentation, the patient has an HbA1c of 8 % and hyperpigmented spots were noted bilaterally on the lower extremities. Initial management was centered around infectious etiologies and management which failed to improve his symptoms. Further work-up included a negative lower extremity duplex ultrasound and a CT scan showing a hypodense lesion in the left lower extremity. Following unsuccessful drainage of the lesion to assess for a possible abscess, MRI of the lower extremities showed bilateral myositis and myonecrosis centered in the left vastus medialis.

Conclusion

This case report highlights a rare complication of diabetes mellitus known as diabetic myonecrosis (DMN). The gold-standard diagnostic tool is a muscle biopsy, however, sensitive imaging like MRI and clinical context are sufficient for a diagnosis. Supportive care centered around pain management remains the standard of care. While this remains as a diagnosis of exclusion, early identification may decrease the number of unnecessary treatments and should remain as a differential in patients with this presentation.

背景：糖尿病是全球迅速增长的健康疾病，其发病率预计将继续上升。各种并发症包括视网膜病变、肾病、外周动脉疾病和溃疡等。然而，像糖尿病肌坏死这样罕见的并发症在文献中却很少见。本病例报告展示了这种并发症的表现形式，以便医疗人员及早发现和治疗：本病例重点描述了一名 49 岁的男性患者，既往病史丰富，患有 2 型糖尿病，因急性发作的左大腿疼痛和肿胀而就诊。就诊时，患者的 HbA1c 为 8%，双侧下肢出现色素沉着斑。最初的治疗以感染病因为中心，但未能改善症状。进一步的检查包括下肢双频超声检查呈阴性，CT 扫描显示左下肢有低密度病变。在对病灶进行引流以评估是否可能存在脓肿未果后，下肢核磁共振成像显示双侧肌炎和以左内侧阔肌为中心的肌坏死：本病例报告强调了糖尿病的一种罕见并发症--糖尿病肌坏死（DMN）。金标准诊断工具是肌肉活检，然而，敏感的成像（如核磁共振成像）和临床背景足以做出诊断。以疼痛管理为中心的支持性治疗仍然是标准的治疗方法。虽然这仍是一种排除性诊断，但早期识别可减少不必要的治疗次数，因此仍应作为有这种表现的患者的鉴别诊断。

{"title":"Diabetic myonecrosis: A rare complication of long-standing diabetes mellitus","authors":"Rosamaria Dias , Ovie Enaohwo , Richard Felli , Aman Garg , Meet Shah , Kathleen Beebe","doi":"10.1016/j.pcd.2024.11.001","DOIUrl":"10.1016/j.pcd.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Diabetes mellitus is a rapidly growing health illness worldwide and its incidence is expected to continue rising. Various complications have been cited including retinopathy, nephropathy, peripheral artery disease and ulceration among others. However, rarer complications such as diabetic myonecrosis are limited in literature. This case report demonstrates the presentation of this complication to allow for earlier detection and treatment by providers.</div></div><div><h3>Case report</h3><div>This case highlights a 49-year-old man with an extensive past medical history inclusive of diabetes mellitus type 2, who presented with acute onset left thigh pain and swelling. On presentation, the patient has an HbA1c of 8 % and hyperpigmented spots were noted bilaterally on the lower extremities. Initial management was centered around infectious etiologies and management which failed to improve his symptoms. Further work-up included a negative lower extremity duplex ultrasound and a CT scan showing a hypodense lesion in the left lower extremity. Following unsuccessful drainage of the lesion to assess for a possible abscess, MRI of the lower extremities showed bilateral myositis and myonecrosis centered in the left vastus medialis.</div></div><div><h3>Conclusion</h3><div>This case report highlights a rare complication of diabetes mellitus known as diabetic myonecrosis (DMN). The gold-standard diagnostic tool is a muscle biopsy, however, sensitive imaging like MRI and clinical context are sufficient for a diagnosis. Supportive care centered around pain management remains the standard of care. While this remains as a diagnosis of exclusion, early identification may decrease the number of unnecessary treatments and should remain as a differential in patients with this presentation.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 1","pages":"Pages 82-85"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Factors influencing the uptake of culturally tailored diabetes self-management education and support programmes among ethnic minority patients with type 2 diabetes: A systematic review 影响少数民族2型糖尿病患者接受文化定制的糖尿病自我管理教育和支持计划的因素：一项系统综述

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-02-01 DOI: 10.1016/j.pcd.2025.01.010

Sariata Abu , Sofia Llahana

Purpose

This systematic review aimed to evaluate the factors influencing the uptake of culturally-tailored Diabetes Self-Management Education and Support (DSMES) programmes among ethnic minority patients diagnosed with type 2 diabetes mellitus (T2DM).

Methods

A systematic review, following PRISMA guidelines, was conducted, including quantitative research studies published in peer-reviewed journals from January 2013 to January 2023. Studies were extracted via the following databases, AMED, MEDLINE, CINAHL, EMBASE, EMCARE, PSYCHINFO, Ovid Nursing, and grey literature. Studies were selected based on eligibility criteria including the evaluation of DSMES programmes tailored for ethnic minorities and involving adult participants with T2DM. The factors affecting the uptake of these programs were mapped against the three categories of the Andersen's Behavioural Model of Health Services Use: predisposing, enabling, and need factors. The quality of the included studies was assessed using the Critical Appraisal Skills Program (CASP) checklist, and a narrative synthesis was conducted to analyse the findings.

Results

Nine studies met the inclusion criteria, demonstrating that culturally-tailored DSMES programmes significantly improve uptake among ethnic minorities. Key factors influencing participation included demographic characteristics, diabetes knowledge, emotional support, and cultural beliefs. Barriers such as language proficiency, cost, and diabetes fatalism were identified, while enablers included the use of local champions and culturally specific strategies.

Conclusions

This systematic review highlights the effectiveness of culturally-tailored DSMES programmes in improving health outcomes among ethnic minority groups. It suggests that more research is needed to explore these barriers and develop strategies to enhance the uptake of DSMES programmes among underserved populations.

目的：本系统综述旨在评估影响少数民族2型糖尿病（T2DM）患者接受文化定制的糖尿病自我管理教育和支持（DSMES）计划的因素。方法：系统回顾2013年1月至2023年1月期间发表在同行评议期刊上的定量研究，遵循PRISMA指南。研究通过以下数据库提取：AMED、MEDLINE、CINAHL、EMBASE、EMCARE、PSYCHINFO、Ovid Nursing和灰色文献。研究的选择基于资格标准，包括为少数民族量身定制的DSMES项目的评估，并涉及患有2型糖尿病的成年参与者。根据安徒生的卫生服务使用行为模型的三类：易感因素、使能因素和需求因素，绘制了影响这些方案采用的因素。采用关键评估技能计划（CASP）检查表对纳入研究的质量进行评估，并进行叙述性综合分析以分析研究结果。结果：9项研究符合纳入标准，表明文化定制的DSMES计划显著提高了少数民族的吸收。影响参与的主要因素包括人口统计学特征、糖尿病知识、情感支持和文化信仰。确定了语言熟练程度、成本和糖尿病宿命论等障碍，而促成因素包括使用当地冠军和文化特定战略。结论：本系统综述强调了文化定制的DSMES计划在改善少数民族群体健康结果方面的有效性。它表明，需要更多的研究来探索这些障碍，并制定战略，以便在服务不足的人口中加强对DSMES方案的吸收。

{"title":"Factors influencing the uptake of culturally tailored diabetes self-management education and support programmes among ethnic minority patients with type 2 diabetes: A systematic review","authors":"Sariata Abu , Sofia Llahana","doi":"10.1016/j.pcd.2025.01.010","DOIUrl":"10.1016/j.pcd.2025.01.010","url":null,"abstract":"<div><h3>Purpose</h3><div>This systematic review aimed to evaluate the factors influencing the uptake of culturally-tailored Diabetes Self-Management Education and Support (DSMES) programmes among ethnic minority patients diagnosed with type 2 diabetes mellitus (T2DM).</div></div><div><h3>Methods</h3><div>A systematic review, following PRISMA guidelines, was conducted, including quantitative research studies published in peer-reviewed journals from January 2013 to January 2023. Studies were extracted via the following databases, AMED, MEDLINE, CINAHL, EMBASE, EMCARE, PSYCHINFO, Ovid Nursing, and grey literature. Studies were selected based on eligibility criteria including the evaluation of DSMES programmes tailored for ethnic minorities and involving adult participants with T2DM. The factors affecting the uptake of these programs were mapped against the three categories of the Andersen's Behavioural Model of Health Services Use: predisposing, enabling, and need factors. The quality of the included studies was assessed using the Critical Appraisal Skills Program (CASP) checklist, and a narrative synthesis was conducted to analyse the findings.</div></div><div><h3>Results</h3><div>Nine studies met the inclusion criteria, demonstrating that culturally-tailored DSMES programmes significantly improve uptake among ethnic minorities. Key factors influencing participation included demographic characteristics, diabetes knowledge, emotional support, and cultural beliefs. Barriers such as language proficiency, cost, and diabetes fatalism were identified, while enablers included the use of local champions and culturally specific strategies.</div></div><div><h3>Conclusions</h3><div>This systematic review highlights the effectiveness of culturally-tailored DSMES programmes in improving health outcomes among ethnic minority groups. It suggests that more research is needed to explore these barriers and develop strategies to enhance the uptake of DSMES programmes among underserved populations.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 2","pages":"Pages 103-110"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pain management and social functioning limitations among adults with chronic pain by diabetes status: National Health Interview Survey, United States, 2019–2020 糖尿病成人慢性疼痛患者的疼痛管理和社会功能限制：美国国家健康访谈调查，2019-2020

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-02-01 DOI: 10.1016/j.pcd.2024.12.008

Ibrahim Zaganjor, Ryan Saelee, Yoshihisa Miyamoto, Fang Xu, Meda E. Pavkov

Aims

This study aims to describe pain management technique usage and social functioning limitations among adults with chronic pain by diabetes status.

Methods

The 2019 and 2020 National Health Interview Survey data were pooled to complete this analysis. Use of the following techniques in the past 3 months were measured: 1) prescription opioids; 2) physical, rehabilitative, or occupational therapy; 3) talk therapies; 4) chiropractic care; 5) yoga, Tai Chi, or Qi Gong; 6) massage; and 7) relaxation techniques. The social functioning limitations assessed were: 1) doing errands alone; 2) participating in social activities; and 3) work limitations. Weighted prevalence and 95 % confidence intervals (CIs) were estimated for each outcome by diabetes status. Logistic regression was used to estimate age- and sex-adjusted odds ratios (aORs) to assess differences by diabetes status.

Results

Adults with diabetes and chronic pain were more likely to use prescription opioids (aOR: 1.4; 95 % CI: 1.2, 1.6) but less likely to use various nonpharmacological techniques than those without diabetes. Additionally, adults with diabetes and chronic pain were more likely to report each social functioning limitation than those without diabetes.

Conclusions

Results suggest adults with diabetes and chronic pain may be missing beneficial opportunities to manage pain.

目的：本研究旨在描述糖尿病慢性疼痛成人患者的疼痛管理技术使用和社会功能限制。方法：收集2019年和2020年全国健康访谈调查数据，完成分析。对近3个月内使用以下技术进行了测量：1)处方阿片类药物；2)物理、康复或职业治疗；3)谈话疗法；4)捏脊护理；5)瑜伽、太极或气功；6)按摩;还有放松技巧。评估的社会功能限制包括：1)独自办事；2)参加社会活动；3)工作限制。加权患病率和95 %置信区间（ci）根据糖尿病状况对每个结果进行估计。使用逻辑回归估计年龄和性别调整的优势比（aORs）来评估糖尿病状态的差异。结果：患有糖尿病和慢性疼痛的成年人更倾向于使用处方阿片类药物(aOR: 1.4；95 % CI: 1.2, 1.6)，但使用各种非药物技术的可能性低于非糖尿病患者。此外，患有糖尿病和慢性疼痛的成年人比没有糖尿病的人更有可能报告每种社会功能限制。结论：结果表明糖尿病和慢性疼痛的成年人可能错过了控制疼痛的有益机会。

{"title":"Pain management and social functioning limitations among adults with chronic pain by diabetes status: National Health Interview Survey, United States, 2019–2020","authors":"Ibrahim Zaganjor, Ryan Saelee, Yoshihisa Miyamoto, Fang Xu, Meda E. Pavkov","doi":"10.1016/j.pcd.2024.12.008","DOIUrl":"10.1016/j.pcd.2024.12.008","url":null,"abstract":"<div><h3>Aims</h3><div>This study aims to describe pain management technique usage and social functioning limitations among adults with chronic pain by diabetes status.</div></div><div><h3>Methods</h3><div>The 2019 and 2020 National Health Interview Survey data were pooled to complete this analysis. Use of the following techniques in the past 3 months were measured: 1) prescription opioids; 2) physical, rehabilitative, or occupational therapy; 3) talk therapies; 4) chiropractic care; 5) yoga, Tai Chi, or Qi Gong; 6) massage; and 7) relaxation techniques. The social functioning limitations assessed were: 1) doing errands alone; 2) participating in social activities; and 3) work limitations. Weighted prevalence and 95 % confidence intervals (CIs) were estimated for each outcome by diabetes status. Logistic regression was used to estimate age- and sex-adjusted odds ratios (aORs) to assess differences by diabetes status.</div></div><div><h3>Results</h3><div>Adults with diabetes and chronic pain were more likely to use prescription opioids (aOR: 1.4; 95 % CI: 1.2, 1.6) but less likely to use various nonpharmacological techniques than those without diabetes. Additionally, adults with diabetes and chronic pain were more likely to report each social functioning limitation than those without diabetes.</div></div><div><h3>Conclusions</h3><div>Results suggest adults with diabetes and chronic pain may be missing beneficial opportunities to manage pain.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 1","pages":"Pages 40-45"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevalence of prediabetes according to sleep apnea status 与睡眠呼吸暂停状态相关的前驱糖尿病患病率。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-02-01 DOI: 10.1016/j.pcd.2024.12.004

Yoo Jin Um , Ho Kim , Joohon Sung , Yoo Hyun Um , Sung-il Cho

Aim

The association between obstructive sleep apnea (OSA) and prediabetes using the STOP-Bang questionnaire remains unknown. We aimed to investigate the prevalence of prediabetes among people based on their sleep apnea status.

Methods

This cross-sectional study included 10131 Korean adults without diabetes with information of STOP-Bang scores, drawn from the dataset of the Korea National Health and Nutrition Examination Survey 2019–2021. Prediabetes was defined in three subsets: only by fasting blood glucose (FBG) (FBG 100–125 mg/dL, HbA1c <5.7 %), only by HbA1c (FBG <100 mg/dL, HbA1c 5.7–6.4 %) or by both. We used multivariable logistic regression to assess the odds ratio (OR) and 95 % confidence intervals (CIs) for prediabetes.

Results

A total of 3828 subjects reported a STOP-Bang score of ≥ 3, which shows increased risk of OSA. Multivariable-adjusted OR (95 % CI) showed that a STOP-Bang score ≥ 3 was associated with prediabetes meeting both FBG and HbA1c criteria (OR 1.06; 95 % CI 1.01–1.12). This association was statistically significant among women, particularly postmenopausal women (OR 1.20, 95 % CI 1.10–1.30; OR 1.21, 95 % CI 1.11–1.32, respectively).

Conclusion

In Korean general population, a significant correlation between higher OSA risk and prediabetes was observed, especially in postmenopausal women.

目的：使用STOP-Bang问卷调查阻塞性睡眠呼吸暂停（OSA）和前驱糖尿病之间的关系尚不清楚。我们的目的是根据人们的睡眠呼吸暂停状态来调查前驱糖尿病的患病率。方法：本横断面研究纳入10131名无糖尿病的韩国成年人，并提供STOP-Bang评分信息，数据来自2019-2021年韩国国家健康与营养检查调查数据集。糖尿病前期分为三个亚群：仅通过空腹血糖（FBG）（FBG 100-125 mg/dL, HbA1c）来定义。结果：共有3828名受试者报告STOP-Bang评分≥ 3，表明OSA的风险增加。多变量校正OR（95 % CI）显示STOP-Bang评分≥ 3与糖尿病前期同时满足FBG和HbA1c标准相关(OR 1.06；95 % ci 1.01-1.12)。这种关联在女性中具有统计学意义，尤其是绝经后女性(OR 1.20, 95 % CI 1.10-1.30；OR 1.21, 95 % CI分别为1.11-1.32)。结论：在韩国普通人群中，观察到OSA高风险与前驱糖尿病之间存在显著相关性，尤其是绝经后妇女。

{"title":"Prevalence of prediabetes according to sleep apnea status","authors":"Yoo Jin Um , Ho Kim , Joohon Sung , Yoo Hyun Um , Sung-il Cho","doi":"10.1016/j.pcd.2024.12.004","DOIUrl":"10.1016/j.pcd.2024.12.004","url":null,"abstract":"<div><h3>Aim</h3><div>The association between obstructive sleep apnea (OSA) and prediabetes using the STOP-Bang questionnaire remains unknown. We aimed to investigate the prevalence of prediabetes among people based on their sleep apnea status.</div></div><div><h3>Methods</h3><div>This cross-sectional study included 10131 Korean adults without diabetes with information of STOP-Bang scores, drawn from the dataset of the Korea National Health and Nutrition Examination Survey 2019–2021. Prediabetes was defined in three subsets: only by fasting blood glucose (FBG) (FBG 100–125 mg/dL, HbA1c <5.7 %), only by HbA1c (FBG <100 mg/dL, HbA1c 5.7–6.4 %) or by both. We used multivariable logistic regression to assess the odds ratio (OR) and 95 % confidence intervals (CIs) for prediabetes.</div></div><div><h3>Results</h3><div>A total of 3828 subjects reported a STOP-Bang score of ≥ 3, which shows increased risk of OSA. Multivariable-adjusted OR (95 % CI) showed that a STOP-Bang score ≥ 3 was associated with prediabetes meeting both FBG and HbA1c criteria (OR 1.06; 95 % CI 1.01–1.12). This association was statistically significant among women, particularly postmenopausal women (OR 1.20, 95 % CI 1.10–1.30; OR 1.21, 95 % CI 1.11–1.32, respectively).</div></div><div><h3>Conclusion</h3><div>In Korean general population, a significant correlation between higher OSA risk and prediabetes was observed, especially in postmenopausal women.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 1","pages":"Pages 61-65"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Positive association of oscillometrically estimated baseline arterial stiffness with incident diabetes and prediabetes: A large population-based cohort study 振荡估计基线动脉硬度与糖尿病和糖尿病前期的正相关：一项基于人群的队列研究。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-02-01 DOI: 10.1016/j.pcd.2024.12.006

Angela L. Beros , John D. Sluyter , Alun D. Hughes , Bernhard Hametner , Siegfried Wassertheurer , Robert Scragg

Aims

This large population-based study aimed to investigate whether arterial stiffness, assessed oscillometrically, was associated with incident diabetes/prediabetes.

Methods

The study sample comprised 4240 participants from the Vitamin D Assessment (ViDA) Study (mean±SD age = 66 ± 8). Arterial stiffness was assessed from 5 April 2011–6 November 2012 by way of aortic PWV (aPWV) and estimated carotid-femoral PWV (ecfPWV). Incident diabetes/prediabetes was determined by linkage to dispensed prescription and national hospital discharge registers. Cox proportional hazards regression was used to assess the risk of diabetes/prediabetes in relation to chosen arterial stiffness measures both overall and over quartiles.

Results

During a mean±SD follow-up of 10.5 ± 0.4 years, 470 participants developed diabetes/prediabetes. Following adjustment for potential confounders, aPWV (hazard ratio (HR) per SD increase, 1.40, 95 % CI, 1.19–1.64) was associated with the incidence of diabetes. The risk of incident diabetes was, compared to the first quartile, higher in the fourth quartile of aPWV (HR, 1.98, 95 %CI, 1.26–3.11)(P_trend=0.01).

Conclusions

Arterial stiffness, as measured by aPWV may be a useful predictor of incident diabetes that can be utilized in clinical practice.

目的：这项基于人群的大型研究旨在调查动脉僵硬是否与糖尿病/前驱糖尿病相关。方法：研究样本包括来自维生素D评估（ViDA）研究的4240名参与者（平均±SD年龄= 66 ± 8）。从2011年4月5日至2012年 11月6日，通过主动脉PWV （aPWV）和估计颈-股动脉PWV （ecfPWV）评估动脉僵硬度。通过与配药处方和国家医院出院登记的联系来确定糖尿病/前驱糖尿病的发生率。Cox比例风险回归用于评估糖尿病/前驱糖尿病风险与所选动脉硬度测量的总体和超过四分位数的关系。结果：在平均±SD随访10.5 ± 0.4年期间，470名参与者出现糖尿病/前驱糖尿病。在对潜在混杂因素进行校正后，aPWV（每SD增加的危险比（HR）， 1.40, 95 % CI, 1.19-1.64）与糖尿病的发病率相关。与第1四分位数相比，aPWV的第4四分位数发生糖尿病的风险更高（HR, 1.98, 95 %CI, 1.26-3.11）（p趋势=0.01）。结论：动脉硬度，作为aPWV测量可能是一个有用的预测糖尿病的发生，可用于临床实践。

{"title":"Positive association of oscillometrically estimated baseline arterial stiffness with incident diabetes and prediabetes: A large population-based cohort study","authors":"Angela L. Beros , John D. Sluyter , Alun D. Hughes , Bernhard Hametner , Siegfried Wassertheurer , Robert Scragg","doi":"10.1016/j.pcd.2024.12.006","DOIUrl":"10.1016/j.pcd.2024.12.006","url":null,"abstract":"<div><h3>Aims</h3><div>This large population-based study aimed to investigate whether arterial stiffness, assessed oscillometrically, was associated with incident diabetes/prediabetes.</div></div><div><h3>Methods</h3><div>The study sample comprised 4240 participants from the Vitamin D Assessment (ViDA) Study (mean±SD age = 66 ± 8). Arterial stiffness was assessed from 5 April 2011–6 November 2012 by way of aortic PWV (aPWV) and estimated carotid-femoral PWV (ecfPWV). Incident diabetes/prediabetes was determined by linkage to dispensed prescription and national hospital discharge registers. Cox proportional hazards regression was used to assess the risk of diabetes/prediabetes in relation to chosen arterial stiffness measures both overall and over quartiles.</div></div><div><h3>Results</h3><div>During a mean±SD follow-up of 10.5 ± 0.4 years, 470 participants developed diabetes/prediabetes. Following adjustment for potential confounders, aPWV (hazard ratio (HR) per SD increase, 1.40, 95 % CI, 1.19–1.64) was associated with the incidence of diabetes. The risk of incident diabetes was, compared to the first quartile, higher in the fourth quartile of aPWV (HR, 1.98, 95 %CI, 1.26–3.11)(<em>P</em><sub>trend</sub>=0.01).</div></div><div><h3>Conclusions</h3><div>Arterial stiffness, as measured by aPWV may be a useful predictor of incident diabetes that can be utilized in clinical practice.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 1","pages":"Pages 66-73"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0