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Efficacy of synchronized diabetes monitoring system in patients with type 2 diabetes: Preliminary results of a pilot, randomized clinical trial 同步糖尿病监测系统对2型糖尿病患者的疗效:一项试点、随机临床试验的初步结果
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-02-01 Epub Date: 2025-11-25 DOI: 10.1016/j.pcd.2025.11.005
Mustafa Kahraman , Ummu Mutlu , Hasan Ediz Ozbek , Elif Beyza Boz , Ramazan Cakmak , Serkan Kurt , Hatice Vildan Dudukcu , Huseyin Yildiz , Mehmet Ali Erturk , Gokhan Ozogur , Hatice Nizam Ozogur , Muhammed Ali Aydin , Nizamettin Aydin , Sukru Ozturk , Kubilay Karsidag , Ilhan Satman , Mehmet Akif Karan

Aim

The purpose of this study is to evaluate the applicability and efficacy of the Synchronized Diabetes Monitoring System (SDMs), which consists of a smart cap attached to insulin pens with recording, alarm, alert, and reminder functions, and software that operates via Bluetooth, in patients with type 2 diabetes on insulin treatment.

Methods

The system consists of a smart mobile apparatus mounted on an insulin pen and automatically recording the dose and time of the administered insulin, an application developed for mobile phones that can read blood glucose results from the glucometer, and a website.

Results

The system has been tested in a 6-month pilot cohort of SDMs group (n = 23, 44 % female, age: 50.1 ± 13 years, duration: 12.2 ± 9.2 years) in a transparent, controlled, and single-center pilot trial, showing promising results. The results were compared to the control group (n = 23, age: 54 ± 9.3 years, 52 % female, duration: 13.8 ± 7.4 years). In the third month, we found that they had better glycemic control, as indicated by a decrease in fasting blood glucose (from 147 to 114 mg/dL, p = 0.024) and HbA1c levels (from 8.5 % to 7.2 %, p = 0.003). Additionally, improvements were achieved in physical function, role limitation, and physical and mental health domains of SF-36 survey in patients using the system.

Conclusion

The preliminary results from this pilot study suggest that the synchronized diabetes monitoring system have the potential to improve glycemic control and increase health satisfaction in insulin-treated patients with type 2 diabetes.
目的:本研究的目的是评估同步糖尿病监测系统(SDMs)在2型糖尿病患者胰岛素治疗中的适用性和有效性。该系统由一个连接在具有记录、报警、警报和提醒功能的胰岛素笔上的智能帽和通过蓝牙操作的软件组成。方法:该系统由安装在胰岛素笔上的智能移动设备、可自动记录给药胰岛素的剂量和时间、为手机开发的可读取血糖仪血糖结果的应用程序和网站组成。结果:该系统在为期6个月的SDMs组(n = 23,44 %女性,年龄:50.1 ± 13岁,持续时间:12.2 ± 9.2岁)的透明、对照、单中心先导试验中进行了测试,显示出令人满意的结果。结果与对照组(n = 23例,年龄:54 ± 9.3岁,52 %为女性,病程:13.8 ± 7.4岁)进行比较。在第三个月,我们发现他们有更好的血糖控制,空腹血糖(从147降至114 mg/dL, p = 0.024)和HbA1c水平(从8.5 %降至7.2 %,p = 0.003)。此外,使用该系统的患者在SF-36调查的身体功能、角色限制和身心健康领域均取得了改善。结论:本中试研究的初步结果表明,糖尿病同步监测系统具有改善胰岛素治疗的2型糖尿病患者血糖控制和提高健康满意度的潜力。
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引用次数: 0
Critical appraisal of “impact of a primary care-based mobile health intervention to ‘sit less and move more’ on HbA1c, blood pressure, and other clinical outcomes in office employees with type 2 diabetes” 对“以初级保健为基础的移动健康干预‘少坐多动’对2型糖尿病办公室员工的HbA1c、血压和其他临床结果的影响”进行了批判性评估。
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-02-01 Epub Date: 2025-11-06 DOI: 10.1016/j.pcd.2025.11.002
Himanshu Shekhar, Parth Aphale, Shashank Dokania
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引用次数: 0
Comment on: Cognitive impairment is associated with poor diabetic foot ulcer outcomes 点评:认知障碍与糖尿病足溃疡预后不良相关。
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-02-01 Epub Date: 2025-11-19 DOI: 10.1016/j.pcd.2025.11.003
Shixuan Guo, Juan Shu
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引用次数: 0
High prevalence of undiagnosed obstructive sleep apnoea in older adults with suboptimally-controlled type 2 diabetes and comorbid insomnia 未确诊的阻塞性睡眠呼吸暂停在控制不佳的2型糖尿病和合并症失眠的老年人中高发。
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-02-01 Epub Date: 2025-12-27 DOI: 10.1016/j.pcd.2025.12.003
Chun Kwan O , Rachel NY Chan , Ka Pang Chan , Hongjiang Wu , Fanny MF Lam , Hester HC Lee , Elaine YK Chow , Andrea OY Luk , Ronald CW Ma , Yun Kwok Wing , Juliana CN Chan , Alice PS Kong

Background

We aimed to explore the prevalence of and clinical factors that identify obstructive sleep apnoea (OSA) in older adults with suboptimally-controlled type 2 diabetes (T2D) and comorbid insomnia.

Methods

In this cross-sectional analysis, participants had age≥ 60 years, HbA1c7.5–10 % and comorbid insomnia [insomnia severity index (ISI)> 14] with no prior history of OSA. All participants had home sleep apnoea testing done to measure apnoea-hypopnea index (AHI) and completed questionnaires including self-reporting of habitual snoring (≥3 nights/week), Four-Variable Screening Tool (FVST) comprising sex, body mass index (BMI), blood pressure and frequency of snoring, and excessive daytime sleepiness (EDS) [Epworth Sleepiness Scale (ESS) score ≥ 10]. Mild, moderate, and severe OSA were defined by AHI 5 to < 15, ≥ 15 to < 30, and ≥ 30 events/hour respectively.

Results

Among 93 participants(mean age: 68.3 ± 4.8 years, 46 % men, BMI:24.8 ± 3.7 kg/m2), 87 % had OSA (43 % moderate-to-severe OSA) and 41.8 % had EDS. A diagnosis of OSA was associated with BMI[odd ratio(OR)1.233(95 %CI:1.015–1.498),p = 0.035], habitual snoring[8.107(2.192–29.977), p = 0.002], and FVST[1.386(1.132–1.698), p = 0.002]. The cut-off value of FVST≥ 5 or ESS≥ 10 had 100 % sensitivity and 20.8 (9.8–31.7)% specificity to detect moderate-to-severe OSA.

Conclusions

Older adults with suboptimally-controlled T2D and comorbid insomnia had high prevalence of undiagnosed OSA with FVST and EDS as potentially useful screening tools.
背景:我们的目的是探讨阻塞性睡眠呼吸暂停(OSA)在老年控制欠佳的2型糖尿病(T2D)和合并症失眠患者中的患病率和临床因素。方法:在本横断面分析中,参与者年龄≥ 60岁,hba1c7.5 - %,共病性失眠[失眠严重程度指数(ISI)> 14],无OSA病史。所有参与者在家中进行睡眠呼吸暂停测试,测量呼吸暂停低通气指数(AHI),并完成问卷调查,包括习惯性打鼾(≥3晚/周)的自我报告,四变量筛选工具(FVST),包括性别、体重指数(BMI)、血压和打鼾频率,以及白天过度嗜睡(EDS) [Epworth嗜睡量表(ESS)评分≥ 10]。轻微、中等和严重的阻塞性睡眠呼吸暂停综合症是由AHI 5结果:在93名参与者(平均年龄:68.3 ± 4.8岁,46 %男性,体重指数:24.8 ±3.7  kg / m2), 87年 %阻塞性睡眠呼吸暂停综合症(43 %是严重阻塞性睡眠呼吸暂停综合症)和41.8 % EDS。OSA的诊断与BMI[奇比(OR)1.233(95 %CI:1.015-1.498),p = 0.035]、习惯性打鼾[8.107(2.192-29.977),p = 0.002]、FVST[1.386(1.132-1.698), p = 0.002]相关。FVST≥ 5或ESS≥ 10的临界值检测中重度OSA的敏感性为100 %,特异性为20.8(9.8-31.7)%。结论:T2D控制不佳并伴有合并症失眠的老年人未确诊OSA的患病率较高,FVST和EDS可作为潜在有用的筛查工具。
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引用次数: 0
Patient-reported experience, patient-reported outcome and overall satisfaction with care: What matters most to people with diabetes? 患者报告的经历、患者报告的结果和总体护理满意度:对糖尿病患者最重要的是什么?
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-02-01 Epub Date: 2025-10-30 DOI: 10.1016/j.pcd.2025.10.004
Nizar Alsubahi , Wim Groot , Ahmed Ali Alzahrani , Milena Pavlova
<div><h3>Background</h3><div>Diabetes management has become a critical healthcare challenge globally, emphasizing the need for patient-centered care to improve the quality of services and enhance treatment outcomes. Patient experiences, perceived outcomes, and satisfaction are crucial to optimizing healthcare delivery, but each reflects different aspects of care. Understanding how these measures relate to each other is key to improving healthcare evaluation and avoiding dependence on a single metric. This study examines how patient-centered care (PCC) is associated with patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs), as well as overall patient satisfaction (PS) among people with diabetes.</div></div><div><h3>Method</h3><div>This study uses cross-sectional quantitative data from a structured, interviewer-administered questionnaire in 47 primary healthcare centers in Jeddah, Saudi Arabia, and is reported in accordance with the CROSS (Consensus-Based Checklist for Reporting of Survey Studies) guidelines. A total of 594 people with diabetes were recruited using random sampling from these centers. PCC was measured using the PCC-36 instrument. PREMs and PROMs were assessed using items adapted from the Swedish National Diabetes Register, while PS was measured using a validated single-item scale. Each was evaluated as a continuous measure, where higher scores indicate more positive experiences, outcomes, or satisfaction. A regression analysis was conducted to investigate the interrelationships between PREMs, PROMs, and PS and control for the effect of relevant sociodemographic and health-related characteristics. The data analysis was carried out using STATA 18.</div></div><div><h3>Result</h3><div>The results of the study indicated that PCC had a significant positive relationship with PROMs (β = 0.316, p < 0.01), PREMs (β = 0.063, p < 0.05), and PS (β = 0.689, p < 0.01). A strong residual correlation was observed between PREMs and PROMs (β = 0.734, p < 0.01), while the residual association between PREMs and PS was minimal (β = 0.063, p < 0.05). Emotional support was significantly associated with PROMs (β = 0.170, p < 0.01) and PREMs (β = 0.078, p < 0.01) but had a negative association with PS (β = −0.084, p < 0.1). Family and friends’ involvement was a significant predictor of PROMs (β = 0.193, p < 0.01), PREMs (β = 0.125, p < 0.01), and PS (β = 0.082, p < 0.05). Physical comfort was positively associated with PS (β = 0.128, p < 0.01) but negatively associated with PROMs (β = −0.143, p < 0.01) and PREMs (β = −0.056, p < 0.05). Access to care is significantly associated with PS (β = 0.176, p < 0.01).</div></div><div><h3>Conclusion</h3><div>This study highlights the crucial role of PCC, showing that higher levels of PCC are associated with more positive patient experiences, health outcomes, and satisfaction among people with diabetes. Key PCC factors include emotional s
背景:糖尿病管理已成为全球医疗保健的一个关键挑战,强调需要以患者为中心的护理,以提高服务质量和提高治疗效果。患者体验、感知结果和满意度对于优化医疗保健服务至关重要,但每个都反映了护理的不同方面。了解这些指标如何相互关联是改进医疗保健评估和避免依赖单一指标的关键。本研究探讨了以患者为中心的护理(PCC)如何与患者报告的体验测量(PREMs)和患者报告的结果测量(PROMs)以及糖尿病患者的总体患者满意度(PS)相关联。方法:本研究使用来自沙特阿拉伯吉达47个初级卫生保健中心的结构化访谈问卷的横断面定量数据,并根据CROSS(报告调查研究的共识清单)指南进行报告。研究人员从这些中心随机抽取了594名糖尿病患者。PCC采用PCC-36仪测定。PREMs和prom采用瑞典国家糖尿病登记册中的项目进行评估,而PS采用经过验证的单项目量表进行测量。每一项都是作为连续的衡量标准来评估的,分数越高表明越积极的经历、结果或满意度。对PREMs、PROMs和PS之间的相互关系进行回归分析,并对相关社会人口统计学和健康相关特征的影响进行控制。使用STATA 18进行数据分析。结果:研究结果表明PCC与PROMs呈显著正相关(β = 0.316, p )。结论:本研究强调了PCC的重要作用,表明高水平的PCC与糖尿病患者更积极的患者体验、健康结果和满意度相关。关键的PCC因素包括情感支持、家人和朋友的参与以及获得护理。因此,以患者为中心的实践必须是糖尿病护理质量改进策略的组成部分。虽然PCC的变化在很大程度上解释了糖尿病患者报告的测量和满意度的变化,但忽略或未观察到的因素的变化驱动了这些测量。这些发现强调了进一步调查PS、PROMs和PREMs之间的性质和关系以及它们在根据患者优先级定制护理中的应用的重要性。
{"title":"Patient-reported experience, patient-reported outcome and overall satisfaction with care: What matters most to people with diabetes?","authors":"Nizar Alsubahi ,&nbsp;Wim Groot ,&nbsp;Ahmed Ali Alzahrani ,&nbsp;Milena Pavlova","doi":"10.1016/j.pcd.2025.10.004","DOIUrl":"10.1016/j.pcd.2025.10.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Diabetes management has become a critical healthcare challenge globally, emphasizing the need for patient-centered care to improve the quality of services and enhance treatment outcomes. Patient experiences, perceived outcomes, and satisfaction are crucial to optimizing healthcare delivery, but each reflects different aspects of care. Understanding how these measures relate to each other is key to improving healthcare evaluation and avoiding dependence on a single metric. This study examines how patient-centered care (PCC) is associated with patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs), as well as overall patient satisfaction (PS) among people with diabetes.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Method&lt;/h3&gt;&lt;div&gt;This study uses cross-sectional quantitative data from a structured, interviewer-administered questionnaire in 47 primary healthcare centers in Jeddah, Saudi Arabia, and is reported in accordance with the CROSS (Consensus-Based Checklist for Reporting of Survey Studies) guidelines. A total of 594 people with diabetes were recruited using random sampling from these centers. PCC was measured using the PCC-36 instrument. PREMs and PROMs were assessed using items adapted from the Swedish National Diabetes Register, while PS was measured using a validated single-item scale. Each was evaluated as a continuous measure, where higher scores indicate more positive experiences, outcomes, or satisfaction. A regression analysis was conducted to investigate the interrelationships between PREMs, PROMs, and PS and control for the effect of relevant sociodemographic and health-related characteristics. The data analysis was carried out using STATA 18.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Result&lt;/h3&gt;&lt;div&gt;The results of the study indicated that PCC had a significant positive relationship with PROMs (β = 0.316, p &lt; 0.01), PREMs (β = 0.063, p &lt; 0.05), and PS (β = 0.689, p &lt; 0.01). A strong residual correlation was observed between PREMs and PROMs (β = 0.734, p &lt; 0.01), while the residual association between PREMs and PS was minimal (β = 0.063, p &lt; 0.05). Emotional support was significantly associated with PROMs (β = 0.170, p &lt; 0.01) and PREMs (β = 0.078, p &lt; 0.01) but had a negative association with PS (β = −0.084, p &lt; 0.1). Family and friends’ involvement was a significant predictor of PROMs (β = 0.193, p &lt; 0.01), PREMs (β = 0.125, p &lt; 0.01), and PS (β = 0.082, p &lt; 0.05). Physical comfort was positively associated with PS (β = 0.128, p &lt; 0.01) but negatively associated with PROMs (β = −0.143, p &lt; 0.01) and PREMs (β = −0.056, p &lt; 0.05). Access to care is significantly associated with PS (β = 0.176, p &lt; 0.01).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This study highlights the crucial role of PCC, showing that higher levels of PCC are associated with more positive patient experiences, health outcomes, and satisfaction among people with diabetes. Key PCC factors include emotional s","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"20 1","pages":"Pages 88-98"},"PeriodicalIF":2.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145423735","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
Kidney failure risk equation (KFRE), A risk-based triage for nephrology referrals: A mixed-methods study at pre-implementation phase among healthcare providers 肾衰竭风险方程(KFRE),肾脏病转诊的基于风险的分诊:一项在医疗保健提供者实施前阶段的混合方法研究。
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-01 Epub Date: 2025-08-13 DOI: 10.1016/j.pcd.2025.08.001
Nur Raziana Rozi , Christine Shamala Selvaraj , Jia-Kai Tan , Zhan-Foong Lim , Noor Wahidah Nordin , Nuqman Hakimi Mazhar , Haris Hafizal , Hooi-Chin Beh , Quan-Hziung Lim , Ying-Guat Ooi , Adina Abdullah , Wan Ahmad Hafiz Wan Md Adnan , Pavai Sthaneswar , Soo-Kun Lim , Lee-Ling Lim

Background

Chronic kidney disease (CKD) poses a significant health challenge globally. There is limited understanding of the challenges and opportunities to enhance CKD management from the perspectives of healthcare providers (HCPs) involved in the direct care of patients with CKD. To integrate a risk-based triage for nephrology referrals, namely the kidney failure risk equation (KFRE), we explored HCPs’ perspectives on the facilitators and barriers to CKD management before the implementation of KFRE.

Methods

We used a mixed methods approach to explore HCPs’ perspectives on the 1) facilitators and barriers to CKD management and 2) perceived benefits and challenges of implementing KFRE, a risk-based triage to guide nephrology referrals at the Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. Interviews were audio recorded, transcribed verbatim, and thematically analyzed. Quantitatively, provider job satisfaction surveys were performed.

Results

Overall, 111 HCPs completed the surveys, with the majority being mostly satisfied with the physical surroundings, co-workers, and supervision received. Mixed responses were expressed about the amount of work and equipment provided. Interviews were conducted among 27 HCPs from the three main CKD care provider groups (primary care medicine, nephrology, and endocrinology). The facilitators’ and barriers’ themes were identified. The top three barriers to CKD management were suboptimal patients’ insights, gaps in practices and confidences, and shortfalls in the healthcare system. By contrast, a good interdisciplinary network and accessibility to specialist resources were the key facilitators. They underscored the importance of human resources empowerment, continuous patient education, and structured interdisciplinary collaboration. HCPs perceived risk-based triage using the KFRE as potentially useful for more targeted care.

Conclusion

We identified several modifiable barriers and facilitators warranting attention to improve the health outcomes of people with CKD. A risk-based triage approach using the KFRE appears promising in facilitating targeted nephrology referrals for better care and resource allocations.
背景:慢性肾脏疾病(CKD)是全球健康面临的重大挑战。从参与CKD患者直接护理的医疗保健提供者(HCPs)的角度来看,对加强CKD管理的挑战和机遇的理解有限。为了整合基于风险的肾脏病转诊分诊,即肾衰竭风险方程(KFRE),我们探讨了HCPs在实施KFRE之前对CKD管理的促进因素和障碍的看法。方法:我们采用混合方法来探讨HCPs对以下方面的看法:1)CKD管理的促进因素和障碍;2)实施KFRE(一种基于风险的分诊方法,用于指导马来西亚吉隆坡马来亚大学医学中心(UMMC)肾脏病转诊)的益处和挑战。采访录音,逐字抄录,并按主题进行分析。定量地,提供者工作满意度调查进行。结果:总共有111名医护人员完成了调查,其中大多数人对物理环境、同事和受到的监督感到满意。对于所提供的工作量和设备,人们的反应不一。对来自三个主要CKD护理提供者组(初级保健医学、肾病学和内分泌学)的27名HCPs进行了访谈。确定了促进因素和障碍因素的主题。CKD管理的前三大障碍是患者的见解不佳,实践和信心的差距,以及医疗保健系统的不足。相比之下,良好的跨学科网络和专家资源的可及性是关键的促进因素。他们强调了人力资源赋权、持续的患者教育和有组织的跨学科合作的重要性。HCPs认为使用KFRE进行基于风险的分诊可能对更有针对性的护理有用。结论:我们确定了几个可改变的障碍和促进因素,值得关注,以改善慢性肾病患者的健康结果。使用KFRE的基于风险的分诊方法似乎有希望促进有针对性的肾病转诊,以获得更好的护理和资源分配。
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引用次数: 0
Diabetes in urban Colombia: A cross-sectional study of its prevalence, lifestyle habits, and sources of health information 哥伦比亚城市糖尿病:患病率、生活习惯和健康信息来源的横断面研究
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-01 Epub Date: 2025-08-27 DOI: 10.1016/j.pcd.2025.08.009
Sebastián A. Gutiérrez-Romero , Agustín Pérez-Londoño , Valentina Cuéllar-Rodríguez , Isabela Correa-Osio , Carolina Betancourt-Villamizar , Carlos O. Mendivil

Aim

To estimate the prevalence of diabetes in urban Colombia and its associated socioeconomic correlates, associated nutrition and lifestyle habits, and sources of health information.

Methods

This was a probabilistically sampled, population-based survey undertaken in five major cities of Colombia between November and December 2022. Diabetes was defined as a prior diagnosis, use of antidiabetic medications, or random blood glucose ≥ 200 mg/dL. Data on lifestyle habits and preferred sources of health information were inquired with reference to the last year.

Results

We studied 1786 adults (55 % women). Diabetes prevalence was 12.9 % (13.6 % in women, 12.0 % in men), increasing linearly with age and adiposity. There was a 12-percent-point difference in diabetes prevalence between extreme categories of education among women, and a 7-percent-point difference between extreme categories of socioeconomic level among men. People with diabetes reported more frequently than people without it to have adopted almost all the inquired healthy lifestyle habits, but the difference was always < 10 %. Unexpectedly, the most frequently reported source of health information was healthcare professionals.

Conclusions

Diabetes is on the rise in urban Colombia, especially among socially disadvantaged groups. Education and empowerment of healthcare professionals may be a conduct to impact diabetes in Colombia and similar countries.
目的:估计哥伦比亚城市糖尿病患病率及其相关的社会经济因素、相关的营养和生活习惯以及健康信息来源。方法:这是一项基于人口的概率抽样调查,于2022年11月至12月在哥伦比亚的五个主要城市进行。糖尿病定义为既往诊断、使用抗糖尿病药物或随机血糖≥ 200 mg/dL。对去年的生活习惯和首选健康信息来源的数据进行了查询。结果:我们研究了1786名成年人(55% %为女性)。糖尿病患病率为12.9 %(女性为13.6 %,男性为12.0 %),随年龄和肥胖呈线性增长。受教育程度不同的女性患糖尿病的几率有12%的差异,社会经济水平不同的男性患糖尿病的几率有7%的差异。糖尿病患者比非糖尿病患者更频繁地采用了几乎所有被调查的健康生活习惯,但差异始终存在。结论:糖尿病在哥伦比亚城市呈上升趋势,特别是在社会弱势群体中。对保健专业人员进行教育和赋权可能是影响哥伦比亚和类似国家糖尿病的一种行为。
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引用次数: 0
The Healthcare Professionals Attitudes Towards Deprescribing (HATD) tool in older persons with multiple long-term chronic conditions and those on palliative care: A mixed methods study 医疗保健专业人员对老年多重长期慢性疾病和姑息治疗的减处方(HATD)工具的态度:一项混合方法研究。
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-01 Epub Date: 2025-08-20 DOI: 10.1016/j.pcd.2025.08.005
Elizabeth Hickman, Clare Gillies, Kamlesh Khunti, Samuel Seidu

Objectives

To investigate healthcare professionals’ (HCPs) perspectives towards deprescribing in older adults living with multiple long term conditions (MLTCs), including those at the end of life, using the validated Healthcare Professionals’ Attitudes Towards Deprescribing (HATD) tool, and to explore implications for medication management in conditions such as diabetes, where polypharmacy is common.

Method

A cross-sectional online survey using the HATD questionnaire was disseminated across the United Kingdom from November 2023 to January 2024. Eligible participants were HCPs with experience managing older adults with MLTCs and/or those receiving end of life care. The tools 23-items covered five domains: concerns about deprescribing, perceived medication burden, organisational support, assurance in deprescribing decisions, and patient involvement. Quantitative data were summarised descriptively.

Results

Sixty-six HCPs participated (53 % doctors, 27 % pharmacists, 21 % allied health professionals). Many expressed discomfort in stopping medications initiated by specialists, particularly due to concerns about symptom recurrence or misattributed patient deterioration. Most recognised high medication burden, acknowledged that some drugs were no longer required, and agree deprescribing could improve quality of life. Barriers included lack of time, workload pressures, and insufficient training. Thematic analysis identified six key issues including perceived risk and fear of complains, absence of clear guidance, tensions between evidence based practice and multimorbidity, influence of specialist authority, resource constraints, and deprescribing as a potential routine practice.

Conclusions

Significant barriers to deprescribing persist in UK practice, highlighting the need for clearer guidance, training, and multidisciplinary collaboration to optimise prescribing, including in chronic conditions such as diabetes.
目的:利用经过验证的医疗保健专业人员对处方减少的态度(HATD)工具,调查医疗保健专业人员(HCPs)对患有多种长期疾病(MLTCs)的老年人(包括生命末期的老年人)处方减少的看法,并探讨对糖尿病等多种药物使用常见疾病的药物管理的影响。方法:从2023年11月至2024年1月,在英国各地使用HATD问卷进行横断面在线调查。符合条件的参与者是具有管理老年MLTCs和/或接受临终关怀经验的HCPs。工具的23个项目涵盖五个领域:对开处方的关注、感知到的药物负担、组织支持、开处方决策的保证以及患者参与。定量数据进行描述性总结。结果:66名HCPs参与其中(53 %医生,27 %药师,21 %专职卫生人员)。许多人对停止由专家开始的药物表示不适,特别是由于担心症状复发或误诊的患者恶化。大多数人认识到药物负担高,承认不再需要一些药物,并同意减少处方可以提高生活质量。障碍包括缺乏时间、工作量压力和培训不足。专题分析确定了六个关键问题,包括感知到的风险和对投诉的恐惧、缺乏明确的指导、基于证据的做法与多病之间的紧张关系、专家权威的影响、资源限制以及将处方作为一种潜在的常规做法。结论:在英国的实践中,减少处方的重大障碍仍然存在,强调需要更明确的指导、培训和多学科合作来优化处方,包括慢性疾病,如糖尿病。
{"title":"The Healthcare Professionals Attitudes Towards Deprescribing (HATD) tool in older persons with multiple long-term chronic conditions and those on palliative care: A mixed methods study","authors":"Elizabeth Hickman,&nbsp;Clare Gillies,&nbsp;Kamlesh Khunti,&nbsp;Samuel Seidu","doi":"10.1016/j.pcd.2025.08.005","DOIUrl":"10.1016/j.pcd.2025.08.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate healthcare professionals’ (HCPs) perspectives towards deprescribing in older adults living with multiple long term conditions (MLTCs), including those at the end of life, using the validated Healthcare Professionals’ Attitudes Towards Deprescribing (HATD) tool, and to explore implications for medication management in conditions such as diabetes, where polypharmacy is common.</div></div><div><h3>Method</h3><div>A cross-sectional online survey using the HATD questionnaire was disseminated across the United Kingdom from November 2023 to January 2024. Eligible participants were HCPs with experience managing older adults with MLTCs and/or those receiving end of life care. The tools 23-items covered five domains: concerns about deprescribing, perceived medication burden, organisational support, assurance in deprescribing decisions, and patient involvement. Quantitative data were summarised descriptively.</div></div><div><h3>Results</h3><div>Sixty-six HCPs participated (53 % doctors, 27 % pharmacists, 21 % allied health professionals). Many expressed discomfort in stopping medications initiated by specialists, particularly due to concerns about symptom recurrence or misattributed patient deterioration. Most recognised high medication burden, acknowledged that some drugs were no longer required, and agree deprescribing could improve quality of life. Barriers included lack of time, workload pressures, and insufficient training. Thematic analysis identified six key issues including perceived risk and fear of complains, absence of clear guidance, tensions between evidence based practice and multimorbidity, influence of specialist authority, resource constraints, and deprescribing as a potential routine practice.</div></div><div><h3>Conclusions</h3><div>Significant barriers to deprescribing persist in UK practice, highlighting the need for clearer guidance, training, and multidisciplinary collaboration to optimise prescribing, including in chronic conditions such as diabetes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 646-650"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984245","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
Evolution of Diabetes Mellitus Care in Hong Kong Public Primary Care Setting: Changes after 10-year Implementation of Risk Assessment and Management Program in Diabetes Mellitus (RAMP-DM) 香港公营基层医疗机构糖尿病护理的演变:实施糖尿病风险评估及管理计划(RAMP-DM) 10年后的变化
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-01 Epub Date: 2025-10-11 DOI: 10.1016/j.pcd.2025.10.002
Fangfang Jiao, Lapkin Chiang, Yim Chu Li, Catherine Xiaorui Chen

Aims

This study aims to evaluate the changes in clinical profiles, complications, and treatment modalities of people with diabetes after a decade of implementing the multidisciplinary Risk Assessment and Management Program in DM (RAMP-DM).

Methods

A two-phase cross-sectional study was conducted to examine the evolution of care for people with diabetes in 13 public primary care clinics from 1 August 2008 to 31 July 2009 and 1 August 2019 to 31 July 2020.

Results

The average systolic blood pressure (SBP) improved from 131.66±16.89 to 126.88±12.54 mmHg (P<0.001). Hemoglobin A1c (HbA1c) and low-density lipoprotein concentration (LDL-C) improved from 7.47±1.4 to 6.88±1.00% (P<0.001) and 3.09±0.85 to 2.01±0.68 mmol/L (P<0.001), respectively. However, the percentage of patients with ischemic heart disease (IHD) rose from 7.73% to 10.47% (P<0.001), and stroke increased from 8.22% to 12.44% (P<0.001) over the decade.

Conclusions

This is the first study to demonstrate the improvement of clinical parameters and treatment modalities of diabetes care in a public primary care setting over a decade. The increasing prevalence of IHD and stroke may be related to the aging population and the decreasing trend of all-cause mortality among people with diabetes.
目的:本研究旨在评估在实施糖尿病多学科风险评估和管理计划(RAMP-DM)十年后,糖尿病患者的临床概况、并发症和治疗方式的变化。方法:采用两阶段横断面研究,研究2008年8月1日至2009年7月31日和2019年8月1日至2020年7月31日期间13家公立初级保健诊所对糖尿病患者护理的演变。结果:平均收缩压(SBP)从131.66±16.89改善到126.88±12.54 mmHg(结论:这是第一个证明十年来公共初级保健机构糖尿病护理临床参数和治疗方式改善的研究。IHD和卒中患病率的上升可能与人口老龄化和糖尿病患者全因死亡率的下降趋势有关。
{"title":"Evolution of Diabetes Mellitus Care in Hong Kong Public Primary Care Setting: Changes after 10-year Implementation of Risk Assessment and Management Program in Diabetes Mellitus (RAMP-DM)","authors":"Fangfang Jiao,&nbsp;Lapkin Chiang,&nbsp;Yim Chu Li,&nbsp;Catherine Xiaorui Chen","doi":"10.1016/j.pcd.2025.10.002","DOIUrl":"10.1016/j.pcd.2025.10.002","url":null,"abstract":"<div><h3>Aims</h3><div>This study aims to evaluate the changes in clinical profiles, complications, and treatment modalities of people with diabetes after a decade of implementing the multidisciplinary Risk Assessment and Management Program in DM (RAMP-DM).</div></div><div><h3>Methods</h3><div>A two-phase cross-sectional study was conducted to examine the evolution of care for people with diabetes in 13 public primary care clinics from 1 August 2008 to 31 July 2009 and 1 August 2019 to 31 July 2020.</div></div><div><h3>Results</h3><div>The average systolic blood pressure (SBP) improved from 131.66±16.89 to 126.88±12.54 mmHg (P&lt;0.001). Hemoglobin A1c (HbA1c) and low-density lipoprotein concentration (LDL-C) improved from 7.47±1.4 to 6.88±1.00% (P&lt;0.001) and 3.09±0.85 to 2.01±0.68 mmol/L (P&lt;0.001), respectively. However, the percentage of patients with ischemic heart disease (IHD) rose from 7.73% to 10.47% (P&lt;0.001), and stroke increased from 8.22% to 12.44% (P&lt;0.001) over the decade.</div></div><div><h3>Conclusions</h3><div>This is the first study to demonstrate the improvement of clinical parameters and treatment modalities of diabetes care in a public primary care setting over a decade. The increasing prevalence of IHD and stroke may be related to the aging population and the decreasing trend of all-cause mortality among people with diabetes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 671-677"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282370","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
Association between the weight-adjusted waist index and type 2 diabetes mellitus: Evidence from the RaNCD study 体重调整腰围指数与2型糖尿病的关系:来自rand研究的证据。
IF 2.3 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-01 Epub Date: 2025-08-28 DOI: 10.1016/j.pcd.2025.08.007
Hawal Lateef Fateh , Mitra Bonyani , Ebrahim Shakiba , Jafar Navabi , Yahya Pasdar

Background

The weight-adjusted-waist index (WWI) emerges as a novel metric for assessing obesity, and this study aimed to determine the association between WWI and type 2 diabetes mellitus (T2DM).

Methods

We conducted a cross-sectional analysis using data collected at the inception of the Ravansar Non-communicable Disease (RaNCD) cohort study in 2014. A total of 8901 participants aged 35–65 were included in the study. The WWI is calculated by dividing the waist circumference (WC) in centimeters by the square root of the weight in kilograms. Logistic regression analysis was performed to assess the association between WWI and T2DM, adjusting for potential confounding variables.

Results

Individuals in the second quartile demonstrate a 56 % (OR: 1.56, 95 % CI: 1.23–1.99) higher odds of T2DM compared to those in first quartile. The odds of having T2DM was elevated in the third and fourth quartiles, with odds ratios of 1.81 (95 % CI: 1.43–2.20) and 2.15 (95 % CI: 1.71–2.71) respectively. After adjusting confounder variables, it is evident that the odds of diabetes in the second, third, and fourth quartiles of WWI has increased by 38 % (95 % CI: 1.07, 1.78), 47 % (95 % CI: 1.14, 1.91), and 43 % (95 % CI: 1.08, 1.89) respectively, compared to the first quartile (P trend = 0.001).

Conclusion

The results of the current study indicate that high levels of WWI are strongly associated to a higher risk of T2DM in Iranian adults. These study findings emphasize the significance of incorporating WWI into strategies for the prevention and management of T2DM.
背景:体重调整腰围指数(WWI)是一种评估肥胖的新指标,本研究旨在确定WWI与2型糖尿病(T2DM)之间的关系。方法:我们使用2014年Ravansar非传染性疾病(randd)队列研究开始时收集的数据进行了横断面分析。共有8901名年龄在35-65岁之间的参与者参与了这项研究。第一次世界大战是用腰围(厘米)除以体重(公斤)的平方根来计算的。采用Logistic回归分析评估第一次世界大战与T2DM之间的关系,并对潜在的混杂变量进行调整。结果:与第一个四分位数的个体相比,第二个四分位数的个体表现出56 % (OR: 1.56, 95 % CI: 1.23-1.99)高的T2DM几率。在第三和第四个四分位数中,患T2DM的几率升高,比值比分别为1.81(95 % CI: 1.43-2.20)和2.15(95 % CI: 1.71-2.71)。在调整混杂变量后,很明显,与第一个四分位数(P趋势= 0.001)相比,第一次世界大战的第二、第三和第四个四分位数中糖尿病的发生率分别增加了38 %(95 % CI: 1.07, 1.78)、47 %(95 % CI: 1.14, 1.91)和43 %(95 % CI: 1.08, 1.89)。结论:目前的研究结果表明,在伊朗成年人中,高水平的WWI与较高的2型糖尿病风险密切相关。这些研究结果强调了将WWI纳入T2DM预防和管理策略的重要性。
{"title":"Association between the weight-adjusted waist index and type 2 diabetes mellitus: Evidence from the RaNCD study","authors":"Hawal Lateef Fateh ,&nbsp;Mitra Bonyani ,&nbsp;Ebrahim Shakiba ,&nbsp;Jafar Navabi ,&nbsp;Yahya Pasdar","doi":"10.1016/j.pcd.2025.08.007","DOIUrl":"10.1016/j.pcd.2025.08.007","url":null,"abstract":"<div><h3>Background</h3><div>The weight-adjusted-waist index (WWI) emerges as a novel metric for assessing obesity, and this study aimed to determine the association between WWI and type 2 diabetes mellitus (T2DM).</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis using data collected at the inception of the Ravansar Non-communicable Disease (RaNCD) cohort study in 2014. A total of 8901 participants aged 35–65 were included in the study. The WWI is calculated by dividing the waist circumference (WC) in centimeters by the square root of the weight in kilograms. Logistic regression analysis was performed to assess the association between WWI and T2DM, adjusting for potential confounding variables.</div></div><div><h3>Results</h3><div>Individuals in the second quartile demonstrate a 56 % (OR: 1.56, 95 % CI: 1.23–1.99) higher odds of T2DM compared to those in first quartile. The odds of having T2DM was elevated in the third and fourth quartiles, with odds ratios of 1.81 (95 % CI: 1.43–2.20) and 2.15 (95 % CI: 1.71–2.71) respectively. After adjusting confounder variables, it is evident that the odds of diabetes in the second, third, and fourth quartiles of WWI has increased by 38 % (95 % CI: 1.07, 1.78), 47 % (95 % CI: 1.14, 1.91), and 43 % (95 % CI: 1.08, 1.89) respectively, compared to the first quartile (P trend = 0.001).</div></div><div><h3>Conclusion</h3><div>The results of the current study indicate that high levels of WWI are strongly associated to a higher risk of T2DM in Iranian adults. These study findings emphasize the significance of incorporating WWI into strategies for the prevention and management of T2DM.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 6","pages":"Pages 618-623"},"PeriodicalIF":2.3,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984042","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
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Primary Care Diabetes
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