Primary Care Diabetes最新文献

{"title":"The effect of a team-based service model on treatment processes and outcomes and healthcare usage among people with type 2 diabetes in North Karelia, Finland","authors":"Marja-Leena Lamidi ,&nbsp;Katja Wikström ,&nbsp;Hilkka Tirkkonen ,&nbsp;Päivi Rautiainen ,&nbsp;Matias Laaninen ,&nbsp;Tiina Laatikainen","doi":"10.1016/j.pcd.2025.01.001","DOIUrl":"10.1016/j.pcd.2025.01.001","url":null,"abstract":"<div><h3>Aims</h3><div>In North Karelia, Finland, a team-based service model was implemented in primary healthcare (PHC) during 2020. In this model, a healthcare customer contacts a nurse who initiates the service process immediately, possibly consulting or directing customers to other professionals. The effect of this new service model among patients with type 2 diabetes (T2D) was assessed.</div></div><div><h3>Methods</h3><div>Data from T2D patients diagnosed by 2016 and still residing in North Karelia in 2023 (N = 6312) were extracted from electronic health records. Diabetes-related contacts with nurses or physicians in PHC and specialised healthcare (SHC) were considered, along with emergency care contacts, measurement activity and levels of glycated haemoglobin (HbA1c) and low-density lipoproteins (LDL) between 2017 and 2022. Annual differences between areas were analysed using logistic and Poisson mixed models.</div></div><div><h3>Results</h3><div>The team-based service model increased T2D-related PHC remote contacts with nurses for a couple of years, but eventually they decreased to a lower level than before. Additionally, the number of other contacts reduced. It had no effect on measurement activity or treatment levels of HbA1c and LDL.</div></div><div><h3>Conclusion</h3><div>The team-based service model might reduce the number of healthcare contacts among T2D patients, but more evidence is needed on its effectiveness and cost-effectiveness.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 2","pages":"Pages 143-148"},"PeriodicalIF":2.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019174","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}

{"title":"Editorial Board and Aims & Scopes","authors":"","doi":"10.1016/S1751-9918(24)00210-9","DOIUrl":"10.1016/S1751-9918(24)00210-9","url":null,"abstract":"","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 6","pages":"Pages ii-iii"},"PeriodicalIF":2.6,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142704253","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}

{"title":"Proactive total diet replacement referral for type 2 diabetes: A service evaluation","authors":"Stephen Wormall ,&nbsp;Karen Richardson","doi":"10.1016/j.pcd.2024.10.004","DOIUrl":"10.1016/j.pcd.2024.10.004","url":null,"abstract":"<div><h3>Aims</h3><div>Type 2 Diabetes Mellitus morbidity disproportionally effects the most socioeconomically deprived 20 % of England. Total Diet Replacement (TDR) is a high impact intervention currently commissioned by Integrated Care Boards (ICB). Finding and referring eligible, motivated patients is a significant challenge. This study evaluates a 12-month population health management, proactive referral intervention commissioned by Nottingham and Nottinghamshire ICB during a 2-year TDR pilot designed to supplement referrals from primary care.</div></div><div><h3>Methods</h3><div>A Diabetes specialist nurse clinically reviewed a list of potentially eligible patients found by searching routinely collected health care data from 16 primary care centres in 3 PCNs.</div></div><div><h3>Results</h3><div>19.7 % (50/254) of potential patients were referred during the intervention period. 19.3 % (49/254) were uncontactable. 39.8 % (101/254) declined referral. 17.7 % (45/254) were ineligible after clinical review. An interrupted time series analysis suggests monthly referrals increased during the study period due to the intervetion (F (1,22) = 5.19 p=0.0345). Searching for patients from more socioeconomically deprived areas (index of multiple deprivation deciles 1–3) did not meaningfully alter the referral yield (19.6 %, 19/97).</div></div><div><h3>Conclusions</h3><div>Proactive care interventions could be used to facilitate referrals to the TDR or other high impact interventions by healthcare commissioning bodies.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 6","pages":"Pages 669-675"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564776","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}

{"title":"Impact of lifestyle intervention on vitamin D, Adiponectin, Insulin-like growth factor 1 and Proneurotensin in overweight individuals from the Middle East","authors":"Nadine Fadhel Dhaher ,&nbsp;Kerstin Brismar ,&nbsp;Miriam Pikkemaat ,&nbsp;Nael Shaat ,&nbsp;Anton Nilsson ,&nbsp;Louise Bennet","doi":"10.1016/j.pcd.2024.10.006","DOIUrl":"10.1016/j.pcd.2024.10.006","url":null,"abstract":"<div><h3>Background</h3><div>Immigrants from the Middle East (ME) have a higher prevalence of type 2 diabetes (T2D) compared to the native-born Swedish population. In individuals free from T2D, ME immigrants are more insulin resistant and have lower levels of adjusted insulin secretion (Disposition index, DIo) compared to Swedish-born individuals. The ethnic differences are not fully explained by traditional risk factors. This has raised the question as to whether hormonal factors other than insulin are involved, contributing to higher T2D risk in ME immigrants.</div></div><div><h3>Aims</h3><div>In ME immigrants at high risk of developing T2D, we aimed to study the effect of a randomized culturally adapted lifestyle intervention on the levels of Vitamin D (25(OH)D), insulin-like growth factor 1 (IGF-1), Pro-neurotensin (Pro-NT) and Adiponectin. Furthermore, we aimed to study if the effect of the intervention was associated to these hormones, or if a direct effect of the intervention remained after accounting for these.</div></div><div><h3>Methods</h3><div>In this culturally adapted randomized controlled trial of four months duration, eligible ME immigrants at high risk of developing T2D identified in the MEDIM cohort were invited to participate. The intervention group (N= 35) received a culturally adapted lifestyle intervention program consisting of seven group sessions and cooking classes. The control group (N= 32) were given treatment as usual with oral and written information to improve their lifestyle habits. Using mixed models’ linear regression analysis, the changes in the levels of 25(OH)D, IGF-1, Adiponectin and Pro-NT were assessed by comparing the groups and we further studied the effects of the changes on insulin action and secretion.</div></div><div><h3>Results</h3><div>The adjusted levels of 25(OH)D significantly increased in the intervention group compared to the control group (β for the effect of the intervention on 25(OH)D: 0.061, 95 % CI 0.009–0.113, <em>P</em> = 0.023). The increase in insulin sensitivity index (ISI) observed in the intervention compared to the control group was altered after adjusting for 25(OH)D: 0.129, 95 % CI −0.016–0.274, <em>P</em> = 0.078). IGF-1, Adiponectin and Pro-NT did not significantly influence the change over time concerning insulin secretion.</div></div><div><h3>Conclusion</h3><div>Lifestyle intervention increases the adjusted levels of 25(OH)D. Moreover, the effect of the lifestyle intervention on insulin action and secretion was altered when adjusting for 25(OH)D.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 6","pages":"Pages 676-682"},"PeriodicalIF":2.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515597","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}

{"title":"Re-purposing SGLT-2 inhibitors for diabetic striatopathy","authors":"Subhankar Chatterjee ,&nbsp;Ritwik Ghosh ,&nbsp;Souvik Dubey ,&nbsp;Richard I.G. Holt","doi":"10.1016/j.pcd.2024.10.001","DOIUrl":"10.1016/j.pcd.2024.10.001","url":null,"abstract":"","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 6","pages":"Pages 683-685"},"PeriodicalIF":2.6,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515598","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}

{"title":"Psychometric properties of the Slovenian versions of the diabetes empowerment scale, long and short form, among the slovenian adults with type 2 diabetes","authors":"Tina Virtič Potočnik ,&nbsp;Špela Miroševič ,&nbsp;Matic Mihevc ,&nbsp;Črt Zavrnik ,&nbsp;Majda Mori Lukančič ,&nbsp;Tonka Poplas Susič ,&nbsp;Zalika Klemenc-Ketiš","doi":"10.1016/j.pcd.2024.10.002","DOIUrl":"10.1016/j.pcd.2024.10.002","url":null,"abstract":"<div><h3>Aims</h3><div>To determine the psychometric properties of the Slovenian versions of the Diabetes Empowerment Scale (DES), both the long form (S-DES-LF) and the short form (S-DES-SF).</div></div><div><h3>Methods</h3><div>Between April and September 2023, we recruited adults with type 2 diabetes (T2D) using convenient sampling in five primary health centres. We examined internal consistency, test-retest reliability, criterion validity, and discriminant validity. Confirmatory factor analysis (CFA) evaluated the fit of the one-and three-factor models for S-DES-SF and S-DES-LF, respectively.</div></div><div><h3>Results</h3><div>The results of 288 individuals, with a mean age of 67 ± 9.2 years, including 132 men and 156 women, showed excellent internal consistency and strong test-retest reliability for both the S-DES-LF (Cronbach’s α=0.90; ICC=0.95) and S-DES-SF (α=0.91; ICC=0.92). Criterion validity of the S-DES-LF was confirmed through known-groups validity, with higher education (p=0.016) and absence of comorbid hypertension (p=0.034) associated with greater empowerment. Discriminant validity was demonstrated by the lack of significant correlations between the S-DES-LF and S-DES-SF scores with age or gender. CFA confirmed a good fit for the S-DES-SF's one-factor model but not for S-DES-LF three-factor model.</div></div><div><h3>Conclusions</h3><div>S-DES-LF and S-DES-SF are valid and reliable tools for assessing diabetes empowerment in Slovenian people with T2D. Future research should further explore the convergent validity of scales.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 6","pages":"Pages 660-668"},"PeriodicalIF":2.6,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484623","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}

{"title":"Understanding primary care provider’s knowledge and perceptions of diabetes self-management education and support","authors":"Christina J. Dietz ,&nbsp;Emily Doherty ,&nbsp;John Emerson ,&nbsp;Karen Kemper ,&nbsp;Lior Rennert ,&nbsp;Windsor Westbrook Sherrill","doi":"10.1016/j.pcd.2024.10.005","DOIUrl":"10.1016/j.pcd.2024.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>The American Diabetes Association Standards of Care recommends that individuals with diabetes receive self-management education, but the utilization of these services remains low. This study explores primary care providers’ knowledge and perceptions of diabetes self-management education and support (DSMES).</div></div><div><h3>Study design</h3><div>A convergent mixed methods study design grounded in the Theoretical Domains Framework was conducted with an initial provider survey, followed by semi-structured interview of a purposeful sub-sample of providers. The survey was distributed via REDCap and interviews were recorded and transcribed verbatim.</div></div><div><h3>Results</h3><div>A total of 140 PCP’s responded to the survey (response rate 37.63 %) and 17 participated in interviews. The average knowledge score of the correct selection of DSMES referral time points was 70.35 %. Five themes emerged in provider interviews: procedural knowledge, ability, beliefs, reinforcement, and cultural norms. Providers wanted bidirectional communication with the DSMES program and were more likely to refer if they had a cultural norm of referring.</div></div><div><h3>Conclusion</h3><div>Providers have limited knowledge of the appropriate time to refer to DSMES but expressed a willingness to refer. They emphasized the importance of providing their patients with appropriate self-management education and support.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 6","pages":"Pages 637-643"},"PeriodicalIF":2.6,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484624","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}

{"title":"Pin-prick (Medipin) assessment for neuropathy in diabetes: Prospective screening study in primary care","authors":"Stacey Fisher ,&nbsp;Hannah Gray ,&nbsp;Nicci Kelsall ,&nbsp;Donna Lowes ,&nbsp;Leon Jonker","doi":"10.1016/j.pcd.2024.10.003","DOIUrl":"10.1016/j.pcd.2024.10.003","url":null,"abstract":"<div><h3>Aims</h3><div>Diabetic patients are at elevated risk of neuropathy; early detection is desirable to minimise the risk of complications. The Medipin pin-prick device was appraised as a screening tool for diabetic neuropathy.</div></div><div><h3>Methods</h3><div>Prospective cross-sectional comparative screening study in primary care setting, involving 389 participants with type 2 diabetes mellitus. The Medipin pin-prick method, involving dorsal application on the hallux of both feet, was compared to 10 g monofilament testing.</div></div><div><h3>Results</h3><div>The ternary and semi-quantitative approach for scoring Medipin pin-prick sensation give very similar results (Spearman rho 0.67, <em>P</em> &lt; 0.001). A total of 59 % patients had no signs of neuropathy (sharp sensation), 38 % reported impaired sensation (dull sensation), and an absence of sensation occurred in 3 % of patients. For the monofilament dorsal method, the figures were 79 % no neuropathy, 14 % elevated risk, and 7 % neuropathy respectively, and with the monofilament plantar method 87 % of patients had no neuropathy and 13 % did. Correlation analyses showed that taller patients and those with existing neuropathic pain are at very modest increased risk of neuropathy.</div></div><div><h3>Conclusions</h3><div>The Medipin pin-prick device can identify diabetic neuropathy and detects (first signs of) neuropathy in relatively more patients than 10 g monofilament testing. The differential targeting of nerve types, namely predominant small (Medipin) versus large (monofilament) fibre, likely underpins the difference in outcomes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 6","pages":"Pages 612-617"},"PeriodicalIF":2.6,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484622","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}

{"title":"Erectile dysfunction as a predictive indicator of asymptomatic diabetes and prediabetes","authors":"Sebastian Becker ,&nbsp;Kadri Suija ,&nbsp;Antti Valpas ,&nbsp;Markku Koiranen ,&nbsp;Juha Auvinen ,&nbsp;Hannu Uusitalo ,&nbsp;Esko Hussi ,&nbsp;Sirkka Keinänen-Kiukaanniemi ,&nbsp;Jaakko Tuomilehto ,&nbsp;Jouko Saramies","doi":"10.1016/j.pcd.2024.09.008","DOIUrl":"10.1016/j.pcd.2024.09.008","url":null,"abstract":"<div><h3>Aims</h3><div>Both erectile dysfunction (ED) and diabetes (DM) are common health problems that share risk factors. The aim of this study was to investigate whether ED can predict glucose metabolism dysfunctions in men at the primary care level.</div></div><div><h3>Methods</h3><div>An 11-year population-based cohort study was conducted in men born between 1933 and 1956. The baseline survey was conducted in 2007–2008, with a follow-up examination 11 years later. The International Index of Erectile Function (IIEF-5) questionnaire was used to assess erectile function. Dysglycemia was evaluated using and a 2-hour oral glucose tolerance test (2hOGTT), in combination with health registry data.</div></div><div><h3>Results</h3><div>At baseline, men with ED but without a history of known DM exhibited a significantly higher prevalence of undetected DM, odds ratio (OR) 4.7 (95 % CI 1.6, 14.4), and preDM, OR 1.9 (1.1, 3.2), compared with men without ED. Over an 11-year follow-up period, a significantly increased cumulative incidence of DM was observed in men who reported symptoms of ED at the start of the study.</div></div><div><h3>Conclusions</h3><div>The symptoms of ED appear to be an early warning sign of existing DM and preDM and predict an increased risk of developing abnormal glucose metabolism in the future.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 6","pages":"Pages 618-623"},"PeriodicalIF":2.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407346","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}

{"title":"Development, feasibility, and preliminary effects of a culturally adapted, evidence-based, and theory-driven diabetes self-management programme for Chinese adults with type 2 diabetes receiving insulin injection therapy","authors":"Wei Liang ,&nbsp;Ka Ming Chow ,&nbsp;Xiaoying Ni ,&nbsp;Yetunde Oluwafunmilayo Tola ,&nbsp;Suzanne Hoi Shan Lo","doi":"10.1016/j.pcd.2024.09.010","DOIUrl":"10.1016/j.pcd.2024.09.010","url":null,"abstract":"<div><h3>Aims</h3><div>To describe the development of a culturally adapted, evidence-based, and theory-driven diabetes self-management programme for Chinese adults with type 2 diabetes receiving insulin injection therapy and to assess the feasibility, acceptability, and preliminary effects of the newly developed intervention.</div></div><div><h3>Methods</h3><div>The Medical Research Council framework was adopted to guide the intervention development and a feasibility study. A prospective, two-arm, parallel-group, assessor-blinded randomised controlled trial was conducted. Participants were randomly allocated to receive either the newly developed intervention or parallel attention control contact from community nurses. Between-group differences in changes in outcome variables were analysed using the Mann-Whitney U test.</div></div><div><h3>Results</h3><div>The newly developed intervention consists of one individual interview session, three group-based education sessions, and two telephone-based maintenance sessions. A total of 24 participants were recruited with the recruitment rate and overall retention rate of 77.4 % and 95.8 %, respectively. The results indicated that the intervention participants reported significantly greater improvements in self-efficacy (Hedge’s <em>g</em> = 1.69) and self-management behaviours (Hedge’s <em>g</em> = 3.24), and reductions in diabetes-related distress (Hedge’s <em>g</em> = 1.49) compared with those in the control group (all <em>p</em> <span><math><mo>&lt;</mo></math></span> 0.05).</div></div><div><h3>Conclusion</h3><div>The diabetes self-management programme was feasible and acceptable. The intervention showed promising patient-centred benefits. A future large-scale randomised controlled trial is warranted.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"18 6","pages":"Pages 649-659"},"PeriodicalIF":2.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378748","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}