Primary Care Diabetes最新文献

英文中文

Impact on diabetes-related health outcomes using a digitally-enabled diabetes self-management platform in Somerset, UK: An interrupted time-series analysis 在英国萨默塞特使用数字化糖尿病自我管理平台对糖尿病相关健康结果的影响：中断时间序列分析。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-05-14 DOI: 10.1016/j.pcd.2025.05.003

Mats Baxter , Nicholas Conway , Alex Bickerton , Scott Cunningham , Scott C. MacKenzie , Jane Dickson , Doogie Brodie , Christopher Sainsbury , Deborah J. Wake

Background

The MyWay Diabetes (MWD) digital platform aims to improve diabetes management through personalised access to health records, structured education, and other self-management features.

Purpose

We aimed to assess health outcomes in MWD users with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) over 6 years of use.

Methods

An interrupted time-series analysis in MWD users with T1DM or T2DM in Somerset, UK, compared pre- and post-MWD registration trends to estimate differences in health outcomes (HbA1c, blood pressure, lipids, BMI, weight). Generalised estimating equations modelling adjusted for participant baseline characteristics and identified significant predictors.

Results

A total of 7207 people (T1DM: n = 750 (52.3 % female, mean age 51.2 (SD15.8)), T2DM: n = 6457 (58.1 % male, mean age 64.7 (SD12.0))) were included in the analysis. The study showed some health outcomes improved significantly for T2DM between pre- and post-MWD registration. HbA1c reduced by 8.6 mmol/mol at 24 months post-MWD registration, with greatest improvements observed in users who were younger, had shorter diabetes durations and who were frequent MWD users. All health outcomes for T1DM were unchanged.

Conclusion

The large HbA1c reduction for T2DM is notable for a scalable digitally-enabled self-management intervention and adds to the evidence base for digital interventions for diabetes self-management.

背景：MyWay Diabetes （MWD）数字平台旨在通过个性化访问健康记录、结构化教育和其他自我管理功能来改善糖尿病管理。目的：我们旨在评估合并1型糖尿病（T1DM）和2型糖尿病（T2DM）的MWD使用者使用6年以上的健康结果。方法：对英国萨默塞特（Somerset）患有1型糖尿病或2型糖尿病的MWD患者进行中断时间序列分析，比较MWD前后登记趋势，以估计健康结局（HbA1c、血压、血脂、BMI、体重）的差异。广义估计方程模型调整了参与者基线特征并确定了重要的预测因子。结果：共纳入7207人(T1DM: n = 750（女性52.3 %，平均年龄51.2 （SD15.8)）， T2DM: n = 6457（男性58.1 %，平均年龄64.7 (SD12.0)））。研究显示，在mwd登记前后，T2DM患者的一些健康结果显著改善。在MWD登记后24个月，HbA1c降低了8.6 mmol/mol，在年轻、糖尿病持续时间较短和频繁使用MWD的用户中观察到最大的改善。T1DM的所有健康结果没有变化。结论：T2DM患者HbA1c的大幅降低对于可扩展的数字化自我管理干预是值得注意的，并为数字化糖尿病自我管理干预提供了证据基础。

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引用次数: 0

Effectiveness of AI-driven interventions in glycemic control: A systematic review and meta-analysis of randomized controlled trials 人工智能驱动的血糖控制干预措施的有效性：随机对照试验的系统回顾和荟萃分析。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-05-12 DOI: 10.1016/j.pcd.2025.05.004

Khadija Elmotia, Oumaima Abouyaala, Soukaina Bougrine, Moulay Laarbi Ouahidi

This systematic review aims to assess the effectiveness of AI-Driven Decision Support Systems in improving glycemic control, measured by Time in Range (TIR) and HbA1c levels, in patients with diabetes. Included studies were randomized controlled trials (RCTs) that evaluated AI interventions in diabetes management. Exclusion criteria included non-English studies, non-peer-reviewed articles. Studies were identified by searching electronic databases including PubMed, EMBASE, and Cochrane Library up to December 2024. Risk of bias was assessed using the Cochrane Risk of Bias tool for RCTs. Results were synthesized using a random-effects meta-analysis model. The review included 17 RCTs with a total of 3381 participants in the intervention group and 3176 in the control group. AI interventions were found to significantly improve TIR and reduce HbA1c levels. The meta-analysis for TIR yielded a mean difference of 0.54 (95 % CI: 0.05–1.03), and for HbA1c a standardized mean difference of –0.91 (95 % CI: –1.23 to –0.58). Evidence was limited by high heterogeneity (I² > 90 % for both outcomes) and indications of publication bias, which may overestimate the effectiveness reported. Despite limitations, the results support the potential of AI interventions in enhancing diabetes management, though variability in effectiveness suggests the need for personalized approaches.

本系统综述旨在评估人工智能驱动的决策支持系统在改善糖尿病患者血糖控制方面的有效性，通过时间范围（TIR）和HbA1c水平来衡量。纳入的研究是评估人工智能干预糖尿病管理的随机对照试验（rct）。排除标准包括非英语研究、非同行评议的文章。通过检索PubMed、EMBASE和Cochrane Library等电子数据库确定研究截止到2024年12月。使用Cochrane rct偏倚风险工具评估偏倚风险。结果采用随机效应荟萃分析模型进行综合。本综述纳入17项随机对照试验，干预组共3381名参与者，对照组3176名参与者。人工智能干预可显著改善TIR并降低HbA1c水平。TIR的荟萃分析得出的平均差异为0.54(95 % CI: 0.05-1.03)， HbA1c的标准化平均差异为-0.91（95 % CI: -1.23至-0.58）。证据受到高度异质性（两种结果均为I²bbb90 %）和发表偏倚指指的限制，这可能高估了报道的有效性。尽管存在局限性，但结果支持人工智能干预在加强糖尿病管理方面的潜力，尽管有效性的可变性表明需要个性化的方法。

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引用次数: 0

Back Matter 2 : PCD_Society news 后事2:pcd_社会新闻

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-05-09 DOI: 10.1016/S1751-9918(25)00093-2

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 : 2025-05-09 DOI: 10.1016/S1751-9918(25)00090-7

引用次数: 0

Back Matter 1 : Colophon PCD 背面材料1:Colophon PCD

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-05-09 DOI: 10.1016/S1751-9918(25)00092-0

引用次数: 0

Evaluating risk stratification according to Type 2 diabetes guidelines in primary care – Insights from the Danish DIAGRAM project 根据初级保健2型糖尿病指南评估风险分层——来自丹麦图表项目的见解。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-05-07 DOI: 10.1016/j.pcd.2025.05.002

Morten H. Charles , Karoline Schousboe , Tanja Thybo , Esben Krogh Hall-Andersen , Søren Tang Knudsen

Aims

To evaluate how Danish General Practitioners (GPs) apply Type 2 diabetes guideline recommendations for risk stratification and management across patient subgroups defined by existing chronic kidney disease (CKD), heart failure (HF), cardiovascular disease (CVD), or elevated risk of incident CVD.

Methods

131 GPs responded to a questionnaire on guideline usage and reviewed randomised patient electronic medical records (EMRs), noting demographics, treatment, comorbidities, and presence of six prespecified CVD risk factors. Patients without comorbidities but with ≥ 3 risk factors were deemed at Higher CVD Risk. When missing data prevented allocation to risk groups, CVD risk was Undefined.

Results

Of 1964 EMRs meeting inclusion criteria, 641 (33 %) had ≥ 1 cardiorenal comorbidity. Of 1307 without comorbidities, 513 (26 %) were at Higher CVD Risk; risk was Undefined for 668 (34 %). Organ-protective antihyperglycaemic agents were used in 1114/1964 (57 %), and more frequently (61–68 %) across comorbidity subgroups, while CVD risk group status did not correlate with guideline-directed organ-protective treatment. Finally, whereas GPs allocated 379 (19 %) patients to CKD, 596 (30 %) EMRs included laboratory data suggesting presence of CKD.

Conclusions

Organ-protective treatment patterns suggest that GPs distinguish patients by comorbidity status but find guideline-defined CVD risk challenging to apply. Additionally, CKD may be underdiagnosed in T2D patients.

目的：评估丹麦全科医生（gp）如何应用2型糖尿病指南建议，对现有慢性肾脏疾病（CKD）、心力衰竭（HF）、心血管疾病（CVD）或心血管疾病发生率升高的患者亚组进行风险分层和管理。方法：131名全科医生回答了一份关于指南使用的问卷，并回顾了随机患者电子病历（emr），注意到人口统计学、治疗、合并症和六种预先指定的心血管疾病危险因素的存在。无合并症但危险因素≥ 3的患者被认为是高CVD风险。当缺少数据无法分配给风险组时，CVD风险为未定义。结果：在符合纳入标准的1964例emr中，641例（33 %）有≥ 1例心肾合并症。在1307名无合并症的患者中，513名（26% %）心血管疾病风险较高；668例（34% %）风险未确定。在1114/1964中（57 %）使用了器官保护抗高血糖药物，在合并症亚组中使用的频率更高（61-68 %），而CVD危险组状态与指南指导的器官保护治疗无关。最后，尽管全科医生将379例（19% %）患者分配为CKD，但596例（30 %）emr包含提示CKD存在的实验室数据。结论：器官保护治疗模式提示全科医生根据合并症状况区分患者，但发现指南定义的心血管疾病风险难以应用。此外，慢性肾病在T2D患者中可能未被充分诊断。

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引用次数: 0

Validity and reliability of the Turkish version of the type 1 diabetes distress scale 土耳其版1型糖尿病痛苦量表的效度和信度。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-05-06 DOI: 10.1016/j.pcd.2025.05.001

Tuğba Bi̇lgehan , Elif Gençer Şendur , Özlem Canbolat , Emre Dünder , William H. Polonsky

Aims

This study aimed to examine the psychometric properties of the Turkish version of the Type 1 Diabetes Distress Scale

Methods

This methodological, descriptive, and correlational study was conducted with 292 individuals diagnosed with Type 1 diabetes. Data were collected between January 2024 and August 2024 using the "Information Form for Individuals with Diabetes," the "Type 1 Diabetes Distress Scale," and the "Patient Health Questionnaire." The linguistic validity and content validity of the scale were evaluated, with content validity assessed using the Davis technique. The psychometric properties of the scale were analyzed through exploratory and confirmatory factor analyses, internal consistency reliability, test–retest reliability, and parallel-form reliability.

Results

The Turkish version of the Type 1 Diabetes Distress Scale consists of 21 items and two subdimensions (Factor 1: Concerns About Diabetes Management; Factor 2: Social Diabetes Perception and Pressure). The two-factor structure explained 66 % of the total variance. The overall Cronbach’s alpha coefficient for the scale was 0.96. Test–retest reliability analysis revealed a high, positive, and statistically significant correlation (r = 0.995, p < 0.05).

Conclusions

The questionnaire was demonstrated to be a valid and reliable instrument for evaluating diabetes distress in patients with type 1 diabetes.

目的：本研究旨在检验土耳其版1型糖尿病痛苦量表的心理测量特性。方法：本方法学、描述性和相关性研究对292名诊断为1型糖尿病的个体进行了研究。数据收集于2024年1月至2024年8月，使用“糖尿病患者信息表”、“1型糖尿病痛苦量表”和“患者健康问卷”。评估量表的语言效度和内容效度，内容效度采用Davis技术评估。通过探索性因子分析和验证性因子分析、内部一致性信度、重测信度和平行形式信度对量表的心理测量特性进行分析。结果：土耳其版1型糖尿病困扰量表包括21个条目和两个子维度(因素1：对糖尿病管理的担忧；因素2：社会糖尿病认知与压力)。双因素结构解释了66% %的总方差。量表的总体Cronbach's alpha系数为0.96。重测信度分析显示高、正、有统计学意义的相关（r = 0.995,p ）。结论：该问卷是评估1型糖尿病患者糖尿病窘迫的有效、可靠的工具。

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引用次数: 0

The association between Ramadan, pre-Ramadan diabetes education (PRE) and metabolic parameters in people with type 2 diabetes: A longitudinal study using routine primary care data 2型糖尿病患者斋月、斋月前糖尿病教育（PRE）与代谢参数之间的关系：一项使用常规初级保健数据的纵向研究

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-05-05 DOI: 10.1016/j.pcd.2025.04.002

Siham Bouchareb , Peter P. Harms , Mohamed Hassanein , Giel Nijpels , Petra J.M. Elders

Aims

To assess the impact of Ramadan and pre-Ramadan diabetes education (PRE) on metabolic parameters in people with type 2 diabetes (T2D). Additionally, we described the proportion of Ramadan-related adverse events.

Methods

A retrospective longitudinal study utilising Dutch routine primary care data from 133 people with T2D who participated in a PRE session. Linear Generalized Estimating Equations models were used to assess the association of metabolic parameters with Ramadan and PRE. We analysed free-text notes and a questionnaire to identify Ramadan-related adverse events.

Results

Ramadan was associated with modest reductions in HbA1c (β −1.07 mmol/mol; p = 0.07), systolic blood pressure (β −1.89 mmHg; p = 0.04), weight (β −0.81 kg; p < 0.01), BMI (β −0.29 kg/m²; p < 0.01), and a slight increase in triglycerides (β 0.27 mmol/l; p = 0.04) compared to non-Ramadan periods. PRE demonstrated no significant impact on metabolic parameters. The number of medical notes regarding Ramadan was small, with the mentioning of some physical complaints and medication errors.

Conclusions

In our study, Ramadan is associated with temporary and marginal metabolic improvements in people with T2D. A single PRE session had no substantial impact on metabolic control. Healthcare professionals should more often discuss Ramadan and medication adjustments with their patients.

目的：评估斋月及斋月前糖尿病教育（PRE）对2型糖尿病（T2D）患者代谢参数的影响。此外，我们描述了斋月相关不良事件的比例。方法：一项回顾性纵向研究，利用荷兰常规初级保健数据，来自133名参加PRE会议的T2D患者。使用线性广义估计方程模型评估代谢参数与斋月和PRE的关系。我们分析了自由文本注释和问卷调查，以确定斋月相关的不良事件。结果：斋月与HbA1c适度降低相关(β -1.07 mmol/mol；p = 0.07)，收缩压(β -1.89 mmHg；P = 0.04)，体重(β -0.81 kg；p 2;p 结论：在我们的研究中，斋月与T2D患者的暂时和边际代谢改善有关。单次PRE训练对代谢控制没有实质性影响。医疗保健专业人员应该更经常地与患者讨论斋月和药物调整。

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引用次数: 0

Comment on ‘Characteristics of metabolic inflammatory syndrome among inpatients with type 2 diabetes: A cross-sectional study in China’ 《中国住院2型糖尿病患者代谢性炎症综合征的特点：一项横断面研究》

IF 2.3 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-05-03 DOI: 10.1016/j.pcd.2025.04.003

Mao Liao

This commentary critically evaluates the cross - sectional study by Li et al. on metabolic inflammatory syndrome (MIS) in type 2 diabetes (T2D) inpatients. It points out limitations including selection bias in the study population, lack of exploration of molecular mechanisms, and discrepancies in dyslipidemia findings. Additionally, it proposes prospective cohort studies and specific research directions to enhance the understanding of MIS as a risk factor for coronary heart disease and improve its clinical relevance.

这篇评论批判性地评价了Li等人关于2型糖尿病（T2D）住院患者代谢炎症综合征（MIS）的横断面研究。它指出了局限性，包括研究人群的选择偏倚，缺乏对分子机制的探索，以及血脂异常发现的差异。并提出前瞻性队列研究和具体研究方向，以增强对MIS作为冠心病危险因素的认识，提高其临床相关性。

引用次数: 0

Bridging illness uncertainty and self-care: The role of cognitive emotion regulation in type 2 diabetes management 桥梁疾病不确定性和自我保健：认知情绪调节在2型糖尿病管理中的作用。

IF 2.6 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Primary Care Diabetes

Pub Date : 2025-04-25 DOI: 10.1016/j.pcd.2025.04.001

Merve Murat Mehmed Ali̇ , Selda Celi̇k , Seda Er , Gulden Anataca

Aims

This study assessed the mediating role of cognitive emotion regulation strategies in the relationship between illness uncertainty and diabetes health-promoting self-care behaviours.

Methods

A cross-sectional study was conducted with 433 T2DM outpatients using the Mishel Uncertainty in Illness Scale, the Diabetes Health Promotion Self-Care Scale, and the Cognitive Emotion Regulation Questionnaire (CERQ). Data were analysed using SPSS (v.29) for descriptive and Pearson correlation tests, and Process Macro for SPSS (Model 4, v.4.2) for mediation analysis.

Results

There is a statistically significant, weak negative relationship between illness uncertainty and diabetes health promotion self-care scores (r = -0.105, p = 0.029). CERQ showed a weak negative correlation with illness uncertainty scores, whereas the questionnaire demonstrated a statistically significant, moderate positive correlation with diabetes health-promoting self-care (p < 0.05). The relationship between illness uncertainty and diabetes health- promoting self-care was mediated by CERQ such as self-blame (β= 0.083, 95 % CI= 0.019 – 0.155), acceptance (β= −0.031, 95 % CI= −0.061 – −0.007), rumination (β= −0.107, 95 % CI= −0.179 – −0.048), and positive reappraisal (β= −0.043, 95 % CI= −0.091 – −0.001).

Conclusions

Illness uncertainty negatively impacts self-care behaviours in T2DM patients. CERQ, including self-blame, acceptance, rumination, and positive reappraisal, play a mediating role, highlighting their potential in interventions to improve self-care.

目的：探讨认知情绪调节策略在疾病不确定性与糖尿病健康促进自我护理行为之间的中介作用。方法：采用Mishel疾病不确定性量表、糖尿病健康促进自我保健量表和认知情绪调节问卷（CERQ）对433例T2DM门诊患者进行横断面研究。数据分析使用SPSS （v.29）进行描述性和Pearson相关检验，并使用SPSS（模型4，v.4.2）的Process Macro进行中介分析。结果：疾病不确定性与糖尿病健康促进自我保健评分呈弱负相关（r = -0.105,p = 0.029）。CERQ与疾病不确定性得分呈弱负相关，而问卷与糖尿病健康促进自我护理呈中等正相关（p ）。结论：疾病不确定性对T2DM患者自我护理行为有负向影响。自责、接纳、反刍和积极的再评价等CERQ在自我照顾干预中发挥中介作用。

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