Pub Date : 2025-05-07DOI: 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.
{"title":"Evaluating risk stratification according to Type 2 diabetes guidelines in primary care – Insights from the Danish DIAGRAM project","authors":"Morten H. Charles , Karoline Schousboe , Tanja Thybo , Esben Krogh Hall-Andersen , Søren Tang Knudsen","doi":"10.1016/j.pcd.2025.05.002","DOIUrl":"10.1016/j.pcd.2025.05.002","url":null,"abstract":"<div><h3>Aims</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 4","pages":"Pages 368-374"},"PeriodicalIF":2.6,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063774","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}
Pub Date : 2025-05-06DOI: 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.
{"title":"Validity and reliability of the Turkish version of the type 1 diabetes distress scale","authors":"Tuğba Bi̇lgehan , Elif Gençer Şendur , Özlem Canbolat , Emre Dünder , William H. Polonsky","doi":"10.1016/j.pcd.2025.05.001","DOIUrl":"10.1016/j.pcd.2025.05.001","url":null,"abstract":"<div><h3>Aims</h3><div>This study aimed to examine the psychometric properties of the Turkish version of the Type 1 Diabetes Distress Scale</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>The questionnaire was demonstrated to be a valid and reliable instrument for evaluating diabetes distress in patients with type 1 diabetes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 4","pages":"Pages 383-389"},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035270","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}
Pub Date : 2025-05-05DOI: 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.
{"title":"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","authors":"Siham Bouchareb , Peter P. Harms , Mohamed Hassanein , Giel Nijpels , Petra J.M. Elders","doi":"10.1016/j.pcd.2025.04.002","DOIUrl":"10.1016/j.pcd.2025.04.002","url":null,"abstract":"<div><h3>Aims</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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/m<sup>2</sup>; 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 4","pages":"Pages 390-399"},"PeriodicalIF":2.6,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048867","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}
Pub Date : 2025-05-03DOI: 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.
{"title":"Comment on ‘Characteristics of metabolic inflammatory syndrome among inpatients with type 2 diabetes: A cross-sectional study in China’","authors":"Mao Liao","doi":"10.1016/j.pcd.2025.04.003","DOIUrl":"10.1016/j.pcd.2025.04.003","url":null,"abstract":"<div><div><span><span>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 </span>dyslipidemia findings. Additionally, it proposes </span>prospective cohort studies<span> and specific research directions to enhance the understanding of MIS as a risk factor for coronary heart disease and improve its clinical relevance.</span></div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 5","pages":"Pages 552-553"},"PeriodicalIF":2.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061385","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}
Pub Date : 2025-04-25DOI: 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.
{"title":"Bridging illness uncertainty and self-care: The role of cognitive emotion regulation in type 2 diabetes management","authors":"Merve Murat Mehmed Ali̇ , Selda Celi̇k , Seda Er , Gulden Anataca","doi":"10.1016/j.pcd.2025.04.001","DOIUrl":"10.1016/j.pcd.2025.04.001","url":null,"abstract":"<div><h3>Aims</h3><div>This study assessed the mediating role of cognitive emotion regulation strategies in the relationship between illness uncertainty and diabetes health-promoting self-care behaviours.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 4","pages":"Pages 375-382"},"PeriodicalIF":2.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035268","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}
Pub Date : 2025-04-11DOI: 10.1016/j.pcd.2025.03.008
Sara Sokary, Hiba Bawadi
Obesity and type 2 diabetes mellites (T2DM) are intertwined epidemics that continue to pose significant challenges to global public health. We aim to review the available evidence on the metabolic effects of tirzepatide, focusing on weight loss and maintenance of lost weight, body composition alterations, appetite regulation, glycemic control, and lipid profile modulation. Tirzepatide administration for 72 weeks elicited significant weight reduction ranging from 5 % to 20.9 % across different trials in a dose-dependent manner. Furthermore, limited evidence showed that lost body weight may be primarily due to fat mass reduction. Tirzepatide also significantly decreased food intake, reduced overall appetite scores and increased fasting visual analog scale scores for satiety and fullness across different clinical trials. Moreover, tirzepatide exhibited favorable effects on glycemic control, with notable reductions in HbA1c levels ranging from 20.4 mmol/mol with the 5 mg dose to 28.2 mmol/mol with the 15 mg dose, following treatment durations lasting 40–52 weeks. Additionally, tirzepatide exerts a beneficial impact on lipid profile parameters, including reductions in total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels, while increasing high-density lipoprotein cholesterol concentrations. Despite its efficacy, tirzepatide is associated with gastrointestinal adverse effects, which requires dose escalation strategies to enhance tolerability. Mild to moderate adverse events are commonly reported at higher doses, with discontinuation rates ranging from 4 % to 10 % across different dosages. In conclusion, tirzepatide has shown multifaceted metabolic effects, along with manageable adverse profiles, which makes it a promising therapeutic agent for addressing both obesity and T2DM. However, further long-term randomized controlled trials are warranted to reveal long-term efficacy and safety outcomes, particularly in diverse patient populations.
{"title":"The promise of tirzepatide: A narrative review of metabolic benefits","authors":"Sara Sokary, Hiba Bawadi","doi":"10.1016/j.pcd.2025.03.008","DOIUrl":"10.1016/j.pcd.2025.03.008","url":null,"abstract":"<div><div>Obesity and type 2 diabetes mellites (T2DM) are intertwined epidemics that continue to pose significant challenges to global public health. We aim to review the available evidence on the metabolic effects of tirzepatide, focusing on weight loss and maintenance of lost weight, body composition alterations, appetite regulation, glycemic control, and lipid profile modulation. Tirzepatide administration for 72 weeks elicited significant weight reduction ranging from 5 % to 20.9 % across different trials in a dose-dependent manner. Furthermore, limited evidence showed that lost body weight may be primarily due to fat mass reduction. Tirzepatide also significantly decreased food intake, reduced overall appetite scores and increased fasting visual analog scale scores for satiety and fullness across different clinical trials. Moreover, tirzepatide exhibited favorable effects on glycemic control, with notable reductions in HbA1c levels ranging from 20.4 mmol/mol with the 5 mg dose to 28.2 mmol/mol with the 15 mg dose, following treatment durations lasting 40–52 weeks. Additionally, tirzepatide exerts a beneficial impact on lipid profile parameters, including reductions in total cholesterol, low-density lipoprotein cholesterol, and triglyceride levels, while increasing high-density lipoprotein cholesterol concentrations. Despite its efficacy, tirzepatide is associated with gastrointestinal adverse effects, which requires dose escalation strategies to enhance tolerability. Mild to moderate adverse events are commonly reported at higher doses, with discontinuation rates ranging from 4 % to 10 % across different dosages. In conclusion, tirzepatide has shown multifaceted metabolic effects, along with manageable adverse profiles, which makes it a promising therapeutic agent for addressing both obesity and T2DM. However, further long-term randomized controlled trials are warranted to reveal long-term efficacy and safety outcomes, particularly in diverse patient populations.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 229-237"},"PeriodicalIF":2.6,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921560","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}
Pub Date : 2025-04-05DOI: 10.1016/j.pcd.2025.03.007
Kirsty Winkley , Isabel Graham , Yvonne Tylor , Mark Chamley , Caroline Rook , Alan Simpson , Khalida Ismail
Objective
To describe diabetes care received and views of people with severe mental illness (SMI) and type 2 diabetes (T2D) in an inner-city primary care setting.
Design
A cross-sectional study of adults with SMI and T2D from two primary care localities in south London.
Methods
Medical record data was extracted on annual diabetes review and participants invited for telephone interview.
Results
125 adults participated, 37 completed interviews. 43 % were female, 48 %, 35 % and 16 % were: Black African/Caribbean, White, Asian/other ethnicity. Mean age= 59.47 years (SD:12.68), diabetes duration= 8.62 years (SD:6.10), systolic blood pressure (BP)= 133.42 mmHg (SD:17.28), diastolic BP= 81.42 mmHg (SD:8.93), BMI= 33.17 m/kg2 (SD:7.22), HbA1c= 61.64 mmol/mol (SD:25.18). Older age (OR:1.06, 95 % C.I.:1.0, 1.10), shorter diabetes duration (OR:0.90, 95 % C.I.:0.84, 0.97) were associated with target HbA1c< /= 58 mM. Younger age and Black ethnicity were associated with BP> 140 mmHg (OR:0.94, 95 % C.I.:0.90, 0.98; OR:0.08 (95 % C.I.:0.01, 0.56). Being older was associated with cholesterol, < 5.0 mmol/mol (OR:1.06, 95 % C.I.:1.01, 1.11). Questionnaires demonstrated low physical activity, alcohol/drug use, diabetes distress, psychiatric symptoms. Interviews indicated that > 50 % wanted more support with SMI and T2D.
Conclusions
Younger, black people with SMI and T2D are potentially at greater cardiometabolic risk. Interviews suggest people with T2D and SMI group require more mental health and diabetes support.
{"title":"The psychosis and type 2 diabetes service model (PODS) population profile study","authors":"Kirsty Winkley , Isabel Graham , Yvonne Tylor , Mark Chamley , Caroline Rook , Alan Simpson , Khalida Ismail","doi":"10.1016/j.pcd.2025.03.007","DOIUrl":"10.1016/j.pcd.2025.03.007","url":null,"abstract":"<div><h3>Objective</h3><div>To describe diabetes care received and views of people with severe mental illness (SMI) and type 2 diabetes (T2D) in an inner-city primary care setting.</div></div><div><h3>Design</h3><div>A cross-sectional study of adults with SMI and T2D from two primary care localities in south London.</div></div><div><h3>Methods</h3><div>Medical record data was extracted on annual diabetes review and participants invited for telephone interview.</div></div><div><h3>Results</h3><div>125 adults participated, 37 completed interviews. 43 % were female, 48 %, 35 % and 16 % were: Black African/Caribbean, White, Asian/other ethnicity. Mean age= 59.47 years (SD:12.68), diabetes duration= 8.62 years (SD:6.10), systolic blood pressure (BP)= 133.42 mmHg (SD:17.28), diastolic BP= 81.42 mmHg (SD:8.93), BMI= 33.17 m/kg<sup>2</sup> (SD:7.22), HbA1c= 61.64 mmol/mol (SD:25.18). Older age (OR:1.06, 95 % C.I.:1.0, 1.10), shorter diabetes duration (OR:0.90, 95 % C.I.:0.84, 0.97) were associated with target HbA1c< /= 58 mM. Younger age and Black ethnicity were associated with BP> 140 mmHg (OR:0.94, 95 % C.I.:0.90, 0.98; OR:0.08 (95 % C.I.:0.01, 0.56). Being older was associated with cholesterol, < 5.0 mmol/mol (OR:1.06, 95 % C.I.:1.01, 1.11). Questionnaires demonstrated low physical activity, alcohol/drug use, diabetes distress, psychiatric symptoms. Interviews indicated that > 50 % wanted more support with SMI and T2D.</div></div><div><h3>Conclusions</h3><div>Younger, black people with SMI and T2D are potentially at greater cardiometabolic risk. Interviews suggest people with T2D and SMI group require more mental health and diabetes support.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 329-333"},"PeriodicalIF":2.6,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797555","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}
Pub Date : 2025-03-29DOI: 10.1016/j.pcd.2025.03.010
Yenifer Diaz Montes , Luis A. Anillo Arrieta , Juan Jose Espitia De La Hoz , Tania Acosta-Vergara , Jorge Acosta-Reyes , Karen C. Flórez Lozano , Rafael Tuesca Molina , Pablo Aschner , Sandra Rodríguez Acosta , Noël C. Barengo
Purpose
This study aimed to measure the impact of a community-based lifestyle modification intervention program on the Health-Related Quality of Life (HRQoL) of adults with prediabetes in two Latin American cities.
Methods
A quasi-experimental study was conducted with participants aged 30 and above in two Colombian cities between 2018 and 2022. The glycemic status of study participants was determined through the administration of an oral glucose tolerance test. Individuals exhibiting impaired glucose tolerance (IGT) were selected for inclusion in the intervention program. Of the 146 individuals identified with IGT, 91 completed the one-year intervention protocol. HRQoL was assessed utilizing the EQ-5D-3L questionnaire, both before and after the intervention. Logistic regression models were used to calculate the odds ratios (OR) and 95 % confidence intervals (CI), while classification models based on machine learning algorithms were utilized to identify factors associated with favorable changes in health-related quality of life (HRQoL).
Results
In Bogotá D.C., a significant improvement in HRQoL was documented (pre-intervention: 0.69 ± 0.17; post-intervention: 0.76 ± 0.16), attaining the threshold for clinically meaningful change (0.06). No changes in HRQoL were observed in the study participants. Logistic regression analysis revealed that the improvement in HRQoL was statistically significantly associated with sex (OR 8.75; 95 % CI 1.91–40.03), age (OR 11.61; 95 % CI 1.44–93.44), place of residence (OR 29.31; 95 % CI 5.26–163.54), and weight loss (OR 5.56; 95 % CI 1.15–26.76). According to the XGBoost model, return to normal glycemic status emerged as the most important variable for improvements in HRQoL.
Conclusion
Gender, age, place of residence, weight loss, and return to normoglycemic status were identified as significant predictors in lifestyle modification to improve HRQoL among participants at high risk of developing type 2 diabetes.
{"title":"Effectiveness of a community intervention program on healthy lifestyles (PREDICOL) among adults with prediabetes in two Latin American cities: A quasi-experimental study","authors":"Yenifer Diaz Montes , Luis A. Anillo Arrieta , Juan Jose Espitia De La Hoz , Tania Acosta-Vergara , Jorge Acosta-Reyes , Karen C. Flórez Lozano , Rafael Tuesca Molina , Pablo Aschner , Sandra Rodríguez Acosta , Noël C. Barengo","doi":"10.1016/j.pcd.2025.03.010","DOIUrl":"10.1016/j.pcd.2025.03.010","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to measure the impact of a community-based lifestyle modification intervention program on the Health-Related Quality of Life (HRQoL) of adults with prediabetes in two Latin American cities.</div></div><div><h3>Methods</h3><div>A quasi-experimental study was conducted with participants aged 30 and above in two Colombian cities between 2018 and 2022. The glycemic status of study participants was determined through the administration of an oral glucose tolerance test. Individuals exhibiting impaired glucose tolerance (IGT) were selected for inclusion in the intervention program. Of the 146 individuals identified with IGT, 91 completed the one-year intervention protocol. HRQoL was assessed utilizing the EQ-5D-3L questionnaire, both before and after the intervention. Logistic regression models were used to calculate the odds ratios (OR) and 95 % confidence intervals (CI), while classification models based on machine learning algorithms were utilized to identify factors associated with favorable changes in health-related quality of life (HRQoL).</div></div><div><h3>Results</h3><div>In Bogotá D.C., a significant improvement in HRQoL was documented (pre-intervention: 0.69 ± 0.17; post-intervention: 0.76 ± 0.16), attaining the threshold for clinically meaningful change (0.06<strong>).</strong> No changes in HRQoL were observed in the study participants. Logistic regression analysis revealed that the improvement in HRQoL was statistically significantly associated with sex (OR 8.75; 95 % CI 1.91–40.03), age (OR 11.61; 95 % CI 1.44–93.44), place of residence (OR 29.31; 95 % CI 5.26–163.54), and weight loss (OR 5.56; 95 % CI 1.15–26.76). According to the XGBoost model, return to normal glycemic status emerged as the most important variable for improvements in HRQoL.</div></div><div><h3>Conclusion</h3><div>Gender, age, place of residence, weight loss, and return to normoglycemic status were identified as significant predictors in lifestyle modification to improve HRQoL among participants at high risk of developing type 2 diabetes.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 277-287"},"PeriodicalIF":2.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143756974","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}
Pub Date : 2025-03-28DOI: 10.1016/j.pcd.2025.03.009
Carolina Guiriguet , Mercè Bustos , Roser Cantenys , Eduardo Hermosilla , Joan Camús , Manuel Medina , Carina Aguilar Martín , Alessandra Queiroga Gonçalves , Ester Gavaldà-Espelta , Francesc Xavier Cos , Núria Nadal , Mireia Fàbregas , Francesc Fina , Leonardo Méndez-Boo , Elisabet Balló , Margarita Garcia Canela , Magdalena Lladó , Ariadna Mas , Ermengol Coma , Sara Rodoreda
Aim
To assess the impact of an electronic scheduling tool (Planificat) on the management of type 2 diabetes mellitus (T2DM) in primary care settings.
Methods
This paired cohort study used data from the Catalan primary care electronic health records. The intervention cohort, using Planificat, included all patients aged 15 years or older with T2DM and was matched 1:1 with a control cohort. The study period lasted one year. Mixed general linear models estimated Odds Ratios (OR) and 95 % confidence intervals (95 %CI) for primary outcomes, including T2DM clinical tests (LDL cholesterol, HbA1c), visit frequency, and non-attendance rates.
Results
A total of 51,619 patients (mean age 68.3 years, 42.1 % of female sex) and their paired controls were included. In the primary analysis, significant increases were observed in the Planificat group (N = 18,542) regarding several measures: cholesterol tests performed (83.5 % vs. 75.4 %; OR: 1.65 [95 %CI: 1.57–1.74]), HbA1c tests performed (83.7 % vs. 75.4 %; OR: 1.7 [95 %CI: 1.61–1.79]), and electrocardiograms (65 % vs. 52 %; OR: 1.72 [95 %CI: 1.65–1.8]). Additionally, there was a 36 % increase in patients achieving HbA1c levels < 8 % (OR: 1.36 [95 %CI: 1.3–1.42]). Statistically significant improvements of 30 % and 40 % were also observed in foot and retinopathy screenings, respectively. Face-to-face visits with general practitioners and non-attendance rates remained comparable between cohorts, while face-to-face nurse visits increased by 7 %.
Conclusions
Planificat significantly improved T2DM management indicators, promoting proactive scheduling and enhancing follow-up in primary care without impacting face-to-face visits. These findings support its integration as a complementary strategy for optimizing chronic disease management.
{"title":"Enhancing the follow-up for patients with type 2 diabetes mellitus using a proactive scheduling computer tool: A paired cohort study in primary care","authors":"Carolina Guiriguet , Mercè Bustos , Roser Cantenys , Eduardo Hermosilla , Joan Camús , Manuel Medina , Carina Aguilar Martín , Alessandra Queiroga Gonçalves , Ester Gavaldà-Espelta , Francesc Xavier Cos , Núria Nadal , Mireia Fàbregas , Francesc Fina , Leonardo Méndez-Boo , Elisabet Balló , Margarita Garcia Canela , Magdalena Lladó , Ariadna Mas , Ermengol Coma , Sara Rodoreda","doi":"10.1016/j.pcd.2025.03.009","DOIUrl":"10.1016/j.pcd.2025.03.009","url":null,"abstract":"<div><h3>Aim</h3><div>To assess the impact of an electronic scheduling tool (Planificat) on the management of type 2 diabetes mellitus (T2DM) in primary care settings.</div></div><div><h3>Methods</h3><div>This paired cohort study used data from the Catalan primary care electronic health records. The intervention cohort, using Planificat, included all patients aged 15 years or older with T2DM and was matched 1:1 with a control cohort. The study period lasted one year. Mixed general linear models estimated Odds Ratios (OR) and 95 % confidence intervals (95 %CI) for primary outcomes, including T2DM clinical tests (LDL cholesterol, HbA1c), visit frequency, and non-attendance rates.</div></div><div><h3>Results</h3><div>A total of 51,619 patients (mean age 68.3 years, 42.1 % of female sex) and their paired controls were included. In the primary analysis, significant increases were observed in the Planificat group (N = 18,542) regarding several measures: cholesterol tests performed (83.5 % vs. 75.4 %; OR: 1.65 [95 %CI: 1.57–1.74]), HbA1c tests performed (83.7 % vs. 75.4 %; OR: 1.7 [95 %CI: 1.61–1.79]), and electrocardiograms (65 % vs. 52 %; OR: 1.72 [95 %CI: 1.65–1.8]). Additionally, there was a 36 % increase in patients achieving HbA1c levels < 8 % (OR: 1.36 [95 %CI: 1.3–1.42]). Statistically significant improvements of 30 % and 40 % were also observed in foot and retinopathy screenings, respectively. Face-to-face visits with general practitioners and non-attendance rates remained comparable between cohorts, while face-to-face nurse visits increased by 7 %.</div></div><div><h3>Conclusions</h3><div>Planificat significantly improved T2DM management indicators, promoting proactive scheduling and enhancing follow-up in primary care without impacting face-to-face visits. These findings support its integration as a complementary strategy for optimizing chronic disease management.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 334-340"},"PeriodicalIF":2.6,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744540","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}
Pub Date : 2025-03-22DOI: 10.1016/j.pcd.2025.03.004
Emma Mason, Kagan E. Karakus, Halis K. Akturk
Glucagon use has been shown to be low in severe hypoglycemia events among adults with type 1 diabetes. In this study, we aimed to explore the barriers to using glucagon. We surveyed 576 adults with type 1 diabetes and demonstrated the barriers in using glucagon and speculated possible solutions.
{"title":"Barriers to glucagon use in patients with type 1 diabetes","authors":"Emma Mason, Kagan E. Karakus, Halis K. Akturk","doi":"10.1016/j.pcd.2025.03.004","DOIUrl":"10.1016/j.pcd.2025.03.004","url":null,"abstract":"<div><div>Glucagon use has been shown to be low in severe hypoglycemia events among adults with type 1 diabetes. In this study, we aimed to explore the barriers to using glucagon. We surveyed 576 adults with type 1 diabetes and demonstrated the barriers in using glucagon and speculated possible solutions.</div></div>","PeriodicalId":48997,"journal":{"name":"Primary Care Diabetes","volume":"19 3","pages":"Pages 341-343"},"PeriodicalIF":2.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143695021","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}
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