Pub Date : 2024-11-13DOI: 10.1016/j.deman.2024.100247
Malek Zarei , Mohammad Abbas Sheikholeslami , Masoud Mozaffari , Yassar Mortada
Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease characterized by the selective destruction of pancreatic insulin-producing beta cells, primarily mediated by CD4+ and CD8+ T cells. This review comprehensively examines the latest advances in immunotherapeutic approaches to T1D, categorizing current strategies into four main groups: antigen-independent therapies, antigen-dependent therapies, beta cell therapies, and stem cell therapies. Antigen-independent strategies, such as antibody-based therapies (e.g., Abatacept and Teplizumab) and cytokine inhibitors (e.g., Anakinra and Etanercept), have shown potential in preserving beta cell function by modulating immune responses. Antigen-dependent strategies focus on inducing immune tolerance to specific beta cell antigens, with mixed results from clinical trials involving autoantigen vaccines like GAD65. Beta cell therapies, including islet transplantation, offer promising outcomes but face challenges related to immunosuppression and donor availability. Stem cell therapies, particularly using mesenchymal stem cells (MSCs) and autologous hematopoietic stem cells (HSCs), demonstrate potential in immune modulation and beta cell regeneration. Novel approaches, such as Chimeric Antigen Receptor (CAR)–Tregs therapy and JAK-STAT pathway inhibition, represent exciting areas of ongoing research. This comprehensive overview underscores the necessity of personalized therapeutic approaches and continued research to optimize existing therapies and explore new targets, ultimately aiming to improve outcomes and achieve a potential cure for T1D.
{"title":"Innovative immunotherapies and emerging treatments in type 1 diabetes management","authors":"Malek Zarei , Mohammad Abbas Sheikholeslami , Masoud Mozaffari , Yassar Mortada","doi":"10.1016/j.deman.2024.100247","DOIUrl":"10.1016/j.deman.2024.100247","url":null,"abstract":"<div><div>Type 1 diabetes mellitus (T1D) is a chronic autoimmune disease characterized by the selective destruction of pancreatic insulin-producing beta cells, primarily mediated by CD4+ and CD8+ T cells. This review comprehensively examines the latest advances in immunotherapeutic approaches to T1D, categorizing current strategies into four main groups: antigen-independent therapies, antigen-dependent therapies, beta cell therapies, and stem cell therapies. Antigen-independent strategies, such as antibody-based therapies (e.g., Abatacept and Teplizumab) and cytokine inhibitors (e.g., Anakinra and Etanercept), have shown potential in preserving beta cell function by modulating immune responses. Antigen-dependent strategies focus on inducing immune tolerance to specific beta cell antigens, with mixed results from clinical trials involving autoantigen vaccines like GAD65. Beta cell therapies, including islet transplantation, offer promising outcomes but face challenges related to immunosuppression and donor availability. Stem cell therapies, particularly using mesenchymal stem cells (MSCs) and autologous hematopoietic stem cells (HSCs), demonstrate potential in immune modulation and beta cell regeneration. Novel approaches, such as Chimeric Antigen Receptor (CAR)–Tregs therapy and JAK-STAT pathway inhibition, represent exciting areas of ongoing research. This comprehensive overview underscores the necessity of personalized therapeutic approaches and continued research to optimize existing therapies and explore new targets, ultimately aiming to improve outcomes and achieve a potential cure for T1D.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100247"},"PeriodicalIF":1.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142705641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-29DOI: 10.1016/j.deman.2024.100246
Raja Hazime , Saad Lamjadli , Morad Guennouni , Mounir Belkrachni , Fatima-Ezzohra Eddehbi , Ider Oujamaa , Lahcen Elmoumou , Aicha Bourrahouate , Imane Ait Sab , Hicham Baizri , Nawal El Ansari , Brahim Admou
Type 1 diabetes mellitus (T1D) is one of the most common chronic diseases in children and is associated with acute and serious chronic complications. T1D is characterized by the destruction of insulin-producing beta cells in the pancreas, with the emergence of circulating autoantibodies (a-Abs) targeting β cell antigens. Identifying autoantibodies can help predict the onset of T1D and associated autoimmune disorders, enhancing patient management strategies.
We aimed to determine the prevalence of T1D autoantibodies and their clinical significance in the pediatric and adult populations. A multicenter cross-sectional study was carried out on 276 patient-first with T1D, including 167 pediatric (60.5 %) and 109 adult (39.5 %) cases, of which 144 were female and 132 were male (sex ratio= 0.91),with an average age of 14.1 ± 8.0 years. The immunological investigation was based on the detection of T1D related a-Abs, including anti-insulin, anti-glutamic acid decarboxylase (GAD65), anti-insulinoma-associated antigen 2 (IA2), and anti-zinc transporter 8 (ZnT8) specificities. The results revealed an overall autoantibody seropositivity rate of 75.36 % (n= 208). Among the positive cases, GAD65 antibodies were the most prevalent at 37.31 %, followed by anti-insulin and anti-ZnT8 antibodies, each at 36.59 %, and anti-IA2 at 28.62 %. Additionally, 45,67 % of patients had one a-Abs, 28.36 % had a two, 21.15 % had three, and 4.8 % had all four a-Abs.
A statistically significant difference was observed between the seropositive and seronegative groups regarding the presence of associated autoimmune diseases (p = 0.005). These findings align with the existing literature, highlighting the importance and scientific value of detecting a-Abs in patients with T1D.
{"title":"Autoantibodies in type 1 diabetes: Prevalence and clinical profiles","authors":"Raja Hazime , Saad Lamjadli , Morad Guennouni , Mounir Belkrachni , Fatima-Ezzohra Eddehbi , Ider Oujamaa , Lahcen Elmoumou , Aicha Bourrahouate , Imane Ait Sab , Hicham Baizri , Nawal El Ansari , Brahim Admou","doi":"10.1016/j.deman.2024.100246","DOIUrl":"10.1016/j.deman.2024.100246","url":null,"abstract":"<div><div>Type 1 diabetes mellitus (T1D) is one of the most common chronic diseases in children and is associated with acute and serious chronic complications. T1D is characterized by the destruction of insulin-producing beta cells in the pancreas, with the emergence of circulating autoantibodies (a-Abs) targeting β cell antigens. Identifying autoantibodies can help predict the onset of T1D and associated autoimmune disorders, enhancing patient management strategies.</div><div>We aimed to determine the prevalence of T1D autoantibodies and their clinical significance in the pediatric and adult populations. A multicenter cross-sectional study was carried out on 276 patient-first with T1D, including 167 pediatric (60.5 %) and 109 adult (39.5 %) cases, of which 144 were female and 132 were male (sex ratio= 0.91),with an average age of 14.1 ± 8.0 years. The immunological investigation was based on the detection of T1D related a-Abs, including anti-insulin, anti-glutamic acid decarboxylase (GAD65), anti-insulinoma-associated antigen 2 (IA2), and anti-zinc transporter 8 (ZnT8) specificities. The results revealed an overall autoantibody seropositivity rate of 75.36 % (n= 208). Among the positive cases, GAD65 antibodies were the most prevalent at 37.31 %, followed by anti-insulin and anti-ZnT8 antibodies, each at 36.59 %, and anti-IA2 at 28.62 %. Additionally, 45,67 % of patients had one a-Abs, 28.36 % had a two, 21.15 % had three, and 4.8 % had all four a-Abs.</div><div>A statistically significant difference was observed between the seropositive and seronegative groups regarding the presence of associated autoimmune diseases (p = 0.005). These findings align with the existing literature, highlighting the importance and scientific value of detecting a-Abs in patients with T1D.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100246"},"PeriodicalIF":1.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142657375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.1016/j.deman.2024.100240
Camilla Mattiuzzi, Giuseppe Lippi
{"title":"Reply to increase in diabetic deaths during COVID-19 pandemic. Some comments","authors":"Camilla Mattiuzzi, Giuseppe Lippi","doi":"10.1016/j.deman.2024.100240","DOIUrl":"10.1016/j.deman.2024.100240","url":null,"abstract":"","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100240"},"PeriodicalIF":1.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142527393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-09DOI: 10.1016/j.deman.2024.100239
Tran Bao Vuong , Triet Minh Tran , Nam Quang Tran
Objectives
The prevalences of diabetes and prediabetes have increased rapidly in recent years in emerging nations such as Vietnam, particularly in the population at high risk of diabetes. This study aimed to investigate the prevalence of prediabetes and undiagnosed diabetes in individuals at high risk of type 2 diabetes (T2D), as well as the related risk factors.
Methods
This cross-sectional study at the clinics of the University Medical Center in Ho Chi Minh City included 360 patients who were 18 years of age or older, and were at risk of developing T2D. The diagnosis of prediabetes and diabetes relied on measurements of fasting plasma glucose, HbA1c, and 2-hour plasma glucose after a 75 g oral glucose tolerance test.
Results
The prevalence of prediabetes was 60.6 % (95 % CI: 55.3–65.6 %), and the prevalence of diabetes was 18.3 % (95 % CI: 14.6–22.8 %). Older age (OR = 1.06), obesity (OR = 3.89), hypertension (OR = 5.71), and dyslipidemia (OR = 2.01) were factors associated with increasing frequencies of undiagnosed T2D and prediabetes.
Conclusion
The prevalences of prediabetes and undiagnosed diabetes were significantly higher among people with a high-risk of dysglycemia in Vietnam. There is a need for screening programs for such high-risk individuals.
{"title":"High prevalence of prediabetes and type 2 diabetes, and identification of associated factors, in high-risk adults in Vietnam: A cross-sectional study","authors":"Tran Bao Vuong , Triet Minh Tran , Nam Quang Tran","doi":"10.1016/j.deman.2024.100239","DOIUrl":"10.1016/j.deman.2024.100239","url":null,"abstract":"<div><h3>Objectives</h3><div>The prevalences of diabetes and prediabetes have increased rapidly in recent years in emerging nations such as Vietnam, particularly in the population at high risk of diabetes. This study aimed to investigate the prevalence of prediabetes and undiagnosed diabetes in individuals at high risk of type 2 diabetes (T2D), as well as the related risk factors.</div></div><div><h3>Methods</h3><div>This cross-sectional study at the clinics of the University Medical Center in Ho Chi Minh City included 360 patients who were 18 years of age or older, and were at risk of developing T2D. The diagnosis of prediabetes and diabetes relied on measurements of fasting plasma glucose, HbA1c, and 2-hour plasma glucose after a 75 g oral glucose tolerance test.</div></div><div><h3>Results</h3><div>The prevalence of prediabetes was 60.6 % (95 % CI: 55.3–65.6 %), and the prevalence of diabetes was 18.3 % (95 % CI: 14.6–22.8 %). Older age (OR = 1.06), obesity (OR = 3.89), hypertension (OR = 5.71), and dyslipidemia (OR = 2.01) were factors associated with increasing frequencies of undiagnosed T2D and prediabetes.</div></div><div><h3>Conclusion</h3><div>The prevalences of prediabetes and undiagnosed diabetes were significantly higher among people with a high-risk of dysglycemia in Vietnam. There is a need for screening programs for such high-risk individuals.</div></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100239"},"PeriodicalIF":1.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142434305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-28DOI: 10.1016/j.deman.2024.100238
Salvatore Chirumbolo
{"title":"Increase in diabetic deaths during COVID-19 pandemic. Some comments","authors":"Salvatore Chirumbolo","doi":"10.1016/j.deman.2024.100238","DOIUrl":"10.1016/j.deman.2024.100238","url":null,"abstract":"","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100238"},"PeriodicalIF":1.0,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142427573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vitamin D is an essential component of healthy bones and its deficiency is widespread in obese patients. Through our study, we aimed to look into vitamin D status in obese and non-obese patients and determine its association with hypertension, glucose levels, and lipid profiles.
Patients and methods
A case-control study was laid out to compare serum Vitamin D levels between obese patients and controls. Obese patients (n= 67) over 18 years old were recruited from our Endocrinology-Diabetology and Nutrition department between March 2018 and September 2023. Controls (n = 60) were randomly assigned and were matched for age, sex, glycated hemoglobin, ethnicity, and geographic area. The levels of Vitamin D in the serum were determined in obese patients and non-obese controls.
Results
Average serum Vitamin D concentration was established in both groups, reaching 10,41±4,2 ng/ml in obese patients and 15,14±6,1 ng/ml in the control group. The mean serum Vitamin D was significantly lower in the obese group (p = 0,000). A positive correlation was noticed between body fat and serum Vitamin D (p < 0,05). A significant correlation between vitamin D status and glycated hemoglobin in the obese group (p = 0,047) was found, whereas it was insignificant in the control group (p = 0,966). In addition, the correlation between vitamin D, blood pressure, and body mass index was significant (p= 0.004) as well as between vitamin D and triglycerides (p= 0.015) and cholesterol (p= 0.014).
Conclusion
Vitamin D deficiency is common in obese patients, as highlighted by our study, which is in line with other findings. This may be explained by the fact that vitamin D must be supplied at a greater volume in obese patients. A significant correlation between BMI, vitamin D, glycated hemoglobin, blood pressure, triglycerides, and total cholesterol was found. The pathophysiology behind this association is complex. Further research is needed to clarify the relationship between vitamin D, adipose tissue, and the other components of metabolic syndrome.
背景维生素 D 是健康骨骼的重要组成部分，肥胖患者普遍缺乏维生素 D。我们的研究旨在调查肥胖和非肥胖患者的维生素 D 状态，并确定其与高血压、血糖水平和血脂状况的关系。患者和方法我们开展了一项病例对照研究，以比较肥胖患者和对照组的血清维生素 D 水平。2018年3月至2023年9月期间，本院内分泌科-糖尿病与营养科招募了18岁以上的肥胖患者（n=67）。对照组（n=60）为随机分配，在年龄、性别、糖化血红蛋白、种族和地理区域方面均匹配。测定了肥胖患者和非肥胖对照组血清中维生素 D 的水平。结果两组患者的平均血清维生素 D 浓度均为 10,41±4,2 纳克/毫升（肥胖患者）和 15,14±6,1 纳克/毫升（对照组）。肥胖组的血清维生素 D 平均值明显较低（p = 0,000）。体脂与血清维生素 D 之间呈正相关（p < 0,05）。肥胖组的维生素 D 状态与糖化血红蛋白之间存在明显的相关性（p = 0,047），而对照组的相关性不明显（p = 0,966）。此外，维生素 D、血压和体重指数之间的相关性显著（p = 0.004），维生素 D 与甘油三酯（p = 0.015）和胆固醇（p = 0.014）之间的相关性也显著。这可能是因为肥胖患者必须摄入更多的维生素 D。研究发现，体重指数、维生素 D、糖化血红蛋白、血压、甘油三酯和总胆固醇之间存在明显的相关性。这种关联背后的病理生理学非常复杂。还需要进一步的研究来阐明维生素 D、脂肪组织和代谢综合征其他成分之间的关系。
{"title":"Assessment of vitamin D status in obese and non-obese patients: A case-control study","authors":"Salma Derbel , Lamiae Zarraa , Imane Assarrar , Nisrine Bouichrat , Siham Rouf , Hanane Latrech","doi":"10.1016/j.deman.2024.100237","DOIUrl":"10.1016/j.deman.2024.100237","url":null,"abstract":"<div><h3>Background</h3><p>Vitamin D is an essential component of healthy bones and its deficiency is widespread in obese patients. Through our study, we aimed to look into vitamin D status in obese and non-obese patients and determine its association with hypertension, glucose levels, and lipid profiles.</p></div><div><h3>Patients and methods</h3><p>A case-control study was laid out to compare serum Vitamin D levels between obese patients and controls. Obese patients (<em>n</em>= 67) over 18 years old were recruited from our Endocrinology-Diabetology and Nutrition department between March 2018 and September 2023. Controls (<em>n</em> = 60) were randomly assigned and were matched for age, sex, glycated hemoglobin, ethnicity, and geographic area. The levels of Vitamin D in the serum were determined in obese patients and non-obese controls.</p></div><div><h3>Results</h3><p>Average serum Vitamin D concentration was established in both groups, reaching 10,41±4,2 ng/ml in obese patients and 15,14±6,1 ng/ml in the control group. The mean serum Vitamin D was significantly lower in the obese group (<em>p</em> = 0,000). A positive correlation was noticed between body fat and serum Vitamin D (<em>p</em> < 0,05). A significant correlation between vitamin D status and glycated hemoglobin in the obese group (<em>p</em> = 0,047) was found, whereas it was insignificant in the control group (<em>p</em> = 0,966). In addition, the correlation between vitamin D, blood pressure, and body mass index was significant (<em>p</em> <em>=</em> 0.004) as well as between vitamin D and triglycerides (<em>p</em> <em>=</em> 0.015) and cholesterol (<em>p</em> <em>=</em> 0.014).</p></div><div><h3>Conclusion</h3><p>Vitamin D deficiency is common in obese patients, as highlighted by our study, which is in line with other findings. This may be explained by the fact that vitamin D must be supplied at a greater volume in obese patients. A significant correlation between BMI, vitamin D, glycated hemoglobin, blood pressure, triglycerides, and total cholesterol was found. The pathophysiology behind this association is complex. Further research is needed to clarify the relationship between vitamin D, adipose tissue, and the other components of metabolic syndrome.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100237"},"PeriodicalIF":1.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000416/pdfft?md5=6312261234fdc2e5e815735d8c34c4e9&pid=1-s2.0-S2666970624000416-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142239733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-03DOI: 10.1016/j.deman.2024.100236
Camilla Mattiuzzi, Giuseppe Lippi
{"title":"The impact of the COVID-19 pandemic on diabetes-related mortality","authors":"Camilla Mattiuzzi, Giuseppe Lippi","doi":"10.1016/j.deman.2024.100236","DOIUrl":"10.1016/j.deman.2024.100236","url":null,"abstract":"","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"17 ","pages":"Article 100236"},"PeriodicalIF":1.0,"publicationDate":"2024-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000404/pdfft?md5=a532904d865fc649ee8f0692d0d710cd&pid=1-s2.0-S2666970624000404-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141961092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-20DOI: 10.1016/j.deman.2024.100235
Ahmed Hasan, Almas Zafar
Gestational diabetes is a prevalent condition that affects up to 24.2 % of women in South-East Asia. A study conducted in Iran highlighted the correlation between gestational diabetes and anxiety/depression. Improvements can be made by conducting a cohort study to better establish the causality between the compounding factors of mental health and gestational diabetes. Additionally, conducting a follow-up study in a region with a higher incidence of gestational diabetes, such as South-East Asia, can broaden the geographic distribution of the available data. We must promote awareness campaigns highlighting this correlation to improve holistic healthcare strategies.
{"title":"Diabetes in pregnancy: Anxious minds precarious times","authors":"Ahmed Hasan, Almas Zafar","doi":"10.1016/j.deman.2024.100235","DOIUrl":"10.1016/j.deman.2024.100235","url":null,"abstract":"<div><p>Gestational diabetes is a prevalent condition that affects up to 24.2 % of women in South-East Asia. A study conducted in Iran highlighted the correlation between gestational diabetes and anxiety/depression. Improvements can be made by conducting a cohort study to better establish the causality between the compounding factors of mental health and gestational diabetes. Additionally, conducting a follow-up study in a region with a higher incidence of gestational diabetes, such as South-East Asia, can broaden the geographic distribution of the available data. We must promote awareness campaigns highlighting this correlation to improve holistic healthcare strategies.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"16 ","pages":"Article 100235"},"PeriodicalIF":1.0,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000398/pdfft?md5=fec62aa64c34fd7b15ca81914bd6bdbf&pid=1-s2.0-S2666970624000398-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141843525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-26DOI: 10.1016/j.deman.2024.100233
Dr. Julie Demoule , Dr. Paul Quindroit , Dr. Camille Frévent , Prof. Dr. Claire Collins , Prof. Dr. Emmanuel Chazard , Prof. Dr. Jean-Baptiste Beuscart , Prof. Dr. Christophe Berkhout , Dr. Matthieu Calafiore , Dr. François Quersin
Background
French health authorities recommend the testing of HbA1c every 3 to 6 months in patients with diabetes. The successive containments linked to the SARSCoV-2 pandemic may have had a profound impact on the follow-up of diabetic patients in primary care. The objective of this study was to investigate the effect of containments on the volume of HbA1c assays and on HbA1c values of type 2 diabetic patients monitored in primary care in Northern France compared to usual seasonal variations.
Methods
Epidemiological study of a multicentre retrospective cohort, collecting the number and the value of HbA1c assays from type 2 diabetic patients, carried out in 73 private medical analysis laboratories in Northern France region between October 1, 2018 and October 31, 2022.
Results
A total of 196,744 patients and 828,037 tests were included. The first and third containments were associated with a significant decrease in the mean number of performed HbA1c tests, the decrease in the 2nd containment did not reach significance. We observed a significant decrease in HbA1c testing during the winter holiday season and the summer months. The variations in HbA1c values were not substantial compared to seasonal variations.
{"title":"Primary care monitoring of HbA1c tests in type 2 diabetic patients in Northern France and impact of the successive COVID-19 pandemic containments","authors":"Dr. Julie Demoule , Dr. Paul Quindroit , Dr. Camille Frévent , Prof. Dr. Claire Collins , Prof. Dr. Emmanuel Chazard , Prof. Dr. Jean-Baptiste Beuscart , Prof. Dr. Christophe Berkhout , Dr. Matthieu Calafiore , Dr. François Quersin","doi":"10.1016/j.deman.2024.100233","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100233","url":null,"abstract":"<div><h3>Background</h3><p>French health authorities recommend the testing of HbA1c every 3 to 6 months in patients with diabetes. The successive containments linked to the SARSCoV-2 pandemic may have had a profound impact on the follow-up of diabetic patients in primary care. The objective of this study was to investigate the effect of containments on the volume of HbA1c assays and on HbA1c values of type 2 diabetic patients monitored in primary care in Northern France compared to usual seasonal variations.</p></div><div><h3>Methods</h3><p>Epidemiological study of a multicentre retrospective cohort, collecting the number and the value of HbA1c assays from type 2 diabetic patients, carried out in 73 private medical analysis laboratories in Northern France region between October 1, 2018 and October 31, 2022.</p></div><div><h3>Results</h3><p>A total of 196,744 patients and 828,037 tests were included. The first and third containments were associated with a significant decrease in the mean number of performed HbA1c tests, the decrease in the 2nd containment did not reach significance. We observed a significant decrease in HbA1c testing during the winter holiday season and the summer months. The variations in HbA1c values were not substantial compared to seasonal variations.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"16 ","pages":"Article 100233"},"PeriodicalIF":1.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000386/pdfft?md5=cd9b06e986a7d80d6a6750bae1c21f51&pid=1-s2.0-S2666970624000386-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-25DOI: 10.1016/j.deman.2024.100228
Ricko Damberg Nissen, Jesper Bo Nielsen
Background
In Denmark, the primary responsibility for treatment of patients with diabetes has shifted from hospitals to primary care. Thus, general practice has assumed responsibility for a complex and multifaceted disease. To address this situation a stratification tool to assist the nurses in primary care in their work with diabetes patients was developed.
Aim
In the present study we evaluated this stratification tool.
Method
The evaluation was based on 18 semi-structured interviews conducted with nurses employed in primary care across Denmark, and who had experience with the stratification tool. The data was subsequently analyzed by content and thematic analyses.
Results
The interviewees were generally positive towards the stratification tool. The analyses established three themes 1. Treatment, 2. Resources, and 3. Points of critique.
Conclusions
Our study indicates that a combined tool for risk stratification of patients with T2D and for subsequent risk communication is perceived as positive and supportive for quality in care. It is seen to potentially reduce the resources presently allocated to well-regulated and stable T2D patients. These resources will eventually be available for other patients. The positive reception by nurses supports that tools like the Diabetes Control Support Tool could be developed and implemented in general practice.
{"title":"Evaluation of a Support Tool for Diabetes Control in primary care – A Qualitative study with primary care staff","authors":"Ricko Damberg Nissen, Jesper Bo Nielsen","doi":"10.1016/j.deman.2024.100228","DOIUrl":"https://doi.org/10.1016/j.deman.2024.100228","url":null,"abstract":"<div><h3>Background</h3><p>In Denmark, the primary responsibility for treatment of patients with diabetes has shifted from hospitals to primary care. Thus, general practice has assumed responsibility for a complex and multifaceted disease. To address this situation a stratification tool to assist the nurses in primary care in their work with diabetes patients was developed.</p></div><div><h3>Aim</h3><p>In the present study we evaluated this stratification tool.</p></div><div><h3>Method</h3><p>The evaluation was based on 18 semi-structured interviews conducted with nurses employed in primary care across Denmark, and who had experience with the stratification tool. The data was subsequently analyzed by content and thematic analyses.</p></div><div><h3>Results</h3><p>The interviewees were generally positive towards the stratification tool. The analyses established three themes 1. Treatment, 2. Resources, and 3. Points of critique.</p></div><div><h3>Conclusions</h3><p>Our study indicates that a combined tool for risk stratification of patients with T2D and for subsequent risk communication is perceived as positive and supportive for quality in care. It is seen to potentially reduce the resources presently allocated to well-regulated and stable T2D patients. These resources will eventually be available for other patients. The positive reception by nurses supports that tools like the Diabetes Control Support Tool could be developed and implemented in general practice.</p></div>","PeriodicalId":72796,"journal":{"name":"Diabetes epidemiology and management","volume":"16 ","pages":"Article 100228"},"PeriodicalIF":1.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666970624000337/pdfft?md5=9c4c5a22cb9a7b99acc7e735767daafd&pid=1-s2.0-S2666970624000337-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141540064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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