Canadian Journal of Diabetes最新文献

{"title":"Temporal Trends in Type 1, Type 2, and Gestational Diabetes in Pregnancy: Impact of Rural Residence, Ethnicity, and Material Deprivation","authors":"Deliwe P. Ngwezi MBChB, PhD ,&nbsp;Anamaria Savu PhD ,&nbsp;Roseanne O. Yeung MD, FRCPC, MPH ,&nbsp;Sonia Butalia BSc, MD, FRCPC, MSc (Epi) ,&nbsp;Padma Kaul PhD","doi":"10.1016/j.jcjd.2023.07.007","DOIUrl":"10.1016/j.jcjd.2023.07.007","url":null,"abstract":"<div><h3>Objective</h3><p><span>Our aim in this study was to implement a newly validated algorithm to identify pregnant women with type 1 diabetes mellitus<span> (T1DM), type 2 diabetes mellitus (T2DM), and gestational diabetes mellitus (GDM), and to identify temporal trends in rates over the last decade. We also compared </span></span>obstetric and neonatal outcomes of pregnancies with and without diabetes mellitus (DM).</p></div><div><h3>Methods</h3><p><span>Among women with live births between 2005 and 2018 in Alberta, we calculated yearly rates of T1DM, T2DM, and GDM, overall, and stratified by ethnicity, urban or rural residence, </span>material deprivation score, and maternal age.</p></div><div><h3>Results</h3><p><span>Between 2005 and 2018, GDM rates increased from 42.3 to 101.8 per 1,000 deliveries (p&lt;0.0001), T2DM rates increased from 2.6 to 6.4 per 1,000 deliveries (p&lt;0.0001), whereas T1DM remained constant at 3.0 per 1,000 deliveries each year (p=0.4301). Higher GDM and T2DM rates were observed among Chinese and South Asian women, respectively, and among women who were materially deprived and living in urban areas. Women with T2DM were older and had the highest rates of pre-existing hypertension (16%). In contrast, women with T1DM were younger and had the highest rates of gestational hypertension<span> (12%), pre-eclampsia (12%), and cesarean section deliveries (62%). Children of women with T1DM had the highest rates of </span></span>large for gestational age<span><span> (46%), neonatal hypoglycemia (41.1%), </span>respiratory distress syndrome (7.7%), and jaundice (29.3%).</span></p></div><div><h3>Conclusions</h3><p>Diabetes-in-pregnancy rates have more than doubled over the last decade, driven primarily by increases in GDM and T2DM. These trends may have significant implications for the future health of mothers and children in Alberta.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10066219","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":"Validity of Alternative Claims-based Algorithms for Type 1, Type 2, and Gestational Diabetes in Pregnancy","authors":"Deliwe P. Ngwezi MBChB, PhD ,&nbsp;Anamaria Savu PhD ,&nbsp;Roseanne O. Yeung MD, FRCPC, MPH ,&nbsp;Sonia Butalia BSc, MD, FRCPC, MSc (Epi) ,&nbsp;Padma Kaul PhD","doi":"10.1016/j.jcjd.2023.07.003","DOIUrl":"10.1016/j.jcjd.2023.07.003","url":null,"abstract":"<div><h3>Objective</h3><p>Our aim in this study was to evaluate the accuracy of alternative algorithms for identifying pre-existing type 1 or 2 diabetes (T1DM or T2DM) and gestational diabetes mellitus (GDM) in pregnant women.</p></div><div><h3>Methods</h3><p>Data from a clinical registry of pregnant women presenting to an Edmonton diabetes clinic between 2002 and 2009 were linked and administrative health records. Three algorithms for identifying women with T1DM<span>, T2DM, and GDM based on International Classification of Diseases---tenth revision (ICD-10) codes were assessed: delivery hospitalization records (Algorithm #1), outpatient clinics during pregnancy (Algorithm #2), and delivery hospitalization plus outpatient clinics during pregnancy (Algorithm #3). In a subset of women with clinic visits between 2005 and 2009, we examined the performance of an additional Algorithm #4 based on Algorithm #3 plus outpatient clinics in the 2 years before pregnancy. Using the diabetes clinical registry as the “gold standard,” we calculated true positive rates and agreement levels for the algorithms.</span></p></div><div><h3>Results</h3><p>The clinical registry included data on 928 pregnancies, of which 90 were T1DM, 89 were T2DM, and 749 were GDM. Algorithm #3 had the highest true positive rate for the detection of T1DM, T2DM, and GDM of 94%, 72%, and 99.9%, respectively, resulting in an overall agreement of 97% in diagnosis between the administrative databases and the clinical registry. Algorithm #4 did not provide much improvement over Algorithm #3 in overall agreement.</p></div><div><h3>Conclusions</h3><p>An algorithm based on ICD-10 codes in the delivery hospitalization and outpatient clinic records during pregnancy can be used to accurately identify women with T1DM, T2DM, and GDM.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10402000","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":"Dominican Adolescents’ Preferences for Content, Design, and Functionality of a Mobile Application for Type 1 Diabetes Mellitus Self-management","authors":"Arelis Moore PhD, MD, MPH, MEd ,&nbsp;Jenny Cepeda MD ,&nbsp;Breauna Franklin BS ,&nbsp;Gabriela Abreu MD ,&nbsp;Shelby Dorth ,&nbsp;Ethan Barkley BS","doi":"10.1016/j.jcjd.2023.07.006","DOIUrl":"10.1016/j.jcjd.2023.07.006","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this interdisciplinary study was to determine Dominican adolescents’ preferences for the content, functionality (i.e. food’s glycemic index<span> list, and amount of insulin based on foods’ carbohydrate count), and design of a culturally and linguistically relevant mobile application (app) for type 1 diabetes mellitus<span> (T1DM) self-management. The app would facilitate T1DM self-management education and support by addressing providers’ challenges in monitoring patients’ disease progression and promoting patient adherence to recommended lifestyle changes. Findings inform an app development process that considers the linguistic and cultural values, norms, and structures of people with T1DM and their providers in the Dominican Republic.</span></span></p></div><div><h3>Methods</h3><p>Phone interviews were conducted with 23 adolescents (14 to 18 years of age), using a semistructured questionnaire. The research team conducted the data analysis using NVivo through a deductive and inductive approach.</p></div><div><h3>Results</h3><p>The findings suggest that, regardless of the context, adolescents with T1DM desire similar features and functionalities in a self-management app. Overall, participants preferred an app with a graphic format that has accessible information, a straightforward design, and instructional videos. Participants also desired that an app provide information and reminders about proper eating and insulin administration timing and be a vehicle to access a social network to foster mutual support and encouragement.</p></div><div><h3>Conclusions</h3><p>Our study highlights adolescents’ perspectives on components for inclusion in an app for T1DM self-management. Participants' recommendations for the app’s potential usability, contents, and design features will be used to guide the development of a new app to promote engagement and foster better health outcomes.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10025306","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":"The Association of Children and Their Educational Attainment With Diabetes-related Complications and Mortality Among Older Adults With Type 2 Diabetes: A Nationwide Cohort Study","authors":"Emma Neble Larsen BSc ,&nbsp;Mathilde Marie Brünnich Sloth BSc ,&nbsp;Jannie Nielsen PhD ,&nbsp;Merete Osler MD, PhD ,&nbsp;Terese Sara Høj Jørgensen PhD","doi":"10.1016/j.jcjd.2023.07.004","DOIUrl":"10.1016/j.jcjd.2023.07.004","url":null,"abstract":"<div><h3>Objective</h3><p>Socioeconomic resources and family support have been shown to improve adherence to treatment in people with type 2 diabetes (T2D) and are associated with a lower risk of diabetes-related complications and death. We investigated the associations of having children and their educational level with diabetes-related complications and death among older adults with T2D.</p></div><div><h3>Methods</h3><p>We included 74,588 adults who were at least 65 years of age at the time of T2D diagnosis over the period from 2000 to 2018 in Denmark and grouped them based on having children (yes [reference]/no), and their children’s highest educational level (low/medium/high [reference]). Multistate models were performed with 3 states: T2D diagnosis, diabetes-related complications, and death. All models were stratified by other chronic diseases at baseline (yes/no).</p></div><div><h3>Results</h3><p>During follow-up (mean, 5.5 years), 14.6% of the adults developed a complication and 24.8% died with or without complications. Not having children was associated with a higher hazard of death without complications among adults without (hazard ratio [HR], 1.25; 95% confidence interval [CI], 1.17 to 1.33) and with (HR, 1.10; 95% CI, 1.02 to 1.18) other chronic diseases and after complications among adults without other chronic diseases (HR, 1.25; 95% CI, 1.12 to 1.38). Having children with a lower educational level was associated with a higher hazard of complications (HR_low, 1.14; 95% CI, 1.05 to 1.24; HR_medium, 1.11; 95% CI, 1.05 to 1.17), death without complications (HR_low, 1.26; 95% CI, 1.17 to 1.36; HR_medium, 1.07; 95% CI, 1.02 to 1.14), and after complications (HR_low, 1.22; 95% CI, 1.07 to 1.39) among adults without other chronic diseases.</p></div><div><h3>Conclusions</h3><p>Among adults without other chronic diseases, having no children or having children with lower educational levels was associated with a higher hazard of death. Among these adults, having children with lower educational levels was also associated with a higher hazard of diabetes-related complications.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S149926712300165X/pdfft?md5=5805b7907a8e8c9b5124dd4ab1508b69&pid=1-s2.0-S149926712300165X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10103856","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":"Socioeconomic Disparities in Glycemic Management in Children and Youth With Type 1 Diabetes: A Retrospective Cohort Study","authors":"Suzanne Simba MSc ,&nbsp;Julia E. Von Oettingen MD, PhD, MMSc ,&nbsp;Elham Rahme PhD ,&nbsp;Jennifer M. Ladd MD, MSc ,&nbsp;Meranda Nakhla MD, MSc ,&nbsp;Patricia Li MD, MSc","doi":"10.1016/j.jcjd.2023.07.005","DOIUrl":"10.1016/j.jcjd.2023.07.005","url":null,"abstract":"<div><h3>Objective</h3><p>In Canada, few studies have addressed health inequalities in type 1 diabetes<span> (T1D) outcomes. In this study, we examined the relationship between socioeconomic status (SES) and glycemic management in children with T1D and determine whether technology use (insulin pumps or continuous glucose monitoring [CGM]), diabetes-related physician visits, and depressive symptoms modified the association.</span></p></div><div><h3>Methods</h3><p><span><span>This work was a retrospective cohort study<span> using the Montréal Children’s Hospital Pediatric Diabetes Database of children 0 to 18 years old, diagnosed with T1D for ≥1 year, and with a hospital visit between November 2019 and October 2020. Main exposure was SES measured by the Material and Social Deprivation Index (least, moderately, or most deprived). We determined the association between SES and mean </span></span>glycated hemoglobin (A1C; main outcome) in the year after the index visit using multivariable </span>linear regression, adjusting for age, sex, diabetes duration, technology use, diabetes-related physician visits, and depressive symptoms (subgroup). We examined interaction terms for technology use, diabetes-related physician visits, and depressive symptoms.</p></div><div><h3>Results</h3><p>The study cohort included 306 children (mean age 13.6 years, mean A1C 8.5%). Children in the most-deprived compared with least-deprived quintiles had higher mean A1C; effect modification was significant with CGM only. Children not using CGM in the most-deprived compared with least-deprived quintiles had higher mean A1C (0.52%; 95% confidence interval, 0.14% to 0.86%), whereas the association was not significant for children using CGM.</p></div><div><h3>Conclusions</h3><p>Lower SES was associated with higher A1C; these disparities were not observed among CGM users. Further research is required to determine strategies to promote CGM access among children of lower SES in the Canadian health-care context.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10338618","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":"The Reponic Classification of Insulin","authors":"Joshua Moen PhD, MPH","doi":"10.1016/j.jcjd.2023.05.007","DOIUrl":"10.1016/j.jcjd.2023.05.007","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9758303","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":"Collaboration and Partnership in a 5-Level Engagement Framework for Diabetic Foot Ulcer Management: A Patient-oriented Scoping Review","authors":"Virginie Blanchette PhD, DPM ,&nbsp;Shweta Todkar PhD ,&nbsp;Magali Brousseau-Foley MD, DPM, MSc ,&nbsp;Nathalie Rheault MSI ,&nbsp;Tom Weisz BA, DCh ,&nbsp;Marie-Eve Poitras PhD, RN ,&nbsp;Jean-Sébastien Paquette MD, MSc ,&nbsp;Marie-Claude Tremblay PhD ,&nbsp;Idevânia G. Costa PhD, RN ,&nbsp;Maman Joyce Dogba PhD ,&nbsp;Anik Giguere PhD ,&nbsp;Charles de Mestral MD, PhD ,&nbsp;France Légaré MD, PhD","doi":"10.1016/j.jcjd.2023.07.002","DOIUrl":"10.1016/j.jcjd.2023.07.002","url":null,"abstract":"<div><h3>Objective</h3><p>The management of diabetic foot ulcers (DFUs) is complex, and patient engagement is essential for DFU healing, but it often comes down to the patient's consultation. Therefore, we sought to document patients’ engagement in terms of collaboration and partnership for DFUs in 5 levels (direct care, organizational, policy level, research, and education), as well as strategies for patient engagement using an adapted engagement framework.</p></div><div><h3>Methods</h3><p>We conducted a scoping review of the literature from inception to April 2022 using the Joanna Briggs Institute method and a patient-oriented approach. We also consulted DFU stakeholders to obtain feedback on the findings. The data were extracted using PROGRESS+ factors for an equity lens. The effects of engagement were described using Bodenheimer’s quadruple aims for value-based care.</p></div><div><h3>Results</h3><p>Of 4,211 potentially eligible records, 15 studies met our eligibility criteria, including 214 patients involved in engagement initiatives. Most studies were recent (9 of 15 since 2020) and involved patient engagement at the direct medical care level (8 of 15). Self-management (7 of 15) was the principal way to clinically engage the patients. None of the studies sought to define the direct influence of patient engagement on health outcomes.</p></div><div><h3>Conclusions</h3><p>Very few studies described patients’ characteristics. Engaged patients were typically men from high-income countries, in their 50s, with poorly managed type 2 diabetes. We found little rigorous research of patient engagement at all levels for DFUs. There is an urgent need to improve the reporting of research in this area and to engage a diversity of patients.</p></div>","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10125380","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":"Moving Beyond One-size-fits-all Solutions: The Importance of Adopting a Health Equity Lens for Addressing the Diabetes Epidemic","authors":"Ghazal S. Fazli MPH, PhD ,&nbsp;Lorraine L. Lipscombe MDCM, MSc, FRCPC","doi":"10.1016/j.jcjd.2023.10.402","DOIUrl":"10.1016/j.jcjd.2023.10.402","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49686327","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":"SINGLE CENTER EXPERIENCE IN TRANSVENOUS LEAD EXTRACTION AND MANAGEMENT OF TRICUSPID VALVE DISEASE","authors":"M. Zaitouni,&nbsp;B. Mondesert,&nbsp;A. Raymond-Paquin,&nbsp;M. Dubuc,&nbsp;B. Thibault,&nbsp;A. Asgar,&nbsp;M. Pellerin,&nbsp;D. Bouchard,&nbsp;P. Garceau","doi":"10.1016/j.jcjd.2023.10.079","DOIUrl":"https://doi.org/10.1016/j.jcjd.2023.10.079","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67735014","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":"EARLY SUCCESS OF THE TAILORING POST DISCHARGE PROGRAM (TPD) INDICATES FEASIBILITY AND SAFETY OF EARLY DISCHARGE FOR LOW-RISK ACS PATIENTS: A MANITOBA ACS NETWORK INITIATIVE","authors":"S. Liu,&nbsp;A. de Haan,&nbsp;D. Kent,&nbsp;L. Avery,&nbsp;T. Nguyen,&nbsp;C. Schaap,&nbsp;J. Cloutier,&nbsp;J. Ducas","doi":"10.1016/j.jcjd.2023.10.036","DOIUrl":"https://doi.org/10.1016/j.jcjd.2023.10.036","url":null,"abstract":"","PeriodicalId":9565,"journal":{"name":"Canadian Journal of Diabetes","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67735986","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}