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2.
Hu Li Za Zhi ; 66(6): 4, 2019 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-31802448

RESUMO

The diabetes population continues to grow worldwide both in terms of overall numbers and rate of increase. It is estimated that 642 million people will suffer from diabetes by 2040 (International Diabetes Federation, 2017). Diabetes was ranked the fifth main cause of death in Taiwan in 2017. (Department of Statistics, Ministry of Health and Welfare, Taiwan, ROC, 2019). Because of differences in the population in terms of disease cognition and disease control behaviors, despite recent advances in medicine and treatment efficacy, many diabetes patients continue to suffer from complications caused by improper blood sugar control, leading to a considerable number of subsequent health problems. Healthcare professionals, especially nurses, have critical roles to play in the health management of diabetes and metabolic-syndrome patients. In both the acute healthcare system and community homecare units, glycemic-related management of diabetes is important. We invite diabetes experts from academic and clinical practice units to share their professional knowledge and practical experiences, emphasizing patient-centered self-management principles. Related articles are expected to draw readers' attention to diabetes-related issues in order to gain new knowledge and skills related to blood sugar management.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus/terapia , Autogestão , Humanos , Taiwan
3.
Hu Li Za Zhi ; 66(6): 13-19, 2019 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-31802450

RESUMO

Diabetes is one of the most prevalent chronic diseases affecting public health. The Taiwan government implemented the Diabetes Shared Care Program to deliver continuous medical care and provide health education in order to help clients with diabetes learn self-management. However, rural older adults with diabetes often have poor access to medical resources and thus face obstacles to obtaining and using the services of this program. This paper introduces the current status of the Diabetes Shared Care Program, discusses the concept of self-management education and support for diabetes cases, and proposes community-based strategies, including (1) provide DSMES (diabetes self-management education and support) with multi-types of services, (2) increase non-professional personnel training, and (3) provide culture-congruent health education, in order to strengthen the diabetes self-management capabilities of rural older adults.


Assuntos
Diabetes Mellitus/terapia , Educação de Pacientes como Assunto , População Rural , Autogestão/educação , Idoso , Humanos , População Rural/estatística & dados numéricos , Taiwan
4.
Sheng Li Xue Bao ; 71(6): 917-934, 2019 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-31879747

RESUMO

Exosome is a kind of nanoscale-size extracellular vesicles secreted by the means of cell active stimulation with outer membrane structure of vacuoles corpuscle. It can carry and transfer a lot of biological molecules, such as DNA fragments, circular RNA (circRNA), messenger RNA (mRNA), microRNA (miRNA), functional proteins, transcription factors, etc., so as to achieve the goal of information transmission between cells. The relationship between exosomes and diabetes has received extensive attention in recent years. The exosomes play an important role in insulin sensitivity, glucose homeostasis and vascular endothelial function. This paper reviews the role of exosomes in the occurrence and development of diabetes and its complications, and discusses the role and prospect of exosomes as a target for diabetes treatment and its role in the diagnosis and treatment of diabetes.


Assuntos
Diabetes Mellitus , Exossomos , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/fisiopatologia , Diabetes Mellitus/terapia , Exossomos/metabolismo , Humanos , Resistência à Insulina/fisiologia , MicroRNAs/metabolismo , RNA Mensageiro/metabolismo
6.
Pan Afr Med J ; 34: 10, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762879

RESUMO

Introduction: There is an increasing commitment in the African Region towards diabetes care, following acknowledgement that it is an important public health issue which needs to be addressed in order to improve population health. We conducted a situational analysis of diabetes care in Guinea Bissau in order to identify the main issues faced in the management of the disease in this country. Methods: The study design was qualitative and data collection was done using semi directive interviews and focus groups with participants involved in primary diabetes care and management in Guinea Bissau (health care professionals, non-governmental organization staff, traditional healers) and patients. The data was analyzed using the five-phase approach of the thematic analysis framework. Results: The major themes identified included: the lack of specialists and properly trained healthcare personnel; no standardized care protocol for diagnosis, treatment, follow up and proper management for diabetic patients; resources poor primary health care settings; no validated epidemiological dataset on prevalence and the lack of awareness about diabetes (in general population and also in medical staff). Conclusion: This first situational analysis can serve as a baseline to develop an action plan to address the main issues identified.


Assuntos
Diabetes Mellitus/terapia , Pessoal de Saúde/organização & administração , Atenção Primária à Saúde/organização & administração , Adulto , Criança , Diabetes Mellitus/diagnóstico , Grupos Focais , Guiné-Bissau , Humanos , Entrevistas como Assunto
7.
Scand Cardiovasc J ; 53(6): 379-384, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31675271

RESUMO

Objective. Patients with diabetes have higher mortality rate than patients without diabetes after ST-segment elevated myocardial infarction (STEMI). Prognosis of patients with new onset diabetes (NOD) after STEMI remains unclear. The aim of this study was to evaluate the prognosis of patients with NOD compared to that of patients without NOD after STEMI. Design. This study was a retrospective observational study. We enrolled 901 STEMI patients. Patients were divided into diabetic and non-diabetic groups at index admission. Non-diabetic group was divided into NOD and non-NOD groups. Kaplan-Meier analysis and Cox's proportional hazard regression models were used to compare major adverse cardiac events (MACE) free survival rate and hazard ratio for MACE between NOD and non-NOD groups. Results. Mean follow-up period was 59 ± 28 months. Diabetes group had higher MACE than non-diabetes group (p = .038). However, MACE was not different between NOD and non-NOD groups (p = 1.000). After 1:2 propensity score matching, incidence of MACE was not different between the two groups. In Kaplan-Meier survival curves, MACE-free survival rates were not statistically different between NOD and non-NOD groups either (p = .244). Adjusted hazard ratios of NOD for MACE, all-cause of death, recurrent myocardial infarction, and target vessel revascularization were 0.697 (95% confidence interval [CI]: 0.362-1.345, p = .282), 0.625 (95% CI: 0.179-2.183, p = .461), 0.794 (95% CI: 0.223-2.835, p = .723), and 0.506 (95% CI: 0.196-1.303, p = .158), respectively. Conclusion. This retrospective observational study with a limited statistical power did not show a different prognosis in patients with and without NOD.


Assuntos
Diabetes Mellitus/terapia , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Adulto , Idoso , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/mortalidade , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Recidiva , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico , Infarto do Miocárdio com Supradesnível do Segmento ST/mortalidade , Fatores de Tempo
8.
Rev Lat Am Enfermagem ; 27: e3166, 2019.
Artigo em Português, Inglês, Espanhol | MEDLINE | ID: mdl-31596406

RESUMO

OBJECTIVE: to identify patterns of associations between the degree of compliance to laboratory test requests by risk strata and the parameters of quality of care outcomes in primary health care (PHC). METHOD: a cross-sectional study involving 108 elderly patients with hypertension and/or diabetes treated in PHC. A semi-structured questionnaire and electronic medical record data were used. To evaluate the quality of care, the Patient Assessment of Chronic Illness Care (PACIC) questionnaire was used. Descriptive analysis, multiple correspondence analysis and k-means grouping were performed. RESULTS: it was observed low compliance of the care practice, standing out as the worst parameter the evaluation of the diabetic foot (2.2%). Three clusters were identified, with cluster 1 having the highest number of individuals (37.0%), with better indicators of quality of care, evidenced by above 50% of compliance with laboratory tests (75.0%), high PACIC score (47.2%), control of blood pressure (70.0%) and metabolic levels (95.0%), and satisfaction with health (92.5%) and health access (90.0%). In contrast, cluster 3 (29.6%) was made up of individuals with worse outcomes of care. CONCLUSION: low compliance of care practice and asymmetries among health actions and users' needs were observed, indicating failures in the care process in PHC.


Assuntos
Diabetes Mellitus/terapia , Serviços de Saúde para Idosos/organização & administração , Hipertensão/terapia , Atenção Primária à Saúde , Qualidade da Assistência à Saúde/normas , Idoso , Idoso de 80 Anos ou mais , Brasil , Doença Crônica , Feminino , Serviços de Saúde para Idosos/normas , Humanos , Masculino , Cooperação do Paciente , Satisfação do Paciente , Encaminhamento e Consulta , Medição de Risco , Inquéritos e Questionários
9.
J Assoc Physicians India ; 67(10): 44-47, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31571452

RESUMO

Introduction: Diabetes is one of the expensive diseases due to its chronic nature and gradual involvement of multiple organs, Moreover loss of economic productivity further enhances the cost of care. Several factors were reported to have impact on overall economic burden in diabetic patients. So, the present study aims to determine influence of various socio-demographic and clinical factors on expenditure of diabetes care among patients residing in resettlement colony of East Delhi. Methodology: A community based one year longitudinal study was conducted in Kalyanpuri area of East Delhi. All the diabetes patients aged 25 years and who were the permanent residents of Kalyanpuri, attending the Diabetic Clinic of a government hospital in November-December 2014 were selected for the study. A pre-tested semi-structured interview schedule was used as study tool. Each subject was followed up 3 monthly from January to December 2015. Results: Data of 150 study subjects was analyzed. Out of 150 subjects 45(30 %) were male and 105 (70%) female. Overall mean age of study subjects was 53 ± 10 years Among socio-demographic factors, Expenditure on diabetes care showed significant association with male gender and among clinical factors, longer duration since diagnosis, use of Insulin with Oral Hypoglycemic drugs, hospitalization and utilization of private care has shown positive association with expenditure on diabetes care. Conclusion: The present study concludes that there is need of better provisioning of services for diabetes care in government health facilities to cater needs of growing diabetic population..


Assuntos
Diabetes Mellitus/terapia , Gastos em Saúde , Adulto , Diabetes Mellitus/economia , Feminino , Humanos , Índia , Insulina , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade
10.
Rev. Soc. Cardiol. Estado de Säo Paulo ; 29(4 (Supl)): 432-440, out.-dez. 2019. tab, graf
Artigo em Português | LILACS | ID: biblio-1047350

RESUMO

O diabetes mellitus tipo 2 (DM2) é considerado um dos principais distúrbios metabólicos relacionados ao desenvolvimento de doenças cardiovasculares e outras comorbidades, com elevada incidência e prevalência no Brasil e no mundo. Apesar dos avanços em seu tratamento, a projeção mundial é de aumento no número de diagnósticos. No Brasil, o total de pessoas com a doença cresceu mais de 60% em 10 anos. Como o manejo dietético é um dos pilares no tratamento do DM2, este trabalho objetivou analisar os estudos que compararam as dietas restritas em carboidratos com outras abordagens dietéticas a fim de elucidar se esta seria a opção mais adequada para os pacientes com DM2. Assim, fez-se uma revisão de ensaios clínicos randomizados por meio das plataformas de pesquisa PubMed e Cochrane Library em outubro de 2018, selecionando os estudos segundo a estratégia PICO de pesquisa. Dos 398 artigos encontrados, 19 atenderam os critérios de elegibilidade. Após a análise, demonstrou-se que as dietas restritas em carboidratos favorecem o controle glicêmico, melhora do perfil lipídico e redução dos medicamentos para DM2 em relação às outras opções dietéticas, no entanto, os trabalhos apresentam vieses metodológicos e são, em geral, de curto prazo. Sendo assim, é precipitado afirmar que essas dietas são mais efetivas para o tratamento do DM


Type 2 diabetes mellitus (T2DM) is considered one of the primary metabolic disorders related to the development of cardiovascular diseases and other comorbidities, with high incidence and prevalence in Brazil and in the world. Despite advances in its treatment, an increase in the number of diagnoses is estimated worldwide. In Brazil, the total number of people with the disease has grown more than 60% in 10 years. As dietary management is one of the mainstays in the treatment of T2DM, this study aimed to analyze the studies that compared carbohydrate-restricted diets with other dietary approaches to elucidate if this would be the most appropriate option for patients with T2DM. Thus, randomized clinical trials were reviewed through the PubMed and Cochrane Library research platforms in October 2018, selecting the studies according to the PICO research strategy. Of the 398 articles found, 19 met the eligibility criteria and had their data collected. After the analysis, it was demonstrated that carbohydrate-restricted diets support glycemic control, loss of body mass, improvement of lipid profile and reduction of medications for T2DM compared to other dietary options. However, a significant part of the studies has methodological biases and is generally short-term. Therefore, the level of evidence supporting dietary restriction of carbohydrates in the management of T2DM is considered moderate. Thus, according to the principle of the null hypothesis, it is unwise to affirm that these diets are superior in the treatment of DM2


Assuntos
Carboidratos , Diabetes Mellitus/terapia , Dieta com Restrição de Carboidratos , Doenças Cardiovasculares , Índice de Massa Corporal , Fatores de Risco , Índice Glicêmico , Dieta , Obesidade
11.
J Assoc Physicians India ; 67(9): 70-77, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31561693

RESUMO

Fasting and feasting are integral part of many religions and cultures. As the amount of food and fluid intake are markedly altered during these phases, patients with diabetes are prone to higher risk of complications. Even though several guidelines for fasting and feasting are available; Indian specific recommendations are the need of the hour, because of the distinct dietary habits and the diet content (high carbohydrate) of Indians. To fill this void, the current guidelines have been developed by experts from India who extensively reviewed the literature, shared their practical knowledge and ultimately arrived at a consensus.


Assuntos
Diabetes Mellitus/terapia , Jejum , Dieta , Comportamento Alimentar , Humanos , Índia
12.
BMC Public Health ; 19(1): 1267, 2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31519162

RESUMO

BACKGROUND: Community health services have played an important role in the prevention and control of diabetes in China. The aims of this study were to examine the frequency of visits to community clinics for diabetic care services, to assess factors correlated with infrequent primary care visits and to identify barriers to regular follow-up visits for urban and rural patients. METHODS: Between October 2014 and November 2014, data were collected from 17 communities in two cities and four townships located in Shandong and Jiangsu Provinces in China. A total of 1598 diabetic patients aged 18 years or older who were registered with a primary health station in local communities were selected by simple random sampling. Each participant was required to complete an interviewer-led questionnaire. Univariate and multivariate analyses were used to identify significant factors for infrequent visitor status using multivariable logistic regression analysis. RESULTS: After being clearly informed of the study protocol, 1508/1598 (94.4%) patients agreed to participate in this survey. Among the 1508 subjects (mean age 64.4 ± 10.6), 683 (45.3%) were classified as infrequent visitors. The following were significant factors determining infrequent visitor status: urban residence, lack of health insurance, per-capita household income< 20,000 (yuan), lack of telephone follow-up and lack of household visit. From the patients' perspectives, the reasons for infrequent visits among urban patients included drug scarcity and longer travel time to clinics. For rural patients, worries about medical expenses and drug scarcity were the most common barriers to clinic visits. CONCLUSION: Determinants of infrequent community visits in diabetes patients include urban residence, lower household income, lack of health insurance, lack of telephone follow-up and lack of household visit services. Strategies aimed at enhancing the utilization of community health care should be implemented in China.


Assuntos
Diabetes Mellitus/terapia , Atenção Primária à Saúde/estatística & dados numéricos , Idoso , China , Cidades , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Inquéritos e Questionários
13.
N C Med J ; 80(5): 261-268, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31471505

RESUMO

BACKGROUND Successful diabetes care requires patient engagement and health self-management. Diabetes shared medical appointments (SMAs) are an evidence-based approach that enables peer support, diabetes group education, and medication management to improve outcomes. The purpose of this study is to learn how diabetes SMAs are being delivered in North Carolina, including the characteristics of diabetes SMAs across the state.METHOD Twelve health systems in the state of North Carolina were contacted to explore clinical workflow and intervention characteristics with a member of the SMA care delivery team. Surveys were used to assess intervention characteristics and delivery.RESULTS Diabetes SMAs were offered in 10 clinics in 5 of the 12 health systems contacted with considerable heterogeneity across sites. The majority of SMAs were open cohorts (80%), offered monthly (60%) for 1.5 hours (60%). SMAs included a mean of 7.5 ± 3.4 patients with a maximum of 11.2 ± 2.7 patients. Survey data revealed barriers (cost-sharing and provider buy-in) to, and facilitators (leadership support and clinical champions) of, clinical adoption and sustained implementation.LIMITATIONS External validity is limited due to the small sample size and geographic clustering.CONCLUSION There is significant heterogeneity in the delivery and characteristics of diabetes SMAs in North Carolina with only modest uptake across the health systems. Further research to determine best practices and effectiveness in diverse, real-world clinical settings is required to inform implementation and dissemination efforts.


Assuntos
Agendamento de Consultas , Diabetes Mellitus/terapia , Pesquisas sobre Serviços de Saúde , Humanos , North Carolina
14.
BMC Public Health ; 19(1): 1104, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412829

RESUMO

BACKGROUND: The burden of tuberculosis (TB) and diabetes mellitus (DM) is rising and substantially affecting the low-income countries, including Tanzania. Integrated management of TB and DM is becoming of importance in TB high burden countries. In this study, we sought to assess the availability and readiness of diabetes facilities to manage TB in Tanzania. METHODS: The present study was based on a secondary analysis of the 2014-2015 Tanzania Service Provision Assessment Survey data. We calculated the service availability as a percentage of diabetes facilities offering TB services: diagnosis and treatment. Regarding the readiness of diabetes facilities to provide TB management, we calculated based on the three domains: staff training and guideline, diagnostics, and medicines as identified by World Health Organization-Service Availability and Readiness Assessment (SARA) manual. A score of at least half (≥50%) of the indicators listed in each of the three domains was considered as high readiness. We used a descriptive statistics to present our findings. RESULTS: There were 619 DM facilities all over the country of which only 238 (38.4%) had TB services.72.6 and 62.6% of these DM facilities with TB services were publicly owned and located in rural settings respectively. Generally, DM facilities had low readiness to manage TB; 12·6%. More specifically, all DM facilities had low readiness in terms of trained staff and guidelines. However, in the domain of diagnostics and medications, higher levels of care (hospitals) had a comparatively higher level of readiness to manage TB. CONCLUSION: Most of the DM facilities had low availability and readiness to manage TB. The findings of our study display an urgent need to mobilize important resources to enhance the integration of TB services in DM facilities. This includes medications, management guidelines, diagnostics, and health professionals who have received refresher training on TB/DM co-management. However, presently, few DM facilities may be allowed to start managing TB as per the Strategic and Action Plan for the Prevention and Control of Non-Communicable Diseases in Tanzania 2016-2020.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Diabetes Mellitus/terapia , Instalações de Saúde/normas , Acesso aos Serviços de Saúde/estatística & dados numéricos , Tuberculose/terapia , Diabetes Mellitus/epidemiologia , Pesquisas sobre Serviços de Saúde , Humanos , Tanzânia/epidemiologia , Tuberculose/epidemiologia , Organização Mundial da Saúde
15.
Complement Ther Clin Pract ; 36: 120-124, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31383429

RESUMO

PURPOSE: To measure the frequency, type, purpose of complementary medicine (CM) use among people with diabetes mellitus. MATERIALS AND METHODS: The population of this descriptive study consisted of the patients hospitalized in the endocrine clinic of a university hospital in Eastern Turkey who were diagnosed with diabetes. Data were collected from 316 patients. RESULTS: 43.0% of the patients were using CM, and 97.0% of those using CM tried herbal methods. The patients who had variable glycated haemoglobin values (60.3%) and those who had DM-related complications (60.3%) used CM more. CONCLUSION: It was determined that CM usage was prevalent among the patients. The most frequently used CM method was herbal therapy. We found that the use of CM was more common in patients with poor metabolic control. Therefore, healthcare professionals must be assess use of CM and provide suitable counseling.


Assuntos
Terapias Complementares/estatística & dados numéricos , Diabetes Mellitus , Diabetes Mellitus/epidemiologia , Diabetes Mellitus/terapia , Humanos , Turquia/epidemiologia
16.
Folia Histochem Cytobiol ; 57(3): 101-115, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31396945

RESUMO

Insulin-producing cells derived from in vitro differentiation of stem cells and non-stem cells by using different factors can spare the need for genetic manipulation and provide a cure for diabetes. In this context, pancreatic progenitors differentiating to ß-like cells garner increasing attention as ß-cell replacement source. This kind of cell therapy has the potential to cure diabetes, but is still on its way of being clinically useful. The primary restriction for in vitro production of mature and functional ß-cells is developing a physiologically relevant in vitro culture system which can mimic in vivo pathways of islet development. In order to achieve this target, different approaches have been attempted for the differentiation of pancreatic stem/progenitor cells to ß-like cells. Here, we will review some of the state-of-the-art protocols for the differentiation of pancreatic progenitors and differentiated pancreatic cells into ß-like cells with a focus on pancreatic duct cells.


Assuntos
Células Acinares/metabolismo , Diferenciação Celular , Células Secretoras de Glucagon/metabolismo , Células Secretoras de Insulina/metabolismo , Células-Tronco Mesenquimais/metabolismo , Células Secretoras de Somatostatina/metabolismo , Células Acinares/transplante , Animais , Diabetes Mellitus/terapia , Células Secretoras de Glucagon/transplante , Humanos , Insulina/metabolismo , Transplante das Ilhotas Pancreáticas , Transplante de Células-Tronco Mesenquimais
17.
Comput Inform Nurs ; 37(8): 413-419, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31394560

RESUMO

The use of mobile applications in chronic disease management has grown significantly over the past decade. When properly designed, these apps provide a convenient, safe, high-quality service to patients. In this study, a health management app was developed, and its usability among patients with diabetes mellitus was examined. A convenience sample of 136 patients, referred to two academic centers from December 2016 to July 2017, was enrolled. Upon completion of informed consent, the participants were asked to install the app on their smartphone. Two weeks later, they were required to complete a postapplication usability questionnaire, comprising 21 questions classified into six domains. The response rate was 89%. The highest scores were given for "ease of use and learnability"; the lowest-scored domains were "interaction quality" and "reliability." Urban residents, participants with lower educational qualifications, and retirees were significantly more satisfied with the app. Overall, patients with diabetes mellitus perceived the app as useful for disease management. However, the overall usability of health apps is expected to improve when a multidisciplinary team (health professionals, computer engineers, art designers) is involved in the development process.


Assuntos
Diabetes Mellitus/terapia , Aplicativos Móveis/estatística & dados numéricos , Autocuidado/tendências , Telemedicina , Interface Usuário-Computador , Doença Crônica , Feminino , Humanos , Irã (Geográfico) , Masculino , Pessoa de Meia-Idade , Smartphone , Inquéritos e Questionários
18.
Diabetes Metab Syndr ; 13(4): 2671-2682, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405693

RESUMO

AIMS: Diabetes educators (DEs) play a major role in diabetes education and management. The aims of this scoping review were to compile the currently identified core competencies for DEs and, to review the currently used criteria to assess DEs' core competencies. METHODS: A scoping review was conducted using the methodology of the Joanna Briggs Institute. Five databases (Ovid, CINAHL, Scopus, Web of Science and PubMed) were searched. Keywords as well as inclusion and exclusion criteria were identified as search strategies and study selection for this review. RESULTS: A total of (n = 22) publications comprising sixteen peer-reviewed studies and six professional-organisations (grey literature) were selected for review, as they listed the core competencies of DEs. The most common core competencies were related to knowledge and skills in diabetes self-management education, knowledge of pathophysiology and epidemiology, teaching skills, clinical skills and cultural competency. Evidently, an appropriate tool for assessing DEs' competencies is currently unavailable. CONCLUSIONS: Given the importance of diabetes education in the care of people living with diabetes, it is imperative that DEs possess competencies in diabetes education and management. The review also identified the need to develop a globally applicable core competency assessment tool for DEs.


Assuntos
Diabetes Mellitus/terapia , Educadores em Saúde/normas , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/organização & administração , Competência Profissional/normas , Autogestão/educação , Gerenciamento Clínico , Humanos
19.
BMC Health Serv Res ; 19(1): 582, 2019 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-31426768

RESUMO

BACKGROUND: To examine the association between delay in planned diabetes care and quality of outcomes. METHODS: A retrospective analysis of primary care and inpatient records for 2567 Aboriginal patients, with diabetes, living in 49 remote communities in the Northern Territory of Australia. Poisson regression was used to estimate the association between delay from diagnosis to documented diabetes care plan and three outcome measures: mean HbA1c level, most recent blood pressure and number of diabetes-related hospital admissions. RESULTS: Compared with no delay (< 60 days), patients with delay had increased risk of elevated mean HbA1c: 60 days to < 2 years, incidence rate ratio (IRR), 1.2 (95% CI:1.07-1.39); 2 years to < 4 years, incidence rate ratio (IRR), 1.2 (95% CI:1.04-1.45); 4 years and over, incidence rate ratio (IRR), 1.3 (95% CI:1.12-1.52). There was no evidence of association between delay and optimal blood pressure control. Risk of diabetes-related admission increased with increased delay. Compared with no delay the IRRs for delay were: 60 days to < 2 years, 1.2 (95% CI:1.07-1.42); 2 to < 4 years, 1.3 (95% CI: 1.15-1.58): and 4 years and over, 2.6 (95% CI,2.28-3.08). CONCLUSION: The study found that a timely diabetes care plan was associated with better short-term blood glucose control and fewer diabetes-related admissions but not with improved blood pressure control. Delays may be a result of both patient and service-related factors.


Assuntos
Assistência à Saúde/normas , Diabetes Mellitus/terapia , Grupo com Ancestrais Oceânicos/etnologia , Atenção Primária à Saúde/normas , Tempo para o Tratamento/estatística & dados numéricos , Adolescente , Adulto , Idoso , Pressão Sanguínea/fisiologia , Assistência à Saúde/etnologia , Assistência à Saúde/estatística & dados numéricos , Diabetes Mellitus/etnologia , Feminino , Hemoglobina A Glicada/metabolismo , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Northern Territory/epidemiologia , Northern Territory/etnologia , Atenção Primária à Saúde/estatística & dados numéricos , Qualidade da Assistência à Saúde/normas , Qualidade da Assistência à Saúde/estatística & dados numéricos , Estudos Retrospectivos , Adulto Jovem
20.
Stud Health Technol Inform ; 264: 1787-1788, 2019 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-31438344

RESUMO

Voice technology offers a range of novel and promising strategies for clinical diabetes management. Incorporation of voice-powered virtual assistants (such as Apple Siri and Microsoft Cortana) into diabetes care programs has the potential to improve patient awareness and adherence; facilitate comprehensive provider-patient integration and data collection; and expedite consultations, procedures, and meal preparations. This study will present a qualitative literature review on existing and speculative applications of voice technology in diabetes care.


Assuntos
Diabetes Mellitus , Conscientização , Diabetes Mellitus/terapia , Humanos , Tecnologia
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