Diabetes Management Journal

Diabetes Management: Optimizing Roles For Nurses In Insulin Initiation

Diabetes management: optimizing roles for nurses in insulin initiation University of California Davis Health System, Sacramento, CA, USA Abstract: Type 2 diabetes is a major public health concern. Screening and early diagnosis followed by prompt and aggressive treatment interventions can help control progression of diabetes and its complications. Nurses are often the first healthcare team members to interact with patients and are being called on to apply their specialized knowledge, training, and skills to educate and motivate patients with diabetes about insulin use and practical ways to achieve treatment goals. Clinical nurse specialists possess specific training and skills to provide this level of care, while staff or office-based nurses may be trained by physicians to fulfill a task-specific role. This manuscript reviews the benefits of intensive glycemic control in type 2 diabetes, therapeutic goals and guidelines, advances in insulin therapy, and contribution of nurses in overcoming barriers to insulin initiation and related aspects of diabetes care. Nurses are particularly well positioned to fill the gap and improve efficiency in diabetes-related healthcare by assisting patients with insulin initiation and other aspects of glycemic self-management. Keywords: insulin, diabetes, diabetes educator, hypoglycemia, diabetes counseling, insulin clinic, insulin pens This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License . By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Continue reading >>

World Journal Of Diabetes - Baishideng Publishing Group

The World Journal of Diabetes (WJD) is a leading academic journal devoted to reporting the latest, cutting-edge research progress and findings of basic research and clinical practice in the field of diabetes. It was launched on March 15, 2010 and is published monthly (12 issues annually) by BPG, the world's leading professional clinical medical journal publishing company. We encourage diabetologists worldwide to submit manuscripts to the WJD describing their original basic or clinical research findings that are of high academic value and which report new diagnostic techniques or summarize their treatment experiences. The usual times related to all publication processes of the WJD are as follows: (1) From manuscript receipt to peer-review: 2-4 weeks; (2) From initial manuscript acceptance, with revisions, to return of the revised manuscript from the authors: 4-5 weeks; (3) From return of the revised manuscript from the authors to final acceptance: 1-2 weeks; (4) From final acceptance to an articleinpress: 2 days; and (5) From article in press designation to formal release of the electronic version and all online documentation: 2-9 weeks.The WJDs acceptance rate: 57%. Submit here >> Continue reading >>

Improvement Noted After A Multifaceted Approach To Diabetes Mellitus Management

Improvement noted after a multifaceted approach to diabetes mellitus management Background: Optimal control of diabetes mellitus remains elusive, especially in developing countries. A comprehensive and standardised approach, coupled with intensive patient and clinician education, may provide the solution. Methods: Comprehensive datasheets accompanied by patient education from a multidisciplinary team and clinician retraining on diabetes management was introduced into the Edendale Hospital diabetes clinic in 2012. This study compares diabetes control starting October 1, 2012 to September 30, 2013 (Y1) to October 1, 2013 to September 30, 2014 (Y2). Results: Significant changes (p-values < 0.005) were noted in the following parameters between Y2 and Y1 respectively: * Mean HbA1c% (10.412.91 vs. 11.262.99). * Mean HbA1c in males (9.46 vs. 10.57) and (10.38 vs. 11.19) for females. * Mean HbA1c for type 1 (11.80 vs.10.77) and type 2 patients (10.91 vs.10.10). * Percentage of patients achieving triglyceride control (64.28 vs. 52.85). * Percentage of patients making lifestyle changes and performing home glucose monitoring. * Increase in female waist circumference (97.29 vs. 85.95cm). * Increase in BMI in males (29.65 vs. 27.92kg/m2). Conclusion: This multifaceted approach to diabetes care in a resource-limited clinic significantly improved glycaemic and triglyceride control. Obesity remains a major challenge. This model could serve as a blueprint for other such resource-limited clinics. Keywords: BMI , blood pressure control , comprehensive approach , diabetes mellitus , lifestyle changes , multi-disciplinary team , obesity , patient and clinician education , resource-limited setting , target cholesterol , target glycaemic control , target triglyceride , waist circumference Ap Continue reading >>

Quality Of Inpatient Diabetes Management | Journal Of Hospital Medicine

Hospitalistrun general medicine service of an academic teaching hospital. 107 consecutive patients with diabetes mellitus or inpatient hyperglycemia. We collected data on up to 4 bedside glucose measurements per day, detailed clinical information, and all orders related to glucose management. The primary outcomes were rate of hyperglycemia (glucose > 180 mg/dL) per patient and mean glucose level per patientday. The mean rate of hyperglycemia was 31% of measurements per patient. Basal insulin was ordered for 43% of patients, and scheduled rapid or shortacting insulin was ordered for 4% of patients. Sixtyfive percent of patients who had at least 1 episode of hyper or hypoglycemia had no change made to any insulin order during the first 5 days of the hospitalization. When adjusted for clinical factors, the use of slidingscale insulin by itself was associated with a 20 mg/dL higher mean glucose level per patientday. Management of diabetes and hyperglycemia on a general medicine service showed several deficiencies in process and outcome. Possible targets for improvement include increased use of basal and nutritional insulin and daily insulin adjustment in response to hyperglycemia. Journal of Hospital Medicine 2006;3:145150. 2006 Society of Hospital Medicine. Copyright 2006 Society of Hospital Medicine Diabetes mellitus is a common comorbidity of hospitalization; in 2003 diabetes was a secondary diagnosis in 17.8% of all adult hospital discharges. 1 When undiagnosed diabetes is included, the prevalence of inpatient diabetes or hyperglycemia may be as high as 38%. 2 Recent studies show that hyperglycemia in hospitalized patients complicates numerous illnesses and is an independent predictor of adverse outcomes. 3 Treatment of inpatient hyperglycemia improves outcomes, includ Continue reading >>

Role Of Self-care In Management Of Diabetes Mellitus

Abstract Diabetes mellitus (DM) is a chronic progressive metabolic disorder characterized by hyperglycemia mainly due to absolute (Type 1 DM) or relative (Type 2 DM) deficiency of insulin hormone. World Health Organization estimates that more than 346 million people worldwide have DM. This number is likely to more than double by 2030 without any intervention. The needs of diabetic patients are not only limited to adequate glycemic control but also correspond with preventing complications; disability limitation and rehabilitation. There are seven essential self-care behaviors in people with diabetes which predict good outcomes namely healthy eating, being physically active, monitoring of blood sugar, compliant with medications, good problem-solving skills, healthy coping skills and risk-reduction behaviors. All these seven behaviors have been found to be positively correlated with good glycemic control, reduction of complications and improvement in quality of life. Individuals with diabetes have been shown to make a dramatic impact on the progression and development of their disease by participating in their own care. Despite this fact, compliance or adherence to these activities has been found to be low, especially when looking at long-term changes. Though multiple demographic, socio-economic and social support factors can be considered as positive contributors in facilitating self-care activities in diabetic patients, role of clinicians in promoting self-care is vital and has to be emphasized. Realizing the multi-faceted nature of the problem, a systematic, multi-pronged and an integrated approach is required for promoting self-care practices among diabetic patients to avert any long-term complications. Introduction Diabetes mellitus (DM) is a chronic progressive metab Continue reading >>

Diabetes Management Today: Issues In Achieving Glycemic Goals

Diabetes management today: Issues in achieving glycemic goals Cleveland Clinic Journal of Medicine 2016 May; 83 Suppl 1(5):S2-S3 Dr. Lansang reported that she has no financial interests or relationships that pose a potential conflict of interest with this article. Boyle JP, Honeycutt AA, Narayan KM, et al. Projection of diabetes burden through 2050: impact of changing demography and disease prevalence in the U.S. Diabetes Care 2001; 24:19361940. Boyle JP, Thompson TJ, Gregg EW, Baker LE, Williamson DF. Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Popul Health Metr 2010; 8:29. Selvin E, Parrinello CM, Sacks DB, Coresh J. Trends in prevalence and control of diabetes in the United States, 1988-1994 and 1999-2010. Ann Intern Med 2014; 160:517525. In the years since the discovery of insulin in 1921, our understanding of diabetes and the development of treatments have greatly improved the lives of patients with diabetes. These advances have not yet led us to a cure. In fact, the percentage of the US population diagnosed with diabetes continues to rise. In 2001, it was projected that nearly 20 million Americans would have diabetes by 2025.1 But in 2015, 29 million Americans had been diagnosed with diabetes, exceeding the 2001 projection by 9 million. Newer projections are soberingthe prevalence of diabetes is estimated to increase from 9.3% of the population in 2012 to between 21% and 30% by 2050.2 As a result, most healthcare providers will face patients with diabetes or at risk for diabetes. Patients with diabetes today differ from those in the past in that increasing numbers of them are insulin resistant with impaired insulin secretion. Elements of metabolic syndrome includi Continue reading >>

Barriers To Diabetes Management: Patient And Provider Factors

Barriers to diabetes management: Patient and provider factors Enter your login details below. If you do not already have an account you will need to register here . Due to migration of article submission systems, please check the status of your submitted manuscript in the relevant system below: Check the status of your submitted manuscript in EVISE Check the status of your submitted manuscript in EES: Once production of your article has started, you can track the status of your article via Track Your Accepted Article. CiteScore: 3.52 CiteScore measures the average citations received per document published in this title. CiteScore values are based on citation counts in a given year (e.g. 2015) to documents published in three previous calendar years (e.g. 2012 14), divided by the number of documents in these three previous years (e.g. 2012 14). The Impact Factor measures the average number of citations received in a particular year by papers published in the journal during the two preceding years. 2017 Journal Citation Reports (Clarivate Analytics, 2018) 5-Year Impact Factor: 3.308 Five-Year Impact Factor: To calculate the five year Impact Factor, citations are counted in 2016 to the previous five years and divided by the source items published in the previous five years. 2017 Journal Citation Reports (Clarivate Analytics, 2018) Source Normalized Impact per Paper (SNIP): 1.445 Source Normalized Impact per Paper (SNIP): SNIP measures contextual citation impact by weighting citations based on the total number of citations in a subject field. SCImago Journal Rank (SJR): 1.538 SCImago Journal Rank (SJR): SJR is a prestige metric based on the idea that not all citations are the same. SJR uses a similar algorithm as the Google page rank; it provides a quantitative and a qualit Continue reading >>

Jmir-a Framework For The Evaluation Of Internet-based Diabetes Management | Mazzi | Journal Of Medical Internet Research

The Karma system is currently undergoing maintenance (Monday, January 29, 2018). The maintenance period has been extended to 8PM EST. Karma Credits will not be available for redeeming during maintenance. Published on 10.01.02 in Vol 4, No 1 (2002) Preprints (earlier versions) of this paper are available at , first published Jan 10, 2002. This paper is in the following e-collection/theme issue: 1Faculty of Medicine, The University of Sydney, Chatswood NSW 2067, Australia 2Department of General Practice, The University of Sydney, Balmain 2041, Sydney, Australia Background: While still in its infancy, Internet-based diabetes management shows great promise for growth. However, the following aspects must be considered: what are the key metrics for the evaluation of a diabetes management site? how should these sites grow in the future and what services should they offer? Objectives: To examine the needs of the patient and the health care professional in an Internet-based diabetes management solution and how these needs are translated into services offered. Methods: An evaluation framework was constructed based on a literature review that identified the requirements for an Internet-based diabetes management solution. The requirements were grouped into 5 categories: Monitoring, Information, Personalization, Communication, and Technology. Two of the market leaders (myDiabetes and LifeMasters) were selected and were evaluated with the framework. The Web sites were evaluated independently by 5 raters using the evaluation framework. All evaluations were performed from November 1, 2001 through December 15, 2001. Results: The agreement level between raters ranged from 60% to 100%. The multi-rater reliability (kappa) was 0.75 for myDiabetes and 0.65 for LifeMasters, indicating substa Continue reading >>

Digital Health Technology And Diabetes Management

Digital health technology and diabetes management The Diabetes Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel Endocrinology and Metabolism Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel Institute of Endocrinology, Rabin Medical Center Beilinson Hospital, PetachTikva, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel The Diabetes Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel Itamar Raz, Diabetes Unit, Hadassah Hebrew University Hospital, PO Box 12000, Jerusalem 91120, Israel. The Diabetes Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel Endocrinology and Metabolism Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel Institute of Endocrinology, Rabin Medical Center Beilinson Hospital, PetachTikva, Israel Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel The Diabetes Unit, Hadassah Hebrew University Hospital, Jerusalem, Israel Itamar Raz, Diabetes Unit, Hadassah Hebrew University Hospital, PO Box 12000, Jerusalem 91120, Israel. Please review our Terms and Conditions of Use and check box below to share full-text version of article. I have read and accept the Wiley Online Library Terms and Conditions of Use. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. Diabetes care is largely dependent on patient selfmanagement and empowerment, given that patients with diabetes must make numerous daily decisions as to what to eat, when to exercise, and determine their insulin dose and timing if required. In addition, patients and providers are generating vast amounts of data from many sources, including electronic medical records, insulin pumps, sensors, glucometers, and other wearables, as well as evolving genomic, proteomi Continue reading >>

Medical Alert Identification: A “scarlet Letter” Or Tool For Diabetes Management

For individuals living with type 1 diabetes, the risk of an insulin reaction, also known as hypoglycemia, is an ever-present danger. The likelihood of this danger escalates during times of illness and injury or unusual activity. Children with type 1 diabetes, especially those on an intensive diabetes control regimen requiring more than two insulin injections per day, are at an increased risk for hypoglycemic reactions (Diabetes Control and Complications Trial 1994, United Kingdom Prospective Diabetes Study Group 1998). This risk requires that blood glucose levels be frequently monitored and glucose sources readily available to prevent and treat hypoglycemia. However, these interventions alone are not enough to offset the dangers facing children with diabetes. Emergency preparedness guidelines issued by the American Diabetes Association (2004a)) encourage individuals with diabetes to wear some form of medical identification indicating they take insulin. This intervention provides emergency personnel and others responsible for the immediate care of a child with diabetes with critical information that will guide additional assessments and medical interventions. Wearing medical identification becomes extremely important during times of acute injury or critical illness when an informed adult may not be readily available to identify the child as having diabetes, resulting in less optimal and even potentially harmful management. Jump to Section Who’s wearing identification? In spite of the importance of this safety measure, little research has been done to discover the degree of adherence to the recommendation for wearing of a medical alert identification. A recent search of MEDLINE and PubMed yielded only one study on this topic. In this study, researchers found that only 6 Continue reading >>

Mobile Health (m-health) For Diabetes Management

Mobile health (m-Health) for diabetes management Diabetes is a major health challenge with a global impact regardless of age, country or economic condition. The increased prevalence of diabetes is reaching alarming levels. The necessity and urgency to find innovative care delivery solutions is becoming more important, particularly in the digital age. It is expected in the near future that more people with diabetes, especially the younger generations will be empowered by their smartphones and relevant mobile health (m-Health) innovations, to take more responsibility of their condition. Clinicians and healthcare providers are increasingly likely to assume the role of navigators and advisors rather than simply the medical gatekeeper for their patients. In this article, we describe the general architecture of current m-Health systems and applications for diabetes management. We also discuss the clinical evidence for impact from these important and innovative approaches to diabetes self-care and management and likely future trends in their usage. The latest statistics indicate that there are more than 1200 diabetes smartphone apps and this area is growing exponentially in terms of ideas, technologies, devices and the associated industry. M-Health for diabetes care is now a major business stream for the medical device, mobile phone and IT telecommunication industries with high expectations arising from the potential benefits to be gained by both patients and healthcare providers. However, this potential has not yet been fully developed on the clinical side. This may be due to many factors including the reluctance of clinicians to engage with these technologies due to the lack of clinical evidence for their efficacy, poor adherence of people with diabetes to long-term use of Continue reading >>

Diabetes Management Journal Moves To Tangello

Diabetes Management Journal moves to Tangello Custom Publishing of Diabetes Management Journal moves to The Tangello Group March 22, 2017 Diabetes Australia announce The Tangello Group has been engaged to manage the publishing for Diabetes Management Journal, the national peak bodys official quarterly journal for general practitioners and other health professionals in the primary care system throughout Australia. "Diabetes Management Journal has been a must read for GPs and many other health professionals for the past 15 years. It is the only regular diabetes focused clinical publication in Australia targeting primary care. The Tangello Group have been tasked with taking Diabetes Management Journal to the next level, said Caroline Wells from Diabetes Australia. Diabetes is one of the biggest challenges in our health system. With diabetes a growing epidemic and GPs time stretched further and further every year, Diabetes Australia wants to ensure the Diabetes Management Journal further develops as a key resource for GPs and other health professsionals to keep them informed and up to date with advances, support continuing education, and most importantly provide them with information they can put into practice immediately for people with diabetes. Tangello Managing Director, Lucinda Mitchell explained, We are going to build on the journals strong editorial foundation to ensure there is an actionable take away in every article for GPs and health professionals We will be redesigning the journal and applying our understanding of consumer publishing as well as science and medical publishing to create compelling, informative and scientifically accurate information all GPs will want to keep in their library to refer back to. Yes you can, but it is a fairly complicated process wh Continue reading >>

Health Publishing Australia Medical Journals

Health Publishing Australia publishes medical journals primarily for the benefit of general practitioners but also circulated to an array of relevant allied health professionals dependent on the journal. Each journal has an independent Editorial Board of specialists in the respective medical field of focus. The Editorial Board identify the subjects to be addressed and nominate the best qualified specialist to write the respective articles. After being edited by the Medical Editor the articles are peer reviewed by the Editorial Board prior to publication. Each Journal is the only regularly published medical journal dedicated and distributed on a complimentary basis to General Practitioners with an absolute clinical focus on the respective title. Diabetes Management Journal-(published on behalf of Diabetes Australia) Paediatrics and Child Health in General Practice Continue reading >>

Commodity 12: A Smart E-health Environment For Diabetes Management - Ios Press

Authors: Kafal, zgr ; | Bromuri, Stefano | Sindlar, Michal | van der Weide, Tom | Aguilar Pelaez, Eduardo | Schaechtle, Ulrich | Alves, Bruno | Zufferey, Damien | Rodriguez-Villegas, Esther | Schumacher, Michael Ignaz | Stathis, Kostas Affiliations: Department of Computer Science, Royal Holloway, University of London, Egham, TW20 0EX, UK. E-mail: {ozgur.kafali,ulrich.schaechtle,kostas.stathis}@cs.rhul.ac.uk | Department of Business Information Systems, University of Applied Sciences Western Switzerland, 3 Technopole, 3960, Sierre, Switzerland. E-mail: {stefano.bromuri,bruno.alves,damien.zufferey,michael.schumacher}@hevs.ch | Portavita B.V., Oostenburgervoorstraat 100, PO Box 1287, 1000 BG, Amsterdam, The Netherlands. E-mail: {m.sindlar,t.van.der.weide}@portavita.eu | Electrical and Electronic Engineering Department, Imperial College London, South Kensington Campus, London, SW7 2BT, UK. E-mail: {eduardo.aguilar-pelaez02,e.rodriguez}@imperial.ac.uk Note: [] Corresponding author. E-mail: [email protected]. Abstract: We present the development of COMMODITY12, a Personal Health System (PHS) to assist in the provision of continuous and personalised health services to diabetic patients, thus empowering their lifestyle regardless of their location. COMMODITY12 consists of ambient, wearable and portable devices, which acquire, monitor and communicate physiological parameters and other health-related context of an individual, such as physical activity and vital body signals. This data is interpreted by intelligent agents that use expert biomedical knowledge to derive important insights about the individual's health status, which are then presented in the form of active feedback to the patient directly from the device, or via health professionals who assist in diagnosis, tr Continue reading >>

Impact On Diabetes Management Of General Practice Management Plans, Team Care Arrangements And Reviews

Impact on diabetes management of General Practice Management Plans, Team Care Arrangements and reviews Leelani K Wickramasinghe, Peter Schattner, Marienne E Hibbert, Joanne C Enticott, Michael P Georgeff and Grant M Russell Med J Aust 2013; 199 (4): 261-265. || doi: 10.5694/mja13.10161 Conclusion: There were significant improvements in process and clinical outcomes for patients on a GPMP or a GPMP and TCA, particularly when these were followed up by regular reviews. Patients using cdmNet were four times more likely to have their GPMP or TCA followed up through regular reviews than the national average. T he prevalence of diabetes is increasing worldwide, placing a major burden on individuals, communities and health services. In meeting this challenge, evidence suggests that the Chronic Care Model (CCM) 1 leads to improved patient care and better health outcomes. 2 The importance of the CCM delivery system longitudinal planned care, regular follow-up and review, and multidisciplinary team care is well established. 3 Studies have shown that delivery system interventions are associated with improvements in clinical processes and outcomes, 4 including glycated haemoglobin (HbA1c) and low-density lipoprotein (LDL) cholesterol levels 5 and glycaemic control 6 in patients with diabetes. In Australia, Chronic Disease Management Medicare items were introduced to increase support for the management of chronic illness. 7 These items provide rebates for General Practice Management Plans (GPMPs) to improve care planning, Team Care Arrangements (TCAs) to foster multidisciplinary care, and GPMP and TCA reviews to support ongoing care and regular follow-up. 8 Evidence indicates that TCAs are associated with improved outcomes for patients with diabetes, 9 , 10 but no detailed study on Continue reading >>