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Evidence Based Diabetes Management

Diabetologist's Perspective On Practice Of Evidence Based Diabetes Management In India

Diabetologist's Perspective On Practice Of Evidence Based Diabetes Management In India

Volume 95, Issue 2 , February 2012, Pages 189-193 Diabetologist's perspective on practice of evidence based diabetes management in India Author links open overlay panel HabibHasan Get rights and content Diabetes demands early diagnosis, prompt treatment, continuous monitoring and follow up. Physicians play a pivotal role in diabetes management. However, evidence suggests that sub-optimal knowledge of guidelines and other issues may lead to ineffective management and poor patient outcomes. The aim of this research was to identify clinical diabetologist's perspectives on evidence based diabetes management, benefits of and barriers to the practice of evidence based guidelines in management of type 2 diabetes. Clinical diabetologists were administered a semi-structured questionnaire. Qualitative responses were analysed to identify key words, phrases and concepts from respondents. Majority of diabetologist (78.2%) preferred ADA guidelines alone or in combination with others guidelines where as 12.7% diabetologist follow all the guidelines on case by case basis. 27% and 25% diabetologists opined that guidelines ensure uniform standard of care across patient and achievement of diabetes management goals respectively. Poor awareness among physicians (22.7%), western guidelines being not applicable to Indian patients (22.7%), cost to patient (18.2%) were some of the barrier to practice of evidence based diabetes management. Some of the mechanism suggested to improve the practice of evidence based diabetes management included education of physicians in EBM (28.9%), making practice of evidence based guidelines legally binding (10.5%) and wider dissemination of existing guidelines (7.8%). Continue reading >>

Certificate Course In Evidence Based Diabetes Management

Certificate Course In Evidence Based Diabetes Management

Certificate Course In Evidence Based Diabetes Management The fundamental objective of the Certificate Course in Evidence Based Diabetes Management is to improve the Treatment outcomes for patients by serving as evidence Based guidance for clinical decision making in risk Assessment, diagnosis, prognosis and management of Diabetes. It is also an effort to translate and transfer Emerging evidence from clinical research to clinical Practice. The total duration of the course is 12 months, with once a month contact session which will be conducted on designated Sunday at regional centres all across the country. Medical graduate (MBBS) with at least 3 years of Experience as primary care physician/clinical Or Medical graduate (MBBS) with Post-graduate * Recommendation from the Faculty is mandatory for enrolment. Introductory Overview of Diabetes Mellitus Presentation and Initial Evaluation of Type 2 Diabetes Non-Pharmacological Management of Type 2 Diabetes Approach to Pharmacotherapy of Type 2 Diabetes Part 1 Approach to Pharmacotherapy of Type 2 Diabetes Part 2 Chronic Complications of Type 2 Diabetes Part 1 Chronic Complications of Type 2 Diabetes Part 2 Special Topics in Care of Patients with Type 2 Diabetes Conclusions and take home messages and Exit Exam The criteria for successful completion of the program Participation in minimum 10 out of 12 monthly Contact sessions (including the pre-test and post Test of each module) Completion of assigned course work (Three Descriptive assignments based on completed Modules given at regular intervals) Appearance in and clearance of final written Examination in the form of 50 MCQs in an hour Along with Module 12 (Min. 50% score required to Clear the examination. The candidate completing the training program Successfully will be awar Continue reading >>

Evidence-based Nutrition Guidelines For The Prevention And Management Of Diabetes

Evidence-based Nutrition Guidelines For The Prevention And Management Of Diabetes

Evidence-based nutrition guidelines for the prevention and management of diabetes Evidence-based nutrition guidelines for the prevention and management of diabetes Our set of nutrition recommendations for adults with diabetes and those at risk of Type 2 diabetes have been written for healthcare professionals who are supporting them. A key strategy applied in these current guidelines was to formulate recommendations from the available evidence highlighting the importance of foods, rather than focusing on individual nutrients, wherever possible. An individualised approach to diet taking into consideration the persons personal and cultural preferences People eat more of certain foods such as vegetables, fruits, wholegrains, fish, nuts and pulses People eat less red and processed meat, refined carbohydrates and sugar sweetened beverages. These nutrition guidelines are relevant to people at risk of developing Type 2 diabetes and people with Type 1 and Type 2 diabetes. Special considerations have also been discussed for Gestational diabetes and Cystic Fibrosis- Related diabetes. Children are not included in the scope of these guidelines. The International Society of Paediatric and Adolescent Diabetes (ISPAD) clinical practice guidelines have been adopted by us. Wefirst published dietary recommendations for people with diabetes in 1982, with subsequent updates in 1992, 2003 and 2011. The previous evidence-based guidelines, published in 2011, had included studies published up to August 2010. The 2018 guidelines incorporate existing evidence and additional studies published between January 2010 and July 2017, although an exception was made to include a major UK study of diabetes remission, published in December 2017. Continue reading >>

Adaptation Of An Evidence-based Diabetes Management Intervention For Delivery In Community Settings: Findings From A Pilot Randomized Effectiveness Trial

Adaptation Of An Evidence-based Diabetes Management Intervention For Delivery In Community Settings: Findings From A Pilot Randomized Effectiveness Trial

To adapt an evidence-based intervention targeting diabetes management in adolescents with poorly controlled type 1 diabetes for use in a community setting by community health workers (CHWs) and to conduct pilot testing of the new intervention, REACH for Control (RFC). The study was conducted as a collaboration between university researchers and a federally qualified health center. In a pilot effectiveness trial, feasibility and acceptability of RFC were evaluated based on participant enrollment, treatment dose, and consumer satisfaction. RFC effects on adolescent adherence, health outcomes, and quality of life were also assessed. The trial used a parallel group design. Families were randomized to 6 months of RFC plus standard medical care (n = 26) or standard care (SC) only (n = 24). Data were collected at baseline and 7-month posttest. A mixed-methods approach was used to analyze data. Qualitative analyses suggested that caregivers viewed RFC and delivery of a home-based intervention by CHWs positively. Furthermore, adolescents who received RFC had statistically significant (p = .05) and clinically meaningful improvements in hemoglobin A1c (HbA1c) (0.7%) and reported significant improvements in quality of life from baseline to follow-up (p = .001). No significant changes were found for adolescents in standard medical care. However, while dose of primary intervention session delivered was acceptable, dose of follow-up sessions used for skills practice was low. Results provide preliminary support for RFCs acceptability and effectiveness to improve health status and quality of life when used in community settings serving high-risk, low-income families. Additional testing in a full-scale effectiveness trial appears warranted. adherence , adolescents , diabetes , family th Continue reading >>

March 2017

March 2017

March 02, 2017 Robert A. Gabbay, MD, PhD, FACP Five-year results of the Why WAIT study at Joslin Diabetes Center. Differential Weight Loss Effects on Type 2 Diabetes Remission Among Adults March 02, 2017 Virender Kumar, PhD; William Encinosa, PhD; Hena Thakur; and Kisha Thakur An analysis of nationally representative survey-based data finds that 5.2% of adults with type 2 diabetes were in remission, without bariatric surgery, at the end of the second year. Diabetes: An Opportunity to Have a Lasting Impact on Health Through Lifestyle Modification March 03, 2017 Hena N. Patel, MD; Andrew M. Freeman, MD, FACC; and Kim A. Williams MD, FACC Three cardiologists, including the 2015-2016 president of the American College of Cardiology, review the evidence in support of lifestyle modification for diabetes management or remission. Can Yoga, Mindfulness Fit With Managed Care? Recent studies have linked yoga and mindfulness with reduced stress, improved glycemic control, and even lower medical costs. Should these low-cost practices find ways to standardize to meet payers' needs? Or is it managed care that needs to adapt? March 04, 2017 Andreas Michaelides, PhD, and Ed Pienkosz, MS Authors from the digital health provider Noom offer an update of a successful employer-based initiative. A Bundle of Nudges: Healthcare Payment in an Era of Behavioral Science Using digital health to manage chronic disease means creating new payment models that recognize care is an ongoing process. A landmark reimbursement decision from Medicare, and news in diabetes prevention. Payer-Provided Fitness Rewards: Employers Will Look At Evidence Recommendations to interrupt long periods of sitting challenge both insurers and employers to find methods, based on evidence, to encourage physical activity through Continue reading >>

Diabetologist's Perspective On Practice Of Evidence Based Diabetes Management In India

Diabetologist's Perspective On Practice Of Evidence Based Diabetes Management In India

Diabetes demands early diagnosis, prompt treatment, continuous monitoring and follow up. Physicians play a pivotal role in diabetes management. However, evidence suggests that sub-optimal knowledge of guidelines and other issues may lead to ineffective management and poor patient outcomes. The aim of this research was to identify clinical diabetologist's perspectives on evidence based diabetes management, benefits of and barriers to the practice of evidence based guidelines in management of type 2 diabetes. Clinical diabetologists were administered a semi-structured questionnaire. Qualitative responses were analysed to identify key words, phrases and concepts from respondents. Majority of diabetologist (78.2%) preferred ADA guidelines alone or in combination with others guidelines where as 12.7% diabetologist follow all the guidelines on case by case basis. 27% and 25% diabetologists opined that guidelines ensure uniform standard of care across patient and achievement of diabetes management goals respectively. Poor awareness among physicians (22.7%), western guidelines being not applicable to Indian patients (22.7%), cost to patient (18.2%) were some of the barrier to practice of evidence based diabetes management. Some of the mechanism suggested to improve the practice of evidence based diabetes management included education of physicians in EBM (28.9%), making practice of evidence based guidelines legally binding (10.5%) and wider dissemination of existing guidelines (7.8%). Do you want to read the rest of this article? ... [17] Poor awareness among physicians, and western guidelines being not applicable to Indian patients are also important barriers to diabetes management. As the barriers are well known, identifying the gaps in diabetic care in an area will help to Continue reading >>

Diabetes Uk Evidencebased Nutrition Guidelines For The Prevention And Management Of Diabetes

Diabetes Uk Evidencebased Nutrition Guidelines For The Prevention And Management Of Diabetes

Diabetes UK evidencebased nutrition guidelines for the prevention and management of diabetes 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. A summary of the latest evidencebased nutrition guidelines for the prevention and management of diabetes is presented. These guidelines are based on existing recommendations last published in 2011, and were formulated by an expert panel of specialist dietitians after a literature review of recent evidence. Recommendations have been made in terms of foods rather than nutrients wherever possible. Guidelines for education and care delivery, prevention of Type 2 diabetes, glycaemic control for Type 1 and Type 2 diabetes, cardiovascular disease risk management, management of diabetesrelated complications, other considerations including comorbidities, nutrition support, pregnancy and lactation, eating disorders, micronutrients, food supplements, functional foods, commercial diabetic foods and nutritive and nonnutritive sweeteners are included. The sections on pregnancy and prevention of Type 2 diabetes have been enlarged and the weight management section modified to include considerations of remission of Type 2 diabetes. A section evaluating detailed considerations in ethnic minorities has been included as a new topic. The guidelines were graded using adapted GRADE methodology and, where strong evidence was lacking, grading was not allocated. These 2018 guidelines emphasize a flexible, individualized approach to diabetes management and weight loss and highlight the emerging evidence for remission Continue reading >>

Evidence-based Behavioral Interventions To Promote Diabetes Management In Children, Adolescents, And Families

Evidence-based Behavioral Interventions To Promote Diabetes Management In Children, Adolescents, And Families

Evidence-Based Behavioral Interventions to Promote Diabetes Management in Children, Adolescents, and Families Marisa E. Hilliard , Priscilla W. Powell , and Barbara J. Anderson Department of Pediatrics, Baylor College of Medicine and Texas Childrens Hospital Correspondence concerning this article should be addressed to Barbara J. Anderson, Department of Pediatrics, Baylor College of Medicine and Texas Childrens Hospital, 1102 Bates Avenue, Suite 940, Houston, TX 77030. [email protected] The publisher's final edited version of this article is available at Am Psychol See other articles in PMC that cite the published article. As members of multidisciplinary diabetes care teams, psychologists are well-suited to support self-management among youth with Type 1 diabetes (T1D) and Type 2 diabetes (T2D) and their families. Psychological and behavioral interventions can promote adherence to the complex and demanding diabetes care regimen, with the goals of promoting high quality of life, achieving optimal glycemic control, and ultimately preventing disease-related complications. This article reviews well-researched contemporary behavioral interventions to promote optimal diabetes family- and self-management and health outcomes in youth with T1D, in the context of key behavioral theories. The article summarizes the evidence base for established diabetes skills training programs, family interventions, and multisystemic interventions, and introduces emerging evidence for technology and mobile health interventions and health care delivery system interventions. Next steps in behavioral T1D intervention research include tailoring interventions to meet individuals and families unique needs and strengths, and systematically evaluating cost-effectiveness to advocate for dissemination of well-d Continue reading >>

Certificate Course In Evidence Based Diabetes Management: A Pan India Capacity Building Program For Primary Care Physicians | 17937

Certificate Course In Evidence Based Diabetes Management: A Pan India Capacity Building Program For Primary Care Physicians | 17937

Introduction:Diabetes is considered as one of the major contributors to global burden of disease; it exemplifies managementchallenge because of long latency, chronicity, multi-organ involvement and long term care. In India, health system is constraintin term of trained manpower and limited institutional capacities for diabetes management. So keeping this fact in mind,Public health foundation of India in collaboration with Dr. Mohan Diabetes Education Academy developed an evidence baseddiabetes management course in 2010 for primary care physicians to build their capacity and improve their skill in diabetesmanagement. With this study we aimed to evaluate the short term impact of PAN India Certificate Course in Evidence BasedDiabetes Management (CCEBDM).Methods:We used mixed method design for data collection incorporation on site pre and post evaluation of all the primarycare physicians and off site follow ups from n=225 participants who attended the course from 2010 to 2012. Impact of onsitepre and post evaluation was assessed used the significance level and off site evaluation was assessed by using 5-point LikertScale and observational technique was used to evaluate the impact of course on their clinical practices and infrastructure.Results:2776 primary care physicians were assessed for knowledge improvement and it was found that there is significantimprovement (P value<0.001) in knowledge regarding basics of diabetes, pharmacological treatment, acute and chroniccomplications with management. Offsite evaluation showed that frequency of treating diabetic patient/physician/monthincreased (38% 501 to 1,500 patients per month and 44% stated that they treated about 101 to 500 patients per month), confidencelevel of physician increased in field of diabetes diagnoses and manag Continue reading >>

Intensive Diabetes Management: Negotiating Evidence-based Practice.

Intensive Diabetes Management: Negotiating Evidence-based Practice.

1. Can J Diet Pract Res. 2010 Summer;71(2):62-8. Intensive diabetes management: negotiating evidence-based practice. (1)Department of Nutritional Sciences and The Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. PURPOSE: An exploration was completed of health professionals' experiencesimplementing evidence-based guidelines that promote intensive management (IM) forpeople with diabetes.METHODS: In-depth, semi-structured interviews were conducted with 50 healthprofessionals from across Canada. These professionals are considered to beopinion leaders in diabetes care. Interviews were audiotaped, transcribedverbatim, and coded with the assistance of NVivo software. Transcripts wereanalyzed using Potter and Wetherell's approach to discourse analysis.RESULTS: Participants noted that recent clinical trials validated intensiveapproaches to diabetes management. While they viewed the evidence as sound, they did not feel that it justified IM approaches in all situations. Evidence-basedpractice therefore gave way to individual patient considerations. Implementingbehavioural strategies, such as the stages of change model, allowed participants to modify their practices in ways that accommodated both evidence-based andpatient-focused practice paradigms.CONCLUSIONS: While evidence-based medicine influenced practice, it was only onediscourse that shaped the way health professionals approached diabetes care. Continue reading >>

Evidence Based Diabetes Management: March 2018 | Ajmc

Evidence Based Diabetes Management: March 2018 | Ajmc

The Potential of a Population Health Strategy to Improve Healthcare Outcomes and Reduce Costs for Medicaid Programs With Medicaid consuming a larger share of the Mississippi's budget, innovative solutions were needed to deliver improved health outcomes at a lower cost. A public-private partnership was created to pursued a population health strategy aimed at reducing preterm births and preventing the progression of prediabetes to type 2 diabetes. How Technology Can Make CMS' Diabetes Prevention Program Viable Missed sessions are the obvious place where digital programs can find a place in the launch of Medicare's first fully reimbursed preventive service. Applying Digital Technology in Clinical Trials to Improve Real-World Outcomes Science 37 hopes to help researchers produce clinical trial results that are closer to real-world experiences, for the benefit of patients, pharma, and payers. Geographic Access to Endocrinologists for Florida's Publicly Insured Children With Diabetes March 31, 2018 Ashby F. Walker, PhD; Jaclyn M. Hall, PhD; Elizabeth A. Shenkman, PhD; Matthew J. Gurka, PhD; Heather L. Morris, PhD; Michael J. Haller, MD; Henry J. Rohrs, MD; Kelsey R. Salazar, MPH; and Desmond A. Schatz, MD Enrollment, claims, and spatial data are used to demonstrate theimportance of outreach strategies for families in rural areas who have children with diabetes. Spatial barriers, alone, do not fully elucidateracial/ethnic disparities in pediatric diabetes for street-level location. (For Tables and the Figure, please access the PDF on the last page.) Impact of a Pharmacist-Managed Diabetes Clinic on Quality Measures March 31, 2018 Nadia J. Aneese, PharmD; Alexandra Halalau, MD; Sarah Muench, PharmD; Daniel Shelden, DO; Janna Fett, PharmD; Colleen Lauster, PharmD This study eva Continue reading >>

Center For Excellence In Aging & Community Wellness -

Center For Excellence In Aging & Community Wellness -

You can manage and maintain an active and fulfilling life by enhancing your skills and ability to manage Diabetes with this 6-session, 2.5 hour peer-led health education workshop that utilizes the evidence-based Diabetes Self-Management Program (DSMP) curriculum developed and tested by Stanford University. The Living Healthy with Diabetes workshop is designed to complement and enhance medical treatment and diabetes management with techniques to handle fatigue, stress, pain and emotions as well as healthy eating, monitoring, appropriate use of medication and skin and foot care. The Diabetes Self-Management Program, developed by Stanford Universitys Patient Education Research Center, is a six-week workshop that takes place once a week for 2 hours and is facilitated by two trained Peer Leaders and/or Master Trainers. This program is designed to help people gain self-confidence in their ability to control their symptoms and how diabetes affects their lives. This workshop teaches the skills needed in the day-to-day management of diabetes in order to maintain and/or increase an active and fulfilling lifestyle. The curriculum teaches self-managed lifestyle change and coping strategies to enable participants to manage their diabetes, medications and increase physical activity levels. People with type 2 diabetes attend this highly participative and supportive workshop. The original Diabetes Self-Management Program was developed in Spanish. Results from the Spanish program showed that the program participants, as compared with usual-care control subjects, demonstrated improved health status, health behavior, and self-efficacy, as well as fewer emergency room visits at four months. At one year, the improvements were maintained and remained significantly different from baseline co Continue reading >>

Diabetes Management: Team-based Care For Patients With Type 2 Diabetes

Diabetes Management: Team-based Care For Patients With Type 2 Diabetes

Diabetes Management: Team-Based Care for Patients with Type 2 Diabetes The Community Preventive Services Task Force recommends team-based care to control type 2 diabetes by improving patients blood glucose (measured using A1c levels), blood pressure, and lipid levels. Interventions also increase the proportion of patients who reach target blood glucose, blood pressure, and lipid levels. Team-based care is a health systems-level, organizational intervention that assigns a multidisciplinary team to help patients manage their diabetes. Each team includes the patient, the patient's primary care provider (not necessarily a physician), and 1 or more other health professionals. Teams work together to help patients get appropriate medical tests and examinations, use medications to manage and control risk factors, self-manage their health care and adhere to treatment, make healthy behavior and lifestyle choices (e.g., improved diet, increased physical activity, cessation of smoking), and improve their quality of life and prevent diabetes-related complications. Continue reading >>

Adaptation Of An Evidence-based Diabetes Management Intervention For Delivery In Community Settings: Findings From A Pilot Randomized Effectiveness Trial.

Adaptation Of An Evidence-based Diabetes Management Intervention For Delivery In Community Settings: Findings From A Pilot Randomized Effectiveness Trial.

To adapt an evidence-based intervention targeting diabetes management in adolescents with poorly controlled type 1 diabetes for use in a community setting by community health workers (CHWs) and to conduct pilot testing of the new intervention, REACH for Control (RFC). The study was conducted as a collaboration between university researchers and a federally qualified health center. In a pilot effectiveness trial, feasibility and acceptability of RFC were evaluated based on participant enrollment, treatment dose, and consumer satisfaction. RFC effects on adolescent adherence, health outcomes, and quality of life were also assessed. The trial used a parallel group design. Families were randomized to 6 months of RFC plus standard medical care (n = 26) or standard care (SC) only (n = 24). Data were collected at baseline and 7-month posttest. A mixed-methods approach was used to analyze data. Qualitative analyses suggested that caregivers viewed RFC and delivery of a home-based intervention by CHWs positively. Furthermore, adolescents who received RFC had statistically significant (p = .05) and clinically meaningful improvements in hemoglobin A1c (HbA1c) (0.7%) and reported significant improvements in quality of life from baseline to follow-up (p = .001). No significant changes were found for adolescents in standard medical care. However, while dose of primary intervention session delivered was acceptable, dose of follow-up sessions used for skills practice was low. Results provide preliminary support for RFC's acceptability and effectiveness to improve health status and quality of life when used in community settings serving high-risk, low-income families. Additional testing in a full-scale effectiveness trial appears warranted. The Author 2017. Published by Oxford Universi Continue reading >>

Diabetologist's Perspective On Practice Of Evidence Based Diabetes Management In India.

Diabetologist's Perspective On Practice Of Evidence Based Diabetes Management In India.

Diabetologist's perspective on practice of evidence based diabetes management in India. Diabetes Research and Clinical Practice [15 Oct 2011, 95(2):189-193] Diabetes demands early diagnosis, prompt treatment, continuous monitoring and follow up. Physicians play a pivotal role in diabetes management. However, evidence suggests that sub-optimal knowledge of guidelines and other issues may lead to ineffective management and poor patient outcomes. The aim of this research was to identify clinical diabetologist's perspectives on evidence based diabetes management, benefits of and barriers to the practice of evidence based guidelines in management of type 2 diabetes. Clinical diabetologists were administered a semi-structured questionnaire. Qualitative responses were analysed to identify key words, phrases and concepts from respondents. Majority of diabetologist (78.2%) preferred ADA guidelines alone or in combination with others guidelines where as 12.7% diabetologist follow all the guidelines on case by case basis. 27% and 25% diabetologists opined that guidelines ensure uniform standard of care across patient and achievement of diabetes management goals respectively. Poor awareness among physicians (22.7%), western guidelines being not applicable to Indian patients (22.7%), cost to patient (18.2%) were some of the barrier to practice of evidence based diabetes management. Some of the mechanism suggested to improve the practice of evidence based diabetes management included education of physicians in EBM (28.9%), making practice of evidence based guidelines legally binding (10.5%) and wider dissemination of existing guidelines (7.8%). Continue reading >>

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