diabetestalk.net

Rubin Dj Hospital Readmission Of Patients With Diabetes Curr Diab Rep 2015 15 17

Hormones.gr

Hormones.gr

Cardiovascular safety of type 2 diabetes medications: Review of existing literature and clinical implications Slvia Paredes,1,2 Claudia Matta-Coelho,1,3Ana Margarida Monteiro,1 Alice Brs,2 Olinda Marques,1Marta Alves,1 Laura Ribeiro2,4,5 1Department ofEndocrinology, Hospital de Braga, Portugal; 2Department of MedicalEducation and Simulation, Faculty of Medicine, University of Porto, Portugal; 3Facultyof Nutrition and Food Sciences, University of Porto, Portugal; 4Departmentof Biochemistry, Faculty of Medicine, University of Porto, Portugal; 5I3S-Institutode Investigao e Inovao em Sade, University of Porto, Portugal Type 2 diabetes mellitus (T2DM),cardiovascular disease (CVD) and the cardiovascular effect of antidiabeticdrugs are today critical medical issues, with the prevalence of T2DM inparticular showing a steep increase worldwide, mainly due to unhealthylifestyle habits. T2DM in association with obesity and other cardiovascularrisk factors, results in the development of CVD, the leading cause of morbidityand mortality in patients with T2DM. Thus, treatment of T2DM is anindividualized and complex challenge in which targeting cardiovascular riskfactors is an important component in the decision making. Given thecardiovascular adverse events associated with rosiglitazone, both the Food andDrug Administration and the European Medicines Agency currently require thedemonstration of cardiovascular safety of new antidiabetic drugs. Consequently,clinical trials to guarantee their cardiovascular safety are now obligatory.This review aims to summarize the available evidence on the cardiovasculareffects and safety of the major drugs used in T2DM treatment and also toprovide an overview of upcoming and ongoing clinical trials in this field. Ourbelief is that this review will be Continue reading >>

Amydonihi From The E&m Blogosphere

Amydonihi From The E&m Blogosphere

How can pharmacists help patients with diabetes bridge the inpatient-to-outpatient transition of care gap? In the very large tertiary care academic medical center where I work as a clinical pharmacist, nearly 30% of all patients have diabetes. Most already carry the diagnosis in their past medical history at the time of admission, but many are new to the diagnosis (although admitted for other reasons). Despite this high prevalence of diabetes, my hospital does not have a dedicated certified diabetes educator (CDE). Shocked? You shouldnt be. The days of a dedicated hospital-based diabetes educator whose sole job is to provide comprehensive diabetes self-management education (DSME) are long gone in many institutions because hospital administrators believe it is inefficient to pay a CDE to run around the hospital to teach patients with diabetes. There are many challenges associated with hospital discharge planning for patients with diabetes. These challenges include pressures to discharge the patient early, treatment inertia, and knowledge deficits among practitioners and nursing staff regarding management of diabetes and insulin therapy.1 Patients are very sick with whatever disease process brought them into the hospital. There is high acuity, and short lengths of stay. But, there are also very good reasons that patients, even those who might have been educated prior to admission, need diabetes education. For example, insulin is the mainstay for glucose management in the hospital setting. This means that nearly all patients new to the diagnosis are given insulin, patients taking non-insulin therapy prior to admission have that therapy switched to insulin, and patients on insulin prior to admission have their insulin therapy changed to the insulin products on formulary. P Continue reading >>

The Case For Diabetes Population Health Improvement: Evidence-based Programming For Population Outcomes In Diabetes.

The Case For Diabetes Population Health Improvement: Evidence-based Programming For Population Outcomes In Diabetes.

of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland Medical System, Baltimore, MD, USA of Endocrinology and Metabolism, Department of Medicine, Temple University School of Medicine, Philadelphia, PA, USA Hopkins Community Physicians at Suburban Hospital, Bethesda, MD, USA on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA 8Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA Purpose of ReviewThe goal of this review is to describe diabetes within a population health improvement framework and to review the evidence for a diabetes population health continuum of intervention approaches, including diabetes prevention and chronic and acute diabetes management, to improve clinical and economic outcomes. Correspondence to: Sherita Hill Golden. Compliance with Ethical Standards Conflict of Interest Sherita Hill Golden, Nisa Maruthur, Nestoras Mathioudakis, Elias Spanakis, and Mihail Zilbermint declare that they have no conflict of interest. Daniel Rubin reports grants from Merck, Boehringer Ingelheim, and AstraZeneca. Felicia Hill-Briggs is a member of the Board of Directors of the American Diabetes Association. Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors. Recent FindingsRecent studies have shown that compared to usual care, lifestyle interventions in prediabetes lower diabetes risk at the population-level and that group-based programs have low Continue reading >>

Deborah Wexler | Harvard Catalyst Profiles | Harvard Catalyst

Deborah Wexler | Harvard Catalyst Profiles | Harvard Catalyst

Opportunities for training and funding in C/T research Grants for clinical and translational research projects. Request single or consolidated IRB review for a multi-site study. Helping researchers navigate clinical & translational research regulatory processes. Harvard-affiliated multi-disciplinary programs, centers and initiatives. Contact, publication, and social network information about Harvard faculty and fellows. The research activities and funding listed below are automatically derived from NIH ExPORTER and other sources, which might result in incorrect or missing items. Faculty can login to make corrections and additions. R18DK102737(WEXLER, DEBORAH J)Sep 15, 2014-Jul 31, 2019 REAL HEALTH-Diabetes: REach Ahead for Lifestyle and Health-Diabetes R03DK090196(WEXLER, DEBORAH J)Jul 1, 2011-Jun 30, 2013 Identifying Effective Treatment Strategies for Older Adults with Diabetes K23DK080228(WEXLER, DEBORAH J)Sep 20, 2007-Nov 30, 2012 Effective Inpatient Diabetes Management and the Transition to Outpatient Care Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Faculty can login to make corrections and additions. Berkowitz SA, Eisenstat SA, Barnard LS, Wexler DJ. Multidisciplinary coordinated care for Type 2 diabetes: A qualitative analysis of patient perspectives. Prim Care Diabetes. 2018 Jan 31. PMID: 29397351. Basu S, Raghavan S, Wexler DJ, Berkowitz SA. Characteristics Associated With Decreased or Increased Mortality Risk From Glycemic Therapy Among Patients With Type 2 Diabetes and High Cardiovascular Risk: Machine Learning Analysis of the ACCORD Trial. Diabetes Care. 2018 Mar; 41(3):604-612. PMID: 29279299. Carter J, Ward C, Wexler D, Donelan K. The association between Continue reading >>

Readmission Prevention Pilot Trial In Diabetes Patients

Readmission Prevention Pilot Trial In Diabetes Patients

You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Readmission Prevention Pilot Trial in Diabetes Patients The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. ClinicalTrials.gov Identifier: NCT03243383 National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Information provided by (Responsible Party): Study Description Study Design Arms and Interventions Outcome Measures Eligibility Criteria Contacts and Locations More Information Post-discharge hospital utilization, i.e., readmissions within 30 days of discharge (30d readmissions) and emergency department (ED) visits, are a high-priority quality measure and target for cost reduction. Patients with diabetes are disproportionately over-represented in 30d readmissions, especially among racial minorities and urban populations. We have developed and validated a tool, the Diabetes Early Readmission Risk Indicator (DERRI), to predict 30d readmission risk among diabetes patients, which is a critical prerequisite for targeting limited resources for reducing readmission risk to those most in need. Currently, there are no proven interventions to reduce the risk of 30d readmission specifically among patients with diabetes. This proposal will assess the feasibility and acceptability of a novel, multifactorial intervention, the Diabetes Transition of Hospital Care Program (DiaTOHC), designed to reduce post-discharge hospital utilization rates in a pilot randomized Continue reading >>

University Of Washington - Diabetes Research Center Diabetes Research Center Publications

University Of Washington - Diabetes Research Center Diabetes Research Center Publications

Osborn, MJ; Webber, BR; Knipping, F; Lonetree, CL; Tennis, N; DeFeo, AP; McElroy, AN; Starker, CG; Lee, C; ... Blazar, BR Evaluation of TCR Gene Editing Achieved by TALENs, CRISPR/Cas9, and megaTAL Nucleases Mol Ther 24 3: 570-81; 2016 PMC4786913 Strand, NS; Hoi, KK; Phan, TM; Ray, CA; Berndt, JD; Moon, RT ; Wnt/beta-catenin signaling promotes regeneration after adult zebrafish spinal cord injury Biochem Biophys Res Commun 477 4: 952-6; 2016 Campbell, MD; Marcinek, DJ ; Evaluation of in vivo mitochondrial bioenergetics in skeletal muscle using NMR and optical methods Biochim Biophys Acta 1862 4: 716-24; 2016 PMC4788529 Yi-Frazier, JP; Hilliard, ME; Fino, NF; Naughton, MJ; Liese, AD; Hockett, CW; Hood, KK; Pihoker, C; Seid, M; ... Lawrence, JM Whose quality of life is it anyway? Discrepancies between youth and parent health-related quality of life ratings in type 1 and type 2 diabetes Qual Life Res 25 5: 1113-21; 2016 PMC4936832 Cassaday, RD; Alan Potts, D, Jr.; Stevenson, PA; Bar, M; Georges, GE; Shustov, AR; Sorror, ML; Wood, BL; Delaney, C; ... Sandmaier, BM Evaluation of allogeneic transplantation in first or later minimal residual disease - negative remission following adult-inspired therapy for acute lymphoblastic leukemia Leuk Lymphoma 57 9: 2109-18; 2016 McKenna, A; Findlay, GM; Gagnon, JA; Horwitz, MS; Schier, AF; Shendure, J ; Whole-organism lineage tracing by combinatorial and cumulative genome editing Science 353 6298: aaf7907; 2016 PMC4967023 Chouraki, V; Reitz, C; Maury, F; Bis, JC; Bellenguez, C; Yu, L; Jakobsdottir, J; Mukherjee, S; Adams, HH; ... International Genomics of Alzheimer's, P Evaluation of a Genetic Risk Score to Improve Risk Prediction for Alzheimer's Disease J Alzheimers Dis 2016 Oshima, J; Sidorova, JM; Monnat, RJ, Jr. ; Werner syndrome: C Continue reading >>

Dsme Support In Diabetes

Dsme Support In Diabetes

Powers et al 1 Margaret A. Powers, PhD, RD Joan Bardsley, MBA, RN Marjorie Cypress, PhD, RN, CNP Paulina Duker, MPN, RN Martha M. Funnell, MS, RN Amy Hess Fischl, MS, RD Melinda D. Maryniuk, MEd, RD Linda Siminerio, RN, PhD Eva Vivian, PharmD, MS From International Diabetes Center at Park Nicollet, Minneapolis, Minnesota (Dr Powers); MedStar Health Research Institute and MedStar Nursing, Hyattsville, Maryland (Ms Bardsley); ABQ Health Partners, Albuquerque, New Mexico (Dr Cypress); LifeScan, a Johnson & Johnson Diabetes Solutions Company, Dubai, United Arab Emirates (Ms Duker); University of Michigan Medical School, Ann Arbor, Michigan (Ms Funnell); University of Chicago, Chicago, Illinois (Ms Fischl); Joslin Diabetes Center, Boston, Massachusetts (Ms Maryniuk); School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania (Dr Siminerio); and University of Wisconsin–Madison, Madison, Wisconsin (Dr Vivian). Correspondence to Margaret A. Powers, International Diabetes Center at Park Nicollet, Minneapolis, MN 55416-2699, USA. ([email protected]). Acknowledgments: The authors gratefully acknowledge the commitment and support of the collabo- rating organizations—the American Association of Diabetes Educators, the American Diabetes Association, and the Academy of Nutrition and Dietetics; their colleagues, including members of the Executive Committee of the National Diabetes Education Program, who participated in discussions and reviews about this inaugural position statement; and patients who teach and inspire them. The authors also thank Erika Gebel Berg (American Diabetes Association) for her invaluable editorial contribution. The position statement was reviewed and approved by the Professional Practice Committee of the American Associa Continue reading >>

Correction To: Hospital Readmission Of Patients With Diabetes

Correction To: Hospital Readmission Of Patients With Diabetes

Correction to: Hospital Readmission of Patients with Diabetes This article was originally published with errors that were introduced during the editing process. The corrected version of this article appears below. Abstract Hospital readmission is a high-priority health care quality measure and target for cost reduction. Despite broad interest in readmission, relatively little research has focused on patients with diabetes. The burden of diabetes among hospitalized patients, however, is substantial, growing, and costly, and readmissions contribute a significant portion of this burden. Reducing readmission rates of diabetic patients has the potential to greatly reduce health care costs while simultaneously improving care. Risk factors for readmission in this population include lower socioeconomic status, racial/ethnic minority, comorbidity burden, public insurance, emergent or urgent admission, and a history of recent prior hospitalization. Hospitalized patients with diabetes may be at higher risk of readmission than those without diabetes. Potential ways to reduce readmission risk are inpatient education, specialty care, better discharge instructions, coordination of care, and post-discharge support. More studies are needed to test the effect of these interventions on the readmission rates of patients with diabetes. Keywords Hospital readmission Inpatient diabetes Transitional care Transitions of care Risk factors Discharge support Hospital readmission is a high-priority health care quality measure and target for cost reduction, particularly within 30 days of discharge (30-day readmission, aka early readmission) [ 1 , 2 , 3 ]. Despite the broad interest in readmission, relatively little research has focused specifically on readmission of patients with diabetes [ 4 , 5 , Continue reading >>

Dr. Sherita Golden, Md Baltimore, Md | Endocrinology

Dr. Sherita Golden, Md Baltimore, Md | Endocrinology

Aldosterone, Renin, Cardiovascular Events, and All-Cause Mortality Among AfricanAmericans: The Jackson Heart Study. Joseph, J. J.,Echouffo-Tcheugui, J. B.,Kalyani, R. R.,Yeh, H. C.,Bertoni, A. G.,Effoe, V. S.,Casanova, R.,Sims, M.,Wu, W. C.,Wand, G. S.,Correa, A.,Golden, S. H.; JACC Heart Fail. 2017 Aug 22. Modifiable Lifestyle Risk Factors and Incident Diabetes in African Americans. Joseph, J. J.,Echouffo-Tcheugui, J. B.,Talegawkar, S. A.,Effoe, V. S.,Okhomina, V.,Carnethon, M. R.,Hsueh, W. A.,Golden, S. H.; Am J Prev Med. 2017 Aug 19. Diabetes and Cognitive Decline in Older Adults: The Ginkgo Evaluation of Memory Study. Palta, P.,Carlson, M. C.,Crum, R. M.,Colantuoni, E.,Sharrett, A. R.,Yasar, S.,Nahin, R. L.,DeKosky, S. T.,Snitz, B.,Lopez, O.,Williamson, J. D.,Furberg, C. D.,Rapp, S....; J. Gerontol. A Biol. Sci. Med. Sci.. 2017 May 17. Foreign Body with Gas Gangrene in an Elderly Patient with Diabetes. Abraham S, Hall E, Golden SH, Kalyani RR; J Diabetes Metab. 2013-11-01. Creating a transdisciplinary research center to reduce cardiovascular health disparities in Baltimore, Maryland: lessons learned. Cooper LA, Boulware LE, Miller ER, Golden SH, Carson KA, Noronha G, Huizinga MM, Roter DL, Yeh H, Bone LR, Levine DM, Hill-Briggs F, Charleston J, Kim M, Wang N, Aboum...; Am J Public Health. 2013-11-01. Physical Environment May Modify the Association Between Depressive Symptoms and Change in Waist Circumference: The Multi-Ethnic Study of Atherosclerosis. Remigio-Baker, R. A.,Diez Roux, A. V.,Szklo, M.,Crum, R. M.,Leoutsakos, J. M.,Franco, M.,Schreiner, P. J.,Carnethon, M. R.,Nettleton, J. A.,Mujahid, M. S.,Michos, E. D...; Psychosomatics. 2014 Jan 07. Validity of meta-analysis in diabetes: meta-analysis is an indispensable tool in evidence synthesis. Golden SH, Bass E Continue reading >>

Diabte : Comment Rduire Le Taux De R-hospitalisations Des Diabtiques ? En Crant Un Diplme Dinfirmire Spcialise En Diabtologie, Et En Engageant Le Virage Ambulatoire De Lhpital - Em|consulte

Diabte : Comment Rduire Le Taux De R-hospitalisations Des Diabtiques ? En Crant Un Diplme Dinfirmire Spcialise En Diabtologie, Et En Engageant Le Virage Ambulatoire De Lhpital - Em|consulte

Diabte : comment rduire le taux de r-hospitalisations des diabtiques ? En crant un Diplme dInfirmire spcialise en Diabtologie, et en engageant le virage ambulatoire de lhpital Diabetes: How to reduce hospital readmissions of diabetic patients? By creating a Diploma of Nursing Specialist in Diabetology, and starting the Ambulatory Shift of Hospital Professeur mrite, Universit Grenoble Alpes - Mdecine Sciences, Grenoble *Correspondance: Universit Grenoble Alpes - Mdecine Sciences 38041 Grenoble Les radmissions hospitalires deviennent aujourdhui un enjeu de sant et mdico-conomique majeur dans tous les pays [ 1 FischerC., LingsmaH.F., Marang-van de MheenP.J., and al. Is the readmission rate a valid quality indicator?. A review of the evidence PLoS One2014 ; 9 : e112282[Erratum in: PLoS One 2015; 10; e0118968]. Click here to see the Library , 2 WhitstonM., ChungS., HendersonJ., YoungB. What can be learned about the impact of diabetes on hospital admissions from routinely recorded data? Diabet Med2012 ; 29 : 1199-1205 [cross-ref] Click here to see the Library , 3 RubinD.J. Hospital readmission of patients with diabetes Curr Diab Rep2015 ; 15 : 17 [cross-ref] Click here to see the Library ]. Les patients diabtiques sont plus souvent hospitaliss (jusqu un tiers des diabtiques en France, chaque anne) et rhospitaliss que les non-diabtiques. Aux tats-Unis, 25% des personnes hospitalises sont diabtiques, et 14 30% sont r-hospitaliss (moyenne internationale : 20%). Les principaux prdicteurs de radmission sont le contexte socioconomique (aux tats-Unis, aussi lethnie), le vieillissement des malades admis, des comorbidits non lies au diabte, et lincapacit de reconnatre le diabte la sortie du patient la suite dun sjour hospitalier non programm - frquemment sans relation avec le diabte Continue reading >>

The Effect Of Diabetes Case Management And Diabetes Resource Nurse Program On Readmissions Of Patients With Diabetes Mellitus

The Effect Of Diabetes Case Management And Diabetes Resource Nurse Program On Readmissions Of Patients With Diabetes Mellitus

The effect of diabetes case management and Diabetes Resource Nurse program on readmissions of patients with diabetes mellitus The effect of diabetes case management and Diabetes Resource Nurse program on readmissions of patients with diabetes mellitus The effect of diabetes case management and Diabetes Resource Nurse program on readmissions of patients with diabetes mellitus Accepted Manuscript The Effect of Diabetes Case Management and Diabetes Resource Nurse Program on Readmissions of Patients With Diabetes Mellitus Andj... Accepted Manuscript The Effect of Diabetes Case Management and Diabetes Resource Nurse Program on Readmissions of Patients With Diabetes Mellitus Andjela Drincic, Elisabeth Pfeffer, Jiangtao Luo, Whitney S. Goldner PII: DOI: Reference: S2214-6237(17)30021-2 JCTE 114 Journal of Clinical & Translational Endocrinology Received Date: Revised Date: Accepted Date: 1 February 2017 19 March 2017 27 March 2017 Please cite this article as: A. Drincic, E. Pfeffer, J. Luo, W.S. Goldner, The Effect of Diabetes Case Management and Diabetes Resource Nurse Program on Readmissions of Patients With Diabetes Mellitus, Journal of Clinical & Translational Endocrinology (2017), doi: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. The Effect of Diabetes Case Management and Diabetes Resource Nurse Program on Readmissions of Patients With Diabetes Mellitus Andjel Continue reading >>

Hospital Readmission Of Patients With Diabetes.

Hospital Readmission Of Patients With Diabetes.

Curr Diab Rep. 2015 Apr;15(4):17. doi: 10.1007/s11892-015-0584-7. Hospital readmission of patients with diabetes. Section of Endocrinology, Diabetes, and Metabolism, School of Medicine, Temple University, 3322 N. Broad ST., Ste 205, Philadelphia, PA, 19140, USA. [email protected] Correction to: Hospital Readmission of Patients with Diabetes. [Curr Diab Rep. 2018] Hospital readmission is a high-priority health care quality measure and target for cost reduction. Despite broad interest in readmission, relatively little research has focused on patients with diabetes. The burden of diabetes among hospitalized patients, however, is substantial, growing, and costly, and readmissions contribute a significant portion of this burden. Reducing readmission rates of diabetic patients has the potential to greatly reduce health care costs while simultaneously improving care. Risk factors for readmission in this population include lower socioeconomic status, racial/ethnic minority, comorbidity burden, public insurance, emergent or urgent admission, and a history of recent prior hospitalization. Hospitalized patients with diabetes may be at higher risk of readmission than those without diabetes. Potential ways to reduce readmission risk are inpatient education, specialty care, better discharge instructions, coordination of care, and post-discharge support. More studies are needed to test the effect of these interventions on the readmission rates of patients with diabetes. Continue reading >>

Resident Research | Department Of Medicine , Internal Medicine Residency Program

Resident Research | Department Of Medicine , Internal Medicine Residency Program

Past Resident Peer Reviewed Publications 2011-2016* *Select Peer Reviewed Publications Originating from Resident Scholarship Bermea, R, Sharma, N, Cohen, K, Liarski, V, Use of eculizumab in atypical hemolytic uremic syndrome, complicating systemic lupus erythematosus. J Clin Rheumatol, Sep; 22(6):320-3 (2016) Deshmukh, A, Deshmukh, P, His bundle pacing: Initial experience and lessons learned. J Electrocardiol, Sep-Oct; 49(5):658-63 (2016) Doukky, R, Hayes, K, Frogge, N, Appropriate use criteria for SPECT myocardial perfusion imaging: Are they appropriate for women? J Nucl Cardiol, Aug; 23(4):695-705 (2016) Doukky R, Frogge N, Appis A, Hayes K, Khoudary G, Fogg L, Williams K, Impact of appropriate use on the estimated radiation risk to men and women undergoing radionuclide myocardial perfusion imaging. J Nucl Med, Aug; 57(8):1251-7 (2016) Farrington, D, Kilgo, P, Thourani, V, Jacob, Steinberg, J, High risk of prosthetic valve endocarditis and death after valve replacement operations in dialysis patients. Annals of Thoracic Surgery, June; 101(6):2217-2223 (2016) Khan, N, Muffly LS, Hlubocky F, Khan N, Wroblewski K, Breitenbach K, Gomez J, McNeer J, Stock W, Daugherty C, Psychological morbidities in adolescent and young adult blood cancer patients undergoing curative intent therapy and in early survivorship. Cancer, Mar 15; 122(6):954-61 (2016) Khoshchehreh M, Groves EM, Tehrani D, Amin A, Patel PM, Malik S, Changes in mortality on weekend versus weekday admissions for Acute Coronary Syndrome in the United States over the past decade. Int J Cardiol, May 1; 210:164-72 (2016) Lee L, Blair J, Gupta S, Nathan S, Upper extremity vascular complications following transradial approach for cardiac catheterization and intervention: a focused review of diagnostic, prognostic and the Continue reading >>

Incidence, Risk Factors, And Causes For Thirty-day Unplanned Readmissions Following Primary Lower-extremity Amputation In Patients With Diabetes

Incidence, Risk Factors, And Causes For Thirty-day Unplanned Readmissions Following Primary Lower-extremity Amputation In Patients With Diabetes

Background:The Centers for Medicare & Medicaid Services targeted thirty-day readmissions as a quality-of-care measure. Hospitals can be penalized on unplanned readmissions. Given the frequency of amputation in diabetic patients and our changing health-care system, the purpose of this study was to determine the incidence, risk factors, and causes for unplanned thirty-day readmissions following primary lower-extremity amputation in diabetic patients. Methods:Patients with a diagnosis of diabetes undergoing primary lower-extremity amputation between 2002 and 2013 were retrospectively identified in a single-center patient database. Chart review determined patient factors including comorbidities, hemoglobin A1c level, amputation level, and demographic characteristics. Patients were divided into groups with and without unplanned readmission within thirty days postoperatively. Univariate and multivariate logistic regression analyses were used to compare cohorts and to identify variables associated with readmission. Results:Overall, forty-six (10.5%) of 439 diabetic patients undergoing primary lower-extremity amputation had an unplanned thirty-day readmission. The top reason for readmission was a major surgical event requiring reoperation (37.0%), followed by medical events (28.3%) and minor surgical events (28.3%). In the univariate analysis, discharge on antibiotics (p = 0.002), smoking (p = 0.003), chronic kidney disease (p = 0.002), peripheral vascular disease (p = 0.002), and higher Charlson Comorbidity Index (p = 0.001) were each associated with readmission. In the multivariate analysis, diagnosis of gangrene (odds ratio [OR], 2.95 [95% confidence interval (95% CI), 1.37 to 6.35]), discharge on antibiotics (OR, 4.48 [95% CI, 1.71 to 11.74]), smoking (OR, 3.22 [95% CI, 1. Continue reading >>

Practical Recommendations For Transitioning Patients With Type 2 Diabetes From Hospital To Home

Practical Recommendations For Transitioning Patients With Type 2 Diabetes From Hospital To Home

Practical Recommendations for Transitioning Patients with Type 2 Diabetes from Hospital to Home The purpose of this review is to provide practical evidence-based recommendations for transitioning hospitalized patients with type 2 diabetes (T2DM) ... Adherence to Therapies in Patients with Type 2 Diabetes Adherence to therapy is defined as the extent to which a persons behavior in taking medication, following a diet, and/or executing lifestyle changes, corresponds with agreed recommendations from a healthcare provider. Patients presenting with type 2 Life transitions often involve complex decisions, challenges and changes that affect diabetes management. Transition to motherhood is a major life event accompanied by increased risk that the pregnancy will lead to or accelerate existing diabetes-rel Curr Diab Rep (2017) 17:52 DOI 10.1007/s11892-017-0876-1 HOSPITAL MANAGEMENT OF DIABETES (A WALLIA AND JJ SELEY, SECTION EDITORS) Practical Recommendations for Transitioning Patients with Type 2 Diabetes from Hospital to Home Amy C. Donihi 1 # Springer Science+Business Media New York 2017 Abstract Purpose of Review The purpose of this review is to provide practical evidence-based recommendations for transitioning hospitalized patients with type 2 diabetes (T2DM) to home. Recent Findings Hospitalized patients who have newly diagnosed or poorly controlled T2DM require initiation or intensification of their outpatient diabetes regimen. Potential barriers to medication access and continuity of care should be identified early in the hospitalization. Throughout hospitalization, patients should receive diabetes education focused on basic survival skills and tailored to learning needs. Patients should leave the hospital with personalized discharge instructions that include a list of al Continue reading >>

More in diabetes