Mastery In Diabetes Management: HbA1c's Role In Diabetes Readmission

Mastery in Diabetes Management: HbA1c's Role in Diabetes Readmission

Mastery in Diabetes Management: HbA1c's Role in Diabetes Readmission
Hirva Bakeri, MD, MS, on how HbA1c levels were not predictive of 30-day hospital readmissions
Patients with a primary diagnosis of diabetes were found to have significantly higher HbA1c levels than those with a secondary diagnosis of diabetes.
Note that patients with multiple readmissions within 30 days had a higher HbA1c when compared to those with one readmission.
Hirva Bakeri, MD, MS, of the University of Connecticut, spoke with MedPage Today at ENDO 2017, the annual meeting of The Endocrine Society in April, when she presented a poster on how mean HbA1c was higher among patients with multiple readmissions compared to those with only 1-readmission, despite HbA1c levels not being significantly associated with overall readmission. Her full poster may be downloaded by clicking here .
Following is a transcript of her remarks:
The research that we did was about the role of hemoglobin A1c on readmission rates for patients with diabetes. To give you a little bit of background, hospital readmission is a high-priority healthcare quality measure and a target for cost reduction. In this current era of major healthcare reform, this is of growing importance.
In 2012, in the month of October, the Centers for Medicare and Medicaid Services came up with a program called Hospital Readmission Reduction program that decreases payments for hospitals if they have higher-than-expected numbers of readmissions. And when I say readmissions, I'm usually talking about early readmissions of patients who were discharged wi Continue reading

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How I used math to develop an algorithm to help treat diabetes

When people ask me why I, an applied mathematician, study diabetes, I tell them that I am motivated for both scientific and human reasons.
Type 2 diabetes runs in my family. My grandfather died of complications related to the condition. My mother was diagnosed with the disease when I was 10 years old, and my Aunt Zacharoula suffered from it. I myself am pre-diabetic.
As a teen, I remember being struck by the fact that my mother and her sister received different treatments from their respective doctors. My mother never took insulin, a hormone that regulates blood sugar levels; instead, she ate a limited diet and took other oral drugs. Aunt Zacharoula, on the other hand, took several injections of insulin each day.
Though they had the same heritage, the same parental DNA and the same disease, their medical trajectories diverged. My mother died in 2009 at the age of 75 and my aunt died the same year at the age of 78, but over the course of her life dealt with many more serious side effects.
When they were diagnosed back in the 1970s, there were no data to show which medicine was most effective for a specific patient population.
Today, 29 million Americans are living with diabetes. And now, in an emerging era of precision medicine, things are different.
Increased access to troves of genomic information and the rising use of electronic medical records, combined with new methods of machine learning, allow researchers to process large amounts data. This is accelerating efforts to understand genetic differences within diseases – including diabetes – and to develop treatments fo Continue reading

How to Support a Loved One With Diabetes

Todays article is not for those of us who have diabetes, but for those of you who care about someone with diabetes. I wanted to write something for the families, friends, and caregivers, who often might find themselves unsure of how to support their friend or family member whos struggling with this disease. I wanted to give some advice on how to be truly helpful, and how to avoid some of the common (honest and well-intentioned) missteps that can drive those of us with diabetes a little nutty sometimes.
Its not always easy to know what to do or what to say. Its often the case that the stress of having a loved one in trouble is worse than being in trouble yourself. The same is true sometimes with a chronic condition like diabetes. A partner, friend, or loved one can feel paralyzed, unsure what to say, wanting to help but not knowing enough to really know what to do; stuck watching everything unfold with no power to change it or help it. So, lets try to change that. Well start with a simple crash course on what exactly diabetes IS and IS NOT.
a chronic disease that comes about because of a combination of genetics and circumstances
a condition in which the body needs help metabolizing sugar that enters the blood due to a deficiency in the systems meant to get that sugar FROM the blood TO the cells that need it for energy.
a manageable condition that requires discipline and focus from the person living with it
a condition that requires the person with it to, as my mother used to say, manually take over functions within the body that are automatic and unnoticed by peop Continue reading

Are Omega 3 Fats Good for Diabetes? - Diabetes Self-Management

You may have heard that omega-3 fatty acids are good for you. Is this true for people with diabetes? If so, whats the best way to get them?
A new study from England found that women who consume more omega 3s have a healthier mix of gut bacteria. These bacteria have been found to reduce the risk of obesity and Type 2 diabetes.
A study from Harvard University found that omega 3s raise levels of a hormone called adiponectin, which increases insulin sensitivity. Researchers felt this might help prevent or control Type 2 diabetes.
Omega 3s are a group of PUFAs (polyunsaturated fatty acids). There are three kinds of omega 3s. Those known as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are mostly found in fish.
A third type, alpha-linolenic acid (ALA), is found in plants. The body can use ALA to produce small amounts of the other types.
All three types help reduce inflammation, prevent heart disease and stroke, and decrease insulin resistance. They seem to prevent depression and help with brain function. EPA seems to be especially important to help brains grown in childhood and to keep them strong in old age.
The other major category of PUFA is omega-6 fatty acids. We need them, too, and in close to equal amounts with omega 3s. Both types help the body make hormones that tend to balance each other out. For example, omega-6-derived hormones may start inflammation the body uses to fight infection. Omega-3-derived hormones stop inflammation when the fight is over.
The problem is the modern food environment. According to an article in Nutrition Journal, A health Continue reading

Researchers emphasize community in diabetes care

Two UNM researchers are taking a community-based approach to studying diabetes self-management for low income Hispanic patients, and they have a $2.3 million grant to fund their research.
Janet Page-Reeves, lead researcher on the study, said the pair previously worked on a smaller project where they concluded that there are many people in Albuquerque’s Latino community with diabetes, and there is a high rate of people who go undiagnosed.
Page-Reeves said the survey found that, out of 100 participants, 59 tested positive for diabetes or prediabetes but only 26 knew about their condition.
The study’s community lead, Lidia Regino, took that information and turned it into a program, which is in its fifth year. One Hope Centro de Vida Health Center offers a five-part class where patients learn about diabetes management from pharmacy or medical students and then meet with medical providers to discuss their individual management plan, she said.
“Over time, Lidia had identified that she felt their work at the clinic was having really...amazing results. They were seeing people change their behavior, they felt like it was really working,” Page-Reeves said.
So the pair decided to study the program’s success with a scientific approach, she said.
Their hypothesis is that a culturally and contextually situated health promotion program will be more successful for individual patients, Page-Reeves said.
“If you have diabetes and I tell you, ‘You should join a gym,’ but you are low income, that’s not going to happen,” she said. “If I tell you to walk in your neighborhoo Continue reading