scholarly journals A Retrospective Analysis of Therapeutic Inertia in Type 2 Diabetes Management Across a Diverse Population of Health Care Organizations in the USA

2021 ◽  
Vol 12 (2) ◽  
pp. 581-594
Author(s):  
Cori R. Rattelman ◽  
Elizabeth L. Ciemins ◽  
Nikita Stempniewicz ◽  
Michelle Mocarski ◽  
Rahul Ganguly ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Retrospective Analysis ◽  
Health Care Organizations ◽  
Diabetes Management ◽  
Diverse Population ◽  
Therapeutic Inertia ◽  
The Usa

scholarly journals Perceptions of Type 2 Diabetes Patients Towards Diabetes Management Visits at Public Primary Health Care Centers with Diverse Opinions Towards Nurse-led Clinics in Muscat, Oman: A Pilot Qualitative Study

2020 ◽  
Vol 35 (6) ◽  
pp. e196-e196
Author(s):  
Kamila Al-Alawi ◽  
Ahmed Al-Mandhari
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Primary Health Care ◽  
Qualitative Study ◽  
Diabetes Management ◽  
Primary Health ◽  
Primary Health Care Centers ◽  
Health Care Centers ◽  
Diabetes Patients

Objectives: The literature has described several positive outcomes related to diabetes management via nurse-led clinics. This is especially true where a shortage of physicians is recorded within a team-based approach. We sought to explore the perceptions of patients with type 2 diabetes towards the current diabetes management visits at public primary health care centers in Muscat, Oman and their opinions towards nurse-led diabetes management clinics. Methods: This pilot qualitative study included seven semi-structured interviews with type 2 diabetes patients from four purposely selected public primary health care centers in Muscat. Qualitative thematic analysis was applied. Results: Patients with type 2 diabetes expressed their satisfaction with the present diabetes management visits at public primary health care. Their opinions towards nurse-led clinic were diverse and divided patients into three categories: those who totally refused the nurse-led clinics, those who accepted the clinics but with reservations, and patients that totally accepted the nurse-led clinics. The patients’ main concern was the nurses’ abilities to handle and understand the disease and its management. Conclusions: Our pilot study revealed type 2 diabetes patients’ satisfaction with the current diabetes management clinics. However, transformation to nurse-led clinics within team-based approach requires further studies with a bigger sample size. Further studies on requirements related to the Omani health care system and a better understanding of patients’ worries and their readiness to accept the concept of nurse-led clinics and their outcomes are also recommended.

scholarly journals Chronic Kidney Disease Testing Among Primary Care Patients With Type 2 Diabetes Across 24 U.S. Health Care Organizations

2021 ◽  
Author(s):  
Nikita Stempniewicz ◽  
Joseph A. Vassalotti ◽  
John K. Cuddeback ◽  
Elizabeth Ciemins ◽  
Amy Storfer-Isser ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Health Care ◽  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Health Care Organizations ◽  
The United States ◽  
Testing Rate

<b>Objective: </b>Clinical guidelines for people with diabetes recommend chronic kidney disease (CKD) testing at least annually using estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (uACR). We aimed to understand CKD testing among people with type 2 diabetes in the United States. <p><b>Research Design and Methods:</b> Electronic health record data were analyzed from 513,165 adults with type 2 diabetes, receiving primary care from 24 health care organizations and 1,164 clinical practice sites. We assessed the percentage of patients with both ≥1 eGFR and ≥1 uACR, <a></a><a>and each test</a> individually, in the 1, 2, and 3 years ending September 2019, by health care organization and clinical practice site. Elevated albuminuria was defined by uACR ≥30 mg/g.</p> <p><strong>Results:</strong> The 1-year median testing rate across organizations was 51.6% for both uACR and eGFR, 89.5% for eGFR, and 52.9% for uACR. uACR testing varied (10<sup>th</sup>–90<sup>th</sup> percentile) from 44.7% to 63.3% across organizations and from 13.3% to 75.4% across sites. Over 3 years, the median testing rate for uACR across organizations was 73.7%. Overall, the prevalence of detected elevated albuminuria was 15%. The average prevalence of detected elevated albuminuria increased linearly with uACR testing rates at sites, with estimated prevalence of 6%, 15%, and 30%, at uACR testing rates of 20%, 50%, and 100%. </p> <p><strong>Conclusions:</strong> While eGFR testing rates are uniformly high among people with type 2 diabetes, testing rates for uACR are suboptimal and highly variable across and within the organizations examined. Guideline-recommended uACR testing should increase detection of CKD.</p>

scholarly journals TRENDS OF INDICATORS CHARACTERIZING THE BURDEN OF TYPE 2 DIABETES ON HEALTH CARE SYSTEMS IN UKRAINE AND SOME DEVELOPED COUNTRIES

2020 ◽  
Vol 46 (3) ◽  
Author(s):  
G. P. Mykhalchyshyn
Keyword(s):  
United States ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Health Care Systems ◽  
Developed Countries ◽  
The United States ◽  
Life Years ◽  
Care Systems ◽  
The Usa

Abstract Purpose of the study. Is to compare the epidemiological trends (2000–2017) of indicators characterizing the burden of type 2 diabetes on health care systems in Ukraine and some developed countries. Materials and methods. The trends in morbidity, prevalence, mortality, years lived with disability (YLDs), as well as disability adjusted life years (DALYs) in type 2 diabetes (per 100 thousand of population) were analyzed. Results. Over a period of 2000–2017, the incidence of type 2 diabetes in Ukraine increased by 10,4%, in Belarus – by 9,2%, in Poland – by 28,1%, in Germany – by 32,1% and in the United States – by 69,6%. Accordingly, the largest increase in the prevalence occurred in the United States (by 83,2%), Germany (by 40,0%) and Poland (by 42,6%) and the least in Ukraine (by 9,9%). The mortality rate in Ukraine as of 2017 was lower than in the USA, Poland and Germany, respectively: 4,0 against 17,4; 13,8; 20,6 per 100 thousand of population. The largest increase in YLDs and DALY occurred in the United States (by 81,0% and 45,6%), Germany (by 45,2% and 28,8%), Poland (by 41,6% and 45,4%), against the background of a slight increase in Ukraine (by 10,2% and 7,8%). Conclusions. Over a period of 2000–2017, the trends of indicators characterizing the burden of type 2 diabetes on the health care systems of Ukraine and other countries differ, which requires further analysis and clarification of this situation. Keywords: burden, incidence, prevalence, YLDs, DALY, type 2 diabetes.

scholarly journals Chronic Kidney Disease Testing Among Primary Care Patients With Type 2 Diabetes Across 24 U.S. Health Care Organizations

2021 ◽  
Author(s):  
Nikita Stempniewicz ◽  
Joseph A. Vassalotti ◽  
John K. Cuddeback ◽  
Elizabeth Ciemins ◽  
Amy Storfer-Isser ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Health Care ◽  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Health Care Organizations ◽  
The United States ◽  
Testing Rate

<b>Objective: </b>Clinical guidelines for people with diabetes recommend chronic kidney disease (CKD) testing at least annually using estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (uACR). We aimed to understand CKD testing among people with type 2 diabetes in the United States. <p><b>Research Design and Methods:</b> Electronic health record data were analyzed from 513,165 adults with type 2 diabetes, receiving primary care from 24 health care organizations and 1,164 clinical practice sites. We assessed the percentage of patients with both ≥1 eGFR and ≥1 uACR, <a></a><a>and each test</a> individually, in the 1, 2, and 3 years ending September 2019, by health care organization and clinical practice site. Elevated albuminuria was defined by uACR ≥30 mg/g.</p> <p><strong>Results:</strong> The 1-year median testing rate across organizations was 51.6% for both uACR and eGFR, 89.5% for eGFR, and 52.9% for uACR. uACR testing varied (10<sup>th</sup>–90<sup>th</sup> percentile) from 44.7% to 63.3% across organizations and from 13.3% to 75.4% across sites. Over 3 years, the median testing rate for uACR across organizations was 73.7%. Overall, the prevalence of detected elevated albuminuria was 15%. The average prevalence of detected elevated albuminuria increased linearly with uACR testing rates at sites, with estimated prevalence of 6%, 15%, and 30%, at uACR testing rates of 20%, 50%, and 100%. </p> <p><strong>Conclusions:</strong> While eGFR testing rates are uniformly high among people with type 2 diabetes, testing rates for uACR are suboptimal and highly variable across and within the organizations examined. Guideline-recommended uACR testing should increase detection of CKD.</p>

scholarly journals Black Women’s Recommendations for Developing Effective Type 2 Diabetes Programming

2017 ◽  
Vol 4 ◽  
pp. 233339361771533 ◽  
Author(s):  
Tera R. Hurt ◽  
Asani H. Seawell ◽  
Carolyn Cutrona ◽  
Margaret C. O’Connor ◽  
Randie D. Camp ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Health Care ◽  
Black Women ◽  
Focus Groups ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Diabetes Knowledge ◽  
Des Moines

The purpose of this study was to learn from 29 Black women how to develop effective Type 2 diabetes programming. Three focus groups were held in Des Moines, Iowa, during fall 2012. Results highlighted themes related to diabetes knowledge, diabetes management and prevention, physical activity, diet, and diabetes management programming. Opinions were shared as to whether family members should be included in programs for supporting those diagnosed with diabetes. These results provided guidance and ideas to scholars and health care professionals aiming to improve effectiveness of diabetes programs for Black women and families.

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