Structuring complexity? A systemic perspective on the implementation of a disease management programme for type II diabetes care in Denmark

2021 ◽  
pp. 1-17
Author(s):  
Karsten Vrangbæk
Keyword(s):  
Disease Management ◽  
Chronic Diseases ◽  
Type Ii Diabetes ◽  
Implementation Process ◽  
Type Ii ◽  
National Health Care ◽  
Disease Management Programmes ◽  
Implementation Progress ◽  
Changing Demographics

Abstract Chronic diseases are major causes of death and reduction in the quality of life worldwide, and their prevalence is expected to rise due to changing demographics. Disease management programmes (DMPs) have been presented as a policy response to challenges of care coordination for such chronic diseases. This paper investigates the implementation of DMPs in a National Health Care system in the Nordic region using type II diabetes as an example. DMPs are detailed descriptions of the sequence and responsibilities for diagnostic, treatment, rehabilitation and prevention procedures. The paper applies a systemic implementation perspective to provide detailed analysis of implementation progress, issues and concerns. The implementation analysis shows that the framework of DMP has facilitated the development of new practices and attention to the roles that each of the stakeholders are playing within the service delivery. Many new initiatives contribute to improved coordination and overall management of the Type 2 diabetes (T2DB) population. Yet, there are also several cross-cutting challenges that are affecting the implementation process.

scholarly journals Safety analysis of early oral feeding after esophagectomy in patients complicated with diabetes

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zhisheng Jiang ◽  
Jing Luo ◽  
Mengqing Xu ◽  
Zhuangzhuang Cong ◽  
Saiguang Ji ◽  
...  
Keyword(s):  
Esophageal Carcinoma ◽  
Type Ii Diabetes ◽  
Radical Resection ◽  
Oral Feeding ◽  
Life Questionnaire ◽  
Type Ii ◽  
Early Oral Feeding ◽  
Nutritional Index ◽  
Feeding Group

Abstract Objective To evaluate the safety of early oral feeding in patients with type II diabetes after radical resection of esophageal carcinoma. Methods The clinical data of 121 patients with type II diabetes who underwent radical resection of esophageal carcinoma in the department of cardiothoracic surgery of Jinling Hospital from January 2016 to December 2018 were retrospectively analyzed. According to the median time (7 days) of the first oral feeding after surgery, the patients were divided into early oral feeding group (EOF, feeding within 7 days after surgery, 67 cases) and late oral feeding group (LOF, feeding after 7 days, 54 cases). Postoperative blood glucose level, incidence of complications, nutritional and immune indexes, inflammatory indexes, normalized T12-SMA (the postoperative/preoperative ratio of vertical spinal muscle cross-sectional area at the 12th thoracic vertebra level) and QLQ-C30 (Quality Of Life Questionnaire) scores were recorded and compared in the two groups. Results There was no statistical difference in preoperative nutritional index and postoperative complication rates between the EOF and LOF group (p > 0.05). The postoperative nutritional index (ALB, PA, TRF, Hb) and immune index (IgA, IgG, IgM) of the EOF group were higher than those of the LOF group (p < 0.05), and the inflammatory indicators (CRP, IL-6) of the EOF group were significantly lower than those of the LOF group (p < 0.05). Moreover, postoperative T12-SMA variation and QLQ-C30 scores of the EOF group were higher than those in LOF group (p < 0.05). Conclusions Early oral feeding is safe and feasible for patients with type II diabetes after radical resection of esophageal cancer, and it can improve short-term nutritional status and postoperative life quality of the patients.

scholarly journals Adherence and Quality of Life in Patients With Type II Diabetes Mellitus in Northern Greece

2016 ◽  
Vol 28 (4) ◽  
pp. 258 ◽  
Author(s):  
Efrosini Zioga ◽  
Kyriakos Kazakos ◽  
Evagelos Dimopoulos ◽  
Christos Koutras ◽  
Kalliopi Marmara ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Northern Greece

scholarly journals ENDOCRINOLOGICAL INTERRELATED DISEASES: CELIAC DISEASE AND DIABETES MELLITUS

2020 ◽  
pp. 103-108
Author(s):  
K. A. Tabanyukhov ◽  
V. A. Scryabin
Keyword(s):  
Celiac Disease ◽  
Chronic Diseases ◽  
Type Ii Diabetes ◽  
Endocrine System ◽  
Special Treatment ◽  
Type Ii ◽  
Wheat Protein ◽  
Gluten Enteropathy ◽  
Analytical Review ◽  
Dipeptidylpeptidase 4

The results of the analytical review of scientific material presented in the article are devoted to the problem of intolerance of wheat protein gliadin in people with a predisposition to this food Allergy, as well as materials related to modern means against diabetes, based on the study of the endocrine system. The DPP-4 enzyme (dipeptidylpeptidase 4), which breaks down gluten protein in the human body, and the consequences of deficiency and excessive production of this enzyme in the form of chronic diseases (celiac disease and type II diabetes), were considered as one of the probable causes that combine these diseases. During the evaluation of the scientific material, the principle of determinism was applied to DPP-4, since this enzyme is the only one specifically interacting in the small intestine with gliadin and casein, and violations of the production and activity of this enzyme cause the appearance of gluten enteropathy. The review also presents data from foreign and Russian sources on the means for controlling diabetes based on substances that suppress the production of the enzyme DPP-4, hypersynthesis of which suppresses the production of insulin, which is one of the endocrinological causes of diabetes. Based on the studied data, it can be argued that the most positive and progressive solution to the problem of both chronic diseases is the method proposed by Japanese scientists, based on a special treatment of ginger root protease a, since, having the ability to break down gluten, this drug also leads to the suppression of dipeptidylpeptidase 4, while being a relatively affordable drug.

scholarly journals Relationship Between Family Support and Self Care Agency with the Quality of Living Type II Diabetes Patients

2019 ◽  
Vol 3 (1) ◽  
pp. 22-32
Author(s):  
Ferawati ◽  
Mei Fitria Kurniati
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Family Support ◽  
Type Ii Diabetes ◽  
Self Care ◽  
P Value ◽  
Diabetic Patients ◽  
Type Ii ◽  
Care Agency

Background: Diabetes Mellitus is a chronic disease characterized by high blood sugar level and is caused by an increase in glucose levels due to a progressive decrease in insulin secretion caused by insulin resistance. The ability of diabetic patients to do appropriate and succesful self-care habits is closely related to morbidity and mortality and significantly affect productivity and quality of life. Purpose: The purpose of this study is to determie the correlation between family support and self care agency with quality of life of diabetes mellitus patient type II.Method: This study uses analitycal methods, namely research that explores how and why health phenomena occur with a cross-sectional approach.Result: The results of the Spearman-Rho test that the P-value in te sig (2-tailed) column 0.123 is more than the level of significance α 0,05 ( 0,000 < 0,05 ) so it can be concluded that H0 is accepted and H1 is rejected.Conclusion: There is no relationship between self care agency and the quality of life of people with type II diabetes mellitus in prolanic patients

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