scholarly journals How well do general practitioners manage laboratory test results for patients with diabetes mellitus and cardiovascular disease?: A systematic review

Author(s):  
Euan J. McCaughey ◽  
Julie Li ◽  
Tony C. Badrick ◽  
Johanna I. Westbrook ◽  
Andrew Georgiou
2021 ◽  
Vol 2 (3) ◽  
pp. 1032-1042
Author(s):  
Yunita Liana ◽  
Pariyana ◽  
Mariana

Abstract.   Coronavirus disease 2019 (COVID-19) is a highly contagious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. The increase in the number of COVID-19 cases is progressing quickly and has been spread between countries. As of October 14, 2020, there are 213 countries/regions around the world that have reported Covid-19 with a total of 38,002,699 confirmed cases of which 1,083,234 died. The purpose of this study was to determine the relationship between mortality factors and mortality in COVID-19 patients to predict the patient's prognosis. This research method is a systematic review through a literature review on mortality factors in COVID-19 patients Literature searches were accessed through internet searches using the Pubmed database based on the preferred reporting items for systemic review and meta-analysis (PRISMA). A systematic search was carried out on 18 October - 20 October 2020 with the keywords “COVID-19” AND “Death” OR “Decease” AND “Factor Associated”. There were 8 literature selected that met the inclusion and exclusion criteria. Based on the findings of the eight journals, mortality is old age, male, has a clinical condition of hypertension, obesity, diabetes, cardiovascular disease, lung disease, neurological disease, lymphophenia laboratory test results, hyperlactate dehydrogenase, increased procalcitonin, increased neutrophils, increased C-reactive protein, and increased D-dimer. All literature reported that a p value <0.05 was obtained from the analysis of the relationship between mortality factors and cases of death in COVID-19 patients. There is a significant relationship between mortality factors and the death of COVID-19 patients, where the mortality factors are elderly, male, have a clinical condition of hypertension, obesity, diabetes, cardiovascular disease, lung disease, neurological disease, lymphophenia laboratory test results, hyperlactate dehydrogenase, increase in procalcitonin, increase in neutrophils, increase in C-reactive protein, and increase in D-dimers in which the prognosis of patients who have mortality factors tends to be worse. Keywords: Mortality, Coronavirus, COVID-19


Author(s):  
Michael Campitelli ◽  
Michael Paterson ◽  
Mahmoud Azimaee ◽  
Anna Greenberg ◽  
P. Alison Paprica ◽  
...  

IntroductionImproving the care and management of patients with diabetes, particularly those with extreme blood glucose and/or cholesterol levels, has been identified as a key priority area for healthcare in Ontario. A multi-organizational collaboration produces audit-and-feedback reports distributed to consenting primary care physicians across the province for quality improvement purposes. Objectives and ApproachWe examined the feasibility of linking the Ontario Laboratory Information System (OLIS), a large and nearly population-wide database of laboratory test results in Ontario, with the existing provincial audit-and-feedback reporting structure to integrate aggregated, physician-level measures of glycemic and cholesterol control among patients with diabetes. All Ontario residents alive on March 31, 2014, attached to a primary care physician, and diagnosed with diabetes for at least two years were included. These patients were linked to OLIS to extract laboratory test orders and results for glycated hemoglobin (HbA1C) and low-density lipoproteins (LDL) between April 1, 2013 and March 31, 2014. ResultsThere were 1,108,530 diabetes patients included who were assigned to 10,085 primary care physicians. During fiscal year (FY) 2013, 70%, 64%, and 59% of diabetes patients were tested for HbA1C, LDL, and both measures, respectively. Among the 648,238 diabetes patients with at least one of each test in FY2013, 13% had a HbA1C test exceeding a threshold of 9%, 4% had a LDL test exceeding a threshold of 4 mmol/L, and 0.8% exceeded both thresholds. At the physician-level, the median (Interquartile Range) proportions of diabetes patients exceeding the testing thresholds were 12% (9%-16%) for HbA1c and 4% (2%-6%) for LDL. In a multilevel logistic regression model, there was significant between-physician variability in the proportions of diabetes patients exceeding the HbA1C (p Conclusion/ImplicationsWe developed a mechanism for integrating population-wide, clinical laboratory test results into physician audit-and-feedback reports to improve diabetes care in Ontario. Significant variation observed in the aggregated, physician-level proportions of diabetes patients testing above clinical thresholds for HbA1C and LDL highlights the importance of reporting such information to physicians.


2020 ◽  
Author(s):  
AliReza Estedlal ◽  
Marjan Jeddi ◽  
Seyed Taghi Heydari ◽  
Mohammad Hossein Dabbaghmanesh

Abstract Background: Coronavirus disease 2019 (COVID-19) is a newly recognized disease whose rapid spread has resulted in a global pandemic. In this resepct, there are several comorbidities presumed to be associated with presentation of complications in COVID-19 such as diabetes mellitus (DM), hypertension (HTN), and cardiovascular diseases (CVDs). Therefore, this study aimed to explore whether DM was a risk factor influencing presentation, progression, and prognosis of COVID-19 or not.Methods: A total number of 447 patients with confirmed COVID-19 were selected from two centers for COVID-19 in the city of Shiraz, south-central Iran, from February 20 to April 29, 2020. Then, demographic data, medical history, signs and symptoms, laboratory test results, as well as chest computed tomography (CT) scan reports were collected and analyzed.Results: This study revealed that older age, HTN, and CVDs could be mostly seen in diabetic patients with COVID-19. In addition, such patients had prolonged hospital stay, lower oxygen (O2) saturation, and abnormal laboratory test results such as higher white blood cell (WBC) count, lower lymphocyte count, elevated serum tumor markers such as aspartate aminotransferase (AST), and abnormal kidney function.Conclusion: DM is an important risk factor for adverse endpoints in patients with COVID-19. In diabetic patients, proper consideration of clinical characteristics is thus of utmost importance. In addition, special clinical insight for disease prevention, good glycemic control during hospitalization, and efforts to develop a vaccine can help improve disease outcomes in this population.


Author(s):  
Nedra S. Whitehead ◽  
Laurina Williams ◽  
Sreelatha Meleth ◽  
Sara Kennedy ◽  
Paul Epner ◽  
...  

Author(s):  
Larisa Dmitrievna Popovich ◽  
Svetlana Valentinovna Svetlichnaya ◽  
Aleksandr Alekseevich Moiseev

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.


2020 ◽  
Vol 16 (6) ◽  
pp. 598-607 ◽  
Author(s):  
Rebeca Barbosa da Rocha ◽  
Cristiano Sales Silva ◽  
Vinícius Saura Cardoso

Background: Self-care is essential for the prevention of complications in patients with diabetes, but several authors report that even with health education programs, the incidence of complications in patients with diabetes continues to increase. Objective: We aimed to examine adherence to self-care strategies and the repercussions of adherence on the clinical profiles of individuals with type 2 diabetes. Methods: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We searched for related studies in 4 databases: PubMed, Web of Science, Scopus, and Latin American and Caribbean Health Science Literature (LILACS). We included observational studies in English and Portuguese that evaluated the effects of selfcare in individuals with type 2 diabetes. Results: The search resulted in the identification of 615 articles, of which 34 met all the inclusion criteria. General self-care was considered unsatisfactory. Physical exercise was classified as the self-care activity that was performed less frequently by individuals with type 2 diabetes mellitus; adherence to medication was the most frequent behavior among volunteers. Conclusion: The studies indicated poor adherence of the population to good self-care practices, reflected by the increase in complications related to DM.


1983 ◽  
Vol 40 (6) ◽  
pp. 1025-1034
Author(s):  
Carol L. Colvin ◽  
Raymond J. Townsend ◽  
William R. Gillespie ◽  
Kenneth S. Albert

2006 ◽  
Vol 27 (13) ◽  
pp. 1565-1570 ◽  
Author(s):  
Alireza Shamaei-Tousi ◽  
Jeffrey W. Stephens ◽  
Ren Bin ◽  
Jacqueline A. Cooper ◽  
Andrew Steptoe ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document