Diabetic patients with prior specialist care have better glycaemic control than those with prior primary care

2005 ◽  
Vol 11 (6) ◽  
pp. 568-575 ◽  
Author(s):  
Baiju R. Shah ◽  
Janet E. Hux ◽  
Andreas Laupacis ◽  
Bernard Zinman Mdcm ◽  
Peter C. Austin ◽  
...  
Keyword(s):  
Primary Care ◽  
Glycaemic Control ◽  
Diabetic Patients ◽  
Specialist Care

scholarly journals Oral hygiene practices and periodontal disease status assessment among diabetic patients from three selected public medical primary care clinics in Kuantan, Malaysia

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Tin Myo Han ◽  
Razida Ismail ◽  
Munirah Yaacob ◽  
Mohd Aznan Md Aris ◽  
Iskandar Firzada Osman ◽  
...  
Keyword(s):  
Primary Care ◽  
Glycaemic Control ◽  
Periodontal Disease ◽  
Oral Hygiene ◽  
Disease Status ◽  
Tooth Brushing ◽  
Diabetic Patients ◽  
Race Difference ◽  
Primary Care Clinics ◽  
Hygiene Practices

Introduction: Evidences on the bilateral relationship between diabetes mellitus (DM) and periodontal diseases (PD) have been growing. Oral hygiene practice (OHP) is one of major determinants for PD. Thus, the aim of this study was to assess periodontal disease status and oral hygiene practices of DM-patients from public medical primary care clinics (PMPCCs). Methods: A medical-dental research team conducted an active PD-screening among 193 DMpatients using both self-reported questions (SRQs) and basic periodontal examination (BPE)  by professionals at 3-PMPCCs in Kuantan in 2015. OHP was categorized into two groups; acceptable OHP (two/three-time tooth-brushing/day using with/without mouthwash/flossing) and need to improve OHP (one-time tooth brushing/day using with/without mouth-wash/flossing). HbA1C ≤ 6.5% was used as cut-off for glycaemic control achievement. A cross- analysis was done to infer the influences of demographic-background and OHP on PD- status and relationship between PD- status and glycaemic control achievement. Results: Out of 193 DM-patients, 72.5% (140/193) were PD-screening positive in self-reporting while 54.9% (106/193) had PD in professional screening. OHP of majority (86%) were acceptable. Only 14% (27/193) achieved glycaemic-control status. Influence of demographic and OHP on PD-status ( by BPE) and relationship between PD and glycaemic control achievement did not found out. There were no age and race difference in OHP; however, acceptable OHP was significantly higher (p<0.05) in female than male DM-patients (94% vs 77.4%). Conclusions:  High prevalence of PD indicated to promote oral health education/care among DM-patients from PMPCCs.  In-detailed OHP/PD assessment and other influencing factors on glycaemic-control achievement should be considered to get more valid results in further study.

Proportion of type 2 diabetic patients achieving treatment goals and the survey of patient’s attitude towards insulin initiation in patients with inadequate glycaemic control with oral anti-diabetic drugs

2020 ◽  
Vol 16 ◽  
Author(s):  
Shivashankara Bhat ◽  
Mukta Chowta ◽  
Nithyananda Chowta ◽  
Rajeshwari Shastry ◽  
Priyanka Kamath
Keyword(s):  
Glycaemic Control ◽  
Diabetic Patients ◽  
Treatment Goals ◽  
Insulin Initiation ◽  
Type 2 Diabetic Patients ◽  
Number Of Patients ◽  
Patient’S Perception ◽  
Hba1c Target ◽  
Type 2 Diabetic

Background: Type 2 diabetic patients often require insulin therapy for better glycaemic control. However, many of these patients do not receive insulin or do not receive it in a timely manner. Objective: The study was planned to assess the proportion of type 2 diabetic patients attaining treatment goals as per the ADA 2018 guidelines. In addition, patient’s perception on insulin therapy assessed and compared between insulin naïve and insulin initiated type 2 diabetic patients. Methods: The study was conducted in type 2 diabetic patients. Data on their demographics, medical history, duration of diabetes, history of diabetes related complications, the current antidiabetic medication received, most recent glycaemic parameters were noted. Patient’s perception on insulin initiation was recorded through structured interview. Results: A total of 129 patients were included in the study. Around 76.7% patients achieved HbA1c target (<7%). Duration of the disease is much higher in patients who did not meet the HBA1c target. A good number of patients felt that insulin injection would be physically painful (56.5%). Majority of the patients also felt that insulin will make their life less flexible (64.8%). Many patients are having the opinion that insulin is required for life long (73.2%). More number of patients on insulin agreed with the statement ‘Leads to good short-term outcomes as well as long-term benefits’ compared to insulin naïve patients. Conclusion: The results highlight that the proportion of patients achieving recommended glycaemic target is not satisfactory. Many patients who are inadequately controlled with oral antidiabetic drugs were reluctant to initiate insulin.

Evidence-Based Treatment for the Eating Disorders

2010 ◽  
pp. 451-451
Author(s):  
Phillipa J. Hay ◽  
Angélica de M. Claudino
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Evidence Base ◽  
Good Evidence ◽  
Distinct Advantage ◽  
Specialist Care ◽  
Feeding And Eating Disorders ◽  
Online Therapies ◽  
Primary Care Practitioners

This chapter comprises a focused review of the best available evidence for psychological and pharmacological treatments of choice for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified and unspecified feeding and eating disorders (OSFED and UFED), discusses the role of primary care and online therapies, and presents treatment algorithms. In AN, although there is consensus on the need for specialist care that includes nutritional rehabilitation in addition to psychological therapy, no single approach has yet been found to offer a distinct advantage. In contrast, manualized cognitive behavior therapy (CBT) for BN has attained “first-line” treatment status with a stronger evidence base than other psychotherapies. Similarly, CBT has a good evidence base in treatment of BED and for BN, and BED has been successfully adapted into less intensive and non-specialist forms. Behavioral and pharmacological weight loss management in treatment of co-morbid obesity/overweight and BED may be helpful in the short term, but long-term maintenance of effects is unclear. Primary care practitioners are in a key role, both with regard to providing care and with coordination and initiation of specialist care. There is an emerging evidence base for online therapies in BN and BED where access to care is delayed or problematic.

Evidence-Based Treatment for the Eating Disorders

2012 ◽  
Author(s):  
Phillipa J. Hay ◽  
Angélica de M. Claudino
Keyword(s):  
Primary Care ◽  
Eating Disorders ◽  
Evidence Base ◽  
Good Evidence ◽  
Distinct Advantage ◽  
Specialist Care ◽  
Feeding And Eating Disorders ◽  
Online Therapies ◽  
Primary Care Practitioners

This chapter comprises a focused review of the best available evidence for psychological and pharmacological treatments of choice for anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED), and other specified and unspecified feeding and eating disorders (OSFED and UFED), discusses the role of primary care and online therapies, and presents treatment algorithms. In AN, although there is consensus on the need for specialist care that includes nutritional rehabilitation in addition to psychological therapy, no single approach has yet been found to offer a distinct advantage. In contrast, manualized cognitive behavior therapy (CBT) for BN has attained “first-line” treatment status with a stronger evidence base than other psychotherapies. Similarly, CBT has a good evidence base in treatment of BED and for BN, and BED has been successfully adapted into less intensive and non-specialist forms. Behavioral and pharmacological weight loss management in treatment of co-morbid obesity/overweight and BED may be helpful in the short term, but long-term maintenance of effects is unclear. Primary care practitioners are in a key role, both with regard to providing care and with coordination and initiation of specialist care. There is an emerging evidence base for online therapies in BN and BED where access to care is delayed or problematic.

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