scholarly journals P010 Influencing change: impactful communication – paediatric diabetes prescriptions

2019 ◽  
Vol 104 (7) ◽  
pp. e2.13-e2
Author(s):  
Emma Barbour
Keyword(s):  
Nursing Staff ◽  
Medical Staff ◽  
Hospital Pharmacy ◽  
Resistance To Change ◽  
Electronic System ◽  
Diabetic Patients ◽  
List Type ◽  
Newly Diagnosed ◽  
Paediatric Ward ◽  
Discharge Letter

AimThe paediatric wards in two hospital sites within one Trust deal with the supply of newly diagnosed diabetic prescriptions differently and the aim of this project was to have uniformity throughout the Trust with regards the supply of these discharge items, with both hospital pharmacy sites supplying the discharge items. Having completed the Pharmacy Management Clinical Leadership in Pharmacy (CLIP) program I wanted to use new skills learned throughout CLIP to be able to lead on influencing a change of practice on one hospital site and have uniformity across the Trust. I wanted to be able to persuade one site to change their practice of over 20 years and start getting the items dispensed through the hospital pharmacy.MethodsUsing the GROW model I ensured I was clear on what my plan was and that my goals were SMARTER. I had to deal with a number of different professionals and was prepared for some conflict as was expecting resistance to change. I met with the key stakeholders with regards the change. I communicated with medical staff, nursing staff and dispensary manager in the relevant hospital, and used the Colours Model1 to help me with this. The Colours Model is a simple and effective way to analyse our own communication preference and also to understand the preference of others. Knowing this I was then able to flex my communication style accordingly to engage with all parties more effectively. I identified what ‘colour’ I classed each group as and used different styles of communication for each. I also reviewed the records of newly diagnosed diabetic patients discharged from the paediatric ward over a period of one year to determine what discharge letter was given to the patient, and what detail was on it.ResultsOf the patients discharged in 2017, only 44% had a discharge on the relevant electronic system with pharmacy items on it, with just one having all required items. I communicated the following way with the different staff, once I had identified their ‘colour’. Medical staff (GREEN - Amiables, who are task focused and have indirect style). I focused on whole team and explained the benefit for change across interface. Nursing staff (RED - Drivers, who are task focused and have a direct style). I got straight to the point, explained reasons and results. Dispensary manager (BLUE - Analyticals, who are task focused and have an indirect style). I emailed in advance. Got to the point and gave exact details.ConclusionAll Staff agreed to the change in process in the paediatric ward. All discharges for newly diagnosed diabetic children on both sites will be electronically written and dispensed within the hospital pharmacy. The outcome for patient care is a more seamless transition of care between interface. By undertaking the CLIP programme I acquired a number of important skills to enable me to successfully lead this change. I made my voice heard and led with impactful communication.ReferenceCLIP workbook Leading with Impactful Communication Chapter 5 The Colours ModelJanuary 2018.

IMMUNOREACTIVE GROWTH HORMONE IN PLASMA AND URINE IN JUVENILE DIABETICS BEFORE AND DURING INITIAL INSULIN TREATMENT

1974 ◽  
Vol 75 (1) ◽  
pp. 50-63 ◽  
Author(s):  
Kristian F. Hanssen
Keyword(s):  
Growth Hormone ◽  
Insulin Treatment ◽  
Juvenile Diabetes ◽  
Control Group ◽  
List Type ◽  
Newly Diagnosed ◽  
Renal Tubular Reabsorption ◽  
Juvenile Diabetics ◽  
The Mean ◽  
Renal Tubular

ABSTRACT Twenty newly diagnosed, but as yet untreated patients of both sexes with classical juvenile diabetes were investigated by determining the mean plasma immunoreactive growth hormone (IRHGH) and urinary IRHGH for a 24 hour period before and during initial insulin treatment. The plasma IRHGH was significantly higher (0.05 > P > 0.01) before than during initial insulin treatment. During initial insulin treatment, the mean plasma IRHGH was significantly higher (0.01 > P > 0.001) than in a control group. The urinary IRHGH was significantly higher (0.01 > P > 0.001) before than during insulin treatment. The increased urinary IRHGH observed before insulin treatment is thought to be partly due to a defective renal tubular reabsorption of growth hormone. No significant correlation was found between the mean blood sugar and plasma or urinary IRHGH either before or during insulin treatment.

Interleukin 2 and soluble interleukin 2-receptor secretion defect in vitro in newly diagnosed type I diabetic patients

Diabetes ◽  
1989 ◽  
Vol 38 (3) ◽  
pp. 310-315 ◽  
Author(s):  
C. Giordano ◽  
F. Panto ◽  
C. Caruso ◽  
M. A. Modica ◽  
A. M. Zambito ◽  
...  
Keyword(s):  
Interleukin 2 ◽  
Diabetic Patients ◽  
Type I ◽  
Newly Diagnosed ◽  
Interleukin 2 Receptor ◽  
Soluble Interleukin 2 Receptor

Increased Serum WISP1 Levels are Associated with Lower Extremity Atherosclerotic Disease in Patients with type 2 Diabetes Mellitus

2021 ◽  
Author(s):  
Yangyang Cheng ◽  
Xiaohui Du ◽  
Bilin Zhang ◽  
Junxia Zhang
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Lower Extremity ◽  
Interleukin 6 ◽  
Atherosclerotic Disease ◽  
Enzyme Linked Immunosorbent Assay ◽  
Diabetic Patients ◽  
Newly Diagnosed

Abstract Background Serum wnt1-induced signaling pathway protein 1 (WISP1) levels are increased with obesity, which is a common complication associated with lower extremity atherosclerotic disease (LEAD). However, to date, the relationship between elevated WISP1 levels and the incidence of lower extremity atherosclerotic disease (LEAD) in type 2 diabetes mellitus (T2DM) remains unclear. Methods 174 newly diagnosed type 2 diabetic patients were enrolled in our study. Patients were divided into two groups, LEAD group (n=100) and control group (n=74). Anthropometric parameters, blood pressure and some biochemical parameters were obtained. Body composition was detected by bioelectrical impedance analysis (BIA). Levels of serum insulin were determined by radioimmunoassay. Serum WISP1 and interleukin 6 (IL-6) levels were determined using an enzyme-linked immunosorbent assay. Results It was shown that serum WISP1 levels in diabetic patients with LEAD were higher than those without LEAD (P<0.001). Serum WISP1 levels were positively related with waist circumference (r=0.237, P=0.003), waist-hip ratio (r=0.22, P=0.006), visceral fat area (r=0.354, P<0.001), serum creatinine (r=0.192, P=0.012), interleukin 6 (r=0.182, P=0.032), c-reactive protein (r=0.681, P<0.001), triglycerides (r=0.119, P<0.001), fasting glucose (r=0.196, P=0.011), glycated hemoglobin (r=0.284, P<0.001), and HOMA-IR (r=0.285, P<0.026). Compared with the lowest tertile, the odds ratio of the middle tertile for LEAD incidence was 3.27 (95% CI, 1.24–8.64) and 4.46 (95% CI, 1.62–12.29) for the highest tertile after adjusting confounding factors. Conclusion The results suggest that increased serum WISP1 levels independently contribute to the incidence of LEAD in patients with newly diagnosed T2DM.

Plasma Folate Levels in Men with Type 2 Diabetes

2005 ◽  
Vol 75 (5) ◽  
pp. 307-311
Author(s):  
Sakuta ◽  
Suzuki ◽  
Yasuda ◽  
Ito
Keyword(s):  
Type 2 Diabetes ◽  
Glucose Tolerance ◽  
Vegetable Intake ◽  
Normal Glucose Tolerance ◽  
Diabetic Patients ◽  
Newly Diagnosed ◽  
Plasma Folate ◽  
Normal Glucose ◽  
Diagnosed Diabetes

Limited data suggest that folate levels are higher in patients with type 2 diabetes than in subjects with normal glucose tolerance (NGT). We compared the fasting plasma folate, glucose (FPG), body mass index (BMI), and supplementary vitamin use among male subjects with NGT, those with impaired glucose tolerance (IGT), those with newly diagnosed type 2 diabetes, and those with previously diagnosed type 2 diabetes. Plasma folate of patients with newly diagnosed diabetes and that of patients with previously diagnosed diabetes was significantly higher than that of NGT subjects (p < 0.001). Prevalence of vitamin use was lower in newly diagnosed or previously diagnosed diabetic patients compared with non-diabetic subjects. Self-rated vegetable intake was similar among the four groups. FPG, BMI, triglycerides, and systolic blood pressure correlated with plasma folate levels independently of lifestyle factors studied. These results suggest that plasma folate levels are elevated in male diabetic patients independently of health-conscious behavior that is recommended for diabetic people.

Treatment of hyperglycaemia in newly diagnosed diabetic patients is associated with a reduction in oxidative stress and improvement inβ-cell function

2014 ◽  
Vol 30 (7) ◽  
pp. 590-598 ◽  
Author(s):  
Jhankar D. Acharya ◽  
Amol J. Pande ◽  
Suyog M. Joshi ◽  
Chittaranjan S. Yajnik ◽  
Saroj S. Ghaskadbi
Keyword(s):  
Oxidative Stress ◽  
Cell Function ◽  
Diabetic Patients ◽  
Newly Diagnosed

scholarly journals Evaluating the Synergistic Activity of Metformin and Apple Cider Vinegar in Type 2 Diabetics

2020 ◽  
pp. 1-7
Author(s):  
Momina Abid ◽  
Farah Ahmed ◽  
Shehla Shaheen ◽  
Zahida Memon ◽  
M. Zaman Shaikh ◽  
...  
Keyword(s):  
Glycemic Control ◽  
The Body ◽  
Diabetic Patients ◽  
Synergistic Activity ◽  
Care Hospital ◽  
Newly Diagnosed ◽  
Type 2 Diabetic Patients ◽  
Apple Cider ◽  
Type 2 Diabetic

Aims: The aim of this study was to observe the effect of Apple Cider Vinegar (ACV) in combination with Metformin on the Body Mass Index (BMI) and glycemic control of newly diagnosed type 2 diabetic patients. Study Design: Single arm pre post quasi experimental clinical trial. Place and Duration of Study: Department of Medicine of a tertiary care hospital and a Diabetes and Endocrinology clinic, based in Karachi, Pakistan from April to July 2019. Methodology: A total of 30 newly diagnosed type 2 diabetic patients were enrolled in the study (Males: 17; females: 13; age range: 27-55 years) after obtaining written informed consent. The parameters of Body weight, BMI, Fasting Blood Sugar (FBS) and Hemoglobin A1c (HbA1c) of each patient were assessed before and after 12 weeks of treatment with Metformin 750 mg plus 2 tablespoons of ACV per day. The baseline and post treatment values of the aforementioned were compared with each other. Results: In all the 30 patients assessed after 12 weeks of treatment, the weight was significantly reduced from 85.66±18.30 kg. to 82.96±18.43 kg with a consequently significant change in the BMI from 29.38±5.08 kg/m2 to 28.43±5.16 kg/m2. Moreover, the glycemic control, assessed as FBS and HbA1c also showed significant reduction in the FBS (127.76±9.17 to 121.23±9.54) and HbA1c (7.14±0.29 to 6.92±0.29) after 12 weeks of treatment in all 30 patients (p<0.01). Conclusion: Apple Cider Vinegar seems to be effective therapy in combination with metformin for newly diagnosed type 2 diabetic patients in improving glycemic control as well as augmenting weight reduction.

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