scholarly journals Inequalities in glycemic management in people living with type 2 diabetes mellitus and severe mental illnesses: cohort study from the UK over 10 years

2021 ◽  
Vol 9 (1) ◽  
pp. e002118
Author(s):  
Jayati Das-Munshi ◽  
Peter Schofield ◽  
Mark Ashworth ◽  
Fiona Gaughran ◽  
Sally Hull ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Pay For Performance ◽  
Mental Illnesses ◽  
Sample Mean ◽  
Glycemic Management ◽  
Hba1c Levels

IntroductionUsing data from a a primary care pay-for-performance scheme targeting quality indicators, the objective of this study was to assess if people living with type 2 diabetes mellitus (T2DM) and severe mental illnesses (SMI) experienced poorer glycemic management compared with people living with T2DM alone, and if observed differences varied by race/ethnicity, deprivation, gender, or exclusion from the scheme.Research design and methodsPrimary care data from a cohort of 56 770 people with T2DM, including 2272 people with T2DM and SMI, from London (UK), diagnosed between January 17, 2008 and January 16, 2018, were used. Adjusted mean glycated hemoglobin (HbA1c) and HbA1c differences were assessed using multilevel regression models.ResultsCompared with people with T2DM only, people with T2DM/SMI were more likely to be of an ethnic minority background, excluded from the pay-for-performance scheme and residing in more deprived areas. Across the sample, mean HbA1c was lower in those with T2DM and SMI (mean HbA1c: 58 mmol/mol; 95% CI 57 to 59), compared with people with T2DM only (mean HbA1c: 59 mmol/mol; 95% CI 59 to 60). However, HbA1c levels were greater in Bangladeshi, Indian, Pakistani, and Chinese people compared with the White British reference in the T2DM/SMI group. People with T2DM/SMI who had been excluded from the pay-for-performance scheme, had HbA1c levels which were +7 mmol/mol (95% CI 2 to 11) greater than those with T2DM/SMI not excluded. Irrespective of SMI status, increasing deprivation and male gender were associated with increased HbA1c levels.ConclusionsDespite a pay-for-performance scheme to improve quality standards, inequalities in glycemic management in people with T2DM and SMI persist in those excluded from the scheme and by gender, ethnicity, and area-level deprivation.

scholarly journals TheType 2 Deiodinase Thr92Ala PolymorphismIs Associated with Worse Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Xiaowen Zhang ◽  
Jie Sun ◽  
Wenqing Han ◽  
Yaqiu Jiang ◽  
Shiqiao Peng ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Meta Analysis ◽  
Increased Risk ◽  
Design And Methods ◽  
Hba1c Levels

Objective. Type 2 deiodinase (Dio2) is an enzyme responsible for the conversion of T4 to T3. The Thr92Ala polymorphism has been shown related to an increased risk for developing type 2 diabetes mellitus (T2DM). The aim of this study is to assess the association between this polymorphism and glycemic control in T2DM patients as marked by the HbA1C levels.Design and Methods.The terms “rs225014,” “thr92ala,” “T92A,” or “dio2 a/g” were used to search for eligible studies in the PubMed, Embase, and Cochrane databases and Google Scholar. A systematic review and meta-analysis of studies including both polymorphism testing and glycated hemoglobin (HbA1C) assays were performed.Results. Four studies were selected, totaling 2190 subjects. The pooled mean difference of the studies was 0.48% (95% CI, 0.18–0.77%), indicating that type 2 diabetics homozygous for the Dio2 Thr92Ala polymorphism had higher HbA1C levels.Conclusions. Homozygosity for the Dio2 Thr92Ala polymorphism is associated with higher HbA1C levels in T2DM patients. To confirm this conclusion, more studies of larger populations are needed.

Improved Control of Type 2 Diabetes Mellitus: A Practical Education/Behavior Modification Program in a Primary Care Clinic

1999 ◽  
Vol 92 (7) ◽  
pp. 667-672 ◽  
Author(s):  
NATHAN A. RIDGEWAY ◽  
DONALD R. HARVILL ◽  
LEO M. HARVILL ◽  
THELMA M. FALIN ◽  
GAYLE M. FORESTER ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Behavior Modification ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
Practical Education

scholarly journals ADHERENCE LEVEL AND BLOOD SUGAR CONTROL OF TYPE 2 DIABETES MELLITUS PATIENTS WHO GETS COUNSELING AND SHORT MESSAGES SERVICE AS REMINDER AND MOTIVATION

2018 ◽  
Vol 11 (2) ◽  
pp. 219 ◽  
Author(s):  
Wirawan Adikusuma ◽  
Nurul Qiyaam
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Treatment Adherence ◽  
Data Retrieval ◽  
Control Group ◽  
Hba1c Levels ◽  
Short Messages

  Objective: Examines the effects of counseling and short messages service (SMS) as a reminder and motivation toward medication adherence improvement and controlled HbA1c levels of type 2 diabetes mellitus (T2DM) patients.Methods: This study used a quasi-experimental method with prospective data retrieval. The subjects of this study were 40 patients with outpatient T2DM in internal disease polyclinic in West Nusa Tenggara Hospital, Indonesia. Patients who fulfilled the inclusion criteria were divided into two groups: The control group (n=20) receiving only the drug care service and the treatment group (n=20) receiving counseling and SMS reminder and motivation from the pharmacist. Data collecting was conducted using the pill count method, and HbA1c levels were taken from the medical record.Results: The results showed that counseling and SMS as reminder and motivation by a pharmacist can improve treatment adherence significantly (p<0.05) by 11.33 ± 8.47 and can decrease HbA1c level significantly (p<0.05) of 1.32 ± 0.72 in the intervention group. There was a positive correlation between T2DM patient treatment adherence to HbA1c levels (r=0.254, p=0.023).Conclusion: The provision of counseling and SMS as a reminder and motivation by the pharmacist can have a positive effect toward medication adherence and control of HbA1c in T2DM patients. 

scholarly journals Correlation Between Lipid Profile with Type 2 Diabetes Mellitus Progression

2020 ◽  
Vol 8 (2) ◽  
pp. 66-72
Author(s):  
Angiesta Pinakesty ◽  
Restu Noor Azizah
Keyword(s):  
Diabetes Mellitus ◽  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Lipid Profile ◽  
Cholesterol Levels ◽  
Type 2 Dm ◽  
Hba1c Levels

Introduction: Diabetes mellitus (DM) is a non-communicable disease that has increased from year to year. Type 2 diabetes mellitus is not caused by lack of insulin secretion, but is caused by the failure of the body's cells to respond to the hormone insulin (insulin resistance). Insulin resistance was found to be a major contributor to atherogenic dyslipidemia. Dyslipidemia in DM risks 2 to 4 times higher than non-DM. Although dyslipidemia has a great risk for people with type 2 diabetes mellitus, this conventional risk factor only explains a portion (25%) of excess cardiovascular risk in type 2 DM. Discussion: In uncontrolled type 2 DM patients, LDL oxidation occurs faster which results from an increase in chronic blood glucose levels. Glycemic control as a determinant of DM progressivity is determined through HbA1c examination. HbA1c levels are associated with blood triglyceride levels. Meanwhile, triglyceride levels are associated with total cholesterol and HDL cholesterol levels. HbA1c levels are also associated with LDL cholesterol levels. Conclusion: There is a relationship between lipid profile and the progression of type 2 diabetes mellitus.   Keywords: type 2 diabetes mellitus, dyslipidemia, HbA1c, glycemic control, lipid profile

scholarly journals HBA1C LEVELS IN TYPE 2 DIABETES MELLITUS PATIENTS WITH AND WITHOUT INCIDENCE OF THROMBOTIC STROKE (Kadar HbA1c Pasien Diabetes Melitus Tipe 2 dengan dan Tanpa Kejadian Strok Infark Trombotik)

2018 ◽  
Vol 23 (1) ◽  
pp. 56
Author(s):  
Dafina Balqis ◽  
Yudhi Adrianto ◽  
Jongky Hendro Prayitno
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hba1c Levels ◽  
Diabetes Melitus

Strok saat ini menjadi salah satu penyebab utama kematian global. Hubungan antara kejadian strok dengan diabetes telahlama diketahui. Kontrol gula darah, yang dipantau melalui kadar HbA1c, telah menunjukkan hubungan dengan strok dan penyakitkardiovaskular lain. Kajian ini untuk menentukan perbedaan kadar HbA1c antara pasien diabetes melitus tipe 2 dengan dan tanpakejadian strok infark trombotik. Metode penelitian yang digunakan adalah analisis retrospektif menggunakan rekam medis pasienselama 3,5 tahun. Penelitian ini mengumpulkan data kadar HbA1c dari 443 pasien diabetes melitus tipe 2 kemudian membandingkanrerata kadar HbA1c antara pasien diabetes mellitus tipe 2 dengan kejadian strok trombotik (n=74) dan tanpa kejadian strok trombotik(n=369). Perbandingan tingkat HbA1c juga dilakukan secara terpisah antara laki-laki dan perempuan. Kajian ini menemukan reratakadar HbA1c yang tinggi di kedua kelompok sampel (10,49%±2,53% untuk kelompok dengan kejadian strok infark trombotik dan10,44%±2,8% untuk kelompok tanpa kejadian strok infark trombotik) dengan perbandingan sarana p>0,05. Perbandingan yangdilakukan secara terpisah di laki-laki dan perempuan juga menunjukkan hasil yang sama dengan p>0,05. Sebagai simpulan, kadarHbA1c di kedua kelompok penelitian sama-sama tinggi dan tidak ada perbedaan bermakna kadar HbA1c yang ditemukan di pasiendengan diabetes tipe 2 dengan dan tanpa kejadian strok trombotik.

Sign in / Sign up

Export Citation Format

Share Document