scholarly journals Glycaemic control, antidiabetic medications and influenza vaccination coverage among patients with diabetes in Udine, Italy

2019 ◽  
Vol 7 (3) ◽  
pp. e000198 ◽  
Author(s):  
Francesca Valent ◽  
Annarita Tullio
Keyword(s):  
Diabetes Mellitus ◽  
Glycaemic Control ◽  
Influenza Vaccination ◽  
Vaccination Coverage ◽  
Diabetes Management ◽  
University Hospital ◽  
Italian Population ◽  
Adjusted Relative Risk ◽  
Patients With Diabetes ◽  
Haemoglobin Testing

ObjectiveThe objectives of this study were to estimate influenza vaccination coverage among patients with diabetes mellitus in an Italian 250 000-inhabitant area in the 2017–2018 season and to assess whether glycaemic control and pharmacological treatment were associated with the likelihood of being vaccinated.DesignIn this cross-sectional study, we analysed anonymous health administrative databases, linked with each other at the individual patient level through a stochastic key: diabetes mellitus registry, vaccinations, drug prescriptions and laboratory database.SettingThe study was conducted in the catchment area of the University Hospital of Udine (‘the Udine area’), a 250 000-inhabitant area in the northeast of Italy.ParticipantsThe study included all subjects included in the regional registry of patients with diabetes mellitus, living in the Udine area as of 1 October 2017.Main outcome measuresVaccination coverage in the 2017–2018 influenza season was calculated. The association between patients’ characteristics and the likelihood of being vaccinated was assessed through multivariate log binomial regression.Result53.0% of 15 900 patients with diabetes living in the area were vaccinated. Coverage increased with age, approaching 75% at ≥85 years. Patients lacking recent glycated haemoglobin testing were less likely to be vaccinated (43.4% vaccination coverage), as were those not treated pharmacologically (44.4% vaccination coverage). Patients treated with both insulin, metformin and other antidiabetic medications were more likely to be vaccinated than those treated with metformin alone (58.1% vaccination coverage; adjusted relative risk=1.07, 95% CI 1.01 to 1.14).ConclusionInfluenza vaccination coverage was suboptimal in this Italian population of patients with diabetes. Strategies to improve diabetes management could in turn positively affect influenza coverage.

scholarly journals Quality improvement project for improving inpatient glycaemic control in non-critically ill patients admitted on medical floor with type 2 diabetes mellitus

2020 ◽  
Vol 9 (3) ◽  
pp. e000982
Author(s):  
Adeel Ahmad Khan ◽  
Aamir Shahzad ◽  
Samman Rose ◽  
Dabia Hamad S H Al Mohanadi ◽  
Muhammad Zahid
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Diabetes Management ◽  
Oral Intake ◽  
Improvement Project ◽  
Type 2 Dm ◽  
Management Protocol ◽  
Patients With Diabetes

A significant number of patients admitted to the medical floor have type 2 diabetes mellitus (DM). Lack of a standardised inpatient hyperglycaemia management protocol leads to improper glycaemic control adding to morbidity in such patients. American Diabetes Association, in its 2019 guidelines, recommends initiation of a regimen consisting of basal insulin (long-acting insulin) or basal plus correctional insulin for non-critically ill hospitalised patients with poor or no oral intake. A combination of basal insulin, bolus (short-acting premeal or prandial) insulin and correctional scale insulin is recommended for inpatient hyperglycaemia management in non-critical patients with type 2 DM who have proper oral intake. Baseline data of 100 patients with diabetes admitted to Hamad General Hospital Doha, Qatar, showed that although insulin was used in the majority of patients, there was lack of uniformity in the initiation of insulin regimen. Adequate glycaemic control (7.8–10 mmol/L) was achieved in 45% of patients. Using Plan–Do–Study–Act (PDSA) model of improvement, a quality improvement project was initiated with the introduction of a standardised inpatient hyperglycaemia management protocol aiming to achieve 50% compliance to protocol and improvement in inpatient glycaemic control from baseline of 45% to 70%. Interventions for change included development of a standardised inpatient hyperglycaemia management protocol and its provision to medical trainees, teaching sessions for trainees and nurses, active involvement of medical consultants for supervision of trainees to address the fear of hypoglycaemia, regular reminders/feedbacks to trainees and nurses about glycaemic control of their patients and education about goals of diabetes management during hospitalisation for patients with diabetes. Overall, glycaemic control improved significantly with target glycaemic control of 70% achieved in 4 of the 10 PDSA cycles without an increase in the number of hypoglycaemic episodes. We conclude that development of a standardised inpatient insulin prescribing protocol, educational sessions for medical trainees and nurses about goals of diabetes management during hospitalisation, regular reminders to healthcare professionals and patient education are some of the measures that can improve glycaemic control of patients with type 2 DM during inpatient stay.

Smart glucometers: revolution in diabetes management

2021 ◽  
pp. 43-45
Author(s):  
Yuliya Prozherina ◽  
Keyword(s):  
Diabetes Mellitus ◽  
Glycaemic Control ◽  
Global Health ◽  
Diabetes Management ◽  
Chronic Complications ◽  
Good Glycaemic Control ◽  
Rapid Spread ◽  
The World ◽  
Patients With Diabetes

The rapid spread of diabetes mellitus (DM) is one of the global health challenges around the world. In Russia, the number of registered patients reached 5.1 million in 2020 [1]. Today, it does not raise doubts that achieving good glycaemic control prevents or significantly reduces the risk of development and progression of chronic complications in patients with diabetes. With advances in technology, “smart” glucometers have been launched, significantly expanding options in diabetes management [2].

scholarly journals A Study to Evaluate the Quality of Life of Patients with Diabetes Mellitus

2021 ◽  
pp. 575-585
Author(s):  
P. Amulya Reddy ◽  
K. Saravanan ◽  
A. Madhukar
Keyword(s):  
Diabetes Mellitus ◽  
Diabetes Management ◽  
Study Data ◽  
Categorical Variables ◽  
P Value ◽  
Diabetic Patients ◽  
Physical Endurance ◽  
Glucose Levels ◽  
Patients With Diabetes ◽  
History Of

Aim: The aim of the study was to evaluate the QOL of patients with Diabetes Mellitus. Study Design: This was a prospective, observational study. Duration of Study: The study was conducted from August 2019 to January 2021 in Yashoda Hospital, Hyderabad. Methodology: Patients of either sex with ≥1year history of diabetes willing to give the consent were included in the study. Patients of either sex with <1year history of DM, Pregnant/lactating women and patients not willing to give the consent were excluded from the study. Data on Blood glucose levels (FBS, PPBS) and HbA1C was also obtained and assessed. QOLID questionnaire was administered to the patients and assessed which consisted of a set of 34 items representing 8 domains such as Role limitation due to the physical health, Physical endurance, General health, Treatment satisfaction, Symptom botherness, Financial worries, Mental health, and Diet satisfaction). Results: A total of 200 patients were analysed in the study,108(54%) were males and 92(46%) were females. The average age of the patients was 58.5 years with majority being 51-70years (73.5%) of age. Patients with higher age and females had poor QOL compared to others. The correlation between various categorical variables with that of scores of QOL in various domains was assessed, Age of the patients influenced QOL score in various domains like RLPH (p value-0.038), PE (p value-0.0183), and SB (p value-0.0002), Gender has influenced QOL score in domains like RLPH (p value-0.0008), PE (p value-0.0106), TS (p value-0.0005) and Educational Qualification has influenced QOL score in RLPH (p value-0.0008), GH (p value-<0.0001), TS (p value-<0.0001), E/MH (p value-<0.0001). Conclusion: The results concluded that overall QOL was noticeably low in Diabetic patients especially in Women and elderly thus indicating that Diabetes management is not restricted to treatment but also requires attention on QOL of patients.

Diabetes management in surgery

2011 ◽  
pp. 1905-1908
Author(s):  
Andrew P. Hall ◽  
Melanie J. Davies
Keyword(s):  
Diabetes Mellitus ◽  
Wound Healing ◽  
Stress Response ◽  
Diabetes Management ◽  
Metabolic Response ◽  
Skin Grafting ◽  
Metabolic Effects ◽  
Ophthalmic Surgery ◽  
Patients With Diabetes ◽  
Catabolic State

Diabetes mellitus is a common condition in the general population, and particularly so among hospital inpatients. Complications associated with diabetes mellitus further increase its incidence in surgical patients, particularly those requiring vascular, renal, or ophthalmic procedures. Patients with diabetes have a higher rate of morbidity and mortality associated with surgery. This includes cardiovascular and renal complications, infection, and impaired wound healing. The process of surgery, a controlled form of trauma, provokes a metabolic response due to the release of cytokines and stress-associated hormones. These agents promote a catabolic state that includes increased insulin resistance. The resulting hyperglycaemia leads to overflow of substrates in the mitochondria and the generation of excess free oxygen radicals, which can be toxic to the cell. It should, therefore, be possible to reduce these effects by avoiding or attenuating the stress response and/or counteracting its metabolic effects. The stress response is proportional to the degree of tissue trauma. Insulin administration and normoglycaemia have been shown to reverse catabolic changes and improve wound healing and skin grafting, and also to reduce the incidence of infective complications. Additionally, the stress response may be, in part, attenuated by the choice of anaesthetic technique. Neuraxial (spinal and epidural local anaesthetic) analgesia can reduce sympathetic nervous system tone and adrenal output. Additionally, much ophthalmic surgery is now performed with local anaesthesia techniques. Such approaches avoid the more prolonged starvation and cardiorespiratory risks associated with general anaesthesia.

Patients’ Experiences of Diabetes Self-Management Education According to Health-Literacy Levels

2019 ◽  
Vol 29 (5) ◽  
pp. 285-292 ◽  
Author(s):  
Suhyun Kim ◽  
Yeoungsuk Song ◽  
Jihyun Park ◽  
Sonja Utz
Keyword(s):  
Health Literacy ◽  
Diabetes Management ◽  
Management Education ◽  
University Hospital ◽  
Self Management ◽  
Lifestyle Modifications ◽  
Low Health Literacy ◽  
Patients With Diabetes ◽  
Conventional Content Analysis ◽  
High Health Literacy

Diabetes self-management is an important part of patient care for those with diabetes. The purpose of this study was to explore patients’ experiences with diabetes self-management education and how these experiences differed by health-literacy levels. A descriptive qualitative design was conducted. In 2016, 20 patients with diabetes who took a formal diabetes self-management course at a university hospital in South Korea were interviewed. A conventional content analysis was conducted. Patients with low health-literacy misunderstood diabetes management, showed passive attitudes towards seeking information, and had difficulty obtaining detailed information. Patients with high health-literacy wanted systematic, in-depth, individualized counselling on lifestyle modifications and medications. Patients’ experiences with diabetes self-management education revealed differences in their health-literacy dimensions. In addition to practising health-literacy precautions, the content and delivery of diabetes self-management education need to be accommodated according to patients’ health-literacy levels to obtain better outcomes.

scholarly journals Relationship between Influenza Vaccination Coverage Rate and COVID-19 Outbreak: An Italian Ecological Study

Vaccines ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 535 ◽  
Author(s):  
Mauro Amato ◽  
José Pablo Werba ◽  
Beatrice Frigerio ◽  
Daniela Coggi ◽  
Daniela Sansaro ◽  
...  
Keyword(s):  
Intensive Care ◽  
Influenza Vaccination ◽  
Intensive Care Units ◽  
Vaccination Coverage ◽  
Ad Hoc ◽  
Coverage Rate ◽  
Italian Population ◽  
Vaccination Coverage Rate ◽  
Multivariable Analyses ◽  
Coverage Rates

Background: The lack of specific vaccines or drugs against coronavirus disease 2019 (COVID-19) warrants studies focusing on alternative clinical approaches to reduce the spread of this pandemic disease. In this study, we investigated whether anti-influenza vaccination plays a role in minimizing the diffusion of COVID-19 in the Italian population aged 65 and over. Methods: Four COVID-19 outcomes were used: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence, hospitalizations for COVID-19 symptoms, admissions to intensive care units for reasons related to SARS-CoV-2, and deaths attributable to COVID-19. Results: At univariate analyses, the influenza vaccination coverage rates correlated negatively with all COVID-19 outcomes (Beta ranging from −134 to −0.61; all p < 0.01). At multivariable analyses, influenza vaccination coverage rates correlated independently with SARS-CoV-2 seroprevalence (Beta (95% C.I.): −130 (−198, −62); p = 0.001), hospitalizations for COVID-19 symptoms (Beta (95% C.I.): −4.16 (−6.27, −2.05); p = 0.001), admission to intensive care units for reasons related to SARS-CoV-2 (Beta (95% C.I.): −0.58 (−1.05, −0.12); p = 0.017), and number of deaths attributable to COVID-19 (Beta (95% C.I.): −3.29 (−5.66, −0.93); p = 0.010). The R2 observed in the unadjusted analysis increased from 82% to 159% for all the considered outcomes after multivariable analyses. Conclusions: In the Italian population, the coverage rate of the influenza vaccination in people aged 65 and over is associated with a reduced spread and a less severe clinical expression of COVID-19. This finding warrants ad hoc studies to investigate the role of influenza vaccination in preventing the spread of COVID-19.

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