scholarly journals Association Between Spirituality and Depression in Adults With Type 2 Diabetes

2012 ◽  
Vol 38 (3) ◽  
pp. 427-435 ◽  
Author(s):  
Cheryl P. Lynch ◽  
Melba A. Hernandez-Tejada ◽  
Joni L. Strom ◽  
Leonard E. Egede
Keyword(s):  
Type 2 Diabetes ◽  
Medical Center ◽  
Diabetes Education ◽  
Academic Medical Center ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Depression Symptoms ◽  
Patients With Diabetes ◽  
Values And Beliefs

Purpose The purpose of the study was to examine the association between spirituality and depression among patients with type 2 diabetes. Methods This study included 201 adult participants with diabetes from an indigent clinic of an academic medical center. Participants completed validated surveys on spirituality and depression. The Daily Spiritual Experience (DSE) Scale measured a person’s perception of the transcendent (God, the divine) in daily life. The Center for Epidemiologic Studies–Depression scale assessed depression. Linear regression analyses examined the association of spirituality as the predictor with depression as the outcome, adjusted for confounding variables. Results Greater spirituality was reported among females, non-Hispanic blacks, those with lower educational levels, and those with lower income. The unadjusted regression model showed greater spirituality was associated with less depression. This association was mildly diminished but still significant in the final adjusted model. Depression scores also increased (greater depression risk) with females and those who were unemployed but decreased with older age and non-Hispanic black race/ethnicity. Conclusions Treatment of depression symptoms may be facilitated by incorporating the spiritual values and beliefs of patients with diabetes. Therefore, faith-based diabetes education is likely to improve self-care behaviors and glycemic control.

scholarly journals Improving Dietary Recommendations for Patients With Type 2 Diabetes and Obesity in an Endocrinology Clinic

2020 ◽  
Author(s):  
Juan J. Delgado-Hurtado ◽  
Erika L. Kline ◽  
Andrew Crawford ◽  
Auden McClure
Keyword(s):  
Type 2 Diabetes ◽  
Medical Center ◽  
Diabetes Education ◽  
Academic Medical Center ◽  
Dietary Recommendations ◽  
Standard Format ◽  
Diabetes And Obesity ◽  
Endocrinology Clinic

“Quality Improvement Success Stories” are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of <em>Clinical Diabetes</em>. The following article describes a project designed to improve the degree and quality of support for lifestyle change provided to patients with type 2 diabetes and obesity in the outpatient endocrinology clinic of a rural academic medical center.

scholarly journals Improving Dietary Recommendations for Patients With Type 2 Diabetes and Obesity in an Endocrinology Clinic

2020 ◽  
Author(s):  
Juan J. Delgado-Hurtado ◽  
Erika L. Kline ◽  
Andrew Crawford ◽  
Auden McClure
Keyword(s):  
Type 2 Diabetes ◽  
Medical Center ◽  
Diabetes Education ◽  
Academic Medical Center ◽  
Dietary Recommendations ◽  
Standard Format ◽  
Diabetes And Obesity ◽  
Endocrinology Clinic

“Quality Improvement Success Stories” are published by the American Diabetes Association in collaboration with the American College of Physicians and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of <em>Clinical Diabetes</em>. The following article describes a project designed to improve the degree and quality of support for lifestyle change provided to patients with type 2 diabetes and obesity in the outpatient endocrinology clinic of a rural academic medical center.

Abstract NS5: Use of a Multidisciplinary Approach to Successfully Improve Inpatient Diabetes Self-Management Education and Diabetes Medication Reconciliation at Discharge for Persons With Diabetes and Stroke at a Major Academic Medical Center

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Suzanne Stone ◽  
Nancy Drobycki ◽  
Mark Johnson
Keyword(s):  
Medication Reconciliation ◽  
Medical Center ◽  
Diabetes Education ◽  
Academic Medical Center ◽  
Blood Pressure Reduction ◽  
Diabetes Medication ◽  
Effective Discharge ◽  
Inpatient Diabetes ◽  
Patients With Diabetes

Background: Persons with diabetes are 1.5 times more likely to have a stroke. Research shows that there is a correlation between increasing diabetes and stroke. Education for stroke patients, however, continues to focus on medication management and blood pressure reduction. American Diabetes Association indicates, “There should be a structured discharge plan tailored to the individual patient with diabetes.” Transitioning from the acute care is risky for diabetics, recommendations now include individualized education for diabetics with stroke. 40% of the stroke population at our institution showed risk factors for diabetes, yet 11% received diabetes education, and only 59% had diabetes medication pre-prescribed at discharge. The stroke team initiated an inpatient diabetes education to increase patient awareness and medication adherence. Purpose: The purpose of this project was to identify and address barriers related to the provision of individualized inpatient diabetes education and outpatient diabetes medication reconciliation for persons with diabetes and stroke. Method: The Endocrinology team was consulted for patients with diabetes and stroke with an A1c level of 7%. These team worked collaboratively to establish a consult process. Endocrinology APPs provided diabetic education and advised the Neurology team on the appropriate discharge medication regimen and follow-up. The stroke coordinator provided reminders during rounds to assure that consults were ordered for patients with diabetes having A1c 7% or greater. Results: Inpatient diabetes education improved from 11% in 2017 to 96% in 2019. Diabetes medication reconciliation, with listing of diabetes medications on the after visit summary at discharge increased from 59% in 2017 to 93% in 2019. Conclusions: Both metrics reflect improvement over a 2-year period, showing that collaboration between the Endocrinology and Neurology teams is key to effective discharge planning, diabetes medication reconciliation and outpatient follow-up.

Pharmacist-Led Group Medical Appointments for the Management of Type 2 Diabetes with Comorbid Depression in Older Adults

2011 ◽  
Vol 45 (11) ◽  
pp. 1346-1355 ◽  
Author(s):  
Tracey H Taveira ◽  
Andrea G Dooley ◽  
Lisa B Cohen ◽  
Sameed Ahmed M Khatana ◽  
Wen-Chih Wu
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Standard Care ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Depression Symptoms ◽  
Multidisciplinary Education ◽  
Patients With Diabetes

Background:: Depression is associated with poor glycemic control, increased number of microvascular and macrovascular complications, functional impairment, mortality, and 4.5 times higher total health care costs in patients with diabetes. Shared medical appointments (SMAs) may be an effective method to attain national guideline recommendations for glycemic control in diabetes for patients with depression through peer support, counseling, problem solving, and improved access to care. Objective: To test the efficacy as assessed by attainment of a hemoglobin A1c (A1C) <7% of pharmacistted group SMA visits, Veterans Affairs Multidisciplinary Education in Diabetes and Intervention for Cardiac Risk Reduction in Depression (VA-MEDIC-D), in patients with type 2 diabetes mellitus. Methods: This was a randomized controlled trial of VA-MEDIC-D added to standard care versus standard care alone in depressed patients with diabetes with A1C >6.5%. VA-MEDIC-D consisted of 4 once-weekly, 2-hour sessions followed by 5 monthly 90-minute group sessions. Each SMA session consisted of multidisciplinary education and pharmacist-led behavioral and pharmacologic interventions for diabetes, lipids, smoking, and blood pressure. No pharmacologic interventions for depression were provided. The change in the proportion of participants who achieved an A1C <7% at 6 months was compared. Results: Compared to standard care (n = 44), a lower proportion of patients in VA-MEDIC-D (n = 44) had systolic blood pressure (SBP) <130 mm Hg at baseline, but were similar in other cardiovascular risk factors and psychiatric comorbidity. The change in the proportion of participants achieving an A1C <7% was greater in the VA-MEDIC-D arm than in the standard care arm (29.6% vs 11.9%), with odds ratio 3.6 (95% CI 1.1 to 12.3). VA-MEDIC-D participants also achieved significant reductions in SBP, low-density lipoprotein cholesterol, and non–high-density lipoprotein (HDL) cholesterol from baseline, whereas significant reductions were attained only in non–HDL cholesterol with standard care. There was no significant change in depressive symptoms for either arm. Conclusions: Pharmacist-led group SMA visits are efficacious in attainment of glycemic control in patients with diabetes and depression without change in depression symptoms.

scholarly journals Home visit: an educational health strategy for self-care in diabetes

2014 ◽  
Vol 27 (1) ◽  
pp. 23-28 ◽  
Author(s):  
Heloisa de Carvalho Torres ◽  
Laura Maria dos Santos ◽  
Palloma Maciel Chaves de Souza Cordeiro
Keyword(s):  
Type 2 Diabetes ◽  
Health Care ◽  
Home Visit ◽  
Diabetes Education ◽  
Self Care ◽  
Health Strategy ◽  
Patients With Diabetes ◽  
Health Care Unit ◽  
Care Practices

OBJECTIVE: To understand the home visit as an educational health care strategy to orient the self-care practices of patients with type 2 diabetes mellitus.METHODS: A qualitative study using 25 home visits to patients with diabetes mellitus, who did not attend the diabetes education program offered by the basic health care unit. Data were organized and categorized by content analysis.RESULTS: Four thematic categories emerged: feelings; knowledge about the disease; adherence to meal plan and physical activity; and barriers to self-care.CONCLUSION: Home visit is an important strategy for health care education to orient patients with type 2 diabetes on self-care practices.

scholarly journals Coping strategies in Type 1 and Type 2 diabetes patients using insulin: the relationship with emotional well-being and glycaemic control

2015 ◽  
Vol 18 (4) ◽  
pp. 41-47
Author(s):  
Oleg G. Motovilin ◽  
Shishkova Y. Andreevna ◽  
Elena V. Surkova
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Coping Strategies ◽  
Depression Scale ◽  
Well Being ◽  
Glycated Haemoglobin ◽  
Epidemiologic Studies ◽  
Hba1c Levels

Background. Over the long disease course of diabetes mellitus (DM), with its demands in terms of everyday self-management of the disease, individual psychological characteristics may be associated with both emotional well-being (WB) and glycaemic control. The former includes various types of coping strategies (CSs) of the patients, which comprise the common ways for patients to overcome difficult situations.Aim. To study the relationships between CS and both glycaemic control and emotional WB in patients with Type 1 diabetes (T1D) and Type 2 diabetes (T2D) treated with insulin.Materials and methods. The study included 84 patients with T1D and 56 patients with insulin-treated T2D [age, 22.5 ± 3.3 and 61.0 ± 8.9 years; men/women, 29/55 and 11/45; duration of DM, 11.9 ± 5.36 and 11.6 ± 6.2 years and glycated haemoglobin (HbA1c), 9.1% ± 2.2% and 9.0% ± 1.4%, respectively]. The HbA1c levels were determined in all patients. The Strategic Approach to Coping Scale constructed by S. Hobfoll was used to study CS, and emotional WB was assessed based on the severity of anxiety and depression. Further, we used the State-Trait Anxiety Inventory developed by C.D. Spielberger and adapted by Y.L. Khanin and the Center for Epidemiologic Studies Depression Scale. Only Russian validated versions of the questionnaires were used in the study.Results. In both groups of patients, ‘Assertive (Persistent) Actions’ was positively associated with emotional WB. In patients with T2D, WB increases when using ‘Cautious Action’ and ‘Social Joining’. The deterioration of emotional WB was associated with ‘Aggressive Actions’ in both groups of patients. In patients with T1D, negative WB was also associated with ‘Avoidance’, while in patients with T2D, negative WB was associated with ‘Instinctive Actions’. In patients with T1D, ‘Instinctive Action’ was associated with higher HbA1c levels. In patients with T2D, ‘Cautious Action’, ‘Avoidance’ and ‘Antisocial Action’ were associated with lower HbA1c levels.Conclusion. In patients with T1D and T2D, CSs are associated with both emotional WB and glycaemic control. Emotional WB and lower HbA1c levels are associated with ‘Assertive Action’, ‘Cautious Action’, ‘Avoidance’ and ‘Asocial Action’. Negative WB and higher HbA1c levels are associated with ‘Aggressive Action’ and ‘Instinctive Action’.

scholarly journals Evaluation of calcium level in patients with diabetes mellitus according to the examination in the mobile medical center (Diamodule)

2021 ◽  
Vol 23 (4) ◽  
pp. 382-388
Author(s):  
Anna V. Zheleznyakova ◽  
◽  
Victoriya L. Volodicheva ◽  
Olga K. Vikulova ◽  
Alexey A. Serkov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Serum Calcium ◽  
Calcium Level ◽  
Medical Center ◽  
Patients With Diabetes

Background. Diabetes mellitus (DM) is characterized by multiple risk factors for the combined development of disorders of phosphorus-calcium metabolism, due to more frequent overweight, decreased renal filtration function and vitamin D deficiency in this category of patients. Aim. To assess the level of calcium in blood serum and its correlations with parameters of carbohydrate metabolism, body mass index (BMI) and renal function in patients with type 1 and type 2 diabetes. Materials and methods. The object of the study: adult patients with type 1 diabetes (T1DM) and type 2 diabetes (T2DM) ≥18 years old who underwent examination in Diamodule (n=294) in 2019 in the Voronezh region, who were additionally tested for serum calcium. The examination at the mobile medical center includes: assessment of anthropometric data (height, weight, BMI), biochemical data of blood lipids and creatinine levels with calculation of glomerular filtration rate (GFR-EPI), albuminuria and the albumin/creatinine in a single portion of urine, measurement of glycated hemoglobin (HbA1c), blood pressure, electrocardiogram, consultation with a cardiologist, ophthalmologist, specialist of the Diabetic Foot office, diabetologist. All biochemical parameters was carried out using commercial kits on a biochemical express analyzer Spotchem EZ ArkraySP-4430. Determination of HbA1c, albuminuria, albumin/creatinine was performed by immunochemical method on a DCA Vantage analyzer. Data analysis was carried out using the Statistica v.13.3 software package (TIBCO Software Inc., USA). The results are presented as medians and quartiles [25; 75], the level of reliability is taken as p<0.05. Results. Hypocalcemia (serum calcium level less 2.15 mmol/L) was detected in 88.3% of patients with T1DM and 73.6% of patients with T2DM. The level of serum calcium in T1DM was 1.96 [1.83; 2.07], in T2DM – 2.04 [1.97; 2.16] (p<0.001) with significant differences in GFR: in T1DM 69.6 [57.8; 82.5], with T2DM 50.5 [44.1; 59.9] (p<0.001). We observed correlation between GFR and calcium level r=-0.3 (p<0.05,). GFR<60 ml/min/1.73 m² was observed in 30.5% of T1DM patients, in 75.0% of T2DM. The HbA1c in T1DM was 8.7% [7.7; 9.8], in T2DM – 8.3% [6.8; 9.4] (p=0.01). Obesity was revealed in T1DM in 12.3%, in T2DM in 71.4%; the median BMI in T1DM was 25.5 kg/m2 [21.9; 28.4], in T2DM – 33.2 kg/m2 [29.7; 37.9]. There was correlation between BMI and calcium level r=0.26 (p<0.05). Conclusion. The results of the study revealed a high prevalence of hypocalcemia among patients with diabetes, the most pronounced in type 1 diabetes. In the presence of a correlation between calcium and GFR, there was a high incidence of hypocalcemia in patients with T1DM, even in the absence of a significant decrease in GFR, which may indicate to additional risk factors. Since the assessment of the level of calcium is not included in the list of standard clinical examination, it is recommended to include this parameter and conduct regular screening in risk groups, which include patients with diabetes. More extensive research is needed to analyze the factors.

scholarly journals Impact of Non-Tailored One-Way Automated Short Messaging Service (OASMS) on Glycemic Control in Type 2 Diabetes: A Retrospective Feasibility Study

2020 ◽  
Vol 17 (20) ◽  
pp. 7590
Author(s):  
Ahmad Alamer ◽  
Charles Palm ◽  
Abdulaziz S. Almulhim ◽  
Charisse Te ◽  
Merri L. Pendergrass ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Feasibility Study ◽  
Medical Center ◽  
Academic Medical Center ◽  
Self Care ◽  
Baseline Hba1c ◽  
Quasi Experimental ◽  
The Impact

Short message service (SMS) is easily accessible and potentially an ideal platform for delivering patient-targeted messages. However, an effective SMS dosing strategy is not well established. Our purpose was to evaluate the impact of diabetes self-care promoting messages via non-tailored one-way automated SMS (OASMS) on glycemic control in type 2 diabetes (T2DM). The change in hemoglobin A1c (HbA1c) was compared between patients who received the service and those who did not. This retrospective quasi-experimental pre–post feasibility study was conducted at an academic medical center endocrinology clinic. English-speaking adults (≥18 years) with uncontrolled T2DM (HbA1c ≥ 8%) were included. A total of 69 patients (intervention n = 34; control n = 35) met the inclusion criteria. The mean (±SD) baseline HbA1c values were 10.2% (±1.9%) and 9.9% (±1.7%) in the intervention and control arms, respectively. Median follow-up was 3.3 months (IQR = 3–4.2). An ANCOVA model adjusted for baseline HbA1c and age showed an estimated HbA1c reduction difference of −0.97% (95% CI, −1.73 to −0.20%, p = 0.014), favoring the intervention arm. Inverse propensity score weighting confirmed the ANCOVA results. Our study suggests that adding diabetes self-care promoting messages via non-tailored OASMS to usual care improves glycemic control in poorly controlled T2DM. Larger and longer studies are needed to evaluate different features of the non-tailored OASMS strategy.

scholarly journals Self-reported adherence to foot care in type 2 diabetes patients: do illness representations and distress matter?

2018 ◽  
Vol 20 ◽  
Author(s):  
M. Graça Pereira ◽  
Susana Pedras ◽  
Gabriela Ferreira
Keyword(s):  
Type 2 Diabetes ◽  
Depressive Symptoms ◽  
Illness Perception ◽  
Self Care ◽  
Depression Scale ◽  
Illness Representations ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Foot Care

AbstractAimThis study examined the differences and the predictive role of clinical variables, illness representations, anxiety, and depression symptoms, on self-reported foot care adherence, in patients recently diagnosed with type 2 diabetes mellitus (T2DM) and assessed no longer than a year after the diagnosis (T1) and four months later (T2).BackgroundThe high rate of diabetes worldwide is one of the major public health challenges. Foot care is the behavior least performed by patients although regular foot care could prevent complications such as diabetic foot and amputation. Psychosocial processes such as illness representations and distress symptoms may contribute to explain adherence to foot self-care behaviors.MethodsThis is a longitudinal study with two assessment moments. The sample included 271 patients, who answered the Revised Summary of Diabetes Self-Care Activities, Brief-Illness Perception Questionnaire, and Hospital Anxiety and Depression Scale.FindingsPatients reported better foot care adherence at T2. Having a higher duration of T2DM and the perception of more consequences of diabetes were associated with better self-reported foot care adherence, at T1. At T2, the predictors were lower levels of HbA1c, better self-reported foot care adherence at T1, higher comprehension about T2DM, as well as fewer depressive symptoms. Interventions to promote adherence to foot care should have in consideration these variables. The results of the present study may help health professionals in designing interventions that early detect depressive symptoms and address illness beliefs, in order to promote foot self-care behaviors reducing the incidence of future complications.

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