Use of Cross-sectional and Perspective Mapping to Spatially and Statistically Represent Inpatient Glucose Control

2021 ◽  
pp. 193229682110272
Author(s):  
George E. Saulnier ◽  
Janna C. Castro ◽  
Lanyu Mi ◽  
Curtiss B. Cook
Keyword(s):  
Glycemic Control ◽  
Glucose Control ◽  
Management Practices ◽  
Point Of Care ◽  
Severity Of Illness ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Statistical Variation ◽  
Included Patient ◽  
Floor Plans

Background: The use of inpatient location for the depiction of glycemic control is an alternative approach to the traditional analysis of hospital-derived glucometric data. Our aim was to develop a method of spatial representation and to test for corresponding statistical variation in inpatient glucose control data. Methods: Point-of-care blood glucose data from inpatients with diabetes mellitus were extracted. Calculations included patient-day weighted means (PDWMs) and percentage of patient hospital days with hypoglycemia. Results were overlaid onto hospital floor plans, and room numbers were used as geolocators to generate cross-sectional (2-dimensional) and perspective (3-dimensional) views of the data. Linear mixed and mixed-effects logistic regression models were used to compare the location effect and to assess statistical variation in the data after adjusting for age, sex, and severity of illness. Results: Visual inspection of cross-sectional and perspective maps demonstrated variation in glucometric outcomes across areas within the hospital. Statistical analysis confirmed significant variation between some hospital wings and floors. Conclusions: Spatial depiction of glucometric data within the hospital could yield insights into hot spots of poor glycemic control. Future studies on how to operationalize this approach, and whether this method of analysis can drive changes in glycemic management practices, need to be conducted.

scholarly journals Suboptimal glycemic control among subjects with diabetes mellitus in India: a subset analysis of cross-sectional wave-7 (2016) data from the International Diabetes Management Practices Study (IDMPS)

2020 ◽  
Vol 11 ◽  
pp. 204201882093721
Author(s):  
Ambady Ramachandran ◽  
Sunil M. Jain ◽  
Sagarika Mukherjee ◽  
Sanjeev Phatak ◽  
Shailesh Pitale ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Management Practices ◽  
Diabetes Management ◽  
Diabetes Education ◽  
Glycated Haemoglobin ◽  
Oral Glucose ◽  
Eligibility Criteria ◽  
Cross Sectional ◽  
Glycemic Targets

Objective: To assess the real-world management practices of subjects with type 2 diabetes mellitus (T2DM) and type 1 diabetes mellitus (T1DM) in India. Methods: This cross-sectional study was conducted between 7 March 2016 and 15 May 2016 in India as part of the seventh wave (2016) of the International Diabetes Management Practices Study (IDMPS). Adult subjects with T1DM or T2DM visiting physicians during a 2-week recruitment period were included. Results: A total of 55 physicians included 539 subjects who met eligibility criteria. Of 495 subjects with T2DM, 303 were treated with oral glucose lowering drugs (OGLDs) only, 158 were treated with OGLD + insulin, and 27 received insulin only. Among 44 subjects with T1DM receiving insulin, 13 (29.5%) were also treated with OGLD therapy. The most commonly used insulin regimens were basal alone (69/184; 37.5%) and premixed alone (63/184; 34.2%) in subjects with T2DM, and basal + prandial insulin (24/44; 54.5%) in subjects with T1DM. Proportions of subjects achieving glycemic targets were low [glycated haemoglobin (HbA1c) <7%: T1DM = 7.3% (3/44), T2DM = 25.2% (106/495); as targeted by the treating physician: T1DM = 31.8% (14/44), T2DM = 32.1% (59/185); global target: T1DM = 4.8% (2/42) and T2DM = 1.7% (8/482)]. In subjects with T2DM, HbA1c <7% was noted in 11/22 subjects receiving insulin only and 76/260 receiving only OGLDs. Lack of experience in self-managing insulin dosing, poor diabetes education and failure to titrate insulin dosages were the main reasons for non-achievement of glycemic targets. Conclusion: Timely insulinization, education and empowerment of people with diabetes may help improve glycemic control in India.

scholarly journals Risk factors associated with cows' lying time, stall and cows' own cleanliness in smallholder dairy farms in Kenya

2019 ◽  
Vol 12 (7) ◽  
pp. 1085-1092
Author(s):  
E. K. Kathambi ◽  
J. A. VanLeeuwen ◽  
G. K. Gitau ◽  
C. Kamunde
Keyword(s):  
Risk Factors ◽  
Management Practices ◽  
Production Systems ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Farm Level ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
The Mean ◽  
Smallholder Dairy

Background and Aim: The welfare of animals kept in livestock production systems has raised concerns around the world. Adult dairy cattle require adequate rest and spend approximately 12 h/day lying down. This cross-sectional study aimed to determine the stall factors and management practices affecting cows' lying time, stall cleanliness, and cows' cleanliness (udder and upper leg), in smallholder dairy cows in Meru County of Kenya. Materials and Methods: A total of 106 milking cows from 73 farms were assessed for daily lying time and cleanliness. Data loggers were used to record the lying time of cows for 3 days. Stall, udder, and upper leg cleanliness were assessed using a 5-score system: 1 (very clean) to 5 (very dirty). Management information was acquired using a questionnaire that was administered face-to-face to the farmers in their native Kimeru language. Univariable and multivariable linear and logistic regression models were fit to determine factors associated with cows' lying time and dichotomized stall and cows' own cleanliness, respectively. Results: The mean daily lying time was 10.9±2.2 h, and the mean stall cleanliness score was 2.4±1.0. The mean average cleanliness scores of the udder and upper legs were 1.9±0.7 and 2.5±1.1, respectively. Overall, 35% of the stalls were categorized as dirty (>2.5), whereas 13% and 47% of the cows had udder and leg cleanliness scores >2.5, respectively. From the final multivariable models (p<0.05), daily lying time increased by 1.0 h for cows older than 5.25 years versus younger cows. Conversely, lying time decreased by 1.0 h with stall cleanliness scores >2.5 and by 1.6 h with poorly positioned neck rails. In an interaction term, addition of new bedding at least once a day without removing stall manure at least once a day decreased the daily lying time of the cows by 1.5 h, whereas failure to add new bedding at least once a day but removing stall manure at least once a day decreased the lying time of the cows by 1.2 h. Farm-level risk factors for stall dirtiness (>2.5) included delayed cleaning of the alley (odds ratio [OR]=6.6, p=0.032), lack of bedding (OR=4.9, p=0.008), and standing idle and/or backward in the stall (OR=10.5, p=0.002). Stalls categorized as dirty (OR=2.9, p=0.041) and lack of bedding (OR=2.7, p=0.065) were cow- and farm-level risk factors for dirtiness of the udder (>2.5), respectively, whereas the stall being dirty (OR=2.3, p=0.043) was the only risk factor (cow level) for dirtiness of the upper legs (>2.5). Conclusion: It was recommended that farmers should pay attention to the specific factors identified regarding the stall design (e.g., neck rail position) and bedding/manure management that impact the cleanliness of cows and their lying time.

scholarly journals Accuracy of Blood Glucose Measurement and Blood Glucose Targets

2020 ◽  
Vol 14 (3) ◽  
pp. 553-559
Author(s):  
Gert-Jan Eerdekens ◽  
Steffen Rex ◽  
Dieter Mesotten
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Glucose Control ◽  
Point Of Care ◽  
Blood Glucose Control ◽  
Daily Practice ◽  
Tight Glycemic Control ◽  
Blood Glucose Measurement ◽  
Glucose Measurement ◽  
Negative Results

Background: To summarize new evidence regarding the methodological aspects of blood glucose control in the intensive care unit (ICU). Methods: We reviewed the literature on blood glucose control in the ICU up to August 2019 through Ovid Medline and Pubmed. Results: Since the publication of the Leuven studies, the benefits of glycemic control have been recognized. However, the methodology of blood glucose control, notably the blood glucose measurement accuracy and the insulin titration protocol, plays an important but underestimated role. This may partially explain the negative results of the large, pragmatic multicenter trials and made everyone realize that tight glycemic control with less-frequent glucose measurements on less accurate blood glucose meters is neither feasible nor advisable in daily practice. Blood gas analyzers remain the gold standard. New generation point-of-care blood glucose meters may be an alternative when using whole blood of critically ill patients in combination with a clinically validated insulin dosing algorithm. Conclusion: When implementing blood glucose management in an ICU one needs to take into account the interaction between aimed glycemic target and blood glucose measurement methodology.

scholarly journals Availability and analytical quality of hemoglobin A1c point-of-care testing in general practitioners’ offices are associated with better glycemic control in type 2 diabetes

2020 ◽  
Vol 58 (8) ◽  
pp. 1349-1356 ◽  
Author(s):  
Mette C. Tollånes ◽  
Anne K. Jenum ◽  
Tore Julsrud Berg ◽  
Karianne F. Løvaas ◽  
John G. Cooper ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycemic Control ◽  
Point Of Care ◽  
Cross Sectional Study ◽  
Analytical Quality ◽  
Cross Sectional ◽  
Unit Increase ◽  
Laboratory Examinations

AbstractBackgroundIt is not clear if point-of-care (POC) testing for hemoglobin A1c (HbA1c) is associated with glycemic control in type 2 diabetes.MethodsIn this cross-sectional study, we linked general practitioner (GP) data on 22,778 Norwegian type 2 diabetes patients to data from the Norwegian Organization for Quality Improvement of Laboratory Examinations. We used general and generalized linear mixed models to investigate if GP offices’ availability (yes/no) and analytical quality of HbA1c POC testing (average yearly “trueness score”, 0–4), as well as frequency of participation in HbA1c external quality assurance (EQA) surveys, were associated with patients’ HbA1c levels during 2014–2017.ResultsTwenty-eight out of 393 GP offices (7%) did not perform HbA1c POC testing. After adjusting for confounders, their patients had on average 0.15% higher HbA1c levels (95% confidence interval (0.04–0.27) (1.7 mmol/mol [0.5–2.9]). GP offices participating in one or two yearly HbA1c EQA surveys, rather than the maximum of four, had patients with on average 0.17% higher HbA1c levels (0.06, 0.28) (1.8 mmol/mol [0.6, 3.1]). For each unit increase in the GP offices’ HbA1c POC analytical trueness score, the patients’ HbA1c levels were lower by 0.04% HbA1c (−0.09, −0.001) (−0.5 mmol/mol [−1.0, −0.01]).ConclusionsNovel use of validated patient data in combination with laboratory EQA data showed that patients consulting GPs in offices that perform HbA1c POC testing, participate in HbA1c EQA surveys, and maintain good analytical quality have lower HbA1c levels. Accurate HbA1c POC results, available during consultations, may improve diabetes care.

Poor Glycemic Control in People with T1D and T2D—Results from the International Diabetes Management Practices Study (IDMPS)

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 1656-P ◽  
Author(s):  
PABLO ASCHNER ◽  
JUAN J. GAGLIARDINO ◽  
HASAN M. ILKOVA ◽  
FERNANDO J. LAVALLE-GONZALEZ ◽  
AMBADY RAMACHANDRAN ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Management Practices ◽  
Diabetes Management ◽  
Poor Glycemic Control

Proposal for Improving Records Management Practices of Traditional Institutions in Ga Molepo, South Africa

Mousaion ◽  
10.25159/2054 ◽  
2017 ◽  
Vol 35 (1) ◽  
pp. 46-67
Author(s):  
Mahlaga Johannes Molepo ◽  
Linda M. Cloete
Keyword(s):  
South Africa ◽  
Rural Communities ◽  
Management Practices ◽  
Records Management ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Record Keeping ◽  
Local Municipalities ◽  
Management Procedures ◽  
Traditional Institutions

The way in which an institution treats its records is crucial for its survival in a rapidly changing society. The purpose of the study was to investigate the records management practices and challenges faced by traditional institutions of leadership and governance in Ga Molepo, Limpopo, South Africa. The researcher employed a cross-sectional survey in order to quantitatively examine the challenges faced by members of traditional councils. A researcher administered questionnaire was used as a data collection tool to study a stratified sample of 35 members from an estimated population of 350. The findings revealed patterns and trends of non-compliance with records management standards and guidelines. Although there were sporadic cases of record keeping, a greater number of respondents revealed that traditional institutions lack the facilities, equipment, education and trained/skilled personnel to apply correct records management procedures in their daily administration of their traditional communities. The main value of the study is to create awareness of records management as one of the neglected areas in traditional institutions – which are by current legislative arrangement, the closest form of leadership and governance for rural communities in light of their relationship with local municipalities and the Department of Cooperative Governance and Traditional Affairs.

Correlation of Glycemic Control Parameters in Non-Diabetic Persons with Cardiovascular Risk Scores - Results from a Cross- Sectional Study

2017 ◽  
Vol 68 (1) ◽  
pp. 108-110
Author(s):  
Gina Botnariu ◽  
Norina Forna ◽  
Alina Popa ◽  
Raluca Popescu ◽  
Alina Onofriescu ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Glycemic Control ◽  
Tolerance Test ◽  
Cross Sectional Study ◽  
Risk Scores ◽  
Oral Glucose ◽  
Cross Sectional ◽  
University Of Edinburgh ◽  
Fasting Glycaemia ◽  
The University

To assess the correlation between main parameters of glycemic control and cardiovascular risk scores in non-diabetic persons. Risk scores were calculated by using the University of Edinburgh Risk Calculator. Risk scores are used to estimate the probability of cardiovascular disease in individuals who have not already developed major atherosclerotic disease. We correlated the results of these scores with the parameters that describes the glycaemic profile: preprandial glicaemia, HbA1c and 1 hour and 2 h post-prandial glycaemia, determined during Oral Glucose Tolerance Test (OGTT).Both fasting glycaemia and HbA1c significantly correlated with cardiovascular risk scores calculated for a period of 10 years. The recorded post-prandial glycaemic values at 1h and 2h after glucose loading didn�t significantly correlate with calculated scores, in the study group. The observed correlations underline the importance of glycaemia in the pathogenesis of cardiovascular diseases.

Effectiveness of Passion Fruit Peel Flour (Passiflora edulis L.) versus Turmeric Flour (Curcuma longa L.) on Glycemic Control: Systematic Review and Meta-Analysis

2020 ◽  
Vol 16 (5) ◽  
pp. 450-456
Author(s):  
Danilo F. Sousa ◽  
Vivian S. Veras ◽  
Vanessa E.C.S. Freire ◽  
Maria L. Paula ◽  
Maria A.A.O. Serra ◽  
...  
Keyword(s):  
Systematic Review ◽  
Glycemic Control ◽  
Curcuma Longa ◽  
Meta Analysis ◽  
Passion Fruit ◽  
Joint Analysis ◽  
Case Control Studies ◽  
Bias Analysis ◽  
Fruit Peel ◽  
Cross Sectional

Background:: It is undeniable that diabetes may cause several health complications for the population. Many of these complications are associated with poor glycemic control. Due to this, strategies to handle this problem are of great clinical importance and may contribute to reducing the various complications from diabetes. Objective: : The aim of this study was to compare the effectiveness of the passion fruit peel flour versus turmeric flour on glycemic control. Methods: This is a systematic review and meta-analysis following the PRISMA protocol. The following inclusion criteria were applied: (1) Case-control studies, cohort studies, and clinical trials, due to the improved statistical analysis and, in restrict cases, cross-sectional studies; (2) Articles published in any language. The databases used for the search were PubMed, Scopus, Web of Science, Cochrane, and LILACS. A bias analysis and a meta-analyses were undertaken using R Studio (version 3.3.1) using effect- size models. Results: : A total of 565 studies were identified from which 11 met the inclusion and exclusion criteria. Through isolated analysis, the effectiveness of turmeric flour on glycemic control was in the order of 0.73 CI (Confidence Interval) (from 0.68 to 0.79) and the effectiveness of passion fruit peel flour was 0.32 CI (0.23 to 0.45). The joint analysis resulted in 0.59 CI (0.52 to 0.68). The assessment of blood glucose was by glycated hemoglobin levels. All values were significant at a p < 0.05 level. Conclusion: Both interventions showed significant effects on glycemic control.

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