DPARD: rationale, design and initial results from the Dutch national diabetes registry

Abstract Background Treatment of diabetes mellitus has majorly improved over the past century, however, the disease burden is high and its prevalence still expanding. Further insight in the diabetes population is imperative to improve the quality of diabetes care by enhancement of knowledge-based diabetes management strategies. To this end, in 2017 a Dutch nationwide consortium of diabetologists, paediatric endocrinologists, and diabetes patients has founded a national outpatient diabetes care registry named Dutch Pediatric and Adult Registry of Diabetes (DPARD). We aim to describe the implementation of DPARD and to provide an overview of the characteristics of patients included during the first 2 years. Methods For the DPARD cohort with long-term follow-up of observational nature, hospital data are gathered directly from electronic health records and securely transferred and stored. DPARD provides weekly updated clinical information on the diabetes population care on a hospital-level benchmarked against the national average. Results Between November 2017 and January 2020, 20,857 patients were included from 8 (11%) Dutch hospitals with a level of care distribution representative of all diabetic outpatients in the Netherlands. Among patients with known diabetes type, 41% had type 1 diabetes, 51% type 2 diabetes, and 8% had diabetes due to other causes. Characteristics of the total patient population were similar to patients with unknown diabetes classification. HbA1c levels decreased over the years, while BMI levels showed an increase over time. Conclusions The national DPARD registry aims to facilitate investigation of prevalence and long-term outcomes of Dutch outpatients with diabetes mellitus and their treatment, thus allowing for quality improvement of diabetes care as well as allowing for comparison of diabetes care on an international level.

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Care for Patients with Type 2 Diabetes in a Random Sample of Community Family Practices in Ontario, Canada

International Journal of Family Medicine ◽

10.1155/2012/734202 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 1

Author(s):

Gina Agarwal ◽

Janusz Kaczorowski ◽

Steve Hanna

Keyword(s):

Best Practices ◽

Diabetes Care ◽

Diabetes Management ◽

Management Strategies ◽

Chart Audit ◽

Pressure Reading ◽

International Data ◽

One Year ◽

Control And Management

Objective. Diabetes care is an important part of family practice. Previous work indicates that diabetes management is variable. This study aimed to examine diabetes care according to best practices in one part of Ontario. Design and Participants. A retrospective chart audit of 96 charts from 18 physicians was conducted to examine charts regarding diabetes care during a one-year period. Setting. Grimsby, Ontario. Main Outcome Measures. Glycemic screening, control and management strategies, documentation and counselling for lifestyle habits, prevalence of comorbidities, screening for hypertension, hyperlipidemia, and use of appropriate recommended preventive medications in the charts were examined. Results. Mean A1c was within target (less than or equal to 7.00) in 76% of patients (ICC = −0.02), at least 4 readings per annum were taken in 75% of patients (ICC = 0.006). Nearly 2/3 of patients had been counselled about diet, more than 1/2 on exercise, and nearly all (90%) were on medication. Nearly all patients had a documented blood pressure reading and lipid profile. Over half (60%) had a record of their weight and/or BMI. Conclusion. Although room for improvement exists, diabetes targets were mainly reached according to recognized best practices, in keeping with international data on attainment of diabetes targets.

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Changing diabetes® barometer: A global quality monitoring framework for improving patient outcomes

Journal of Social Health and Diabetes ◽

10.1055/s-0038-1676181 ◽

2013 ◽

Vol 01 (01) ◽

pp. 044-047

Author(s):

Pavika Jain ◽

Niels Aamand

Keyword(s):

Quality Of Care ◽

Patient Outcomes ◽

Diabetes Care ◽

Best Practice ◽

Diabetes Management ◽

Global Perspective ◽

Quality Monitoring ◽

Good Practices ◽

Quality Of Diabetes Care

This article has a global perspective and includes examples from several continents i.e. Latin America, Africa, Asia and Europe. The Changing Diabetes® Barometer (CDB) is a Novo Nordisk initiative that works as a worldwide quality monitoring system for diabetes management to measure the gains made in the fight against diabetes focusing on quality of care and patient outcomes. CDB provides a platform for countries to share local diabetes data and good practices. In doing so it aims to disseminate improved practices of care. CDB is conceptualised as a framework that can help change diabetes. Its three cornerstones are “Measure, Share, Improve” (MSI):• MEASURE the quality of diabetes care through patient outcomes and care processes.• SHARE data on the quality of diabetes care and good practices with all relevant stakeholders.• IMPROVE the quality of diabetes care by identifying and actively spreading good practices in diabetes care and inspire others to adopt and follow best practice examples.Italy and Algeria both constitute best practice examples of CDB initiatives. In Italy a registry solution is already solidly implemented and improvements in patient outcomes have been documented. The initiative in Algeria has recently been initiated including establishment of IT equipment in participating clinics to ensure all relevant measurements. This will enable transparency on current level of quality of diabetes care. Both initiatives have the common goal of driving improvements in quality of care and patient outcomes across clinics. India is another good example where data is collected through the CDB aimed at driving improvement of diabetes care in order to improve quality of life for people with diabetes. CDB in India is implemented in five states (Goa, Bihar, Gujarat, Puducherry and Andhra Pradesh) and is planned to be expanded to five additional states.

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A Narrative Review of Diabetes Intervention Studies to Explore Diabetes Care Opportunities for Pharmacists

Journal of Diabetes Research ◽

10.1155/2016/5897452 ◽

2016 ◽

Vol 2016 ◽

pp. 1-11 ◽

Cited By ~ 7

Author(s):

Shamala Ayadurai ◽

H. Laetitia Hattingh ◽

Lisa B. G. Tee ◽

Siti Norlina Md Said

Keyword(s):

Diabetes Care ◽

Intervention Studies ◽

Diabetes Management ◽

Intervention Strategy ◽

Pressure Control ◽

Evidence Based ◽

Diabetes Intervention ◽

Randomised Controlled ◽

Evidence Based Care

Background. We conducted a review of current diabetes intervention studies in type 2 diabetes and identified opportunities for pharmacists to deliver quality diabetes care.Methods. A search on randomised controlled trials (RCT) on diabetes management by healthcare professionals including pharmacists published between 2010 and 2015 was conducted.Results and Discussion. Diabetes management includes multifactorial intervention which includes seven factors as outlined in diabetes guidelines, namely, glycaemic, cholesterol and blood pressure control, medication, lifestyle, education, and cardiovascular risk factors. Most studies do not provide evidence that the intervention methods used included all seven factors with exception of three RCT which indicated HbA1c (glycated hemoglobin) reduction range of 0.5% to 1.8%. The varied HbA1C reduction suggests a lack of standardised and consistent approach to diabetes care. Furthermore, the duration of most studies was from one month to two years; therefore long term outcomes could not be established.Conclusion. Although pharmacists’ contribution towards improving clinical outcomes of diabetes patients was well documented, the methods used to deliver structured, consistent evidence-based care were not clearly stipulated. Therefore, approaches to achieving long term continuity of care are uncertain. An intervention strategy that encompass all seven evidence-based factors will be useful.

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Smart Diabetic Screening and Managing Software, A Novel Decision Support System

Journal of Biomedical Physics and Engineering ◽

10.31661/jbpe.v8i3sep.870 ◽

2018 ◽

Vol 8 (3Sep) ◽

Cited By ~ 1

Author(s):

M Ghoddusi Johari ◽

M H Dabaghmanesh ◽

H Zare ◽

A R Safaeian ◽

Gh Abdollahifard

Keyword(s):

Diabetes Mellitus ◽

Decision Support ◽

Chronic Disease ◽

Decision Support System ◽

Support System ◽

Diabetes Care ◽

Diabetes Management ◽

Clinical Decision Support Systems ◽

Clinical Decision ◽

Diabetic Screening

Background: Diabetes is a serious chronic disease, and its increasing prevalence is a global concern. If diabetes mellitus is left untreated, poor control of blood glucose may cause long-term complications. A big challenge encountered by clinicians is the clinical management of diabetes. Many IT-based interventions such ad CDSS have been made to improve the adherence to the standard care for chronic diseases.Objective: The aim of this study is to establish a decision support system of diabetes management based on diabetes care guidelines in order to reduce medical errors and increase adherence to guidelines.Materials and Methods: To start the process, at first the existing guidelines in the field of diabetes mellitus such as ADA 2017 and AACE guideline 2017 were reviewed, and accordingly, flowcharts and algorithms for screening and managing of diabetes were designed. Then, it was passed on to the information technology team to design software.Results: The most significant outcome of this research was to establish a smart diabetic screening and managing software, which is an important stride to promote patients' health status, control diabetes and save patients' information as an important and reliable source. Conclusion: Health care technologies have the potential to improve the quality of diabetes care through IT-based intervention, such as clinical decision support systems. In a chronic disease like diabetes, the critical component is the disease management. The advantages of this web-based system are on-time registration, reports of diabetic prevalence, uncontrolled diabetes, diabetic complications and reducing the rate of mismanagement of diabetes, so that it helps the physicians in order to manage the patients in a better way.

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Norwegian Childhood Diabetes Registry: Childhood onset diabetes in Norway 1973-2012

Norsk Epidemiologi ◽

10.5324/nje.v23i1.1598 ◽

2013 ◽

Vol 23 (1) ◽

Cited By ~ 2

Author(s):

Torild Skrivarhaug

Keyword(s):

Children And Adolescents ◽

Diabetes Care ◽

Population Based ◽

Childhood Diabetes ◽

Childhood Onset ◽

Diabetes Registry ◽

Onset Diabetes ◽

Quality Of Diabetes Care ◽

Norwegian Childhood Diabetes Registry ◽

Incident Cases

The Norwegian Childhood Diabetes Registry (NCDR) is a prospective, population-based, nationwide registry which systematically register all incident cases of childhood diabetes, and systematically monitors the outcome of diabetes care in children and adolescents. NCDR includes data on childhood onset diabetes since 1973, and diabetes care outcome since 2001. NCDR was founded with the following objectives: To improve the diagnostics, classifications and treatment of childhood-onset diabetes, surveillance of incidence of diabetes in children and adolescents, surveillance of quality of diabetes care in Norwegian paediatric departments, and to stimulate to research in diabetes.

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Quantifying Remission Probability in Type 2 Diabetes Mellitus

Clinics and Practice ◽

10.3390/clinpract11040100 ◽

2021 ◽

Vol 11 (4) ◽

pp. 850-859

Author(s):

Sanjay Kalra ◽

Ganapathi Bantwal ◽

Nitin Kapoor ◽

Rakesh Sahay ◽

Saptarshi Bhattacharya ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Diabetes Management ◽

Treatment Options ◽

Nutrition Therapy ◽

Progressive Disorder ◽

Medical Nutrition

Type 2 diabetes mellitus (T2DM) is a chronic progressive disorder and is associated with significant morbidity and mortality. The concept of T2DM remission and the reversal of diabetic parameters to normal levels has been gaining momentum over the past years. T2DM remission is increasingly being recognized by various global guidelines. Multiple models have been developed and validated for quantifying the extent of remission achieved. Based on favorable clinical evidence, T2DM remission can be considered as the therapeutic goal in diabetes management and, in select cases, as an alternative to expensive treatment options, which can be burdensome as T2DM progresses. This narrative review discusses the available strategies, such as lifestyle interventions, physical activity, bariatric surgery, medical nutrition therapy, and non-insulin glucose-lowering medications, for achieving T2DM remission. Although the concept of T2DM remission has emerged as a real-world option, effective implementation in routine clinical practice may not be feasible until long-term studies prove the efficacy of different approaches in this regard.

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A Social-Ecological Approach to Determine Barriers of DMSM Practice For Patients with Type 2 Diabetes Mellitus: A literature review

International Journal of Nursing and Health Services (IJNHS) ◽

10.35654/ijnhs.v1i1.2 ◽

2018 ◽

Vol 1 (1) ◽

pp. 1-20

Author(s):

Andi Mayasari Usman ◽

Rian Adi Pamungkas

Keyword(s):

Diabetes Mellitus ◽

Health Care ◽

Health Care Provider ◽

Health Care Providers ◽

Care Provider ◽

Diabetes Care ◽

Diabetes Management ◽

Self Management ◽

Care Providers

Diabetes mellitus is one of the global problems the world. Since the complexity of the patient’s tasks is required in the diabetes care, the consistency to engage this various health behavior for addressing the glycemic control target is difficult to achieve. Failure management may reflect by patient, family, inadequate intervention strategies by health care provider as well as organization factor. Three databases used such as PubMed, MIDLINE, and CINAHL to address patient’s barriers, family’s barriers, and provider’s barriers as well as organization barriers for diabetes management. Patient’s attitudes and belief, knowledge, culture, and ethnicity, self-efficacy, financial resources and economic status, lack of Social Support Perceived, and lack of time may influence the diabetes self-management. Family factors lead to patients’ diabetes self-management such as lack of knowledge and skill to support patients in diabetes management and quality of the relationship between patients-family. Health care providers factors included beliefs, attitudes, knowledge and skill and patient–family-provider interaction and communication. Other factors lead to diabetes self-management and health care provider performance to provide the intervention from organization level such as integrated health system sufficiency health insurance to support resources. A deeper understanding of the barriers in diabetes management is necessary to improve the diabetes care and quality of health care services for patients with diabetes. Further research needs to consider these barriers before designing the effective, sensitive interventions and problem solving for diabetes care

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Effects of a self-help group for diabetes care in long-term patients with type 2 diabetes mellitus: an experience in a Japanese rural community

Australian Journal of Rural Health ◽

10.1111/j.1440-1854.2004.00626.x ◽

2004 ◽

Vol 12 (6) ◽

pp. 251-252 ◽

Cited By ~ 9

Author(s):

Kazuhiko Kotani ◽

Naoki Sakane

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Rural Community ◽

Diabetes Care ◽

Self Help ◽

Self Help Group

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An Expert Opinion on “Glycemic Happiness”: Delineating the Concept and Determinant Factors for Persons with Type 2 Diabetes Mellitus

Clinics and Practice ◽

10.3390/clinpract11030071 ◽

2021 ◽

Vol 11 (3) ◽

pp. 543-560 ◽

Cited By ~ 1

Author(s):

Sanjay Kalra ◽

Ashok Kumar Das ◽

Gagan Priya ◽

Ameya Joshi ◽

Hitesh Punyani ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Expert Opinion ◽

Diabetes Care ◽

Diabetes Management ◽

Psychological Impact ◽

Psychological Outcomes ◽

Psychosocial Burden

The importance of the psychological impact of diabetes is globally well-documented. Evidence suggests that there is a high level of psychosocial burden of diabetes in India. Moreover, there is a lack of relevant knowledge among the patients and caregivers regarding the psychological impact of diabetes and how to cope with it, as compared to the majority of other countries. “Happiness of the patient” is an essential component of diabetes management, which potentially affects the treatment outcome, treatment adherence, self-care, and lifelong management of diabetes. Although several validated tools and scales exist for measuring psychological outcomes both in patients and physicians, tools to assess “happiness in diabetes care” are still lacking. With this background, an expert group meeting was held in India in September 2019, involving nine expert diabetologists and endocrinologists across the country to discuss the concept of “glycemic happiness”. This article summarizes the expert opinion on the factors affecting psychological outcomes in diabetes, introduces the concept of glycemic happiness, describes available scales and tools to measure general happiness, and delineates the five sets of questionnaires developed with questions that may help correlate with “glycemic happiness”. The questionnaires are based on a five-point Likert method. The experts also discussed and decided upon the study design for a proposed observational survey to assess glycemic happiness of persons with type 2 diabetes mellitus (T2DM) based on the developed five sets of questionnaires. Given the huge burden of diabetes in India, the introduction of the concept of glycemic happiness will help in the optimization of diabetes care in the country.

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