scholarly journals The criteria and indices of evaluation of quality of out-patient medical care in case of chronic diseases exemplified by microvascular complications of diabetes mellitus

2019 ◽  
Vol 60 (5) ◽  
pp. 233-239
Author(s):  
Oleg V. Udovichenko ◽  
D. O. Meshkov ◽  
E. A. Berseneva
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Complications Of Diabetes ◽  
Rate Of Development ◽  
Practice Analysis ◽  
Results Of Treatment ◽  
Evaluation Techniques

The special evaluation techniques establishing quality and effectiveness of treatment in out-patient practice for every disease are required. The study was carried out to develop criteria and indices for evaluating quality of out-patient medical care of patients with micro-vascular complications of diabetes mellitus (diabetic retinopathy and nephropathy). The method of publications; search and practice analysis was applied to formulate criteria and indices of evaluating structure, processes and results of treatment. The evaluation of quality of result requires the most complicated techniques of data collection. In this respect the most perspective atre indices based on rate of development of terminal stages of mentioned complications. The obtained data can be applied to determine effectiveness of treatment of other diseases with chronic pro-gradient course.

scholarly journals The development of criteria, indices and indicators and of medical care quality for patients with syndrome of diabetic foot in out-patient practice

2019 ◽  
Vol 60 (3) ◽  
pp. 138-142
Author(s):  
Oleg V. Udovichenko ◽  
E. A. Berseneva ◽  
D. O. Meshkov
Keyword(s):  
Data Collection ◽  
Medical Care ◽  
Diabetic Foot ◽  
Care Quality ◽  
Practice Analysis ◽  
Results Of Treatment ◽  
Quality Of Structure ◽  
Chronic Course

The special techniques of evaluation of every single disease are required for assessing quality and effectiveness of treatment in out-patient practice. The purpose of study was development of criteria, indices and indicators of evaluation of quality of out-patient medical care of patients with syndrome of diabetic foot. The technique of literary searching and practice analysis were applied to develop criteria, indices and indicators for evaluating structure, processes and results of treatment. The evaluation of quality of result requires more complicated techniques of data collection as opposed to indices of quality of structure and processes. The developed indices can be also applied in evaluating effectiveness of treatment of other diseases with chronic course though curable in the main.

scholarly journals Correlation between atherogenic factors in complicated and uncomplicated type 2 diabetes mellitus

2020 ◽  
Vol 7 (7) ◽  
pp. 1083
Author(s):  
Rajdeepak V. S. ◽  
Rekha G. ◽  
Jayashree S. C.
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
Glucose Production ◽  
Poor Glycemic Control ◽  
Complications Of Diabetes

Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The factors contributing to hyperglycemia include reduced insulin secretion, decreased glucose utilization and increased glucose production. The vascular complications of DM are subdivided into microvascular (retinopathy, neuropathy, nephropathy) and macrovascular complications (coronary artery disease, peripheral vascular disease, cerebrovascular disease). There is an observed disparity between various vascular complications of diabetes and the atherogenic factors.Methods: The patients with type 2 diabetes mellitus attending outpatient and inpatient departments in Dr. B. R. Ambedkar Medical College and hospital, from September 2014 to September 2016 were selected for this study. All patients were subjected to detailed history, physical examination and laboratory investigations with respect to complications of diabetes mellitus.Results: In this study, 76% of the patients had poor glycemic control with elevated HbA1c >7%. 38% of patients had normal BMI. 36% of patients were overweight and 26% were obese. 62% of patients were either overweight or obese. Hypercholesterolemia was seen in 26% of patients with poor glycemic control. Hyperhomocysteinemia was present in 38% of patients with microvascular complications and 33% of patients with macrovascular complications.Conclusions: Type 2 diabetes mellitus showed a strong correlation between glycemic status and incidence of diabetes complications. Hypercholesterolemia and hyperhomocysteinemia have added to the increased incidence of complications as additional factors in metabolic derangements as a consequence of poor glycemic control.

Evaluation of medical care for Diabetic and Hypertensive patients in primary care in Mexico: Observational retrospective study (Preprint)

2020 ◽  
Author(s):  
Agustin Lara-Esqueda ◽  
Sergio A Zaizar-Fregoso ◽  
Violeta M Madrigal-Perez ◽  
Mario Ramirez-Flores ◽  
Daniel A Montes-Galindo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Medical Care ◽  
Serum Lipids ◽  
Quality Care ◽  
Premature Death ◽  
Current Standard ◽  
Anonymized Data ◽  
Quality Of Medical Care

BACKGROUND Diabetes Mellitus is a worldwide health problem and the leading cause of premature death with increasing prevalence over time. Usually, along with it, Hypertension presents and acts as another risk factor that increases mortality risk. Both diseases impact the country's health while also producing an economic burden for society, causing billions of dollars to be invested in their management. OBJECTIVE The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico, according to the official Mexican standard for each pathology. METHODS 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical records database, exported as anonymized data for research purposes. Each patient record was compared against the standard to test the quality of medical care. RESULTS Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease of diabetes or hypertension. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination in the whole population. Specialty referral reached 1% in angiology or cardiology in the whole population. CONCLUSIONS Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards. While patients with DM and HBP do not have a current standard to evaluate their own needs.

Vascular complications of diabetes mellitus: what role for phospholipid-binding antibodies?

Lupus ◽  
1998 ◽  
Vol 7 (7) ◽  
pp. 469-474 ◽  
Author(s):  
F Galtier-Dereure ◽  
C Biron ◽  
M Vies ◽  
V Bourgeois ◽  
J-F Schved ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vascular Complications ◽  
Complications Of Diabetes ◽  
Phospholipid Binding

scholarly journals “Complications of Gastrointestinal System in Diabetes Mellitus”- Neglected Part of Diabetic Management

2020 ◽  
Author(s):  
Jayanta Paul ◽  
Ambalathu Veettil Hussain SHIHAZ
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Daily Life ◽  
Clinical Suspicion ◽  
Complications Of Diabetes ◽  
Gi Symptoms ◽  
Liver And Pancreas ◽  
Proper Diagnosis ◽  
Prevalence Of Diabetes Mellitus

The incidence and prevalence of diabetes mellitus and its complications are increasing. Like other complications, most of the diabetes patients have gastrointestinal (GI) symptoms but in majority of cases GI complications are under diagnosed and not treated properly, resulting in impairment of the quality of daily life. GI system including liver and pancreas are involved in diabetes mellitus. These GI complications of diabetes mellitus need proper diagnosis and treatment to get a quality of life and clinician needs clinical suspicion to identify and proper knowledge to treat.

scholarly journals To study levels of serum fibrinogen in type 2 diabetes mellitus and its association with diabetic microvascular complications

2017 ◽  
Vol 4 (1) ◽  
pp. 10
Author(s):  
Gurinder Mohan ◽  
Ranjeet Kaur ◽  
Aakash Aggarwal ◽  
Parminder Singh
Keyword(s):  
Diabetes Mellitus ◽  
Microvascular Complications ◽  
Vascular Complications ◽  
High Serum ◽  
Diabetic Patients ◽  
Coagulation Disorder ◽  
Urine Albumin ◽  
Group A ◽  
Diabetic Microvascular Complications ◽  
Group B

Background: Diabetes mellitus is a hypercoagulable state associated with atherosclerosis leading to development of vascular complications, including microvascular complications.Methods: In our study a total of 60 diabetic patients with duration of diabetes more than 5 years, attending the OPD/ indoor of SGRDIMSR, Amritsar, Punjaqqb, India were included. They were divided in two groups, group A of 30 patients including diabetics with any of the three microvascular complications (diabetic nephropathy, diabetic retinopathy and diabetic neuropathy) and group B of 30 patients including diabetics without any microvascular complication. Group C comprised of 30 age and sex matched non-diabetic subjects who served as controls. Subjects with liver cirrhosis, malignancy or coagulation disorder were excluded. After taking the consent, detailed history taking and detailed physical examination and relevant investigations were done. The serum fibrinogen (hemostasis marker), HBA1C and UACR (urine albumin creatinine ratio) along with routine investigations were measured.Results: It was observed that serum fibrinogen levels were significantly higher in diabetic patients (266.16±54.73 mg/dl) as compared to non-diabetic controls (174.66±18.32 mg/dl); p <0.001.Further, serum fibrinogen levels were found to be significantly higher in diabetic patients with microvascular complications (293.43±51.09 mg/dl) as compared to those without microvascular complications (238.90±44.12); p<0.001.Conclusions: Significantly high serum fibrinogen level was found in diabetic patients as compared to controls and was in positive correlation with development of microvascular complications.

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