scholarly journals Factors Associated with Healthcare Services Utilization and Pharmacological Treatment in Individuals with Diabetes Diagnosis: Lessons from a Nationwide Program for Diabetes Mellitus Detection in Brazil

2011 ◽  
Vol 2011 ◽  
pp. 1-6
Author(s):  
Maria Isabel Fischer ◽  
Cristiana Maria Toscano ◽  
Sotero Serrate Mengue
Keyword(s):  
Pharmacological Treatment ◽  
Screening Program ◽  
Healthcare Services ◽  
Diabetes Diagnosis ◽  
Services Utilization ◽  
Factors Associated ◽  
Glucose Levels ◽  
Diabetes Status ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes

The Brazilian Nationwide Population Screening Program for Diabetes, conducted in 2001, diagnosed 346,168 new cases. Although unexpected, approximately 65,000 previously diabetic individuals participated. We describe their characteristics compared to new cases, based on data obtained by a follow-up study of a subsample of 4991 positively screened from a representative sample of 90,106 individuals. Two groups were analyzed regarding factors associated with adherence to treatment, healthcare services utilization, and compliance to pharmacological treatment: 497 with newly diagnosed diabetes and 257 individuals with previous diabetes diagnosis who were not under treatment at the screening program. For this group, healthcare service utilization was lower when compared with the new cases (OR = 0.06; 95% CI: 0.03–0.12). Diabetes status (OR = 0.23; 95% CI: 0.14–0.37), a healthy behavior score (OR = 0.53, 95% CI: 0.34–0.83), and glucose levels at screening (altered, OR = 5.01; 95% CI: 2.38–10.6 and likely and very likely DM OR = 11.2; 95% CI: 6.85–18.4) were independently associated with pharmacological treatment.

scholarly journals Diverse transitions in diabetes status during the clinical course of patients with resectable pancreatic cancer

2020 ◽  
Vol 50 (12) ◽  
pp. 1403-1411
Author(s):  
Ayako Shingyoji ◽  
Rintaro Mikata ◽  
Sadahisa Ogasawara ◽  
Yuko Kusakabe ◽  
Shin Yasui ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Distal Pancreatectomy ◽  
Cancer Patients ◽  
Clinical Course ◽  
Newly Diagnosed ◽  
Resectable Pancreatic Cancer ◽  
Diabetes Status ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes ◽  
Diabetes Resolution

Abstract Objective Pancreatic cancer and diabetes status have complex bilateral interactions; therefore, understanding their clinical features is essential for the clinical management of pancreatic cancer patients. We aimed to evaluate the diabetes status before diagnosis, after resection and until the time of recurrence in patients with resectable pancreatic cancer and to clarify the correlations among the clinical course of pancreatic cancer, operative procedure and diabetes status. Methods Between 2011 and 2016, we retrospectively identified 189 pancreatic cancer patients who underwent pancreatoduodenectomy or distal pancreatectomy at our institution. The entire clinical course of each patient was retrieved from the medical records, and the diabetes status in the longest possible duration was assessed. Results Among 115 pancreatic cancer patients who had normal glucose tolerance at the time of resection, 22 (19.1%) developed type 2 diabetes after resection. In a multivariate analysis, distal pancreatectomy was strongly associated with the development of postoperative diabetes. On the other hand, 74 pancreatic cancer patients had already been diagnosed with type 2 diabetes at the time of resection. During the follow-up period, 15 patients were noted to have diabetes resolution after resection; interestingly, the majority of these patients had newly diagnosed diabetes, which was defined as the diagnosis of diabetes within 3 months before resection. Moreover, newly diagnosed diabetes was an independent factor for diabetes resolution after resection. Conclusions In pancreatic cancer patients who underwent pancreatectomy, distal pancreatectomy was correlated with postoperative diabetes, and newly diagnosed diabetes had a high probability of resolution after resection.

scholarly journals Thirty-year Trends in Complications in U.S. Adults With Newly Diagnosed Type 2 Diabetes

2021 ◽  
Author(s):  
Michael Fang ◽  
Elizabeth Selvin
Keyword(s):  
Cardiovascular Disease ◽  
Diabetes Diagnosis ◽  
Newly Diagnosed ◽  
The Past ◽  
History Of ◽  
Lipid Control ◽  
Retinal Microaneurysms ◽  
Diagnosed Diabetes ◽  
Design And Methods ◽  
Newly Diagnosed Diabetes

<b>Objective:</b> To assess the prevalence of and trends in complications among US adults with newly diagnosed diabetes. <p><b>Research design and methods:</b> We included 1,486 nonpregnant adults (aged≥20 years) with newly diagnosed diabetes (diagnosed within the past 2 years) from the 1988-1994 and 1999-2018 National Health and Nutrition Examination Survey. We estimated trends in albuminuria (albumin-to-creatinine ratio≥30 mg/g), reduced estimated glomerular filtration rate (eGFR<60 ml/min/1.73 m<sup>2</sup>), retinopathy (any retinal microaneurysms or blot hemorrhages), and self-reported cardiovascular disease (history of congestive heart failure, heart attack, or stroke).</p> <p><b>Results: </b>From 1988-1994 to 2011-2018, there was a significant decrease in the prevalence of albuminuria (38.9 to 18.7%, p-for-trend<0.001), but no change in the prevalence of reduced eGFR (7.5 to 9.9%, p-for-trend=0.30), retinopathy (1988-1994 to 1999-2008 only; 13.2 to 12.1%, p-for-trend=0.86), or self-reported cardiovascular disease (19.0 to 16.5%, p-for-trend=0.64). There were improvements in glycemic, blood pressure, and lipid control in the population, and these partially explained the decline in albuminuria. Complications were more common at the time of diabetes diagnosis for adults who were older, lower income, less educated, and obese.</p> <p><b>Conclusion:</b> Over the past three decades, there have been encouraging reductions in albuminuria and risk factor control in adults with newly diagnosed diabetes. However, the overall burden of complications around the time of diagnosis remains high.</p>

scholarly journals Increased Arterial Stiffness in Prediabetic Subjects Recognized by Hemoglobin A1c with Postprandial Glucose but Not Fasting Glucose Levels

2019 ◽  
Vol 8 (5) ◽  
pp. 603
Author(s):  
Chung-Hao Li ◽  
Feng-Hwa Lu ◽  
Yi-Ching Yang ◽  
Jin-Shang Wu ◽  
Chih-Jen Chang
Keyword(s):  
Arterial Stiffness ◽  
Hemoglobin A1c ◽  
Pulse Wave ◽  
Glycated Hemoglobin ◽  
Fasting Glucose ◽  
Postprandial Glucose ◽  
Newly Diagnosed ◽  
Glucose Levels ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes

Previous studies exploring the association between arterial stiffness and prediabetes remain controversial. This study aimed to investigate the association of the different domains of prediabetes categorized by glycated hemoglobin A1c (A1c) 5.7–6.4%, impaired fasting glucose (IFG), fasting plasma glucose of 5.6–6.9 mmol/L, and impaired glucose tolerance (IGT), two-hour post-load glucose of 7.8–11.0 mmol/L, on arterial stiffness. These were measured by brachial–ankle pulse-wave velocity (baPWV). We enrolled 4938 eligible subjects and divided them into the following nine groups: (1) normoglycemic; (2) isolated A1c 5.7–6.4%; (3) isolated IFG; (4) IFG with A1c 5.7–6.4%; (5) isolated IGT; (6) combined IGT and IFG with A1c <5.7%; (7) IGT with A1c 5.7–6.4%; (8) combined IGT and IFG with A1c 5.7–6.4%; and (9) newly diagnosed diabetes (NDD). The baPWV values were significantly high in subjects with NDD (β = 47.69, 95% confidence interval (CI) = 29.02–66.37, p < 0.001), those with IGT with A1c 5.7–6.4% (β = 36.02, 95% CI = 19.08–52.95, p < 0.001), and those with combined IGT and IFG with A1c 5.7–6.4% (β = 27.72, 95% CI = 0.68–54.76, p = 0.044), but not in the other subgroups. These findings suggest that increased arterial stiffness was found in prediabetes individuals having an A1c 5.7–6.4% with IGT, but not IFG. Isolated A1c 5.7–6.4% and isolated IGT were not associated with elevated arterial stiffness.

scholarly journals Longitudinal Average Glucose Levels and Variance and Risk of Stroke: A Chinese Cohort Study

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Xuenan Peng ◽  
Jinzhuo Ge ◽  
Congju Wang ◽  
Hongpeng Sun ◽  
Qinghua Ma ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Glucose Level ◽  
Cox Regression ◽  
Diabetes Diagnosis ◽  
Glucose Levels ◽  
Diabetes Status ◽  
Chinese Cohort ◽  
Average Blood Glucose ◽  
Average Glucose

Background. Diabetes is a known independent risk factor for stroke. However, whether higher glucose levels (126–139.9 mg/dl) can increase the risk of stroke in people without diabetes is still unknown. Moreover, as a fluctuating parameter, long-term glucose levels may also be related to the risk of stroke outcome. It is important to explore the correlation between long-term average blood glucose, as well as its variability, and stroke. Methods. We used 40,975 clinical measurements of glucose levels and 367 measurements of glycated hemoglobin A1c levels from 12,321 participants without stroke to examine the relationship between glucose levels and the risk of stroke. Participants were from the Weitang Geriatric Diseases study, including 5,707 men and 6,614 women whose mean age at baseline was 60.8 years; 1,011 participants had diabetes, and 11,310 did not. We estimated the long-term average blood glucose level based on the multilevel Bayesian model and fit in Cox regression models, stratified according to diabetes status. Results. Over a median follow-up period of 5 years, stroke developed in 279 of the 12,321 participants (244 without diabetes and 35 with). For people with an average glucose level of 126–139.9 mg per deciliter, compared with 90–99.9 mg per deciliter, the adjusted hazard ratio (HR) for total stroke was 1.78 (95% confidence interval (CI), 1.16–2.75), and the HR for levels higher than 140 mg per deciliter was 1.89 (95% CI, 1.09–3.29). Among those without diabetes whose glucose level was higher than 140 mg per deciliter, compared with 90–99.9 mg per deciliter, the adjusted HRs for total stroke and fatal stroke were 3.66 (95% CI, 1.47–9.08) and 5 (95% CI, 1.77–14.15), respectively. For a glucose standard deviation level higher than 13.83 mg per deciliter, compared with that lower than 5.91 mg per deciliter, the adjusted HR for total stroke was 2.31 (95% CI, 1.19–4.48). Conclusions. Our results suggest that higher average glucose levels (126–139.9 mg/dl) and variance may be risk factors for stroke, even among people without diabetes diagnosis.

Providing Care Across Settings for an Adult With Newly Diagnosed Diabetes Mellitus and Methicillin-Resistant Staphylococcus Aureus: A Case Study

2015 ◽  
Vol 8 (1) ◽  
pp. 87-97
Author(s):  
Ella Marie Ares
Keyword(s):  
Staphylococcus Aureus ◽  
Nurse Practitioners ◽  
Medication Management ◽  
Ambulatory Setting ◽  
Newly Diagnosed ◽  
Methicillin Resistant ◽  
Glucose Levels ◽  
Experience Teaching ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes

It is common for new cases of diabetes to be diagnosed in an acute hospital admission for other conditions. Treating these newly diagnosed diabetic hospitalized patients and transitioning them safely to care in the ambulatory setting requires the ability to evaluate the patient’s changing insulin needs and experience teaching the necessary diabetes survival skills. Certified diabetes educators who are nurse practitioners, having earned a clinical doctorate with a focus on comprehensive care and having demonstrated competency treating diabetes disease processes, diabetes medication management, and teaching diabetes self-care, are prepared to address the needs of these patients. This case was selected to illustrate this role in evaluating a patient hospitalized with a methicillin-resistant Staphylococcus aureus soft tissue infection and new onset hyperglycemia that required initiating and titrating insulin therapy and individualizing insulin protocols for optimal glucose levels and transition to outpatient care.

Control of hypertension and diabetes among adults aged over 40 years with or without physical disabilities

2015 ◽  
Vol 14 (2) ◽  
Author(s):  
Jung-A Lee ◽  
Jong Heon Park
Keyword(s):  
Plasma Glucose ◽  
Screening Program ◽  
Physical Disabilities ◽  
Female Gender ◽  
Healthcare Services ◽  
Tertiary Hospital ◽  
Health Screening ◽  
Effective Control ◽  
Screening Programs ◽  
Glucose Levels

AbstractDisabled individuals have poorer health compared to non-disabled individuals and they exhibit a higher prevalence of chronic diseases, such as hypertension (HTN) and diabetes mellitus (DM). We explored how effectively blood pressure (BP) and fasting plasma glucose (FPG) level, factors influencing development of HTN and DM, were controlled in disabled and non-disabled individuals over the age of 40 years. We hypothesized that control of BP and FPG levels in disabled individuals would be lower than that in non-disabled participants.Records of the National Health Insurance Scheme (NHIS) were analyzed and the health screening program database was examined between the years 2007 and 2009. We identified patients who had used healthcare services to treat HTN or DM. Health-related information that might influence effective control of both BP and FPG levels in those with or without physical disabilities were examined.The extent of effective BP and DM control did not differ between people with and without disabilities, but plasma glucose levels were slightly better controlled in individuals with disabilities than those without disabilities. HTN and DM control was more closely associated with female gender, age, grade of disability, non-smoking and non-drinker status, engagement in physical activity, presentation for health examinations, and frequent tertiary hospital visits for HTN management.Our paper is significant because of our focus on differences between disabled and non-disabled individuals. Our results and future data from NHIS health screening programs can be used to regularly monitor population health status and to evaluate information relevant to the management of HTN and DM control.

scholarly journals Frequency of Hyperglycemia in Patients with Covid-19 Infection and Pneumonia

2021 ◽  
Author(s):  
Valeriy Ivanovich Vechorko ◽  
Evgeny Mikhailovich Evsikov ◽  
Oksana Alekseevna Baykova ◽  
Natalya Vadimovna Teplova ◽  
Dmitriy Aleksandrovich Doroshenko
Keyword(s):  
Diabetes Mellitus ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Carbohydrate Metabolism ◽  
Age Groups ◽  
Newly Diagnosed ◽  
Glucose Levels ◽  
Control And Prevention ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes

Diabetes mellitus can increase the risk of death in COVID-19 by 12 times, according to the portal of the us Centers for disease control and prevention. Coronavirus-infected diabetics are six times more likely to need inpatient treatment, and diabetes is the second most severe complication in COVID-19 after cardiovascular diseases. The state of carbohydrate metabolism in patients with COVID-19 has not been sufficiently studied in clinical studies. Isolated studies indicate that viral infection may be accompanied by an increase in the concentration of glycated hemoglobin in patients with viral pneumonia. To assess the frequency of hyperglycemia and diagnosis of newly diagnosed diabetes mellitus in patients with COVID-19 and acute lung damage aged 41–80 years, who were hospitalized in a repurposed infectious diseases hospital in Moscow with a diagnosis of pneumonia. In the observational study analyzed laboratory and clinical diagnostic data of 278 patients who had, according to the anamnesis and the medical conclusions of impaired glucose tolerance and manifested forms of diabetes, including 163 men and 115 women, aged 41–80 years, admitted to the hospital for diagnosis and treatment in the period from 12.04.2020 on 10.11.2020 of diagnoses according to ICD-10: U07.1 Coronavirus infection. In the selected groups of patients, the initial and subsequent fasting blood glucose levels were analyzed after 8 hours without food intake on a stationary automatic analyzer and using portable glucose, meters using diagnostic test strips. The concentration of glucose and ketones in the urine was determined by a semi-quantitative method. We evaluated the dynamics of indicators when detecting pathological values of glucose concentration. Glucose levels above 6.4 mmol/l were taken as pathological. In patients aged 41–80 years who were hospitalized with covid-19 infection and pneumonia, fasting hyperglycemia was diagnosed in 31–47%, glucosuria in 1.9–6.1%, ketonuria – 20.4-46.2% of cases, in different age groups. In 16.6–31.3% of cases in patients with covid-19,after treatment and regression of changes in the lungs, normalization of glucose levels was observed, but in 14.8–16.7% of the changes persisted, and in 9–13% of them, after an additional study, newly diagnosed diabetes mellitus was diagnosed. Hyperglycemia was significantly more often detected in patients with arterial hypertension of 2–3 degrees of severity and with a tendency to reliability, in patients with obesity of 2–3 degrees. Lipid metabolism disorders (hypertriglyceridemia and hypercholesterolemia), which are characteristic of changes in carbohydrate metabolism in patients with impaired glucose tolerance and diabetes, were significantly more often diagnosed in patients with covid-19 than in the group of patients with acute and chronic lung pathology without proven infection with this virus, but only in the group of patients aged 41–60 years. Covid-19 infection complicated by pneumonia occurs in individuals aged 41–80 years with a high incidence of hyperglycemia and ketonuria. The incidence of newly diagnosed diabetes mellitus in such patients is 9–13%.

scholarly journals Newly diagnosed diabetes and outcomes after acute myocardial infarction in young adults

Heart ◽  
2020 ◽  
pp. heartjnl-2020-317101 ◽  
Author(s):  
Qinglan Ding ◽  
Erica S Spatz ◽  
Kasia J Lipska ◽  
Haiqun Lin ◽  
John A Spertus ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Health Status ◽  
Pharmacological Treatment ◽  
Diabetes Education ◽  
Discharge Diagnosis ◽  
Newly Diagnosed ◽  
Diagnosed Diabetes ◽  
Newly Diagnosed Diabetes ◽  
Disease Specific

ObjectiveTo examine prevalence and characteristics of newly diagnosed diabetes (NDD) in younger adults hospitalised with acute myocardial infarction (AMI) and investigate whether NDD is associated with health status and clinical outcomes over 12-month post-AMI.MethodsIn individuals (18–55 years) admitted with AMI, without established diabetes, we defined NDD as (1) baseline or 1-month HbA1c≥6.5%; (2) discharge diabetes diagnosis or (3) diabetes medication initiation within 1 month. We compared baseline characteristics of NDD, established diabetes and no diabetes, and their associations with baseline, 1-month and 12-month health status (angina-specific and non-disease specific), mortality and in-hospital complications.ResultsAmong 3501 patients in Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients study, 14.5% met NDD criteria. Among 508 patients with NDD, 35 (6.9%) received discharge diagnosis, 91 (17.9%) received discharge diabetes education and 14 (2.8%) initiated pharmacological treatment within 1 month. NDD was more common in non-White (OR 1.58, 95% CI 1.23 to 2.03), obese (OR 1.72, 95% CI 1.39 to 2.12), financially stressed patients (OR 1.27, 95% CI 1.02 to 1.58). Compared with established diabetes, NDD was independently associated with better disease-specific health status and quality of life (p≤0.04). No significant differences were found in unadjusted in-hospital mortality and complications between NDD and established or no diabetes.ConclusionsNDD was common among adults≤55 years admitted with AMI and was more frequent in non-White, obese, financially stressed individuals. Under 20% of patients with NDD received discharge diagnosis or initiated discharge diabetes education or pharmacological treatment within 1 month post-AMI. NDD was not associated with increased risk of worse short-term health status compared with risk noted for established diabetes.Trial registration numberNCT00597922.

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