2021 Clinical Practice Guidelines for Diabetes Mellitus in Korea

The Committee of Clinical Practice Guidelines of the Korean Diabetes Association (KDA) updated the previous clinical practice guidelines for Korean adults with diabetes and prediabetes and published the seventh edition in May 2021. We performed a comprehensive systematic review of recent clinical trials and evidence from real-world practice among the Korean population. The guidelines are intended for use at sites across the country by all healthcare providers (including physicians, diabetes experts, and certified diabetes educators) who treat diabetes. The recommendations for screening and antihyperglycemic agents have been revised and updated. Continuous glucose monitoring with insulin pump use and screening and treatment for non-alcoholic fatty liver disease were added in the type 2 diabetes sections. The KDA recommends active vaccination for COVID-19 in patients with diabetes. An abridgement that contains practical information for patient education and systematic clinic management was published separately.

Interventional Strategies Based on the Types of Family Characteristics for the Diabetes Educator

Family roles are important consideration in diabetes management. The various psychosocial contexts within families, especially those with a member with diabetes, are very complex and play a key role in comprehensive care. It is important that all diabetes educators are aware of such family characteristics when designing an intervention. Diabetes educators are required to understand diverse types of family characteristics and should be well trained regarding such roles to support families with a diabetic member.

A USABILITY EVALUATION OF PORTABLE BREATH KETONE SENSOR DEVICES BY AND FOR YOUNG PEOPLE WITH TYPE 1 DIABETES MELLITUS

Background. Portable breath ketone sensors may help people with Type 1 Diabetes Mellitus (T1DM) avoid episodes of diabetic ketoacidosis; however the design features preferred by users have not been studied. We aimed to elucidate design preferences associated with breath ketone sensors among young people with T1DM aged 12-16 years, their parents, and diabetes educators. Research Designs and Methods. Two commercially available breath ketone sensors, designed for ketogenic diet monitoring, were assessed over one week by ten young people with T1DM following a usability evaluation approach. Participants interacted with the devices at least twice daily for five days, taking breath ketone, blood ketone and blood glucose measurements. Semi-structured interviews were conducted post-testing with participants, parents and two diabetes educators to elicit design preferences to inform the co-design of diabetes breath ketone sensor prototypes. Results. Participants acknowledged the non-invasiveness of breath sensors as compared to blood testing. Affordability, reliability and accuracy were identified as prerequisites for breath ketone sensors used for diabetes management. Design features valued by young people included portability, ease of use, sustainability, readability and suitability for use in public. The time required to use breath sensors was similar to that for blood testing. The requirement to maintain a 10-second breath exhalation posed a challenge for users. Conclusions. Breath ketone sensors for diabetes management bear potential to facilitate ketone testing in young people. Our study affirms features for young people that drive usability of breath sensors among this population, and provides a model of usability assessment of medical devices among young users.

Common Errors by Diabetes Patients Influencing Management

Merely visiting a physician and receiving a prescription is not enough while treating a patient suffering from diabetes. Many mistakes are committed by patients, which make physician’s job very challenging.Many patients do not take prescribed pills on right time, in right dose in right manner because of which blood reports are influenced. Patients have their own myths and misbeliefs to commit these faults. The only way to minimize these faults is diabetes education which a sparingly rendered by the physicians in our part of the world and we do not have a well set system of diabetes educators.

EDITORIAL: PILAR PERAWATAN MANDIRI DIABETES MELLITUS

Diabetes Meliitus merupakan penyakit kronik. Perawatan mandiri penderita DM bertujuan untuk mengelola penyakit terhadap dampak fisiologis, emosi dan hubungan interpersonal. Pada tahun 2014, American Association of Diabetes Educators (AADE) merumuskan ada tujuh pilar perawatan mandiri DM, antara lain: Pola makan yang sehat, Aktif secara fisik/aktif bergerak, minum obat, pemantauan, pemecahan masalah, mekanisme koping yang sehat, dan mengurangi resiko. Diabetes Mellitus is a chronic disease. Self-care for DM sufferers aims to manage the disease on its physiological, emotional and interpersonal relationships. In 2014, the American Association of Diabetes Educators (AADE) formulated seven pillars of DM self-care, including: a healthy diet, being physically active/actively moving, taking medication, monitoring, problem solving, healthy coping mechanisms, and reducing stress. risk.

A Study Of Certified Diabetes Educators: A Descriptive Exploration Of The Delivery Of Diabetes Self Management Support In Community Based Settings In Ontartio

There has been a recent shift in diabetes care from hospitals to community settings. This exploratory descriptive study used a convenience sample (n=33) recruited from the Canadian Diabetes Association Educator Sections, in Ontario, to examine the extent to which certified diabetes educators (CDEs) perceive the delivery of diabetes self management support (DSMS), in community settings and the supports and barriers that influence DSMS delivery. Overall, CDEs reported delivering DSMS at a level that reflected consistent implementation at the team level, but lacked system wide consistency. The patient support element most consistently delivered was patient involvement in decisions; the organizational element most frequently endorsed was multidisciplinary teams. Patient related factors were the most frequently reported barriers; the most frequently reported support was a multidisciplinary team approach. This is the first study to examine DSMS delivery in community settings, thus these findings serve as a baseline for future comparison.

A Study Of Certified Diabetes Educators: A Descriptive Exploration Of The Delivery Of Diabetes Self Management Support In Community Based Settings In Ontartio

There has been a recent shift in diabetes care from hospitals to community settings. This exploratory descriptive study used a convenience sample (n=33) recruited from the Canadian Diabetes Association Educator Sections, in Ontario, to examine the extent to which certified diabetes educators (CDEs) perceive the delivery of diabetes self management support (DSMS), in community settings and the supports and barriers that influence DSMS delivery. Overall, CDEs reported delivering DSMS at a level that reflected consistent implementation at the team level, but lacked system wide consistency. The patient support element most consistently delivered was patient involvement in decisions; the organizational element most frequently endorsed was multidisciplinary teams. Patient related factors were the most frequently reported barriers; the most frequently reported support was a multidisciplinary team approach. This is the first study to examine DSMS delivery in community settings, thus these findings serve as a baseline for future comparison.

Exploring the interpersonal collaboration during the integration of diabetes teams into primary care.

Background Specialised diabetes teams, specifically certified nurse and dietitian diabetes educator teams, are being integrated part-time into primary care to provide better care and support for Canadians living with diabetes. This practice model is being implemented throughout Canada in an effort to increase patient access to diabetes education, self-management training, and support. Interprofessional collaboration can have positive effects on both health processes and patient health outcomes, but few studies have explored how health professionals are introduced to and transition into this kind of interprofessional work. Method Data from 18 interviews with diabetes educators, 16 primary care physicians, 23 educators’ reflective journals, and 10 quarterly debriefing sessions were coded and analysed using a directed content analysis approach, facilitated by NVIVO software. Results Four major themes emerged related to challenges faced, strategies adopted, and benefits observed during this transition into interprofessional collaboration between diabetes educators and primary care physicians: (a) negotiating space, place, and role; (b) fostering working relationships; (c) performing collectively; and (d) enhancing knowledge exchange. Conclusions Our findings provide insight into how healthcare professionals who have not traditionally worked together in primary care are collaborating to integrate health services essential for diabetes management. Based on the experiences and personal reflections of participants, establishing new ways of working requires negotiating space and place to practice, role clarification, and frequent and effective modes of formal and informal communication to nurture the development of trust and mutual respect, which are vital to success.