Telemedicine-Based Diabetic Care Powered With Artificial Intelligence

Diabetes is one of the chronic diseases which keep increasing at an alarming rate, and the patients need to visit the clinic to routinely check their sugar levels and adjust their treatment plans. Artificial intelligence-enabled telemedicine is found to be a promising approach to monitor the health status of diabetic patients. Some of the promising artificial intelligence technologies for treating diabetic patients are a reactive machine, limited memory, theory of minds, and self-awareness. Each of these techniques is discussed with architecture, characteristics, algorithms, advantages, and applications. Performance analysis is carried out towards the performance metrics like accuracy, medical error rate, speed, and learning rate, and the performance achieved by self-awareness artificial intelligence technique is found to be better in delivering telemedicine-based care for diabetic patients with a very high level of precision and speed of operation.

The role of rehabilitation in the management of diabetic foot wounds.

Diabetes is one of the most common health problems worldwide. Diabetic foot wounds (DFWs) are hazardous complications of the disease. Patients are often referred to rehabilitation facilities at later stages of the diabetic complications, particularly after amputation surgery. There are potential benefits of rehabilitation practices in preventing and managing DFWs. Therefore, rehabilitation needs to be more involved in the management of DFWs and should be in all stages of diabetic care. In this review, we discuss literature data to bring rehabilitation perspective to the multidisciplinary management of DFWs.

The Effect of Educational Program on Pain Management, Self-Efficacy Behavior, and Quality of Life among Adult Diabetic Patients with Peripheral Neuropathy Pain: A Randomized Controlled Trial

Objective Jordan has a high prevalence of painful diabetic peripheral neuropathy (PDPN), leg complications, and amputations due to diabetes. This study evaluated the effect of educational programs on pain management, self-efficacy behaviors, and quality of life (QoL) among adult patients with PDPN. Methods The randomized controlled trial study was conducted at the Jordanian Ministry of Health hospitals between October 2019 – March 2020. Seventy-two adult patients with PDPN were randomized to an experimental group of 36 patients who attended an educational program and a control group who followed routine diabetic care in the study setting. The data were collected using a socio-demographic and diabetes clinical/laboratory data form, the numeric rating scale (NRS), diabetes self-efficacy scale (DSES), and the quality-of-life questionnaire (EQ-5D). The intervention program consisted of four educational sessions at weekly intervals. Pre-test and post-test evaluations were conducted. Results After the educational intervention, the mean scores of the NRS (p=0.020), DSES (p<0.001), and EQ-5D (p<0.001) in the experimental group improved significantly improved compared to those in the control group. Additionally, while there were no significant correlations between the three study outcomes in the pre-test stage, correlations were observed to be significant after the educational intervention. Conclusion This study shows that the design and implementation of educational intervention combined with routine diabetic care facilitate effective pain management, self-efficacy behaviors, and QoL of patients with PDPN. The health care providers are recommended to use the educational programs for such patients at various levels of services in both health centers and diabetes clinics.

Psychological Impact of Diabetic Care on Satisfaction and Quality of Life of Diabetes Patients Attending Endocrinology Clinic, LAUTECH Teaching Hospital, Osun State, Southwest, Nigeria

Aims: Diabetes mellitus (DM) is a complex, debilitating and chronic illness that presents substantial challenges to every individual living with the condition. The impact of DM reaches far beyond the physical symptoms of the disease, often the emotional distress and psychosocial impact on the quality of life (QoL) of these patients complicates the effective management of the disease. Therefore, the objective of this study was to evaluate the impact of psychological experience and satisfaction with diabetic care on quality of life of diabetes patients. Study Design: This was a descriptive research survey design carried out among diabetes patients attending endocrinology clinic of LAUTECH Teaching Hospital, Osogbo, Osun State, Southwest, Nigeria between August to December 2020. Methodology: Sample size determination was obtained using Taro Yamane’s formula and sample consisted of one hundred and ten (110) diabetic patients attending endocrinology clinic of LAUTECH Teaching Hospital, Osogbo. Samples were selected using convenience sampling method. Data were collected using modified Kessler psychological distress scale and Diabetes Quality of life Instrument and analyzed using descriptive statistics of frequencies, percentages and table. Inferential statistics of chi-square was used to test hypotheses at 0.05 level of significance. Results: The results showed that more than half of the patients had poor psychological experience 61(55.5%) with diabetic care, though majority were satisfied 66(60.0%) with diabetic care but demonstrated poor quality of life 65(59.1%). The result also showed a significant relationship between psychological experience and quality of life (x2=5.564; df=1; p-value=0.018), level of satisfaction with diabetic care and quality of life (x2=25.280; df=2; p-value=0.000), level of satisfaction with diabetic care and psychological experience of diabetes patients (x2=25.185; df=1; p-value=0.000). Conclusion: Promotion of psychological wellbeing of diabetes patients and quality outcome of diabetic care as well as patient-centered psychological care are essential by providing care that is respectful and responsive to individual patient preferences, needs and values.

Smartphone Application for Diabetes in Indonesia: A Narrative Review

In 2017, Indonesia was ranked sixth in the top ten countries with the highest diabetes cases. The prevalence is expected to continue increasing. The use of Smartphone applications is one of the alternative methods in promoting better disease management and preventing diabetes. The purpose of this review is to identify existing studies regarding Smartphone applications for diabetes in Indonesia and to highlight the important findings. There are only a few original clinical studies about Smartphone applications for diabetes in Indonesia. A total of 5 studies were reviewed here. There are the Nutri Diabetic Care, the Teman DM, the DM Calendar App, the E-diary DM, and the Salam Sehat. The study was conducted on several respondents with the use of short-term applications and using the variable method. Nevertheless, the studies found that Smartphone applications for diabetes can be beneficial for improving self-care, self-efficacy, increased knowledge, and medication and diet compliance among diabetic patients in Indonesia. The information and utility criteria for diabetes application which should be relevant to clinical guidelines are not discussed. The implementation of Smartphone applications for diabetes is suitable for Indonesian condition. The best application with the right information, utility, and supported by clinical studies is suggested as a complement to the diabetes management by a health professional.

Oppurtunistic completion of the 9 diabetic care processes during inpatient admission to a mental health hospital: an audit of local practice

AimsDiabetes is more prevalent in people with mental illness than in the general population. Those with both mental illness and diabetes are more likely to have poor glycaemic control. Clients with mental illness and diabetes are less likely to receive the 9 NICE recommended annual diabetic care processes than the general population. In 2017, the Joint British Diabetes Societies for Inpatient Care (JBDS-IP) and the Royal College of Psychiatrists released guidance recommending that inpatient psychiatric admissions should be used as an opportunity to complete diabetic care processes, and a named staff member should be responsible for this.We aimed to review local compliance with this JBDS-IP guidance, increase knowledge and improve local care for clients living with both mental illness and diabetes.MethodWe reviewed the notes of all current inpatients to general, forensic or learning disability wards at our centre and identified all patients with a known diagnosis of Diabetes. We identified which of the 9 care processes had been completed (or had the most recent result documented, or had a plan made for completion) during this admission. We identified if a named staff member was responsible for completing processes on each ward, and whether the care processes were documented in the patients’ notes.ResultWe identified 18 current diabetic inpatients at our centre (14% of inpatients). We found that none of these patients had a diabetic care processes review documented and none of these patients had had a foot check and urinary albumin performed during admission, or had the last community result identified and documented. We found that less than 15% of patients had a documented plan concerning the completion of retinal screening. One ward had a named staff member responsible for reviewing their diabetic patients’ screening. However, 6/9 care processes had been completed in the significant majority of patients (>75%).ConclusionOur centre is not compliant with the guideline audited. We have implemented a plan to increase awareness of care processes through posters, teaching (at junior and consultant level), creating documentation templates and ensuring wards nominate a staff member to review care processes. We have organised a re-audit. Organising foot examination, renal function testing and retinal screening during admission for clients who may have complicated social situations and may not be aware of (or be non adherent with) the long term management of their diabetes has the potential to significantly reduce morbidity in this client subgroup.