Download or read book Self monitoring Blood Glucose in Type 2 Diabetes a Continuous Improvement Initiative written by Rossi Maria Chiara and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: Self-monitoring blood glucose (SMBG) is a key tool for therapeutic decision and structured patient education. Despite there is evidence that SMBG improves metabolic control both in insulin-treated and in non insulin treated patients with type 2 diabetes (T2DM), the prescription and execution of SMBG is suboptimal and heterogeneous. AIM: AMD Annals initiative aims to improve quality of diabetes care in Italy. This analysis assessed the use of SMBG in patients with T2DM to evaluate frequency of SMBG, metabolic control, and hypoglycemia in the different therapeutic schemes including or not insulin. METHOD: A specific software has been used for the standardized extraction of the information contained in the electronic medical records. Extracted data included clinical data, therapies and all SMBG values downloaded on EMR by different glucose meters routinely used by the patients. Sample was constituted by T2DM patients with at least one HbA1c value during the years 2014 and 2015 and with at least 1 available SMBG value measured in the 90 days before the HbA1c test. RESULTS: Overall 21 centers and 27,768 observations were included in the analysis. Frequency of SMBG, levels of fasting and post-prandial blood glucose (FBG and PPG), and values below 60 mg/dl were evaluated in the following treatment schemes: metformin only (N=3188); secretagogues only (N=685); metformin + secretagogues (N=2929); metformin + DPP-IV inhibitor (N=612); metformin + secretagogues + DPP-IV (N=3132); metformin + secretagogues + acarbose (N=337); GLP1RA + metformin + secretagogue (N=375); GLP1RA + metformin (N=516); basal insulin + metformin + secretagogues (N=3486); basal + short acting insulin + metformin (N=1666); basal + short acting insulin (N=6842). SMBG was frequently recommended also to patients not treated with insulin: 45.7% of observations referred to patients not treated with insulin. Frequency of SMBG was suboptimal in all treatment schemes; even patients treated with schemes including insulin monitored their glucose less than two times per day. Furthermore, 39.5% of SMBG tests could not be univocally classified as FBG or post-prandial glucose (PPG). In all treatment schemes, of those values which could be univocally classified, over 95% of SMBG tests were FBG values and less than 5% were PPG values. Pre-breakfast FBG values represented about 50% of all available FBG values in all treatment schemes. The frequency of SMBG does not substantially differed among the most common schemes with oral agents, irrespective of the use of secretagogues. The average FBG during three months was over 130 mg/dl in 38% to 84% of the cases in the different schemes, while average PPG was over 140 mg/dl in 36% to 73% of the cases. Even when looking at the most common therapeutic approaches, it emerged that substantial proportions of cases have elevated FBG and PPG, even though average HbA1c levels were often acceptable. The use of therapeutic schemes including secretagogues was associated with a two to three-fold increased risk of glycemic values

Download or read book Self Monitoring of Blood Glucose in Patients with Type 2 Diabetes Mellitus Meta Analysis of Effectiveness written by U. S. Department of Veterans Affairs and published by Createspace Independent Pub. This book was released on 2013-06-18 with total page 52 pages. Available in PDF, EPUB and Kindle. Book excerpt: According to the World Health Organization, at least 180 million people worldwide suffer from diabetes. Though prevalent throughout the world, diabetes is more common (especially type 2) in more developed countries like the United States. The National Diabetes Information Clearinghouse estimates that diabetes costs $132 billion in the United States alone every year. Given these estimates along with the projection that the worldwide incidence of diabetes will double in the next 20 years, 1 intensified research into better management of this chronic disease is paramount. Tighter control of blood glucose is advocated as a means to reduce microvascular and macrovascular complications. VA has performance measures assessing the proportion of patients meeting certain A1c goals, currently 7% and 9%. Theoretically, self-monitoring of blood glucose (SMBG) can improve compliance with recommendations on diet and exercise and medication regimens. The American Diabetes Association has recommended that the optimal frequency of SMBG for patients with type 2 diabetes should be adequate to facilitate reaching glucose goals. This hypothesis is based on the expectation that life style changes are facilitated by SMBG. Under these conditions, we should expect an improvement of glycemic control SMBG may decrease patient management costs, and because of the high prevalence of type 2 diabetes, efforts to establish the efficacy of SMBG in type 2 diabetes mellitus are of greater relevance. Methods to achieve improved glycemic control, and therefore a higher proportion of patients meeting target A1c levels, include diet, exercise, and medication. However, evidence supporting the use of SMBG for diabetics not requiring insulin is not as clear. The purpose of this review is to analyze the literature to answer four key questions given to us by VA: 1) Is regular self-monitoring of blood glucose effective in achieving target A1c levels for patients with type 2 diabetes?; 2) Is regular self-monitoring of blood glucose effective in maintaining target A1c levels for patients with type 2 diabetes?; 3) Does regular self-monitoring of blood glucose reduce the frequency of hypoglycemia in patients with type 2 diabetes?; 4) Is there evidence that different frequencies of testing result in differences in improvements in A1c?

Download or read book Diabetes Education with a Focus on Blood Glucose Self management written by Jennifer M. Young (RN FNP-C) and published by . This book was released on 2022 with total page 102 pages. Available in PDF, EPUB and Kindle. Book excerpt: This quality improvement project was conducted to evaluate whether a focused educational session on self-management of blood glucose monitoring increased the frequency of monitoring for adult type II diabetics who were not taking insulin therapy. The purpose of this improvement project was to add to the body of research from this project. Currently, there are no recommendations for people with type II diabetes who are not taking insulin therapy regarding monitoring their blood glucose. This quantitative project was conducted online to reduce face-toface contact during the COVID-19 pandemic. It was conducted online through diabetes support groups found on Facebook. Permission was obtained through the group administrators to post in the diabetes support groups and obtain participants. Participants were given information for the quality improvement project and were given a consent form. A pre- and postquestionnaire were utilized. These questionnaires were designed identically for statistical purposes. An educational video provided a focused educational session on self-monitoring blood glucose. There was a total of five participants utilized. A Wilcoxon signed-rank test was utilized for statistical analysis. The data was found to be not statistically significant except for one question. Question 15 was noted to be statistically significant in that participants were noted to have a decrease in physical activity to obtain optimal blood glucose levels after viewing the focused educational session. Keywords: type II diabetes, blood glucose monitoring, self-management, noninsulindependent type II diabetics, focused education

Download or read book The Learning Healthcare System written by Institute of Medicine and published by National Academies Press. This book was released on 2007-06-01 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: As our nation enters a new era of medical science that offers the real prospect of personalized health care, we will be confronted by an increasingly complex array of health care options and decisions. The Learning Healthcare System considers how health care is structured to develop and to apply evidence-from health profession training and infrastructure development to advances in research methodology, patient engagement, payment schemes, and measurement-and highlights opportunities for the creation of a sustainable learning health care system that gets the right care to people when they need it and then captures the results for improvement. This book will be of primary interest to hospital and insurance industry administrators, health care providers, those who train and educate health workers, researchers, and policymakers. The Learning Healthcare System is the first in a series that will focus on issues important to improving the development and application of evidence in health care decision making. The Roundtable on Evidence-Based Medicine serves as a neutral venue for cooperative work among key stakeholders on several dimensions: to help transform the availability and use of the best evidence for the collaborative health care choices of each patient and provider; to drive the process of discovery as a natural outgrowth of patient care; and, ultimately, to ensure innovation, quality, safety, and value in health care.

Download or read book Self monitoring of Blood Glucose in Patients with Type 2 Diabetes Mellitus written by United States. Department of Veterans Affairs. Health Services Research and Development Service and published by . This book was released on 2007 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Self monitoring of Blood Glucose in Type Two Diabetes written by C. Clar and published by . This book was released on 2010 with total page 140 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Self monitoring of Blood Glucose in Patients with Type 2 Diabetes Mellitus written by United States. Department of Veterans Affairs. Health Services Research and Development Service and published by . This book was released on 2007 with total page 46 pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: Diabetes is a prevalent and costly disease in Veterans. Control of blood glucose is an important VA objective. Self-monitoring of blood glucose (SMBG) is advocated as a method to better achieve control. The Key Questions were: Key Question 1. Is regular SMBG effective in achieving target A1c levels for patients with type 2 diabetes? Key Question 2. Is regular SMBG effective in maintaining target A1c levels for patients with type 2 diabetes? Key Question 3. Does regular SMBG reduce the frequency of hypoglycemia in patients with type 2 diabetes? Key Question 4. Is there evidence that different frequencies of testing result in differences in improvements in A1c? METHODS: We searched PubMed from 2004-2006 using standard search terms. We performed an update search in July 2007. Titles, abstracts, and articles were reviewed in duplicate by physicians trained in the critical analysis of literature. Data were extracted by quantitative analysts. Pooled analyses were performed for trials with A1c outcomes at six months and 12 months or greater of follow-up. All other data were narratively summarized. RESULTS: We screened 52 titles, 14 were rejected, and we performed a more detailed review on 38 articles. From this, we identified 14 randomized controlled trials (RCTs) that measured the effect of SMBG compared to a group not receiving SMBG and monitored A1c levels with at least three months of follow-up. Four trials were excluded; one because it presented duplicate data and three because they evaluated SMBG in both the control and intervention groups, leaving 10 trials contributing to the efficacy analysis. We identified five observational studies assessing effectiveness in diabetic Veterans.

Download or read book Blood Glucose Self monitoring in Type 2 Diabetes written by Andrew J. Farmer and published by . This book was released on 2009 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book The Utility of Self monitoring of Blood Glucose in the Management of Type II Diabetes written by Margaret Sue Muldoon and published by . This book was released on 1994 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book The SMBG Study Structured Self monitoring of Blood Glucose in Non insulin Treated Type 2 Diabetes written by Parsons Sharon and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The SMBG Study: Structured Self-Monitoring of Blood Glucose in Non-insulin Treated Type 2 DiabetesBackground: The benefit of Self-Monitoring of Blood Glucose (SMBG) in people with non-insulin treated type 2 diabetes (T2DM) continues to be debated with inconsistent evidence from randomised controlled trials and observational studies. There is a growing consensus that structured SMBG, whereby the person with diabetes and health care provider are educated to detect patterns of glycaemic abnormality and take appropriate action according to the blood glucose profiles, can prove beneficial in terms of glycaemic control and overall well-being.Aim: To determine whether structured SMBG with or without additional telecare support, can enable poorly controlled, non-insulin treated people with T2DM to better manage their diabetes.Method: A 12 month, multi-centre, randomised controlled trial was conducted in people with established (>1 year) T2DM not on insulin therapy, with poor glycaemic control (HbA1cu22657.5% u2264 13%). A total of 666 participants were recruited from 16 primary and secondary care sites across Wales and England. 446 people were randomised into one of three groups; Group 1 (G1), a control group receiving usual diabetes care; Group 2 (G2), carried out structured SMBG with clinical review every 3 months; Group 3 (G3), carried out structured SMBG with monthly telecare support from a trained study nurse. Participants in both SMBG groups (G2 & G3) and all healthcare professionals involved in the study received standardised training including SMBG technique, glycaemic pattern recognition and the use of the clinical algorithms. The testing regimen consisted of paired testing pre and 2 hours post breakfast and main meal, 2 days each week. This was increased to recording a 7 point profile for 3 days the week prior to the 3 monthly study visit. At each study visit clinical measurements, such as weight, waist circumference and BMI were recorded, and a blood sample taken to measure HbA1c and total cholesterol. Quality of life measures were also administered at each visit along with questionnaires to gauge attitudes towards SMBG. Blood glucose management was based on SMBG results alone for those in Groups 2 & 3 with all participants and healthcare professionals involved in the study blinded to the HbA1c results taken as part of the study visit. The final HbA1c result was reported once the participant completed the study.Results: Of the 446 participants randomised, 259 were male (58%) with mean (range) age 61.7 (27 - 80)years. 267 participants (60%) had diabetes for 5 years or more with 85 (19%) having complications associated with the condition. There were no significant differences in the demographic profiles of the 3 groups. The primary outcome measure was HbA1c at 12 months and the mean (SD) HbA1c at randomisation was 8.6(1.1)%, 8.5(1.1)%, 8.6(1.2)% for Groups 1, 2 & 3 respectively. 323 participants attended the final visit at 12 months when the mean (sd) HbA1c was 8.3(1.31)% (n=116, p

Download or read book Self Monitoring of Blood Glucose in Non insulin treated Type 2 Diabetes written by NHS Diabetes Working Group and published by . This book was released on 2010 with total page 16 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Prediction Methods for Blood Glucose Concentration written by Harald Kirchsteiger and published by Springer. This book was released on 2015-11-25 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book tackles the problem of overshoot and undershoot in blood glucose levels caused by delay in the effects of carbohydrate consumption and insulin administration. The ideas presented here will be very important in maintaining the welfare of insulin-dependent diabetics and avoiding the damaging effects of unpredicted swings in blood glucose – accurate prediction enables the implementation of counter-measures. The glucose prediction algorithms described are also a key and critical ingredient of automated insulin delivery systems, the so-called “artificial pancreas”. The authors address the topic of blood-glucose prediction from medical, scientific and technological points of view. Simulation studies are utilized for complementary analysis but the primary focus of this book is on real applications, using clinical data from diabetic subjects. The text details the current state of the art by surveying prediction algorithms, and then moves beyond it with the most recent advances in data-based modeling of glucose metabolism. The topic of performance evaluation is discussed and the relationship of clinical and technological needs and goals examined with regard to their implications for medical devices employing prediction algorithms. Practical and theoretical questions associated with such devices and their solutions are highlighted. This book shows researchers interested in biomedical device technology and control researchers working with predictive algorithms how incorporation of predictive algorithms into the next generation of portable glucose measurement can make treatment of diabetes safer and more efficient.

Download or read book Psychosocial Care for People with Diabetes written by Deborah Young-Hyman and published by American Diabetes Association. This book was released on 2012-12-25 with total page 330 pages. Available in PDF, EPUB and Kindle. Book excerpt: Psychosocial Care for People with Diabetes describes the major psychosocial issues which impact living with and self-management of diabetes and its related diseases, and provides treatment recommendations based on proven interventions and expert opinion. The book is comprehensive and provides the practitioner with guidelines to access and prescribe treatment for psychosocial problems commonly associated with living with diabetes.

Download or read book Type 2 Diabetes written by Mira Siderova and published by BoD – Books on Demand. This book was released on 2019-11-27 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt: The emergence of type 2 diabetes as a global pandemic is one of the major challenges to health care in the 21st century. This book contains chapters covering the newest scientific concepts in the pathogenesis of type 2 diabetes, and the complications and approaches in diagnosis and glycemic control. Part of the book is dedicated to the effect of diabetes on the mental functions and treatment strategies to prevent cognitive decline. Glucose monitoring, using cutting-edge technologies, is outlined, as well as the role of health information technologies in diabetes management. Updates on glucose lowering therapy are presented, and the new emerging class of SGLT2 inhibitors is discussed in detail. The purpose of this book is to disseminate knowledge on type 2 diabetes and to contribute to the professional development of physicians, internists, endocrinologists, medical students, and research scientists in diabetes.

Download or read book Type 1 Diabetes An Issue of Endocrinology and Metabolism Clinics of North America E Book written by Osagie Ebekozien and published by Elsevier Health Sciences. This book was released on 2024-01-30 with total page 270 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this issue of Endocrinology and Metabolism Clinics of North America, guest editor Dr. Osagie Ebekozien brings his considerable expertise to the topic of Type 1 Diabetes. Top experts in the field provide a timely update on type 1 diabetes care in children and adults, and provide recommendations for treatment and improving access to care. Contains 14 relevant, practice-oriented topics including type 1 diabetes population health improvement; access to care for type 1 diabetes; emerging technologies and therapeutics; social determinants of health (SDOH) in type 1 diabetes; COVID-19 and type 1 diabetes; and more. Provides in-depth clinical reviews on type 1 diabetes, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

Download or read book The CSIRO Low Carb Diet written by Grant Brinkworth and published by Macmillan Publishers Aus.. This book was released on 2017-02-28 with total page 312 pages. Available in PDF, EPUB and Kindle. Book excerpt: BOOK 1 OF THE #1 BESTSELLING LOW-CARB DIET The CSIRO Low-carb Diet is based on a major scientific study that has successfully helped Australians lose weight and improve their overall health. Written for easy implementation at home, this book contains: - a straightforward scientific explanation of why and how the diet works so well - a detailed outline of your daily allowances for carbs, healthy fats and protein - 12 weekly meal plans to help you reduce your carb intake initially, then increase it slightly for dietary flexibility - 80 delicious recipes with all daily allowances calculated and explained - a fully illustrated exercise section to show you how to combine movement with healthy eating to maximise health outcomes. There is also detailed information about the benefits of the diet for those suffering from a range of metabolic conditions, including heart disease, high cholesterol and type 2 diabetes. Accessible, affordable and achievable, this is a fully researched approach to better eating and improved health from Australia's peak science organisation. This is a specially formatted fixed layout ebook that retains the look and feel of the print book.

Download or read book Evidence based Management of Diabetes written by Giten Vora, and published by tfm Publishing Limited. This book was released on 2012-10-01 with total page 549 pages. Available in PDF, EPUB and Kindle. Book excerpt: The clinical management of patients with diabetes is rapidly evolving. Evidence-based Management of Diabetes provides a succinct summary of a range of topics, including areas where there is already well developed evidence for a particular treatment, but also those areas where the evidence is perhaps doubtful or there is some associated controversy or ambiguity. Where possible throughout the book treatment recommendations are given based on the available evidence and practice guidelines. The book also highlights the gaps in evidence where further research is needed. In the practice of diabetes care, there are many issues influencing practitoners currently. This book addresses many of the most pertinent issues concerning delivery of diabetes care. The authors are internationally renowned experts in the field of diabetes care who successfully and succinctly present state-of-the-art reviews based on the medical evidence designed to help the clinician be as best informed as possible in the care of patients with diabetes.