Diabetes Centres (diabetes + centre)

Distribution by Scientific Domains

Selected Abstracts

Audit of time taken to heal diabetic foot ulcers

DPodM, Linda Robertshaw BSc (Hons), SRCh Senior I Podiatrist
Abstract Since the Newcastle Diabetes Centre opened in 1997, the three podiatrists working in the centre have established specialised ulcer clinics to see patients with foot ulcers at least twice per week. As this was a new service, a baseline audit was proposed to provide a level with which to compare future developments. The standard was set at 80% of diabetic foot ulcers to be healed within six months of referral to the podiatry team. All patients with diabetes presenting at the Podiatry Department, Newcastle Diabetes Centre, with a new foot ulcer during the period from 1 December 1997 to 31 May 1998 were entered into the audit. The ulcers were then monitored for up to six months until the end of the audit period on 30 November 1998. The result was that 85% of diabetic foot ulcers healed within six months, which exceeds the standard set at 80%. The average time taken to heal diabetic foot ulcers was eight weeks. Copyright © 2001 John Wiley & Sons, Ltd. [source]

Model simulation of the patient flow through a screening centre for diabetic retinopathy

Anja B. Hansen
Abstract. Purpose:,To construct a quantitative, flexible and simplified mathematical model of the patient flow through the Eye Clinic at the Steno Diabetes Centre (SDC) in order to enable rational dimensioning and assess the effects of modifications. Methods:,Patient data were drawn from the Eye Care database at the SDC. A simple patient flow model was constructed, allowing simultaneous adjustments of all variables, and the model was tested. Two scenarios were simulated: (1) adjusting the algorithm that assigns the follow-up intervals, and (2) increasing the population size to include all patients with diabetes in Copenhagen County. Results:,The model can describe the patient flow under steady state conditions, but is less precise in predicting transient changes with the present set-up. Accordingly all simulations were run for a substantial number of iterations. The two scenarios illustrate the usefulness of the model by calculating the required photographic examination capacity for the specific population, thereby allowing better estimations of future dimensioning of the organization. Conclusion:,The study presents a patient flow model that can be used to illustrate the effects of proposed changes prior to their implementation, specifically with respect to the capacity of the system. [source]

Burns to persons suffering from diabetes: a systemic preventive approach

MScN (edu), Ma'en Zaid Abu-Qamar Dnurs
Aims. To report the findings of an investigation of patients with diabetes and burns, with emphasis on implications for practice: primary and secondary preventions. Background. Diabetes and burns are complex conditions with multi-system involvements, which worsen outcomes for patients, and their management. This research investigated outcomes for patients and diabetes management. Methods. Data on outcomes were obtained from records of patients hospitalised for foot burns in an Australian hospital from 1999,2004. A questionnaire survey design was employed to obtain information on how clinicians in burns units manage diabetes. SPSS was used to analyse data obtained from both resources. Comments written in the questionnaire were analysed using relational analysis. Results. Of the 64 patients, 12 were with diabetes and 52 were without diabetes. Those with diabetes were more likely to sustain contact foot burns (58·3% Diabetes Mellitus vs. 13·5% non Diabetes Mellitus ,2 = 11·487, p = 0·002). The duration of hospitalisation was statistically significantly longer among patients with diabetes compared with those without diabetes (U = 169, p = 0·014); although the two groups were not statistically significant different in terms of severity of burns and received treatment. Of the 29 clinical leaders, 21 (72%) indicated that they regularly provided care to patients with diabetes. Most respondents (n = 15; 58%) reported that new plans need to be initiated to accommodate the combined insult of diabetes and burns. Diabetes centres were located in all participating sites; but not always involved in the process of care. Conclusion. The co-existence of diabetes and burns worsens outcomes for patients, and complicates management plans. Optimal management can be achieved via a multidisciplinary approach starting with glycaemic control, and continued to aggressive management of diabetes and burns. Relevance to clinical practice. Preventive measures should start with tight glycaemic control, identification and avoidance of sources of trauma, early detection and treatment, and continue to aggressive inpatient management of patients with both diabetes and a burn injury. [source]

Lactate levels in Asian patients with type 2 diabetes mellitus on metformin and its association with dose of metformin and renal function

Vivien C. C. Lim
Summary Aim:, Our aims are to discover the average fasting plasma lactate level (FPL) in Asian patients with type 2 diabetes mellitus on metformin, with or without renal impairment and whether FPL is associated with the total daily dose of metformin (Tmet) and the degree of renal impairment in these patients. Methods:, We conducted an observational cross-sectional study of Asian patients with type 2 diabetes, using measurements of FPL levels and glomerular filtration rate (GFR) calculated, using the abbreviated modification of diet in renal disease (MDRD) formula. The association between FPL, Tmet, GFR and other potential predictors was analysed. Results:, A total of 97 subjects were recruited from our diabetes centre between July 2005 and February 2006. Sixty (61.9%) of the subjects were males; 69 (71.1%) Chinese, 21 (21.6%) Malays and 6 (6.2%) Indians. The mean (SD) age was 58.8 years (10.7) and the mean body mass index was 27.1 kg/m2 (5.3). The mean FPL was 1.8 mmol/l (0.9) with 20 (20.6%) of subjects having an FPL beyond the upper limit of our reference range of 2.2 mmol/l. The mean FPL (two SE) of subjects with Tmet of , 1000, 1001,2000 and > 2000 mg were 1.7 mmol/l (0.2), 1.6 mmol/l (0.2) and 2.1 mmol/l (0.5) respectively, (p = 0.119). The mean FPL of subjects with GFR of < 60, 60,90 and > 90 ml/min/1.73 m2 was 1.7 mmol/l (0.3), 1.8 mmol/l (0.3) and 1.8 mmol/l (0.4) respectively, p = 0.757. Among the potential predictors analysed, aspartate transaminase (p = 0.001) was found to be significantly associated with FPL. Conclusions:, Our study shows no correlation between Tmet and GFR with FPL in Asian type 2 diabetic patients on metformin. [source]

The prevalence and predictors of erectile dysfunction in men with newly diagnosed with type 2 diabetes mellitus

Adel Al-Hunayan
OBJECTIVE To determine the prevalence of and risk factors for erectile dysfunction (ED) in men newly diagnosed with type 2 diabetes mellitus (DM). PATIENTS AND METHODS All consecutive samples of men newly diagnosed with type 2 DM attending the diabetes centre in the capital of Kuwait were included in the study. Face-to-face interviews with the men were conducted using the International Index of Erectile Function (IIEF)-5 questionnaire. A threshold IIEF-5 score of <21 was used to identify men with ED. Pertinent clinical and laboratory characteristics were collected. RESULTS Of 323 men with newly diagnosed type 2 DM, 31% had ED; comparing potent men and men with ED, there were statistically significant differences for smoking, duration of smoking, hypertension, education level, body mass index and serum glycosylated haemoglobin level. Among these, age was the most important risk factor identified by multivariate logistic regression. CONCLUSION About a third of men with newly diagnosed type 2 DM had ED; this was associated with many variables, but most notably with age at presentation. [source]

Joint liaison psychiatry,diabetes clinic: a new specialist service

C. Mitchell
Summary Aims Specialist diabetes clinics have an established role in prevention and management of complications. As psychological problems are usually treated separately from diabetes centres, the role of a specialist psychiatrist within a teaching hospital was assessed. The aims of the study were to describe referral patterns, specific psychiatric conditions and treatments offered. Results During weekly outpatient sessions over a 12-month period, 31 patients were referred with a wide range of psychiatric diagnoses. One-third of patients were seen on the day and two-thirds within 2 weeks of referral. Treatments included anti-depressant medication, counselling and cognitive behaviour therapy. Successful discharge was obtained in 10 subjects and eight were undergoing continued treatment. Conclusions The range of specific diagnoses requiring psychiatric supervision supported the role of specifically trained personnel as seen in a joint liaison psychiatry,diabetes service. Keywords diabetes mellitus, joint clinic, liaison psychiatry [source]

Long-term outcomes after a structured hypertension education programme for patients with diabetes and hypertension

B Osterbrink Nurse Teacher, Diabetes Counsellor, Principal of the Academy of Health Professions
Abstract A structured hypertension treatment and education programme (HTEP) was developed in the Düsseldorf area in the 1990s for patients with diabetes mellitus and hypertension and was found to be effective in a randomised controlled trial. The German Association of Diabetes Education and Counselling Professions (VDBD) implemented the HTEP all over Germany in order to optimise the care of patients with diabetes and hypertension. The objectives of the HTEP are to enable patients to gain knowledge of hypertension, to participate actively in their treatment to improve blood pressure (BP) and metabolic control and to self-measure their BP. The implementation consisted of two stages. The first stage comprised the training of 312 diabetes counsellors (DCs). During the second stage 473 patients with type 1 or type 2 diabetes and hypertension in 35 diabetes centres throughout Germany received the HTEP including instructions in BP self-measurement. The HTEP consists of four units each one with a duration of 90 minutes covering the topics: hypertension, BP self-monitoring according to the standards of the German Hypertension League, antihypertensive medication including effects and side effects, recommendations to moderate exercise, weight reduction, dietary advice with reference to reduction of salt and alcohol and normalising the intake of protein. These patients participated in a prospective non-experimental study with a follow up of three years investigating the long-term outcomes of the HTEP in uncontrolled settings. The DCs assessed the accuracy of patients' self-monitoring by parallel measurement. Assessments included questionnaires evaluating patients' understanding of hypertension and metabolic control. The mean BP monitored by the DC fell from 150/85mmHg to 147/80mmHg (p<0.0001). The accuracy of self-measurements increased from 76% to 86% (p<0.005) and mean self-measurement readings decreased from 142/81mmHg to 139/78mmHg. HbA1c fell significantly from 7.9±1.6% to 7.3±1.1% (mean ± SD, p<0.001) and total cholesterol was lowered from 241±67.1mg/dl to 200±40.4mg/dl (p<0.001). Patients' knowledge of hypertension increased from 62% before the intervention to 72% after three years' follow up. Patients over 70 years showed less knowledge than younger patients (p<0.005). It was concluded that the HTEP is effective in improving BP, metabolic control and knowledge of hypertension. It enables patients to measure their BP precisely and regularly. Copyright © 2005 FEND. [source]

Long-term follow-up of women with gestational diabetes mellitus: The South Australian Gestational Diabetes Mellitus Recall Register

Background:, Women who have had gestational diabetes mellitus (GDM) are at increased risk of developing type 2 diabetes. Early detection and management of type 2 diabetes are important for reducing associated complications and costs. Aims:, To evaluate an existing register for long-term follow-up of women who have been diagnosed with GDM. Methods:, Recruitment to the GDM Recall Register began at the diabetes centres of two hospitals in South Australia from July 2002, and was expanded to include a third hospital from September 2005. Women enrolled on the Register are sent an annual letter reminding them that they are at increased risk of developing type 2 diabetes and encouraging them to get their blood glucose checked. An update form is also included for women to complete and return to the Register. Results:, As at 30 June 2009, 817 women were enrolled on the Register. Of women diagnosed with GDM at the participating hospital sites, recruitment to the Register was 68.4% in 2002 and 64.4% in 2007. Of the 429 women who had been sent their first reminder letter, 46.4% had returned the update form. Of these, 56.3% had undergone a glucose test for diabetes. Two women reported developing type 2 diabetes. Conclusions:, Expansion of the GDM Recall Register is likely to result in increased opportunities for early detection of diabetes for this high-risk group in South Australia, therefore allowing earlier intervention and treatment to prevent or reduce serious, costly diabetes-related complications. [source]