Academic literature on the topic 'Diabetes eye exams'
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Journal articles on the topic "Diabetes eye exams"
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Wilcox, Samuel, Hayrettin Okut, Robert Badgett, Stephanie Hassouneh, and Elizabeth Ablah. "Effectiveness of Flow Sheet Implementation on Diabetes Progression Screening at a Student-Run Free Clinic." Kansas Journal of Medicine 13 (November 24, 2020): 285–89. http://dx.doi.org/10.17161/kjm.vol13.13423.
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Introduction: Diabetes mellitus (DM) disproportionately affects people with low socioeconomic-status (SES). Student-run free clinics (SRFC) aim to care for low SES populations and experience high clinician turnover. Flow sheets have been used to improve care for those with diabetes, yet no research has assessed the use of such a flow sheet in a SRFC. The aim of this project was to determine if use of a flow sheet improved care for people with DM in an SRFC.
Methods: Charts from all patients receiving care for DM at one SRFC in the year before (n=53) and after (n=56) implementation of the flow sheet were reviewed. Pre and post group comparisons and post subgroup comparisons were made for glycosylated-hemoglobin (HgbA1c), microalbumin, and foot and eye exams.
Results: During a one-year period, a larger proportion of patients who received care post flow sheet introduction received at least two HgbA1c tests (53%), a microalbumin test (46%), and a foot-exam (46%) compared to those receiving care before the flow sheet (28%, 2%, and 25%, respectively). There was no difference in proportions of patients undergoing eye exams. In post subgroup analysis, flow sheets were used for 50% of patients, and patients who received care with the flow sheet were more likely to receive at least two HgbA1c tests and a foot exam per year.
Conclusions: Our study suggests that flow sheets can improve the process of care for patients with diabetes in a SRFC. A systematic integration of the flow sheet is being implemented in the SRFC now.
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Comer-HaGans, DeLawnia, Shamly Austin, Zo Ramamonjiarivelo, and Alicia K. Matthews. "Diabetes Standard of Care Among Individuals Who Have Diabetes With and Without Cognitive Limitation Disabilities." Diabetes Educator 46, no. 1 (December 24, 2019): 94–107. http://dx.doi.org/10.1177/0145721719896262.
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Purpose The purpose of this study is to examine diabetes standard of care among individuals who have diabetes with and without cognitive limitation disabilities (CLDs). Individuals with CLDs are more likely to develop diabetes and less likely to participate in diabetes standard of care services compared to those without CLDs. Methods We used pooled cross-sectional data (2011-2016) from the Household Component of the Medical Expenditure Panel Survey (HC-MEPS). Dependent variables were utilization of dilated eye exams, foot checks, A1C blood tests, and engagement in moderate or vigorous physical exercise 5 times per week. Our independent variable was diabetes with CLDs vs diabetes without CLDs. We controlled for predisposing, enabling, and need factors. Results Findings suggest that individuals with diabetes and CLDs were less likely to engage in moderate or vigorous physical exercise 5 times per week compared to individuals without CLDs. For other diabetes care services, individuals with CLDs are as likely to participate in health services utilization as those without CLDs. Conclusions Our study supports research that indicates individuals with diabetes and CLDs were less likely to participate in physical exercise compared to individuals without CLDs. Conversely, individuals with diabetes and CLDs were just as likely to receive a dilated eye exam, have their feet checked, and have their A1C checked as individuals without CLDs, which is a very encouraging finding.
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Hillenbrand, Molly, and Senu Apewokin. "1166. Evaluating the Impact of the 2016 Candidemia Guidelines on the Incidence of Ocular Complications of Candidemia." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S609. http://dx.doi.org/10.1093/ofid/ofaa439.1352.
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Abstract Background The incidence of Candida bloodstream infections has risen over the last several decades. Complications of candidemia include endogenous fungal endophthalmitis which can result in devastating outcomes including vision loss. In 2015, the IDSA guidelines were updated to recommend echinocandins as initial therapy for candidemia. Given the poor ocular penetration of echinocandins there has been some concern this change may portend an increased incidence of ocular complications in candidemic patients. We sought to examine whether patients who received empiric echinocandin therapy developed higher rates of ophthalmic complications of candidemia. Methods We identified patients in our healthcare system who had blood cultures positive for Candida species and a completed ophthalmology consult between January 1, 2014 and April 30, 2019. Chi-squared analysis was used to compare antifungal prescribing patterns before and after release of the updated IDSA guidelines. We assessed whether the switch to empiric echinocandin therapy as directed by the guidelines was associated with higher rates of abnormal eye exams. Results 47 patients treated before the guideline change were compared to 57 patients treated after the guideline change. There was no significant difference in age, gender, or comorbid diabetes and hypertension between the groups. Before the guideline change, 24/47 (51%) of patients received eye-penetrating antifungals. This decreased to 21/57 after the updated guideline (37%, p=0.21). The percentage of patients with positive eye exams was nearly equal before and after the updated guidelines, 10/47 (21%) before vs 13/57 (22%) after (p=1). After the guideline change, 7/21 (33%) of the patients treated with penetrating antifungals had positive eye exams vs 6/36 (16%) who received echinocandins (p=0.19). Conclusion Echinocandins are known to have poor ocular penetration yet our data demonstrate no change in the incidence of ophthalmic complications of candidemia after the 2016 guideline endorsed echinocandins as empiric therapy. The prevalence of positive eye exams throughout our study period was 22%, suggesting ongoing utility for these exams. Ongoing investigation is necessary to confirm and further study these findings. Disclosures All Authors: No reported disclosures
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Chen, Roxana, Allen Cheadle, Donna Johnson, and Bonnie Duran. "US Trends in Receipt of Appropriate Diabetes Clinical and Self-care From 2001 to 2010 and Racial/Ethnic Disparities in Care." Diabetes Educator 40, no. 6 (August 20, 2014): 756–66. http://dx.doi.org/10.1177/0145721714546721.
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Purpose The purpose of this study was to examine trends in the receipt of 8 recommended diabetes clinical and self-care indicators from 2001 to 2010 and assess racial/ethnic disparities in care. Methods This observational study examined receipt of A1C tests, annual eye and foot exams, flu vaccination, diabetes self-management education (DSME), exercise, self-monitoring of blood glucose (SMBG), and self feet examinations among US adults with diabetes using national survey data from 2001 to 2010. Analyses included estimating proportions for each indicator by year, testing differences in magnitude of change from 2001 to 2010 by race/ethnicity, and regression models to assess changes in care over time and factors associated with care. Results There were significant increases from 2001 to 2010 in A1C tests, annual foot exams, flu shots, DSME, and SMBG but declines in eye and self feet exams. DSME was positively associated with receipt of several care indicators. However, only half of respondents received DSME. White and black non-Hispanics, respectively, experienced improvements in at least 3 indicators. Hispanics experienced a significant increase in exercise but were consistently less likely than whites to receive or engage in most care. Conclusions While improvements in several indicators were observed, patterns varied by race/ethnicity, with Hispanics falling short on most measures. DSME was strongly associated with most care and demonstrates the potential to improve receipt of recommended care by increasing DSME participation. With the Affordable Care Act (ACA), health professionals have a prime opportunity to leverage ACA provisions to increase access to recommended services, including DSME.
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Zhou, Yifan, Xiaowen Li, Qinglei Sun, Jin Wei, Haiyun Liu, Keyan Wang, and Jianfeng Luo. "Adherence to Annual Fundus Exams among Chinese Population with Diagnosed Diabetes." Journal of Clinical Medicine 11, no. 22 (November 21, 2022): 6859. http://dx.doi.org/10.3390/jcm11226859.
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Adherence to annual fundus examinations in the Chinese population with diabetes and its correlates have not been investigated. The present study obtained data for the first nationally representative survey in China, China Health and Retirement Longitudinal Survey (CHARLS), which collected a wide range of data every 2 years, including demographic, socioeconomic, medical and lifestyle-related information. The adherence rates to annual fundus exams across four waves (2011–2018) were assessed. Univariate and multivariable logistic regressions were used to determine factors associated with adherence. The adherence rates to annual fundus examinations of ou study population were 23.6% in 2011, 15.3% in 2013, 17.5% in 2015 and 21.5% in 2018, respectively. Consistent results over four waves showed that non-adherent patients had a relatively lower educational level, insufficient diabetes medication use, fewer non-medication treatments and irregular physical examination compared to those who were adherent to the annual fundus exam (all p values < 0.05). These variables were further identified as factors associated with adherence according to univariate and multivariate logistic regression analyses (all p values < 0.05). The present study provides explicit evidence that the adherence rate to annual fundus examinations among Chinese population with diabetes is worryingly low. Insufficient educational attainment, especially specific diabetes education, has a negative impact on patients’ adherence to clinical guideline for eye health.
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Vaughan, Elizabeth M., Craig A. Johnston, Victor J. Cardenas, Jennette P. Moreno, and John P. Foreyt. "Integrating CHWs as Part of the Team Leading Diabetes Group Visits: A Randomized Controlled Feasibility Study." Diabetes Educator 43, no. 6 (October 19, 2017): 589–99. http://dx.doi.org/10.1177/0145721717737742.
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Purpose The purpose of the study was to evaluate the feasibility of integrating Community Health Workers (CHWs) as part of the team leading diabetes group visits. Methods This was a randomized controlled study that integrated CHWs as part of the team leading diabetes group visits for low-income Hispanic adults (n = 50). Group visits met for 3 hours each month for a 6-month duration. Main measures included baseline and 6-month clinical outcomes (ie, A1C, lipids), concordance with 8 standard of care guidelines (ie, screens for cervical, breast, and colon cancer) from the US Preventive Task Force and American Diabetes Association, and participant acceptability. Results Compared to control participants, the intervention group resulted in significantly better clinical outcomes or guideline concordance for the following areas: target A1C levels, retinal eye exams, diabetes foot exams, mammograms, and urine microalbumin. Significantly more individuals in the control group gained weight, whereas a greater number of participants in the intervention group lost weight. Intervention participants found the group visits highly acceptable. Conclusions Integrating CHWs as part a comprehensive diabetes group visit program is a feasible and effective system-level intervention to improve glycemic control and achieve guideline concordance.
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Gediminas, Raila, Liseckienė Ida, Jarusevičienė Lina, and Leonas Valius. "Guideline Adherence and the Factors Associated with Better Care for Type 2 Diabetes Mellitus Patients in Lithuanian PHC: Diabetes Mellitus Guideline Adherence in Lithuania PHC." Open Medicine Journal 6, no. 1 (August 30, 2019): 50–57. http://dx.doi.org/10.2174/1874220301906010050.
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Background: Type 2 diabetes mellitus is one of the most common chronic conditions, which requires appropriate management and care at PHC level, which is described in guidelines. However, guideline adherence at the international arena is insufficient and little is known about the reasons for guideline non-adherence. Objective: The aim of the survey was to analyse to what extent the Lithuanian family practitioners adhere to diabetes guidelines in order to compare to international data and to discover the factors associated with better diabetes care. Methods: The present study is a part of EUPRIMECARE Project, which sets out to develop a framework aiming at the analysis of PHC across Europe. The sample strategy was based on an unequal probability sampling design. An audit of 4 public and 6 private PHC medical records of the year 2011 was carried out in Kaunas region, clinical records of 382 diabetes type 2 patients were reviewed. Demography, diseases and diabetes performance indicators data were collected using a uniform template. Binary and multivariable logistic regression analyses were used in the investigation of the factors related to better diabetes guideline adherence. Results: Three guideline adherence levels were identified: high performance (performed in more than 90% cases) - BP measurement and HbA1c exam; good performance (performed in more than 50% cases) - ECG examination and serum creatinine check; insufficient performance (performed in less than 50% of cases) - annual endocrinologist consultation, eye fundus and foot examinations, LDL check and BMI calculation. Insufficient glycaemic control was positive associated with increased endocrinologist consultation and foot exam rates, elevated BP demonstrated the positive effect to creatinine check rate, multimorbidity had positive association to the annual eye, ECG, creatinine check rates; frequent FP attendance showed no positive effect on process indicators. Rural patients have a negative association to foot and ECG exam rates compared to urban patients. In a stepwise logistic regression model, 3 dependent variables had statistically significant impact on overall diabetes care indicator performance: negative - rural location of patients (OR 0.4, 95% CI 0.2-0.8), elevated mean BP (OR 0.6, 95% CI 0.4-0.9); positive - multimorbidity (OR 2.0, 95% CI 1.2-3.4). Conclusion: Guideline adherence for T2DM is not optimal in Lithuanian PHC. The best are BP and HbA1c checks. Suboptimal are BMI and LDL annual checks. The situation with these is almost the same as in other European countries. The better guideline adherence has been observed in urban (foot exam, ECG exam), multimorbidity (eye, ECG, creatinine exams), controlled by means of BP patients (serum creatinine test).
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Armor, Becky L., Mark L. Britton, Vincent C. Dennis, and Nancy A. Letassy. "A Review of Pharmacist Contributions to Diabetes Care in the United States." Journal of Pharmacy Practice 23, no. 3 (May 28, 2009): 250–64. http://dx.doi.org/10.1177/0897190009336668.
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This paper summarizes the outcomes associated with pharmacist involvement in diabetes care in all pharmacy practice settings. Published literature was identified through a search of MEDLINE (1960 to September, week 1, 2008) and International Pharmaceutical Abstracts using the search terms “pharmacist,” “pharmaceutical care,” and “diabetes mellitus.” Only articles reporting clinical or behavior change outcomes were selected for review; papers written outside the United States and citations only in abstract form were not reviewed. The specific data extracted included the following: practice setting, model of care, roles of the pharmacist, study design, number of patients studied, duration of the evaluation, and documented outcomes such as changes in hemoglobin A1c values, adherence to standards of care (lipids, blood pressure, eye exams, foot exams, aspirin use), and changes in quality of life. The greatest improvements in hemoglobin A1c values tend to be observed when pharmacists work in collaborative practice models. Growing evidence demonstrates that pharmacists, working as educators, consultants, or clinicians in partnership with other health care professionals, are able to contribute to improved patient outcomes.
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Comer-HaGans, DeLawnia, Shamly Austin, Zo Ramamonjiarivelo, and Ledric D. Sherman. "Diabetes Self-Management Among Individuals With Diabetes and Physical Disabilities." Science of Diabetes Self-Management and Care 47, no. 4 (August 2021): 264–78. http://dx.doi.org/10.1177/26350106211024136.
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Purpose The purpose of this study was to examine diabetes self-management behavior among individuals who have diabetes living with and without physical limitations. Methods Pooled cross-sectional data (2011-2016) from the Household Component of the Medical Expenditure Panel Survey was used. Dependent variables were utilization of dilated eye exams, foot checks, at least 1 dental checkup annually, treating diabetes with oral medication, treating diabetes with insulin injections, and engagement in moderate or vigorous physical exercise 5 times per week. The independent variable was diabetes with physical limitations compared with diabetes without physical limitations. The study controlled for predisposing, enabling, and need factors. Results Findings indicate that individuals with diabetes and physical limitations were less likely to engage in moderate or vigorous physical exercise 5 times per week, have at least 1 annual dental checkup, and treat their diabetes orally with medication. Conclusions Self-management behavior was poor among individuals with diabetes and physical limitations. Environmental barriers may partially contribute to reasons why individuals with diabetes and physical limitations do not engage in diabetes self-management behaviors that would assist them in mitigating diabetes complications. Other reasons could be the lack of equipment accessibility or adaptability and cultural competence among providers treating/caring for individuals with physical limitations.
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Kiran, T., A. Kopp, R. Moineddin, J. C. Victor, R. J. Campbell, B. R. Shah, and R. H. Glazier. "Unintended consequences of delisting routine eye exams on retinopathy screening for people with diabetes in Ontario, Canada." Canadian Medical Association Journal 185, no. 3 (January 7, 2013): E167—E173. http://dx.doi.org/10.1503/cmaj.120862.
Full textBook chapters on the topic "Diabetes eye exams"
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Edouard, Thomas, and Maïthé Tauber. "Syndromic growth disorders." In Oxford Textbook of Endocrinology and Diabetes, 1095–107. Oxford University Press, 2011. http://dx.doi.org/10.1093/med/9780199235292.003.7086.
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Short stature (SS) is defined as height less than the third percentile or below –2 standard deviation score (SDS) with reference to chronological age according to standard growth curves. Children are born small for gestational age (SGA) when their birth height and/or birth weight are below or equal to –2 SDS using standards such as Usher and McLean. In patients presenting with SS associated with abnormal physical features, malformations, or delayed development, a syndromic growth disorder should be considered. Whilst individually rare, there are many syndromes with short stature as a component—in the London Dysmorphology Database (Winter and Baraitser), there are 873 such syndromes, 175 of which are of prenatal onset. In these patients, malformations and/or sensorineural abnormalities should be systematically screened by complementary exams (skeletal X-rays, cardiac and abdominal ultrasound, complete eye and hearing evaluations). In some cases, these abnormalities could help in making the diagnosis (e.g. pulmonary stenosis suggestive of Noonan’s syndrome). Different chromosome disorders may present with SS. For this reason, chromosome studies, preferably high-resolution analysis, should be performed to search for chromosome abnormalities in these children. Specific gene analysis may be requested when a specific syndrome is suspected. In these syndromes, growth failure may be due to a wide variety of mechanisms, including growth hormone deficiency (GHD), growth hormone resistance (Laron syndrome, bone dysplasia) or in combination with nutritional issues with, in many, the underlying mechanisms still being unknown. A complete evaluation of growth hormone/IGF-1 axis is necessary in these children. There are many classifications of short stature, each with specific advantages and disadvantages. Indeed, syndromes with SS could be classified according to clinical presentation and in particular auxological and anthropometrical parameters (SS with normal prenatal growth, SS with intrauterine growth retardation, SS with obesity), or to pathophysiology (GHD or growth hormone insensitivity, bone disorders and idiopathic SS). Here, a classification based on clinical presentation is used. Those syndromes with SS that are most common and are often followed by paediatric endocrinologists namely Silver–Russell, Noonan’s, Turner’s and Prader–Willi syndromes will be reviewed, as well as some rarer syndromes.
Conference papers on the topic "Diabetes eye exams"
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Silva, Bruno Custódio, Gisele Delazeri, Ana Luíza Kolling Konopka, Giulia Righetti Tuppini Vargas, Paulo Ricardo Gazzola Zen, and Rafael Fabiano Machado Rosa. "Report of a family affected by fragile X syndrome and type 1 diabetes mellitus." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.076.
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Context: The fragile X syndrome is characterized by intellectual deficit and some physical characteristics, which become more evident during growth, especially craniofacial and macroorchidism. Case report: A 22 year-old male patient with diabetes mellitus type 1 (DM1) diagnosed at 7 years of age is following-up with ophthalmology due to low visual acuity. On physical exam, he did not maintain eye contact and performed repetitive movements. In addition, he had an elongated face and upward slanting eyelid clefts, a high palate and prognathism, large and prominent ears. In the family history, 3 of his siblings, one male and two female, also had intellectual deficit, and two of them had concomitant DM1. One brother had only DM1 and the other none of the diseases. The parents had consanguinity (they were cousins in the 3rd degree). The patient’s karyotype, using the chromosomal breaks technique after cultivation in medium-low folic acid, showed the presence of fragility on the X chromosome in the region q27.3 [46, XY, fra (x) (q27.3)], compatible with the diagnosis of fragile X syndrome. This result was confirmed using the PCR-multiplex technique. Conclusions: In this family, the concomitant presence in several individuals of the fragile X syndrome and DM1 stands out. However, although both conditions are not related, they are frequent, which could justify their simultaneous occurrence.
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Nascimento, Graciele Nóbrega, Ana Beatriz Marinho Moura Lima, Maria Clara Lino Justino, Fernando José de Lima Ramos-Júnio, and Deysiane Oliveira Brandão. "CORRELAÇÃO ENTRE VALORES DE GLICOSE EM JEJUM COM A HEMOGLOBINA GLICADA." In I Congresso Brasileiro de Bioquímica Humana On-line. Revista Multidisciplinar em Saúde, 2021. http://dx.doi.org/10.51161/rems/665.
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Introdução: O Diabetes mellitus é caracterizada pela hiperglicemia e considerada uma das doenças crônicas de maior repercussão. Atualmente, a hemoglobina glicada é um dos métodos mais utilizado no diagnóstico e controle, visto que ele reflete o histórico glicêmico dos últimos três meses à coleta de sangue. Por isso, o teste de hemoglobina glicada apresenta estabilidade maior do que a glicemia de jejum. Objetivo: Correlacionar os valores de glicose em jejum com a hemoglobina glicada para verificação da eficiência do teste em um laboratório da Paraíba na cidade de Campina Grande. Material e métodos: Trata-se de uma pesquisa de caráter descritivo, retrospectivo, documental, exploratório, realizado em um laboratório de análises clínicas referência no atendimento a diabéticos na cidade de Campina Grande, Paraíba. Para a pesquisa, foi utilizado o sistema de dados do próprio laboratório, sem possibilidade de identificação individual, onde foram extraídas informações relacionadas a hiperglicemia e dosagens elevadas hemoglobina glicada durante o período de Janeiro a Dezembro de 2020. Para o tratamento estatístico, foi utilizado o programa Microsoft Office Excel 2016. Resultados: Foram analisados 580 laudos. A glicemia de jejum média foi 112 mg/dL e a média da hemoglobina glicada foi 6,5%. A maioria dos laudos (75,2%) apresentou glicemia de jejum e hemoglobina glicada acima dos valores de referência. Os laudos em estudo que apresentaram glicemia de jejum normal (abaixo de 99g/dL) e hemoglobina glicada alta (acima de 5,5%) foi de 10,50 %. Ou seja, realizaram o jejum no dia do exame, entretanto não seguem a dieta recomendada. O número de laudos com glicemia de jejum alta e hemoglobina glicada normal foi de 14,30%. Demonstrando que o jejum não foi adequado, apesar de, aparentemente, a dieta estar sendo seguida. Conclusão: Após análise dos dados, foi possível observar que há grande relação entre a glicemia de jejum e hemoglobina glicada aparentemente se a glicemia de jejum está elevada a hemoglobina glicada também estará.