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Exploring Clinical Outcomes in Diabetes Patients

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 10658

Special Issue Editors


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Guest Editor
Clinical Pharmacist Specialist, University of California San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences, La Jolla, CA 92093-0657, USA
Interests: helping patients with type 2 diabetes to achieve personalized diabetes and other metabolic goals through medication optimization, lifestyle modifications, and improved diabetes education; type 2 diabetes treatment modalities; macrovascular and microvascular complications management in people with type 2 diabetes; evaluating and improving adherence rate outcomes in patients with diabetes; advancing and expanding clinical pharmacist collaborative patient care services; innovative pharmacy education

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Guest Editor
1. Department of Translational Medicine, Herbert Wertheim College of Medicine, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
2. Department of Health Policy & Management, Robert Stempel College of Public Health & Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA
3. Faculty of Medicine, Riga Stradiņš University, LV-1007 Riga, Latvia
Interests: diabetes prevention; diabetes epidemiology; public health; risk factors and lifestyle habits of chronic noncommunicable diseases; screening for type 2 diabetes; implementation science; dissemination science
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Special Issue Information

Dear Colleagues,

Diabetes has reached worldwide epidemic proportions. According to the International Diabetes Federation in 2019, approximately 837 million people were either living with diabetes (436 million adults) or were at increased risk for developing type 2 diabetes (347 million). Moreover, treatment costs continue to rise at an alarming trajectory, especially those associated with managing macro- and microvascular diabetes complications. In the last few decades, numerous studies have demonstrated that glycemic control can prevent or delay onset of diabetes, or associated eye, kidney, amputations, heart attacks, and strokes associated with diabetes. Healthcare providers, including physician extenders (i.e., pharmacists, nurses, nurse practitioners, physician assistants, certified diabetes care and education specialists, dieticians, physiotherapists), are instrumental in educating and helping patients to achieve their personalized glycemic goals. This Special Issue offers the opportunity to share best practices of how to achieve successful clinical outcomes, improving treatment control in patients with type 2 diabetes. In addition, papers assessing the economic impact of diabetes control and evaluating the cost saving potential are also welcome. Papers addressing these topics are invited for this Special Issue.

Prof. Dr. Candis M. Morello
Prof. Dr. Noël Christopher Barengo
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • type 2 diabetes
  • pre-diabetes
  • glycemic control
  • metabolic goals
  • physician extenders
  • comprehensive metabolic care
  • medication adherence
  • collaborative practice
  • medication management
  • diabetes complications
  • diabetes education
  • lifestyle education
  • economic impact

Published Papers (4 papers)

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Research

12 pages, 867 KiB  
Article
T1DMicro: A Clinical Risk Calculator for Type 1 Diabetes Related Microvascular Complications
by Paul Minh Huy Tran, Eileen Kim, Lynn Kim Hoang Tran, Bin Satter Khaled, Diane Hopkins, Melissa Gardiner, Jennifer Bryant, Risa Bernard, John Morgan, Bruce Bode, John Chip Reed, Jin-Xiong She and Sharad Purohit
Int. J. Environ. Res. Public Health 2021, 18(21), 11094; https://doi.org/10.3390/ijerph182111094 - 21 Oct 2021
Cited by 2 | Viewed by 2211
Abstract
Development of complications in type 1 diabetes patients can be reduced by modifying risk factors. We used a cross-sectional cohort of 1646 patients diagnosed with type 1 diabetes (T1D) to develop a clinical risk score for diabetic peripheral neuropathy (DPN), autonomic neuropathy (AN), [...] Read more.
Development of complications in type 1 diabetes patients can be reduced by modifying risk factors. We used a cross-sectional cohort of 1646 patients diagnosed with type 1 diabetes (T1D) to develop a clinical risk score for diabetic peripheral neuropathy (DPN), autonomic neuropathy (AN), retinopathy (DR), and nephropathy (DN). Of these patients, 199 (12.1%) had DPN, 63 (3.8%) had AN, 244 (14.9%) had DR, and 88 (5.4%) had DN. We selected five variables to include in each of the four microvascular complications risk models: age, age of T1D diagnosis, duration of T1D, and average systolic blood pressure and HbA1C over the last three clinic visits. These variables were selected for their strong evidence of association with diabetic complications in the literature and because they are modifiable risk factors. We found the optimism-corrected R2 and Harrell’s C statistic were 0.39 and 0.87 for DPN, 0.24 and 0.86 for AN, 0.49 and 0.91 for DR, and 0.22 and 0.83 for DN, respectively. This tool was built to help inform patients of their current risk of microvascular complications and to motivate patients to control their HbA1c and systolic blood pressure in order to reduce their risk of these complications. Full article
(This article belongs to the Special Issue Exploring Clinical Outcomes in Diabetes Patients)
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10 pages, 1896 KiB  
Article
Improved Patient-Reported Medication Adherence, Patient Satisfaction, and Glycemic Control in a Collaborative Care Pharmacist-Led Diabetes “Tune-Up” Clinic
by Jan D. Hirsch, Nancy Kong, Kevin T. Nguyen, Christine L. Cadiz, Crystal Zhou, Sarah A. Bajorek, Mark Bounthavong and Candis M. Morello
Int. J. Environ. Res. Public Health 2021, 18(17), 9242; https://doi.org/10.3390/ijerph18179242 - 01 Sep 2021
Cited by 5 | Viewed by 2231
Abstract
Diabetes complications remain a leading cause of death, which may be due to poor glycemic control resulting from medication nonadherence. The relationship between adherence status and HbA1c (glycemic control) has not been well-studied for clinical pharmacist interventions. This study evaluated medication adherence, patient [...] Read more.
Diabetes complications remain a leading cause of death, which may be due to poor glycemic control resulting from medication nonadherence. The relationship between adherence status and HbA1c (glycemic control) has not been well-studied for clinical pharmacist interventions. This study evaluated medication adherence, patient satisfaction, and HbA1c, in a collaborative pharmacist-endocrinologist diabetes clinic over 6 months. Of 127 referred, 83 patients met the inclusion criteria. Mean medication adherence scores, considered “good” at baseline, 1.4 ± 1.2, improved by 0.05 points (p = 0.018), and there was a 26% increase in patients with good adherence. A significant improvement of 0.40 percentage points (95% CI: −0.47, −0.34) was observed in mean HbA1c across the three time points (p < 0.001). Mean total satisfaction scores were high and increased, with mean 91.3 ± 12.2 at baseline, 94.7 ± 9.6 at 3 months, and 95.7 ± 10.8 at 6 months (p = 0.009). A multimodal personalized treatment approach from a pharmacist provider significantly and positively impacted glycemic control regardless of self-reported medication adherence, and patient satisfaction remained high despite changing to a clinical pharmacist provider and increased care intensity. Full article
(This article belongs to the Special Issue Exploring Clinical Outcomes in Diabetes Patients)
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10 pages, 1614 KiB  
Article
Evaluation of the Complementary Health Provision of the Podiatric Foot Care Program for Diabetic Patients in Catalonia (Spain)
by Jessica Ruiz-Toledo, Antonio J. Zalacain-Vicuña and Elena de Planell-Mas
Int. J. Environ. Res. Public Health 2021, 18(10), 5093; https://doi.org/10.3390/ijerph18105093 - 11 May 2021
Cited by 2 | Viewed by 2350
Abstract
The Catalan diabetic foot health program was established in 2009 in order to prevent complications caused by type 2 diabetes. This study aims to describe its application from 2009 to 2018. The objective was to describe diabetic foot care provision in the National [...] Read more.
The Catalan diabetic foot health program was established in 2009 in order to prevent complications caused by type 2 diabetes. This study aims to describe its application from 2009 to 2018. The objective was to describe diabetic foot care provision in the National Health System of Catalonia between 2009 and 2018, including the number of patients and professionals involved, the causes behind patients’ visits, and the most demanded codes for diagnosis and treatment filled by the podiatrist in each consultation during 2018–2020. This description was addressed through an analysis of the database provided by the Association of Podiatrists to evaluate the implementation of the program. The results for the diabetic foot health program in Catalonia showed a growth in demand from 2009 (1726) to 2018 (213,095) in terms of visits and from 2009 (1541) to 2018 (104,629) in terms of patients. The number of registered podiatrists from 2009 to 2018 increased from 165 to 470. The most commonly used diagnosis codes were (a) without sensory alterations in control and treatment of grade 1 lesions; (b) grade 0 without neuropathic, vascular, structural, or biomechanical alteration; (c) no sensory structural alterations in the foot; (d) keratopathies. The treatments most commonly used were (a) conservative (chiropody), (b) without ortho-podiatric treatment, and (c) plantar supports. The conclusions show that the health program is in great demand amongst the population. Similarly, the coding system has made it possible to identify the diagnosis and treatment of such demand. Full article
(This article belongs to the Special Issue Exploring Clinical Outcomes in Diabetes Patients)
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12 pages, 317 KiB  
Article
The Association between Social Determinants of Health and Self-Reported Diabetic Retinopathy: An Exploratory Analysis
by Emily L. Silverberg, Trevor W. Sterling, Tyler H. Williams, Grettel Castro, Pura Rodriguez de la Vega and Noël C. Barengo
Int. J. Environ. Res. Public Health 2021, 18(2), 792; https://doi.org/10.3390/ijerph18020792 - 18 Jan 2021
Cited by 14 | Viewed by 3055
Abstract
One-third of Americans with diabetes will develop diabetic retinopathy (DR), the leading cause of blindness in working-age Americans. Social determinants of health (SDOHs) are conditions in a person’s environment that may impact health. The objective of this study was to determine whether there [...] Read more.
One-third of Americans with diabetes will develop diabetic retinopathy (DR), the leading cause of blindness in working-age Americans. Social determinants of health (SDOHs) are conditions in a person’s environment that may impact health. The objective of this study was to determine whether there is an association between SDOHs and DR in patients with type II diabetes. This cross-section study used data from the 2018 Behavioral Risk Factor Surveillance System (BRFSS). This study included people with self-reported diabetes in the US in 2018 (n = 60,703). Exposure variables included homeownership, marital status, income, health care coverage, completed level of education, and urban vs. rural environment. The outcome variable was DR. Logistic regression analysis were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Alaskan Native/Native American (OR 2.11; 95% CI: 1.14–3.90), out of work (OR 2.82; 95% CI: 1.62–4.92), unable to work (OR 2.14; 95% CI: 1.57–2.91), did not graduate high school (OR 1.91; 95% CI: 1.30–2.79), only graduated high school (OR 1.43; 95% CI 1.08–1.97), or only attended college or technical school without graduating (OR 1.42; 95% CI: 1.09–1.86) were SDOHs associated with DR in patients with diabetes. Health care providers should identify these possible SDOHs affecting their diabetic patients. Full article
(This article belongs to the Special Issue Exploring Clinical Outcomes in Diabetes Patients)
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