| 1. |
- Adolfsson, Eva Thors, et al.
(författare)
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The Swedish National Survey of the Quality and Organization of Diabetes Care in Primary Healthcare—Swed-QOP
- 2010
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1751-9918 .- 1878-0210. ; 4:2, s. 91-97
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Tidskriftsartikel (refereegranskat)abstract
- AIM:To describe the quality and organization of diabetes care in primary healthcare in Sweden regarding resources and ways of working.METHOD:A questionnaire was used to collect data from all 921 primary healthcare centres (PHCCs) in Sweden. Of these, 74.3% (n=684) responded to the questionnaire covering list size of the PHCCs, number of diabetic patients, personnel resources and ways of working.RESULTS:The median list size reported from the PHCCs was 9,000 patients, 294 of whom were diabetic patients. The majority (72%) of PHCCs had diabetes-responsible general practitioners (GPs) and almost all (97%) had diabetes specialist nurses (DSNs) with some degree of postgraduate education in diabetes. The PHCCs reported that they used regional/local diabetes guidelines (93%), were engaged in call-recall diabetic reviews by GP(s) (66%) and DSN(s) (89%), checked that patients had participated in the reviews by GP(s) (69%) and DSN(s) (78%), arranged group education programmes (23%) and reported data to a National Diabetes Register (82%).CONCLUSIONS:The presence of diabetes-responsible GP(s) and DSN(s) who use guidelines may contribute to good and equal quality of care. It is, however, necessary to improve the call-recall system and there is an urgent need for all diabetic patients to receive patient education.
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| 2. |
- Amin, Kawa
(författare)
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Levels of cytokines and GADA in type I and II diabetic patients
- 2020
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Ingår i: Primary Care Diabetes. - : Elsevier. - 1751-9918 .- 1878-0210. ; 14:1, s. 61-67
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Tidskriftsartikel (refereegranskat)abstract
- AbstractBACKGROUND:Diabetes Mellitus is described as a group of metabolic diseases in which the patient has higher blood glucose levels due to many causes. These include a defect in insulin secretion and failure of the body's cells to respond to the hormone. Cytokines and autoantibodies have a critical role in the pathogenesis of diabetes, especially type I.AIM OF THE STUDY:The aim of this study was to measure the serum levels of interleukin-1 beta (IL-1 β), interleukin-3 (IL-3), interferon-gamma (INF- γ), and glutamic acid decarboxylase autoantibody (GADA) in patients with type I and type II diabetes mellitus.MATERIAL AND METHODS:In this cross-sectional study, serum samples were taken from 250 individuals, including 100 samples from patients with type II diabetes mellitus, 100 samples from healthy controls, and 50 samples from patients with type I diabetes mellitus. Five milliliters of venous blood were taken from each individual and the samples were analyzed for cytokines (IL-1 β, IL-3, and INF- γ) and GABA using ELISA.RESULTS:In the study, we found that the serum levels of IL-1 β were significantly higher in the healthy control group compared to the patients with type I and type II diabetes mellitus. The levels of IL-3 and INF- γ were significantly higher in type II diabetes mellitus, while GABA serum levels were higher in type I diabetes mellitus.CONCLUSION:Our data showed that GADA is an important autoantibody, not only in type I but also in type II diabetes mellitus and can probably be used in the future for diagnosis of this disease. There was also a close association of GADA with systemic immunoregulation in type I and II diabetes mellitus. The relation of cytokines (IL-1 β, IL-3, and INF- γ) and GADA in patients with diabetes will also increase our understanding for the immunology of diabetes mellitus and to propose specific treatment on the basis of our findings. Our data also include correlation between age and the level of cytokines and GADA with different conclusion for each parameter.
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| 3. |
- Andersson, Susanne, et al.
(författare)
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It's up to me! Experiences of living with pre-diabetes and the increased risk of developing type 2 diabetes mellitus
- 2008
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Ingår i: Primary Care Diabetes. - Amsterdam : Elsevier. - 1751-9918 .- 1878-0210. ; 2:4, s. 187-193
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To explore experiences of pre-diabetes and the associated increased risk of type 2 diabetes mellitus. Methods: Eight participants with pre-diabetes were interviewed for a 45-60 min period. The interviews were audio taped, transcribed verbatim and analysed using a phenomenological hermeneutic approach. Results: Living with pre-diabetes means existing on the borderline of being healthy and suffering from T2DM. Three themes were formulated; "seeing possibilities in an uncertain future", "facing obstacles and loss of liberty" and "balancing between possibilities and obstacles" Being on the borderline and balancing between possibilities and obstacles were interpreted as a distressing feeling of being at increased risk of developing T2DM, although this feeling can change to one of either facing possibilities or facing obstacles. Conclusions: Special focus must be directed towards persons with pre-diabetes, as they are caught between possibilities and obstacles. Advanced care in the form of health dialogues can convince these people of their own abilities to influence the outcome of pre-diabetes. The result of this study can guide health care practitioners in comprehending each participant's understanding of the situation, thus helping them to create pedagogical dialogues in which patients' experiences, conceptions, explanations as well as explicit and implicit questions are identified. © 2008 Primary Care Diabetes Europe.
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| 4. |
- Bennet, Louise, et al.
(författare)
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Ethnicity is an independent risk indicator when estimating diabetes risk with FINDRISC scores: A cross sectional study comparing immigrants from the Middle East and native Swedes
- 2014
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1751-9918 .- 1878-0210. ; 8:3, s. 231-238
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Tidskriftsartikel (refereegranskat)abstract
- Aims: This study sought to compare type 2 diabetes (T2D) risk indicators in Iraqi immigrants with those in ethnic Swedes living in southern Sweden. Methods: Population-based, cross-sectional cohort study of men and women, aged 30-75 years, born in Iraq or Sweden conducted in 2010-2012 in Malmö, Sweden. A 75 g oral glucose tolerance test was performed and sociodemographic and lifestyle data were collected. T2D risk was assessed by the Finnish Diabetes Risk Score (FINDRISC). Results: In Iraqi versus Swedish participants, T2D was twice as prevalent (11.6 vs. 5.8%, p < 0.001). A large proportion of the excess T2D risk was attributable to larger waist circumference and first-degree family history of diabetes. However, Iraqi ethnicity was a risk factor for T2D independently of other FINDRISC factors (odds ratio (OR) 2.5, 95% CI 1.6-3.9). The FINDRISC algorithm predicted that more Iraqis than Swedes (16.2 vs. 12.3%, p < 0.001) will develop T2D within the next decade. The total annual costs for excess T2D risk in Iraqis are estimated to exceed 2.3 million euros in 2005, not accounting for worse quality of life. Conclusions: Our study suggests that Middle Eastern ethnicity should be considered an independent risk indicator for diabetes. Accordingly, the implementation of culturally tailored prevention programs may be warranted. © 2014 Primary Care Diabetes Europe.
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| 5. |
- Berntorp, Kerstin, et al.
(författare)
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Initiation of biphasic insulin aspart 30/70 in subjects with type 2 diabetes mellitus in a largely primary care-based setting in Sweden.
- 2011
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1878-0210 .- 1751-9918. ; 5, s. 89-94
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: Despite a wealth of clinical trial data supporting use of the premixed insulin analogue, biphasic insulin aspart 30 (BIAsp 30) in the treatment of type 2 diabetes mellitus (T2DM), there is limited documentation of its use in primary care-based clinical practice. METHODS: An observational study investigating the safety and efficacy of BIAsp 30 in routine clinical practice was conducted. Patients were followed up 3 and 6 months after initiating insulin treatment. Safety and efficacy measures were documented. RESULTS: During the course of the study, 1154 patients were included (age range 20-95years), of whom 89% completed the 6-month follow-up period. Mean HbA(1c) at baseline was 8.8% (73mmol/mol), and had improved to 7.2% (55mmol/mol) after 6 months of treatment. The rate of total hypoglycaemia at completion of the study was 4.1 events per patient year. Major hypoglycaemic events were rare (two in total). CONCLUSIONS: BIAsp 30 was initiated safely and effectively in insulin-naïve patients with T2DM. The safety and efficacy profile observed in clinical trials was confirmed in this largely primary care-based setting in Sweden.
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| 6. |
- Boström, Eva, et al.
(författare)
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Role clarity and role conflict among Swedish diabetes specialist nurses
- 2013
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Ingår i: Primary care diabetes. - : Elsevier. - 1878-0210 .- 1751-9918. ; 7:3, s. 207-212
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To explore diabetes specialist nurses (DSNs)' perceptions of their role in terms of clarity, conflict and other psychosocial work aspects.METHODS: A cross-sectional study was conducted among DSNs in a county in northern Sweden. The DSNs answered the Nordic Questionnaire of Psychological and Social Factors at Work (QPS Nordic) about psychosocial aspects of their work. Statistical analysis compared DSNs with a reference group of different health professionals. Correlations between role clarity, role conflict, and other variables were analysed.RESULTS: The DSNs perceived more, and higher, job demands, including quantitative, decision-making and learning demands, but also more positive challenges at work compared with the reference group. Role clarity correlated with experiences of health promotion, perception of mastery, co-worker support, and empowering leadership, while role conflict correlated with quantitative and learning demands.CONCLUSIONS: The DSNs perceived high demands but also positive challenges in their work. Their role expectations correlated with several psychosocial work aspects. It is important that DSNs should be presented with positive challenges as meaningful incentives for further role development and enhanced mastery of their work.
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| 7. |
- Diurlin, Sven, et al.
(författare)
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Persisting prediabetic conditions and glomerular filtration rate - A longitudinal study
- 2022
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Ingår i: Primary Care Diabetes. - : Elsevier BV. - 1751-9918 .- 1878-0210. ; 16:4, s. 597-599
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Tidskriftsartikel (refereegranskat)abstract
- The aim was to explore differences in the development of eGFR in persisting prediabetic conditions. This prospective study including 1327 individuals showed that eGFR decreased more in individuals with persisting IGT than in individuals with persisting IFG. Repeating OGTT and monitoring eGFR might improve the risk estimation in prediabetes.
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| 8. |
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| 9. |
- Ghandour, R., et al.
(författare)
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Complications of type 2 diabetes mellitus in Ramallah and al-Bireh : The Palestinian Diabetes Complications and Control Study (PDCCS)
- 2018
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Ingår i: Primary Care Diabetes. - : Elsevier Ltd. - 1751-9918 .- 1878-0210. ; 12:6, s. 547-557
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Tidskriftsartikel (refereegranskat)abstract
- Background: Type 2 diabetes mellitus (T2DM) is a growing pandemic that will lead, if not managed and controlled, to frequent complications, poor quality of life, and high rates of disability and death. Little is known about T2DM complications in Palestine. The aim of this study is to estimate the prevalence of T2DM complications in Ramallah and al-Bireh governorate of Palestine. Methods: The study was conducted in eleven primary healthcare clinics offering services for persons with T2DM. Macrovascular complications were assessed using the Diabetes complication index. Microvascular complications were measured by physical examinations and laboratory tests. Questionnaires, laboratory tests, and physical examinations were used to assess socio-demographic characteristics, co-morbidities and other risk factors. Results: 517 adult men and nonpregnant women participated in the study (166 men, 351 women). The response rate was 84%. Mean age and mean duration of diabetes were 58.1 and 9.4 years respectively. Prevalence of diagnosed microvascular and macrovascular complications was 67.2% and 28.6% respectively. 78.2% of the participants had poor glycemic control (HbA1c ≥ 7.0%). Conclusion: Significant proportions of persons with T2DM had macro- and microvascular complications and poor metabolic control. These findings are important for policy development and the planning of health services. © 2018 Primary Care Diabetes Europe
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| 10. |
- Goldberg, Alexandra, et al.
(författare)
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Swedish guidelines for type 1 diabetes and pregnancy outcomes : A nationwide descriptive study of consensus and adherence
- 2021
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Ingår i: Primary Care Diabetes. - : Elsevier. - 1751-9918 .- 1878-0210. ; 15:6, s. 1040-1051
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Tidskriftsartikel (refereegranskat)abstract
- Aims: Type 1 diabetes (DM1) during pregnancy and labor is associated with an increased risk of maternal and fetal complications. Evidence-based care is therefore provided in accordance with guidelines. In this study, we aimed to compare all the Swedish guidelines for DM1 during pregnancy and labor in terms of the variables emphasized in the national guidelines from the US and from England and Wales. The second aim was to measure adherence to local guidelines at the four hospitals in Stockholm that cared for pregnant women with DM1 during 2016 and to describe the pregnancy and labor outcomes. Methods: All the Swedish guidelines for DM1 during pregnancy and labor were reviewed on 31 variables. The medical records of 114 women were reviewed according to whether >= 70% of 22 variables in the guidelines were followed. Results: No consensus was found in the Swedish guidelines for any of the 31 variables. Some guidelines were contradictory. The pregnancy guidelines were followed in 17.5% of the medical records, 18.4% followed the labor guidelines, and 5.3% followed both guidelines. The onset of labor, mode of delivery and HbA1c in the third trimester varied significantly, depending on the adherence to guidelines. Conclusions: The Swedish guidelines for DM1 during pregnancy and labor lack both consensus and adherence. A national guideline on DM1 during pregnancy and childbirth with high adherence could improve care for pregnant Swedish women with DM1 and their fetuses.
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