bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Perceptions of Prandial Oral Therapy for Type 2 Diabetes
Authors: Bonneville Miohele , Colgin Joan , Nalesnick Jo Ann , Perez Joan , Wentz Lynne 
Published: April 2008

PURPOSE This survey was conducted to assess patient perceptions of glycemic control, convenience, and flexibility of a prescribed prandial oral therapy for type 2 diabetes mellitus. METHODS Questionnaires distributed by physicians yielded baseline responses from 3696 patients who were beginning repaglinide treatment. Data were analyzed from 1233 respondents who also completed follow-up questionnaires after 4 weeks of treatment. RESULTS Among respondents, 60% were taking repaglinide with other antidiabetic agents in combination therapy; 59% were taking metformin, and 24% were taking troglitazone. Most respondents (84%) indicated that they were "satisfied" or "very satisfied" with repaglinide therapy, 92% wished to continue its use, and 60% believed that the treatment had improved their attitude toward taking antidiabetic medication. Patients perceived that fasting blood glucose levels were reduced during treatment, as was the incidence of hyperglycemia. Corresponding changes in perceived frequency of hypoglycemia during repaglinide treatment were minimal. CONCLUSIONS Patient perceptions of prandial oral therapy with repaglinide were predominantly positive, due mostly to the perception that glucose control was achieved, with minimal perception of any increase in hypoglycemic episodes.
Perceived Difficulty of Diabetes Treatment in Primary Care: Does it Differ by Patient Ethnicity?
Authors: Egede Leonard E. , Miohel Yvonne 
Published: April 2008

PURPOSE The purpose of this cross-sectional study was to determine the attitudes of internal medicine physicians toward treating diabetes in different patient ethnic groups and compared with treating common chronic medical conditions in primary care. METHODS The survey instrument was administered to 55 internal medicine physicians. An e-mail message was sent to each physician with a hyperlink to a site where the survey could be completed. The instrument was a modified, quantitative 10-point scale designed to measure attitudes regarding the difficulty of treating diabetes. RESULTS Diabetes was perceived to be more difficult to treat than hyperlipidemia and angina. African Americans with diabetes were perceived to be more difficult to treat than Caucasian patients. Difficulty in treating diabetes was comparable to that for hypertension, arthritis, and congestive heart failure. Physicians were confident about treatment efficacy for diabetes and changing diabetes outcomes, but not about the adequacy of time and resources for diabetes treatment. CONCLUSIONS Diabetes was perceived as a difficult disease to treat, African American patients were more difficult to treat, and time and resources were inadequate for diabetes treatment. To improve diabetes care, there is a need to address these attitudes and concerns of internal medicine physicians.
A National Job Analysis of Certified Diabetes Educators by the National Certification Board for Diabetes Educators
Authors: Zrebiec John 
Published: April 2008

PURPOSE The job analysis described in this report was conducted by the National Certification Board for Diabetes Educators (NCBDE) to (1) provide a basis for documenting the continuing validity of the certified diabetes educator examination (CDE), (2) define areas that should be assessed in future certification examinations, and (3) ensure that the content of certification examinations is job related. METHODS A diabetes educator job task list was developed and used to create a job analysis survey. The survey was distributed randomly to 1079 CDEs throughout the United States. RESULTS Of the 1079 surveys that were distributed, 327 were suitable for analysis, with relevant demographic subgroups adequately represented. An examination matrix and detailed content outline were constructed from the survey data that will be used by the NCBDE to assemble future test forms. CONCLUSIONS Specifications for the CDE examination were developed that were directly related to the important activities that diabetes educators perform. Future forms of the CDE examination will be matched to job-related, criterion-referenced test specifications and will have strong evidence of content validity. Future forms of the exam will contain 200 items at specified cognitive levels with a representative sampling of tasks within 4 core areas from the detailed content outline.
Development and Validation of a Literacy Assessment Tool for Persons With Diabetes
Authors: Nath Charlotte Reese , Sylvester Shirley Theriot , Yasek Van , Gunel Erdogan 
Published: April 2008

PURPOSE this research was conducted to develop a valid, reliable, quick, and nonstigmatizing tool for assessing literacy in the healthcare setting. METHODS The Literacy Assessment for Diabetes (LAD) instrument was developed as a word recognition test composed of 3 graded word lists in ascending difficulty. This literacy test, which was specific to diabetes, measured a patient's ability to pronounce terms that they would encounter during clinic visits and in reading menu and self-care instructions. The majority of the terms were on a 4th-grade reading level, with the remaining words ranging from the 6th- through 16th-grade levels. To assess reliability and validity, the LAD was compared with the Wide Range Achievement Test (WRAT3) and the Rapid Estimate of Adult Literacy in Medicine (REALM) by administering all 3 tests to 203 participants in a test-retest study design. RESULTS All 3 tests (LAD, REALM, and WRAT3) reliably detected true intrasubject variation in word recognition from test to retest. In addition, LAD measured word recognition ability similar to the REALM and WRAT3. CONCLUSIONS The LAD is a reliable and valid instrument for measuring literacy in adults with diabetes. It can be administered in 3 minutes or less, and the raw score is scaled to a reading grade level.
Development of the Diabetes Problem-Solving Measure for Adolescents
Authors: Cook Sandy , Aikens James E. , Berry Carolyn A. , MoNabb Wylle L. 
Published: April 2008

PURPOSE this paper describes the development and psychometric properties of the Diabetes Problem-Solving Measure for Adolescents (DPSMA). METHODS The DPSMA is a structured, interview-based questionnaire that examines how adolescents with type 1 diabetes solve diabetes-related self-management problems. Seventeen diabetes-related self-management problem vignettes were derived from a survey of adolescents and their parents. The vignettes were reviewed and finalized by a multidisciplinary team of diabetes experts. A sample of 43 adolescents, 13 to 17 years old, with type 1 diabetes, was used to establish the psychometric properties of the instrument. RESULTS The scale demonstrated acceptable internal consistency and interrater reliability. Predicted relationships with scores on concurrently administered measures of adherence, diabetes quality of life, and metabolic control provided support for construct validity. CONCLUSIONS The results suggest that the DPSMA has acceptable internal consistency, interrater reliability, and construct validity. It may be a useful tool to help healthcare providers understand the diabetes-related problem-solving abilities of their adolescent patients.
Syringe Disposal Practices and Gender Differences
Authors: McConville Debra E. , Hamilton Edith M. 
Published: April 2008

PURPOSE The purpose of this study was to describe syringe disposal practices of individuals with diabetes who take insulin and to investigate the attitude toward and effect of previous information on proper syringe disposal. METHODS Adult men and women who injected insulin were recruited from an endocrinology practice and given 2 questionnaires concerning syringe disposal practices and attitude toward proper syringe disposal. Completed questionnaires were returned by mail to the investigator. Nonparametric statistical procedures were used to analyze the data. RESULTS Men with higher income tended to use the trash for syringe disposal more often than lower income men, and older women exhibited a higher positive attitude score than younger women. A positive attitude significantly correlated with the likelihood of proper syringe disposal, and those who had received previous information were more likely to dispose of syringes properly. Healthcare providers were identified as the main source of information. CONCLUSIONS Diabetes educators can improve the syringe disposal practices of their patients through education at each office visit. Knowing more about the environmental and social problems that may ensue from improper syringe disposal may influence patients to practice better disposal methods.
Do Persons With Diabetes Know Their (AIC) Number?
Authors: Harwell Todd S. , Dettori Nancy , McDowall Janet M. , Quesenberry Kim , Priest Linda , Butcher Marcene K. , Flook Benjamin N. , Helgerson Steven D. , Gohdes Dorothy 
Published: April 2008

PURPOSE The objective of this study was to compare self-reported knowledge about Al C testing with information from the medical record. METHODS A telephone survey was conducted among patients with diabetes in a rural fee-for-service practice and a community health center. Self-reported information regarding Al C testing, the last Al C value, and perceived blood glucose control was compared with the most current Al C value documented in the medical record. RESULTS Seventy five percent of survey respondents reported having 1 or more Al C tests in the past year, which generally agreed with information from their medical records. However, only 24% of those who reported having a test remembered the actual value, and the self-reported values correlated weakly with the last Al C on the medical record. Among those with a documented Al C value, half described their blood glucose as very well controlled. The last Al C value, however, was <7.0% in only half of those respondents. CONCLUSIONS Persons with diabetes were aware of their previous Al C testing but did not interpret the values accurately in relation to their own glycemic control. If clinicians expect patient knowledge and understanding of glycemic control measures to improve outcomes of care, patient education will need to emphasize the meaning of these values.
Functional Health Status of Persons With Diabetes in a Nurse-Managed Clinic
Authors: Hartley Lou Ann 
Published: April 2008

PURPOSE The purpose of this psychometric analysis was to (1) describe the functional health status of medically underserved persons with diabetes participating in an exercise program; (2) examine the relationships between functional health status scores and physiologic measures for blood pressure, heart rate, and blood glucose levels; and (3) examine the reliability and validity of the Medical Outcomes Study SF-36 survey. METHODS Data were collected from 31 men and women receiving diabetes disease management in a community-based nurse-managed clinic. The SF-36 survey was used to measure functional health status. Blood pressure, heart rate, and blood glucose also were measured (pretestlposttest). RESULTS The SF-36 survey had good internal consistency in the total sample. Blood pressure and blood glucose levels decreased significantly and heart rate increased significantly from pretest to posttest. Functional health status was negatively associated with physiological parameters. CONCLUSIONS Further research is needed on the use of the SF-36 survey in medically underserved persons with diabetes because this instrument lacked construct validity as a measure of functional health status in this population.
Increasing Problem Solving in Adolescents With Type 1 Diabetes: The Choices Diabetes Program
Authors: Cook Sandy , Herold Kevan , Edidin Deborah V. , Briars Rosemary 
Published: April 2008

The purpose of this pilot study was to test the hypothesis that adolescents with type 1 diabetes can learn to become better problem solvers in diabetes self-care and thereby improve their metabolic control. METHODS Fifty-three adolescents aged 13 to 17 with type 1 diabetes were randomly assigned to either a 6-week problem-solving diabetes education program or to a control group (usual care). Al C levels were obtained as well as assessments of problem solving, frequency of behavior, level of responsibility, and 24-hour behavior recall at baseline and 6 months. RESULTS The experimental group participants showed significantly improved problem-solving test scores and Al C values from baseline to 6 months, changes not evident in the control group. At 6 months, the experimental group participants were doing blood glucose testing more often than those in the control group. However, there was no significant difference in problem-solving test scores or Al C values. CONCLUSIONS This 6-week intervention for adolescents with diabetes resulted in better problem-solving skills, more frequent blood glucose testing, and improved Al C values. The results suggest that a diabetes problem-solving program for adolescents can be effective in improving metabolic control.
Culturally Competent Dietary Education for Southern Rural African Americans With Diabetes
Authors: Anderson-Loftin Wanda , Barnett Steve , Sullivan Patra , Bunn Peggy Summers , Tavakoli Abbas 
Published: April 2008

PURPOSE The purpose of this article is to describe a culturally competent, dietary self-management intervention designed to improve physiological outcomes, diabetes self-management, and costs of care for high-risk African Americans with type 2 diabetes. METHODS A longitudinal, quasi-experimental design was used to evaluate the effectiveness of the intervention for 23 adult African Americans from a physician practice group in rural South Carolina. The intervention consisted of 4 low-fat dietary education classes, 6 discussion groups, and follow-up. Intervention sessions were provided by a dietitian and nurse case managers and framed as social events; families were encouraged to participate. RESULTS Data suggest that the intervention significantly improved fat-related dietary habits, Al C values, fasting blood glucose, and frequency of acute care visits. A trend in reduction of lipids and weight also was observed. CONCLUSIONS Culturally competent dietary self-management provides a meaningful approach to focused diabetes education for rural African Americans. Integrating nursing case management provides an innovative method of addressing the more global issues of delivery of care to underserved rural populations and decreasing the high costs of care.
Insulin Lispro Update
Authors: Meece Jerry D. , Campbell R. Keith 
Published: April 2008

PURPOSE This paper provides a review of the literature and clinical studies for insulin lispro and updated information on its advantages over regular insulin for various populations of people with diabetes. METHODS Information was gathered from a search of Medline articles and from review of clinical studies. RESULTS Patients in various special populations using insulin lispro, with proper adjustment of basal insulin, had a greater reduction in hemoglobin Al C and fewer episodes of hypoglycemia than patients on regular insulin. CONCLUSIONS More recently published literature shows that due to its faster onset and shorter duration of action, insulin lispro is useful for not only lowering Al C values, but also for reducing hypoglycemic events in various populations with diabetes, including pediatric and pregnant patients, those with gastroparesis, and insulin pump users.
A Systematic Literature Review of the Effectiveness of Diabetes Education of School Personnel
Authors: Nichols Phyllis J. , Norris Susan L. 
Published: April 2008

PURPOSE This paper describes current knowledge levels of school personnel about diabetes, discusses the findings of a systematic review of the literature on the effectiveness of diabetes educational interventions for school personnel, and presents recommendations for future research. METHODS English language literature published between January 1966 and May 2001 regarding the effectiveness of diabetes education of school personnel was systematically reviewed using multiple electronic databases. RESULTS Four studies that examined the effectiveness of diabetes education of school personnel were identified. One study demonstrated improvement in teacher knowledge of treatment, another reported significant improvement in comprehensive knowledge scores, and a third study demonstrated significant knowledge deficits across 4 measures of teacher knowledge about diabetes. A fourth study demonstrated a decrease in the cumulative frequency of diabetic ketoacidosis. CONCLUSIONS The literature regarding the effectiveness of diabetes education of school personnel is scant, the methodology is inadequate, the results are mixed, and the focus is on a narrow range of outcomes. Further research is needed to define effective interventions for improving the health and quality of life of school-age children and adolescents with diabetes.
Prevention of Overweight and Obesity in Children: Influences on the Food Environment
Authors: Haire-Joshu Debra , Nanney M. S. 
Published: April 2008

PURPOSE There is an epidemic of pediatric overweight and obesity leading to type 2 diabetes in youth. The purpose of this review is to describe the multiple paths of influence on the food environment of youth and to identify diabetes education strategies focused on early prevention of overweight and obesity. METHODS A review of relevant professional literature was conducted. RESULTS Models of obesity prevention in youth need to address genetic factors that influence the development of food preferences in the young child, parenting influences on eating pattern development, and access and availability of foods in the physical environment of the child. CONCLUSIONS Early intervention with parents of young children is required to prevent the development of eating patterns that lead to pediatric obesity and type 2 diabetes in youth. Diabetes educators need to be able to inform parents of the multiple paths of influence on the food environment of the child and suggest strategies to encourage the development of positive food preferences and intake.
Nocturnal Polyuria in Type 2 Diabetes: A Symptom of Obstructive Sleep Apnea
Authors: Chasens Eileen R. , Umlauf Mary Q. , Pillion Dennis J. , Wells Judy A. 
Published: April 2008

PURPOSE Polyuria and nocturia in individuals with type 2 diabetes may be due to obstructive sleep apnea (OSA), a recently recognized etiology of excess nighttime urine production. This exploratory study examined the relationships among glucose control, OSA, and nocturnal urine production. METHODS A sample of community-dwelling older adults (20 nondiabetic subjects and 10 poorly controlled type 2 diabetes subjects) was recruited based on self-report of nocturia more than twice per night. Participants were monitored on a metabolic research unit for 24 hours to track intake/output, collect blood and urine samples, and conduct an overnight polysomnography sleep study. RESULTS None of the subjects had fasting serum glucose levels above the renal threshold. OSA was found in 65% of subjects. Those with moderate/severe OSA had significantly greater overnight urine production than subjects without OSA. Subjects with type 2 diabetes and moderate/severe OSA had the highest nocturnal urine production. CONCLUSIONS The high incidence of undetected OSA in subjects with type 2 diabetes with nocturia suggests that nocturia, OSA, and type 2 diabetes frequently coexist and may be interrelated.
The Impact of Self-Monitoring of Blood Olucose on Self-Efficacy and Pregnancy Outcomes in Women With Diet-Controlled Gestational Diabetes
Authors: Homko Carol J. , Sivan Eyal , Reece E. Albert 
Published: April 2008

PURPOSE The purpose of this study was to examine the effects of self-monitoring of blood glucose (SMBG) on feelings of self-efficacy, dietary compliance, and pregnancy outcomes in women with diet-controlled gestational diabetes mellitus (GDM). METHODS Fifty-eight women with GDM and a fasting blood glucose level <95 mg/dL were randomly assigned to 2 groups. The experimental group measured their blood glucose levels 4 times daily using a reflectance meter with memory. Metabolic status was assessed in the control group by periodic monitoring at prenatal visits. Otherwise the management protocol was identical for both groups. The Diabetes Empowerment Scale was completed at study entry and at 37 weeks gestation to assess feelings of self-efficacy. Dietary compliance was assessed at each visit. RESULTS Both groups of women achieved excellent glucose control; only 1 woman in each group required insulin therapy. There were no significant differences with regard to feelings of self-efficacy, dietary compliance, birth weight, gestational age at delivery, Apgar scores, and neonatal complications. Rates of macrosomia, delivery by cesarean section, and occurrence of birth trauma were similar. CONCLUSIONS SMBG appears to have little effect on maternal feelings of self-efficacy, dietary compliance, or pregnancy outcomes in women with diet-controlled GDM.
An Initiative to Improve Diabetes Care Standards in Healthcare Organizations Serving Minorities
Authors: Hosler Akiko S. , Godley Kathryn , Rowland Daniel H. 
Published: April 2008

PURPOSE this study was designed to assess changes of diabetes care standards in healthcare organizations that participated in 2-year initiative to improve diabetes care and expand outreach in minority communities. METHODS An independent sample of the medical records of adults with type 2 diabetes was randomly drawn at 3 points of time (N=829). Rates of compliance with 20 selected measures of standards of basic diabetes care were measured and compared over time. RESULTS Significant improvements in compliance rates from baseline to the end point were found in 11 measures including annual hemoglobin A1 C testing (65.8% to 76.3%), annual lipid profile (33.8% to 49.1%), and biannual lower extremity examination (40.0% to 56.3%). CONCLUSIONS Improvements in diabetes care were credited with giving providers feedback on their compliance and increasing support of patient self-care, especially through tailoring outreach and services to minorities.
Diabetes Care Processes and Outcomes in Patients Treated by Nurse Practitioners or Physicians
Authors: Lenz Elizabeth R. , Mundinger Mary O'Neil , Hopkins Sarah C. , Lin Susan X. , Smolowitz Janice L. 
Published: April 2008

PURPOSE the purpose of this study was to compare selected diabetes care processes and outcomes of nurse practitioners (NPs) and physicians (MDs) in the primary care of adults with type 2 diabetes. METHODS Adults with type 2 diabetes and no regular source of primary care were enrolled from the emergency room and randomized to an NP or MD practice. Chart reviews were conducted to assess processes of care; patient interviews and hemoglobin Al C (Al C) testing were performed to measure patient outcomes. RESULTS NPs were more likely than MDs to document provision of general diabetes education and education about nutrition, weight, exercise, and medications. They were more likely to document patient height, urinalyses results, and Al C values. No differences were found in documenting current medications; alcohol, illicit drug, or tobacco use; depression; weight and blood pressure; foot and cardiovascular exams; blood glucose and creatinine testing; or referral to ophthalmologists. No differences were found in patient outcomes. CONCLUSIONS This study provides preliminary evidence of interdisciplinary differences in the processes of care employed by primary care NPs and MDs in caring for patients with type 2 diabetes. NPs documented the provision of diabetes education and selected monitoring tests more frequently than MDs; however, these differences were not reflected in 6-month patient outcomes.