ISSN / EISSN : 0891-8929 / 1945-4953
Published by: American Diabetes Association (10.2337)
Total articles ≅ 1,006
Latest articles in this journal
Clinical Diabetes; https://doi.org/10.2337/cd21-0110
This study examined the clinical profile, treatment profile, and vision outcomes of people ≤40 years of age with diabetes and diabetic macular edema (DME). Within this age-group, the prevalence of center-involving DME was 16%, with 74% of eyes showing cystoid edema, 37% showing spongiform edema, and 41% having neurosensory detachment. Longer diabetes duration (P = 0.001) and greater severity of diabetic retinopathy (P<0.001) were associated with DME prevalence. Thus, regular and more frequent follow-up, as well as early and aggressive treatment of diabetic eye disease, are required in people diagnosed early with diabetes.
Clinical Diabetes; https://doi.org/10.2337/cd21-0099
Foot ulceration is a serious problem among people with diabetes. This study assessed the knowledge, attitude, and practice of 483 people with diabetes with regard to the prevention of diabetic foot ulcers (DFUs). Data were collected using a valid and reliable questionnaire, and logistic regression was carried out to predict the effect of statistically significant independent variables on the scores of dependent variables. A significant association was found between knowledge and attitude about DFU prevention. Individuals who were unmarried were more likely to have higher knowledge scores than those who were married, and those who had university and secondary education were more likely to have higher attitude and practice scores than other groups. Overall, however, only a small percentage of study participants achieved high scores for knowledge, practice, and attitude in this study.
Clinical Diabetes; https://doi.org/10.2337/cd20-0122
Recent studies of diabetes suggest an obesity paradox: mortality risk increases with weight in people without diabetes but decreases with weight in people with diabetes. A recent study also reports the paradox more generally with health care utilization. Whether this paradox in health care utilization and spending is causal or instead the result of empirical biases and confounding factors has yet to be examined in detail. This study set out to examine changes in the relationship between BMI and health care expenditures in populations with versus without diabetes, controlling for confounding risk factors. It found that the obesity paradox does not exist and is the result of statistical biases such as confounding and reverse causation. Obesity is not cost-saving for people with diabetes. Thus, insurers and physicians should renew efforts to prevent obesity in people with diabetes.
Clinical Diabetes; https://doi.org/10.2337/cd20-0116
Adolescents with type 1 diabetes face barriers that can have a negative influence on self-management behaviors. This study was an analysis of semi-structured interviews with adolescents, parents, and health-care providers to better understand these barriers among adolescents in Jordan. Adolescents with type 1 diabetes reported individual-level barriers including feeling labeled, pitied, and stigmatized for having type 1 diabetes. They also discussed the system-level barrier of an education system that does not adapt to meet their needs. Individual- and system-level barriers are interrelated and could influence adolescents’ decisions regarding whether to disclose their condition to others.
Clinical Diabetes; https://doi.org/10.2337/cd21-0070
Identifying patients at high risk for diabetic ketoacidosis (DKA) is crucial for informing efforts at preventive intervention. This study sought to develop and validate an electronic medical record (EMR)-based tool for predicting DKA risk in pediatric patients with type 1 diabetes. Based on analysis of data from 1,864 patients with type 1 diabetes, three factors emerged as significant predictors of DKA: most recent A1C, type of health insurance (public vs. private), and prior DKA. A prediction model was developed based on these factors and tested to identify and categorize patients at low, moderate, and high risk for experiencing DKA within the next year. This work demonstrates that risk for DKA can be predicted using a simple model that can be automatically derived from variables in the EMR.
Clinical Diabetes, Volume 40, pp 62-69; https://doi.org/10.2337/cd21-0066
The Chief Residents Summit on Intensifying Diabetes Management, now in its 15th year, has resulted in real-world improvements in patient outcomes and has shown itself to be an effective model for teaching diabetes to family medicine residents. This article describes the program and the evidence supporting its effectiveness.
Clinical Diabetes, Volume 40, pp 97-107; https://doi.org/10.2337/cd21-0043
Clinical Diabetes, Volume 40, pp 75-77; https://doi.org/10.2337/cd21-0096
Clinical Diabetes, Volume 40, pp 51-61; https://doi.org/10.2337/cd20-0071
There has been little recognition that people with type 2 diabetes are vulnerable to weight stigma and diabetes stigma and almost no research examining the implications of these forms of stigma for their health and well-being. This study examined health behavior correlates of weight stigma and diabetes stigma in 1,227 adults with type 2 diabetes. Results showed that experiencing weight stigma in health care, experiencing differential treatment from others because of their diabetes, and engaging in self-stigma for diabetes and body weight were each significantly associated with increased frequency of binge eating and eating as a coping strategy to deal with negative feelings. Internalizing weight stigma was also significantly associated with lower levels of physical activity and worse self-rated health. These findings suggest that initiatives to improve the health and well-being of people with type 2 diabetes must consider the potentially harmful roles of weight stigma and diabetes stigma.
Clinical Diabetes, Volume 40, pp 39-50; https://doi.org/10.2337/cd21-0016
Gestational diabetes mellitus (GDM) increases type 2 diabetes risk; however, postpartum diabetes screening rates are low. Using semi-structured interviews and focus groups, this study investigates the understanding of GDM and its relationship to future diabetes risk and diabetes prevention among patients with public or no insurance (n = 36), health care providers (n = 21), and clinic staff (n = 9) from Federally Qualified Health Centers. Five main themes emerged: 1) general understanding of GDM diagnosis with focus on neonatal complications; 2) variable recall of diet, exercise, and weight recommendations; 3) overwhelming medication and self-monitoring routines; 4) short-term focus of type 2 diabetes risk and screening; and 5) limited understanding of all options for diabetes prevention. The results may inform diabetes screening and prevention interventions in primary care settings.