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  • 1
    Online Resource
    Online Resource
    International Diabetes Center: COVID-19 Won’t Stop Us From Fulfilling Our Mission
    SAGE Publications ; 2020
    In:  Journal of Diabetes Science and Technology Vol. 14, No. 4 ( 2020-07), p. 725-726
    Details
    In: Journal of Diabetes Science and Technology, SAGE Publications, Vol. 14, No. 4 ( 2020-07), p. 725-726
    Type of Medium: Online Resource
    ISSN: 1932-2968 , 1932-2968
    URL: Article
    DOI: 10.1177/1932296820927410
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2467312-2
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  • 2
    Online Resource
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    Comparing Patch vs Pen Bolus Insulin Delivery in Type 2 Diabetes Using Continuous Glucose Monitoring Metrics and Profiles
    SAGE Publications ; 2022
    In:  Journal of Diabetes Science and Technology Vol. 16, No. 5 ( 2022-09), p. 1167-1173
    Details
    In: Journal of Diabetes Science and Technology, SAGE Publications, Vol. 16, No. 5 ( 2022-09), p. 1167-1173
    Abstract: CeQur Simplicity™ (CeQur, Marlborough, MA) is a 3-day insulin delivery patch designed to meet mealtime insulin requirements. A recently reported 48-week, randomized, multicenter, interventional trial compared efficacy, safety and self-reported outcomes in 278 adults with type 2 diabetes (T2D) on basal insulin therapy who initiated and managed mealtime insulin therapy with a patch pump versus insulin pen. We assessed changes in key glycemic metrics among a subset of patients who wore a continuous glucose monitoring (CGM) device. Methods: Study participants (patch, n = 49; pen, n = 48) wore a CGM device in masked setting during the baseline period and prior to week 24. Glycemic control was assessed using international consensus guidelines for percentage of Time In Range (%TIR: 〉 70% at 70-180 mg/dL), Time Below Range (%TBR: 〈 4% at 〈 70 mg/dL; 〈 1% at 〈 54 mg/dL), and Time Above Range (%TAR: 〈 25% at 〉 180 mg/dL; 〈 5% at 〉 250 mg/dL). Results: Both the patch and pen groups achieved recommended targets in %TIR (74.1% ± 18.7%, 75.2 ± 16.1%, respectively) and marked reductions in %TAR 〉 180 mg/dL (21.1% ± 19.9%, 19.7% ± 17.5%, respectively) but with increased %TBR 〈 70 mg/dL (4.7% ± 5.2%, 5.1 ± 5.8, respectively), all P 〈 .0001. No significant between-group differences in glycemic improvements or adverse events were observed. Conclusions: CGM confirmed that the patch or pen can be used to safely initiate and optimize basal-bolus therapy using a simple insulin adjustment algorithm with SMBG. Preference data suggest that use of the patch vs pen may enhance treatment adherence.
    Type of Medium: Online Resource
    ISSN: 1932-2968 , 1932-2968
    URL: Article
    DOI: 10.1177/19322968211016513
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2467312-2
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  • 3
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    Effect of Professional CGM (pCGM) on Glucose Management in Type 2 Diabetes Patients in Primary Care
    SAGE Publications ; 2021
    In:  Journal of Diabetes Science and Technology Vol. 15, No. 3 ( 2021-05), p. 539-545
    Details
    In: Journal of Diabetes Science and Technology, SAGE Publications, Vol. 15, No. 3 ( 2021-05), p. 539-545
    Abstract: Little data exists regarding the impact of continuous glucose monitoring (CGM) in the primary care management of type 2 diabetes (T2D). We initiated a quality improvement (QI) project in a large healthcare system to determine the effect of professional CGM (pCGM) on glucose management. We evaluated both an MD and RN/Certified Diabetes Care and Education Specialist (CDCES) Care Model. Methods: Participants with T2D for 〉 1 yr., A1C ≥7.0% to 〈 11.0%, managed with any T2D regimen and willing to use pCGM were included. Baseline A1C was collected and participants wore a pCGM (Libre Pro) for up to 2 weeks, followed by a visit with an MD or RN/CDCES to review CGM data including Ambulatory Glucose Profile (AGP) Report. Shared-decision making was used to modify lifestyle and medications. Clinic follow-up in 3 to 6 months included an A1C and, in a subset, a repeat pCGM. Results: Sixty-eight participants average age 61.6 years, average duration of T2D 15 years, mean A1C 8.8%, were identified. Pre to post pCGM lowered A1C from 8.8% ± 1.2% to 8.2% ± 1.3% (n=68, P=0.006). The time in range (TIR) and time in hyperglycemia improved along with more hypoglycemia in the subset of 37 participants who wore a second pCGM. Glycemic improvement was due to lifestyle counseling (68% of participants) and intensification of therapy (65% of participants), rather than addition of medications. Conclusions: Using pCGM in primary care, with an MD or RN/CDCES Care Model, is effective at lowering A1C, increasing TIR and reducing time in hyperglycemia without necessarily requiring additional medications.
    Type of Medium: Online Resource
    ISSN: 1932-2968 , 1932-2968
    URL: Article
    DOI: 10.1177/1932296821998724
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
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  • 4
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    Knowing Well, Being Well: well-being born of understanding: Addressing the Caregiving Crisis: The Roles for Employers and Policy Makers
    SAGE Publications ; 2021
    In:  American Journal of Health Promotion Vol. 35, No. 7 ( 2021-09), p. 1028-1047
    Details
    In: American Journal of Health Promotion, SAGE Publications, Vol. 35, No. 7 ( 2021-09), p. 1028-1047
    Type of Medium: Online Resource
    ISSN: 0890-1171 , 2168-6602
    URL: Article
    DOI: 10.1177/08901171211030142
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2134271-4
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  • 5
    Online Resource
    Online Resource
    USPHS Corps Care : Force Health Protection for Public Health Officers During the Ebola and COVID-19 Responses
    SAGE Publications ; 2021
    In:  Public Health Reports Vol. 136, No. 2 ( 2021-03), p. 148-153
    Details
    In: Public Health Reports, SAGE Publications, Vol. 136, No. 2 ( 2021-03), p. 148-153
    Abstract: Force health protection (FHP) is defined as “the prevention of disease and injury in order to protect the strength and capabilities” of any service population. FHP was the foundational principal of the US Public Health Service (USPHS). President John Adams’ signing of An Act for Sick and Disabled Seamen on July 16, 1798, marked the first dedication of US federal resources to ensuring the well-being of US civilian sailors and Naval service members. On January 4, 1889, President Cleveland enacted the USPHS Commissioned Corps, creating the world’s first (and still only) uniformed service dedicated to promoting, protecting, and advancing the health and safety of the United States and the world. Building on the lessons of the 2014-2015 response to the Ebola virus pandemic, the Corps Care program was formalized in 2017 to establish and implement a uniform and comprehensive strategy to meet the behavioral health, medical, and spiritual needs of all Commissioned Corps officers. Its role was expanded in response to the coronavirus disease 2019 (COVID-19) pandemic, which has placed unprecedented demands on health care workers and spotlighted the need for FHP strategies. We describe the FHP roles of the Corps Care program for the resiliency of Commission Corps officers in general and the Corps’ impact during the response to the COVID-19 pandemic. Qualitative analysis of FHP discussions with deployed officers highlights the unique challenges to FHP presented by the pandemic response.
    Type of Medium: Online Resource
    ISSN: 0033-3549 , 1468-2877
    URL: Article
    DOI: 10.1177/0033354920984775
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2017700-8
    SSG: 20,1
    SSG: 27
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  • 6
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    Predictors of glycaemic control among HIV-positive veterans with diabetes
    SAGE Publications ; 2015
    In:  International Journal of STD & AIDS Vol. 26, No. 4 ( 2015-03), p. 262-267
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 26, No. 4 ( 2015-03), p. 262-267
    Abstract: Antiretroviral therapy has decreased HIV-related mortality. However, the incidence of diabetes as a co-morbidity is increasing as HIV-positive patients age. The purpose of this study was to assess the correlation between markers of HIV-infection and diabetes and to determine the proportion of patients achieving an haemoglobin A1c (HbA1c) goal 〈 7% according to specific antiretroviral therapy regimens and adherence. In this retrospective study, HIV-positive veterans with diabetes from 2007 to 2012 were identified. Patients were required to be on the same antiretroviral therapy and diabetes regimen for ≥3 months. In 56 patients, it was identified that for each unit increase in log 10 viral load, HbA1c increased 0.67 units ( p = 0.0085). Only 38% of patients prescribed a protease inhibitor–based regimen vs. 56% of patients not on a protease inhibitor–based regimen achieved an HbA1c goal ( p = 0.1864). Additionally, patients on an insulin-based regimen and patients that were less adherent were less likely to be at HbA1c goal ( p = 0.018 and p = 0.0378, respectively). Patients with higher viral loads and patients that were less adherent to antiretroviral therapy were more likely to have a higher HbA1c demonstrating that poor adherence to antiretroviral therapy leads to poor control of both disease states.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1177/0956462414535207
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2009782-7
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  • 7
    Online Resource
    Online Resource
    The Relationships Between Time in Range, Hyperglycemia Metrics, and HbA1c
    SAGE Publications ; 2019
    In:  Journal of Diabetes Science and Technology Vol. 13, No. 4 ( 2019-07), p. 614-626
    Details
    In: Journal of Diabetes Science and Technology, SAGE Publications, Vol. 13, No. 4 ( 2019-07), p. 614-626
    Abstract: As the use of continuous glucose monitoring (CGM) increases, there is a need to better understand key metrics of time in range 70-180 mg/dL (TIR 70-180 ) and hyperglycemia and how they relate to hemoglobin A1c (A1C). Methods: Analyses were conducted utilizing datasets from four randomized trials encompassing 545 adults with type 1 diabetes (T1D) who had central-laboratory measurements of A1C. CGM metrics were calculated and compared with each other and A1C cross-sectionally and longitudinally. Results: Correlations among CGM metrics (TIR 70-180 , time 〉 180 mg/dL, time 〉 250 mg/dL, mean glucose, area under the curve above 180 mg/dL, high blood glucose index, and time in range 70-140 mg/dL) were typically 0.90 or greater. Correlations of each metric with A1C were lower (absolute values 0.66-0.71 at baseline and 0.73-0.78 at month 6). For a given TIR 70-180 percentage, there was a wide range of possible A1C levels that could be associated with that TIR 70-180 level. On average, a TIR 70-180 of 70% and 50% corresponded with an A1C of approximately 7% and 8%, respectively. There also was considerable spread of change in A1C for a given change in TIR 70-180 , and vice versa. An increase in TIR 70-180 of 10% (2.4 hours per day) corresponded to a decrease in A1C of 0.6%, on average. Conclusions: In T1D, CGM measures reflecting hyperglycemia (including TIR and mean glucose) are highly correlated with each other but only moderately correlated with A1C. For a given TIR or change in TIR there is a wide range of possible corresponding A1C values.
    Type of Medium: Online Resource
    ISSN: 1932-2968 , 1932-2968
    URL: Article
    DOI: 10.1177/1932296818822496
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
    detail.hit.zdb_id: 2467312-2
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  • 8
    Online Resource
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    Coaching of Physicians by RNs to Improve Diabetes Care
    SAGE Publications ; 2013
    In:  The Diabetes Educator Vol. 39, No. 2 ( 2013-03), p. 171-177
    Details
    In: The Diabetes Educator, SAGE Publications, Vol. 39, No. 2 ( 2013-03), p. 171-177
    Abstract: The purpose of this study is to describe preliminary results of an innovative quality improvement intervention focused on improving physician practice patterns in diabetes care via Coaching Physicians by RN certified diabetes educators (CDEs), a program called “CPR for Diabetes Care.” Methods The program identified primary care physicians with optimal diabetes control rates below the system aggregate (n = 195). Physicians with the lowest rates (n = 74) were targeted for comprehensive intervention. All other low-performing physicians practicing in the same clinic system (n = 121) comprised the comparison group. Data were obtained from electronic diabetes registries for 2007 and 2008. Each physician had a set of measures from 2 points in time. Measures included optimal diabetes scores and the 5 component measures of the optimal diabetes care bundle (A1C 〈 7, low-density lipoprotein cholesterol 〈 100, blood pressure 〈 130/80, aspirin use if older than 40, and no tobacco use). T tests and difference-in-difference models were used to examine changes over time. Results Optimal diabetes scores increased 11.7 points (from 14.7% to 26.4%) for intervention physicians and 4.0 points (from 29.7% to 32.9%) for comparison physicians. The improvement was greater for the intervention group. The greatest component improvements were in control of blood pressure and cholesterol. Conclusions Coaching low-performing physicians dramatically improved the proportion of diabetes patients with optimal diabetes control. The CPR for Diabetes Care program represents an innovative and effective way to address the long-standing problem of disseminating and sustaining quality improvement efforts by focusing on low-performing physicians.
    Type of Medium: Online Resource
    ISSN: 0145-7217 , 1554-6063
    URL: Article
    DOI: 10.1177/0145721713475847
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2013
    detail.hit.zdb_id: 3062380-7
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  • 9
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    A comparison of the effectiveness of lipid-lowering therapy between HIV- and non-HIV-infected subjects with hyperlipidaemia
    SAGE Publications ; 2007
    In:  International Journal of STD & AIDS Vol. 18, No. 12 ( 2007-12-01), p. 851-855
    Details
    In: International Journal of STD & AIDS, SAGE Publications, Vol. 18, No. 12 ( 2007-12-01), p. 851-855
    Abstract: This retrospective cohort study conducted at the Durham Veterans Affairs Medical Center evaluated the effectiveness and safety of lipid-lowering therapy (LLT) in a HIV-infected population as compared with a general population with hyperlipidaemia. Fifty-three HIV-infected subjects who developed dyslipidaemia and 53 age-matched non-HIV-infected subjects receiving LLT were selected. Efficacy of LLT was assessed after three and six months. Non-HIV-infected subjects were more likely to achieve total cholesterol (TC) goals at three and six months ( P = 0.045, P = 0.005) and triglyceride (TG) goals at six months ( P = 0.017). Less than 45% of HIV-infected subjects met National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) goals at three or six months. While non-HIV-infected subjects were more likely to achieve TC and TG goals than HIV-infected subjects, overall achievement of NCEP III goals was poor. This result was likely due to treatment with inappropriately low doses of statins.
    Type of Medium: Online Resource
    ISSN: 0956-4624 , 1758-1052
    URL: Article
    DOI: 10.1258/095646207782716974
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2007
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  • 10
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    Pain Early After Anterior Cruciate Ligament Reconstruction is Associated With 6-Month Loading Mechanics During Running
    SAGE Publications ; 2022
    In:  Sports Health: A Multidisciplinary Approach
    Details
    In: Sports Health: A Multidisciplinary Approach, SAGE Publications
    Abstract: Anterior cruciate ligament reconstruction (ACLR) results in persistent altered knee biomechanics, but contributing factors such as pain or patient function, leading to the altered loading, are unknown. Hypothesis: Individuals with worse self-reported pain after ACLR would have poorer biomechanics during running, and poor loading mechanics would be present in the ACLR limb compared with contralateral and control limbs. Study Design: Cohort pilot study. Level of Evidence: Level 3. Methods: A total of 20 patients after ACLR (age, 18.4 ± 2.7 years; height, 1.7 ± 0.1 m; mass, 84.2 ± 19.4 kg) completed visual analog scale and Knee Injury and Osteoarthritis Outcomes Score (KOOS) at 1 and 6 months postsurgery. At 6 months postsurgery, patients underwent biomechanical testing during running. A total of 20 control individuals also completed running biomechanical analyses. Associations between patient outcomes and biomechanics were conducted, and differences in running biomechanics between groups were analyzed. Results: KOOS pain score 1 month after surgery was associated with peak ACLR knee abduction moment ( R 2 = 0.35; P = 0.01). At 6-months, KOOS sport score was related to peak abduction moment in the ACLR limb ( R 2 = 0.23; P = 0.05). For change scores, the improvement in pain scores related to ACLR limb peak knee abduction moment ( R 2 = 0.55; P = 0.001). The ACLR limb had lower knee excursion, extension moments, and ground-reaction forces compared with the uninvolved and control limb. The uninvolved limb also had higher ground-reaction forces compared with the ACLR limb and control limb. Conclusion: These results suggest that patient-reported outcomes 1 and 6 months after surgery are associated with running mechanics 6 months after ACLR. Further, the underloading present in the ACLR limb and overloading in the uninvolved limb indicates greater need for running rehabilitation after ACLR. Clinical Relevance: Understanding pain and how it may be linked to movement dysfunction is important for improving long-term outcomes.
    Type of Medium: Online Resource
    ISSN: 1941-7381 , 1941-0921
    URL: Article
    DOI: 10.1177/19417381221139478
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2474978-3
    SSG: 31
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