To explore the relationship of glycemic variability with lower extremity arterial disease (LEAD) and diabetic peripheral neuropathy (DPN). Seventy-eight patients with type 2 diabetes were enrolled. All patients underwent 72-hour dynamic blood glucose monitoring and obtained mean amplitude of glycemic excursions (MAGE), mean of daily differences (MODD), standard deviation of blood glucose (SD), largest amplitude of glycemic excursion (LAGE), mean blood glucose (MBG), T≥10.0 (percentage of time for blood glucose levels ≥10.0 mmol/L), T≤3.9 (percentage of time for blood glucose levels ≤3.9 mmol/L), and other glycemic variability parameters. In the meanwhile, in order to explore the correlation of glycemic variability parameters with ankle-brachial index (ABI), vibration perception threshold (VPT), and current perception threshold (CPT), all patients underwent quantitative diabetic foot screening, including ABI for quantitative assessment of lower extremity arterial lesions and VPT and CPT for quantitative assessment of peripheral neuropathy. Patients were divided into abnormal CPT group (n = 21) and normal CPT group (n = 57) according to the CPT values. Compared with the normal CPT group, abnormal CPT group showed significantly higher levels of HbA1c, longer duration of diabetes, and higher levels of T≤3.9 (P < .05). However, there was no significant difference of MAGE, SD, LAGE, MODD, and other glycemic variability parameters between abnormal CPT group and normal CPT group (P > .05). Pearson correlation analysis or Spearman correlation analysis showed that ABI negatively correlated with MBG, T≥10.0, SD, LAGE, and MAGE (P < .05), but no correlation of ABI with T≤3.9 and MODD (P > .05) was shown. VPT showed a positive correlation with T≥10.0 (P < .05), but no correlation with other glycemic variability parameters (P > .05). There was no correlation between the other CPT values and the glycemic variability parameters (P > .05), except that the left and right 250 Hz CPT values were positively correlated with T≤3.9 (P > .05). The higher the blood glucose levels, the severer the degree of LEAD and DPN lesions; the higher the incidence of hypoglycemia, the severer the degree of DPN lesions; the greater the fluctuation of blood glucose, the severer the degree of LEAD lesions. However, the glycemic variability was not significantly correlated with DPN.
Objective: To investigate the clinical nurses' knowledge of SBAR's (Situation, Background, Assessment, Recommendation) blood glucose management in a large hospital of Guangzhou and to provide a basis for the training and promotion of SBAR's blood glucose management knowledge in the hospital. Methods: 100 clinical nurses from a large hospital of Guangzhou were selected as the research objects. Data were collected by means of questionnaire survey to investigate and analyze the clinical nurses' knowledge of SBAR's management of blood glucose. Results: The awareness rate of SBAR in clinical nurses was 42.55%. The awareness rate of SBAR in the management of blood glucose in hospital was 23.40%, and the clinical significance of SBAR in the management of high and low blood glucose was 39.36%. With the improvement of educational background, professional title and working years, the scores of nurses on SBAR related knowledge gradually increased, and the higher education background had a significant impact on SBAR related knowledge (P < 0.05). The scores of nurses who received SBAR training were higher than those who did not received (P < 0.01). The knowledge most desired by clinical nurses in the management of in-hospital blood glucose was analyzed by SBAR (61.43%), and the clinical significance of SBAR in the management of non-endocrine blood glucose (50%). Conclusion: clinical nurses' knowledge of SBAR management of blood glucose in the hospital is relatively inadequate, and unified norms and standards should be formulated in terms of SBAR model analysis of high and low blood glucose and timely treatment.
Objective: To estimate the incidence of and identified factors associated with hypoglycemia among perioperative diabetes patients with insulin pump therapy. Methods: This was a retrospective cohort study of type 2 diabetes patients with insulin pump therapy newly received surgery. All patients were divided into hypoglycemia group and non-hypoglycemia group according to whether they experienced hypoglycemia. Information about clinical characteristics and treatments were collected and compared between two groups. We estimated the incidence of hypoglycemia, and identified factors associated with hypoglycemia by using multivariable logistic regression. Results: A total of 172 episodes of hypoglycemia were observed in 88 (39.8%) patients, among which, 146 (84.9%) were level 1 hypoglycemia (<3.9 mmol/L) and 26 (15.1%) were level 2 (< 3.0 mmol/L). No severe hypoglycemia (level 3) was reported in this study. Results from the multivariable logistic regression model found that diabetes patients with a longer duration of pump use were more likely to have hypoglycemia (AOR=1.09 with 95% CI=1.04-1.15). However, those diabetes patients who were with higher BMI and eGFR were less likely to have hypoglycemia (AOR=0.86 with 95% CI=0.76-0.98; AOR=0.86 with 95% CI=0.76-0.98, respectively). Conclusion: Perioperative diabetes patients with insulin pump therapy were prone to develop mild to moderate hypoglycemia. The long-term of receiving insulin pump therapy during the perioperative period, with lower BMI and eGFR, put type 2 diabetes at higher risks in hypoglycemia. It may help healthcare providers to screen hypoglycemia among type 2 diabetes patients with receiving long-term insulin pump therapy.
Objective: To examine the efficacy of Toyota Business Practice (TBP) method in improving the utilization rate of insulin pump in non-endocrine diabetic patients. Methods: Toyota method is a process requires continuous learning and improvement. The characteristic feature of Toyota's working method is the problem-solving guided by basic consciousness. It is the essential basic knowledge for every person who studies Toyota problem solving methods. TBP is an ideal and scientific tool for achieving goals, careful planning, effective implementation, timely review and effective measures are the ways to make TBP a more efficient and economical tool. It is divided into eight steps including clarify problems, decompose problems, set goals, identify the real causes, formulate countermeasures, implement, evaluate results and processes, as well as consolidate achievements were used in the process of prescribing insulin pump to patients with diabetic treated in non-endocrine department. The efficacy of Toyota TBP will be measured and compared in a cohort before and after the implantation. Results: After utilizing Toyota TBP method, the use of insulin pump in non-endocrinology department increased by 10%. Conclusion: Our data suggested that the Toyota TBP method optimized the process of using insulin pump in non-endocrinology department, improved the work flow and the overall utilization rate as well as the prognosis of patients.
Objective: To explore the effect of Nursing Quality Improvement on reducing the incidence of hypoglycemia prior to and during colonoscopy in diabetes patients. Methods: The causes of hypoglycemia prior to and during colonoscopy were first analyzed. Then, the corresponding improvement plan and special procedure rules prior to and during colonoscopy were put forward. All the nurses including 23 nurses in the endocrinology department and 2 nurses in the endoscopy room must strictly obey the procedure rules. The Ward of Manager and the Nurse in charge were responsible for supervision. The awareness rate of nurse staff on the knowledge of colonoscopy and behavior improvement of nurse staff before and after the improvement were compared. The incidence of hypoglycemia prior to and during colonoscopy before and after the improvement were calculated. Results: After the Nursing Quality Improvement, the awareness rate of colonoscopy related knowledge in nurse staff was improved from 97.6 to 100%. All the nurses changed their nursing behavior related to bowel preparation from "Occasionally" to "Always". Besides, the incidence of hypoglycemia prior to and during colonoscopy was reduced from 25% to 8.58% after the improvement. Conclusion: The application of Nursing Quality Improvement prior to and during colonoscopy can reduce the incidence of hypoglycemia and ensure the safety of patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.