Introduction

Cheng, Alice

doi:10.1016/j.jcjd.2013.01.009

Cited by 305 publications

(164 citation statements)

References 13 publications

(7 reference statements)

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“…Ethnicity (Aboriginal and non-Aboriginal), age and gender are also identified as co-morbidities by the Canada Diabetes Association [7]. Therefore, screening included obtaining such demographic data from the participants.…”

Section: Methods and Proceduresmentioning

confidence: 99%

Nurse-led diabetic retinopathy screening: a pilot study to evaluate a new approach to vision care for Canadian Aboriginal peoples

Spurr

Bullin

Bally

et al. 2018

International Journal of Circumpolar Health

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Diabetic retinopathy is the most common cause of new cases of blindness and is pandemic among Aboriginal people around the world. To reduce health inequities, accessible vision screening among these high-risk populations is essential. To assess cardio-metabolic co-morbidities associated with type 2 diabetes and the use of a portable fundus camera as a novel approach for convenient, earlier and more accessible vision screening for Aboriginal peoples living with type 2 diabetes in northern and remote Canadian communities. This quantitative pilot study screened participants diagnosed with type 2 diabetes for commonly associated cardio-metabolic co-morbidities using anthropometrical measurements, blood pressure and a A1c (HbA1c) blood glucose test, followed by vision exams conducted first by a trained nurse and then by an ophthalmologist to screen for signs of retinopathy using fundus photography. Large numbers of the participants presented with overweight/obese (84.8%), pre-hypertension/hypertension (69.7%) and an elevated A1C (78.8%). Inter-rater reliability demonstrated substantial agreement between vision exam judgements made by the nurse and ophthalmologist (k = .67). Nurse-led vision screening in remote or northern communities can improve the standard of care by extending access to health services, lowering the costs to families by reducing travel expenses and preventing vision loss in a family member.

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Section: Methods and Proceduresmentioning

confidence: 99%

Nurse-led diabetic retinopathy screening: a pilot study to evaluate a new approach to vision care for Canadian Aboriginal peoples

Spurr

Bullin

Bally

et al. 2018

International Journal of Circumpolar Health

View full text Add to dashboard Cite

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“…Clinic visits consisted of a standardized assessment and hardcopy form that highlighted blood pressure and urine albumin control, review of core laboratory studies every 3 months for at least 1 year (hemoglobin, electrolytes, serum creatinine, calcium, phosphate, and urine albumin to creatinine ratio [ACR]), cardiovascular risk modification, management of CKD complications, medication reconciliation and specialist referrals for comorbidity management. Evidence-based guidelines were provided on the standardized assessment forms for treatment of CKD [18], hypertension [19], hyperlipidemia [20] and diabetic nephropathy [21] (online suppl. fig.…”

Section: Methodsmentioning

confidence: 99%

Improving Care after Acute Kidney Injury: A Prospective Time Series Study

Silver

Harel

Harvey

et al. 2015

Nephron

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Background: Acute kidney injury (AKI) complicates 15-20% of hospitalizations, and AKI survivors are at increased risk of chronic kidney disease and death. However, less than 20% of patients see a nephrologist within 3 months of discharge, even though a nephrologist visit within 90 days of discharge is associated with enhanced survival. To address this, we established an AKI Follow-Up Clinic and characterized the patterns of care delivered. Methods: We conducted a prospective time series study. All hospitalized patients who developed Kidney Disease Improving Global Outcomes (KDIGO) stage 2 or 3 AKI were eligible. The pre-intervention period consisted of electronic reminders to the nephrology consults and cardiovascular surgery services to refer to the AKI Follow-Up Clinic. In the post-intervention period, eligible patients were automatically scheduled into the AKI Follow-Up Clinic at discharge. The primary outcome was the percentage of KDIGO stages 2-3 AKI survivors assessed by a nephrologist within 30 days of discharge. Results: In the pre-intervention period, 8 of 46 patients (17%) were seen by a nephrologist within 30 days after discharge, and no additional patients were seen for 90 days. In the post-intervention period, 17 of 69 patients (25%) were seen by a nephrologist within 30 days after discharge (p = 0.36), with an additional 30 patients seen in 90 days (47 of 69, 68%, p < 0.001). The mean serum creatinine was 99 (SD 35) µmol/l prior to hospitalization and 133 (58) µmol/l at 3 months. Fifty-five of 79 patients (70%) received at least 1 medical intervention at their first AKI Follow-Up Clinic visit. Conclusions: An AKI Follow-Up Clinic with an automatic referral process increased the proportion of patients seen at 90 days, but not 30 days post discharge. Being seen in the AKI Follow-Up Clinic was associated with interventions in most patients. Future research is needed to evaluate the effect of the AKI Follow-Up Clinic on patient-centered outcomes, but physicians should be aware that AKI survivors may benefit from close outpatient follow-up and a multipronged approach to care similarly for other high-risk populations.

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“…Hypoglycaemia definitions, including symptomatic vs. blood glucose measured and the use of different blood glucose cut‐off points, vary in different studies, regions and guidelines 7, 8, 9. For example, the ADA and American Academy of Clinical Endocrinologists consider blood glucose values ≤ 3.9 mmol/l as hypoglycaemia 5, 8; the International Hypoglycaemia Study Group and ADA/EASD recommend reporting all events with blood glucose < 3.0 mmol/l 10; the Canadian Diabetes Association use a cut‐off of 4 mmol/l 7; whereas a cut‐off of 3.5 mmol/l has been used to define clinically meaningful hypoglycaemia 6. The use of different hypoglycaemia definitions has a major effect on reported hypoglycaemia incidence 10, 11, 12.…”

Section: Introductionmentioning

confidence: 99%

Regional variations in definitions and rates of hypoglycaemia: findings from the global HAT observational study of 27 585 people with Type 1 and insulin‐treated Type 2 diabetes mellitus

et al. 2018

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AimTo determine participant knowledge and reporting of hypoglycaemia in the non‐interventional Hypoglycaemia Assessment Tool (HAT) study.Methods HAT was conducted in 24 countries over a 6‐month retrospective/4‐week prospective period in 27 585 adults with Type 1 or insulin‐treated Type 2 diabetes mellitus. Participants recorded whether hypoglycaemia was based on blood glucose levels, symptoms or both.ResultsHypoglycaemia rates were consistently higher in the prospective compared with the retrospective period. Most respondents (96.8% Type 1 diabetes; 85.6% Type 2 diabetes) knew the American Diabetes Association/European Association for the Study of Diabetes hypoglycaemia definition, but there were regional differences in the use of blood glucose measurements and/or symptoms to define events. Confirmed symptomatic hypoglycaemia rates were highest in Northern Europe/Canada for Type 1 diabetes (63.9 events/year) and in Eastern Europe for Type 2 diabetes (19.4 events/year), and lowest in South East Asia (Type 1 diabetes: 6.0 events/year; Type 2 diabetes: 3.2 events/year). Unconfirmed symptomatic hypoglycaemia rates were highest in Eastern Europe for Type 1 diabetes (5.6 events/year) and South East Asia for Type 2 diabetes (4.7 events/year), and lowest for both in Russia (Type 1 diabetes: 2.1 events/year; Type 2 diabetes: 0.4 events/year). Participants in Latin America reported the highest rates of severe hypoglycaemia (Type 1 diabetes: 10.8 events/year; Type 2 diabetes 3.7 events/year) and severe hypoglycaemia requiring hospitalization (Type 1 diabetes: 0.56 events/year; Type 2 diabetes: 0.44 events/year). The lowest rates of severe hypoglycaemia were reported in South East Asia (Type 1 diabetes: 2.0 events/year) and Northern Europe/Canada (Type 2 diabetes: 1.3 events/year), and the lowest rates of severe hypoglycaemia requiring hospitalization were in Russia (Type 1 diabetes: 0.15 events/year; Type 2 diabetes: 0.09 events/year). The blood glucose cut‐off used to define hypoglycaemia varied between regions (Type 1 diabetes: 3.1–3.6 mmol/l; Type 2 diabetes: 3.5–3.8 mmol/l).ConclusionsUnder‐reporting of hypoglycaemia rates in retrospective recall and regional variations in participant definitions of hypoglycaemia may contribute to the global differences in reported rates. Discrepancies between participant definitions and guidelines may highlight a need to redefine hypoglycaemia criteria. (Clinical Trials Registry No: NCT01696266).

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Introduction

Cited by 305 publications

References 13 publications

Nurse-led diabetic retinopathy screening: a pilot study to evaluate a new approach to vision care for Canadian Aboriginal peoples

Nurse-led diabetic retinopathy screening: a pilot study to evaluate a new approach to vision care for Canadian Aboriginal peoples

Improving Care after Acute Kidney Injury: A Prospective Time Series Study

Regional variations in definitions and rates of hypoglycaemia: findings from the global HAT observational study of 27 585 people with Type 1 and insulin‐treated Type 2 diabetes mellitus

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