Strategies to Improve Prevention and Management in Diabetic Retinopathy: Qualitative Insights from a Mixed-Methods Study.

Nonproliferative and proliferative diabetic retinopathy (DR) are common, progressive complications of diabetes with a rising incidence. Over time, patients with nonproliferative DR may progress to more advanced stages of DR, with an increased risk of vision-threatening conditions such as diabetic macular edema (DME). DME is the most frequent cause of vision loss in patients with diabetes and eventually can lead to blindness.

Insulin: Making Sense of Current Options.

Newer insulin products have advanced the evolution of insulin replacement options to more accurately mimic natural insulin action. There are new, modified, and concentrated insulins; administration devices calibrated for both increased concentrations and administration accuracy to improve adherence and safety; and inhaled insulin. There are new combinations of longer-acting basal insulin and rapid-acting insulin or glucagon like protein-1 receptor agonists.

Preventive intervention in diabetes: a new model for continuing medical education.

Competence and skills in overcoming clinical inertia for diabetes treatment, and actually supporting and assisting the patient through adherence and compliance (as opposed to just reiterating what they "should" be doing and then assigning them the blame if they fail) is a key component to success in addressing diabetes, and to date it is a component that has received little formal attention. To improve and systematize diabetes care, it is critical to move beyond the "traditional" continuing medical education (CME) model of imparting knowledge as the entirety of the educational effort, and move toward a focus on Performance Improvement CME. This new approach does not just teach new information but also provides support for improvements where needed most within practice systems based on targeted data-based on self-assessments for the entire system of care.

Coordinated primary and specialty care for type 2 diabetes mellitus, guidelines, and systems: an educational needs assessment.

Objective: To determine knowledge, competence, and attitudinal issues among primary care providers (PCPs) and diabetes specialists regarding the use and application of evidence-based clinical guidelines and the coordination of care between PCPs and diabetes specialists specifically related to referral practices for patients with diabetes.

Methods: A survey tool was completed by 491 PCPs and 249 diabetes specialists. Data were collected from specialists online and from PCP attendees at live symposia across the United States.

The integrated Joslin performance improvement/CME program: a new paradigm for better diabetes care.

Ongoing continuing medical education is an essential component of life-long learning and can have a positive influence on patient outcomes. However, some evidence suggests that continuing medical education has not fulfilled its potential as a performance improvement (PI) tool, in part due to a paradigm of CME that has focused on the quantity of continuing medical education credits attained rather than the quality of outcomes. The Joslin Diabetes Center has undertaken a new performance-based CME program model that offers performance improvement and continuing medical education as a unified entity that is convenient and accessible for the overburdened primary care physician.

Usage patterns of devices designed to support diabetes management: an educational needs assessment.

Objective: To determine knowledge, competence, and attitudinal issues among diabetes specialists and primary care providers (PCPs) regarding the use of insulin delivery devices such as insulin pens and insulin pumps and the role of glucose monitoring devices and systems in the care of patients with diabetes.

Methods: A quantitative survey tool was developed that contained 51 questions directed to diabetes specialists and 49 questions directed to PCPs. A 5-point, Likert-type scale or multiple-choice format was used.

Insulin therapy and the reluctant patient.

Preview When diabetic patients learn that insulin therapy is necessary, they may fee) overwhelmed by anticipated changes in lifestyle. The key to success is to realize that every person with diabetes has individual needs and that these must be assessed, addressed, and accommodated. Better diabetes control will be the result.