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Introduction: Patient outcomes resulting from optimal type 1 diabetes (T1D) care have historically focused on driving a single metric, hemoglobin A. Our objectives were to design, build, and launch an aggregate clinical indicator that comprehensively reflects patient management status beyond hemoglobin A alone. This project aimed to show proof of principle that an aggregate score comprised of T1D outcome metrics could be built to track quality performance.
Methods: We established an electronic medical record-based diabetes registry and utilized its population health modules to design and build this diabetes care metric. Elements representing optimal diabetes management, as defined by current guidelines and expert opinion, were identified. Nine elements fall into categories of management tools, care assessments, and complications risk. The Type 1 Diabetes Composite Score (T1DCS) aggregates these outcome measures to reflect the overall diabetes care status for each patient. Higher scores suggest better management and overall improved patient health.
Results: We launched this metric build in November 2018 and applied the scoring to our T1D population (≈1,900 patients). The T1DCS quickly provides a summary of current diabetes management status. T1DCS viewed over the registry cohort demonstrates a normal distribution, and scores improved from March to September 2019, reflecting better care and outcomes, and illustrating the potential to track program effectiveness.
Conclusions: The T1DCS is a useful metric to evaluate the clinical status of T1D patients, assess the capability of a clinical program to achieve optimal diabetes outcomes, identify patient diversity opportunities, and document outcome improvement as a novel comprehensive quality measure.
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http://dx.doi.org/10.1097/pq9.0000000000000354 | DOI Listing |
Diabetes Ther
December 2024
IMMEDIAB Laboratory, Institut Necker Enfants Malades, INSERM U1151, CNRS, UMR 8253, Paris, France.
Introduction: While people with diabetes (PWD)'s experiences with their insulin delivery systems (IDS) are frequently reported in clinical trials, few real-world data exist on the subject. This study aimed to assess the real-world experience and satisfaction with IDS in PWD.
Methods: This cross-sectional survey of PWD treated with tubed or tubeless insulin pumps, hybrid closed loop (HCL) systems, or multiple daily injections (MDI) for at least 3 months ran from 4 to 16 May 2023.
Urolithiasis
December 2024
Department of Urology, University of Health Sciences School of Medicine, Ankara State Hospital, Ankara, Turkey.
The current study aimed to determine the risk factors and define a new scoring system for predicting febrile urinary tract infection (F-UTI) following retrograde intrarenal surgery (RIRS) by using machine learning methods. We retrospectively analyzed the medical records of patients who underwent RIRS and 511 patients were included in the study. The patients were divided into two groups: Group 1 consisted of 34 patients who developed postoperative F-UTI, and Group 2 consisted of 477 patients who did not.
View Article and Find Full Text PDFOphthalmology
December 2024
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan. Electronic address:
Cardiovasc Revasc Med
December 2024
Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany. Electronic address:
Objective: The study investigates long-term outcomes of unselected inpatients undergoing invasive coronary angiography (CA) with and without diabetes mellitus type II (T2DM).
Background: Due to continual shifts in demographics and advancements in treating cardiovascular disease, there has been a notable evolution in the types of patients undergoing CA over the past decades. Comprehensive data on the extended outcomes of CA patients, both with and without concurrent T2DM, remains scarce.
Endocrinol Diabetes Metab
January 2025
Department of Hematology, Affiliated Hospital of Qingdao University, Qingdao, China.
Background: With the elevated level of NAFLD prevalence, the incidence of diabetes, hypertension, metabolic syndrome and other diseases is also significantly elevated. GLP-1RA can exert weight loss, glucose-lowering effects and various nonglycaemic effects. However, the relationship between quantitative reduction in hepatic fat content and improvement of pancreatic islet function by GLP-1RA is unclear.
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