Integrated personalized diabetes management (IPDM) has emerged as a promising approach to improving outcomes in patients with diabetes mellitus (DM). This care approach emphasizes the integration and coordination of different providers, including physicians, nurses, dietitians, social workers and pharmacists. The goal of IPDM is to provide patients with personalized care that is tailored to their needs. This review addresses the concept of integrated care and the use of technology (including data, software applications and artificial intelligence) as well as managerial, regulatory and financial aspects. The implementation and upscaling of digitally enabled IPDM are discussed, with elaboration of successful practices and related evidence. Finally, recommendations are made. It is concluded that the adoption of digitally enabled IPDM on a global level is inevitable, considering the challenges created by an increasing prevalence of patients with DM and the need for better outcomes and improvement of health system sustainability.
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http://dx.doi.org/10.1111/dom.15476 | DOI Listing |
J Am Med Inform Assoc
January 2025
Institute of Data Science, National University of Singapore, 117602, Singapore.
Objectives: This study introduces Smart Imitator (SI), a 2-phase reinforcement learning (RL) solution enhancing personalized treatment policies in healthcare, addressing challenges from imperfect clinician data and complex environments.
Materials And Methods: Smart Imitator's first phase uses adversarial cooperative imitation learning with a novel sample selection schema to categorize clinician policies from optimal to nonoptimal. The second phase creates a parameterized reward function to guide the learning of superior treatment policies through RL.
J Bras Nefrol
January 2025
Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil.
Introduction: Acute kidney injury (AKI) in the setting of COVID-19 is associated with worse clinical and renal outcomes, with limited long-term data.
Aim: To evaluate critically ill COVID-19 patients with AKI that required nephrologist consultation (NC-AKI) in a tertiary hospital.
Methods: Prospective single-center cohort of critically ill COVID-19 adult patients with NC-AKI from May 1st, 2020, to April 30th, 2021.
Medicine (Baltimore)
January 2025
Teaching Office, Second People's Hospital of Shenzhen (First Affiliated Hospital of Shenzhen University), Shenzhen City, China.
Previous studies have provided relatively limited evidence in examining the impact of preoperative serum albumin levels on the length of hospital stay (LOS) in patients with hip fractures. This study aimed to elucidate the association between preoperative serum albumin levels and LOS in elderly patients with hip fractures. This retrospective cohort study included 1444 elderly patients undergoing surgical treatment for hip fractures at the Second People's Hospital of Shenzhen from January 2012 to December 2021.
View Article and Find Full Text PDFMedicine (Baltimore)
January 2025
Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Background: This study evaluates the efficacy and safety of sitagliptin versus gliclazide, combined with metformin, in treatment-naive patients with type 2 diabetes mellitus (T2DM) and glucotoxicity.
Methods: In this single-center, randomized, controlled noninferiority trial, 129 treatment-naive patients with T2DM with glucotoxicity (fasting plasma glucose [FPG] ≥ 200 mg/dL and glycated hemoglobin ≥ 9.0%) were randomized to receive sitagliptin plus metformin (n = 66) or gliclazide plus metformin (n = 63) for 12 weeks.
Medicine (Baltimore)
January 2025
Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, China.
This study analyzes the prognostic factors of thrombosis in patients with hematological diseases after peripherally inserted central catheter (PICC) surgery. We conducted a retrospective analysis of 223 patients with hematological diseases who underwent PICC catheterization between January 2017 and June 2021. These patients were categorized into the thrombotic group and non-thrombotic group based on the occurrence of thrombosis following PICC catheterization.
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