1. Improving Care and Promoting Health in Populations: <i>Standards of Medical Care in Diabetes—2021</i>

Association, American Diabetes

doi:10.2337/dc21-s001

Cited by 88 publications

(62 citation statements)

References 91 publications

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“…These results underline the importance of HbA 1c levels below the threshold to diagnose diabetes and to identify individuals with an increased risk. Therefore, our findings underline previous statements from the American Diabetes Association [ 30 ] concerning the measurement of HbA 1c for cardiovascular risk assessment as well as the recent European Society of Cardiology 2019 guidelines [ 6 ] on adults without a diagnosis of diabetes. In this context, neither guideline defines prediabetes as a self-contained clinical entity although individuals with prediabetes have an increased risk to develop diabetes or cardiovascular disease [ 6 , 30 , 31 ].…”

Section: Discussionsupporting

confidence: 86%

“…Therefore, our findings underline previous statements from the American Diabetes Association [ 30 ] concerning the measurement of HbA 1c for cardiovascular risk assessment as well as the recent European Society of Cardiology 2019 guidelines [ 6 ] on adults without a diagnosis of diabetes. In this context, neither guideline defines prediabetes as a self-contained clinical entity although individuals with prediabetes have an increased risk to develop diabetes or cardiovascular disease [ 6 , 30 , 31 ]. The American guidelines underline the fact that prediabetes is associated with cardiovascular risk factors like obesity, arterial hypertension, and dyslipidemia and further that levels in the prediabetes range are associated with the risk to develop diabetes.…”

Section: Discussionsupporting

confidence: 86%

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Association of glycated hemoglobin A1c levels with cardiovascular outcomes in the general population: results from the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium

Sinning

Makarova

Völzke

et al. 2021

Cardiovasc Diabetol

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Background Biomarkers may contribute to improved cardiovascular risk estimation. Glycated hemoglobin A1c (HbA1c) is used to monitor the quality of diabetes treatment. Its strength of association with cardiovascular outcomes in the general population remains uncertain. This study aims to assess the association of HbA1c with cardiovascular outcomes in the general population. Methods Data from six prospective population-based cohort studies across Europe comprising 36,180 participants were analyzed. HbA1c was evaluated in conjunction with classical cardiovascular risk factors (CVRFs) for association with cardiovascular mortality, cardiovascular disease (CVD) incidence, and overall mortality in subjects without diabetes (N = 32,496) and with diabetes (N = 3684). Results Kaplan–Meier curves showed higher event rates with increasing HbA1c levels (log-rank-test: p < 0.001). Cox regression analysis revealed significant associations between HbA1c (in mmol/mol) in the total study population and the examined outcomes. Thus, a hazard ratio (HR) of 1.16 (95% confidence interval (CI) 1.02–1.31, p = 0.02) for cardiovascular mortality, 1.13 (95% CI 1.03–1.24, p = 0.01) for CVD incidence, and 1.09 (95% CI 1.02–1.17, p = 0.01) for overall mortality was observed per 10 mmol/mol increase in HbA1c. The association with CVD incidence and overall mortality was also observed in study participants without diabetes with increased HbA1c levels (HR 1.12; 95% CI 1.01–1.25, p = 0.04) and HR 1.10; 95% CI 1.01–1.20, p = 0.02) respectively. HbA1c cut-off values of 39.9 mmol/mol (5.8%), 36.6 mmol/mol (5.5%), and 38.8 mmol/mol (5.7%) for cardiovascular mortality, CVD incidence, and overall mortality, showed also an increased risk. Conclusions HbA1c is independently associated with cardiovascular mortality, overall mortality and cardiovascular disease in the general European population. A mostly monotonically increasing relationship was observed between HbA1c levels and outcomes. Elevated HbA1c levels were associated with cardiovascular disease incidence and overall mortality in participants without diabetes underlining the importance of HbA1c levels in the overall population.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionsupporting

confidence: 86%

Association of glycated hemoglobin A1c levels with cardiovascular outcomes in the general population: results from the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium

Sinning

Makarova

Völzke

et al. 2021

Cardiovasc Diabetol

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“… 4 This can be achieved through lifestyle changes, administration of oral hypoglycemic drugs and/or insulin injections, and self-care. 5 Strict metabolic control and self-care ability can improve diabetes treatment outcomes and considerably reduce the risk of complications. 6 Active participation in the treatment process helps patients consciously manage their health.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial Determinants of Treatment Adherence in Patients with Type 2 Diabetes – A Review

Świątoniowska-Lonc¹,

Tański²,

Polański³

et al. 2021

DMSO

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Less than 50% of patients with diabetes achieve the glycaemic goals recommended by the American Diabetes Association. The set of factors associated with adherence to treatment is very broad. Evidence suggests that psychosocial factors are related to medication adherence of patients with type 2 diabetes. Due to the lack of a clear statement from researchers regarding the relationship of psychosocial factors to adherence, an electronic search was conducted in PubMed, MEDLINE, Academic Search Ultimate, CINAHL Complete, Edition and Health Source: Nursing/Academic Edition using the following keywords “adherence”, “diabetes”, “social support”, “stress”, “anxiety and depression”, “beliefs about medicine”, “communication”, “older age”, “frailty”, “cognitive impairment”, “addiction”, “acceptance of illness”, “sense of coherence” obtaining 2758 results. After a narrowing of searches and reference scanning, 36 studies were qualified. The studies analysed showed negative effects of anxiety, diabetes distress, older age, poor communication with physicians, stress, concerns about medicines and cognitive impairment on levels of self-care and medication adherence. One study did not confirm the association of depression with adherence. Self-efficacy, social and family support, and acceptance of illness had a beneficial effect on medication adherence. In conclusion, the current evidence suggests that the relationship between psychosocial factors and adherence has reliable scientific support.

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“…The use of telehealth in the field of diabetes management has been utilized for care delivery for decades and is in many respects a paradigm for telehealth delivery [34] . Effective diabetes self-management requires a combination of factors including blood glucose monitoring, medication adherence, as well as incorporating healthy lifestyle factors such as dietary habits and regular physical activity [35] . Adequate glycemic control is critical to mitigate the risk of long-term macro- and microvascular complications [36] .…”

Section: Overview Of Telehealth For the Management Of Diabetesmentioning

confidence: 99%

Telemedicine in cystic fibrosis

Desimone

Sherwood

Soltman

et al. 2021

Journal of Clinical & Translational Endocrinology

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Cystic Fibrosis (CF) requires lifetime multidisciplinary care to manage both pulmonary and extra pulmonary manifestations. The median age of survival for people with CF is rising and the number of adults with CF is expected to increase dramatically over the coming years. People with CF have better outcomes when managed in specialty centers, however access can be limited. Telemedicine and technology-based care solutions may help to overcome barriers to availability and improve access. This review outlines the use of telehealth for CF management. Telehealth has been utilized for CF across a broad variety of indications, even prior to the COVID-19 pandemic, and in general has been well accepted by patients and providers. There are a paucity of data, however, related to health outcomes, and the healthcare utilization specific to CF and its related comorbidities. Future studies are needed to address the questions of health outcomes, cost, burdens of telehealth and barriers to implementation.

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1. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes—2021

Cited by 88 publications

References 91 publications

Association of glycated hemoglobin A1c levels with cardiovascular outcomes in the general population: results from the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium

Association of glycated hemoglobin A1c levels with cardiovascular outcomes in the general population: results from the BiomarCaRE (Biomarker for Cardiovascular Risk Assessment in Europe) consortium

Psychosocial Determinants of Treatment Adherence in Patients with Type 2 Diabetes – A Review

Telemedicine in cystic fibrosis

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