Metabolic outcome for diabetes shared care program outpatients in a veterans hospital of southern Taiwan

Hao, Lyh Jyh; Tien, Kai Jen; Chao, Hai-Lun; Hong, Ching Ju; Chou, F. S.; Wu, Ta Jen; Chao, Jiang Kang; Shi, Ming; Chai, Kuo Liang; Ko, Kuang Chung; Cheng, Jin Shiung; Chia, Mi

doi:10.1016/j.jcma.2011.05.003

Cited by 15 publications

(15 citation statements)

References 27 publications

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“… 1 This care model emphasised the team care of the treating physicians, diabetes specialists, nurses and dietitians with the aim of improving the quality of care for patients with diabetes. 9 Previous studies have demonstrated the improvement of cardiovascular and metabolic outcomes in the DSCP participants of patients with type 2 diabetes. 9 12 However, currently, no studies have investigated the influence of the DSCP on the outcomes of infection-related hospitalisation.…”

Section: Introductionmentioning

confidence: 98%

“… 9 Previous studies have demonstrated the improvement of cardiovascular and metabolic outcomes in the DSCP participants of patients with type 2 diabetes. 9 12 However, currently, no studies have investigated the influence of the DSCP on the outcomes of infection-related hospitalisation. In this study, we aimed to evaluate the efficacy of the DSCP in patients with type 2 diabetes hospitalised for infectious diseases.…”

Section: Introductionmentioning

confidence: 98%

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Diabetes Shared Care Program (DSCP) and risk of infection mortality: a nationwide cohort study using administrative claims data in Taiwan

Chen

et al. 2018

BMJ Open

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ObjectiveThe Diabetes Shared Care Program (DSCP) is an integrated care model in Taiwan that has been proven to improve the care quality of patients with diabetes. We aimed to evaluate the efficacy of DSCP in decreasing the hospital mortality of infectious diseases.MethodsFrom 1 662 929 patients with type 2 diabetes newly diagnosed between 1999 and 2013, we retrieved a total of 919 patients who participated in the DSCP with the first hospitalisation for an infectious disease as the study cohort and 9190 propensity score-matched patients with type 2 diabetes who did not participate as the comparison.The efficacy of DSCP was evaluated via the following comparisons between the DSCP and non-DSCP cohorts: hospital mortality, 1-year medical cost prior to and during the hospitalisation, and complications, such as receiving mechanical ventilation and intensive care unit admission. The ratio (OR) for hospital mortality of the DSCP participants was calculated by logistical regression. Further stratification analyses were conducted to examine which group of patients with type 2 diabetes benefited the most from the DSCP during hospitalisation for infectious diseases.ResultsThe DSCP cohort had a lower hospital mortality rate than the non-DSCP participants (2.18% vs 4.82%, p<0.001). The total medical cost during the hospitalisation was lower in the DSCP cohort than in the non-DSCP cohort (NT$72 454±30 429 vs NT$86 385±29 350) (p=0.006). In the logistical regression model, the DSCP participants exhibited a significantly decreased adjusted OR for hospital mortality (adjusted OR=0.42, 95% CI 0.26 to 0.66, p=0.0002). The efficacy of the DSCP was much more prominent in male patients with type 2 diabetes and in patients with lower incomes.ConclusionParticipation in the DSCP was associated with a lower risk of hospital mortality for infectious diseases.

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Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 98%

Diabetes Shared Care Program (DSCP) and risk of infection mortality: a nationwide cohort study using administrative claims data in Taiwan

Chen

et al. 2018

BMJ Open

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“…Institutional performance in the diabetes arena may be judged by the proportion of patients reaching target A1C values. 22,23 Good glycemic control is not only associated with reduced chronic complications, but it is also implicated in the elimination of HCV. 24 Hence, proper assessment of glycemic control is vital in patients with diabetes and HCV infection.…”

Section: Discussionmentioning

confidence: 99%

Combination effect of ribavirin and erythropoietin treatment on hemoglobin A1c in a diabetic patient with chronic hepatitis C

Tai¹,

Wu²,

Tsai³

2012

Journal of the Chinese Medical Association

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Any condition that shortens erythrocyte lifespan or decreases mean erythrocyte age may falsely lower hemoglobin A1c (A1C) test results. Ribavirin (RBV) used for chronic hepatitis C virus (HCV) infection can cause reversible hemolytic anemia; erythropoietin (EPO) used for treatment-related anemia can stimulate the production of red blood cells. We reported a 55-year-old woman with diabetes who received peginterferon alfa plus RBV for HCV infection. Four weeks following HCV therapy, her Hb level declined from 13.3 g/dL to 11.3 g/dL with elevated lactate dehydrogenase and reduced haptoglobin, which confirmed hemolysis. As her Hb fell to a nadir of 8.5 g/dL at the eighth week, darbepoetin alfa was administered to treat anemia consecutively for 10 weeks. Two months later, the patient's A1C declined from 7.5% to an extremely low value of 4.0%, accompanied by a fasting glucose level of 116 mg/dL. During the preceding 3 months, there was no self-reported hypoglycemia or documented low blood glucose. About 3 months after HCV therapy was terminated, the A1C returned to 6.1% without medication adjustment. The concurrent use of RBV and EPO treatments can synergistically cause falsely low A1C values and may lead to inappropriate relaxation of glycemic control. During HCV treatment with RBV, A1C should not be used alone to guide diabetes therapy.

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“…Thank to Dr. Hao and his colleagues who frankly presented their results of DSCP and also discussed the weak point of this program in their hospitals. 5 They concluded that the improvement in control of hyperglycemia, blood pressure, and hypercholesterolemia after completion of 1-and 3-year interventions is low.…”

mentioning

confidence: 99%

“…10 Although the proportion of patients achieving these therapeutic goals was also low in this small study from local hospital, the target rate was significantly increased from 4.03% to 8.87% after 3-year intervention. 5 In my view, if we could pay more attention to characteristics that help in attainment of glycemic, blood pressure, and cholesterol control, we may improve diabetes outcomes and diminish the future health care burden from various diabetes complications.…”

mentioning

confidence: 99%

The effects of diabetes share care program in southern Taiwan

Chen

2011

Journal of the Chinese Medical Association

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Metabolic outcome for diabetes shared care program outpatients in a veterans hospital of southern Taiwan

Cited by 15 publications

References 27 publications

Diabetes Shared Care Program (DSCP) and risk of infection mortality: a nationwide cohort study using administrative claims data in Taiwan

Diabetes Shared Care Program (DSCP) and risk of infection mortality: a nationwide cohort study using administrative claims data in Taiwan

Combination effect of ribavirin and erythropoietin treatment on hemoglobin A1c in a diabetic patient with chronic hepatitis C

The effects of diabetes share care program in southern Taiwan

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