Diabetes care
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Multicenter Study
Obstructive sleep apnea among obese patients with type 2 diabetes.
To assess the risk factors for the presence and severity of obstructive sleep apnea (OSA) among obese patients with type 2 diabetes. ⋯ Physicians should be particularly cognizant of the likelihood of OSA in obese patients with type 2 diabetes, especially among individuals with higher waist circumference and BMI.
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Multicenter Study
Lifetime risk of cardiovascular disease among individuals with and without diabetes stratified by obesity status in the Framingham heart study.
We assessed the lifetime risk of cardiovascular disease (CVD) among individuals with and without obesity and diabetes. ⋯ The lifetime risk of CVD among individuals with diabetes is high, and this relationship is further accentuated with increasing adiposity.
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Randomized Controlled Trial Multicenter Study
Adjust to target in type 2 diabetes: comparison of a simple algorithm with carbohydrate counting for adjustment of mealtime insulin glulisine.
Carbohydrate counting is an effective approach to mealtime insulin adjustment in type 1 diabetes but has not been rigorously assessed in type 2 diabetes. We sought to compare an insulin-to-carbohydrate ratio with a simple algorithm for adjusting the dose of prandial insulin glusiline. ⋯ Weekly basal-bolus insulin adjustments based on premeal and bedtime glucose patterns resulted in significant reductions in A1C. Having two effective approaches to delivering and adjusting rapid-acting mealtime insulin may increase physicians' and patients' willingness to advance therapy to a basal-bolus insulin regimen.
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Randomized Controlled Trial Multicenter Study
Comparison of negative pressure wound therapy using vacuum-assisted closure with advanced moist wound therapy in the treatment of diabetic foot ulcers: a multicenter randomized controlled trial.
The purpose of this study was to evaluate safety and clinical efficacy of negative pressure wound therapy (NPWT) compared with advanced moist wound therapy (AMWT) to treat foot ulcers in diabetic patients. ⋯ NPWT appears to be as safe as and more efficacious than AMWT for the treatment of diabetic foot ulcers.
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Randomized Controlled Trial Multicenter Study
Diabetes, depression, and death: a randomized controlled trial of a depression treatment program for older adults based in primary care (PROSPECT).
We sought to test our a priori hypothesis that depressed patients with diabetes in practices implementing a depression management program would have a decreased risk of mortality compared with depressed patients with diabetes in usual-care practices. ⋯ Older depressed primary care patients with diabetes in practices implementing depression care management were less likely to die over the course of a 5-year interval than depressed patients with diabetes in usual-care practices.