Diabetes care
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Using the common-sense model of illness behavior, we developed and validated a self-report instrument for assessment of patients' cognitive and emotional representations of diabetic peripheral neuropathy (DPN) influencing foot self-care. ⋯ The 39-item PIN questionnaire is a reliable and valid measure of patients' cognitive and emotional representations of neuropathy affecting foot self-care.
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Randomized Controlled Trial Multicenter Study
Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial.
The aim of this trial was to evaluate the effects of alpha-lipoic acid (ALA) on positive sensory symptoms and neuropathic deficits in diabetic patients with distal symmetric polyneuropathy (DSP). ⋯ Oral treatment with ALA for 5 weeks improved neuropathic symptoms and deficits in patients with DSP. An oral dose of 600 mg once daily appears to provide the optimum risk-to-benefit ratio.
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Recent studies show the importance of controlling blood glucose variability in relationship to both reducing hypoglycemia and attenuating the risk for cardiovascular and behavioral complications due to hyperglycemia. It is therefore important to design variability measures that are equally predictive of low and high blood glucose excursions. ⋯ In a large SMBG database, the ADRR showed strong association with subsequent out-of-control glucose readings. Compared with other variability measures, the ADRR demonstrated a superior balance of sensitivity to predicting both hypoglycemia and hyperglycemia. This prediction was independent from type of diabetes.
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Simple process-of-care indicators are commonly recommended to assess and compare quality of diabetes care across health plans. We sought to determine whether variation in the number of simple diabetes processes of care across provider groups is associated with variation in other quality indicators, including cardiometabolic risk factor levels, patient satisfaction with care, or patient-rated quality of care. ⋯ Variation in the number of simple process-of-care indicators across provider groups or health plans is associated with differences in patient-centered measures of quality, but assessment of the quality of cardiometabolic risk factor control will require more advanced clinical performance indicators.