Effect of multidisciplinary intensive targeted care in improving diabetes mellitus  outcomes: a randomized controlled pilot study – the Integrated Diabetes Education, Awareness and Lifestyle modification in Singapore (IDEALS) Program

In this study, we aimed to investigate the impact of intensive multidisciplinary diabetes mellitus care with patient empowerment versus routine clinical care on the rate of progression of micro and macrovascular complications and peripheral atherosclerotic burden, as measured by changes in femoral intima-media thickness (IMT) in patients with persistently elevated HbA1c and nephropathy.MethodsThe study is a single-center randomized controlled trial (RCT) with two study arms - intensive diabetes mellitus care versus routine clinical care. Patients in the intensive arm will receive care from a multidisciplinary team consisting of an endocrinologist, diabetes nurse educator, dietitian, renal pharmacist and medical social worker for counselling. In addition, patients will be provided with tools for self-care empowerment such as glucometers, blood pressure monitors and android tablets to facilitate care, monitoring and education. Patients in the routine clinical care arm will receive standard clinical care. Follow up (FU) will be for 3  years. Primary outcomes include cardiovascular events, rate of progression of nephropathy and development of end-stage renal disease. Secondary endpoints include the proportions of patients with documented improved control of cardiovascular risk factors (HbA1c, blood pressure, low density lipopro tein-C (LDL-C), reduction in body weight), frequency of hypoglycemia, hospitalization days and changes in femoral IMT. We will also examine the pre...
Source: Trials - Category: Research Source Type: clinical trials

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Journal Name: Journal of Pediatric Endocrinology and Metabolism Issue: Ahead of print
Source: Journal of Pediatric Endocrinology and Metabolism - Category: Endocrinology Source Type: research
Publication date: Available online 7 December 2019Source: Trends in Endocrinology &MetabolismAuthor(s): Jennifer R. Snaith, Deborah J. Holmes-Walker, Jerry R. GreenfieldIndividuals with type 1 diabetes (T1D) frequently fail to achieve glycemic goals and have excess cardiovascular risk and premature death. Adjunctive agents may play a role in reducing morbidity, mortality, and the adverse sequelae of insulin treatment. A surge in type 2 diabetes drug development has revealed agents with benefits beyond glucose lowering, including cardiovascular risk reduction. Could these benefits translate to T1D? Specific trials for T...
Source: Trends in Endocrinology and Metabolism - Category: Endocrinology Source Type: research
Source: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy - Category: Endocrinology Tags: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Source Type: research
Source: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy - Category: Endocrinology Tags: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Source Type: research
AbstractThe age-performance relationship describes changes in the organism ’s structural and functional capabilities over the course of the lifespan. The typical, empirical pattern is an asymmetrical inverted-U shape association with peak capacity occurring early in life. This process is well described in the literature, with an increasing interest in features that chara cterize this pattern, such as the rate of growth, age of peak performance, and rate of decline with aging. This is usually examined in cohorts of individuals followed over time with repeat assessments of physical or cognitive abilities. This framewor...
Source: Archives of Public Health - Category: International Medicine & Public Health Source Type: research
ConclusionsOur results suggest that hyperostosis of the posterior longitudinal ligament in OPLL may not be associated with bone strength and bone mineral status at the extremities.
Source: Osteoporosis International - Category: Orthopaedics Source Type: research
AbstractEndovaginal sonographic imaging has been shown to reliably identify pelvic endometriosis, but most United States  imaging practices do not adequately assess locations and features of endometriosis beyond ovarian endometrioma. In this article, we propose a protocol for sonographer-acquired images and maneuvers to be interpreted subsequently by sonologists (radiologists or gynecologists). The purpose is to impr ove the sensitivity of endovaginal sonography for the detection of endometriosis in imaging practices that involve the non-physician sonographer as part of their workflow.
Source: Abdominal Imaging - Category: Radiology Source Type: research
(Natural News) Every time you turn on the news, there always seems to be a new deadly disease on the loose. These reports should be taken seriously. A pandemic can occur at any time and when it does, people’s lives will drastically change. People often interchange pandemic and epidemic, but they’re not quite the same....
Source: NaturalNews.com - Category: Consumer Health News Source Type: news
You are there to help bring a new life into the world, comforting and reassuring new parents. You are there in the middle of the night to return a call to a distraught mom whose child is running a high fever and is panicked. You are there to encourage and instruct a diabetic heart patient […]Find jobs at  Careers by KevinMD.com.  Search thousands of physician, PA, NP, and CRNA jobs now.  Learn more.
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Patient Primary Care Public Health & Policy Source Type: blogs
The objective of the present study was to evaluate the beneficial effect of endorectal power Doppler/grayscale ultrasound-guided biopsy over that of mpMRI/TRUS-guided biopsy for decision-making regarding prostatectomy in males with a high risk of prostate cancer. Data regarding endorectal power Doppler/grayscale ultrasound-guided biopsies and mpMRI/TRUS-guided biopsies of 1,094 males with elevated specific prostate antigen, were included. Radical prostatectomy was performed in males aged
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
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