Feasibility of Implementing Community Partnerships to Provide Diabetes Prevention Services to Youth

Type 2 diabetes (T2D) in youth has increased as a result of the obesity epidemic. Diabetes prevention programming is needed for youth, at risk for T2D, and their families. However, there is a lack of diabetes prevention services for this population. There is evidence for the benefit of lifestyle modification for decreasing diabetes risk, however there are barriers for youth to access these services in a traditional clinical setting. Our Youth Diabetes Prevention Clinic (YDPC) created partnerships within the community to increase access to diabetes prevention services for at risk youth. YDPC personnel approached community organizations who had the expertise and capacity to partner in needed areas. These partnerships allowed for the development and facilitation of a community-based diabetes prevention group. Youth and their families participated in a 12 week diabetes prevention group. We measured attendance and participant satisfaction with the program. Families attended an average of 5.1 sessions from January to October 2016. Participant satisfaction was collected five times. Physical activity was rated as “awesome” or “good” by 88% of the respondents. The nutrition activities were rated as “awesome” or “good” by 97% of respondents. Physicians and families express a desire for diabetes prevention services, however barriers make it difficult for families to fully participate. Creating partnerships within the community allows for increased access to diabetes prevention services for high-risk, underserved families

Diabetes prevention and management in South Asia

Background: Globally, the number of people living with Diabetes Mellitus (DM) has increased four-fold since 1980. South Asia houses one-fifth of the world’s population living with diabetes, and it was the 8th leading cause of deaths in 2013 for South Asians.Aim: To review and discuss the context of diabetes in South Asia, with a particular focus on, a) contributing factors and impact; b) national health policies around non-communicable diseases in the region, and c) to o er recommendations for prevention and management of diabetes.Method: We assessed relevant publications using PubMed, Scopus and OvidSP. Similarly, the World health Organization (WHO) and relevant ministries of each South Asian country were searched for reports and policy documents.Results: Emerging evidence supports that the prevalence of diabetes (ranging from 3.3% in Nepal up to 8.7% in India) in South Asia follows the global trend over the past decades. Urban populations in the region demonstrate a higher prevalence of diabetes, although is also a public health concern for rural areas. Changes in the pattern and types of diet, together with increasingly sedentary, lifestyles are major causes of diabetes. The overall agenda of health promotion to prevent diabetes has not yet been established in the region, and the majority of the countries in the region are inadequately prepared for the therapeutic services for diabetes.Conclusions: The early onset of the diabetes, longevity of morbidity and early mortality may have a significant impact on people’s health expenditure and health systems, as well as on the region’s demographic composition. There is an urgent need to reduce the prevalence of diabetes in the region through evidence-based interventions ranging from prevention and early detection to appropriate treatment and care. We suggest that a multi-sectorial collaboration across all stakeholders is necessary to raise awareness about diabetes, its prevention, treatment and care in the region

Beyond peer observation of teaching

OBJECTIVE To summarize the evidence on effectiveness of translational diabetes prevention programs, based on promoting lifestyle change to prevent type 2 diabetes in real-world settings and to examine whether adherence to international guideline recommendations is associated with effectiveness. RESEARCH DESIGN AND METHODS Bibliographic databases were searched up to July 2012. Included studies had a follow-up of ≥12 months and outcomes comparing change in body composition, glycemic control, or progression to diabetes. Lifestyle interventions aimed to translate evidence from previous efficacy trials of diabetes prevention into real-world intervention programs. Data were combined using random-effects meta-analysis and meta-regression considering the relationship between intervention effectiveness and adherence to guidelines. RESULTS Twenty-five studies met the inclusion criteria. The primary meta-analysis included 22 studies (24 study groups) with outcome data for weight loss at 12 months. The pooled result of the direct pairwise meta-analysis shows that lifestyle interventions resulted in a mean weight loss of 2.12 kg (95% CI -2.61 to -1.63; I(2) = 91.4%). Adherence to guidelines was significantly associated with a greater weight loss (an increase of 0.3 kg per point increase on a 12-point guideline-adherence scale). CONCLUSIONS Evidence suggests that pragmatic diabetes prevention programs are effective. Effectiveness varies substantially between programs but can be improved by maximizing guideline adherence. However, more research is needed to establish optimal strategies for maximizing both cost-effectiveness and longer-term maintenance of weight loss and diabetes prevention effects

The Role of Prevention in Bending the Cost Curve

Examines how much disease prevention, including those funded in the 2010 healthcare reform law such as diabetes and HIV prevention, smoking cessation, community interventions, and reducing racial/ethnic disparities, can help slow health spending growth

Diet and diabetes

Provides current evidence regarding the differing diets in diabetes prevention and management once type 2 diabetes mellitus (T2DM) arises, including the role in management of complications such as = hypoglycaemia. Background Guidelines for the prevention and management of type 2 diabetes mellitus (T2DM) reinforce lifestyle management, yet advice to guide general practitioners on principles around dietary choices is needed. Objective This article provides current evidence regarding the differing diets in diabetes prevention and management once T2DM arises, including the role in management of complications such as hypoglycaemia. Discussion Diets should incorporate weight maintenance or loss, while complementing changes in physical activity to optimise the metabolic effects of dietary advice. Using a structured, team-care approach supports pragmatic and sustainable individualised plans, while incorporating current evidence-based dietary approaches

Diabetic foot plantar pressure monitoring system using force sensitive resistor system

Many people are suffering from diabetes; it was the major cause that has led many to hospitalization. According to [1], patients with Type 2 diabetes suffering from peripheral neuropathy are at high risks of developing diabetic foot syndrome, which leads to foot ulcerations that caused mainly by high peak plantar pressures. Without early prevention and intervention [2], diabetic foot ulcer has 15 times greater risk to cause lower limb amputation. Therefore, further studies on early prevention may help in healthcare management

Implementation and Outcomes of the New York State YMCA Diabetes Prevention Program: A Multisite Community-Based Translation, 20102012

Weight loss and physical activity achieved through the Diabetes Prevention Program (DPP) have been shown to reduce type 2 diabetes risk among individuals with prediabetes. The New York State Young Men's Christian Association (YMCA) delivered the 16-week evidence-based model at 14 YMCAs. A mixed methods process and outcomes evaluation was conducted

Dietary management of older people with diabetes

Diabetes UK's revised nutrition guidelines for the prevention and management of diabetes, published recently, encourage education in self-management and include additional guidance for older people with diabetes. The incidence of diabetes in older people is increasing. Many older people with diabetes are healthy and mobile, and live in the community, but a number are frail and living in care homes. Those who are frail are at increased risk of malnutrition from a range of causes. Older people with diabetes should be assessed for malnutrition risk and referred to a dietitian if required. Management of these patients focuses on foods that are high in protein and energy foods. A case study gives an example of how a community nurse may be involved.Peer reviewedFinal Accepted Versio

Dietary dairy product intake and incident type 2 diabetes: a prospective study using dietary data from a 7-day food diary

The consumption of specific dairy types may be beneficial for the prevention of diabetes. Abstract: The aim of this study was to investigate the association between total and types of dairy product intake and risk of developing incident type 2 diabetes, using a food diary. Methods: A nested case-cohort within the EPIC-Norfolk Study was examined, including a random subcohort (n=4,000) and cases of incident diabetes (n=892, including 143 cases in the subcohort) followed-up for 11 years. Diet was assessed using a prospective 7-day food diary. Total dairy intake (g/day) was estimated and categorised into high-fat (≥3.9%) and low-fat (<3.9% fat) dairy, and by subtype into yoghurt, cheese and milk. Combined fermented dairy product intake (yoghurt, cheese, sour cream) was estimated and categorised into high- and low-fat. Prentice-weighted Cox regression HRs were calculated. Results: Total dairy, high-fat dairy, milk, cheese and high-fat fermented dairy product intakes were not associated with the development of incident diabetes. Low-fat dairy intake was inversely associated with diabetes in age- and sex-adjusted analyses (tertile [T] 3 vs T1, HR 0.81 [95% CI 0.66, 0.98]), but further adjustment for anthropometric, dietary and diabetes risk factors attenuated this association. In addition, an inverse association was found between diabetes and low-fat fermented dairy product intake (T3 vs T1, HR 0.76 [95% CI 0.60, 0.99]; ptrend=0.049) and specifically with yoghurt intake (HR 0.72 [95% CI 0.55, 0.95]; ptrend=0.017) in multivariable adjusted analyses. Conclusions/interpretation: Greater low-fat fermented dairy product intake, largely driven by yoghurt intake, was associated with a decreased risk of type 2 diabetes development in prospective analyses. These findings suggest that the consumption of specific dairy types may be beneficial for the prevention of diabetes, highlighting the importance of food group subtypes for public health messages

Pre-diabetes in the Hispanic Population: Adolescents to Adulthood

Purpose/Background: Preventing prediabetes from developing into diabetes has led to successful programs like the Diabetes Prevention Program, although translation to minority populations is not readily available. Since minorities endure a disproportionate effect from diabetes and its complications, finding tailored interventions that work for minorities and can prevent the progression of prediabetes is crucial Materials & Methods: Searching four electronic databases yielded 1,606 articles relating to prediabetes interventions in Hispanics across the lifespan. Research had to be published during the timeframe of 2008 to 2018 and include intervention as a focus. Titles and abstracts were read to narrow results. An additional 26 articles were identified by examining references. This was narrowed to 21 studies for full review. Results: This review found six studies relating to adolescents, two to pregnant Hispanic women, and 12 involving the adult Hispanic population. Modification of the National Diabetes Prevention Program was most commonly used and had success across ages. Cultural tailoring of programs has included promotoras, bilingual presenters, and specific focus on cuisine/recipe modification for adults. In adolescents, fewer applications are noted, though success has been seen using social media and by with mixed approaches of diet/activity. Discussion/Conclusion: Culturally tailoring programs to the Hispanic population can effectively reduce risks by reducing weight and A1C. Further study, especially relating to interventions for adolescents, needs to be done to affect their risk for diabetes