Control of Risk Factors Among People With Diagnosed Diabetes, by Lower Extremity Disease Status

Introduction We examined the control of modifiable risk factors among a national sample of diabetic people with and without lower extremity disease (LED). Methods The sample from the 1999-2004 National Health and Nutrition Examination Survey consisted of 948 adults aged 40 years or older with diagnosed diabetes and who had been assessed for LED. LED was defined as peripheral arterial disease (ankle-brachial index <0.9), peripheral neuropathy (≥1 insensate area), or presence of foot ulcer. Good control of modifiable risk factors, based on American Diabetes Association recommendations, included being a nonsmoker and having the following measurements: hemoglobin A1c (HbA1c) less than 7%, systolic blood pressure less than or equal to 130 mm Hg, diastolic blood pressure less than or equal to 80 mm Hg, high-density lipoprotein (HDL) cholesterol greater than 50 mg/dL, and body mass index (BMI) between 18.5 kg/m2 and 24.9 kg/m2. Results Diabetic people with LED were less likely than were people without LED to have recommended levels of HbA1c (39.3% vs 53.5%) and HDL cholesterol (29.7% vs 41.1%), but there were no differences in systolic or diastolic blood pressure, BMI classification, or smoking status between people with and without LED. Control of some risk factors differed among population subgroups. Notably, among diabetic people with LED, non-Hispanic blacks were more likely to have improper control of HbA1c (adjusted odds ratio [AOR] = 2.0; 95% confidence interval [CI], 1.1-3.9), systolic blood pressure (AOR = 1.9; 95% CI, 1.1-3.2), and diastolic blood pressure (AOR = 2.6; 95% CI, 1.1-5.8), compared with non-Hispanic whites. Conclusion Control of 2 of 6 modifiable risk factors was worse in diabetic adults with LED compared with diabetic adults without LED. Among diabetic people with LED, non-Hispanic blacks had worse control of 3 of 6 risk factors compared with non-Hispanic whites

Effects of Multisensory Phonics-Based Training on the Word Recognition and Spelling Skills of Adolescents with Reading Disabilities

The purpose of this study was to explore the effectiveness of an Orton-Gillingham-based reading instruction system, the Barton Reading and Spelling System (BRSS; Barton 2000), that was used as a supplemental reading instruction program for increasing the lower-level reading skills of a group of adolescents with persistent reading problems. Nine students participated in the supplemental reading program based on pre-test scores of a spoken and written language assessment battery. Progress was measured at the end of intervention by post-testing students on the same assessment battery. Each student showed some improvements from their pretest to posttest scores on all of the measures utilized, with some having moderate to large effect sizes, supporting the view that the BRSS is an appropriate supplemental reading program for struggling adolescent readers within a response to instruction framework. Future research should include a larger sample size and a control group

The Missed Patient With Diabetes: How access to health care affects the detection of diabetes

OBJECTIVE—This study examined the association between access to health care and three classifications of diabetes status: diagnosed, undiagnosed, and no diabetes

Implementasi Pembelajaran Rme ( Realistic Mathematic Education ) Terhadap Penalaran Dan Kemampuan Memecahkan Masalah Matematika Siswa Kelas V Sdn Karangayu 02 Semarang

This research is motivated by the lack of reasoning and problem-solving skills math class V students on the subject of the story about the multiplication and division of fractions. Students are less able to understand and decipher the core issues contained in the matter of the story. In addition, students difficulty changing story problems into mathematical form. This makes the learning achievements of students who achieved less than the maximum. Issues examined in this study were (1) Is the mathematical reasoning fifth grade students Karangayu SD N 02 Semarang can reach the learning criterion was after receiving RME? (2) Is there any difference in the ability to solve mathematical problems Karangayu fifth grade students of SDN 02 Semarang after receiving RME learning? This research is quantitative. By using the design / design study pre-experimental design types of one- group pre-test-post-test design. Based on the pre-test and post-test reasoning variables obtained average value of 51.38 in the pre-test criteria for low and average value of the post-test 65.06 on the criterion of moderate / normal. The research hypothesis has been mentioned that, H01 is rejected and thank Ha1 the mathematical reasoning fifth grade students Karangayu SD N 02 Semarang reach criterion medium / normal after getting learning RME (Realistic Mathematic Education). While the t-test on the variable math problem-solving skills obtained t count> t table = 5.971> 2.021. The research hypothesis has been mentioned that, H01 and thank Ha1 denied that there are differences in the ability to solve mathematical problems graders V SD N Karangayu 02 Semarang after getting learning RME

Trends in Emergency Department Visit Rates for Hypoglycemia and Hyperglycemic Crisis among Adults with Diabetes, United States, 2006-2011.

Despite concerns about hypoglycemia events from overly aggressive glycemic reduction, population trends in hypoglycemia and hyperglycemic crisis incidence are unclear. To address this gap, we examined changes in emergency department (ED) visit rates for hypoglycemia and hyperglycemic crisis 2006-2011.Using data from the Nationwide Emergency Department Sample, we estimated the number of ED visits for hypoglycemia and hyperglycemic crisis via ICD-9-CM among adults with diabetes. Using data from the National Health Interview Survey, we estimated the population of adults with diabetes and calculated ED visit rates.From 2006 to 2011, ED visit rates for hypoglycemia declined by 22% from 1.8 to 1.4 per 100 adults (p = 0.003). The rates decreased in all age groups (all P<0.05) except those aged 18 to 44 years (P = 0.31). Hypoglycemia rates displayed a J-shaped curve across age, with the highest rates among adults aged 75 years or older (P <0.001). ED visit rates for hyperglycemic crisis did not change overall but increased 17% for adults aged 65 to 74 years (P = 0.02) and 29% for women (P = 0.01). Hyperglycemic crisis rates were highest among adults aged 18 to 44 years (P <0.001).Hypoglycemia rates have declined for all adults but persons aged 18-44 years while rates for hyperglycemic crisis remained stable. Future preventive efforts should target on the susceptible population of adults aged 18 to 44 years and those aged 75 years or older

Trends in type 2 diabetes detection among adults in the USA, 1999–2014

Geiss LS, Bullard KMK, Brinks R, Hoyer A, Gregg EW. Trends in type 2 diabetes detection among adults in the USA, 1999–2014. BMJ Open Diabetes Research &amp; Care. 2018;6(1): e000487. **Objective** To examine recent trends in type 2 diabetes detection among adults in the USA. **Research design and methods** We used data from the 1999–2014 National Health and Nutrition Examination Surveys on non-pregnant adults (aged ≥18 years) not reporting a diagnosis of diabetes (n=16 644 participants, averaging about 2000 for each 2-year cycle). We defined undiagnosed diabetes as a fasting plasma glucose ≥126 mg/dL or a hemoglobin A1c ≥6.5% (48 mmol/mol). We measured case detection as the probability of finding undiagnosed type 2 diabetes among the population without diagnosed diabetes. Linear regression models were used to examine trends overall and by sociodemographic characteristics (ie, age, gender, race/ethnicity, education, poverty-income ratio (PIR)). **Results** Age-standardized probability of finding undiagnosed type 2 diabetes was 3.0% (95% CI 2.1% to 4.2%) during 1999–2000 and 2.8% (2.2%–3.6%) during 2013–2014 (Pfor trend=0.52). Probability increased among Mexican-Americans (Pfor trend=0.01) but decreased among adults aged 65 years or older (Pfor trend=0.04), non-Hispanic (NH) white (Pfor trend=0.02), and adults in the highest PIR tertile (Pfor trend=0.047). For all other sociodemographic groups, no significant trends were detected. **Conclusions** We found little evidence of increased detection of undiagnosed type 2 diabetes among adults in the USA during the past 15 years. Although improvements were seen among NH white, older, and wealthy adults, these improvements were not large. As the scope of primary prevention efforts increases, case detection may improve. </p