New Measure of Insulin Sensitivity Predicts Cardiovascular Disease Better than HOMA Estimated Insulin Resistance

10.1371/journal.pone.0074410PLoS ONE89-POLN

Replication data for Psychometric properties of the Problem Areas in Diabetes (PAID) instrument in Singapore

Minimal dataset for the paper on Pyschometric properties of PAID scale accepted for publication in PLOS ON

Challenges in diabetes management with particular reference to India

Diabetes was estimated to be responsible for 109 thousand deaths, 1157 thousand years of life lost and for 2263 thousand disability adjusted life years (DALYs) in India during 2004. However, health systems have not matured to manage diabetes effectively. The limited studies available on diabetes care in India indicate that 50 to 60% of diabetic patients do not achieve the glycemic target of HbA1c below 7%. Awareness about and understanding of the disease is less than satisfactory among patients, leading to delayed recognition of complications. The cost of treatment, need for lifelong medication, coupled with limited availability of anti-diabetic medications in the public sector and cost in the private sector are important issues for treatment compliance. This article attempts to highlight the current constraints in the health system to effectively manage diabetes and the need for developing workable strategies for ensuring timely and appropriate management with extensive linkage and support for enhancing the availability of trained manpower, investigational facilities and drugs

Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D): Implementation of a new care model in the Singapore Polyclinic setting

WONCA Asia Pacific Conference 201

Altered motor and motor perceptual cognitive imagery task-related activation in diabetic peripheral neuropathy: insights from functional MRI

OBJECTIVE To compare central nervous system (CNS) activation in patients with and without diabetic peripheral neuropathy (DPN) during motor and motor imagery tasks and to correlate activation with functional performance. RESEARCH DESIGN AND METHODS Twenty-six participants (13 with DPN, 13 without DPN) underwent functional MRI during three tasks: ankle dorsi plantar flexion (motor task [MT]) and motor imagery tasks of walking on a smooth surface (SMIT) and rough surface (RMIT). Functional assessment included gait analysis, ankle muscle strength, and ankle range of motion. RESULTS The tasks activated the sensorimotor, motor preparation, visual processing, and decision-making regions. Activation was significantly lower in patients with DPN than in those without DPN during MT and SMIT but not RMIT. Poor functional performance in patients with DPN was associated with greater activation in motor preparation regions. CONCLUSIONS In patients with DPN, CNS responses appear muted compared with patients without DPN, but they remain capable of enhancing CNS activation when tasks are more challenging or when functional deficits are substantial

Personalised Care-and-Support-Planning in Singapore: Qualitative interviews with people living with diabetes

10.3399/bjgpo.2023.0055BJGP OpenBJGPO.2023.0055-BJGPO.2023.005

Personalised care and support planning in Singapore: qualitative interviews with people living with diabetes

Background: Personalised care and support planning (CSP) is a person-centred approach for the care of people living with long-term conditions. Patient Activation through Community Empowerment/Engagement for Diabetes Management (PACE-D) adapts the Year of Care Partnerships (YOCP) approach to CSP in the UK for people living with diabetes at Singapore polyclinics. Polyclinics are multi-storey primary care hubs that provide affordable, multidisciplinary, comprehensive, and high-throughput public health care for the multi-ethnic, multilingual Singapore population. Aim: To explore the experience of PACE-D-enrolled people living with diabetes with personalised CSP at Singapore polyclinics. Design & setting: Qualitative interviews of people living with diabetes who experienced personalised CSP at National University Polyclinics (NUP) in Singapore between July 2020 and November 2021. Method: PACE-D-enrolled people living with diabetes who experienced personalised CSP were purposively sampled. In-depth semi-structured interviews were recorded, transcribed, and analysed using Braun and Clarke’s reflexive thematic analysis. Results: Fifty-two patients participated in the study. Four main themes were identified. Theme 1 was the importance of the care-planning letter. Patients reported that the CPL prompted reflection and patient preparation for CSP conversations. Theme 2 was the role of the programme coordinator. PACE-D programme coordinators amplified self-management by playing advocate and confidant beyond administrative duties. Theme 3 was the value of the personalised CSP conversation. CSP providers were perceived as partners in care, with more time to listen compared with usual consultations. Patient engagement was affected by language confidence. Theme 4 was agency in self-management. With adequate time and support, patients increased in confidence and agency both in CSP engagement and diabetes self-management. Conclusion: While language confidence may affect patient engagement, personalised CSP shows promise for strengthening patient engagement and self-management among people living with diabetes at Singapore polyclinics

Short-term strength and balance training does not improve quality of life but improves functional status in individuals with diabetic peripheral neuropathy: a randomised controlled trial

10.1007/s00125-019-04979-7DIABETOLOGIA62122200-221