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Issue 161 - 17 Nov 2010

Diabetes Awareness Week

16-22 November 2010
'Stay Sweet As'


Articles on Diabetes 
Request from the NZNO Library

1. Cultural Translation of Interventions: Diabetes Care in American Samoa.
By DePue, Judith D. et al. American Journal of Public Health, Nov 2010, Vol. 100 Issue 11: p2085-2093
Translation of research advances into clinical practice for at-risk communities is important to eliminate disease disparities. Adult type 2 diabetes prevalence in the US territory of American Samoa is 21.5%, but little intervention research has been carried out there. We discuss our experience with cultural translation, drawing on an emerging implementation science, which aims to build a knowledge base on adapting interventions to real-world settings. We offer examples from our behavioral intervention study, Diabetes Care in American Samoa, which was adapted from Project Sugar 2, a nurse and community health worker intervention to support diabetes self-management among urban African Americans. The challenges we experienced and solutions we used may inform adaptations of interventions in other settings. [ABSTRACT FROM AUTHOR]

2. Diabetes Control With Reciprocal Peer Support Versus Nurse Care Management
By Heisler, Michele et al. Annals of Internal Medicine, 10/19/2010, Vol. 153 Issue 8: p507-W.182
Resource barriers complicate diabetes care management. Support from peers may help patients manage their diabetes.
Objective: To compare a reciprocal peer-support (RPS) program with nurse care management (NCM)
Design: Randomized, controlled trial. ( registration number: NCT00320112)
Setting: 2 U.S. Department of Veterans Affairs health care facilities. Patients: 244 men with hemoglobin A1c (HbA1c) levels greater than 7.5% during the previous
6 months.
Measurements: The primary outcome was 6-month change in HbA1c level. Secondary outcomes were changes in insulin therapy; blood pressure; and patient reports of medication adherence, diabetes-related support, and emotional distress. Intervention: Patients in the RPS group attended an initial group session to set diabetes-related behavioral goals, receive peer communication skills training, and be paired with another age-matched peer patient. Peers were encouraged to talk weekly using a telephone platform that recorded call occurrence and provided reminders to promote peer contact. These patients could also participate in optional group sessions at 1, 3, and 6 months. Patients in the NCM group attended a 1.5-hour educational session and were assigned to a nurse care manager.
Results: Of the 244 patients enrolled, 216 (89%) completed the HbA1c assessments and 231 (95%) completed the survey assessments at 6 months. Mean HbA1c level decreased from 8.02% to 7.73% (change, -0.29%) in the RPS group and increased from 7.93% to 8.22% (change, 0.29%) in the NCM group. The difference in HbA1c change between groups was 0.58% (P = 0.004). Among patients with a baseline HbA1c level greater than 8.0%, those in the RPS group had a mean decrease of 0.88%, compared with a 0.07% decrease among those in the NCM group (between group difference, 0.81%; P < 0.001). Eight patients in the RPS group started insulin therapy, compared with 1 patient in the NCM group (P = 0.020). Groups did not differ in blood pressure, self-reported medication adherence, or diabetes-specific distress, but the RPS group reported improvement in diabetes social support.
Limitation: The study included only male veterans and lasted only 6 months.
Conclusion: Reciprocal peer support holds promise as a method for diabetes care management. [ABSTRACT FROM AUTHOR]

3. Management of diabetes in patients at the end of life
By Budge, Pauline. Nursing Standard, 10/13/2010, Vol. 25 Issue 6: p42-46
Diabetes is a complex metabolic disorder that is more common in patients with cancer than in the general population. The ethical dilemmas facing many healthcare professionals in the management of diabetes during the terminal phase of life include the timing of withholding or withdrawing treatment. Communication can also be difficult between healthcare professionals, patients and their families at this time. If the patient's preferences have not been discussed at an earlier stage in the illness trajectory, mismanagement of diabetes may occur. Local protocols on diabetes management at the end of life have been developed in some areas, but there are no national or standardised guidelines. This can result in fragmented care. This article explores the need for better communication and the development of national guidelines so that the quality of end of life care for patients with diabetes can be improved. [ABSTRACT FROM AUTHOR]

4. Self-management skills for people with type 2 diabetes
By Hicks, Debbie. Nursing Standard, 10/13/2010, Vol. 25 Issue 6: p48-56
This article discusses type 2 diabetes, including the underlying causes and the treatment algorithm needed to manage this condition. The article also explores the educational opportunities available to encourage self-management of this chronic life long condition. [ABSTRACT FROM AUTHOR]

5. Diabetes in the older adult
By Viljoen, Adie; Sinclair, Alan. Pulse, 10/13/2010, Vol. 70 Issue 30: p22-25
The article discusses the treatment of diabetes in older people. It states that the medication of diabetes in older adults became more challenging compared to younger patients due to their high rate of functional, cognitive and psychological disorders. It highlights the recommended glucose control from the European Diabetes Working Party for Older People for frail and non-frail patients. It also notes metformin and insulin as the most effective treatment options.

6. Prescribing in type 2 diabetes: choices and challenges
By Hill, Jill. Nursing Standard, 10/6/2010, Vol. 25 Issue 5: p55-58
There has been a significant increase in the choice of agents to control blood glucose levels recently. Although the National Institute for Health and Clinical Excellence gives a recommendation for what to use at each step of the glycaemic pathway, practitioners have a choice at each step. Recent controversies about the safety of intensifying glycaemic control, the cost of new therapies and the drive to achieve tighter targets through the Quality and Outcomes Framework need to be taken into account when prescribing the most appropriate medication for each individual. This article discusses the options for the prescriber when supporting those with type 2 diabetes to achieve target blood glucose levels. [ABSTRACT FROM AUTHOR]

Journals - Table of Contents

7. From Nursing Times, 2 November 2010
Tragedy puts skills deficit in the spotlight [The case of an agency nurse mistakenly turning off a disabled patient’s ventilator is symptomatic of the increasing dilution of skills in overstretched community nurse teams, senior nurses have warned]
7B. The NHS must support its staff to speak out against poor practice [Whistleblowing has become synonymous with bullying and harassment. Praising nurses not pillorying staff for reporting incidents will empower them to challenge practice, says Jane Reid]
7C. Does the risk of reprisal prevent nurses blowing the whistle on bad practice? [Nurses are often exposed to the dilemma of whistleblowing. A literature review was undertaken to identify the barriers to speaking out against unsafe practice]
7D. Enhancing nurses’ roles to improve quality and efficiency of non-medical cardiac stress tests [Nurses and other non-medical staff have reduced a 42 week waiting time for myocardial perfusion imaging to just two weeks. The trust reveals how]
7E. How to effectively manage hypertensive disorders in women who are pregnant [Hypertension is the most frequent complication of pregnancy. NICE guidance advises how to care for women who have, or are at risk of developing, the condition]
7F. Breathlessness in advanced disease 1: definitions, epidemiology and pathophysiology
7G. Using support workers to release time for qualified midwives in maternity care

Conferences, Seminars, Training Courses

8. New Zealand Society for the study of Diabetes - Annual Scientific Meeting and Annual General Meeting
The Diabetes Nurse Specialist and Dietitians’ Special Interest Group Study Days, including a Podiatry Special Interest Group and a Registrar Training Day will be held during this time
Date: 4-6 May 2011
Venue: Nelson, Rutherford Hotel
More information:

9. Annual Scientific Meeting 2011
New Zealand Rheumatology Association with New Zealand Health Professionals in Rheumatology
4-7 August 2011
Venue: Rydges Harbourview Hotel,Auckland, New Zealand
More information:

News - National

10. Autism expert Unproven treatments may do harm
New Zealand Herald - 17th Nov 2010
Many autism treatments are unproven and may be harming children, an education specialist says. Professor Jeff Sigafoos of Victoria University says without a more evidence-based approach to education, autistic children are potentially at risk.

11. Cuts 'bad for nation's health'
Manawatu Standard - 16th Nov 2010

Dabetes Awareness Week celebrations started today with national leaders watching to see whether the MidCentral District Health Board decides to cut $100,000 from its Diabetes Lifestyle Centre specialist service.

News - International

12. Could an antidepressant solve the mystery that is migraine?
The Telegraph
Mystic visions often have a very prosaic explanation: migraine. Sufferer Steve Jones looks at the causes and a possible cure. 

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