188 research outputs found
International Diabetes Federation guideline for management of postmeal glucose : a review of recommendations
No full textDiabetes is a significant and growing concern, with over 246 million people around the world living with the disease and another 308 million with impaired glucose tolerance. Depending on the resources of different nations, intervention has generally focused on optimizing overall glycaemic control as assessed by glycated haemoglobin (HbA1c) and fasting plasma glucose (FPG) values. Nevertheless, increasing evidence supports the importance of controlling all three members of the glucose triad, namely HbA1c, FPG and postmeal glucose (PMG) in order to improve outcome in diabetes. As part of its global mission to promote diabetes care and prevention and to find a cure, the International Diabetes Federation (IDF) recently developed a guideline that reviews evidence to date on PMG and the development of diabetic complications. Based on an extensive database search of the literature, and guided by a Steering and Development Committee including experts from around the world, the IDF Guideline for Management of Postmeal Glucose offers recommendations for appropriate clinical management of PMG. These recommendations are intended to help clinicians and organizations in developing strategies for effective management of PMG in individuals with Type 1 and Type 2 diabetes. The following review highlights the recommendations of the guideline, the supporting evidence provided and the major conclusions drawn. The full guideline is available for download at www.idf.org
Cost-benefit model of diabetes prevention and care: model construction, assumptions and validation
No full textThis paper describes the structure of the Cost Benefit Model of Diabetes Prevention and Care and lists the data sources used and assumptions embedded in the model. Agnes Walker, Stephen Colagiuri and Michele McLennan validate the model through checks of model outputs against data published by other organisations. They also discuss the sensitivity of model outputs to changes in certain key assumptions
Cost-Benefit Model System of Chronic Diseases in Australia to Assess and Rank Prevention and Treatment Options
No full textChronic diseases - eg heart disease, cancer, diabetes, mental disorders - affect around 80% of older Australians, are the main causes of disability and premature death, and account for 70% of total health expenditures. Because lifestyle patterns are major risk factors, chronic disease prevention and treatment are not only of medical concern, but also of considerable social, family-level and personal interest. While this makes microsimulation approaches particularly suitable for assessing intervention costs and benefits, such approaches will need to be combined with disease-progression models if health status and treatment choices are also to be simulated. AIMS: Describe methodological and technical proposals for the development of a cost-benefit model-system. METHODS: Several chronic disease progression models are to be linked to an ‘Umbrella’ microsimulation model representing the Australian population. To project 20 years ahead, use of reweighting techniques are proposed for population projections, disease-specific predictions and for health-related projections. The model-system is to account simultaneously for Australians’ demographic, socioeconomic and health-risk-factor characteristics; progression of their health status; the number of chronic diseases (comorbidities) they accumulate over time; health-related expenditures; and changes in quality of life. Standard methods are proposed to estimate costs versus benefits of simulated policy interventions and related quality of life improvements. KEY OUTCOME: Proposal of novel methods for modelling comorbidities - a task rarely attempted, although quality of life is known to decline and health expenditures to increase well above what a linear addition of the effects of individual chronic diseases would predict.Chronic Disease, Comorbidities, Cost-Benefit Model, Australia
An approach to implementing international diabetes guidelines
No full textDiabetes is a common, costly and ever-increasing health problem, with chronic complications that result in a heavy socioeconomic burden for people with the disease, the health care system and society (International Diabetes Foundation, 2007; Ringborg et al, 2009). Chronic complications, the major cause of morbidity, premature mortality and costs of diabetes, can be significantly reduced by control of blood glucose and associated cardiovascular risk factors (Kelly et al, 2009; Ray et al, 2009). The cost of these treatments is within the range of currently accepted preventative interventions (Gæde et al, 2008). Despite the available evidence, prevention strategies have not been widely incorporated into clinical practice and the care received by many people with diabetes is less than optimal worldwide (Chan et al, 2009).Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - la Plata. Centro de Endocrinología Experimental y Aplicada. Universidad Nacional de la Plata. Facultad de Cs.médicas. Centro de Endocrinología Experimental y Aplicada; Argentina. Organizacion Mundial de la Salud; ArgentinaFil: Colagiuri, Stephen. University of Sydney; Australi
sj-docx-1-dst-10.1177_19322968211054110 – Supplemental material for Evaluation of a Continuous Blood Glucose Monitor: A Novel and Non-Invasive Wearable Using Bioimpedance Technology
No full textSupplemental material, sj-docx-1-dst-10.1177_19322968211054110 for Evaluation of a Continuous Blood Glucose Monitor: A Novel and Non-Invasive Wearable Using Bioimpedance Technology by Farid Sanai, Arshman S. Sahid, Jacqueline Huvanandana, Sandra Spoa, Lachlan H. Boyle, Jonathan Hribar, David Ta-Yuan Wang, Benjamin Kwan, Stephen Colagiuri, Shane J. Cox and Thomas J. Telfer in Journal of Diabetes Science and Technology</p
Chronic diseases and multi-morbidity - a conceptual modification to the WHO ICCC model for countries in health transition
No full textBackgroundThe burden of non-communicable diseases is rising, particularly in low and middle-income countries undergoing rapid epidemiological transition. In sub-Saharan Africa, this is occurring against a background of infectious chronic disease epidemics, particularly HIV and tuberculosis. Consequently, multi-morbidity, the co-existence of more than one chronic condition in one person, is increasing; in particular multimorbidity due to comorbid non-communicable and infectious chronic diseases (CNCICD). Such complex multimorbidity is a major challenge to existing models of healthcare delivery and there is a need to ensure integrated care across disease pathways and across primary and secondary care.DiscussionThe Innovative Care for Chronic Conditions (ICCC) Framework developed by the World Health Organization provides a health systems roadmap to meet the increasing needs of chronic disease care. This framework incorporates community, patient, healthcare and policy environment perspectives, and forms the cornerstone of South Africa's primary health care re-engineering and strategic plan for chronic disease management integration. However, it does not significantly incorporate complexity associated with multimorbidity and CNCICD.Using South Africa as a case study for a country in transition, we identify gaps in the ICCC framework at the micro-, meso-, and macro-levels. We apply the lens of CNCICD and propose modification of the ICCC and the South African Integrated Chronic Disease Management plan. Our framework incorporates the increased complexity of treating CNCICD patients, and highlights the importance of biomedicine (biological interaction). We highlight the patient perspective using a patient experience model that proposes that treatment adherence, healthcare utilization, and health outcomes are influenced by the relationship between the workload that is delegated to patients by healthcare providers, and patients' capacity to meet the demands of this workload. We link these issues to provider perspectives that interact with healthcare delivery and utilization.SummaryOur proposed modification to the ICCC Framework makes clear that healthcare systems must work to make sense of the complex collision between biological phenomena, clinical interpretation, beliefs and behaviours that follow from these. We emphasize the integration of these issues with the socio-economic environment to address issues of complexity, access and equity in the integrated management of chronic diseases previously considered in isolation
Cost-benefit model of diabetes prevention and care Australia: model construction, assumptions and validation
No full textIn this paper Agnes Walker, Stephen Colagiuri and Michele McLennan document key features of the Cost-Benefit Model of Diabetes Prevention and Care, which was developed by NATSEM in collaboration with the Diabetes Centre at the Prince of Wales Hospital in Sydney
Comparison of clinical-metabolic monitoring and outcomes and coronary risk status in people with type 2 diabetes from Australia, France and Latin America
No full textAim: To compare clinical-metabolic monitoring and coronary risk status in people with type 2 diabetes from Australia, France and Latin America. Methods: Retrospective analysis of data collected at primary care (4540 participants from each population) matched for age, gender and disease duration. Measurements included participants' characteristics, performance frequency of clinical-metabolic process indicators, and percentage of clinical-metabolic outcomes at recommended target values. Results: The weighted mean of the percentage of process performance was within 68 to 81%; that of outcomes at target dropped to 29 to 45%. Although statistically significant, differences among groups were far from those in healthcare budgets, and probably only of marginal clinical impact. The percentage of patients with low, slight or high coronary risk was similar in the three groups, with most people at high or very high risk. Conclusions: Despite the high difference in health per capita investment and system characteristics among countries, the study populations had striking similarities regarding the low percentage of participants who achieved cardiovascular risk factor and diabetes treatment goals. Therefore, differences in health budget and system characteristics would not be the main drivers in care quality. Diabetes education at every level and quality care registries would contribute to improve this situation and assess such improvement.Fil: Gagliardino, Juan Jose. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico La Plata. Centro de Endocrinología Experimental y Aplicada (i); ArgentinaFil: Kleinebreil, Line. Hopital Europeen Georges Pompidou; FranciaFil: Colagiuri, Stephen. Prince Of Wales Hospital; AustraliaFil: Flack, Jeff. Prince Of Wales Hospital; AustraliaFil: Caporale, Joaquín E.. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico La Plata. Centro de Endocrinología Experimental y Aplicada (i); ArgentinaFil: Siri, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico La Plata. Centro de Endocrinología Experimental y Aplicada (i); ArgentinaFil: Clark Jr., Charles. Indiana University School of Medicine; Estados Unido
Global and regional estimates and projections of diabetes-related health expenditure: Results from the International Diabetes Federation Diabetes Atlas, 9th edition
No full textHealth Policy in Ageing Populations: Economic modeling of chronic disease policy options in Australia
No full textIn a global environment of rapid increases in health expenditures, health policies in Australia and in many other countries are currently undergoing major reforms. To contain future cost increases, accurate tools able to identify and rank ‘best value for money’ health investments are essential. In Australia non-communicable chronic diseases – e.g. diabetes, heart disease, cancer, arthritis and mental disorders – affect the majority of the elderly, account for 70% of health expenditures, and cause poor health, deteriorating quality of life and premature death. This book focuses on how to identify ‘best value for money’ health investments within the context of on-going and future health reforms, and on quantifying the major benefits that would flow from such investments in terms of longer and better lives. This book will be of interest to general readers, social and economic researchers, and students interested in health care in ageing populations
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