Search Results for: diabet
Clinical Notes: diabetes, LMW heparin, dressings, lymphedema
Factors affecting medication adherence in patients with diabetes identified
Factors associated with better adherence to antidiabetic medications taken by patients with diabetes include older age, male sex, higher education, higher income, use of mail-order vs. retail pharmacies, primary care vs. nonendocrinology specialist prescribers, higher daily total pill burden, and lower out-of-pocket costs. (more…)
Read MoreNanotech-enabled moisturizer speeds healing of diabetic skin wounds
Clinical Notes : Diabetes, medical honey, silver dressings, clostridium
Guidelines for optimal off-loading to prevent diabetic foot ulcers
“The management of diabetic foot ulcers through optimal off-loading,” published in the Journal of the American Podiatric Medical Association, presents consensus guidelines and states the “evidence is clear” that off-loading increases healing of diabetic foot ulcers.
The article calls for increased use of off-loading and notes that “current evidence favors the use of nonremovable casts or fixed ankle walking braces as optimum off-loading modalities.” The authors reviewed about 90 studies. (more…)
Read MoreClinical Notes: Radiation & Lymphedema, Decline in Diabetic Foot Ulcers
Clinician Resources: Opioid-Prescribing, Diabetes, Pressure Injuries
Here are a variety of resources you might want to explore.
Considering opioid-prescribing practices
Healthcare providers’ prescribing patterns for opioids vary considerably by state, according to a report in Vital Signs from the Centers for Disease Control and Prevention (CDC). Here are some facts from the report:
• Each day, 46 people die from an overdose of prescription painkillers in the United States.*
• Healthcare providers wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills.
• Ten of the highest prescribing states for painkillers are in the South. (more…)
Clinical Notes: Pressure Injury Prevention, Diabetes, LIV
Incidence density best measure of pressure-ulcer prevention program
According to the National Pressure Ulcer Advisory Panel (NPUAP), incidence density is the best quality measure of pressure-ulcer prevention programs. Pressure-ulcer incidence density is calculated by dividing the number of inpatients who develop a new pressure ulcer by 1,000 patient days. Using the larger denominator of patient days allows fair comparisons between institutions of all sizes. (more…)
Read MoreMinor foot wounds a major threat for diabetics
Clinical Notes: diabetic foot osteomyelitis, BIA, footwear
Antibiotics and conservative surgery yield similar outcomes in patients with diabetic foot osteomyelitis
A study in Diabetes Care finds that antibiotics and surgery have similar outcomes related to rate of healing, time of healing, and short-term complications in patients who have neuropathic forefoot ulcers and osteomyelitis, but no ischemia or necrotizing soft-tissue infections.
“Antibiotics versus conservative surgery for treating diabetic foot osteomyelitis. A randomized comparative trial” compared two groups: an antibiotics group and a surgery group. Patients in the antibiotics group received antibiotics for 90 days, and patients in the surgery group received conservative surgery with postoperative antibiotics for 10 days. (more…)
Read MoreClinical Notes: Pressure-Ulcer Data, Diabetic Foot Ulcers, IFG & HbA1c
Hospital pressure-ulcer comparison data not accurate
Performance scores for rates of hospital-acquired pressure ulcers might not be appropriate for comparing hospitals, according to a study in the Annals of Internal Medicine.
“Hospital report cards for hospital-acquired pressure ulcers: How good are the grades?,” funded by the Agency for Healthcare Research and Quality, analyzed 2 million all-payer administrative records from 448 California hospitals and quarterly hospital surveillance data from 213 hospitals from the Collaborative Alliance for Nursing Outcomes. (more…)
Read MoreClinical Notes: Debridement, Optimal Wound Healing, Diabetes, Sacral Wounds
Frequent debridement improves wound healing
A study in JAMA Dermatology reports that frequent debridements speed wound healing.
“The more frequent the debridement, the better the healing outcome,” concludes “Frequency of debridements and time to heal: A retrospective cohort study of 312 744 wounds.” The median number of debridements was two.
Most of the wounds in the 154,644 patients were diabetic foot ulcers, venous leg ulcers, and pressure ulcers. The study authors note that debridement is a “key process” in wound bed preparation and starting the healing process.
The findings are congruent with previous studies and are based on an analysis of the largest wound data set to date. (more…)
Read MoreClinician Resources: Guideline Clearinghouse, Patient Safety, Diabetic Foot-Ulcers
Here are some resources of value to your practice.
National Guideline Clearinghouse
The National Guideline Clearinghouse, supported by the Agency for Healthcare Research and Quality, summarizes many guidelines of interest to wound care, ostomy, and lymphedema clinicians. Here are some examples:
- Guideline for management of wounds in patients with lower-extremity neuropathic disease
- Pressure ulcer prevention and treatment protocol
- Lower limb peripheral arterial disease: diagnosis and management
- Screening for intimate partner violence and abuse of elderly and vulnerable adults: U.S. Preventive Services Task Force recommendation statement.
You can search for guidelines and compare more than one guideline.