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Closing the policy gap in diabetes care for individuals with advanced CKD.
Habte-Asres, Hellena Hailu; Rosenthal, Miranda; Nitsch, Dorothea; Wheeler, David C.
Afiliación
  • Habte-Asres HH; Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.
  • Rosenthal M; Royal Free London, NHS Foundation Trust, London, UK.
  • Nitsch D; King's College Hospital, London, UK.
  • Wheeler DC; Royal Free London, NHS Foundation Trust, London, UK.
Diabet Med ; : e15381, 2024 Jun 10.
Article en En | MEDLINE | ID: mdl-38859547
ABSTRACT

AIM:

The co-existence of diabetes and CKD poses significant challenges to healthcare systems, current frameworks often inadequately address the complex needs of individuals with both conditions. Recognising these gaps, we introduced a new diabetes care model for people with advanced CKD in renal satellite units.This paper aims to evaluate this new diabetes model care.

METHOD:

We conducted a prospective audit of a new integrated diabetes kidney care model. Data were presented as mean ± SD or counts/percentages, and pre- and post-intervention differences were assessed using paired samples t-tests.

RESULTS:

A total of 291 individuals with diabetes and advanced CKD stages 4 or 5, or undergoing haemodialysis, were included. The mean age was 68.5 (±13.0) years, 58.4% were males. Nearly half of the cohort had four or more long-term conditions, while two-thirds experienced mild/severe frailty. Only 6% were receiving ongoing diabetes care from secondary care diabetes specialist services. For patients with CKD not receiving dialysis, comparing pre- and post-intervention, there were improvements in HbA1c (-13.0 mmol/mol, p < 0.001), SBP (-13.7 mm Hg, p < 0.0001), and weight (-2.9 kg, p < 0.0001). Furthermore, there was an increase in guideline-directed therapies, with notable usage of SGLT2i (62.9%) and GLP1-RA (28.4%), while access to diabetes technology increased to 89%.

CONCLUSION:

This new model of care resulted in improved metabolic outcomes, increased utilisation of guideline-directed therapies, and enhanced access to diabetes technologies. However, the model also revealed significant unmet clinical needs in areas such as access to diabetes care, diabetes eye screening and foot surveillance.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Diabet Med Asunto de la revista: ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Diabet Med Asunto de la revista: ENDOCRINOLOGIA Año: 2024 Tipo del documento: Article País de afiliación: Reino Unido Pais de publicación: Reino Unido