Title |
Can primary care team-based transition to insulin improve outcomes in adults with type 2 diabetes: the stepping up to insulin cluster randomized controlled trial protocol
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Published in |
Implementation Science, February 2014
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DOI | 10.1186/1748-5908-9-20 |
Pubmed ID | |
Authors |
John S Furler, Doris Young, James Best, Elizabeth Patterson, David O’Neal, Danny Liew, Jane Speight, Leonie Segal, Carl May, Jo-Anne Manski-Nankervis, Elizabeth Holmes-Truscott, Louise Ginnivan, Irene D Blackberry |
Abstract |
Type 2 diabetes (T2D) brings significant human and healthcare costs. Its progressive nature means achieving normoglycaemia is increasingly difficult, yet critical to avoiding long term vascular complications. Nearly one-half of people with T2D have glycaemic levels out of target. Insulin is effective in achieving glycaemic targets, yet initiation of insulin is often delayed, particularly in primary care. Given limited access to specialist resources and the size of the diabetes epidemic, primary care is where insulin initiation must become part of routine practice. This would also support integrated holistic care for people with diabetes. Our Stepping Up Program is based on a general practitioner (GP) and practice nurse (PN) model of care supported appropriately by endocrinologists and credentialed diabetes educator-registered nurses. Pilot work suggests the model facilitates integration of the technical work of insulin initiation within ongoing generalist care. |
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Geographical breakdown
Country | Count | As % |
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United States | 2 | 22% |
Ireland | 1 | 11% |
Australia | 1 | 11% |
Unknown | 5 | 56% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 6 | 67% |
Practitioners (doctors, other healthcare professionals) | 2 | 22% |
Science communicators (journalists, bloggers, editors) | 1 | 11% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Australia | 1 | <1% |
South Africa | 1 | <1% |
Mexico | 1 | <1% |
Denmark | 1 | <1% |
Spain | 1 | <1% |
United States | 1 | <1% |
Unknown | 167 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Bachelor | 24 | 14% |
Student > Master | 23 | 13% |
Student > Ph. D. Student | 19 | 11% |
Researcher | 15 | 9% |
Student > Postgraduate | 11 | 6% |
Other | 35 | 20% |
Unknown | 46 | 27% |
Readers by discipline | Count | As % |
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Medicine and Dentistry | 41 | 24% |
Nursing and Health Professions | 37 | 21% |
Social Sciences | 10 | 6% |
Biochemistry, Genetics and Molecular Biology | 7 | 4% |
Psychology | 7 | 4% |
Other | 23 | 13% |
Unknown | 48 | 28% |