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  1. Article ; Online: A Primer on Diabetes Mellitus: Foundations for the Incoming First-Year Resident.

    Amori, Renee E / Simon, Barbara

    MedEdPORTAL : the journal of teaching and learning resources

    2016  Volume 12, Page(s) 10469

    Abstract: Introduction: Given the increasing prevalence of diabetes mellitus, trainees should have a strong foundation in the management of diabetes. Published literature on the knowledge base and comfort level of medical trainees in diabetes care describes ... ...

    Abstract Introduction: Given the increasing prevalence of diabetes mellitus, trainees should have a strong foundation in the management of diabetes. Published literature on the knowledge base and comfort level of medical trainees in diabetes care describes varying levels of exposure to diabetes management in both inpatient and outpatient settings.
    Methods: This eight-module curriculum provides a foundation in the diagnosis, evaluation, and management of diabetes mellitus in the adult patient, as well as pharmacological treatment, patient education, and complications. Specifically, the modules consist of an introduction to diabetes, diagnosis and glycemic goals, patient education, basic nutrition, noninsulin therapies, insulin therapies, complications of diabetes, and financial considerations and cost. Each is a stand-alone presentation that may be viewed nonsequentially. We estimate each module taking 15 to 30 minutes to read. Students received a postsurvey.
    Results: We received responses from 23 (18%) of the total eligible residents over the course of 3 years. Approximately 50% of respondents completed an endocrinology elective as either a medical student or first-year resident. Overall, the majority of respondents felt that the modules had the correct amount of content, the online format was adequate, their understanding of diabetes was enhanced, and the curriculum led to altering their care.
    Discussion: This resource is unique to MedEdPORTAL as it includes basic information on diabetes education and medical-nutritional therapy. We have required completion of these modules by our internal medicine residents since the class that enrolled in 2013. The curriculum is directed towards incoming first-year internal medicine residents but may also be used by trainees in other primary care fields.
    Language English
    Publishing date 2016-09-28
    Publishing country United States
    Document type Journal Article
    ISSN 2374-8265
    ISSN (online) 2374-8265
    DOI 10.15766/mep_2374-8265.10469
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A Primer on Diabetes Mellitus

    Renee E. Amori / Barbara Simon

    MedEdPORTAL, Vol

    Foundations for the Incoming First-Year Resident

    2016  Volume 12

    Abstract: Abstract Introduction Given the increasing prevalence of diabetes mellitus, trainees should have a strong foundation in the management of diabetes. Published literature on the knowledge base and comfort level of medical trainees in diabetes care ... ...

    Abstract Abstract Introduction Given the increasing prevalence of diabetes mellitus, trainees should have a strong foundation in the management of diabetes. Published literature on the knowledge base and comfort level of medical trainees in diabetes care describes varying levels of exposure to diabetes management in both inpatient and outpatient settings. Methods This eight-module curriculum provides a foundation in the diagnosis, evaluation, and management of diabetes mellitus in the adult patient, as well as pharmacological treatment, patient education, and complications. Specifically, the modules consist of an introduction to diabetes, diagnosis and glycemic goals, patient education, basic nutrition, noninsulin therapies, insulin therapies, complications of diabetes, and financial considerations and cost. Each is a stand-alone presentation that may be viewed nonsequentially. We estimate each module taking 15 to 30 minutes to read. Students received a postsurvey. Results We received responses from 23 (18%) of the total eligible residents over the course of 3 years. Approximately 50% of respondents completed an endocrinology elective as either a medical student or first-year resident. Overall, the majority of respondents felt that the modules had the correct amount of content, the online format was adequate, their understanding of diabetes was enhanced, and the curriculum led to altering their care. Discussion This resource is unique to MedEdPORTAL as it includes basic information on diabetes education and medical-nutritional therapy. We have required completion of these modules by our internal medicine residents since the class that enrolled in 2013. The curriculum is directed towards incoming first-year internal medicine residents but may also be used by trainees in other primary care fields.
    Keywords Diabetes Mellitus ; Evidence-Based Medicine ; Endocrinology ; Chronic Disease Management ; Medicine (General) ; R5-920 ; Education ; L
    Subject code 571
    Language English
    Publishing date 2016-09-01T00:00:00Z
    Publisher Association of American Medical Colleges
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Efficacy and safety of incretin therapy in type 2 diabetes: systematic review and meta-analysis.

    Amori, Renee E / Lau, Joseph / Pittas, Anastassios G

    JAMA

    2007  Volume 298, Issue 2, Page(s) 194–206

    Abstract: Context: Pharmacotherapies that augment the incretin pathway have recently become available, but their role in the management of type 2 diabetes is not well defined.: Objective: To assess the efficacy and safety of incretin-based therapy in adults ... ...

    Abstract Context: Pharmacotherapies that augment the incretin pathway have recently become available, but their role in the management of type 2 diabetes is not well defined.
    Objective: To assess the efficacy and safety of incretin-based therapy in adults with type 2 diabetes based on randomized controlled trials published in peer-reviewed journals or as abstracts.
    Data sources: We searched MEDLINE (1966-May 20, 2007) and the Cochrane Central Register of Controlled Trials (second quarter, 2007) for English-language randomized controlled trials involving an incretin mimetic (glucagonlike peptide 1 [GLP-1] analogue) or enhancer (dipeptidyl peptidase 4 [DPP4] inhibitor). We also searched prescribing information, relevant Web sites, reference lists and citation sections of recovered articles, and abstracts presented at recent conferences.
    Study selection: Randomized controlled trials were selected if they were at least 12 weeks in duration, compared incretin therapy with placebo or other diabetes medication, and reported hemoglobin A(1c) data in nonpregnant adults with type 2 diabetes.
    Data extraction: Two reviewers independently assessed trials for inclusion and extracted data. Differences were resolved by consensus. Meta-analyses were conducted for several efficacy and safety outcomes.
    Results: Of 355 potentially relevant articles identified, 51 were retrieved for detailed evaluation and 29 met the inclusion criteria. Incretins lowered hemoglobin A(1c) compared with placebo (weighted mean difference, -0.97% [95% confidence interval {CI}, -1.13% to -0.81%] for GLP-1 analogues and -0.74% [95% CI, -0.85% to -0.62%] for DPP4 inhibitors) and were noninferior to other hypoglycemic agents. Glucagonlike peptide 1 analogues resulted in weight loss (1.4 kg and 4.8 kg vs placebo and insulin, respectively) while DPP4 inhibitors were weight neutral. Glucagonlike peptide 1 analogues had more gastrointestinal side effects (risk ratio, 2.9 [95% CI, 2.0-4.2] for nausea and 3.2 [95% CI, 2.5-4.4] for vomiting). Dipeptidyl peptidase 4 inhibitors had an increased risk of infection (risk ratio, 1.2 [95% CI, 1.0-1.4] for nasopharyngitis and 1.5 [95% CI, 1.0-2.2] for urinary tract infection) and headache (risk ratio, 1.4 [95% CI, 1.1-1.7]). All but 3 trials had a 30-week or shorter duration; thus, long-term efficacy and safety could not be evaluated.
    Conclusions: Incretin therapy offers an alternative option to currently available hypoglycemic agents for nonpregnant adults with type 2 diabetes, with modest efficacy and a favorable weight-change profile. Careful postmarketing surveillance for adverse effects, especially among the DPP4 inhibitors, and continued evaluation in longer-term studies and in clinical practice are required to determine the role of this new class among current pharmacotherapies for type 2 diabetes.
    MeSH term(s) Adamantane/analogs & derivatives ; Adamantane/therapeutic use ; Adenosine Deaminase Inhibitors ; Diabetes Mellitus, Type 2/drug therapy ; Dipeptidyl Peptidase 4 ; Dipeptidyl-Peptidase IV Inhibitors ; Glucagon-Like Peptide 1/analogs & derivatives ; Glucagon-Like Peptide 1/therapeutic use ; Glycoproteins/antagonists & inhibitors ; Humans ; Hypoglycemic Agents/therapeutic use ; Liraglutide ; Nitriles/therapeutic use ; Peptides/therapeutic use ; Pyrazines/therapeutic use ; Pyrrolidines/therapeutic use ; Sitagliptin Phosphate ; Triazoles/therapeutic use ; Venoms/therapeutic use
    Chemical Substances Adenosine Deaminase Inhibitors ; Dipeptidyl-Peptidase IV Inhibitors ; Glycoproteins ; Hypoglycemic Agents ; Nitriles ; Peptides ; Pyrazines ; Pyrrolidines ; Triazoles ; Venoms ; Liraglutide (839I73S42A) ; Glucagon-Like Peptide 1 (89750-14-1) ; exenatide (9P1872D4OL) ; DPP4 protein, human (EC 3.4.14.5) ; Dipeptidyl Peptidase 4 (EC 3.4.14.5) ; vildagliptin (I6B4B2U96P) ; Adamantane (PJY633525U) ; Sitagliptin Phosphate (TS63EW8X6F)
    Language English
    Publishing date 2007-07-11
    Publishing country United States
    Document type Journal Article ; Meta-Analysis ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2958-0
    ISSN 1538-3598 ; 0254-9077 ; 0002-9955 ; 0098-7484
    ISSN (online) 1538-3598
    ISSN 0254-9077 ; 0002-9955 ; 0098-7484
    DOI 10.1001/jama.298.2.194
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Inpatient medical errors involving glucose-lowering medications and their impact on patients: review of 2,598 incidents from a voluntary electronic error-reporting database.

    Amori, Renee E / Pittas, Anastassios G / Siegel, Richard D / Kumar, Sanjaya / Chen, Jack S / Karnam, Suneel / Golden, Sherita H / Salem, Deeb N

    Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists

    2008  Volume 14, Issue 5, Page(s) 535–542

    Abstract: ... reporting system (e-ERS) between August 1, 2000, and December 31, 2005. Persons reporting the errors ... determined the level of impact on patient care.: Results: The median duration of e-ERS use was 3.1 years ... Conclusion: An e-ERS provides an accessible venue for reporting and tracking inpatient medical errors ...

    Abstract Objective: To describe characteristics of inpatient medical errors involving hypoglycemic medications and their impact on patient care.
    Methods: We conducted a cross-sectional analysis of medical errors and associated adverse events voluntarily reported by hospital employees and staff in 21 nonprofit, nonfederal health-care organizations in the United States that implemented a Web-based electronic error-reporting system (e-ERS) between August 1, 2000, and December 31, 2005. Persons reporting the errors determined the level of impact on patient care.
    Results: The median duration of e-ERS use was 3.1 years, and 2,598 inpatient error reports involved insulin or orally administered hypoglycemic agents. Nursing staff provided 59% of the reports; physicians reported <2%. Approximately two-thirds of the errors (1,693 of 2,598) reached the patient. Errors that caused temporary harm necessitating major treatment or that caused permanent harm accounted for 1.5% of reports (40 of 2,598). Insulin was involved in 82% of reports, and orally administered hypoglycemic agents were involved in 18% of all reports (473 of 2,598). Sulfonylureas were implicated in 51.8% of reports involving oral hypoglycemic agents (9.4% of all reports).
    Conclusion: An e-ERS provides an accessible venue for reporting and tracking inpatient medical errors involving glucose-lowering medications. Results are limited by potential underreporting of events, particularly by physicians, and variations in the reporter perception of patient harm.
    MeSH term(s) Adverse Drug Reaction Reporting Systems/statistics & numerical data ; Cross-Sectional Studies ; Drug-Related Side Effects and Adverse Reactions/epidemiology ; Drug-Related Side Effects and Adverse Reactions/etiology ; Humans ; Hypoglycemic Agents/adverse effects ; Incidence ; Insulin/adverse effects ; Medical Errors/statistics & numerical data ; Sulfonylurea Compounds/adverse effects ; United States/epidemiology
    Chemical Substances Hypoglycemic Agents ; Insulin ; Sulfonylurea Compounds
    Language English
    Publishing date 2008-07
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1473503-9
    ISSN 1934-2403 ; 1530-891X
    ISSN (online) 1934-2403
    ISSN 1530-891X
    DOI 10.4158/EP.14.5.535
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