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Article ; Online: In type 2 diabetes with periodontitis, intensive periodontitis treatment improved glycemic control at 1 year.

Punthakee, Zubin

2019 Volume 170, Issue 8, Page(s) JC40

MeSH term(s)	Blood Glucose ; Diabetes Mellitus, Type 2 ; Humans ; Periodontitis
Chemical Substances	Blood Glucose
Language	English
Publishing date	2019-04-12
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/ACPJ201904160-040
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Article ; Online: Role of the laboratory in diabetes diagnosis and screening--the 2013 CDA CPGs.

Punthakee, Zubin

Clinical biochemistry

2013 Volume 46, Issue 9, Page(s) 707–709

MeSH term(s)	Canada ; Diabetes Mellitus/blood ; Diabetes Mellitus/diagnosis ; Glycated Hemoglobin A/metabolism ; Humans ; Mass Screening ; Practice Guidelines as Topic
Chemical Substances	Glycated Hemoglobin A
Language	English
Publishing date	2013-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	390372-2
ISSN	1873-2933 ; 0009-9120
ISSN (online)	1873-2933
ISSN	0009-9120
DOI	10.1016/j.clinbiochem.2013.04.019
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Article ; Online: An assessment of adaptation and fidelity in the implementation of an audit and feedback-based intervention to improve transition to adult type 1 diabetes care in Ontario, Canada.

Ahmad, Syed Zain / Ivers, Noah / Zenlea, Ian / Parsons, Janet A / Shah, Baiju R / Mukerji, Geetha / Punthakee, Zubin / Shulman, Rayzel

Implementation science communications

2024 Volume 5, Issue 1, Page(s) 25

Abstract: Background: The fit between an intervention and its local context may affect its implementation and effectiveness. Researchers have stated that both fidelity (the degree to which an intervention is delivered, enacted, and received as intended) and ... ...

Abstract	Background: The fit between an intervention and its local context may affect its implementation and effectiveness. Researchers have stated that both fidelity (the degree to which an intervention is delivered, enacted, and received as intended) and adaptation to the local context are necessary for high-quality implementation. This study describes the implementation of an audit and feedback (AF)-based intervention to improve transition to type 1 diabetes adult care, at five sites, in terms of adaptation and fidelity. Methods: An audit and feedback (AF)-based intervention for healthcare teams to improve transition to adult care for patients with type 1 diabetes was studied at five pediatric sites. The Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) was used to document the adaptations made during the study. Fidelity was determined on three different levels: delivery, enactment, and receipt. Results: Fidelity of delivery, receipt, and enactment were preserved during the implementation of the intervention. Of the five sites, three changed their chosen quality improvement initiative, however, within the parameters of the study protocol; therefore, fidelity was preserved while still enabling participants to adapt accordingly. Conclusions: We describe implementing a multi-center AF-based intervention across five sites in Ontario to improve the transition from pediatric to adult diabetes care for youth with type 1 diabetes. This intervention adopted a balanced approach considering both adaptation and fidelity to foster a community of practice to facilitate implementing quality improvement initiatives for improving transition to adult diabetes care. This approach may be adapted for improving transition care for youth with other chronic conditions and to other complex AF-based interventions. Trial registration: ClinicalTrials.gov NCT03781973. Registered 13 December 2018. Date of enrolment of the first participant to the trial: June 1, 2019.
Language	English
Publishing date	2024-03-18
Publishing country	England
Document type	Journal Article
ISSN	2662-2211
ISSN (online)	2662-2211
DOI	10.1186/s43058-024-00563-2
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Article ; Online: Impact of COVID-19 Lockdown on Occurrence of Acute Complications of Type 1 and Type 2 Diabetes and Overall Glycemic Management.

Parihar, Richa / Rana, Simrit / Punthakee, Zubin / Gerstein, Hertzel / Braga, Manoela / Pigeyre, Marie

Canadian journal of diabetes

2023 Volume 48, Issue 2, Page(s) 120–124

Abstract: Objectives: The association of diabetes, and COVID-19 infection has been studied extensively; however, the occurrence of diabetic ketoacidosis (DKA) or hyperglycemic/hyperosmolar states (HHS) in adults during the lockdown has not been well characterized. ...

Abstract	Objectives: The association of diabetes, and COVID-19 infection has been studied extensively; however, the occurrence of diabetic ketoacidosis (DKA) or hyperglycemic/hyperosmolar states (HHS) in adults during the lockdown has not been well characterized. In this study, we aimed to identify the impact of the lockdown on occurrence and severity of DKA/HHS admissions and glycemic management. Methods: A retrospective chart review was conducted of patients admitted to Hamilton Health Sciences with a diagnosis of DKA or HHS from April to September 2019 (pre-lockdown) and from April to September 2020 (lockdown). Adult (≥18 years old) nonpregnant patients with a single admission in the study period were included for study. Results: There were 229 admissions related to diabetes, with 171 admissions meeting the inclusion criteria (n=92 pre-lockdown, n=79 lockdown). In the lockdown group, 51.8% of the patients had type 2 diabetes mellitus, with 96.2% of admissions secondary to DKA. When comparing the 2 periods, the lockdown group trended toward higher rates of death (5.4% vs 10.1%, p=0.247) and euglycemic DKA (17.6% vs 24.4%, p=0.403). There were more new diagnoses of type 1 diabetes mellitus in the lockdown group compared with the pre-lockdown group (7.3% vs 16.7%, p=0.230). The average glycated hemoglobin was lower in the lockdown group compared with the pre-lockdown group (11.8% vs 10.4%, p=0.032). Conclusions: Overall, this study is among the first in Canada to assess the impact of the COVID-19 lockdown on admissions due to DKA and HHS. Although no significant differences were noted in severity of admissions, there was a trend toward more new diagnoses of type 1 diabetes mellitus presenting in DKA during the lockdown period.
MeSH term(s)	Adult ; Humans ; Adolescent ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 1/epidemiology ; Diabetes Mellitus, Type 1/complications ; Retrospective Studies ; Hyperglycemic Hyperosmolar Nonketotic Coma ; COVID-19/epidemiology ; COVID-19/complications ; Communicable Disease Control ; Diabetic Ketoacidosis/etiology ; Diabetic Ketoacidosis/complications
Language	English
Publishing date	2023-12-12
Publishing country	Canada
Document type	Journal Article
ISSN	2352-3840
ISSN (online)	2352-3840
DOI	10.1016/j.jcjd.2023.12.001
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Article: Relationship of parental feeding practices and diet with children's diet among South Asians in Canada

Slapnicar, Calum / Lear, Scott A. / Dehghan, Mahshid / Gupta, Milan / Rangarajan, Sumathy / Punthakee, Zubin

Appetite. 2022 June 01, v. 173

2022

Abstract: South Asian children's diets are considered unhealthy, yet the relationship with food parenting among South Asians is understudied. In a cross-sectional study, questionnaires were administered to dyads of Canadian South Asian elementary and high school ... ...

Abstract	South Asian children's diets are considered unhealthy, yet the relationship with food parenting among South Asians is understudied. In a cross-sectional study, questionnaires were administered to dyads of Canadian South Asian elementary and high school children and a parent. Relationships between parental factors (perceived responsibility, restriction, pressure to eat, monitoring, home food environment, nutrition knowledge and intake of fruits and vegetables (FV), sugary beverages (SB) and sweets and fast foods (SWFF) and children's intake of FV, SB and SWFF were assessed by linear regression adjusted for sociodemographics. Subgroup differences by children's age and acculturation were explored by interaction analysis. 291 children (age 9.8 ± 3.2 years) had mean daily intake frequencies of 3.1 ± 2.0 FV, 1.0 ± 0.9 SB and 2.1 ± 1.5 SWFF. Positive associations were found between parent and child intake of FV (standardized beta (ß) = 0.230, [95%CI 0.115, 0.345], p < 0.001), SB (β = 0.136 [0.019, 0.252], p = 0.02), and SWFF (β = 0.167 [0.052, 0.282], p = 0.005). Parental monitoring was associated with lower children's SWFF intake (ß = −0.131 [-0.248, −0.015], p = 0.03). Among those expressing less Western culture, parental SWFF intake was associated with child's SB intake (β = 0.255 [0.085, 0.425], p = 0.004). Among those expressing less traditional culture, positive home food environment was associated with lower child SWFF intake (β = −0.208 [-0.374, −0.042], p = 0.015). South Asian children's diets have stronger relationships with their parents' diets than with food parenting practices or nutrition knowledge, though parental monitoring was associated with lower unhealthy food intake. However, with greater acculturation, the home food environment was more important for unhealthy food intake.
Keywords	acculturation ; appetite ; children ; cross-sectional studies ; food intake ; nutrition knowledge ; regression analysis ; sociodemographic characteristics ; Canada
Language	English
Dates of publication	2022-0601
Publishing place	Elsevier Ltd
Document type	Article
ZDB-ID	764440-1
ISSN	0195-6663
ISSN	0195-6663
DOI	10.1016/j.appet.2022.105991
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Diabetes knowledge, risk perception, and quality of life among South Asian caregivers in young adulthood.

Koipuram, Angela / Carroll, Sandra / Punthakee, Zubin / Sherifali, Diana

BMJ open diabetes research & care

2020 Volume 8, Issue 2

Abstract: Introduction: Persons of South Asian descent have a higher prevalence of type 2 diabetes mellitus (T2DM). The management of T2DM in the South Asian community has required the support of adult children, potentially impacting the quality of life, diabetes- ...

Abstract	Introduction: Persons of South Asian descent have a higher prevalence of type 2 diabetes mellitus (T2DM). The management of T2DM in the South Asian community has required the support of adult children, potentially impacting the quality of life, diabetes-related knowledge, and risk perception among these caregivers. Research design and methods: To investigate diabetes-related knowledge, quality of life, risk perception, and actual risk of developing diabetes among South Asian young adults whose parents are living with T2DM. A cross-sectional study was conducted (n=150). An online survey was administered. Data were analyzed with descriptive and inferential statistics. Results: There was a statistically significant difference in diabetes-related knowledge between males and females (p<0.001). Males (in comparison to females) had a lower risk perception of developing diabetes (p=0.06). Further, risk perception and diabetes-related knowledge were positively associated with caregiver's physical health (p Conclusion: Findings highlight the importance of providing gender-specific and culturally tailored diabetes educational interventions.
MeSH term(s)	Adult ; Caregivers ; Child ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/epidemiology ; Female ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Perception ; Quality of Life ; Young Adult
Language	English
Publishing date	2020-11-07
Publishing country	England
Document type	Journal Article
ZDB-ID	2732918-5
ISSN	2052-4897 ; 2052-4897
ISSN (online)	2052-4897
ISSN	2052-4897
DOI	10.1136/bmjdrc-2020-001268
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Article ; Online: Relationship of parental feeding practices and diet with children's diet among South Asians in Canada.

Slapnicar, Calum / Lear, Scott A / Dehghan, Mahshid / Gupta, Milan / Rangarajan, Sumathy / Punthakee, Zubin

Appetite

2022 Volume 173, Page(s) 105991

Abstract: Background: South Asian children's diets are considered unhealthy, yet the relationship with food parenting among South Asians is understudied.: Methods: In a cross-sectional study, questionnaires were administered to dyads of Canadian South Asian ... ...

Abstract	Background: South Asian children's diets are considered unhealthy, yet the relationship with food parenting among South Asians is understudied. Methods: In a cross-sectional study, questionnaires were administered to dyads of Canadian South Asian elementary and high school children and a parent. Relationships between parental factors (perceived responsibility, restriction, pressure to eat, monitoring, home food environment, nutrition knowledge and intake of fruits and vegetables (FV), sugary beverages (SB) and sweets and fast foods (SWFF) and children's intake of FV, SB and SWFF were assessed by linear regression adjusted for sociodemographics. Subgroup differences by children's age and acculturation were explored by interaction analysis. Results: 291 children (age 9.8 ± 3.2 years) had mean daily intake frequencies of 3.1 ± 2.0 FV, 1.0 ± 0.9 SB and 2.1 ± 1.5 SWFF. Positive associations were found between parent and child intake of FV (standardized beta (ß) = 0.230, [95%CI 0.115, 0.345], p < 0.001), SB (β = 0.136 [0.019, 0.252], p = 0.02), and SWFF (β = 0.167 [0.052, 0.282], p = 0.005). Parental monitoring was associated with lower children's SWFF intake (ß = -0.131 [-0.248, -0.015], p = 0.03). Among those expressing less Western culture, parental SWFF intake was associated with child's SB intake (β = 0.255 [0.085, 0.425], p = 0.004). Among those expressing less traditional culture, positive home food environment was associated with lower child SWFF intake (β = -0.208 [-0.374, -0.042], p = 0.015). Conclusion: South Asian children's diets have stronger relationships with their parents' diets than with food parenting practices or nutrition knowledge, though parental monitoring was associated with lower unhealthy food intake. However, with greater acculturation, the home food environment was more important for unhealthy food intake.
MeSH term(s)	Adolescent ; Asians ; Canada ; Child ; Cross-Sectional Studies ; Diet ; Feeding Behavior ; Humans ; Parent-Child Relations ; Parenting ; Parents ; Surveys and Questionnaires
Language	English
Publishing date	2022-03-07
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1461347-5
ISSN	1095-8304 ; 0195-6663
ISSN (online)	1095-8304
ISSN	0195-6663
DOI	10.1016/j.appet.2022.105991
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Article ; Online: Development and Validation of the Transition Readiness Assessment Instrument in Type 1 Diabetes "On TRAck".

Al Khalifah, Reem A / McConnell, Meghan / Al Nahari, Ahmed A / Ravi, Roshni / Punthakee, Zubin

Canadian journal of diabetes

2022 Volume 46, Issue 5, Page(s) 510–517

Abstract: Objectives: Transition to adult care is challenging for youth with type 1 diabetes (T1D) and their caregivers. We have developed the diabetes-specific "On TRAck" transition readiness scale, and in this study we assess its reliability and validity ... ...

Abstract	Objectives: Transition to adult care is challenging for youth with type 1 diabetes (T1D) and their caregivers. We have developed the diabetes-specific "On TRAck" transition readiness scale, and in this study we assess its reliability and validity compared with TRANSITION-Q, a generic transition readiness questionnaire. Methods: We systematically created 3 versions of On TRAck: adolescent, parent and health-care provider (HCP) versions (for case managers and physicians). Among adolescents 13 to 18 years of age with T1D at a single academic centre, we conducted an exploratory factor analysis and assessed interrater agreement, internal consistency and relationship with age; recent glycated hemoglobin (A1C); and recent diabetic ketoacidosis (DKA) with On TRAck and TRANSITION-Q. Results: One hundred fifteen adolescents (aged 15.8±1.6 years and diabetes duration 6.7±4.1 years), their caregivers and diabetes HCPs participated. The final 24-item adolescent and parent scales (with 3 subscales: "Self-efficacy," "Autonomy" and "Support & maturity") and the 3-item HCP version had a Cronbach's alpha of 0.86 to 0.93. Adolescent scores correlated with parents (r=0.64), case managers (r=0.39) and physicians (r=0.28). Mean adolescent score was 190.3±27.1 points out of 240. Adolescent scores were 3.4 points higher per year of age (p=0.03) and 4.4 points higher for every 1% lower A1C (p=0.01), but were not associated with DKA. TRANSITION-Q was associated with age. On TRAck HCP scores were associated with adolescent's age, A1C and DKA. Conclusions: On TRAck represents a new psychometrically comprehensive diabetes-specific scale that can be used in adolescent diabetes clinics for measuring transition readiness. It is a multidimensional instrument with ease of use and high reliability scores.
MeSH term(s)	Adolescent ; Adult ; Diabetes Mellitus, Type 1/therapy ; Diabetic Ketoacidosis/diagnosis ; Diabetic Ketoacidosis/prevention & control ; Glycated Hemoglobin A ; Humans ; Infant ; Parents ; Psychometrics ; Reproducibility of Results ; Surveys and Questionnaires
Chemical Substances	Glycated Hemoglobin A
Language	English
Publishing date	2022-02-11
Publishing country	Canada
Document type	Journal Article
ISSN	2352-3840
ISSN (online)	2352-3840
DOI	10.1016/j.jcjd.2022.02.005
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Article ; Online: Indications for ordering thyroid-stimulating hormone in noncritically ill adult inpatients-A Delphi consensus recommendation.

Surendran, Anasuiya / Lubchansky, Stephanie / Epp, Riley / Luthra, Meera / Sovran, Steven / Punthakee, Zubin

Journal of hospital medicine

2022 Volume 17, Issue 11, Page(s) 865–871

Abstract: Background: Thyroid-stimulating hormone (TSH) is ordered commonly among inpatients, but the possibility of nonthyroidal illness syndrome challenges interpretation.: Objective: Our objective was to obtain Canadian consensus on appropriate indications ... ...

Abstract	Background: Thyroid-stimulating hormone (TSH) is ordered commonly among inpatients, but the possibility of nonthyroidal illness syndrome challenges interpretation. Objective: Our objective was to obtain Canadian consensus on appropriate indications for ordering TSH in the first 48 h following presentation of a noncritically ill internal medicine patient. Design, setting and participants: Canadian endocrinologists with inpatient expertise were invited via snowball sampling to an online 3-round Delphi study. Main Outcome and Measures using a 6-point Likert scale, they rated 58 indications on appropriateness for measuring TSH in medical inpatients. These indications included clinical presentations, signs, and symptoms. Items that reached consensus and agreement (≥80% of participants selecting a rating of 5 or 6 on the Likert scale) were tabulated and dropped after each round. Qualitative analysis of comments identified additional contextual considerations as themes. Results: There were 45 participants (academic setting: 84%) representing 8 provinces (Ontario: 64%). Rounds 2 and 3 were completed by 42 and 33 participants, respectively. Nine indications reached consensus and agreement: presumed myxedema coma, presumed thyroid storm, atrial fibrillation/flutter, euvolemic hyponatremia, proptosis, adrenal insufficiency, hypothermia, thyroid medication noncompliance, and goiter. There was also agreement that two contextual considerations identified in thematic analysis, including a recent abnormal outpatient TSH, and the presence of other findings of thyroid dysfunction, would significantly change some mid-range responses. Conclusions: Canadian experts agreed upon nine specific indications for ordering an inpatient TSH, with others requiring consideration of previous TSH measurement and clinical context.
MeSH term(s)	Adult ; Humans ; Consensus ; Delphi Technique ; Thyrotropin ; Inpatients ; Ontario
Chemical Substances	Thyrotropin (9002-71-5)
Language	English
Publishing date	2022-06-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	2233783-0
ISSN	1553-5606 ; 1553-5592
ISSN (online)	1553-5606
ISSN	1553-5592
DOI	10.1002/jhm.12890
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Article: THE IMPACT OF RESIDENT SENIORITY ON GUIDELINES ADHERENCE: A COMMENTARY ON DIABETES MANAGEMENT IN THE HOSPITAL.

Aljazeeri, Jafar / Punthakee, Zubin

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

2017 Volume 23, Issue 12, Page(s) 1479–1481

MeSH term(s)	Diabetes Mellitus ; Guideline Adherence ; Hospitals ; Humans ; Internship and Residency ; Physicians ; Practice Guidelines as Topic
Language	English
Publishing date	2017-11-16
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	1473503-9
ISSN	1530-891X
ISSN	1530-891X
DOI	10.4158/EP-2017-0028
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