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Biomedical subjects

R G Hiss

Publications and source records attributed to R G Hiss.

43 records · Page 3Linked to original sources
PubMedDate not supplied

Screening for diabetic retinopathy in communities.

Twelve retinopathy screening clinics serving 489 diabetic patients were conducted in three Michigan communities as part of the outreach effort of the Michigan Diabetes Research and Training Center. Screening activities were initiated by local diabetes educators who conducted a program designed to promote detection of diabetic eye disease and increase patient and health care provider awareness of accepted ophthalmic evaluation guidelines. This experience suggests that retinopathy screening clinics can be successfully conducted if health care professionals in the community consider diabetic retinopathy to be a serious problem, one individual is willing to oversee the organizational aspects of the clinic, and an ophthalmologist with laser treatment capability is present or nearby. These clinics are effective in detecting diabetic eye disease and facilitating subsequent patient visits to an ophthalmologist for evaluation in accordance with national recommendations.

Adult↗
PubMedDate not supplied

Evaluation of an activated patient diabetes education newsletter.

This study evaluated a monthly, activated patient newsletter sent to over 7000 patients in Michigan with diabetes. The newsletter provided concise and action-oriented information about diabetes care. Patients who had signed up to receive the newsletter during the first 4 months of the project (1863) were surveyed to determine how many patients found the newsletter helpful; 80% (1498) of the patients replied. Patients who found the newsletter most helpful were older; had lower incomes, and reported more complications, less understanding of diabetes, and being in poorer overall health. They also were more likely to have non-insulin-dependent diabetes mellitus (NIDDM) than insulin-dependent diabetes mellitus (IDDM). We concluded that the activated patient newsletter is a useful public health/patient education intervention for persons with diabetes. Such a newsletter should be part of a coordinated system of ongoing patient care, education, screening, and social and psychological support.

Adult↗
PubMedDate not supplied

The diabetes education experience of randomly selected patients under the care of community physicians.

The purpose of this study was to describe the diabetes education and nutritional counseling received by patients under the active care of community physicians. The study population consisted of 440 patients with diabetes from the practices of 68 primary care physicians in eight Michigan communities. Fifty-eight percent of the sample reported having received diabetes education, and the mean number of years since the most recent education was 4.15 years. Sixty-six percent reported having seen a dietitian. Patients who had received diabetes education scored higher on a basic diabetes knowledge test (70% correct vs 60%) than patients who had not received diabetes education. From 1981 to 1991, a decline was observed in the percentage of patients who reported having received diabetes education (70% to 58%). Although patient education is an integral part of comprehensive diabetes care, too few patients are receiving it. Furthermore, diabetes education often results in less-than-optimal levels of knowledge. The situation has deteriorated over the past 10 years, and patients who are not on insulin typically are the least well served.

Adult↗
PubMedDate not supplied

Community diabetes care in the 1980s.

This is a study of diabetes care and care outcomes for patients under the active care of private physicians. Randomly selected communities, physicians, and patients in Michigan were the subjects of this study. Data on the care practices of physicians and patients and care outcomes were collected from 1980 to 1981 and again in 1985 from eight communities, 61 physicians, and 261 patients. We found that the use of multiple injections of insulin and self-monitoring of blood glucose increased significantly, whereas hospitalizations for diabetes control decreased. The mean glycosylated hemoglobin values for this cohort of patients remained unchanged. The study results suggest that, for patients under the active care of community physicians, modern methods of diabetes care are being implemented, but the results of improved care do not show an impact on blood glucose control as measured by glycosylated hemoglobin values. The study was not designed to establish causation for the decrease in hospitalizations for these patients, but the data suggest that decreases may be more a function of changes in health-care policies rather than changes in patient health.

Adult↗
PubMedDate not supplied

Psychosocial correlates of survival in diabetes.

The goal of this research was to quantify the relationships between patient survival and a set of explanatory variables in a randomly selected sample of community-based patients with non-insulin-dependent diabetes mellitus (NIDDM). The sample included 343 patients with NIDDM initially entered into the study in 1981-1982 and reexamined in 1985-1986. Mortality data were collected on reexamination in 1985 and updated from death-certificate data through 1 January 1986. The data collected from the patients included demographic and clinical variables, psychosocial variables related to diabetes, measures of physiologic control, hospitalization, and mortality. The Cox proportional-hazards model was used to compute a hazard rate for each individual and to determine risk covariates. The results indicated that the variables most associated with the risk of mortality were patient age, social impact of diabetes, renal function, complexity of diet regimen, and history of smoking. Two of these variables (social impact and complexity of diet regimen) were obtained from the Diabetes Educational Profile completed by all patients on entry to the study. The five predictor variables were more closely related to mortality than diabetes control as measured by HbA1, previous hospital admissions, previous heart attacks, and other physiologic measures frequently used as outcome measures. The only physiologic predictor was renal function.

Adult↗