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Item Effect of the Affordable Care Act on diabetes care at major health centers: newly detected diabetes and diabetes medication management(BMJ, 2021-06) Furmanchuk, Al'ona; Liu, Mei; Song, Xing; Waitman, Lemuel R.; Meurer, John R.; Osinski, Kristen; Stoddard, Alexander; Chrischilles, Elizabeth; McClay, James C.; Cowell, Lindsay G.; Tachinardi, Umberto; Embi, Peter J.; Mosa, Abu Saleh Mohammad; Mandhadi, Vasanthi; Shah, Raj C.; Garcia, Diana; Angulo, Francisco; Patino, Alejandro; Trick, William E.; Markossian, Talar W.; Rasmussen-Torvik, Laura J.; Kho, Abel N.; Black, Bernard S.; Biostatistics, School of Public HealthItem Impact of community health workers on diabetes management in an urban United States Community with high diabetes burden through the COVID pandemic(Elsevier, 2024-02-09) Hansotte, Elinor; Andrea, Sarah B.; Weathers, Tess D.; Stone, Cynthia; Jessup, Alisha; Staten, Lisa K.; Community and Global Health, Richard M. Fairbanks School of Public HealthObjective: Community Health Worker (CHW) interventions are promising approaches to increasing access to health care, garnering better health outcomes, and decreasing health inequities for historically marginalized populations. This study examines the impact of a health system-based CHW program embedded in the Diabetes Impact Project - Indianapolis Neighborhoods (DIP-IN), a large, place-based, multi-year intervention to reduce diabetes burden. We assessed the CHW program's effectiveness in managing glucose control and reducing diabetes-associated complications across the COVID timeline. Methods: We examined the association between the CHW intervention and diabetes management in 454 CHW patients and 1,020 propensity score-matched comparison patients. Using electronic medical records for encounters between January 1, 2017, and March 31, 2022, we estimated the CHW program effect using a difference-in-difference approach through generalized linear mixed models. Results: Participation was associated with a significant reduction (-0.54-unit (95 % CI: -0.73, -0.35) in glycosylated hemoglobin (A1C) on average over time that was beyond the change observed among comparison patients, higher odds of having ≥ 2 A1C measures in a year (OR = 2.32, 95 % CI: 1.79, 3.00), lower odds of ED visits (OR: 0.88; 95 % CI: 0.73, 1.05), and lower odds of hospital admission (OR: 0.81; 95 % CI: 0.60,1.09). When analyses were restricted to a pre-pandemic timeframe, the pattern of results were similar. Conclusion: This program was effective in improving diabetes management among patients living in diabetes-burdened communities, and the effects were persistent throughout the pandemic timeline. CHW programs offer crucial reinforcement for diabetes management during periods when routine healthcare access is constrained.Item An informatics approach to medication adherence assessment and improvement using clinical, billing, and patient-entered data(Oxford University Press, 2014-05) Dixon, Brian E.; Jabour, Abdulrahman M.; O’Kelly Phillips, Erin; Marrero, David G.; BioHealth Informatics, School of Informatics and ComputingThe aim of this study was to describe an integrated informatics approach to aggregating and displaying clinically relevant data that can identify problems with medication adherence and facilitate patient-provider communication about strategies to improve medication use. We developed a clinical dashboard within an electronic health record (EHR) system that uses data from three sources: the medical record, pharmacy claims, and a personal health record. The data are integrated to inform clinician-patient discussions about medication adherence. Whereas prior research on assessing patterns of medication adherence focused on a single approach using the EHR, pharmacy data, or patient-entered data, we present an approach that integrates multiple electronic data sources increasingly found in practice. Medication adherence is a complex challenge that requires patient and provider team input, necessitating an integrated approach using advanced EHR, clinical decision support, and patient-controlled technologies. Future research should focus on integrated strategies to provide patients and providers with the right combination of informatics tools to help them adequately address the challenge of adherence to complex medication therapies.Item Is Bariatric Surgery an Effective Treatment for Type II Diabetic Kidney Disease?(American Society of Nephrology, 2016-03-07) Friedman, Allon N.; Wolfe, Bruce; Department of Medicine, IU School of MedicineType II diabetic kidney disease is devastating to patients and society alike. This review will evaluate bariatric surgery as a treatment for diabetic kidney disease primarily through its ability to induce and maintain regression of type II diabetes. The review begins by outlining the global challenge of diabetic kidney disease, its link to obesity, and the comparative benefits of bariatric surgery on weight and type II diabetes. It then surveys comprehensively the relevant literature, which reports that although bariatric surgery is associated with reductions in albuminuria, its effect on harder clinical end points like progression of diabetic kidney disease is not known. The review also includes a critical assessment of the risks and costs of bariatric surgery and concludes by acknowledging the major knowledge gaps in the field and providing research strategies to overcome them. Until these knowledge gaps are filled, clinicians will be forced to rely on their own subjective judgment in determining the benefit-risk ratio of bariatric surgery for patients with diabetic kidney disease.Item ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes(Wiley, 2022) de Wit, Maartje; Gajewska, Katarzyna A.; Goethals, Eveline R.; McDarby, Vincent; Zhao, Xiaolei; Hapunda, Given; Delamater, Alan M.; DiMeglio, Linda A.; Pediatrics, School of Medicine