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Hermanns N, Kulzer B, Klonoff DC, Heinemann L. Evidence and Diabetes Technology: A Catch-22? J Diabetes Sci Technol 2023; 17:1427-1432. [PMID: 37129215 PMCID: PMC10658697 DOI: 10.1177/19322968231170884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Diabetes technology is a dynamically evolving field. Sometimes the pace of evaluation of new diabetes technologies does not keep pace with its dynamic development. This leads to a dilemma: either the evaluation lags behind the developing technologies or diabetes technologies are used without sufficient evaluation. This situation is known as the Catch 22 dilemma. The aim of this paper is a discussion of ideas for a timely assessment, taking account of the speed of technological development and the need for evidence and safety improvement.
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Affiliation(s)
- Norbert Hermanns
- Research Institite of the Diabetes Acaemy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - Bernd Kulzer
- Research Institite of the Diabetes Acaemy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - David C. Klonoff
- Diabetes Research Institute, Mills-Peninsula Medical Center, San Mateo, CA, USA
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Linnenkamp U, Gontscharuk V, Ogurtsova K, Brüne M, Chernyak N, Kvitkina T, Arend W, Schmitz-Losem I, Kruse J, Hermanns N, Kulzer B, Evers SMAA, Hiligsmann M, Hoffmann B, Icks A, Andrich S. PHQ-9, CES-D, health insurance data-who is identified with depression? A Population-based study in persons with diabetes. Diabetol Metab Syndr 2023; 15:54. [PMID: 36945050 PMCID: PMC10031874 DOI: 10.1186/s13098-023-01028-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 03/11/2023] [Indexed: 03/23/2023] Open
Abstract
AIMS Several instruments are used to identify depression among patients with diabetes and have been compared for their test criteria, but, not for the overlaps and differences, for example, in the sociodemographic and clinical characteristics of the individuals identified with different instruments. METHODS We conducted a cross-sectional survey among a random sample of a statutory health insurance (SHI) (n = 1,579) with diabetes and linked it with longitudinal SHI data. Depression symptoms were identified using either the Centre for Epidemiological Studies Depression (CES-D) scale or the Patient Health Questionnaire-9 (PHQ-9), and a depressive disorder was identified with a diagnosis in SHI data, resulting in 8 possible groups. Groups were compared using a multinomial logistic model. RESULTS In total 33·0% of our analysis sample were identified with depression by at least one method. 5·0% were identified with depression by all methods. Multinomial logistic analysis showed that identification through SHI data only compared to the group with no depression was associated with gender (women). Identification through at least SHI data was associated with taking antidepressants and previous depression. Health related quality of life, especially the mental summary score was associated with depression but not when identified through SHI data only. CONCLUSION The methods overlapped less than expected. We did not find a clear pattern between methods used and characteristics of individuals identified. However, we found first indications that the choice of method is related to specific underlying characteristics in the identified population. These findings need to be confirmed by further studies with larger study samples.
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Affiliation(s)
- Ute Linnenkamp
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany.
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
| | - Veronika Gontscharuk
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Katherine Ogurtsova
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
| | - Manuela Brüne
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Nadezda Chernyak
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Tatjana Kvitkina
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
| | - Werner Arend
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | | | - Johannes Kruse
- Clinic for Psychosomatic and Psychotherapy, University Clinic Gießen, Gießen, Germany
| | - Norbert Hermanns
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Bernd Kulzer
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - Silvia M A A Evers
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, the Netherlands
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, Heinrich-Heine University Düsseldorf, Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Silke Andrich
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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3
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Heinemann L, Nguyen T, Bailey TS, Hassoun A, Kulzer B, Oliveria T, Reznik Y, de Valk HW, Mader JK. Needle Technology for Insulin Administration: A Century of Innovation. J Diabetes Sci Technol 2023; 17:449-457. [PMID: 34889142 PMCID: PMC10012366 DOI: 10.1177/19322968211059564] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Innovations in syringe and pen needle (PN) technology over the last 100 years have led to important advances in insulin delivery for people with diabetes, paralleling the strides made in developing recombinant DNA human insulin and insulin analogs with varying onset and duration of action. In this review, the history of advances in insulin delivery is described, focusing on progress in syringe, needle, and PN technologies. The early glass and metal syringes that required sterilization by boiling have been replaced by disposable, single-use syringes or pens with clear labeling for precise insulin dosing. The early needles ranging in length from 19 to 26 mm that required manual sharpening against a whetstone have been replaced by syringe needles of 6 mm and PNs of 4 mm in length as slender as 34 gauge. Imaging studies using ultrasound and computed tomography measured the thickness of skin and subcutaneous tissue layers to show feasibility of targeted insulin administration with shorter needles. These developments, coupled with innovations in needle/PN wall and tip structure, have led to improved injection experience for people with diabetes. It is also important to acknowledge the role of injection technique education, together with these advances in injection technology, for improving clinical outcomes and patient satisfaction. With continued projected growth of diabetes prevalence, particularly in developing countries where expensive and complex insulin delivery systems may not be practical, insulin syringes and pens will continue to serve as reliable and cost-effective means of insulin delivery for people with diabetes.
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Affiliation(s)
| | - Trung Nguyen
- Becton, Dickinson and Company,
Eysins, Switzerland
- Trung Nguyen, PharmD, Becton,
Dickinson and Company, Sàrl Terre Bonne, Route de Crassier 17, 1262
Eysins, Switzerland.
| | | | - Ahmed Hassoun
- Division of Endocrinology,
Department of Internal Medicine, Fakeeh University Hospital, Dubai, United
Arab Emirates
| | - Bernd Kulzer
- Research Institute Diabetes
Academy Mergentheim, Bad Mergentheim, Germany
- Diabetes Center Mergentheim, Bad
Mergentheim, Germany
- University Bamberg, Bamberg,
Germany
| | | | - Yves Reznik
- Department of Endocrinology and
Diabetology, CHU Côte de Nacre, Caen, France
- Medical School, University of
Caen Basse-Normandie, Caen, France
| | - Harold W. de Valk
- Department of Internal
Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Julia K. Mader
- Division of Endocrinology &
Diabetology, Department of Internal Medicine, Medical University of Graz,
Graz, Austria
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4
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Ehrmann D, Eichinger V, Vesper I, Kober J, Kraus M, Schäfer V, Hermanns N, Kulzer B, Silbermann S. Health care effects and medical benefits of a smartphone-based diabetes self-management application: study protocol for a randomized controlled trial. Trials 2022; 23:282. [PMID: 35410241 PMCID: PMC8996650 DOI: 10.1186/s13063-022-06248-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Diabetes self-management is a mainstay of diabetes care, but the implementation of self-management regimens into daily life is complex and often results in discouragement and distress. Modern approaches such as smartphone-based self-management applications are therefore needed to support people with diabetes. Since reimbursability would increase the availability of such digital applications to people with diabetes, we designed a study that meets all scientific and methodological requirements set by the German Digital Healthcare Act to allow reimbursement for a specific application (mySugr PRO). Here, we report the protocol of this study that aims at evaluating the efficacy of the digital self-management application with regard to patient-reported outcomes and medical benefits.
Methods/design
This multicenter, open-label, randomized, parallel-group, controlled trial will evaluate the health care effects and medical benefits of mySugr PRO. A total of 466 people with diabetes will be randomly allocated (2:1 randomization) to the interventional group (n = 311) that will use the digital self-management application during the 12-week study period or the control group (n = 155; no usage of the application). Baseline and follow-up examinations will assess diabetes distress as the primary endpoint as well as empowerment, HbA1c, blood glucose data, self-management, general well-being, and treatment satisfaction as secondary endpoints. Statistical analyses will use an intention-to-treat procedure (using multiple imputation for missing values) as well as a per-protocol approach for sensitivity analysis.
Discussion
To the best of our knowledge, this study will be one of the largest diabetes-specific evaluations of a digital health application supporting people with diabetes in their diabetes self-management that follow the requirements of the German Digital Healthcare Act.
Trial registration
German Clinical Trial Register DRKS00022923. Registered on 22 October 2020.
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Kampling H, Köhler B, Germerott I, Haastert B, Icks A, Kulzer B, Nowotny B, Hermanns N, Kruse J. An Integrated Psychosomatic Treatment Program for People with Diabetes (psy-PAD). Dtsch Arztebl Int 2022; 119:245-252. [PMID: 35074044 DOI: 10.3238/arztebl.m2022.0094] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 09/29/2021] [Accepted: 12/20/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Many people with diabetes have permanently elevated blood sugar concentrations and a high level of diabetes-related psychological stress, also called "diabetes distress." In clinical practice, diabetes distress is often an impediment to successful self-management. psy-PAD is a psychodynamically oriented short-term therapy program whose goal is to reduce diabetes distress and improve glycemic control. METHODS A randomized controlled trial was conducted with 143 patients with either type 1 or type 2 diabetes who were being treated in eleven specialized diabetological practices. psy-PAD in the intervention group (eight sessions) was compared with optimized standard care as the control condition. The inclusion criteria were HbA1c ≥ 7.5% combined with diabetes distress (PAID >35, or doctor's determination). The primary endpoint was the HbA1c at six months (t1). Diabetes-related distress (PAID), depressive symptoms (HADS-D, PHQ-9), anxiety symptoms (HADS-A), health-related quality of life (SF-36), panic (short form of the PHQ-D), body mass index (BMI), and triglyceride levels were secondary endpoints. Follow-ups were conducted at six (t1) and 12 months (t2) (trial registration: DRKS00003247). RESULTS The intergroup comparison at t1 revealed a significant, clinically relevant reduction of HbA1c by -0.53 percentage points (95% confidence interval [-0.89; -0.16], p = 0.005). The secondary analyses revealed relevant differences in the point estimators for diabetes distress at t1 and t2, depressive symptoms at t2 and BMI at t1. CONCLUSION For people with diabetes and diabetes distress who do not achieve satisfactory glycemic control despite intensive treatment in specialized diabetological practices, integrated psychosomatic-psychotherapeutic treatment can lower blood sugar levels over the intermediate term and also reduce diabetes distress and depressive symptoms over a one-year period.
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Affiliation(s)
- Hanna Kampling
- Department of Psychosomatic Medicine and Psychotherapy, Justus Liebig University Gießen; mediStatistica, Wuppertal; Institute for Health Services Research and Health Economics, Center for Health and Society, Faculty of Medicine at Heinrich Heine University Düsseldorf; German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ) Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Diabetes Center Mergentheim, Germany; Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany University Bamberg; Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf; Clinical Experimentation, Research and Development Pharmaceuticals, Bayer AG, Wuppertal; Department of Psychosomatics and Psychotherapy of the Justus Liebig University Gießen and Philipps University Marburg, Philipps-Universität Marburg
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Kress S, Anderten H, Borck A, Freckmann G, Heinemann L, Holzmüller U, Kulzer B, Portele A, Schnell O, Varlemann H, Zemmrich C, Lobmann R. Preulcerous Risk Situation in Diabetic Foot Syndrome: Proposal for a Simple Ulcer Prevention Score. J Diabetes Sci Technol 2021; 15:816-826. [PMID: 32522035 PMCID: PMC8258539 DOI: 10.1177/1932296820922592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Preulcerous risk situations in patients with diabetes are often undiagnosed and care administered too late. Even with regular medical check-ups and status documentation, foot examinations have not been given enough attention. Diagnosing an individual patients' risk of developing diabetic foot ulcers may increase vigilance for diabetic foot syndrome (DFS), and the appropriate prevention measures matching the risk involved may prevent the emergence of diabetic ulcers. The classical DFS risk factors are well established and have been extensively covered in the literature; however, there is a lack of efficient screening tools that could be used for a rapid assessment of diabetic foot ulcer risk. METHODS A methodical literature search was conducted to assess relevant publications for the preparation of a simple risk score for amputation related to diabetic foot ulcer. We then analyzed the risk factors for predictive value as odds ratios in foot ulcers and/or amputation. We used the available data to deduce a mean value to reflect the authors' consensus. RESULTS In view of the current literature on the matter, we have developed a semi-quantitative scoring system using just a few items to allow rapid and visual risk assessment for diabetic foot ulcers alongside recommendations for prevention and a sensible follow-up strategy to match the risk. CONCLUSION This relatively simple score enables rapid risk classification for patients that can ease the way for both physicians and patients in gaining an insight into individual risk situations. The score provides more effective preventative measures for high-risk patients against future complications.
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Affiliation(s)
- Stephan Kress
- Vinzentinus-Krankenhaus, Landau, Germany
- Stephan Kress, MD, Diabeteszentrum, Vinzentius-Krankenhaus, Cornichonstrasse 4, 76829 Landau, Germany.
| | - Helmut Anderten
- Gemeinschaftspraxis Anderten-Krok & Partner, Hildesheim, Germany
| | - Anja Borck
- Sanofi-Aventis Deutschland GmbH, Berlin, Germany
| | - Guido Freckmann
- Institut für Diabetes-Technologie Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Germany
| | | | - Ulrike Holzmüller
- Klinik für Endokrinologie und Nephrologie der Universität Leipzig, Germany
| | - Bernd Kulzer
- Forschungsinstitut der Diabetes Akademie Bad Mergentheim (FIDAM), Germany
| | | | | | | | - Claudia Zemmrich
- Praxis für Cardiovascular- und Ultraschalldiagnostik, Herz-Kreislauf-Erkrankungen und Psychotherapie, Berlin, Germany
| | - Ralf Lobmann
- Klinik für Endokrinologie, Diabetologie und Geriatrie, Stuttgart, Germany
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Icks A, Wittgens C, Haastert B, Jöckel KH, Engel M, Erbel R, Andrich S, Kruse J, Kulzer B, Hermanns N, Herder C, Moebus S, Stang A, Kowall B. High Depressive Symptoms in Previously Undetected Diabetes - 10-Year Follow-Up Results of the Heinz Nixdorf Recall Study. Clin Epidemiol 2021; 13:429-438. [PMID: 34140811 PMCID: PMC8203301 DOI: 10.2147/clep.s294342] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 03/16/2021] [Indexed: 01/08/2023] Open
Abstract
Aim To determine the 10-year cumulative incidence of high depressive symptoms in people with diagnosed and, in particular, previously undetected diabetes compared to those without diabetes in a population-based cohort study in Germany. Materials and Methods We included 2813 participants (52.9% men, mean age (SD) 58.9 (7.7) years, 7.1% diagnosed diabetes, 5.6% previously undetected diabetes) from the Heinz Nixdorf Recall study. We calculated the odds ratios (OR) with 95% confidence intervals (CI) using multiple logistic regression analyses for diagnosed and undetected diabetes. Results Cumulative 10-year incidences (95%-CI) of high depressive symptoms in participants with diagnosed diabetes, previously undetected diabetes, and without diabetes were 15.4% (10.7–21.2), 10.1% (5.9–15.9), and 12.4% (11.1–13.8), respectively. Age-sex-adjusted ORs were 1.51 (1.01–2.28) in participants with diagnosed diabetes compared to those without, 1.40 (0.92–2.12) after adjustment for BMI, physical activity, education, and smoking, and 1.33 (0.87–2.02) after further adjustment for stroke and myocardial infarction. ORs in participants with previously undetected diabetes were 0.96 (0.56–1.65), 0.85 (0.49–1.47), and 0.85 (0.49–1.48), respectively, and lower in men than in women. Conclusion As expected, we found an increased odds of developing high depressive symptoms in participants with diagnosed diabetes. However, the odds ratios decreased when we considered comorbidities and other covariates. Interestingly, in participants with previously undetected diabetes, the odds was not increased, even 10 years after detection of diabetes. These results support the hypothesis that high depressive symptoms develop due to diabetes-related burdens and comorbidities and not due to hyperglycemia or hyperinsulinemia.
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Affiliation(s)
- Andrea Icks
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.,Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.,German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany
| | - Charlotte Wittgens
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Burkhard Haastert
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.,mediStatistica, Neuenrade, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
| | - Miriam Engel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
| | - Silke Andrich
- Institute for Health Services Research and Health Economics, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.,Institute for Health Services Research and Health Economics, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Johannes Kruse
- Institute for Psychosomatics and Psychotherapy, University Hospital Gießen, Gießen, Germany
| | - Bernd Kulzer
- Research Institute of the Diabetes Academy Mergentheim and Diabetes Centre Mergentheim, Bad Mergentheim, Germany
| | - Norbert Hermanns
- Research Institute of the Diabetes Academy Mergentheim and Diabetes Centre Mergentheim, Bad Mergentheim, Germany
| | - Christian Herder
- German Center for Diabetes Research, Partner Düsseldorf, München-Neuherberg, Germany.,Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.,Division of Endocrinology and Diabetology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Susanne Moebus
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
| | - Bernd Kowall
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Essen, Germany
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Abstract
In addition to the continuous use, the intermittent use of continuous glucose monitoring (CGM) is an application of CGM, expanding the typical medical use cases. There are a variety of reasons and occasions that speak in favor of using CGM only for a limited time. To date, these circumstances have not been sufficiently discussed. In this article, we define discontinuous or intermittent CGM use, provide reasons for using it, and expand on the benefits and possibilities of using CGM on a temporary basis. We aim to draw attention to this important topic in the discussion of CGM use and give examples for a different method of CGM use. As well, we would like to foster the allocation of CGM to the right patient groups and indications, especially in cases of limited resources. From a global point of view, intermittent CGM use is more likely to occur than continuous use, primarily for economic reasons.
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Affiliation(s)
- Ralph Ziegler
- Diabetes Clinic for Children and
Adolescents, Muenster, Germany
- Ralph Ziegler, MD, Diabetes Clinic
for Children and Adolescents Mondstr. 148, Muenster 48155, Germany.
| | | | - Guido Freckmann
- Institut für Diabetes-Technologie,
Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm,
Germany
| | - Oliver Schnell
- Forschergruppe Diabetes e.V.,
Helmholtz Zentrum, Munich, Germany
| | | | - Bernd Kulzer
- Diabetes Center Bad Mergentheim,
Research Institute of the Diabetes Academy, Bad Mergentheim, University
Bamberg, Germany
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9
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Hermanns N, Ehrmann D, Finke-Groene K, Kulzer B. Trends in diabetes self-management education: where are we coming from and where are we going? A narrative review. Diabet Med 2020; 37:436-447. [PMID: 32017188 DOI: 10.1111/dme.14256] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/23/2020] [Indexed: 10/25/2022]
Abstract
AIMS To summarize the history, development and efficacy of diabetes self-management education on glycaemic control and mental health in adults and children or adolescents with type 1 diabetes and people with type 2 diabetes. A further aim was to review the status of implementation of diabetes self-management education into routine care and outline current gaps in implementation and research. METHODS We searched PubMed and Google scholar for German- and English-language articles regarding diabetes self-management education, glycaemic control and mental health, and restricted this search to meta-analyses. RESULTS Diabetes education has evolved from a compliance- and knowledge-oriented approach to an empowerment- and self-management-oriented approach. Diabetes self-management education seems to have a greater impact on glycaemic outcomes than on mental health outcomes, but the latter are rarely assessed. Technological development and digitalization can provide chances and challenges for diabetes self-management education. Digital solutions show promising results and great potential for improving the efficacy of diabetes self-management education further and providing ongoing support. The implementation of diabetes self-management education into routine clinical care frequently remains a challenge. CONCLUSION Diabetes self-management education has been acknowledged as an essential part of diabetes therapy; however, current gaps regarding the efficacy of diabetes self-management education on mental health, and the need for education on the use of diabetes technology, are future avenues for research.
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Affiliation(s)
- N Hermanns
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
- Diabetes Clinic Mergentheim, Bad Mergentheim, Germany
| | - D Ehrmann
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
| | - K Finke-Groene
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - B Kulzer
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Department of Clinical Psychology and Psychotherapy, University of Bamberg, Bamberg, Germany
- Diabetes Clinic Mergentheim, Bad Mergentheim, Germany
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10
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Abstract
Insulin pumps are used by a steadily increasing number of patients with diabetes. Avoiding certain disadvantages of conventional pumps (ie, the insulin infusion set) might make pump therapy even more attractive. Patch pumps are usually attached by means of an adhesive layer to the skin and have several additional advantages (smaller, more discrete, easier to use, and cheaper than conventional insulin pumps). This review provides a general overview of patch pumps, the technologies used, basic clinical requirements, why a number of developments failed, which clinical studies are needed to provide sufficient evidence for their usage, which costs are associated, what the patient preferences are (which might differ between certain patient groups), and what is the future of patch pumps (ie, artificial pancreas systems).
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Affiliation(s)
- Lutz Heinemann
- Science Consulting in Diabetes GmbH, Neuss, Germany
- Lutz Heinemann, PhD, Science Consulting in Diabetes GmbH, Geulenstr. 50, 41462 Neuss, Germany.
| | | | | | - Ralph Ziegler
- Diabetologische Schwerpunktpraxis für Kinder und Jugendliche, Münster, Germany
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11
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Kampling H, Mittag O, Herpertz S, Baumeister H, Kulzer B, Petrak F. Can trajectories of glycemic control be predicted by depression, anxiety, or diabetes-related distress in a prospective cohort of adults with newly diagnosed type 1 diabetes? Results of a five-year follow-up from the German multicenter diabetes cohort study (GMDC-Study). Diabetes Res Clin Pract 2018; 141:106-117. [PMID: 29698712 DOI: 10.1016/j.diabres.2018.04.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 04/06/2018] [Indexed: 01/30/2023]
Abstract
AIMS The longitudinal association between glycemic control with depression, anxiety or diabetes-related distress in type 1 diabetes is poorly understood. Therefore, we examined long-term trajectories of HbA1c in a new-onset cohort of adults with type 1 diabetes, and analyzed associations with depression, anxiety, and diabetes-related distress. METHODS We included 313 newly diagnosed adults with type 1 diabetes in a prospective multicenter cohort study. Depression, anxiety, and diabetes-related distress were assessed starting with the diabetes diagnosis and at five annual surveys. HbA1c-measurements started with the one-year follow-up. HbA1c trajectories were analyzed applying Growth mixture modeling, while prediction of membership in the trajectories classes was analyzed using multiple regression, and one-way ANOVA/Chi2 to identify differences between classes. RESULTS Average HbA1c increased constantly: follow-up at 1-year 6.5% (48 mmol/mol), 2-years 6.9% (52 mmol/mol), 3-years 7.1% (54 mmol/mol), 4-years 7.1% (54 mmol/mol), and 5-years 7.4% (57 mmol/mol). HbA1c trajectories included one 'good control' and three 'poor control' (52% of patients) classes. At the five-year follow-up, mean HbA1c was 6.3% (45 mmol/mol) in the 'good control' class, and ranging from 7.9% (63 mmol/mol) to 9.0% (75 mmol/mol) in the three 'poor control' classes. Classes were neither predicable, nor differentiated by depression, anxiety, or diabetes-related distress. CONCLUSIONS We identified distinct trajectories of glycemic control. Depression and anxiety were highly prevalent but they neither predicted 'poor'/'good' glycemic control trajectories nor were they associated with glycemic control at any assessment point.
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Affiliation(s)
- Hanna Kampling
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 49, D-79115 Freiburg, Germany.
| | - Oskar Mittag
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetter Str. 49, D-79115 Freiburg, Germany.
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum - Ruhr-University Bochum, Alexandrinenstrasse 1-3, D-44791 Bochum, Germany.
| | - Harald Baumeister
- University of Ulm, Institute of Psychology and Education, Department of Clinical Psychology and Psychotherapy, Albert-Einstein-Allee 47, D-89069 Ulm, Germany.
| | - Bernd Kulzer
- Diabetes Center Mergentheim, Klotzbücher Str. 12, D-97980 Bad Mergentheim, Germany; Research Institute of the Diabetes Academy Mergentheim, Klotzbücher Str. 12, D-97980 Bad Mergentheim, Germany; Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Markusplatz 3, D-96047 Bamberg, Germany.
| | - Frank Petrak
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum - Ruhr-University Bochum, Alexandrinenstrasse 1-3, D-44791 Bochum, Germany; Center for Psychotherapy Wiesbaden, Sonnenberger Str. 20, D-65193 Wiesbaden, Germany.
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12
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Dänschel I, Dänschel W, Messinger D, Schramm W, Vesper I, Weissmann J, Heinemann L, Kulzer B. Therapieoptimierung durch integriertes Personalisiertes Diabetesmanagement: Ergebnisse des PDM-ProValue-Studienprogramms. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | | | | | - W Schramm
- GECKO Institut, Hochschule Heilbronn, Heilbronn, Germany
| | - I Vesper
- Roche Diabetes Care GmbH, Mannheim, Germany
| | - J Weissmann
- Roche Diabetes Care Deutschland GmbH, Mannheim, Germany
| | - L Heinemann
- Science Consulting in Diabetes GmbH, Düsseldorf, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes Akademie Mergentheim (FIDAM), Bad Mergentheim, Germany
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13
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Maier B, Kulzer B, Schäfer A, Tombek A, Greiner J, Brämswig S, Haak T. Junge Erwachsene mit Typ-1-Diabetes (18 – 25 Jahre): ein neues stationäres Therapiekonzept. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- B Maier
- Diabetes Zentrum Bad Mergentheim, Bad Mergentheim, Germany
| | - B Kulzer
- Diabetes Zentrum Bad Mergentheim, Bad Mergentheim, Germany
| | - A Schäfer
- Diabetes Zentrum Bad Mergentheim, Bad Mergentheim, Germany
| | - A Tombek
- Diabetes Zentrum Bad Mergentheim, Bad Mergentheim, Germany
| | - J Greiner
- Diabetes Zentrum Bad Mergentheim, Bad Mergentheim, Germany
| | - S Brämswig
- Diabetes Zentrum Bad Mergentheim, Bad Mergentheim, Germany
| | - T Haak
- Diabetes Zentrum Bad Mergentheim, Bad Mergentheim, Germany
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Kulzer B, Ehrmann D, Schipfer M, Lippmann-Grob B, Haak T, Hermanns N. Verbessertes psychosoziales Wohlbefinden nach Teilnahme an einem strukturierten Schulungs- und Behandlungsprogramm für die Insulinpumpentherapie (INPUT). DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- B Kulzer
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - D Ehrmann
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - M Schipfer
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - B Lippmann-Grob
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - T Haak
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - N Hermanns
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
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15
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Heinemann L, Dänschel W, Dänschel I, Messinger D, Schramm W, Vesper I, Weissmann J, Kulzer B. Integriertes Personalisiertes Diabetes-Management (iPDM) verbessert die glykämische Einstellung von insulinbehandelten Patienten mit Typ-2 Diabetes: Ergebnisse des PDM-ProValue Studienprogramms. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- L Heinemann
- Science Consulting in Diabetes GmbH, Düsseldorf, Germany
| | | | | | | | - W Schramm
- GECKO Institut, Hochschule Heilbronn, Heilbronn, Germany
| | - I Vesper
- Roche Diabetes Care GmbH, Mannheim, Germany
| | | | - B Kulzer
- Forschungsinstitut der Diabetes Akademie Mergentheim (FIDAM), Mannheim, Germany
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16
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Schmitt A, Reimer A, Kulzer B, Haak T, Hermanns N. Evaluation eines Stepped-Care-Ansatzes zur Behandlung von Depression und Diabetes Distress bei Menschen mit Diabetes: Ergebnisse der randomisiert-kontrollierten ECCE HOMO-Studie. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Schmitt
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - A Reimer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - T Haak
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - N Hermanns
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
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17
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Schmitt A, Reimer A, Hermanns N, Haak T, Kulzer B. Stellen Patienten mit Depressivität sowie gleichzeitig Diabetes Distress eine Hochrisikogruppe dar? – Baseline-Ergebnisse des Depression and Diabetes Control Trial (DCCT). DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Schmitt
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - A Reimer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - N Hermanns
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - T Haak
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
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18
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Kulzer B, Dänschel W, Dänschel I, Messinger D, Schramm W, Vesper I, Weissmann J, Heinemann L. Integriertes Personalisiertes Diabetes-Management (iPDM) verbessert die Therapiezufriedenheit von Ärzten und insulinbehandelten Patienten mit Typ-2 Diabetes: Ergebnisse des PDM-ProValue Studienprogramms. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- B Kulzer
- Forschungsinstitut der Diabetes Akademie Mergentheim (FIDAM), Bad Mergentheim, Germany
| | | | | | | | - W Schramm
- GECKO Institut, Hochschule Heilbronn, Heilbronn, Germany
| | - I Vesper
- Roche Diabetes Care GmbH, Mannheim, Germany
| | | | - L Heinemann
- Science Consulting in Diabetes GmbH, Düsseldorf, Germany
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19
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Schmitt A, Reimer A, Hermanns N, Baumeister H, Bendig E, Haak T, Kulzer B. Differentielle Assoziationen von Depressivität versus Diabetes Distress mit Selbstbehandlungsverhalten und HbA1c – Eine Strukturgleichungsanalyse. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Schmitt
- Diabetes Zentrum Mergentheim (DZM), Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - A Reimer
- Diabetes Zentrum Mergentheim (DZM), Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - N Hermanns
- Diabetes Zentrum Mergentheim (DZM), Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
- Institut für Psychologie, Otto-Friedrich-Universität Bamberg, Bamberg, Germany
| | - H Baumeister
- Abteilung Klinische Psychologie und Psychotherapie, Institut für Psychologie und Pädagogik, Universität Ulm, Ulm, Germany
| | - E Bendig
- Abteilung Klinische Psychologie und Psychotherapie, Institut für Psychologie und Pädagogik, Universität Ulm, Ulm, Germany
| | - T Haak
- Diabetes Zentrum Mergentheim (DZM), Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - B Kulzer
- Diabetes Zentrum Mergentheim (DZM), Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
- Institut für Psychologie, Otto-Friedrich-Universität Bamberg, Bamberg, Germany
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20
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Schmitt A, Reimer A, Kulzer B, Schäfer A, Maier B, Haak T, Hermanns N. Effekt eines Behandlungsprogramms für Menschen mit Diabetes und gestörter Krankheitsakzeptanz – Eine nicht-randomisierte Matched-Pair-Studie. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- A Schmitt
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - A Reimer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - A Schäfer
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - B Maier
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - T Haak
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - N Hermanns
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
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21
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Ehrmann D, Kulzer B, Schipfer M, Lippmann-Grob B, Haak T, Hermanns N. Evaluierung der Wirksamkeit eines neuen strukturierten Schulungs- und Behandlungsprogramms für die Insulinpumpentherapie (INPUT): Ergebnisse einer randomisierten, kontrollierten Studie. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- D Ehrmann
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - M Schipfer
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - B Lippmann-Grob
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - T Haak
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - N Hermanns
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
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22
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Hermanns N, Ehrmann D, Schipfer M, Lippmann-Grob B, Haak T, Kulzer B. Reduktion schwerer Hypoglykämien nach Teilnahme an einem neuen strukturierten Schulungs- und Behandlungsprogramm für die Insulinpumpentherapie (INPUT). DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- N Hermanns
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - D Ehrmann
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - M Schipfer
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - B Lippmann-Grob
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - T Haak
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - B Kulzer
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
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23
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Ehrmann D, Hermanns N, Schipfer M, Haak T, Kulzer B. Wie zufrieden sind Menschen mit Diabetes mit Flash Glucose Monitoring im Vergleich zur Blutzuckermessung? DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- D Ehrmann
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - N Hermanns
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - M Schipfer
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - T Haak
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
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Hermanns N, Ehrmann D, Schipfer M, Haak T, Kulzer B. Gibt es einen Unterschied in der glykämischen Kontrolle zwischen erfahrenen und neuen Nutzern von Flash Glukose Monitoring? DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- N Hermanns
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - D Ehrmann
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - M Schipfer
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - T Haak
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
| | - B Kulzer
- Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
- Forschungsinstitut Diabetes-Akademie Bad Mergentheim (FIDAM GmbH), Bad Mergentheim, Germany
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25
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Schipfer M, Albrecht C, Ehrmann D, Haak T, Kulzer B, Hermanns N. Makes FLASH the difference between the intervention group and the treatment-as-usual group in an evaluation study of a structured education and treatment programme for flash glucose monitoring devices in people with diabetes on intensive insulin therapy: study protocol for a randomised controlled trial. Trials 2018; 19:91. [PMID: 29402319 PMCID: PMC5800040 DOI: 10.1186/s13063-018-2479-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 01/18/2018] [Indexed: 11/10/2022] Open
Abstract
Background People with diabetes on intensive insulin therapy need sufficient glycaemic control to prevent the onset or progression of diabetic complications. The burden of multiple daily blood glucose self-testing can be lessened by novel diabetes technology like flash glucose monitoring systems which provide more information compared to self-monitoring of blood glucose. Despite this delivered additional information studies are showing no significant effect on HbA1c reduction, but a reduced time spent in a hypoglycaemic glucose range. We assume that users of these devices need additional education and training to integrate the delivered information into treatment decisions. Therefore, FLASH, an education and treatment programme, was developed. The programme evaluation follows herein. Methods/design Patients are recruited through 40 diabetes outpatient study centres located across Germany. They will be randomly assigned to participate in the education and treatment programme (intervention group) or to obtain treatment as usual (control group). All patients have to give blood samples and to answer a bench of questionnaires during baseline assessment, at the end of the intervention, and 6 months after the end of the intervention. Physicians will be asked to declare some additional clinical data (such as details of the diabetes therapy) for every patient at every one of the three assessment points. Discussion This study is conducted as a randomised controlled trial to test the hypothesis that the newly developed education and treatment programme combined with the use of a flash glucose monitoring device (intervention group) is superior to reduce HbA1c compared to the use of flash glucose monitoring alone (control group). The first results will be expected in 2018. Trial registration ClinicalTrials.gov, ID: NCT03175315. Registered on 2 May 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2479-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Melanie Schipfer
- Research Institute Diabetes Academy Bad Mergentheim (FIDAM GmbH), Johann-Hammer-Str. 24, 97980, Bad Mergentheim, Germany.
| | - Carmen Albrecht
- Research Institute Diabetes Academy Bad Mergentheim (FIDAM GmbH), Johann-Hammer-Str. 24, 97980, Bad Mergentheim, Germany
| | - Dominic Ehrmann
- Research Institute Diabetes Academy Bad Mergentheim (FIDAM GmbH), Johann-Hammer-Str. 24, 97980, Bad Mergentheim, Germany
| | - Thomas Haak
- Diabetes Center Bad Mergentheim, Theodor-Klotzbücherstr. 12, 97980, Bad Mergentheim, Germany
| | - Bernd Kulzer
- Research Institute Diabetes Academy Bad Mergentheim (FIDAM GmbH), Johann-Hammer-Str. 24, 97980, Bad Mergentheim, Germany
| | - Norbert Hermanns
- Research Institute Diabetes Academy Bad Mergentheim (FIDAM GmbH), Johann-Hammer-Str. 24, 97980, Bad Mergentheim, Germany
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Hermanns N, Ehrmann D, Schall S, Maier B, Haak T, Kulzer B. The effect of an education programme (MEDIAS 2 BSC) of non-intensive insulin treatment regimens for people with Type 2 diabetes: a randomized, multi-centre trial. Diabet Med 2017; 34:1084-1091. [PMID: 28257159 DOI: 10.1111/dme.13346] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/27/2017] [Indexed: 01/04/2023]
Abstract
AIMS A self-management oriented education programme (MEDIAS 2 BSC) for people with Type 2 diabetes who are on a non-intensive insulin treatment regimen was developed. In a randomized, multi-centre trial, the effect of MEDIAS 2 BSC was compared with an established education programme that acted as a control group. METHODS The primary outcome was the impact of MEDIAS 2 BSC on glycaemic control. Secondary outcomes included the incidence of severe hypoglycaemia, hypoglycaemia unawareness, diabetes-related distress, diabetes knowledge, quality of life and self-care behaviour. RESULTS In total, 182 participants were randomized to the control group or MEDIAS 2 BSC [median age 64.0 (interquartile range 58.0-68.5) vs. 63.5 (57.0-70.0) years; HbA1c 62.8 ± 12.7 mmol/mol vs. 63.7 ± 14.0 mmol/mol; 7.9% ± 1.2% vs. 8.0% ± 1.3%]. After a 6-month follow-up, there was a mean decrease in HbA1c of 3.5 mmol/mol (0.32%) in the control group and 6.7 mmol/mol (0.61%) in MEDIAS 2 BSC. After adjusting for baseline differences and study centre, the mean difference between the groups was -3.3 mmol/mol [95% confidence interval (CI) -0.54 to -5.90 mmol/mol] [-0.30% (95% CI -0.05 to -0.54)] in favour of MEDIAS 2 BSC (P = 0.018). There were no increases in severe hypoglycaemia or hypoglycaemia unawareness. The education programmes had no significant effects on psychosocial outcome variables. CONCLUSION MEDIAS 2 BSC was more effective in lowering HbA1c than the control condition. MEDIAS 2 BSC is a safe educational tool that improves glycaemic control without increasing the risk for hypoglycaemia. (Clinical Trials Registry No; NCT 02748239).
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Affiliation(s)
- N Hermanns
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Diabetes Centre Mergentheim, Bad Mergentheim, Germany
- Department of Clinical Psychology of the Otto Friedrich University Bamberg, Bamberg, Germany
| | - D Ehrmann
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Department of Clinical Psychology of the Otto Friedrich University Bamberg, Bamberg, Germany
| | - S Schall
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - B Maier
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Diabetes Centre Mergentheim, Bad Mergentheim, Germany
| | - T Haak
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Diabetes Centre Mergentheim, Bad Mergentheim, Germany
| | - B Kulzer
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
- Diabetes Centre Mergentheim, Bad Mergentheim, Germany
- Department of Clinical Psychology of the Otto Friedrich University Bamberg, Bamberg, Germany
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Schmitt A, Reimer A, Kulzer B, Icks A, Paust R, Rölver KM, Kaltheuner M, Ehrmann D, Schipfer M, Hermanns N, Haak T. Suboptimale Diabetesakzeptanz ist mit einer schlechteren Diabetes-Selbstbehandlung und darüber mit einer schlechteren glykämischen Kontrolle assoziiert: Eine Mediationsanalyse. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A Schmitt
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - A Reimer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - A Icks
- Deutsches Zentrum für Diabetesforschung (DZD), München-Neuherberg, Germany
| | - R Paust
- Institut für Psychosoziale Medizin, Elisabeth-Krankenhaus Essen, Essen, Germany
| | - KM Rölver
- Diabetes-Zentrum Quakenbrück, Christliches Krankenhaus Quakenbrück, Quakenbrück, Germany
| | - M Kaltheuner
- Gemeinschaftspraxis für Innere Medizin, Diabetologie und Allgemeinmedizin, Leverkusen, Germany
| | - D Ehrmann
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - M Schipfer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - N Hermanns
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - T Haak
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
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Schmitt A, Reimer A, Hermanns N, Ehrmann D, Schipfer M, Haak T, Kulzer B. Prävalenzen und Prädiktoren klinisch relevanter diabetesbezogener Belastung bei Patienten mit Typ-1- und Typ-2-Diabetes in der tertiären Versorgung: Ergebnisse der ECCE HOMO-Studie. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A Schmitt
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - A Reimer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - N Hermanns
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - D Ehrmann
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - M Schipfer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - T Haak
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
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Ehrmann D, Kulzer B, Schipfer M, Lippmann-Grob B, Haak T, Hermanns N. Unterschiede zwischen Patienten mit einer Insulinpumpe und Patienten mit intensivierter Insulintherapie. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- D Ehrmann
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - M Schipfer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | | | - T Haak
- Diabetes Zentrum Mergentheim, Bad Mergentheim, Germany
| | - N Hermanns
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
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Reimer A, Schmitt A, Ehrmann D, Kulzer B, Haak T, Hermanns N. Depressivität und diabetesbezogene Belastungen bei Behandlung mit Antidepressiva: Screening-Ergebnisse der DDCT-Studie. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A Reimer
- Forschungsinstitut der Diabetes-Akademie Mergentheim, Bad Mergentheim, Germany
| | - A Schmitt
- Forschungsinstitut der Diabetes-Akademie Mergentheim, Bad Mergentheim, Germany
| | - D Ehrmann
- Forschungsinstitut der Diabetes-Akademie Mergentheim, Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes-Akademie Mergentheim, Bad Mergentheim, Germany
| | - T Haak
- Diabetes Zentrum Mergentheim, Bad Mergentheim, Germany
| | - N Hermanns
- Forschungsinstitut der Diabetes-Akademie Mergentheim, Bad Mergentheim, Germany
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Schmitt A, Reimer A, Hermanns N, Ehrmann D, Haak T, Kulzer B. Depression and Diabetes Control Trial (DCCT): Baseline-Ergebnisse einer randomisiert-kontrollierten Studie zur Behandlung von Diabetespatienten mit erhöhten affektiven Symptomen und suboptimaler glykämischer Kontrolle. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A Schmitt
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - A Reimer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - N Hermanns
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - D Ehrmann
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - T Haak
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
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Kulzer B, Ehrmann D, Schipfer M, Hermanns N, Haak T. Wie effektiv ist die strukturierte Diabetesschulung bei Menschen mit Typ-1-Diabetes und Insulinpumpentherapie (CSII)? DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- B Kulzer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - D Ehrmann
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - M Schipfer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - N Hermanns
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - T Haak
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
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Hermanns N, Ehrmann D, Schipfer M, Kulzer B, Haak T. Wie häufig nutzen Patienten mit einer Insulinpumpentherapie (CSII) die Features ihrer Insulinpumpe? DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- N Hermanns
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - D Ehrmann
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - M Schipfer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - T Haak
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
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Hermanns N, Ehrmann D, Schipfer M, Kulzer B, Haak T. Wie misst man Erfahrungen und Einstellungen zur Insulinpumpentherapie: Eine psychometrische Analyse des Fragebogens zu Erfahrungen und Einstellungen zur CSII-Therapie (CSII-EE). DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- N Hermanns
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - D Ehrmann
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - M Schipfer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - T Haak
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Bad Mergentheim, Germany
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Schmitt A, Reimer A, Kulzer B, Baumeister H, Ehrmann D, Schipfer M, Haak T, Hermanns N. Erfassung von Angst vor diabetischen Folgekrankheiten: Reliabilität und Validität der deutschen Version des Fear of Complications Questionnaire (FCQ). DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A Schmitt
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - A Reimer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - B Kulzer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - H Baumeister
- Abteilung für Klinische Psychologie und Psychotherapie, Universität Ulm, Ulm, Germany
| | - D Ehrmann
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - M Schipfer
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - T Haak
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
| | - N Hermanns
- Forschungsinstitut der Diabetes-Akademie Bad Mergentheim (FIDAM), Diabetes Zentrum Mergentheim (DZM), Bad Mergentheim, Germany
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Budden F, Schmitt A, Herder C, Reimer A, Kulzer B, Roden M, Haak T, Hermanns N. Associations between pro- and anti-inflammatory cytokines and depressive symptoms in patients with diabetes – potential differences by diabetes type and depression screening instruments. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- F Budden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
| | - A Schmitt
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - C Herder
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
| | - A Reimer
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - B Kulzer
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - M Roden
- Institute for Clinical Diabetology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine Universität Düsseldorf, Düsseldorf, Germany
| | - T Haak
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
| | - N Hermanns
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany
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Kampling H, Petrak F, Farin E, Kulzer B, Herpertz S, Mittag O. Trajectories of depression in adults with newly diagnosed type 1 diabetes: results from the German Multicenter Diabetes Cohort Study. Diabetologia 2017; 60:60-68. [PMID: 27787619 DOI: 10.1007/s00125-016-4123-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 08/31/2016] [Indexed: 12/13/2022]
Abstract
AIMS/HYPOTHESIS There is a paucity of longitudinal data on type 1 diabetes and depression, especially in adults. The present study prospectively analysed trajectories of depressive symptoms in adults during the first 5 years of living with type 1 diabetes. We aimed to identify distinct trajectories of depressive symptoms and to examine how they affect diabetes outcome. METHODS We reanalysed data from a prospective multicentre observational cohort study including 313 adults with newly diagnosed type 1 diabetes. At baseline and in annual postal surveys over 5 consecutive years, we gathered patient characteristics and behavioural and psychosocial data (e.g. Symptom Checklist-90-R [SCL-90-R]). Medical data (e.g. HbA1c levels) was obtained from the treating physicians. We applied growth mixture modelling (GMM) to identify distinct trajectories of depression over time. RESULTS Five years after diagnosis, 7.8% (n = 20) of patients were moderately depressed and 10.2% (n = 26) were severely depressed. GMM statistics identified three possible models of trajectories (class 1, 'no depressive symptoms'; class 2, 'worsening depressive symptoms that improve after 2 years'; class 3, 'worsening depressive symptoms'). Severity of depression symptoms at baseline (subscale of the SCL-90-R questionnaire) significantly predicted membership of classes 2 and 3 vs class 1. After 5 years, higher HbA1c values were detected in class 3 patients (mean = 8.2%, 66 mmol/mol) compared with class 1 and class 2 (both: mean = 7.2%, 55 mmol/mol). CONCLUSIONS/INTERPRETATION We identified distinct trajectories of depressive symptoms that are also relevant for diabetes outcome. Patients with worsening depressive symptoms over time exhibited poor glycaemic control after the first 5 years of living with diabetes. They also exhibited a reduced quality of life and increased diabetes-related distress.
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Affiliation(s)
- Hanna Kampling
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 49, 79106, Freiburg, Germany.
| | - Frank Petrak
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum - Ruhr-University Bochum, Bochum, Germany
- Center for Psychotherapy Wiesbaden, Wiesbaden, Germany
| | - Erik Farin
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 49, 79106, Freiburg, Germany
| | - Bernd Kulzer
- Diabetes Center Mergentheim, Germany; Research Institute of the Diabetes Academy Mergentheim, Bad Mergentheim, Germany
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich-University of Bamberg, Bamberg, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum - Ruhr-University Bochum, Bochum, Germany
| | - Oskar Mittag
- Section of Health Care Research and Rehabilitation Research, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hugstetterstr. 49, 79106, Freiburg, Germany
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Kulzer B, Albus C, Herpertz S, Kruse J, Lange K, Lederbogen F, Petrak F. Psychosoziales und Diabetes. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0042-113783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- B. Kulzer
- Diabetes-Zentrum Bad Mergentheim, Forschungsinstitut der Diabetes Akademie (FIDAM), Mergentheim
| | - C. Albus
- Klinik und Poliklinik für Psychosomatik und Psychotherapie, Universität Köln
| | - S. Herpertz
- Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum der Ruhr-Universität Bochum
| | - J. Kruse
- Klinik für Psychosomatik und Psychotherapie der Justus-Liebig-Universität Gießen und Philipps-Universität Marburg
| | - K. Lange
- Forschungs- und Lehreinheit Medizinische Psychologie, Medizinische Hochschule, Hannover
| | | | - F. Petrak
- Klinik für Psychosomatische Medizin und Psychotherapie, LWL-Universitätsklinikum der Ruhr-Universität Bochum
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Zahn D, Herpertz S, Albus C, Hermanns N, Hiemke C, Hiller W, Kronfeld K, Kruse J, Kulzer B, Müller MJ, Ruckes C, Petrak F. hs-CRP Predicts Improvement in Depression in Patients With Type 1 Diabetes and Major Depression Undergoing Depression Treatment: Results From the Diabetes and Depression (DAD) Study. Diabetes Care 2016; 39:e171-3. [PMID: 27489334 DOI: 10.2337/dc16-0710] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/10/2016] [Indexed: 02/03/2023]
Affiliation(s)
- Daniela Zahn
- Department of Health Psychology, Institute of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Stephan Herpertz
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Clinic Bochum, Ruhr University Bochum, Bochum, Germany
| | - Christian Albus
- Department of Psychosomatic Medicine and Psychotherapy, University of Cologne, Köln, Germany
| | | | - Christoph Hiemke
- Department of Psychiatry and Psychotherapy, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Wolfgang Hiller
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Kai Kronfeld
- Interdisciplinary Centre for Clinical Trials Mainz, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Johannes Kruse
- Clinic for Psychosomatic and Psychotherapy, University Clinic Giessen and Marburg, Philipps University Marburg, Marburg, Germany
| | - Bernd Kulzer
- Diabetes Center Mergentheim, Bad Mergentheim, Germany
| | - Matthias J Müller
- Vitos Clinic for Psychiatry and Psychotherapy Giessen-Marburg and Justus Liebig University Giessen, Giessen, Germany
| | - Christian Ruckes
- Interdisciplinary Centre for Clinical Trials Mainz, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Frank Petrak
- Department of Psychosomatic Medicine and Psychotherapy, LWL University Clinic Bochum, Ruhr University Bochum, Bochum, Germany Center for Psychotherapy Wiesbaden, Wiesbaden, Germany
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Schmitt A, Reimer A, Kulzer B, Haak T, Ehrmann D, Hermanns N. How to assess diabetes distress: comparison of the Problem Areas in Diabetes Scale (PAID) and the Diabetes Distress Scale (DDS). Diabet Med 2016; 33:835-43. [PMID: 26287511 DOI: 10.1111/dme.12887] [Citation(s) in RCA: 74] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/14/2015] [Indexed: 12/30/2022]
Abstract
AIMS To compare the properties of the two most commonly used assessment tools for diabetes distress, the Problem Areas in Diabetes Scale (PAID) and the Diabetes Distress Scale (DDS), in order to discriminate their psychometric capabilities and functions. METHODS Six hundred and twenty-eight people with diabetes (67% Type 1, 33% Type 2) were cross-sectionally assessed with the PAID, the DDS and further self-report scales regarding coping, quality of life, depressive symptoms and self-care, and medical data were gained. We analysed the PAID and DDS for areas of contentual/psychometric divergence in assessing diabetes distress and compared their associations with criteria of interest. RESULTS Content analysis: The PAID covers a greater variety of emotional concerns and shows a stronger focus on food-related problems and complications. The DDS is more reflective of physician-related distress and problems concerning diabetes self-management. Psychometric analysis: Exploratory factor analyses revealed four-factor structures of both scales, explaining 60% (PAID) and 67% (DDS) of variance. Confirmatory factor analyses confirmed that single-factor and four-factor models fit the data. Total scales proved high and subscales mostly satisfactory reliability. Associations with criteria of interest: The PAID was significantly more strongly associated with dysfunctional coping styles, quality of life and depressive symptoms. The DDS showed significantly stronger associations with diabetes self-care and metabolic outcomes. CONCLUSION Our results support both PAID and DDS as good self-report measures of diabetes distress. The observed contentual/psychometric differences suggest that a justified choice with regard to the intended clinical or scientific purpose can improve the acquisition of the required data.
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Affiliation(s)
- A Schmitt
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - A Reimer
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - B Kulzer
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - T Haak
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - D Ehrmann
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - N Hermanns
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
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Schipfer M, Ehrmann D, Haak T, Hermanns N, Kulzer B. Evaluation des Fragebogens zur Erfassung der Zufriedenheit des Glukosemonitorings bei Typ-1-Diabetes (T1-GMSS). DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kulzer B, Hermanns N, Maier B, Schall S, Haak T. Effekte des MEDIAS2 BOT+SIT+CT Schulungs- und Behandlungsprogrammes für Menschen mit einem Typ-2-Diabetes und einer nicht-intensivierten Insulintherapie auf HbA1c und Hypoglykämierisiko. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ehrmann D, Hermanns N, Bergis-Jurgan N, Haak T, Kulzer B. Wer profitiert von strukturierten Schulungs- und Behandlungsprogrammen? DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Freckmann G, Kulzer B, Borck A, Anderten H. Blutzuckerselbstmessung mit Abschätzung des HbA1c – Zufriedenheit von Patienten und Ärzten mit einer neuen Technologie. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ehrmann D, Schmitt A, Reimer A, Haak T, Kulzer B, Hermanns N. Zusammenhang von Depression auf die glykämische Kontrolle in Abhängigkeit des Schweregrades der depressiven Symptomatik. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Reimer A, Schmitt A, Ehrmann D, Hermanns N, Haak T, Kulzer B. Erhöhte Depressivität bei Menschen mit Diabetes trotz Antidepressivatherapie: Ergebnisse der Ecce Homo-Studie. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kulzer B, Wehrhahn T, Kaplan L, Golden A, O'Neil P, Nadglowski J, Kolotkin R, Kyle T, Look M, Dhurandhar N, Lum C, Donsmark M. Divergence of patient and clinician perceptions of obesity and weight management. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Schipfer M, Ehrmann D, Schmitt A, Kulzer B, Haak T, Hermanns N. Evaluation einer deutschen Fassung der Diabetes Distress Scale für Typ-1-Diabetes (T1-DDS). DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Reimer A, Schmitt A, Ehrmann D, Hermanns N, Kulzer B, Haak T. Hohe Diabetesbelastung bei Menschen mit Typ-1-Diabetes vor allem in den ersten Jahren nach Manifestation. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1580837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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