2^nd International Conference on Diabetes and Diabetic Nursing Care September 28-29, 2018 Montreal, Quebec, Canada

Biography:

currently at the last phase of her PhD study at the Stellenbosch University, Division of Anatomy and Histology.  She is strongly interested in the teaching of different aspects of Human Anatomy and physiology.  Her research interest resides in the islet microvasculature and its implication in diabetes mellitus.  Her PhD work focuses on establishing the morphological changes in the islet microvasculature and its implication in drug delivery.  Her commitment for scientific research and development in her country gives her the opportunity to intervene regularly in meetings encouraging young African women in science.  While highlighting the importance of women in the development of any society she fight against any form of violence to women.

Abstract:

In the pancreas, the duodenal islets are more susceptible to pathological conditions and are less numerous compared to the splenic islets. Many studies have described the regional heterogeniety of islet cell distribution and composition in human and rodents, but very little is known of the association between islet microvasculature and islet cell density. To understand the functional relationships between these two factors, we evaluated quantitatively the distribution of endothelial cells and the thickness of their basement membrane using anti-CD34 antibody and methenamine silver stains, respectively. Serial sections from both the duodenal and splenic portion of pancreata of STZ- and HFD-induced diabetic rats were used for immunohistochemical studies. Images from tissue sections were captured at 20x and stored in Tagged Image File Format and analysed using image J colorization methods. Duodenal islets were less vascularized and were supported by a thinner basement membrane in both control and diabetic animals. Anti CD34 antibody and methanamine stained pixel areas were significantly greater in the splenic portion with mean ±SEM of duodenal vs splenic portion in control animals =5.61±0.0575 vs 6.08±0.043% (p<0.05) and 15.6±0.3.2 vs 18±0.21% (p<0.01) for both stains respectively. From this study, it is clear that the duodenal islets are exposed to pathological conditions such as diabetes due the weakness in the thickness of their Peri-islet Basement Membrane (PBM) and the minimal vascularization they have.

Biography:

Angela Irony, PhD, RN is the Chief Nursing and Medical Centers Officer at Maccabi HealthCare Services, the second largest HMO in Israel. At her prior position as the director of the Telehealth centers she led the creation and operation of the on-line platform for remote chronic care. Angela represented Maccabi's telehealth experience in the World Economic Forum in New York in September 2017. She is a guest lecturer in universities and colleges.

Abstract:

Background: The diabetes epidemic call for integrative solutions to address this challenge.  Maccabi Telecare Center (MTC) is a multi-disciplinary service providing a remote treatment solution to 6,000 members who suffer from chronic illness. Proactive monitoring led by a personal nurse and MTC's multi-disciplinary staff is based on the chronic care model (CCM) empowering patients to self-management through self-efficacy. Aim: To examine the association between MTC's treatment setting (CCM + telemedicine) and patients’ DM self-efficacy (DMSE) and other health outcomes compared with the DMSE of patients receiving standard community care. Method: A large-scale comparative prospective study with stratified sampling and repeat measures. Study population include all HMO members with diabetes type 2, and HbA1c > 8%. Patients who were recruited to MTC comprised the intervention group. Patients matched by demographic and clinical variables encompassed the control group.  During the 8-9 month intervention period MTC personal nurse proactively contacts the patient and develops a personalized care plan including clinical targets. The personal nurse monitors the patient's condition, provides guidance and empowers him/her to self-management. Patients in the control group received standard community care. All participants completed DMSE Scale at baseline, 3-4 months and 8-9 months. Data regarding compliance index and HbA1c values were drawn from patient's medical record. Results: 832 patients - 433 (intervention) and 399 (control) – aged 59 (±11.3), 8.9 (±5.5) years of diabetes duration and HbA1c of 10.1 at baseline (±1.7). Participation in the intervention group was related to higher DMSE along the study period. At baseline, DMSE in both groups was identical (p = NS), yet after 3-4 months and after 8-9 months DMSE was higher in the intervention group (p < .001). Second, over the study period, compliance index increased in the intervention group and declined in the control group (p < .05). Hb1Ac values declined in both the intervention (-2.11%) and the control (-1.41%) groups though the decline was greater in the intervention group (p < .001). Conclusions: This study demonstrates the effect of MTC plan led by nurse on creating a cognitive-behavioral-clinical change among diabetes patients. Tailored interventions are effective in increasing self-efficacy and achieving self-management.

Biography:

Angela Irony, PhD, RN is the Chief Nursing and Medical Centers Officer at Maccabi HealthCare Services, the second largest HMO in Israel. At her prior position as the director of the Telehealth centers she led the creation and operation of the on-line platform for remote chronic care. Angela represented Maccabi's telehealth experience in the World Economic Forum in New York in September 2017. She is a guest lecturer in universities and colleges.

Abstract:

Background: The diabetes epidemic call for integrative solutions to address this challenge.  Maccabi Telecare Center (MTC) is a multi-disciplinary service providing a remote treatment solution to 6,000 members who suffer from chronic illness. Proactive monitoring led by a personal nurse and MTC's multi-disciplinary staff is based on the chronic care model (CCM) empowering patients to self-management through self-efficacy. Aim: To examine the association between MTC's treatment setting (CCM + telemedicine) and patients’ DM self-efficacy (DMSE) and other health outcomes compared with the DMSE of patients receiving standard community care. Method: A large-scale comparative prospective study with stratified sampling and repeat measures. Study population include all HMO members with diabetes type 2, and HbA1c > 8%. Patients who were recruited to MTC comprised the intervention group. Patients matched by demographic and clinical variables encompassed the control group.  During the 8-9 month intervention period MTC personal nurse proactively contacts the patient and develops a personalized care plan including clinical targets. The personal nurse monitors the patient's condition, provides guidance and empowers him/her to self-management. Patients in the control group received standard community care. All participants completed DMSE Scale at baseline, 3-4 months and 8-9 months. Data regarding compliance index and HbA1c values were drawn from patient's medical record. Results: 832 patients - 433 (intervention) and 399 (control) – aged 59 (±11.3), 8.9 (±5.5) years of diabetes duration and HbA1c of 10.1 at baseline (±1.7). Participation in the intervention group was related to higher DMSE along the study period. At baseline, DMSE in both groups was identical (p = NS), yet after 3-4 months and after 8-9 months DMSE was higher in the intervention group (p < .001). Second, over the study period, compliance index increased in the intervention group and declined in the control group (p < .05). Hb1Ac values declined in both the intervention (-2.11%) and the control (-1.41%) groups though the decline was greater in the intervention group (p < .001). Conclusions: This study demonstrates the effect of MTC plan led by nurse on creating a cognitive-behavioral-clinical change among diabetes patients. Tailored interventions are effective in increasing self-efficacy and achieving self-management.

Biography:

Fernanda Paiva has completed her undergraduate nursing program at the age of 23 years from University of Brasilia and studied as an exchange student during one year in the nursing program at Lehman College – CUNY in New York, USA. Currently, she’s a master’s student in Sciences and Technologies in Health at the University of Brasilia, Brazil.

Abstract:

In addition to the evident increase in the number of elderly, there is also a higher prevalence of Non-Communicable Chronic Diseases (NCD), such as Diabetes Mellitus (DM). Poorly controlled DM causes several complications such as pain, which compromise the productivity, the life expectancy, and the quality of life (QOL). QOL is an important aspect of diabetes because a poor quality of life reduces the self-care, resulting in a worse glycemic control, and increasing the risks of complications. The purpose of this study is to evaluate the pain and its impact on quality of life of elderly patients with DM in a primary care unit in Brazil. Methodology & Theoretical Orientation: A descriptive and quantitative study, which data were collected from September to November 2015, through a semi-structured questionnaire and previously tested, composed of questions about the sociodemographic profile, and the WHOQOL-OLD and WHOQOL-BREF questionnaires. Findings: Through scores of WHOQOL-BREF questionnaires and WHOQOL-OLD, it was observed that those people who did not report pain had better QOL scores than those reported pain, except in the physical domain and in the facet autonomy. Conclusion & Significance: The results of this study show that pain affects the QOL of the elderly with DM and enables the better planning of actions that meet the specific needs of this population.