XI. STRATEGIES FOR IMPROVING DIABETES CARE D iabetes is a chronic illness that requires continuing medical care and patient self-management education to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues, beyond glycemic control, be addressed. A large body of evidence exists that supports a range of interventions to improve diabetes outcomes. These standards of care are intended to provide clinicians, patients, researchers, payors, and other interested individuals with the components of diabetes care, treatment goals, and tools to evaluate the quality of care. While individual preferences, comorbidities, and other patient factors may require modification of goals, targets that are desirable for most patients with diabetes are provided. These standards are not intended to preclude more extensive evaluation and management of the patient by other specialists as needed. For more detailed information, refer to Bode (Ed.): Medical Management of Type 1 Diabetes (1), Burant (Ed): Medical Management of Type 2 Diabetes (2), and Klingensmith (Ed): Intensive Diabetes Management (3). The recommendations included are diagnostic and therapeutic actions that are known or believed to favorably affect health outcomes of patients with diabetes. A grading system (Table 1), developed by the American Diabetes Association (ADA) and modeled after existing methods, was utilized to clarify and codify the evidence that forms the basis for the recommendations. The level of evidence that supports each recommendation is listed after each recommendation using the letters A, B, C, or E.

Standards of Medical Care in Diabetes

The lack of representation of diverse ancestral backgrounds in genomic research is well-known, and the resultant scientific and ethical limitations are becoming increasingly appreciated. The paucity of data on individuals with African ancestry is especially noteworthy as Africa is the birthplace of modern humans and harbors the greatest genetic diversity. It is expected that greater representation of those with African ancestry in genomic research will bring novel insights into human biology, and lead to improvements in clinical care and improved understanding of health disparities. Now that major efforts have been undertaken to address this failing, is there evidence of these anticipated advances? Here, we evaluate the promise of including diverse individuals in genomic research in the context of recent literature on individuals of African ancestry. In addition, we discuss progress and achievements on related technological challenges and diversity among scientists conducting genomic research.

/pdf/evaluating-the-promise-of-inclusion-of-african-ancestry-1k4cped7ap.pdf

Evaluating the promise of inclusion of African ancestry populations in genomics.

Kidney damage and associated risk factors in rural and urban sub-Saharan Africa (AWI-Gen): a cross-sectional population study.

Las medidas antropometricas estan siendo ampliamente utilizadas para el acompanamiento y el desenvolvimiento de ninos, en la verificacion de las adaptaciones en respuesta a entrenamiento, en la selecion de atletas y en estudios de caracterizacion etnica, entre varias otras areas. El control da la calidad de esas medidas va a resultar en datos mas confiables y medidas antropometricas mas precisas. El proposito del presente estudio es el de difundir la estrategia para la obtencion del error tecnico de medicion (ETM), siguiendo la metodologia de Kevin Norton y Tim Olds (2000) y evaluar el desempeno de empleados de laboratorio. Tres antropometristas del Laboratorio de Fisiologia del Ejercicio (Labofise) de la Universidad del Brasil fueron evaluados. Ellos realizaron las medidas de pliegues cutaneos (Cescorf, 0.1mm) en nueve diferentes puntos antropometricos de 35 voluntarios (25,45 ± 9,96 anos). Para las medidas, fue adoptada la padronizacion de la International Society for Advancement in Kinanthropometry (ISAK). Para la verificacion del ETM intra-evaluador, las medidas fueron realizadas en los mismos voluntarios en dos dias diferentes; y, para la obtencion del ETM inter-avaliador, las medidas fueron hechas en un mismo grupo de voluntarios, en el mesmo dia, por los tres antropometristas. Los resultados apuntaron ETMs no aceptables apenas para dos evaluadores en el analisis intra-evaluador. Los demas ETMs alcanzaron resultados aceptables. Los ETMs no aceptables demostraron la necesidad de entrenamiento tecnico de los antropometristas, de modo de minimizar la variabilidad constatada.

/pdf/calculo-del-error-tecnico-en-la-medicion-de-antropometria-57ryjsqud3.pdf

Cálculo del error técnico en la medición de antropometria

Background: There is a high and increasing prevalence of overweight and obesity in South Africans of all ages. Risk factors associated with overweight and obesity must be identified to provide targ...

https://www.tandfonline.com/doi/pdf/10.1080/16549716.2018.1448250

Demographic, socio-economic and behavioural correlates of BMI in middle-aged black men and women from urban Johannesburg, South Africa.

There is an alarming tide of cardiovascular and metabolic disease (CMD) sweeping across Africa. This may be a result of an increasingly urbanized lifestyle characterized by the growing cons...

https://www.tandfonline.com/doi/pdf/10.1080/16549716.2018.1507133

Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for Phase 1 of the AWI-Gen population cross-sectional study

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Genomic and environmental risk factors for cardiometabolic diseases in Africa: methods used for Phase 1 of the AWI-Gen population cross-sectional study