Nuha El Sayed
Harvard University, Endocrinology, Faculty Member
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Implicit bias," also called "unconscious bias," refers to associations outside of conscious awareness that adversely affect one's perception of a person or group. Awareness of implicit bias has been increasing in the realm of diabetes... more
Implicit bias," also called "unconscious bias," refers to associations outside of conscious awareness that adversely affect one's perception of a person or group. Awareness of implicit bias has been increasing in the realm of diabetes care. Here, the authors highlight several types of unconscious bias on the part of clinicians and patients, including biases based on race, ethnicity, and obesity. They discuss how these biases can negatively affect patient-centered clinical interactions and diabetes care delivery, and they recommend implementation of evidence-based interventions and other health system policy approaches to reduce the potential impact of such biases in health care settings.
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Only around 30% of patients with diabetes meet targets for A1c (A), blood pressure (B) or lipid (C) and 14% meet targets for ABC and non-smoking. Following a survey among general practitioners (GPs) on educational needs, an education... more
Only around 30% of patients with diabetes meet targets for A1c (A), blood pressure (B) or lipid (C) and 14% meet targets for ABC and non-smoking. Following a survey among general practitioners (GPs) on educational needs, an education program was designed to improve the performance of the GP and the quality of diabetes care in Japan. GPs and nurses learned at a live workshop how to create a plan-do-study-act cycle and established an improvement plan to implement. In a 2nd workshop, held 3 months later, GPs examined whether the improvement plan was carried out and established strategies for further improvement. A, B, C and smoking status were provided by each participant on up to 25 patients pre and post intervention. Goals were: A1c <7%, BP <130/80 mmHg, LDL-C< 120mg/dl (based on Japan Diabetes Society). The proportions of patients in each of the groups at goal pre and post program were compared using chi-square. Results: 2 cohorts of GPs provided data on 648 patients. The i...
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PURPOSE Global health challenges require systematic approaches that bring together a wide range of stakeholders and experts unevenly distributed worldwide. We saw an even greater need to find novel ways to collaborate during the pandemic... more
PURPOSE Global health challenges require systematic approaches that bring together a wide range of stakeholders and experts unevenly distributed worldwide. We saw an even greater need to find novel ways to collaborate during the pandemic due to limited in-person meetings and travel restrictions. The purpose of this project is to accelerate collaborations in learning health systems with online technologies to improve communication, education, and knowledge management. METHODS We developed Alicanto Cloud, an online collaboration platform for healthcare professionals to support learning health systems. Alicanto aims to help groups communicate, share educational resources, discuss complex clinical cases across institutions and countries. Alicanto provides multiple ways for users to create synchronous and asynchronous discussions. Alicanto was developed by the BIDMC Division of Clinical Informatics in collaboration with local and international colleagues with a specific focus on global h...
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Fasting the Holy month of Ramadan constitutes one of the five pillars of the Muslim faith. Although there is some evidence that intermittent fasting during Ramadan may be of benefit in losing weight and cardiometabolic risk factors, there... more
Fasting the Holy month of Ramadan constitutes one of the five pillars of the Muslim faith. Although there is some evidence that intermittent fasting during Ramadan may be of benefit in losing weight and cardiometabolic risk factors, there is no strong evidence these benefits apply to people with diabetes. The American Diabetes Association/European Association for the Study of Diabetes consensus recommendations emphasize the importance of patient factors and comorbidities when choosing diabetes medications including the presence of comorbidities, atherosclerotic cardiovascular disease, heart failure, chronic kidney disease, hypoglycemia risk, weight issues and costs. Structured education and pre-Ramadan counseing are key components to successful management of patients with diabetes. These should cover important aspects like glycemic targets, self-monitoring of blood glucose, diet, physical activity including Taraweeh prayers, medication and dose adjustment, side effects and when to b...
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Practitioners need to prepare for a rapid expansion of new concentrated insulins. For many years, the treatment regimens for patients have been limited to 2 concentrations (100 units/mL and 500 units/mL), which pose challenges to both... more
Practitioners need to prepare for a rapid expansion of new concentrated insulins. For many years, the treatment regimens for patients have been limited to 2 concentrations (100 units/mL and 500 units/mL), which pose challenges to both patients and providers. As the new concentrated insulins are at various stages of development, this manuscript reviews the available information on the new concentrated products. This information was obtained from publications, poster presentations, abstracts, and the manufacturers for the products in earlier stages of development. To have a basis for comparison, it is important to understand the activity profile and the challenges with use of the currently available concentrated insulin, regular insulin 500 units/mL (U500R). We also examine how the newer products may assist clinicians and patients with the difficulties faced with the use of U500R.