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One of the challenges in clinical diabetology today is to develop and implement diabetes prevention management programs for clinical practice. Recent studies have convincingly demonstrated that lifestyle intervention, addressing diet and exercise as well as pharmacologic preventive strategies reduced the risk of progressing from impaired glucose tolerance to diabetes. With respect to the worldwide burden of diabetes these studies offer a compelling evidence-base for the important translation of the research findings into community-based prevention strategies and the development of a National Diabetes Prevention Program. The workgroup "diabetes prevention" from the German Diabetes Association together with the National Action Forum Diabetes and the German Diabetes Foundation developed a concept for a National Program. This comprises a 3-step-intervention: in a first step individuals at high risk to develop type 2 diabetes are identified. The second step provides an intensive group intervention to prevent diabetes and in a third step continuous intervention should facilitate motivation maintenance and evaluation. This third step is the crucial step to maintain the effect in changing lifestyle. Recently, a compendium for diabetes prevention was developed as a practical guideline explaining how to implement prevention programs. This guideline also includes the structure of a national prevention program with a prevention manager having a central role in the concept and suggestions for evaluation and quality control.

This article defines and explains the concept of good clinical sense. It defines good clinical sense as "the presence of sensory faculties, their usage and interpretation, by which one is able to practice good clinical medicine". Good clinical sense differs from good clinical practice (GCP) and good clinical acumen. It encompasses all steps of the clinical, diagnostic and therapeutic process, and encourages diligent practice of clinical medicine. Good clinical sense is integral to the practice of diabetology.

OBJECTIVE: Screening for advanced fibrosis (AF) resulting from metabolic dysfunction-associated steatotic liver disease (MASLD) is recommended in diabetology. This study aimed to compare the performance of noninvasive tests (NITs) with that of two-step algorithms for detecting patients at high risk of AF requiring referral to hepatologists. RESEARCH DESIGN AND METHODS: We conducted a planned interim analysis of a prospective multicenter study including participants with type 2 diabetes and/or obesity and MASLD with comprehensive liver assessment comprising blood-based NITs, vibration-controlled transient elastography (VCTE), and two-dimensional shear-wave elastography (2D-SWE). AF risk stratification was determined by a composite criterion of liver biopsy, magnetic resonance elastography, or VCTE ≥12 kPa depending on availability. RESULTS: Of 654 patients (87% with type 2 diabetes, 56% male, 74% with obesity), 17.6% had an intermediate/high risk of AF, and 9.3% had a high risk of AF. The area under the empirical receiver operating characteristic curves of NITs for detection of high risk of AF were as follows: fibrosis-4 index (FIB-4) score, 0.78 (95% CI 0.72-0.84); FibroMeter, 0.74 (0.66-0.83); FibroTest, 0.78 (0.72-0.85); Enhanced Liver Fibrosis (ELF) test, 0.82 (0.76-0.87); and SWE, 0.84 (0.78-0.89). Algorithms with FIB-4 score/VCTE showed good diagnostic performance for referral of patients at intermediate/high risk of AF to specialized care in hepatology. An alternative FIB-4 score/ELF test strategy showed a high negative predictive value (NPV; 88-89%) and a lower positive predictive value (PPV; 39-46%) at a threshold of 9.8. The FIB-4 score/2D-SWE strategy had an NPV of 91% and a PPV of 58-62%. The age-adapted FIB-4 score threshold resulted in lower NPVs and PPVs in all algorithms. CONCLUSIONS: The FIB-4 score/VCTE algorithm showed excellent diagnostic performance, demonstrating its applicability for routine screening in diabetology. The ELF test using an adapted low threshold at 9.8 may be used as an alternative to VCTE.

OBJECTIVES: Advanced diabetic nephropathy (DN) is characterized by a marked development of cardiovascular and renal disease. These patients are frequently managed by different health professionals with the consequence that the quality of care may differ substantially. To compare the management of cardiovascular risk factors in patients with type 2 DN and an estimated glomerular filtration rate (GFR) of 15-60 ml/min per 1.73 m2 followed in nephrology, diabetology and primary care. METHODS: This multicentre cross-sectional study verified the control of blood pressure (BP), total cholesterol, triglycerides, glycosylated haemoglobin A1c (HbA1c) and haemoglobin in patients exclusively followed in either nephrology (n = 266), diabetology (n = 246) or primary care (n = 195) of the same metropolitan area for at least 1 year. RESULTS: Primary care patients were older and had a greater prevalence of previous cardiovascular events. The GFR was lower in nephrology than in diabetology and primary care (33 +/- 13 versus 47 +/- 9 and 40 +/- 12 ml/min per 1.73 m2, P < 0.0001). The prevalence of BP target (< 130/80 mmHg) was similarly low in nephrology, diabetology and primary care (14, 13 and 10%, P = 0.421) probably because of insufficient prescription of diuretics and low-salt diet. Whereas the prevalence of the triglycerides target was similar, that of total cholesterol (< 200 mg/dl) was larger in diabetology (63%) than in nephrology and primary care (59 and 46%, P = 0.003) because of greater statin prescription in hypercholesterolemic individuals (70, 50 and 41%, respectively, P = 0.002). The attainment of HbA1c less than 7% was less frequent in diabetology (32%) than in nephrology and primary care (61 and 46%, P = 0.0003) despite a more frequent prescription of insulin/oral agents in diabetology. The control of anaemia was better in diabetology. Multivariate analysis adjusted for the patient case-mix and physician-level clustering confirmed these differences except for anaemia. CONCLUSION: Patients with advanced DN, despite the worst renal and cardiovascular prognosis, are at high risk of being under-treated independently of the type of clinical setting.

Studies have shown that sodium-glucose cotransporter type 2 (SGLT2) inhibitors not only help lower blood glucose levels but also offer cardioprotective effects, reduce the progression of heart failure, and may even slow the progression of aortic stenosis. The mechanisms of these beneficial properties are thought to involve multiple pathways, including reducing inflammation, oxidative stress, and improving cellular energy metabolism. Advancing knowledge about the mechanisms of action of these drugs and their effects on the course of the aforementioned diseases has become the subject of intensive clinical and scientific research. This publication aims to provide insight into the role of SGLT2 inhibitors in the context of diabetes mellitus, heart failure and acute coronary syndrome, through clinical analysis, mechanistic insights and comparison of the effects of these drugs.

The convergence of diabetology and nanotechnology has emerged as a promising synergy with the potential to revolutionize the management and treatment of diabetes mellitus. Diabetes, a complex metabolic disorder affecting millions worldwide, necessitates innovative approaches to enhance monitoring, diagnosis, and therapeutic interventions. Nanotechnology, a burgeoning field that manipulates materials at the nanoscale, offers unprecedented opportunities to address the challenges posed by diabetes. This abstract explores the multifaceted interface between diabetology and nanotechnology, highlighting key areas of integration. Nanotechnology has paved the way for the development of advanced glucose monitoring systems with enhanced accuracy, sensitivity, and patient convenience. Miniaturized biosensors and implantable devices equipped with nanoscale materials enable continuous and real-time glucose monitoring, empowering individuals with diabetes to make timely and informed decisions about their dietary and insulin management. Furthermore, nanotechnology has facilitated breakthroughs in targeted drug delivery, addressing the limitations of conventional therapies in diabetes treatment. Nano-sized drug carriers can improve bioavailability, enable controlled release, and enhance the selectivity of therapeutic agents, minimizing side effects and optimizing treatment outcomes. Moreover, nanoengineered materials have opened avenues for tissue engineering and regenerative medicine, offering the potential to restore damaged pancreatic islets and insulin-producing cells. The amalgamation of diabetology and nanotechnology also holds promise for early disease detection and prevention. Nanoscale diagnostic tools, such as biomarker-based nanoprobes and lab-onchip devices, offer rapid and accurate detection of diabetes-related biomolecules, enabling timely interventions and reducing the risk of complications. However, this compelling combination also presents challenges that warrant careful consideration. Safety, biocompatibility, regulatory approval, and ethical implications are crucial factors that demand meticulous evaluation during the translation of nanotechnology-based solutions into clinical practice. In conclusion, the integration of diabetology and nanotechnology represents a transformative paradigm that has the potential to reshape the landscape of diabetes management. By harnessing the unique properties of nanoscale materials, researchers and clinicians are poised to usher in an era of personalized and precise diagnostics, therapeutics, and preventive strategies for diabetes mellitus. As advancements in nanotechnology continue to unfold, the journey towards realizing the full potential of this compelling combination remains an exciting frontier in medical science. This review has thoroughly and critically studied the usage of nanomedicine in the diagnosis, monitoring, and management of diabetes and its effects, providing a clear picture of their potential clinical application in the future. This evaluation covers additional numerous clinical trials research and patents that are currently in way in this subject. Thus in the light of this we intended to provide a broad picture of the state of technological development in the area of diabetes management through nanotechnology.

Despite the implementation of preventive measures to counteract the obesity epidemics, the prevalence of childhood obesity is still alarming all over the world. Childhood obesity is the most common risk factor for both cardiovascular and metabolic diseases. In fact, an earlier onset of obesity can cause a greater risk of adiposity tracking across the lifespan and consequently a longer exposure to cardiometabolic risk factors. Accumulating evidence provided by prospective and intervention studies demonstrated the link between pediatric obesity and selected subclinical signs of cardiovascular damage (atherosclerosis and left ventricular hypertrophy), or fatal and not fatal cardiovascular events as early as 40 years of age.The numerous guidelines and scientific documents published in the last years demonstrate the relevance of assessing cardiometabolic risk factors in children and adolescents with OB.This Position paper, released by experts of the "Childhood Obesity study group" within the Italian Society for Pediatric Endocrinology and Diabetology, aims to review the assessment of cardiometabolic risk factors and comorbidities in children and adolescents with OW/OB on the light of the most recent scientific evidence.The main recommendations are: (a) early detection of comorbidities, including hypertension, dyslipidemia, prediabetes/type 2 diabetes, metabolic dysfunction-associated steatotic liver disease, polycystic ovary syndrome, inactivity, obstructive sleep apnea and decline in kidney function; (b) weight loss treatment, which is associated with a reduction of all cardiometabolic risk factors; (c) specific treatment of comorbidities, through lifestyle modifications or pharmacological treatment added to lifestyle for suitable individuals; d). monitoring comorbidities for mitigating future morbidity and mortality.

This Position Statement updates the different components of the therapy of obesity (lifestyle intervention, drugs, and surgery) in children and adolescents, previously reported in the consensus position statement on pediatric obesity of the Italian Society of Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics. Lifestyle intervention is the first step of treatment. In children older than 12 years, pharmacotherapy is the second step, and bariatric surgery is the third one, in selected cases. Novelties are available in the field of the medical treatment of obesity. In particular, new drugs demonstrated their efficacy and safety and have been approved in adolescents. Moreover, several randomized control trials with other drugs are in process and it is likely that some of them will become available in the future. The increase of the portfolio of treatment options for obesity in children and adolescents is promising for a more effective treatment of this disorder.

This editorial aims to highlight the various rules and regulations of waste disposal and explain them a propos diabetes waste. It hopes to encourage a nation-wide movement for green diabetology, which utilizes scientific practices to prevent an adverse impact of diabetes waste on our environment. The communication also tries to sensitize diabetes care professionals to their responsibility toward the physical environment, while reinforcing the need for interdisciplinary cooperation between all stakeholders. Diabetes has become pan-endemic now.[1] Apart from the health-related and economic consequence of uncontrolled glycemia, avoidable chronic complications, and acute co-morbid conditions, there is another issue that has hitherto been ignored. This is the burden that modern diabetes management places upon the environment. While modern insulin technique guidelines address the need for appropriate disposal of needles and syringes,[23] this aspect is not discussed in conjunction with national regulations for biomedical waste disposal. Thus, the potential impact of diabetes care upon our surroundings is not realized. ENVIRONMENTAL BURDEN The 65 million Indians living with diabetes consume about 160 million insulin syringes and about 50 million pen needles annually, along with about 40 million syringes used for immunization (source: IMS data and market assumption on insulin injection habits). Each syringe weighs 3.28 g. Excluding the weight of the cannula, the net amount of plastic generated from insulin syringes alone, each year is 600,000 kg (3 g × 200 million syringes) (derived from IMS data). Apart from this, roughly 9.6 crore (96,000,000) vials, cartridges and prefills are consumed in a 12-month period (6.7 crore vials, 2.5 cartridge and 0.7 disposable pens), adding to the burden of glass and plastic on the environment (derived from IMS data). As the number of people living with diabetes increase, diabetes care-related waste is bound to rise, as modern tools and devices are used more frequently for diabetes management. Table 1 lists some commonly produced diabetes waste, which can be classified into bio-medical, plastic, and e-waste. Table 2 enumerates the various categories of bio-medical waste, as listed in current Indian regulations.Table 1: Bio-medical waste produced in diabetologyTable 2: Bio-medical waste disposalBIO-MEDICAL WASTE “Bio-medical waste” means any waste, which is generated during the diagnosis, treatment or immunization of human beings or animals, or in research activities pertaining there to or in the production or testing of biologicals.[4] As per current Indian regulations, medical products used and discarded in a hospital setting are considered biomedical waste. However, those used in the home care or domestic setting, including insulin syringes, needles, lancets, cartridge and pens, are included in municipal solid waste (MSW), and disposed accordingly.[4] Untreated bio-medical waste should not be mixed with other waste. It should be segregated into color-coded, labeled containers/bags at the point of generation, prior to storage, transportation, treatment and disposal. Bags of appropriate color with nonwashable labels must be used. According to earlier guidelines, glucose monitoring sticks, and other solid waste were to be collected in red bags. Now, they can be disposed of in yellow nonchlorinated bags. Disposable pens should be disposed of after removing pen needles. Pen needles should also be disposed of safely. Transport should be undertaken only in authorized vehicles. Storage of bio-medical waste of categories 1, 2, 3, and 6 should not exceed 48 h without treatment. This includes items contaminated with blood and body fluids, including monitoring sticks, cotton swabs, ulcer dressings, (category 6) and waste from clinical/laboratory samples (category 3).[4] PLASTIC WASTE Plastic waste is a separate type of special waste. Various plastics used in manufacture are classified into seven types by the Bureau of Indian Standards. These include both recyclable and nonrecyclable varieties. Plastic is an important waste generated by diabetology. Plastic syringes, disposable pens, reusable pens, pen needles, glucometers, and other monitoring devices are all made of plastic. Medicine bottles and insulin syringes are made of polypropylene (PP). Disposable pens are also made of PP. Most disposable pens contain a cartridge made of type 1 (flint) glass, a plunger of bromobutyl, a stopper of bromobutyl/polyisoprene, and a glass ball to facilitate resuspension. Dimeticone or silicon emulsion may have been used to treat the cartridge plunger, and/or the glass cartridge.[56] RE-CYCLING According to Indian MSW (Management and Handling) Rules, 2000, treated biomedical wastes that are subjected to disinfection or autoclaving are considered to be devoid of any biological or microbiological organisms. They can, in effect, be disposed of as MSW. The bulk of plastic used in diabetes care, therefore, can easily be shifted from bio-medical waste to plastic waste, provided it is disinfected properly. This will include all insulin syringes, plastic cartridges and pens. The plastic used in the manufacture of many disposable pens is biodegradable. However, the time frame for bio-degradation is quite long. Hence, disinfection, followed by recycling, is a better option. The same applies for glass waste, such as vials and cartridges, and stainless steel waste, like needles. These can also be disinfected and recycled as per norms of MSW disposal. Such a practice will allow recycling, promote conservation and efficiency, and help in revenue generation for waste disposal sites. Strict safeguards to prevent the spread of infections among waste handlers and end-users must be put in place. It must be re-emphasized that recycling; which is an acceptable approach to plastic disposal, is completely different from re use, which is absolutely contraindicated. The Schedule I specifically mentions that “shredding and mutilation must be such that so as to prevent unauthorized reuse.” Cutting the needle hub allows separation of most, but not all, of the stainless steel component from the plastic component of syringes. Plastic waste can be recycled, used for co-processing in cement plants, or blended with bitumen and used to construct roads. All these conventional technologies are more reliable than an unproven method such as plasma pyrolysis and liquid fuel generation. Incineration and land filling of plastic should be avoided. SUMMARY Diabetes care professionals have a responsibility not only towards persons with diabetes, but also towards the community at large, and the environment. Modern diabetes care understands its social obligations and works to involve society, community and family in the management of the syndrome. Our attitude toward the physical environment, however, is not so laudable. We exhibit a person-centric approach toward our environment, advocating for diabetes – friendly surroundings.[7] While we decry the role of chemical pollutants and physical obstacles in promoting disease, we neglect our own contribution to pollution of our environment. This responsibility has to be shared by all stake-holders from consumer to waste disposer to recycler [Table 3]. However, as health care professionals, it is our duty and responsibility to ensure that safe disposal takes place.[89]Table 3: Recommendations for optimal disposal of diabetes-related wasteGREEN DIABETOLOGY Through this editorial, we support the call for a green diabetology movement,[9] which addresses safe and environment-friendly insulin disposal. We encourage adoption of simple practices that will facilitate optimal recycling and usage of insulin-related waste material while providing a source for revenue generation as well.

The metabolic syndrome as a consequence of the obesity pandemic resulted in a substantial increase in the prevalence of metabolic-associated fatty live disease (MAFLD) and type 2 diabetes mellitus (T2DM). Because of the similarity in pathobiology shared between T2DM and MAFLD, both disorders coexist in many patients and may potentiate the disease-related outcomes with rapid progression and increased complications of the individual diseases. In fact, awareness about this coexistence and the risk of complications are often overlooked by both hepatologists and diabetologists. Management of these individual disorders in a patient should be addressed wholistically using an appropriate multidisciplinary team approach involving both the specialists and, when necessary, liaising with dieticians and surgeons. This comprehensive review is to compile the current evidence from a diabetologist's perspective on MAFLD and T2DM and to suggest optimal management strategies.

Many reports have documented the negative health consequences that environmental stressors can have on patients with diabetes. Studies examining the interaction between the environment and a patient with diabetes can be unified under a single discipline termed "geoenvironmental diabetology." Geoenvironmental diabetology is defined more specifically as the study of how geophysical phenomena impact a patient with diabetes, to include effects on metabolic control, ancillary equipment (e.g., glucometers and insulin pumps), medications, supplies, access to care, and influences on the adaptive strategies employed by patients to care for their diabetes under extreme circumstances. Geological events such as natural disasters (e.g., earthquakes) or extreme weather (e.g., heat waves) are examples of stressors that can affect patients with diabetes and that can be included under the heading of geoenvironmental diabetology. As proposed here, geoenvironmental diabetology refers to how events in the physical world affect those with diagnosed diabetes, rather than how environmental factors might trigger development of disease. As the global prevalence of diabetes continues to increase, including in parts of the world that are especially vulnerable to disasters and climate change, further discussion is warranted on how to best prepare for management of diabetes under conditions of extreme geological and weather events and a changing climate. An overview is presented of various studies that have detailed how geoenvironmental phenomena can adversely affect patients with diabetes and concludes with a discussion of requirements for developing strategies for geoenvironmental diabetes management.

The current classification of diabetes, based on hyperglycaemia, islet-directed antibodies and some insufficiently defined clinical features, does not reflect differences in aetiological mechanisms and in the clinical course of people with diabetes. This review discusses evidence from recent studies addressing the complexity of diabetes by proposing novel subgroups (subtypes) of diabetes. The most widely replicated and validated approach identified, in addition to severe autoimmune diabetes, four subgroups designated severe insulin-deficient diabetes, severe insulin-resistant diabetes, mild obesity-related diabetes and mild age-related diabetes subgroups. These subgroups display distinct patterns of clinical features, disease progression and onset of comorbidities and complications, with severe insulin-resistant diabetes showing the highest risk for cardiovascular, kidney and fatty liver diseases. While it has been suggested that people in these subgroups would benefit from stratified treatments, RCTs are required to assess the clinical utility of any reclassification effort. Several methodological and practical issues also need further study: the statistical approach used to define subgroups and derive recommendations for diabetes care; the stability of subgroups over time; the optimal dataset (e.g. phenotypic vs genotypic) for reclassification; the transethnic generalisability of findings; and the applicability in clinical routine care. Despite these open questions, the concept of a new classification of diabetes has already allowed researchers to gain more insight into the colourful picture of diabetes and has stimulated progress in this field so that precision diabetology may become reality in the future.

Introduction: Both hyperglycaemia and hypoglycaemia in hospitalized patients have been shown to be associated with a longer length of stay, higher readmission rates, and higher rates of morbidity and mortality. With 25%-30% of all hospitalized patients carrying a diagnosis of diabetes, it is important to optimize glycaemic control. Current guidelines for care of inpatients with diabetes now suggest consulting a specialized diabetes team for all patients when possible. Aim: This study was a retrospective cohort study to evaluate the impact of an inpatient diabetology consult within 48 hours of admission on patients' length of stay. Methods: All patients admitted to the general medicine service between 2013 and 2018 with a diagnosis of diabetes in their medical record were included, which consisted of 11 477 inpatient stays. We looked at the effect of an inpatient diabetology consultation within the first 48 hours on length of stay, complications and 30-day readmission rates. Results: We found that patients whose care included a diabetology consult within 48 hours of admission had a statistically significant shorter length of stay by 1.56 days compared to the remainder of the group. There was no difference in complications or 30-day readmission rates between the groups. Conclusion: Among general medicine patients with a diagnosis of diabetes, timely diabetology consultations reduced patients' length of stay and have the potential to improve their care and lessen the economic impact.

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Diabetology & Metabolic Syndrome (D&MS), the official journal of the Brazilian Diabetes Society (SBD), is a new open access, peer reviewed journal publishing research on all aspects of the pathophysiology of diabetes and metabolic syndrome. With the many ongoing and upcoming challenges for diabetes diagnosis, treatment and care, a dedicated journal providing unrestricted access for researchers and health care professionals working in the field of diabetes is needed. Diabetology & Metabolic Syndrome aims to fulfil this need.

Diabetes, with its acute and long-term complications, has become a major health hazard in developing countries. An estimated 62.4 million people in India have diabetes. With increasing urbanization and industrialization, we can expect huge numbers of people with diabetes in India in the future. Moreover, all diabetes efforts in India are currently focused in urban areas while 70% of India's population actually lives in rural areas. The current statistics demonstrates that urgent interventions are mandatory to curb the epidemic of diabetes and its complications at the grassroots level. This gap in providing diabetes care can be nullified by the use of tele-diabetology. This holds great potential to overcome barriers and improve quality and access to diabetes care to remote, underserved areas of developing counties. The Chunampet Rural Diabetes Prevention Project (CRDPP) has been developed and tested as a successful model for screening and delivering diabetes care to rural areas in developing countries. Using a tele-diabetology mobile van loaded with appropriate equipment, trained technicians, and satellite technology helped us to screen for diabetes and its complications and deliver diabetes care to remote villages in southern India. The Chunampet model can be applied in reaching out to remote areas where specialized diabetes care facilities may not be available.

As a first-line treatment for diabetes, the insulin-sensitizing biguanide, metformin, regulates glucose levels and positively affects cardiovascular function in patients with diabetes and cardiovascular complications. Endothelial dysfunction (ED) represents the primary pathological change of multiple vascular diseases, because it causes decreased arterial plasticity, increased vascular resistance, reduced tissue perfusion and atherosclerosis. Caused by "biochemical injury", ED is also an independent predictor of cardiovascular events. Accumulating evidence shows that metformin improves ED through liver kinase B1 (LKB1)/5'-adenosine monophosphat-activated protein kinase (AMPK) and AMPK-independent targets, including nuclear factor-kappa B (NF-κB), phosphatidylinositol 3 kinase-protein kinase B (PI3K-Akt), endothelial nitric oxide synthase (eNOS), sirtuin 1 (SIRT1), forkhead box O1 (FOXO1), krüppel-like factor 4 (KLF4) and krüppel-like factor 2 (KLF2). Evaluating the effects of metformin on endothelial cell functions would facilitate our understanding of the therapeutic potential of metformin in cardiovascular diabetology (including diabetes and its cardiovascular complications). This article reviews the physiological and pathological functions of endothelial cells and the intact endothelium, reviews the latest research of metformin in the treatment of diabetes and related cardiovascular complications, and focuses on the mechanism of action of metformin in regulating endothelial cell functions.

This article gives a short summary of standardized documentation for pediatric diabetology from a European perspective. The approach chosen by the Austrian/German DPV (Diabetes Patienten Verlaufsdokumentation) group is detailed. The electronic health record used is briefly described, as are external benchmarking reports and national and international comparisons. Similar initiatives like the Hvidore study group, the SWEET initiative (Pediatric Diabetes: Working to Create Centers of Reference in Europe), and the T1DExchange (Type 1 Diabetes Exchange Registry) are compared to the DPV effort.

Much has been written about patient-centered care (PCC) in medical literature. PCC has been praised as the ultimate objective of medicine by some. However, critics have pointed out the obvious: The antonym of PCC is doctor-centered medical care. Is doctor-centered care wrong? And what do we practice if we do not follow PCC? Can physicians transfer all responsibility for decision making to patients, in the name of PCC? Do patients have a right to choose outcomes, and make clinical decisions to achieve those outcomes? Most of the work on PCC has been done in the fields of family medicine and primary care. Minimal publications are available to highlight the role of PCC in endocrinology and diabetology. This brief communication discusses some concepts of PCC, and expands upon this term, to assess its relevance to diabetology.