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Biomedical subjects

D D Etzwiler

Publications and source records attributed to D D Etzwiler.

14 recordsLinked to original sources
PubMed1987

Rapid decrease of insulin-specific IgG antibody levels in insulin-dependent patients transferred to semi-synthetic human insulin.

A multicenter, open trial was designed to examine the efficacy and safety of semi-synthetic human insulin (SSHI; Novolin R and Novolin L, SQUIBB-NOVO) in patients with insulin-dependent diabetes mellitus who were transferred from other commercially-available insulins. Whether such a change in therapy would reduce circulating IgG antibodies to antibovine insulin was also evaluated. A total of 68 males and females, 8-62 yr of age, were maintained on their original insulin therapy for 4 weeks, when both glycosylated hemoglobin and fasting blood glucose were assessed. IgG antibody titers to antibovine insulin were also measured. All patients were then transferred to SSHI for a period of 20 weeks. The same variables were evaluated at Weeks 2, 4, 8, and 20. Mean fasting blood glucose levels rose monotonically from 189-226.3 mg/dl over the course of the 20-week clinical trial. There was a slight but insignificant increase in glycosylated hemoglobin by the end of the test period. The average value for antibovine insulin IgG antibodies decreased from 2.54 mu/ml at baseline to 1.32 mu/ml by the completion of the trial. Significant decreases were first observed 4 weeks after the patients were placed on SSHI therapy. After transfer to SSHI, 43.3% of the patients achieved some improvement in glycemic control and only 16.4% were worse than at baseline. A decrease in weekly hypoglycemic reactions occurred during the course of the SSHI therapy. It appears that SSHI provides safe and effective treatment for insulin-dependent diabetic patients and that its use results in a rapid and significant decrease in insulin antibody formation.

Adult↗
PubMed1986

Diabetes management. The importance of patient education and participation.

Since its establishment in 1967, the International Diabetes Center, Minneapolis, has broadened its interest in patient education from an active concern to a worldwide effort. In addition to providing formal educational programs for diabetics and their families, the Center has trained thousands of health professionals, many of whom have returned to their own clinics, hospitals, and other facilities to initiate similar programs. In 1984, building on its long history of consulting with health care provider organizations in the development of diabetes education programs, the International Diabetes Center initiated a systems development program. Under this program, the Center works with selected hospitals and clinics to develop a national network of sophisticated, integrated diabetes management centers. These Affiliates work with the Center to develop education, clinical care, and research programs that mirror those at the Center.

Diabetes Mellitus↗
PubMedDate not supplied

Clinical evaluation of the impact of a patient education program.

A 5-day patient education program, taught on an outpatient basis, was evaluated to determine its effect on metabolic control as reflected by glycosylated hemoglobin test values. A quasi-experimental design was used, consisting of a pretest, a posttest, and a follow-up assessment made approximately 6 months after the posttest. The 72 experimental and 324 comparison subjects all had insulin-dependent diabetes mellitus (IDDM), were between 14 and 78 years of age, and had a duration of diabetes ranging from 1 to 20 years. The experimental group demonstrated a statistically significant improvement in Hb A1 values from pre- to posttest and sustained these posttest levels upon follow-up, although not at statistically significant levels. The comparison group showed no pre- to posttest difference, but demonstrated an improvement from posttest to follow-up assessment.

Adult↗
PubMedDate not supplied

Psychometric study of patient knowledge test.

The results of a psychometric study of the Test of Patient Knowledge are reported. The 50-item, multiple-choice test, developed by Etzwiler and associates at the International Diabetes Center, consists of a total score and seven subscores based on seven nonoverlapping content categories: nutrition, insulin, general knowledge, methods of control, pattern control, exercise, and complications. The results described herein provide evidence for the validity of the test (content, concurrent, and discriminant validity), a high level of reliability (Cronbach's alpha = .88), readability for the layperson at the 7th- to 8th-grade level, and sensitivity to instructional gains. The literature on psychometric research with other tests of patient knowledge of diabetes is reviewed and compared with the results of this study.

Adolescent↗