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Aims: To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbA1c level in people with Type 2 diabetes mellitus (T2DM).Methods: People with T2DM attending 846 PHCCs (n=230958) were included in this cross-sectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities. Data were analysed using a generalized estimating equations linear regression models.Results: After adjusting for PHCC- and individual-level confounding factors, personnel resources associated with lower individual HbA1c level were mean credits of diabetes-specific education among registered nurses (RNs) (-0.02mmol/mol for each additional credit; P<0.001) and length of regular visits to RNs (-0.19mmol/mol for each additional 15min; P<0.001). Organisational features associated with HbA1c level were having a diabetes team (-0.18mmol/mol; P<0.01) and providing group education (-0.20mmol/mol; P<0.01).Conclusions: In this large sample, PHCC personnel resources and organisational features were associated with lower HbA1c level in people with T2DM. [ABSTRACT FROM AUTHOR]

As part of the preparations for the accession of Slovenia to the European Union, the National Health Insurance Institute has introduced a European model for quality management. In this regard a benchmarking has been carried out, comparing the Health Insurance Institute of Slovenia with the Accounts Office of Cumbernauld in the UK. This was a so-called generic benchmarking between two public service organisations in different fields and it was made by third parties focusing on the quality of the Processes of the two organisations. The results of the comparative analysis show that the health insurance institute has strong financial management, supported by a well-developed model for partnership negotiations and advanced applications of information technology. There are, however, weaknesses in the management of human resources and quality improvements. To counteract these weaknesses requires a cultural change within the health insurance institute. [ABSTRACT FROM AUTHOR]

Forty-three patients suffering from familial amyloidosis with polyneuropathy were examined by means of barium meal, barium follow through, barium enema, cholecystogram, and gastroscopy. The findings were reviewed with respect to the presence of steatorrhea and impaired d-xylose absorption. Seven patients had gastric stasis (without gross anatomical changes) on barium meal examination and seven others on the gastroscopy. Gastroscopy revealed that another five patients had inactive peristalsis of the antrum-pylorus. Only one patient had slow transit of barium on follow through. The transit time of barium did not correlate with increased fecal fat output or decreased d-xylose absorption. Barium enema and cholescystogram were normal. The main radiological and gastroscopic finding in familial amyloidosis with polyneuropathy was reduced gastric motility. [ABSTRACT FROM AUTHOR]

Background: Early insulin treatment is considered more beneficial than anti-diabetic medication with sulphonylureas, because the latter may exert negative effects on beta-cell function, while the former may help preserve it. In a previous study, we found that C-peptide response was increased in the insulin-treated group, whereas it was decreased in the glibenclamide group. However, it was not certain whether the advantage remained in the longer term., Aim: In this study, we tested whether early insulin treatment is more beneficial than glibenclamide against a 6-year follow-up perspective., Methods: We designed a randomized clinical trial in subjects with newly diagnosed type 2 diabetes. Glucagon stimulatory tests, measuring C-peptide and islet amyloid polypeptide (IAPP), were performed after 2, and 3, days of temporary insulin and glibenclamide withdrawal., Results: 18 subjects initially randomized to glibenclamide, and 16 randomized to two daily injections of insulin, participated in end-of-study investigations. C-peptide response to glucagon deteriorated (p < 0.01 vs. baseline) in initially glibenclamide-treated patients (n = 18), but not in insulin-treated patients (p < 0.05 for difference between groups, after 2 days of treatment withdrawal). The IAPP response to glucagon declined in the glibenclamide group (p < 0.001), but not in insulin-treated subjects (p = 0.05 for difference between groups)., Conclusions: Early insulin treatment preserves beta-cell secretory function better than glibenclamide even in a 6-year perspective.