Katherine L. Modzelewski's research while affiliated with Boston University and other places

Publications (24)

Article
Hyperglycemic crisis (HC) has been reported in patients with COVID-19 infection, but there is little data about HC following COVID-19 vaccination, with 10 patients described to date. We performed a retrospective observational study examining the correlation between COVID-19 vaccination and HC in adult patients admitted from 1/1/21-7/1/21 at our ins...
Article
Background There is urgent need for safe, effective, and easily implementable treatments that reduce the progression of respiratory failure in COVID-19. Despite increased adoption during the pandemic, the effectiveness of prone positioning on respiratory failure progression among non-intubated patients is unclear. Research Question What is the eff...
Article
Background Despite increases in continuous glucose monitor (CGM) and insulin pump use in adults with diabetes, there is room for expansion. Technology adoption may be influenced by the training environment and fellowship education. However, little is known about adult endocrinology trainee comfort with, understanding of, or methods by which trainee...
Article
Background: Continuous Glucose Monitoring (CGM) has been increasingly shown to be beneficial in patients with both type 1 and type 2 diabetes using insulin. Despite this, challenges remain in obtaining coverage for these devices. We sought to define the process of initiation of CGM and better understand factors associated with successful initiatio...
Chapter
Over millennia, sharing the practical experience of one physician with others has been a proven way of disseminating best practices of the time with esteemed colleagues and teaching new generations of doctors. This selfless and generous sharing of knowledge is the cornerstone of teaching medical students and residents at the bedside and in classroo...
Article
Full-text available
Background Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) are potentially life-threatening complications of diabetes. Many hospitals have developed protocols to guide the management of these conditions and align with best practices. One of the main complications encountered in the treatment of hyperglycemic crises is hypogly...
Article
The unprecedented public health burdens of coronavirus disease 2019 (COVID-19) have intensified the urgency to identify effective, low-cost treatments that limit the need for advanced life support measures and improve clinical outcomes. However, personal protective equipment and staffing shortages, disease virulence, and infectivity have created si...
Article
Objective To benchmark rates of guideline-concordant insulin infusion initiation, identify factors associated with guideline-concordant insulin practices, and examine the association between hospital-level guideline concordance and mortality among critically ill patients with sepsis. Methods We performed a multicenter retrospective cohort study of...
Article
Objective As rapid improvement in blood glucose (BG) occurs shortly after weight loss surgery (WLS) in patients with type 2 diabetes (T2DM), postoperative glucose management can be challenging. Our study examined the safety and effectiveness of insulin management strategies during hospitalization and after discharge two weeks after WLS. Methods Si...
Chapter
Diabetes digital health is a field that has been rapidly expanding in clinical practice with great potential to impact health-care delivery. Despite its adoption, there is limited consensus as to how best to regulate and study digital health. Given the rapid pace with which technology becomes available and changes, traditional research study design...
Article
Background: Low-income, minority, and underserved populations are often excluded from mobile health (mHealth) research. This cross-sectional study sought to define how patients at an urban, academic safety net hospital use technology in their daily lives in an effort to incorporate mHealth into clinical care and research. Methods: Patients receivi...
Article
Background: Comprehensive transgender care involves a multidisciplinary team of primary care providers, mental health providers (MHPs), endocrinologists and surgeons. Management of gender dysphoria (GD) includes hormonal and surgical treatment, with the latter being irreversible. Mental health evaluation to confirm GD is an essential step in transg...
Article
In this commentary, we briefly review the currently recommended approaches to interpretation and management of continuous glucose monitor (CGM) rate of change (ROC) trend arrows and discuss the inherent difficulty in incorporating practical recommendations for their application into routine clinical care. We have limited our review and discussion t...
Article
Full-text available
Interest in improved access to diabetes care through mHealth interventions is widespread and is increasingly recognized as playing an important role in care. However, limited data is available on the use of mHealth in diabetes care, with traditional research models focusing on clinical outcomes. While traditional clinical outcomes are important whe...
Article
Objective: The patterns of emergency department (ED) visits in patients with diabetes are not well understood. The Emergency Department Diabetes Rapid-referral Program (EDRP) allows direct booking of ED patients presenting with urgent diabetes needs into a diabetes specialty clinic within 1 day of ED discharge. The objective of this secondary anal...
Article
Mobile health (mHealth) is an emerging branch of medicine that utilizes technology to impact health care. With increasing access to smartphones and mobile devices, there has been an increase in both the availability and use of mHealth resources, including the use of text messages, apps, and web portals. In diabetes, there is particular interest as...
Article
Full-text available
Objective: Hyperglycemic crisis encompasses a group of diabetes emergencies characterized by insulin deficiency with high morbidity and mortality. Cocaine use is increasingly prevalent in the United States and may be associated with increased risk of diabetic ketoacidosis. The objective was to determine if active cocaine use at hospital admission c...
Article
Objective: Patients who present to the emergency department (ED) for diabetes without hyperglycemic crisis are at risk of unnecessary hospitalizations and poor outcomes. To address this, the ED Diabetes Rapid-referral Program (EDRP) was designed to provide ED staff with direct booking into the diabetes center. The objective of this study was to det...
Article
Objective: Patients who present to the Emergency Department (ED) for diabetes without hyperglycemic crisis are at risk of unnecessary hospitalizations and poor outcomes. To address this, the Emergency Department Diabetes Rapid-referral Program (EDRP) was designed to provide ED staff with direct booking into the diabetes center. The objective of thi...

Citations

... The literature search retrieved 1712 studies. After the exclusion of duplicates, reviews, and ineligible articles, we included a total of 11 RCTs with a cumulative sample size of 2385 patients (1218 in the APP group and 1167 in the control group) in our review [14,[22][23][24][25][26][27][28][29][30][31]. The literature screening process is summarised in Figure 1. ...
... 8 older with confirmed or suspected COVID-19 per the treating clinician, were within 48 hours of admission to a medical ward, not intubated and had access to a functioning smartphone during their hospitalization. Patients receiving supplemental oxygen with flow rates of 6 L/minute or more were excluded due to concern from consulting physicians during the design phase and from the institutional review board that self-prone positioning in patients receiving higher oxygen flow rates was rapidly becoming standard care and that clinical equipoise may not exist. ...
... This construct is defined as the patient's self-assessment of the process attributes and the outcomes of the treatment experience. Also, when referring to medical devices, aspects related to their technical features are often considered, such as device appearance and design, usefulness, and potential discomfort in use (Modzelewski et al., 2019). The treatment with CSII has been studied compared to treatment using multiple daily injections. ...
... Recent reporting suggests disparities in access that have persisted for decades are narrowing. [11][12][13] For example, smartphone ownership among US adults is becoming more common across different economic, educational, and racial/ethnic backgrounds. 14 From this closing of the digital divide, the conclusion often follows that more people are using health apps; however, it is necessary to critically examine usage by individuals' characteristics to understand whether and where disparities persist. ...
... Change in bolus insulin dose according to trend arrows has been suggested for both patients with multiple daily injections and insulin pumps [2]. For users of insulin pump with the predictive low-glucose suspend (PLGS) feature, only the arrows for management of hyperglycemia (upward arrows) should be used for insulin adjustments, as the insulin pump algorithm has incorporated Open Access the downward arrows for hypoglycemia prevention [3]. ...
... investigated how interventions for specific disease states can improve the discharge process and follow-up. 5 In other processes of care, clinical decision tools are now used frequently in the ED, specifically with regard to stratifying illness severity on presentation and risk-stratifying patients in need of additional laboratory studies or imaging. [6][7][8][9] In the inpatient setting, appropriate discharge planning remains a core element of care coordination, and numerous studies have demonstrated the benefit of robust discharge planning processes, such as decreased readmission rates and increased prescription drug adherence. ...
... There are estimates of 59% of 886,000 deaths per year (UNCRC, 2020), and 41.92% of people have a chronic illness with a minimum of one side impairment due to chronic disease. A critical literature gap was identified regarding re-conceptualizing end-user's perspective predictors for chronic care that influences mHealth adoption (Loosman, 2020;Modzelewski et al., 2018;Yuan, 2016). But the understanding of the drivers of the chronic care system for primary care is little explored. ...
... For example, Saunders et al. [19] study, which was conducted in the UK, was excluded from this review because the type of substance abused was not stated in the study. In addition, many other studies including Modzelewski et al. [20] study, conducted in USA, Lee et al. [21] study conducted in Australia, Saif-Ali et al. [22] study, carried out in Yemen, Isidro and Jorge [23] study, carried out in Spain, and Warner et al. [24] study, conducted in USA examined the effect of abuse of different substances in patients with diabetes. However, the outcome measures of cardio-metabolic significance in these studies were blood glucose parameters which are not the focus of the current review. ...
... For outpatient programs to effectively support EDs, enhanced communication and program referral are required. Limited evidence suggests that improving diabetes program referral processes at emergency and primary care settings and educating healthcare providers on diabetes program services can increase diabetes education enrollment and reduce ED visits and hospitalization [17][18][19]. Particularly since hyper-or hypoglycemia are preventable diabetes complications [20,21] that often result in ED visits and hospitalization. ...
... The Emergency Department Diabetes Rapid-referral Program (EDRP) is a currently active clinical intervention at Boston Medical Center designed to rapidly connect patients with diabetes who present to the ED with acute diabetes needs to comprehensive diabetes specialty management services in the outpatient setting. We previously showed that patients referred to the EDRP had an improvement in glycemic control and experienced approximately 40% fewer hospital admissions in the subsequent year compared to historical controls (13). There was also a reduced likelihood of ED revisits in the EDRP group. ...