Blanchard Valley Health System, or (BVHS), is a non-profit, integrated regional health system based in Findlay, a city in Ohio. Governed by a community board of trustees representing large and small business, education, law, medicine, and finance, BVHS oversees all operations of its member organizations. BVHS is one of the largest employers in its micropolitan area, employing more than 3000 people.BVHS serves an eight-county area that includes Allen, Hancock, Hardin, Henry, Putnam, Seneca, Wood and Wyandot counties in Ohio.In addition, a dedicated group of more than 600 volunteers support BVHS through their contributions.
ABSTRACT Introduction Although continuous glucose monitoring (CGM) in adults with type 2 diabetes (T2D) has known glycemic benefits, the underlying behavioural and psychosocial processes driving these outcomes remain poorly understood. We examined how CGM influences patient‐reported outcomes and whether changes in those outcomes predict glycemic improvement. Research Design and Methods This 6‐month prospective observational study included 115 adults with T2D and elevated HbA1c who did not use fast‐acting insulin and initiated CGM through a real‐world program. At baseline, 3‐ and 6‐months, HbA1c, medication use/changes and key psychosocial and self‐care behaviours were assessed. Longitudinal structural equation models assessed changes over time and predictors of HbA1c reduction. Post hoc moderation analyses explored whether the effect of self‐care behaviour improvements on HbA1c outcomes depended upon new medication starts at baseline. Results HbA1c declined significantly from 9.4% (79 mmol/mol) at baseline to 7.3% (56 mmol/mol) at both 3 and 6 months (ps < 0.001). Participants reported increased diabetes engagement, reduced distress, increased physical activity, fewer missed medications and less overeating (ps < 0.001). In multivariate models, greater HbA1c reduction was independently predicted by: (1) starting a new diabetes medication in the few months before baseline (b = −1.06, p < 0.001); (2) increases in physical activity (b = −0.13, p = 0.040); and (3) improvements in medication‐taking (b = 2.33, p < 0.001). Post hoc moderation analysis revealed that behaviour changes were most predictive of glycemic benefit among participants who had not started a new diabetes medication pre‐baseline. Conclusions Real‐world CGM initiation was associated with significant improvements in glycemic control, self‐care behaviours and psychosocial outcomes. Behaviour change—notably, improved diet and physical activity—was a key contributor to glycemic gains, particularly among those not undergoing medication adjustments prior to CGM initiation. These findings support CGM as a catalyst for engagement and behaviour change in T2D management.
Oxyntic gland adenomas (OGAs) are benign gastric neoplasms composed of gland-forming epithelial cells with predominantly chief cell differentiation resembling oxyntic glands confined to the mucosa. If the tumor has submucosal invasion, it should be classified as gastric adenocarcinoma of fundic gland type. The OGAs can pose a diagnostic challenge, as they can resemble aggressive gastric neoplasms. There are no current guidelines on the management of OGA. Due to the relatively small size and low malignant potential, these lesions are typically managed endoscopically. In this case, we are reporting a 22-year-old woman who was diagnosed with OGA during evaluation of iron deficiency anemia and underwent successful endoscopic resection.
