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diabetes older

Andrew S Hwang, Steven J Atlas, Johan Hong, Jeffrey M Ashburner, Adrian H Zai, Richard W Grant, Clemens S Hong
BACKGROUND: A better understanding of the attributes of patients who require more effort to manage may improve risk adjustment approaches and lead to more efficient resource allocation, improved patient care and health outcomes, and reduced burnout in primary care clinicians. OBJECTIVE: To identify and characterize high-effort patients from the physician's perspective. DESIGN: Cohort study. PARTICIPANTS: Ninety-nine primary care physicians in an academic primary care network...
October 21, 2016: Journal of General Internal Medicine
J Slieker, P Frauche, J Jurt, V Addor, C Blanc, Nicolas Demartines, M Hübner
BACKGROUND: Enhanced recovery after surgery (ERAS) pathway includes recovery goals requiring active participation of the patients; this may be perceived as "aggressive" care in older patients. The aim of the present study was to assess whether ERAS was feasible and beneficial in older patients. METHODS: Since June 2011, all consecutive colorectal patients were included in an ERAS pathway and documented in a dedicated prospective database. This retrospective analysis included 513 patients, 311 younger patients (<70 years) and 202 older patients (≥70 years)...
October 21, 2016: International Journal of Colorectal Disease
Taulant Muka, Lauren C Blekkenhorst, Joshua R Lewis, Richar L Prince, Nicole S Erler, Albert Hofman, Oscar H Franco, Fernando Rivadeneira, Jessica C Kiefte-de Jong
OBJECTIVE: We aimed to study whether dietary fat composition (n-3 and n-6 polyunsaturated fatty acids ratio (PUFAs) and PUFAs and saturated fatty acids (SFAs) ratio) is associated with total body fat (TF) and body fat distribution and whether this association was modified by the presence of chronic disease in middle-aged and elderly women in two population-based cohorts in the Netherlands and Australia. METHODS: The study was performed in the Rotterdam Study (RS), a prospective cohort study among subjects aged 55 years and older (N = 1182 women) and the Calcium Intake Fracture Outcome Study (CAIFOS), a 5-year randomized controlled trial among women age 70+ (N = 891)...
September 28, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Přemysl Frič, Jan Škrha, Aleksi Šedo, Tomaš Zima, Petr Bušek, Klára Kmochová, Martin Laclav, Bohuš Bunganič, Svatopluk Solař, Petr Hrabal, František Bělina, Pavel Záruba, Pavel Škrha, Miroslav Zavoral
High-resolution imaging methods (HRIMs) and biomarkers present the second step of pancreatic cancer (PC) diagnostics in at-risk individuals. These include patients with positive risk factors, early symptoms, nonresponders to the initial antidiabetic therapy, patients older than 50 years of age with new-onset unstable diabetes requiring insulin as well as patients with long-term insulin-non-dependent diabetes and recent (up to 6 months) failure of antidiabetic therapy. The procedures should be started without delay and the co-operation between the primary and tertiary medical centers is highly desirable...
December 2016: European Journal of Gastroenterology & Hepatology
Wesley T O'Neal, Kristine E Lee, Elsayed Z Soliman, Ronald Klein, Barbara E K Klein
PURPOSE: To determine the incidence and determinants of developing abnormalities on the 12-lead electrocardiogram (ECG) in persons with type 1 diabetes. METHODS: We evaluated the distribution of ECG abnormalities and risk factors for developing new abnormalities in 266 (mean age = 44 years ± 9.0; 50 % female) people with type 1 diabetes from the Wisconsin Epidemiologic Study of Diabetic Retinopathy. This analysis included participants with complete ECG data from study visit 5 (2000-2001) and follow-up ECGs from study visit 7 (2012-2014)...
October 20, 2016: Journal of Endocrinological Investigation
Anna Chapman, Claudia Meyer, Emma Renehan, Keith D Hill, Colette J Browning
INTRODUCTION: Falls as a complication of diabetes mellitus (DM) can have a major impact on the health of older adults. Previous reviews have demonstrated that certain exercise interventions are effective at reducing falls in older people; however, no studies have quantified the effectiveness of exercise interventions on falls-related outcomes among older adults with DM. METHODS: A systematic search for all years to September 2015 identified available literature...
September 30, 2016: Journal of Diabetes and its Complications
Ruth S Weinstock, Ingrid Schütz-Fuhrmann, Crystal G Connor, Julia M Hermann, David M Maahs, Morten Schütt, Shivani Agarwal, Sabine E Hofer, Roy W Beck, Reinhard W Holl
AIMS: Compare characteristics, therapies and clinical outcomes in older adults with type 1 diabetes in the United States T1D Exchange (T1DX) and German/Austrian Diabetes Patienten Verlaufsdokumentation (DPV) registries. METHODS: Cross-sectional study of adults ≥60years old with type 1 diabetes seen in 2011-2012 in the T1DX (n=1283) and DPV (n=2014) registries. Wilcoxon rank-sum test was used for continuous variables and chi-square test for categorical variables...
October 4, 2016: Diabetes Research and Clinical Practice
Ho Sun Kim, Joon-Shik Shin, Jinho Lee, Yoon Jae Lee, Me-Riong Kim, Young-Hyeon Bae, Ki Byung Park, Eun-Jung Lee, Joo-Hee Kim, In-Hyuk Ha
BACKGROUND: Osteoarthritis is a significant burden on personal health and for social cost, and its prevalence is rising. Recent research has revealed an association between osteoarthritis and cardiovascular disease, and this study uses the Framingham risk score (FRS), which is widely used as a composite index of cardiovascular risk factors, to investigate the association between osteoarthritis and various cardiovascular risk factors. METHODS: A total 9,514 participants aged 50 years or older who received knee X-ray diagnosis of the 5th Korean National Health and Nutrition Examination Survey (total surveyees = 24,173) released by the Korean Centers for Disease Control and Prevention was included for analysis...
2016: PloS One
John I Shin, Kevin Phan, Parth Kothari, Jun S Kim, Javier Z Guzman, Samuel K Cho
STUDY DESIGN: This is a retrospective analysis of administrative database. OBJECTIVE: To elucidate the effect of glycemic control on surgical outcomes of middle-aged and elderly idiopathic scoliosis patients undergoing spinal fusion surgery. SUMMARY OF BACKGROUND DATA: Diabetes mellitus (DM) is a condition thought to adversely affect outcomes of spine surgery. However, no study has stratified glycemic control levels and their impact on outcome for idiopathic scoliosis patients receiving a spinal fusion surgery...
October 19, 2016: Clinical Spine Surgery
Josefin Sundh, Scott Montgomery, Mikael Hasselgren, Mary Kämpe, Christer Janson, Björn Ställberg, Karin Lisspers
Health status is a prognostic factor included in the assessment of chronic obstructive pulmonary disease (COPD). The aim of our study was to examine the associations of clinical factors with change in health status over a 7-year follow-up period. In 2005, 970 randomly selected primary and secondary care patients with a COPD diagnosis completed questionnaires including the Clinical COPD Questionnaire (CCQ); and in 2012, 413 completed the CCQ questionnaire again. Linear regression used difference in mean total CCQ score between 2005 and 2012 as the dependent variable...
October 20, 2016: NPJ Primary Care Respiratory Medicine
M Henze, H Alfonso, L Flicker, J George, S A Paul Chubb, G J Hankey, O P Almeida, J Golledge, P E Norman, B B Yeap
AIMS: To investigate behavioural, physical and biochemical characteristics associated with diabetes in the oldest age group of elderly men. METHODS: We conducted a cross-sectional analysis of community-dwelling men aged 79-97 years from Perth, Western Australia. Lifestyle behaviours, self-rated health, physical function, and fasting glucose and HbA1c levels were assessed. RESULTS: Of 1426 men, 315 had diabetes (22%). Men with diabetes were of similar age to men without (84...
October 20, 2016: Diabetic Medicine: a Journal of the British Diabetic Association
Karina Friis, Benedicte Donslund Vind, Rebecca K Simmons, Helle Terkildsen Maindal
Background. People with diabetes who have poor health behaviours are at greater risk for a range of adverse health outcomes. We aimed to investigate the relationship between health literacy and health behaviour (smoking, alcohol, physical activity, and diet) in people with diabetes. Methods. The study was based on respondents aged 25 years or older from a population-based survey in 2013 who reported having diabetes (n = 1685). Two dimensions from the Health Literacy Questionnaire were used: "understand health information" and "actively engage with healthcare providers...
2016: Journal of Diabetes Research
Sedighe Moradi, Mohammad Javad Haji Ghanbari, Hedyeh Ebrahimi
BACKGROUND: Diabetes is a leading cause of cardiovascular disease (CVD). Moreover, CVD accounts for primary cause of death among diabetic patients. Physicians, especially in the primary care setting, have effective role in the management of cardiovascular risk factors. Therefore, we aimed to compare the prevalence of modifiable cardiovascular risk factors in Type 2 diabetic patients attending to an urban health center as a primary care center with Institute of Endocrinology and Metabolism Diabetes Clinic (IEMDC) as a tertiary center...
2016: International Journal of Preventive Medicine
Andrea Gruneir, Lauren E Griffith, Kathryn Fisher, Dilzayn Panjwani, Sima Gandhi, Li Sheng, Chris Patterson, Amiram Gafni, Jenny Ploeg, Maureen Markle-Reid
OBJECTIVE: To characterize comorbid chronic conditions, describe health services use, and estimate health care costs among community-dwelling older adults with prior stroke. METHODS: This is a retrospective cohort study using administrative data from Ontario, Canada. We identified all community-dwelling individuals aged 66 and over on April 1, 2008 (baseline), who had experienced a stroke at least 6 months prior. We estimated the prevalence of 14 comorbid conditions at baseline; we captured all physician visits, emergency department visits, hospital admissions, home care contacts, and associated costs over 5 years stratifying by number of comorbid conditions...
October 19, 2016: Neurology
Daniel J Friedman, Haikun Bao, Erica S Spatz, Jeptha P Curtis, James P Daubert, Sana M Al-Khatib
BACKGROUND: -A prolonged PR interval is common among cardiac resynchronization therapy (CRT) candidates; however, the association between PR interval and outcomes is unclear, and data are conflicting. METHODS: -We conducted inverse probability weighted (IPW) analyses of 26,451 CRT eligible (EF≤35, QRS≥120ms) patients from the National Cardiovascular Data Registry ICD Registry to assess the association between a prolonged PR interval (≥230ms), receipt of CRT with defibrillator (CRT-D) versus implantable cardioverter defibrillator (ICD), and outcomes...
October 19, 2016: Circulation
Meilin Zhang, Li Zheng, Ping Li, Yufeng Zhu, Hong Chang, Xuan Wang, Weiqiao Liu, Yuwen Zhang, Guowei Huang
BACKGROUND/AIMS: Our aim was to evaluate whether visceral adiposity index (VAI) could predict the risk of type 2 diabetes (T2D) in different genders and to compare the predictive ability between VAI and other fatness indices. METHODS: Four thousand seventy-eight participants including 1,817 men and 2,261 women, aged 18 and older and free of T2D at baseline were enrolled in 2010 and followed up for 4 years. New cases of T2D were identified via the annual medical examination...
October 20, 2016: Annals of Nutrition & Metabolism
Anne van der Vorst, G A Rixt Zijlstra, Nico De Witte, Daan Duppen, Andreas E Stuck, Gertrudis I J M Kempen, Jos M G A Schols
BACKGROUND: Most older people wish to age in place, for which functional status or being able to perform activities of daily living (ADLs) is an important precondition. However, along with the substantial growth of the (oldest) old, the number of people who develop limitations in ADLs or have functional decline dramatically increases in this part of the population. Therefore, it is important to gain insight into factors that can contribute to developing intervention strategies at older ages...
2016: PloS One
Hyun Min Kim, Jong-Mi Seong, Jaetaek Kim
The objective of this study was to carry out a large population-based study to understand the factors associated with hypoglycemia-related hospitalizations among older Korean adults with diabetes mellitus.This study analyzed data from a subset of the 2013 Health Insurance and Review and Assessment service-Adult Patient Sample. A total of 307,170 subjects, comprising 41.7% men and 58.3% women, had diabetes mellitus. Hypertension (80.8%) was the most common comorbidity, and dyslipidemia (59.0%) and ischemic heart disease (21...
October 2016: Medicine (Baltimore)
I-Shiang Tzeng, Su-Hsun Liu, Kuan-Fu Chen, Chin-Chieh Wu, Jih-Chang Chen
To reduce patient boarding time at the emergency department (ED) and to improve the overall quality of the emergent care system in Taiwan, the Minister of Health and Welfare of Taiwan (MOHW) piloted the Grading Responsible Hospitals for Acute Care (GRHAC) audit program in 2007-2009.The aim of the study was to evaluate the impact of the GRHAC audit program on the identification and management of acute myocardial infarction (AMI)-associated ED visits by describing and comparing the incidence of AMI-associated ED visits before (2003-2007), during (2007-2009), and after (2009-2012) the initial audit program implementation...
October 2016: Medicine (Baltimore)
Petra Rust, Cem Ekmekcioglu
Excessive dietary salt (sodium chloride) intake is associated with an increased risk for hypertension, which in turn is especially a major risk factor for stroke and other cardiovascular pathologies, but also kidney diseases. Besides, high salt intake or preference for salty food is discussed to be positive associated with stomach cancer, and according to recent studies probably also obesity risk. On the other hand a reduction of dietary salt intake leads to a considerable reduction in blood pressure, especially in hypertensive patients but to a lesser extent also in normotensives as several meta-analyses of interventional studies have shown...
October 19, 2016: Advances in Experimental Medicine and Biology
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