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Watanabe S, Ito T, Sugiyama T, Tomita M, Kobayashi S, Tamiya N. Current conditions of use of long-term care insurance services for home-based long-term care recipients who need insulin therapy. Geriatr Gerontol Int 2023; 23:253-255. [PMID: 36772868 DOI: 10.1111/ggi.14556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 01/16/2023] [Accepted: 01/21/2023] [Indexed: 02/12/2023]
Affiliation(s)
- Shinobu Watanabe
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Department of Nursing, School of Health Sciences, Ibaraki Prefectural University of Health Sciences, Ami-machi, Ibaraki, Japan
| | - Tomoko Ito
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takehiro Sugiyama
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.,Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Makiko Tomita
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Analytics and Innovation Department, Research and Development Group, SMS Co., Ltd., Tokyo, Japan
| | - Shu Kobayashi
- Analytics and Innovation Department, Research and Development Group, SMS Co., Ltd., Tokyo, Japan
| | - Nanako Tamiya
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan.,Department of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Endo K, Itoh T, Tanno M, Ohno K, Hotta H, Kato N, Matsumoto T, Ooiwa H, Kubo H, Miki T. Characteristics of patients with emergency attendance for severe hypoglycemia and hyperglycemia in a general hospital in Japan. Medicine (Baltimore) 2021; 100:e26505. [PMID: 34160469 PMCID: PMC8238261 DOI: 10.1097/md.0000000000026505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 06/02/2021] [Indexed: 01/04/2023] Open
Abstract
Despite advances in treatments for diabetes mellitus (DM), severe acute glycemic crises still occur. In this study, the characteristics of patients who were transported to an emergency department due to acute glycemic crises were investigated.We enrolled patients who were transported to our hospital by ambulance due to hypoglycemia or hyperglycemia during the period from January 2015 to December 2019. Initial glucose levels below 70 mg/dL and above 250 mg/dL were defined as hypoglycemia and hyperglycemia, respectively.In the 5-year period, 16,910 patients were transported to our hospital by ambulance. Of those patients, 87 patients (0.51%) were diagnosed with hypoglycemia, 26 patients (0.15%) were diagnosed with hyperglycemia and 1 patient was diagnosed with lactic acidosis. Compared to patients with hypoglycemia, blood urea nitrogen, serum potassium and hemoglobin levels were higher in patients with hyperglycemia. Systolic blood pressure was lower and pulse rate was higher in patients with hyperglycemia, possibly reflecting dehydration in hyperglycemia. Patients with hyperglycemia were younger (63 vs 70 years old, median), more likely to be hospitalized (92.3% vs 23.0%) with poorer prognosis (23.1% vs 4.6%) than those with hypoglycemia. In 64 DM patients with hypoglycemia, 34 patients were treated with insulin and 24 patients were treated with sulfonylurea or glinide, and their medication was often inappropriate. Excessive alcohol intake and malnutrition were the main causes of hypoglycemia in 23 non-DM patients. The main reasons for hyperglycemia were interrupted treatment, forgetting insulin injection and infection.To avoid acute glycemic crises, optimization of anti-DM therapy and education of patients are needed.
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Affiliation(s)
- Keisuke Endo
- Department of Cardiology and Diabetes, Oji General Hospital, Tomakomai
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo
| | - Takahito Itoh
- Department of Cardiology and Diabetes, Oji General Hospital, Tomakomai
| | - Masaya Tanno
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo
| | - Kouhei Ohno
- Department of Cardiology and Diabetes, Oji General Hospital, Tomakomai
| | - Hiroyuki Hotta
- Department of Cardiology and Diabetes, Oji General Hospital, Tomakomai
| | - Nobuo Kato
- Department of Cardiology and Diabetes, Oji General Hospital, Tomakomai
| | - Tomoaki Matsumoto
- Department of Cardiology and Diabetes, Oji General Hospital, Tomakomai
| | - Hitoshi Ooiwa
- Department of Cardiology and Diabetes, Oji General Hospital, Tomakomai
| | - Hirofumi Kubo
- Medical Record Administration Center, Oji General Hospital, Tomakomai, Japan
| | - Takayuki Miki
- Department of Cardiology and Diabetes, Oji General Hospital, Tomakomai
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