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Malek Rivan NF, Shahar S, Singh DKA, Che Din N, Mahadzir H, You YX, Kamaruddin MZA. Development of cognitive frailty screening tool among community-dwelling older adults. Heliyon 2024; 10:e34223. [PMID: 39104490 PMCID: PMC11298820 DOI: 10.1016/j.heliyon.2024.e34223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 06/30/2024] [Accepted: 07/05/2024] [Indexed: 08/07/2024] Open
Abstract
Purpose To develop a brief screening tool consisting of twelve items that can be self-administered for rapid identification of older adults at risk of cognitive frailty (CF), named as Cognitive Frailty Screening Tool (CFST). Patients and methods A total of 1318 community-dwelling individuals aged 60 years and above were selected and assessed for cognitive frailty using a set of neuropsychology batteries and physical function tests. A binary logistic regression (BLR) was used to identify predictors of CF to be used as items in the screening tool. A suitable cut-off point was developed using receiver operating characteristic analysis. Results Twelve items were included in the screening tool, comprising of gender, education years, medical history, depressive symptoms and functional status as well as lifestyle activities. The area under the curve (AUC) was 0.817 (95 % CI:0.774-0.861), indicating an excellent discriminating power. The sensitivity and specificity for cut-off 7 were 80.8 % and 79.0 %, with an acceptable range of positive predictive value (PPV) (73.3 %) and negative predictive value (NPV) (85.2 %) for screening tools. Concurrent validity of CFST score with standard cognitive and frailty assessment tools shows a significant association with the total score of CFST with low to moderate correlation (p < 0.05 for all parameters). Conclusion CFST had good sensitivity and specificity and was valid for community-dwelling older adults. There is a need to evaluate further the cost-effectiveness of implementing CFST as a screening for the risk of CF in the community. Its usage in clinical settings needs further validation.
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Affiliation(s)
- Nurul Fatin Malek Rivan
- Nutritional Sciences Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Suzana Shahar
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Devinder Kaur Ajit Singh
- Physiotherapy Programme & Centre for Healthy Ageing and Wellness (H-CARE), Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Normah Che Din
- Health Psychology Programme and Centre of Rehabilitation Science, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Hazlina Mahadzir
- Internal Medicine & Geriatric Department, Pusat Perubatan Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Batu 9 Cheras, Kuala Lumpur, Malaysia
| | - Yee Xing You
- Dietetics Programme and Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Mohd Zul Amin Kamaruddin
- Centre for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
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Qin L, Junjie P, Xinhong W, Shengju F, Ruifen S. Comparative effectiveness of different modes of exercise interventions in diabetics with frailty in China: a systematic review and a network meta-analysis. Diabetol Metab Syndr 2024; 16:48. [PMID: 38409038 PMCID: PMC10895831 DOI: 10.1186/s13098-023-01248-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/25/2023] [Indexed: 02/28/2024] Open
Abstract
OBJECTIVE To systematically evaluate the efficacy of different training modes in patients with diabetes decline. METHODS PubMed, Cochrane Library, EMbase, Web of Science, CNKI, VIP, WANFANG, SinoMed were searched in computer to collect randomized controlled trials (RCTs) of training intervention in patients with diabetes and frailty, and the search time was as of May 21, 2023. After two review authors independently screened studies, extracted data, and assessed the risk of bias of included studies, network meta-analysis was performed using Stata14.0 and R4.3.1 software. Fasting blood glucose (FGB), glycosylated haemoglobin (HbA1c), two-hour postprandial blood glucose (PBG), total cholesterol (TCH), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), Short Physical Performance Battery (SPPB), and body mass index (BMI) were used as outcome measures. RESULTS A total of 15 RCTs were included, including 1550 patients. The results of the network meta-analysis showed that integrated training reduced FBG compared with the control group; integrated training, Pilates training, resistance training can reduce HbA1c; Pilates training and resistance training can reduce PBG; integrated training, Pilates training, resistance training can reduce TCH; Pilates training and resistance training can reduce TG; resistance training improves BMI. The results of the best probability ranking showed that multi-group training had the most significant effect on improving PBG and SPPB scores. CONCLUSION The current evidence suggests that multi-group training is the best way to reduce fasting blood glucose and improve physical activity before meals, and Pilates training may be the best way to reduce glycated hemoglobin, blood glucose two hours after meals, improve blood lipid level and BMI in patients with diabetes in China. TRIAL REGISTRATION PROSPERO registration number for this study: CRD42023427868.
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Affiliation(s)
- Liu Qin
- School of Government, Yunnan University, Kunming, 650504, China
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, 650500, China
| | - Peng Junjie
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, 650500, China
| | - Wei Xinhong
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, 650500, China
| | - Fang Shengju
- School of Government, Yunnan University, Kunming, 650504, China.
| | - Sun Ruifen
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, 650500, China.
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Liu L, Wang R, Gao J, Yan J, Zhang J, Zhang Z, Liu J, Lin H, Rao S, Yao X, Wu W, Bian H, Wang X, Guo S, Gao X, Yan H. Insulin Glargine is More Suitable Than Exenatide in Preventing Muscle Loss in Non-Obese Type 2 Diabetic Patients with NAFLD. Exp Clin Endocrinol Diabetes 2023; 131:583-588. [PMID: 37524110 PMCID: PMC10645484 DOI: 10.1055/a-2145-1004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 06/28/2023] [Indexed: 08/02/2023]
Abstract
AIM This study investigated the effects of insulin glargine and exenatide on the muscle mass of patients with newly diagnosed type 2 diabetes (T2DM) and nonalcoholic fatty liver disease (NAFLD). METHODS We performed a post-hoc analysis of our previously study, a 24-week randomized controlled multicenter clinical trial (ClinicalTrials.gov, NCT02303730). Seventy-six patients were randomly assigned 1:1 to receive insulin glargine or exenatide treatment. The changes in psoas muscle area (PMA) (mm2) were obtained with the cross-sectional Dixonfat magnetic resonance images at the fourth lumber vertebra. RESULTS There were no significant differences in age, BMI, gender, and PMA in insulin glargine and exenatide groups at baseline. After treatment, PMA tended to increase by 13.13 (-215.52, 280.80) mm2 in the insulin glargine group and decrease by 149.09 (322.90-56.39) mm2 in the exenatide group (both p>0.05). Subgroup analysis showed a 560.64 (77.88, 1043.40) (mm2) increase of PMA in the insulin group relative to the Exenatide group in patients with BMI<28 kg/m2 (p0.031) after adjusting for gender, age, and research center. Interaction analysis showed an interaction between BMI and treatment (p0.009). However, no interaction was observed among subgroups with a BMI≥28 kg/m2 or with different genders and ages. CONCLUSION Compared to exenatide, insulin glargine can relativity increase PMA in patients with T2DM having BMI<28 kg/m2 and NAFLD.
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Affiliation(s)
- Lin Liu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Ruwen Wang
- School of Kinesiology, Shanghai University of Sport, Shanghai,
China
| | - Jian Gao
- Department of Nutrition, Zhongshan Hospital, Fudan
University
- Center of Clinical Epidemiology and Evidence-based Medicine, Fudan
University
| | - Jianhua Yan
- Shanghai Key Laboratory of Molecular Imaging, Shanghai University of
Medicine and Health Sciences, Shanghai, China
| | - Jingtian Zhang
- Department of Nutrition, Zhongshan Hospital, Fudan
University
| | - Zhitian Zhang
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
| | - Jiaojiao Liu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
| | - Huandong Lin
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Shengxiang Rao
- Department of Radiology, Zhongshan Hospital, Fudan University,
Shanghai, China
| | - Xiuzhong Yao
- Department of Radiology, Zhongshan Hospital, Fudan University,
Shanghai, China
| | - Weiyun Wu
- Department of Laboratory Medicine, Zhongshan Hospital, Fudan
University, Shanghai, China
| | - Hua Bian
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Xiangyu Wang
- Department of Nutrition, Zhongshan Hospital, Fudan
University
| | - Shanshan Guo
- School of Kinesiology, Shanghai University of Sport, Shanghai,
China
- School of Life Sciences, Fudan University, Shanghai,
China
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
| | - Hongmei Yan
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan
University, Shanghai, China
- Fudan Institute for Metabolic Disease, Fudan University, Shanghai,
China
- Department of Endocrinology and Metabolism, Wusong Branch of Zhongshan
Hospital, Fudan University, Shanghai, China.
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Massimino E, Izzo A, Castaldo C, Ferretti E, Rivellese AA, Della Pepa G. Risk of Sarcopenia and Associated Factors in Older Adults with Type 2 Diabetes: An Exploratory Cross-Sectional Study. Healthcare (Basel) 2023; 11:2081. [PMID: 37510524 PMCID: PMC10380017 DOI: 10.3390/healthcare11142081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Evidence on the risk of sarcopenia and associated factors in older adults with type 2 diabetes (T2D) is lacking. We evaluate (1) the proportion of patients at risk of sarcopenia in older adults with T2D; and (2) the factors associated with the risk of sarcopenia. METHODS We conducted a cross-sectional study on T2D patients over 65 years referred to our outpatient clinic and who carried out the yearly complication assessment visit. Eligible patients were administered questionnaires during phone interviews for the risk evaluation of sarcopenia (SARC-F), the risk evaluation of malnutrition (Mini Nutritional Assessment Short Form (MNA®-SF)), the adherence to the Mediterranean diet (MEDI-quest), and the evaluation of physical activity (the International Physical Activity Questionnaire short form). RESULTS A total of 138 patients were included in the study, and 12 patients (8.7% (95% CI 4.6-14.7)) were at risk of sarcopenia. The mean SARC-F score was significantly higher in women compared with men (2.1 ± 1.8 vs. 0.9 ± 1.4, respectively; p < 0.001). The majority of patients identified at risk of sarcopenia compared with those not at risk were women (75% vs. 30%, respectively; p = 0.003), had a higher proportion of neuropathy (50% vs. 19%, respectively; p = 0.027), a lower mean MNA®-SF score (11.6 ± 1.5 vs. 13.0 ± 1.4, respectively; p = 0.001), a lower mean MEDI-quest score (5.2 ± 1.5 vs. 5.9 ± 1, respectively; p = 0.037), and were more inactive (92% vs. 61%, respectively; p = 0.032). CONCLUSIONS In a sample of older adults with T2D, the risk of sarcopenia was identified in 8.7% (95% CI: 4.6-14.7) of the sample, and the main factors associated were female gender, neuropathy, a lower MNA®-SF score, low adherence to the Mediterranean diet, and low physical activity.
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Affiliation(s)
- Elena Massimino
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Anna Izzo
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Carmen Castaldo
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Erica Ferretti
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Angela Albarosa Rivellese
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
| | - Giuseppe Della Pepa
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy
- Cardiometabolic Risk Unit, Institute of Clinical Physiology, National Research Council-CNR, Via Giuseppe Moruzzi 1, 56124 Pisa, Italy
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Hand grip strength: A reliable assessment tool of frailty status on the person with type 2 diabetes Mellitus. NUTR CLIN METAB 2023. [DOI: 10.1016/j.nupar.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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[Malnutrition management of hospitalized patients with diabetes/hyperglycemia and sarcopenia]. NUTR HOSP 2022; 39:15-22. [PMID: 36546336 DOI: 10.20960/nh.04507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Introduction Sarcopenia is a multidimensional condition that negatively affects muscle mass, muscle strength, and physical performance. The prevalence of sarcopenia in people with diabetes is much higher than that of the general population, especially in individuals with poor nutritional status. Both sarcopenia and malnutrition are conditions amenable to intervention to improve clinical prognosis. This article describes the results of the expert consensus and the responses of the panelists on the nutritional management in routine clinical practice of patients with diabetes/hyperglycemia hospitalized (non-critically ill) with sarcopenia.
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Kulkarni P, Babu PK, Vanmathi A, Ashwini A, Murthy MRN. Relationship between Frailty, Glycemic Control, and Nutritional Status among the Elderly with Diabetes Mellitus Residing in an Urban Community of Mysuru. J Midlife Health 2022; 13:294-299. [PMID: 37324790 PMCID: PMC10266571 DOI: 10.4103/jmh.jmh_30_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/23/2022] [Accepted: 06/22/2022] [Indexed: 06/17/2023] Open
Abstract
Background In India, the elderly (aged 60 and above) constitute 8.2% of the total population and are expected to increase to 10% by the year 2020. Globally, around 450 million people are suffering from diabetes mellitus. Frailty is regarded as a predisability state and, therefore, if identified early, may avert many adverse health outcomes in the elderly. Diabetes and frailty are found to be close associates. Materials and Methods This community-based cross-sectional study was conducted among 104 elderlies with diabetes mellitus residing in an urban slum situated in Mysuru for a period of 6 months. Pretested structured questionnaire was used to collect the information on sociodemographic characteristics and details of diabetes. The Tilburg's Frailty Scale was used to assess frailty, and the Mini Nutritional Assessment Scale was used to assess the nutritional status. Results The prevalence of frailty among the study population was 53.8%. 51% of the subjects were found to have their glycemic status under control, 16.3% were malnourished, and 70.2% were at risk of malnutrition (RMN). The majority of the subjects with malnourishment were frail (76.5%) followed by those at RMN, 36 (49.3%). Gender, marital status, engaging in occupation, socio economic status, poor glycemic control were found to be significantly associated with frailty. Conclusion The prevalence of frailty is significantly higher among elderly diabetics. The poorer glycemic control is a significant factor associated with frailty, and malnourished elderlies are more at risk of developing frailty.
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Affiliation(s)
- Praveen Kulkarni
- Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Poorvika K. Babu
- Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - A. Vanmathi
- Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - A. Ashwini
- Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - M. R. Narayana Murthy
- Department of Community Medicine, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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Abd.Ghafar MZA, O’Donovan M, Sezgin D, Moloney E, Rodríguez-Laso Á, Liew A, O’Caoimh R. Frailty and diabetes in older adults: Overview of current controversies and challenges in clinical practice. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:895313. [PMID: 36992729 PMCID: PMC10012063 DOI: 10.3389/fcdhc.2022.895313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022]
Affiliation(s)
- Mohd Zaquan Arif Abd.Ghafar
- Faculty of Medicine, Universiti Teknologi MARA (Sungai Buloh), Selangor, Malaysia
- Geriatrics Unit, Selayang Hospital, Selangor, Malaysia
- *Correspondence: Mohd Zaquan Arif Abd.Ghafar,
| | - Mark O’Donovan
- Department of Geriatric Medicine, Mercy University Hospital, Cork, Ireland
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - Duygu Sezgin
- School of Nursing and Midwifery, Aras Moyola, National University of Ireland Galway, Galway, Ireland
| | - Elizabeth Moloney
- Department of Geriatric Medicine, Mercy University Hospital, Cork, Ireland
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
| | - Ángel Rodríguez-Laso
- CIBERFES (Área temática de Fragilidad y Envejecimiento Saludable del Centros de Investigación Biomédica en Red), Instituto de Salud Carlos III, Madrid, Spain
| | - Aaron Liew
- Department of Endocrinology, National University of Ireland Galway, Galway, Ireland
| | - Rónán O’Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, Cork, Ireland
- Health Research Board Clinical Research Facility, University College Cork, Cork, Ireland
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Adherence to Medication in Older Adults with Type 2 Diabetes Living in Lubuskie Voivodeship in Poland: Association with Frailty Syndrome. J Clin Med 2022; 11:jcm11061707. [PMID: 35330032 PMCID: PMC8953376 DOI: 10.3390/jcm11061707] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/09/2022] [Accepted: 03/17/2022] [Indexed: 02/06/2023] Open
Abstract
Purpose: Diabetic patients aged 65 years or older are more likely to be frail than non-diabetic older adults. Adherence to therapeutic recommendations in the elderly suffering from diabetes and co-existent frailty syndrome may prevent complications such as micro- or macroangiopathy, as well as significantly affect prevention and reversibility of frailty. The study aimed at assessing the impact of frailty syndrome (FS) on the level of adherence to medication in elderly patients with type 2 diabetes (DM2). Patients and Methods: The research was carried out among 175 DM2 patients (87; 49.71% women and 88; 50.29% men) whose average age amounted to 70.25 ± 6.7. Standardized research instruments included Tilburg frailty indicator (TFI) to assess FS and adherence in chronic disease scale questionnaire (ACDS) to measure adherence to medications. Results: The group of 101 (57.71%) patients displayed medium, 39 (22.29%)—low, and 35 (20.00%)—high adherence. As many as 140 of them (80.00%) were diagnosed with frailty syndrome. The median of the average result of TFI was significantly higher in the low adherence group (p ˂ 0.001) (Mdn = 9, Q1–Q3; 7–10 pt.) than in the medium (Mdn = 6, Q1–Q3; 5–9 pt.) or high adherence (Mdn = 6.00, Q1–Q3; 4.5–8 pt.) ones. The independent predictors of the chance to be qualified to the non-adherence group included three indicators: TFI (OR 1.558, 95% CI 1.245–1.95), male gender (OR 2.954, 95% CI 1.044–8.353), and the number of all medications taken daily (each extra pill decreased the chance of being qualified to the non-adherence group by 15.3% (95% CI 0.728–0.954). Conclusion: Frailty syndrome in elderly DM2 patients influenced medical adherence in this group. The low adhesion group had higher overall TFI scores and separately higher scores in the physical and psychological domains compared to the medium and high adhesion groups.
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Focus on Nutritional Aspects of Sarcopenia in Diabetes: Current Evidence and Remarks for Future Research. Nutrients 2022; 14:nu14020312. [PMID: 35057493 PMCID: PMC8781815 DOI: 10.3390/nu14020312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 01/22/2023] Open
Abstract
Sarcopenia has been defined as a progressive and generalized loss of muscle mass that can be observed after the age of 40 years, with a rate of deterioration of about 8% every ten years up to 70 years, and 15-25% thereafter [...].
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Itelman E, Segev A, Ahmead L, Leibowitz E, Agbaria M, Avaky C, Negro L, Shenhav-Saltzman G, Wasserstrum Y, Segal G. Low ALT values amongst hospitalized patients are associated with increased risk of hypoglycemia and overall mortality: a retrospective, big-data analysis of 51 831 patients. QJM 2022; 114:843-847. [PMID: 32642782 DOI: 10.1093/qjmed/hcaa219] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/13/2020] [Accepted: 06/23/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Sarcopenia and frailty influence clinical patients' outcomes. Low alanine aminotransferase (ALT) serum activity is a surrogate marker for sarcopenia and frailty. In-hospital hypoglycemia is associated, also with worse clinical outcomes. AIM We evaluated the association between low ALT, risk of in-hospital hypoglycemia and subsequent mortality. DESIGN This was a retrospective cohort analysis. METHODS We included patients hospitalized in a tertiary hospital between 2007 and 2019. Patients' data were retrieved from their electronic medical records. RESULTS The cohort included 51 831 patients (average age 70.88). The rate of hypoglycemia was 10.8% (amongst diabetics 19.4% whereas in non-diabetics 8.3%). The rate of hypoglycemia was higher amongst patients with ALT < 10 IU/l in the whole cohort (14.3% vs. 10.4%, P < 0.001) as well as amongst diabetics (24.6% vs. 18.8%, P < 0.001). Both the overall and in-hospital mortality were higher in the low ALT group (57.7% vs. 39.1% P < 0.001 and 4.3% vs. 3.2%, P < 0.001). A propensity score matching, after which a regression model was performed, showed that patients with ALT levels < 10 IU/l had higher risk of overall mortality (HR = 1.21, CI 1.13-1.29, P < 0.001). CONCLUSIONS Low ALT values amongst hospitalized patients are associated with increased risk of in-hospital hypoglycemia and overall mortality.
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Affiliation(s)
- E Itelman
- From the Internal Medicine "T". Chaim Sheba Medical Center, Tel-Hashomer, 2 Sheba Road. Ramat-Gan 5262000, Israel
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Haim Levanon 55 st, Tel-Aviv 6997801, Israel
| | - A Segev
- From the Internal Medicine "T". Chaim Sheba Medical Center, Tel-Hashomer, 2 Sheba Road. Ramat-Gan 5262000, Israel
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Haim Levanon 55 st, Tel-Aviv 6997801, Israel
| | - L Ahmead
- From the Internal Medicine "T". Chaim Sheba Medical Center, Tel-Hashomer, 2 Sheba Road. Ramat-Gan 5262000, Israel
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Haim Levanon 55 st, Tel-Aviv 6997801, Israel
| | - E Leibowitz
- Department of Internal Medicine "A", Yoseftal Hospital, Yotam road, POB 600. Eilat 88104, Israel
| | - M Agbaria
- From the Internal Medicine "T". Chaim Sheba Medical Center, Tel-Hashomer, 2 Sheba Road. Ramat-Gan 5262000, Israel
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Haim Levanon 55 st, Tel-Aviv 6997801, Israel
| | - C Avaky
- From the Internal Medicine "T". Chaim Sheba Medical Center, Tel-Hashomer, 2 Sheba Road. Ramat-Gan 5262000, Israel
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Haim Levanon 55 st, Tel-Aviv 6997801, Israel
| | - L Negro
- From the Internal Medicine "T". Chaim Sheba Medical Center, Tel-Hashomer, 2 Sheba Road. Ramat-Gan 5262000, Israel
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Haim Levanon 55 st, Tel-Aviv 6997801, Israel
| | - G Shenhav-Saltzman
- From the Internal Medicine "T". Chaim Sheba Medical Center, Tel-Hashomer, 2 Sheba Road. Ramat-Gan 5262000, Israel
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Haim Levanon 55 st, Tel-Aviv 6997801, Israel
| | - Y Wasserstrum
- From the Internal Medicine "T". Chaim Sheba Medical Center, Tel-Hashomer, 2 Sheba Road. Ramat-Gan 5262000, Israel
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Haim Levanon 55 st, Tel-Aviv 6997801, Israel
| | - G Segal
- From the Internal Medicine "T". Chaim Sheba Medical Center, Tel-Hashomer, 2 Sheba Road. Ramat-Gan 5262000, Israel
- Sackler School of Medicine, Tel-Aviv University, Ramat-Aviv, Haim Levanon 55 st, Tel-Aviv 6997801, Israel
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Trends in the diabetes incidence and mortality in India from 1990 to 2019: a joinpoint and age-period-cohort analysis. J Diabetes Metab Disord 2021; 20:1725-1740. [PMID: 34900822 DOI: 10.1007/s40200-021-00834-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 06/12/2021] [Indexed: 10/20/2022]
Abstract
Introduction Globally, a metabolic disorder like Diabetes is considered as one of the largest global health issues, as it accounts for the majority of the disease burden and happens to be one of the leading causes of mortality as well as reduced life expectancy across the world. As in 2019, India is home to the second-largest number (77 million) of Diabetic adults and the number of people affected has been increasing rapidly over the years. Termed as "the diabetes capital of the world," with every fifth diabetic in the world being an Indian, there is an urgent need to address many critically significant challenges posed by Diabetes in India, like, increasing prevalence among young people in urban areas, less awareness among people, high cost of disease management, limited healthcare facilities, suboptimal diabetes control etc. In Indian context, not enough attempts have been made to observe and understand the long-term pattern of diabetes incidence and mortality. This study aims to provide deep insights into the recent trends of diabetes incidence and mortality in India from 1990 to 2019. Materials and methods This is an observational study based on the most recent data from the Global Burden of Disease (GBD) Study 2019. We extracted numbers, age-specific and age-standardized incidence and mortality rates of diabetes (from 1990 to 2019) from the Global Health Data Exchange. The average annual percentage changes in incidence and mortality were analysed by joinpoint regression analysis; the net age, period, and cohort effects on the incidence and mortality were estimated by age-period-cohort analysis. Results During the study period, age-standardized incidence and mortality rates of diabetes in India experienced an upsurge in numbers, the incidence rate increased from 199.14 to 317.02, and consequently, mortality increased from 22.30 to 27.35 per 100,000 population. The joinpoint regression analysis showed that the age-standardized incidence significantly rose by 1.63 % (95 % CI: 1.57 %, 1.69 %) in Indian males and 1.56 % in Indian females (95 % CI: 1.49 %, 1.63 %) from 1990 to 2019. On the other hand, the age-standardized mortality rates rose by 0.77 % (95 % CI: 0.24 %, 1.31 %) in Indian males and 0.57 % (95 % CI: -0.54 %, 1.70 %) in Indian females. For age-specific rates, incidence increased in most age groups, with exception of age groups 5-9, 70-74, 75-79 and 80-84 in male, and age groups 5-9, 75-79 and 80-84 in female. Mortality in male saw a decreasing trend till age group 20-24, whereas in female, the rate decreased till age group 35-39. The age effect on incidence showed no obvious changes with advancing age, but the mortality significantly increased with advancing age; period effect showed that both incidence and mortality increased with advancing time period; cohort effect on diabetes incidence and mortality decreased from earlier birth cohorts to more recent birth cohorts, while incidence showed no material changes from 1975 to 1979 to 2000-2004 birth cohort. Conclusions Mortality of diabetes decreased in younger age groups but increased in older age groups; however, Incidence increased in most age groups for both male and female. The net age or period effect showed an unfavourable trend while the net cohort effect presented a favourable trend. Aging was likely to drive a continued increase in the mortality of diabetes. Timely population-level interventions aiming for health education, lifestyle modification with special emphasis on the promotion of physical activity and healthy diet should be conducted, especially for male and earlier birth cohorts at high risk of diabetes.
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Parajuli S, Aziz F, Garg N, Wallschlaeger RE, Lorden HM, Al-Qaoud T, Mandelbrot DA, Odorico AJS. Frailty in Pancreas Transplantation. Transplantation 2021; 105:1685-1694. [PMID: 33606487 DOI: 10.1097/tp.0000000000003586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
There are a variety of definitions and criteria used in clinical practice to define frailty. In the absence of a gold-standard definition, frailty has been operationally defined as meeting 3 out of 5 phenotypic criteria indicating compromised function: low grip strength, low energy, slowed walking speed, low physical activity, and unintentional weight loss. Frailty is a common problem in solid organ transplant candidates who are in the process of being listed for a transplant, as well as after transplantation. Patients with diabetes or chronic kidney disease (CKD) are known to be at increased risk of being frail. As pancreas transplantation is exclusively performed among patients with diabetes and the majority of them also have CKD, pancreas transplant candidates and recipients are at high risk of being frail. Sarcopenia, fatigue, low walking speed, low physical activity, and unintentional weight loss, which are some of the phenotypes of frailty, are very prevalent in this population. In various solid organs, frail patients are less likely to be listed or transplanted and have high waitlist mortality. Even after a transplant, they have increased risk of prolonged hospitalization, readmission, and delayed graft function. Given the negative impact of frailty on solid organ transplants, we believe that frailty would have a similar or even worse impact on pancreas transplantation. Due to the paucity of data specifically among pancreas transplant recipients, here we include frailty data from patients with CKD, diabetes, and various solid organ transplant recipients.
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Affiliation(s)
- Sandesh Parajuli
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Fahad Aziz
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Neetika Garg
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Rebecca E Wallschlaeger
- Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Heather M Lorden
- Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Talal Al-Qaoud
- Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Didier A Mandelbrot
- Division of Nephrology, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - And Jon S Odorico
- Division of Transplantation, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Massimino E, Izzo A, Riccardi G, Della Pepa G. The Impact of Glucose-Lowering Drugs on Sarcopenia in Type 2 Diabetes: Current Evidence and Underlying Mechanisms. Cells 2021; 10:1958. [PMID: 34440727 PMCID: PMC8393336 DOI: 10.3390/cells10081958] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 07/25/2021] [Accepted: 07/29/2021] [Indexed: 12/19/2022] Open
Abstract
The age-related decrease in skeletal muscle mass together with the loss of muscle power and function is defined sarcopenia. Mounting evidence suggests that the prevalence of sarcopenia is higher in patients with type 2 diabetes mellitus (T2DM), and different mechanisms may be responsible for this association such as impaired insulin sensitivity, chronic hyperglycemia, advanced glycosylation end products, subclinical inflammation, microvascular and macrovascular complications. Glucose-lowering drugs prescribed for patients with T2DM might impact on these mechanisms leading to harmful or beneficial effect on skeletal muscle. Importantly, beyond their glucose-lowering effects, glucose-lowering drugs may affect per se the equilibrium between protein anabolism and catabolism through several mechanisms involved in skeletal muscle physiology, contributing to sarcopenia. The aim of this narrative review is to provide an update on the effects of glucose-lowering drugs on sarcopenia in individuals with T2DM, focusing on the parameters used to define sarcopenia: muscle strength (evaluated by handgrip strength), muscle quantity/quality (evaluated by appendicular lean mass or skeletal muscle mass and their indexes), and physical performance (evaluated by gait speed or short physical performance battery). Furthermore, we also describe the plausible mechanisms by which glucose-lowering drugs may impact on sarcopenia.
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Affiliation(s)
| | | | | | - Giuseppe Della Pepa
- Department of Clinical Medicine and Surgery, Federico II University, Via Sergio Pansini 5, 80131 Naples, Italy; (E.M.); (A.I.); (G.R.)
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Low prealbumin levels are associated with sarcopenia in older men with type 2 diabetes mellitus: A cross-sectional study. Nutrition 2021; 91-92:111415. [PMID: 34399401 DOI: 10.1016/j.nut.2021.111415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 06/20/2021] [Accepted: 06/28/2021] [Indexed: 01/04/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the association between the serum levels of prealbumin and sarcopenia in older adults with type 2 diabetes mellitus. METHODS This cross-sectional study included 582 older adults with type 2 diabetes mellitus. Sarcopenia was defined based on the recently updated Asian Working Group for Sarcopenia 2019 criteria. Appendicular skeletal muscle was measured by dual energy x-ray absorptiometry. Serum levels of prealbumin, hemoglobin, hemoglobin A1c, and 25-hydroxyvitamin D3 were also tested. Multivariate analyses were used to assess the association between prealbumin levels and sarcopenia, adjusted for potential confounders. RESULTS The overall prevalence of sarcopenia was 9%, of which 12% for men and 6% for women. Male participants with sarcopenia had lower prealbumin levels than those without sarcopenia (213 ± 72 versus 260 ± 56 mg/L, P < 0.001). The proportion of men with low prealbumin level (<170 mg/L) was significantly higher in individuals with sarcopenia than in those without (31% versus 6%, respectively). In a logistic regression model, after adjusting for all potential covariates, low prealbumin (odds ratio, 4.15; 95% confidence interval, 1.13-15.25; P = 0.03) was significantly associated with sarcopenia in men, but the relationship between prealbumin and sarcopenia was not found in women. CONCLUSION Low prealbumin levels were associated with an increased risk for sarcopenia in older men with T2DM.
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A Narrative Review on Sarcopenia in Type 2 Diabetes Mellitus: Prevalence and Associated Factors. Nutrients 2021; 13:nu13010183. [PMID: 33435310 PMCID: PMC7826709 DOI: 10.3390/nu13010183] [Citation(s) in RCA: 150] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/03/2021] [Accepted: 01/07/2021] [Indexed: 12/15/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) represents a major health burden for the elderly population, affecting approximately 25% of people over the age of 65 years. This percentage is expected to increase dramatically in the next decades in relation to the increased longevity of the population observed in recent years. Beyond microvascular and macrovascular complications, sarcopenia has been described as a new diabetes complication in the elderly population. Increasing attention has been paid by researchers and clinicians to this age-related condition—characterized by loss of skeletal muscle mass together with the loss of muscle power and function—in individuals with T2DM; this is due to the heavy impact that sarcopenia may have on physical and psychosocial health of diabetic patients, thus affecting their quality of life. The aim of this narrative review is to provide an update on: (1) the risk of sarcopenia in individuals with T2DM, and (2) its association with relevant features of patients with T2DM such as age, gender, body mass index, disease duration, glycemic control, presence of microvascular or macrovascular complications, nutritional status, and glucose-lowering drugs. From a clinical point of view, it is necessary to improve the ability of physicians and dietitians to recognize early sarcopenia and its risk factors in patients with T2DM in order to make appropriate therapeutic approaches able to prevent and treat this condition.
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Shih AC, Chen LH, Tsai CC, Chen JY. Correlation between Sleep Quality and Frailty Status among Middle-Aged and Older Taiwanese People: A Community-Based, Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249457. [PMID: 33348703 PMCID: PMC7766620 DOI: 10.3390/ijerph17249457] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/14/2020] [Accepted: 12/15/2020] [Indexed: 12/12/2022]
Abstract
Poor sleep quality and frailty are common problems among aged people. However, the association between sleep quality and frailty in middle-aged and older people is seldom discussed in Asia, especially in Taiwan. This study investigated this association hopefully to provide pertinent knowledge for the prevention of frailty. We conducted a cross-sectional study and enrolled 828 subjects, 237 male and 591 female, aged 50–85 years old, from a community in Northern Taiwan. Poor sleep quality was defined as the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) > 5. Prefrailty and frailty were defined as fulfillment of one or two and three, respectively, of five phenotypic criteria: exhaustion, weakness, slowness, weight loss, and low physical activity. Our univariate analysis showed that the incidence of prefrailty/frailty in the group of poor sleep quality was higher than that in the group of CPSQI ≤ 5 (p < 0.001). Further multiple logistic regression analysis revealed that poor sleep quality was an independent factor for prefrailty and frailty status (odds ratio = 1.95, 95% confidence interval = 1.38–2.77), after adjustment for confounding factors. We concluded that poor sleep quality is independently associated with prefrailty and frailty status in our study population.
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Affiliation(s)
- An-Chen Shih
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan;
| | - Lee-Hwa Chen
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan 333, Taiwan; (L.-H.C.); (C.-C.T.)
| | - Chin-Chueh Tsai
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan 333, Taiwan; (L.-H.C.); (C.-C.T.)
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou Branch, Taoyuan 333, Taiwan;
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Correspondence: ; Tel.: +886-975362672
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Cerletti P, Keidel D, Imboden M, Schindler C, Probst-Hensch N. The modifying role of physical activity in the cross-sectional and longitudinal association of health-related quality of life with physiological functioning-based latent classes and metabolic syndrome. Health Qual Life Outcomes 2020; 18:345. [PMID: 33081800 PMCID: PMC7574351 DOI: 10.1186/s12955-020-01557-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 09/09/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Single cardio-metabolic risk factors are each known modifiable risk factors for adverse health and quality of life outcomes. Yet, evidence on the clustered effect of these parameters and the metabolic syndrome (MetS) on health-related quality of life (HRQoL) is still limited and mostly cross-sectional. The objectives of this study were to identify clusters of cardio-metabolic physiological functioning, to assess their associations with HRQoL in comparison with the MetS, to elucidate the modifying role of physical activity, and to assess differences in health service utilization. METHODS This study is based on longitudinal data from two time points (2010/11 & 2017/18) of the Swiss Study on Air Pollution and Lung and Heart Diseases (SAPALDIA). Latent class analysis (LCA) grouped participants based on a priori selected cardio-metabolic and MetS related physiological functioning variables (Body mass index, body fat, glycated hemoglobin, blood triglycerides, blood pressure). The 36-item Short-Form Health Survey (SF-36) was used to assess HRQoL. Quantile regressions were performed with and without adjustment for physical activity, to detect independent associations of the latent classes, MetS and physical activity with HRQoL. To assess the modifying role of physical activity, we additionally grouped participants based on the combination of physical activity and latent classes or MetS, respectively. Logistic regressions were used to investigate health service utilization as outcome. RESULTS The LCA resulted in three classes labeled "Healthy" (30% of participants in 2017/18), "At risk" and "Unhealthy" (29%). The Unhealthy class scored lowest in all physical component scores of HRQoL. Compared to healthy and active participants, inactive participants in the "Unhealthy" class showed lower scores in the physical functioning domain both cross-sectionally (- 9.10 (- 12.02; - 6.18)) and longitudinally. This group had an odds ratio of 2.69 (1.52; 4.74) for being hospitalized in the previous 12 months. CONCLUSIONS These results point to subjects with adverse cardio-metabolic physiological functioning and low activity levels as an important target group for health promotion and maintenance of well-being. The promotion of physical activity at the early stages of aging seems pivotal to mitigate the impact of the MetS on HRQoL at higher age.
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Affiliation(s)
- Paco Cerletti
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, CH, Switzerland
- University of Basel, Petersplatz 1, 4001, Basel, CH, Switzerland
| | - Dirk Keidel
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, CH, Switzerland
- University of Basel, Petersplatz 1, 4001, Basel, CH, Switzerland
| | - Medea Imboden
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, CH, Switzerland
- University of Basel, Petersplatz 1, 4001, Basel, CH, Switzerland
| | - Christian Schindler
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, CH, Switzerland
- University of Basel, Petersplatz 1, 4001, Basel, CH, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Socinstrasse 57, 4051, Basel, CH, Switzerland.
- University of Basel, Petersplatz 1, 4001, Basel, CH, Switzerland.
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Inflammation, Frailty and Cardiovascular Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1216:55-64. [PMID: 31894547 DOI: 10.1007/978-3-030-33330-0_7] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chronic inflammation, which is called "inflamm-aging" , is characterized by an increased level of inflammatory cytokines in response to physiological and environmental stressors, and causes the immune system to function consistently at a low level, even though it is not effective. Possible causes of inflammaging include genetic susceptibility, visceral obesity, changes in gut microbiota and permeability, chronic infections and cellular senescence. Inflammation has a role in the development of many age-related diseases, such as frailty. Low grade chronic inflammation can also increase the risk of atherosclerosis and insulin resistance which are the leading mechanisms in the development of cardiovascular diseases (CVD). As it is well known that the risk of CVD is higher in older people with frailty and the risk of frailty is higher in patients with CVD, there may be relationship between inflammation and the development of CVD and frailty. Therefore, this important issue will be discussed in this chapter.
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García Díaz E, Alonso Ramírez J, Herrera Fernández N, Peinado Gallego C, Pérez Hernández DDG. Effect of strength exercise with elastic bands and aerobic exercise in the treatment of frailty of the elderly patient with type 2 diabetes mellitus. ENDOCRINOL DIAB NUTR 2019. [DOI: 10.1016/j.endien.2019.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Efecto del ejercicio de fuerza muscular mediante bandas elásticas combinado con ejercicio aeróbico en el tratamiento de la fragilidad del paciente anciano con diabetes mellitus tipo 2. ENDOCRINOL DIAB NUTR 2019; 66:563-570. [DOI: 10.1016/j.endinu.2019.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Revised: 01/16/2019] [Accepted: 01/20/2019] [Indexed: 02/07/2023]
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Lekan DA, McCoy TP. Frailty risk in hospitalised older adults with and without diabetes mellitus. J Clin Nurs 2018; 27:3510-3521. [DOI: 10.1111/jocn.14529] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2018] [Indexed: 12/21/2022]
Affiliation(s)
- Deborah A. Lekan
- School of Nursing; University of North Carolina at Greensboro; Greensboro North Carolina
| | - Thomas P. McCoy
- School of Nursing; University of North Carolina at Greensboro; Greensboro North Carolina
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Abstract
The rationale of diabetes related fatigue syndrome and interventions.
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Affiliation(s)
- Angela Shin-Yu Lien
- School of Nursing, College of Medicine, Chung-Gung University, Taoyuan, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital Linko Branch, Taoyuan, Taiwan
| | - Jawl-Shan Hwang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital Linko Branch, Taoyuan, Taiwan
| | - Yi-Der Jiang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
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Russo GT, Scavini M, Acmet E, Bonizzoni E, Bosi E, Giorgino F, Tiengo A, Cucinotta D. The Burden of Structured Self-Monitoring of Blood Glucose on Diabetes-Specific Quality of Life and Locus of Control in Patients with Noninsulin-Treated Type 2 Diabetes: The PRISMA Study. Diabetes Technol Ther 2016; 18:421-8. [PMID: 27327185 PMCID: PMC4931729 DOI: 10.1089/dia.2015.0358] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND To evaluate whether structured self-monitoring of blood glucose (SMBG) is associated with changes in diabetes-specific quality of life (DSQoL) and locus of control (LOC) in patients with noninsulin-treated type 2 diabetes (T2DM). STUDY DESIGN AND METHODS In this analysis of the PRISMA (Prospective Randomized Trial on Intensive SMBG Management Added Value in Noninsulin-Treated T2DM Patients) Study psychosocial data, we evaluated the impact of 12 months of structured SMBG on the individual domains of DSQoL and LOC questionnaires, including the role of selected confounders. RESULTS The score for Satisfaction, Impact, and Worry domains (DSQoL) improved when compared with baseline, without significant differences between structured SMBG regimen (intervention group, n = 501) and active control group (n = 523). Scores for Internal, Chance, and Powerful Others domains (LOC) improved compared with baseline, with a significant between-group change in Chance (P = 0.0309). For DSQoL domain score, improvements were associated with higher number of SMBG measurements (P = 0.007), older age (P = 0.013), and male sex (P = 0.0133) for Satisfaction and with male sex (P < 0.0001) for Worry. Concerning LOC domain score, improvements were associated with longer diabetes duration (P = 0.0084) and younger age (P < 0.0001) for Chance and total number of SMBG measurements (P = 0.0036) for Internal, with the intervention group close to being significant (P = 0.06). CONCLUSIONS Our analysis demonstrates that in patients with noninsulin-treated T2DM, structured SMBG is not associated with a deterioration of quality of life and LOC, which is strongly predicted by demographics and diabetes-related variables. These findings should be considered when tailoring educational support to SMBG for these patients.
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Affiliation(s)
- Giuseppina T. Russo
- Department of Clinical and Experimental Medicine, Policlinico Universitario Gaetano Martino, Messina, Italy
| | - Marina Scavini
- Diabetes Research Institute, San Raffaele Scientific Institute, Milan, Italy
| | - Elena Acmet
- Medical Affairs, Roche Diagnostics S.p.A., Monza, Italy
| | - Erminio Bonizzoni
- Section of Medical Statistics and Biometry G.A. Maccacaro, Department of Occupational Health Clinica del Lavoro L. Devoto, School of Medicine, University of Milan, Milan, Italy
| | - Emanuele Bosi
- Diabetes Research Institute, San Raffaele Scientific Institute, Milan, Italy
- San Raffaele Vita-Salute University, Milan, Italy
| | - Francesco Giorgino
- Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Emergency and Organ Transplantation, University of Bari School of Medicine, Bari, Italy
| | - Antonio Tiengo
- Division of Metabolic Diseases, Department of Clinical and Experimental Medicine, University of Padova, Padova, Italy
| | - Domenico Cucinotta
- Department of Clinical and Experimental Medicine, Policlinico Universitario Gaetano Martino, Messina, Italy
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Prenatal diagnosis of abdominal cystic hygroma. Prenat Diagn 1989; 16:ijerph16010158. [PMID: 30626127 PMCID: PMC6339039 DOI: 10.3390/ijerph16010158] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 12/27/2018] [Accepted: 12/28/2018] [Indexed: 12/20/2022]
Abstract
Background: The prevalence of diabetes mellitus is rapidly increasing in China, but the secular trends in incidence and mortality remain unknown. This study aims to examine time trends from 1990 to 2017 and the net age, period, and cohort effects on diabetes incidence and mortality. Methods: Incidence and mortality rates of diabetes (1990–2017) were collected for each 5-year age group (from 5–9 to 80–84 age group) stratified by gender from the Global Burden of Disease 2017 Study. The average annual percentage changes in incidence and mortality were analyzed by joinpoint regression analysis; the net age, period, and cohort effects on the incidence and mortality were estimated by age-period-cohort analysis. Results: The joinpoint regression analysis showed that age-standardized incidence significantly rose by 0.92% (95% CI: 0.6%, 1.3%) in men and 0.69% in women (95% CI: 0.3%, 1.0%) from 1990 to 2017; age-standardized mortality rates rose by 0.78% (95% CI: 0.6%, 1.0%) in men and decreased by 0.12% (95% CI: −0.4%, 0.1%) in women. For age-specific rates, incidence increased in most age groups, with exception of 30–34, 60–64, 65–69 and 70–74 age groups in men and 25–29, 30–34, 35–39 and 70–74 age groups in women; mortality in men decreased in the younger age groups (from 20–24 to 45–49 age group) while increased in the older age groups (from 50–54 to 80–84 age group), and mortality in women decreased for all age groups with exception of the age group 75–79 and 80–84. The age effect on incidence showed no obvious changes with advancing age while mortality significantly increased with advancing age; period effect showed that both incidence and mortality increased with advancing time period while the period trend on incidence began to decrease since 2007; cohort effect on incidence and mortality decreased from earlier birth cohorts to more recent birth cohorts while incidence showed no material changes from 1982–1986 to 2012–2016 birth cohort. Conclusions: Mortality decreased in younger age groups but increased in older age groups. Incidence increased in most age groups. The net age or period effect showed an unfavorable trend while the net cohort effect presented a favorable trend. Aging likely drives a continued increase in the mortality of diabetes. Timely population-level interventions aiming for obesity prevention, healthy diet and regular physical activity should be conducted, especially for men and earlier birth cohorts at high risk of diabetes.
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