How to Manage Diabetes Mellitus in Older Persons in the 21st Century: Applying These Principles to Long Term Diabetes Care

Abstract Background Treatment of diabetes mellitus has majorly improved over the past century, however, the disease burden is high and its prevalence still expanding. Further insight in the diabetes population is imperative to improve the quality of diabetes care by enhancement of knowledge-based diabetes management strategies. To this end, in 2017 a Dutch nationwide consortium of diabetologists, paediatric endocrinologists, and diabetes patients has founded a national outpatient diabetes care registry named Dutch Pediatric and Adult Registry of Diabetes (DPARD). We aim to describe the implementation of DPARD and to provide an overview of the characteristics of patients included during the first 2 years. Methods For the DPARD cohort with long-term follow-up of observational nature, hospital data are gathered directly from electronic health records and securely transferred and stored. DPARD provides weekly updated clinical information on the diabetes population care on a hospital-level benchmarked against the national average. Results Between November 2017 and January 2020, 20,857 patients were included from 8 (11%) Dutch hospitals with a level of care distribution representative of all diabetic outpatients in the Netherlands. Among patients with known diabetes type, 41% had type 1 diabetes, 51% type 2 diabetes, and 8% had diabetes due to other causes. Characteristics of the total patient population were similar to patients with unknown diabetes classification. HbA1c levels decreased over the years, while BMI levels showed an increase over time. Conclusions The national DPARD registry aims to facilitate investigation of prevalence and long-term outcomes of Dutch outpatients with diabetes mellitus and their treatment, thus allowing for quality improvement of diabetes care as well as allowing for comparison of diabetes care on an international level.

Download Full-text

Covid- 19 and Diabetes Mellitus; An Overview

International Journal of Pharmaceutical Sciences Review and Research ◽

10.47583/ijpsrr.2021.v69i01.010 ◽

2021 ◽

Vol 69 (1) ◽

Author(s):

Dr Reshna V

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Diabetes Care ◽

The Body ◽

Diabetic Patients ◽

Good Glycemic Control ◽

Best Management ◽

Increased Risk ◽

Seriously Ill

Diabetes Mellitus (DM) is a long-term metabolic disorder that affects many organs in the body. Diabetes may be linked to a serious type of Coronavirus Disease in 2019 (COVID-19). COVID-19 will make people with diabetes three times more likely to become seriously ill or die. They discovered that advanced age, obesity, and other medical conditions linked to diabetes are also associated with increased risk. In the countries hardest hit by the pandemic, increased morbidity and mortality from COVID-19 in diabetic patients have been observed, and this link, as well as the best management of infected diabetic patients, deserve further investigation. Antidiabetic medications that can minimise inflammation while maintaining good glycemic control are ideal. Patients admitted to the hospital with extreme COVID-19 can need changes to their diabetes care, such as stopping current medications and starting insulin therapy.

Download Full-text

Abstract #710: Long Term Outcomes of Bariatric Surgery on Bone Density in Patients with Type 2 Diabetes Mellitus

Endocrine Practice ◽

10.1016/s1530-891x(20)45119-5 ◽

2016 ◽

Vol 22 ◽

pp. 151

Author(s):

Megan Crawford ◽

James Bena ◽

Philip Schauer ◽

Sangeeta Kashyap

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Bariatric Surgery ◽

Type 2 Diabetes Mellitus ◽

Bone Density ◽

Long Term Outcomes

Download Full-text

Surgical reconstruction for unilateral iliac artery lesions in patients younger than 50 years

VASA ◽

10.1024/0301-1526/a000151 ◽

2011 ◽

Vol 40 (6) ◽

pp. 474-481 ◽

Cited By ~ 1

Author(s):

Radak ◽

Babic ◽

Ilijevski ◽

Jocic ◽

Aleksic ◽

...

Keyword(s):

Diabetes Mellitus ◽

Limb Salvage ◽

Iliac Artery ◽

Graft Patency ◽

Long Term Results ◽

Surgical Reconstruction ◽

Safe Procedure ◽

Term Survival

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.

Download Full-text

P3267 Impact of diabetes mellitus prior to heart transplantation on long-term survival

European Heart Journal ◽

10.1016/s0195-668x(03)95893-3 ◽

2003 ◽

Vol 24 (5) ◽

pp. 618

Author(s):

R VAZQUEZ

Keyword(s):

Diabetes Mellitus ◽

Heart Transplantation ◽

Term Survival ◽

Long Term Survival

Download Full-text

Evaluation of serum triglyceride levels as a marker of long-term patient compliance in diabetes mellitus type

Diabetologie und Stoffwechsel ◽

10.1055/s-0031-1277369 ◽

2011 ◽

Vol 6 (S 01) ◽

Author(s):

A Stylianou ◽

G Lavranos ◽

A Hatziyianni ◽

P Georgiou ◽

G Olymbios

Keyword(s):

Diabetes Mellitus ◽

Patient Compliance ◽

Serum Triglyceride ◽

Diabetes Mellitus Type

Download Full-text

Short and long-term glycemic variability associated with severe hypoglycemia and retinopathy in type 1 diabetes mellitus

Endocrine Abstracts ◽

10.1530/endoabs.70.aep520 ◽

2020 ◽

Author(s):

Martín Borja Sanz ◽

Gimeno Sergio Roman ◽

Peteiro Miranda Carlos Miguel ◽

Ortez Toro Jose Jorge ◽

Ana Agudo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Severe Hypoglycemia ◽

Glycemic Variability ◽

Short And Long Term

Download Full-text

Hospital and long-term prognosis of patients with non-ST-segment elevation myocardial infarction

Orvosi Hetilap ◽

10.1556/oh.2008.28404 ◽

2008 ◽

Vol 149 (45) ◽

pp. 2115-2119 ◽

Cited By ~ 2

Author(s):

András Jánosi ◽

Dániel Várnai ◽

Zsófia Ádám ◽

Adrienn Surman ◽

Katalin Vas

Keyword(s):

Diabetes Mellitus ◽

Myocardial Infarction ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Long Term Prognosis

A szerzők 139, nem ST-elevációs infarktus miatt kezelt betegük adatait elemzik. Vizsgálják a betegek kórházi és késői prognózisát, egyes echokardiográfiás adatok prognózissal való összefüggését, valamint a kórházból elbocsátott betegek esetén a szekunder prevenció szempontjából ajánlott gyógyszeres kezelés gyakoriságát. Az utánkövetés a betegek 98%-ában sikeres volt, a bekövetkezett eseményekről, illetve az utánkövetés idején alkalmazott gyógyszeres kezelésről postai kérdőív útján szereztek adatokat. A nők átlagéletkora 78,6, a férfiaké 71,4 év volt. A kezelt betegeknél gyakori volt a társbetegségek (hypertonia, diabetes mellitus, korábbi ischaemiás szívbetegség) előfordulása. A kórházi kezelés időszakában 30 betegnél (22%) történt koronarográfia, és 29 betegnél revascularisatiós beavatkozásra is sor került. A kórházi halálozás 15% volt, az utánkövetés háromnegyed éve alatt 17%-os halálozást észleltek. A kórházban, illetve az utánkövetési idő alatt meghalt betegek szignifikánsan idősebbek voltak azoknál, akik életben maradtak. Egyes echokardiográfiás adatok (ejekciós frakció, végszisztolés átmérő, szegmentális falmozgászavar és a mitralis insufficientia nagysága) prognosztikus jelentőségűnek bizonyultak, mivel szignifikánsan különböztek az életben maradt és a meghalt betegek esetén. A kórházból elbocsátott betegek igen magas arányban részesültek a másodlagos prevenció szempontjából fontosnak ítélt gyógyszeres kezelésben (aszpirin, béta-blokkoló, ACE-gátló, statin). Az utánkövetés idején sem csökkent ezen gyógyszerek használatának aránya, ami a betegek jó compliance-ét igazolja.

Download Full-text