scholarly journals Type 2 diabetes in older patients: an analysis of the DPV and DIVE databases

2020 ◽  
Vol 11 ◽  
pp. 204201882095829
Author(s):  
Gesine van Mark ◽  
Sascha R. Tittel ◽  
Stefan Sziegoleit ◽  
Franz Josef Putz ◽  
Mesut Durmaz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Older Patients ◽  
Microvascular Complications ◽  
Oldest Old ◽  
Age Groups ◽  
Young Patients ◽  
Severe Hypoglycemia ◽  
Old Patients

Background: The clinical profile differs between old and young patients with type 2 diabetes mellitus (T2DM). We explored, based on a large real-world database, patient and disease characteristics and actual treatment patterns by age. Methods: The analysis was based on the DIVE and DPV registries of patients with T2DM. Patients were analyzed by age groups 50–59 (middle-young), 60–69 (young-old), 70–79 (middle-old), 80–89 (old), and 90 years or more (oldest-old). Results: A total of 396,719 patients were analyzed, of which 17.7% were 50–59 years, 27.7% 60–69 years, 34.3% 70–79 years, 18.3% 80–89 years and 2.0% at least 90 years. We found that (a) T2DM in old and oldest-old patients was characterized much less by the presence of metabolic risk factors such as hypertension, obesity, dyslipidemia and smoking than in younger patients; (b) the HbA1c was much lower in oldest-old than in middle-young patients (7.2 ± 1.6% versus 8.0 ± 2.2%; p < 0.001), but it was associated with higher proportions of patients with severe hypoglycemia (7.0 versus 1.6%; p < 0.001); (c) this was potentially associated with the higher and increasing rates of insulin use in older patients (from 17.6% to 37.6%, p < 0.001) and the particular comorbidity profile of these patients, for example, chronic kidney disease (CKD); (d) patients with late diabetes onset had lower HbA1c values, lower bodyweight and less cardiovascular risk factors; (e) patients with a longer diabetes duration had a considerable increase in macrovascular and even more microvascular complications. Conclusion: In very old patients there is a need for frequent careful routine assessment and a tailored pharmacotherapy in which patient safety is much more important than blood-glucose-lowering efficacy.

Medical service demands of older patients in different age groups in a new model of free Telemedicine

2020 ◽  
Author(s):  
Yu Gong ◽  
Jianyuan Zhou
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Coronary Heart Disease ◽  
Type 2 Diabetes Mellitus ◽  
Heart Disease ◽  
Older Patients ◽  
Medical Service ◽  
Age Groups ◽  
New Model

Abstract Background Medical service for the older patients is a worldwide challenge for public health system. Telemedicine can provide convenient and effective medical service for older patients. But the existing telemedicine models rely upon a direct communication between a doctor and a patient via the Internet but the doctor would be unable to give the patient a direct physical examination, it may lead to diagnostic errors. A new model of telemedicine jointly performed by general practitioners in community health centers and specialists in a university teaching hospital has been established. It is supervised by the government health department and is free for older patients. However, medical service demands of older patients in different age groups applying the new telemedicine are not well characterized. This study is to analyze medical service demands of older patients in different age groups applying the new telemedicine. Methods 472 older patients (aged ≥ 60) were enrolled and were divided into the young older group (aged 60 to 74), the old older group (aged 75 to 89) and the very old group (aged ≥ 90) according to the age stratification for older people defined by World Health Organization. Proportion of the top 10 diseases of older patients of different age groups was analyzed. Results Coronary heart disease and type 2 diabetes mellitus were identified as the top two diseases in the older patients and the young older patients as well as the old older patients applying the new telemedicine. Conclusions The new telemedicine model can provide effective free medical services to older patients. Different medical service demands were identified in different age groups of older patients. Coronary heart disease and type 2 diabetes mellitus were the main diseases of the older patients and young older patients as well as the old older patients applying the new telemedicine. Results of this study will provide basis for the health administrative departments to formulate health policies for older patients. Familiar with the main diseases in different age groups of older patients may provide better medical services to older patients.

The world pandemic of diabetes

2011 ◽  
pp. 1795-1799
Author(s):  
Nigel Unwin
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Geographical Area ◽  
Age Groups ◽  
The World ◽  
Level Of Economic Development ◽  
Increasing Trends

A pandemic refers to a disease that is rapidly increasing in frequency across many populations, over a wide geographical area (1). Put another way, it refers to the situation in which epidemics of the disease are occurring simultaneously in many countries. This is the case for diabetes, which has the dubious distinction of being one of the few chronic non-communicable diseases known to be increasing in all countries from which data are available, irrespective of the level of economic development (2). This is mirrored by a pandemic of people who are overweight or obese (3), the major risk factors for type 2 diabetes. This chapter focuses on diabetes in adults (aged 20 years old and above), of which 85% to more than 95%, depending on the population, have type 2 diabetes (2, 4), which is thus the main contributor to the growing burden of diabetes. However, it is worth noting that, in children (<15 years old), the incidence of type 1 diabetes is also increasing, particularly in the youngest age groups, across the vast majority of countries from which good data are available (5). The reasons for this increase are unclear, although various environmental risk factors have been implicated (5). This chapter aims to do the following: ◆ provide an overview of the prevalence and trends in diabetes in adults across the world and its contribution to mortality ◆ describe the broad determinants that underlie the increasing trends in diabetes in adults ◆ provide an introduction to variations by ethnicity in the prevalence of type 2 diabetes

Microvascular Complications of Type 2 Diabetes Mellitus

2020 ◽  
Vol 18 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Charles Faselis ◽  
Alexandra Katsimardou ◽  
Konstantinos Imprialos ◽  
Pavlos Deligkaris ◽  
Manolis Kallistratos ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Sexual Dysfunction ◽  
Microvascular Complications ◽  
Diagnostic Methods ◽  
Laboratory Evaluation

Background: Type 2 diabetes mellitus (T2DM) is a chronic, non communicable, multisystem disease that has reached epidemic proportions. Chronic exposure to hyperglycaemia affects the microvasculature, eventually leading to diabetic nephropathy, retinopathy and neuropathy with high impact on the quality of life and overall life expectancy. Sexual dysfunction is an often-overlooked microvascular complication of T2DM, with a complex pathogenesis originating from endothelial dysfunction. Objective: The purpose of this review is to present current definitions, epidemiological data and risk factors for diabetic retinopathy, nephropathy, neuropathy and sexual dysfunction. We also describe the clinical and laboratory evaluation that is mandatory for the diagnosis of these conditions. Method: A comprehensive review of the literature was performed to identify data from clinical studies for the prevalence, risk factors and diagnostic methods of microvascular complications of T2DM. Results: Diabetic nephropathy and retinopathy affect approximately 25% of patients with T2DM; diabetic neuropathy is encountered in almost 50% of the diabetic population, while the prevalence of erectile dysfunction ranges from 35-90% in diabetic men. The duration of T2DM along with glycemic, blood pressure and lipid control are common risk factors for the development of these complications. Criteria for the diagnosis of these conditions are well established, but exclusion of other causes is mandatory. Conclusion: Early detection of microvascular complications associated with T2DM is important, as early intervention leads to better outcomes. However, this requires awareness of their definition, prevalence and diagnostic modalities.

Risk Factors for Microvascular Complications of Diabetes Among South Indian Subjects with Type 2 Diabetes—The Chennai Urban Rural Epidemiology Study (CURES) Eye Study-5

2010 ◽  
Vol 12 (10) ◽  
pp. 755-761 ◽  
Author(s):  
Rajendra Pradeepa ◽  
Ranjit Mohan Anjana ◽  
Ranjit Unnikrishnan ◽  
Anbazaghan Ganesan ◽  
Vishwanathan Mohan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Microvascular Complications ◽  
Epidemiology Study ◽  
Complications Of Diabetes ◽  
South Indian ◽  
Urban Rural

Frequency and risk factors of severe hypoglycemia in insulin-treated type 2 diabetes: a literature survey

2006 ◽  
Vol 20 (6) ◽  
pp. 402-408 ◽  
Author(s):  
Kamran Akram ◽  
Ulrik Pedersen-Bjergaard ◽  
Knut Borch-Johnsen ◽  
Birger Thorsteinsson
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Severe Hypoglycemia ◽  
Literature Survey

Sex-specific differences in glycemic control and cardiovascular risk factors in older patients with insulin-treated type 2 diabetes mellitus

2010 ◽  
Vol 7 (6) ◽  
pp. 593-599 ◽  
Author(s):  
Christian S. Göbl ◽  
Werner Brannath ◽  
Latife Bozkurt ◽  
Ammon Handisurya ◽  
Christian Anderwald ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiovascular Risk ◽  
Glycemic Control ◽  
Cardiovascular Risk Factors ◽  
Older Patients

Microvascular complications and their associated risk factors in type 2 diabetes mellitus

2017 ◽  
Vol 11 ◽  
pp. S577-S581 ◽  
Author(s):  
Parvin Akter Khanam ◽  
Sayama Hoque ◽  
Tanjima Begum ◽  
Samira Humaira Habib ◽  
Zafar Ahmed Latif
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Microvascular Complications ◽  
Associated Risk Factors

scholarly journals Cardiovascular Autonomic Neuropathy in Context of Other Complications of Type 2 Diabetes Mellitus

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Anca Moţăţăianu ◽  
Rodica Bălaşa ◽  
Septimiu Voidăzan ◽  
Zoltán Bajkó
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Peripheral Neuropathy ◽  
Autonomic Neuropathy ◽  
Microvascular Complications ◽  
Demographic Data ◽  
Macrovascular Complications ◽  
Cardiac Autonomic Neuropathy ◽  
Group A

The aim of this study was to investigate the relationship between cardiac autonomic neuropathy (CAN) and other micro- and macrovascular complications and risk factors for type 2 diabetes. We included, in this study, 149 patients with type 2 diabetes. We evaluated their cardiovascular risk factors, demographic data, and any major micro- and macrovascular complications of their diabetes. Assessments of CAN were based upon Ewing’s battery.Results. CAN was present in 38.9% of patients. In the CAN group, the duration of diabetes, BMI, systolic blood pressure, lipid levels, and HBA1c were all significantly higher than those in the other group. A significant association was found between CAN and retinopathy, peripheral neuropathy, ABI, and IMT. Multivariate logistic regression demonstrated that, in type 2 diabetes, the odds of CAN (OR (95% confidence intervals)) increase with the age of the patients (1.68 (1,4129–2.0025)), the average diabetes duration (0.57 (0.47–0.67)), cholesterol (1.009 (1.00-1.01)), HbA1c levels (1.88 (1.31–2.72)), peripheral neuropathy (15.47 (5.16–46.38)), BMI (1.12 (1.05–1.21)), and smoking (2.21 (1.08–4.53)).Conclusions. This study shows that CAN in type 2 diabetes is significantly associated with other macro- and microvascular complications and that there are important modifiable risk factors for its development.

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