scholarly journals Nutritional Predictors of Mortality after Discharge in Older Patients with type 2 Diabetes

2020 ◽  
Author(s):  
Mileni Vanti Beretta ◽  
Camila Nery da Silva ◽  
Juliane Viero Feldman ◽  
Ticiana da Costa Rodrigues
Keyword(s):  
Type 2 Diabetes ◽  
Older Patients ◽  
Muscle Thickness ◽  
Mortality Data ◽  
Calf Circumference ◽  
Post Discharge ◽  
Adductor Pollicis Muscle ◽  
Predictors Of Mortality

Abstract Background: Older patient with type 2 diabetes (T2D) and malnutrition have a greater chance of negative events during hospitalization and a higher risk of mortality. The aim of this study was to investigate nutritional markers as mortality predictors following discharge hospitalized older patients with T2D. Methods: This is a prospective cohort study with follow-up of four years. All patients were subjected to Mini Assessment Nutrition, Subjective Global Assessment, calf circumference, arm circumference and adductor pollicis muscle thickness, obtained all within 48 h of admission. Mortality data were verified by medical registry and analyzed using Cox-proportional hazard models and survival curves. Results: 311 patients were included; the mean age was 71.35 years. There were 113 (36.3 %) deaths in the follow-up period. Nutritional status evaluated according to BMI identified 54.5% (n = 168) were overweight, for other hand the MAN identified 45.7% of patients were at risk of malnutrition and 37.7% malnutrition and the SGA identify 61.7% (n = 192) presented normal nutrition in admission. Malnutrition patients (OR=2.02), with low calf circumference (OR=1.43) or with APMT less than 5th percentile (2.33) were associated with post-discharge mortality. Conclusion: Malnutrition, reduced calf circumference and reduced APMT were nutritional predictors of mortality after hospital discharge in older patients with diabetes

scholarly journals Muscle strength, an independent determinant of glycemic control in older adults with long-standing type 2 diabetes: a prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo Kyung Koo ◽  
Seoil Moon ◽  
Min Kyong Moon
Keyword(s):  
Insulin Resistance ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Glycemic Control ◽  
Muscle Mass ◽  
Older Patients ◽  
Primary Outcome ◽  
Muscle Quality

Abstract Background Although the proportion of older patients with type 2 diabetes mellitus (T2DM) has increased, few studies have reported the factors affecting glucose levels in older patients with long-standing T2DM. This study assessed the determinants of glycemic control in older adults with T2DM of a duration of ≥10 years, including muscle mass, muscle quality, and β-cell function. Methods This was a prospective study of older patients aged ≥60 years with a T2DM duration of ≥10 years. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index, handgrip strength (HGS), and body composition through bioelectrical impedance analysis were assessed. The primary outcome was a composite of: (i) increment of glycated hemoglobin (HbA1c) from the baseline ≥0.6% and (ii) HbA1c ≥ 9% at any time point during the follow-up period. To find the predicting determinants of the outcome, we performed the Cox proportional hazard analysis. Results Among 100 patients (mean age, 64.0 ± 8.6 years; median duration of diabetes, 20 [interquartile range (IQR), 17–23] years; median HbA1c at baseline, 7.1 [IQR, 6.7–7.4] %), the primary outcome was observed in 40 (40.0%) patients during 4.0 (IQR 2.3–5.0) years of follow-up. A Cox proportional hazards model adjusted for age, sex, baseline HbA1c, obesity, duration of DM and anti-diabetic medication at baseline showed that low HGS and insulin resistance at the baseline were independent determinants of the primary outcome (hazard ratio [HR] = 2.23 [95% confidence interval (CI), 1.06–4.72] and 2.39 [95% CI, 1.18–4.83], respectively). Sex stratification confirmed that HGS and muscle mass were independent determinants of the primary outcome only in women (HR per quartile, 0.58 [95% CI, 0.37–0.93] and 0.46 [95% CI, 0.25–0.85], respectively). `. Conclusions Low HGS and insulin resistance were independent risk factors for aggravated glycemic control among older patients with long standing T2DM.

scholarly journals Inappropriate intensification of glucose-lowering treatment in older patients with type 2 diabetes: the global DISCOVER study

2021 ◽  
Vol 9 (1) ◽  
pp. e001585
Author(s):  
Brenda Bongaerts ◽  
Suzanne V Arnold ◽  
Bernard H Charbonnel ◽  
Hungta Chen ◽  
Andrew Cooper ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
High Risk ◽  
Older Patients ◽  
Intensive Treatment ◽  
Middle Income ◽  
Glucose Lowering ◽  
Factors Associated ◽  
Middle Income Countries

IntroductionAlthough individualized target glycated hemoglobin (HbA1c) levels are recommended in older people with type 2 diabetes, studies report high levels of potential overtreatment. We aimed to investigate the proportion of older patients (aged ≥65 years) who potentially received an inappropriately intensive treatment (HbA1c level <7.0% (53.0 mmol/mol)) in a global study. Factors associated with intensive glycemic management and using glucose-lowering medications associated with a high risk of hypoglycemia (high-risk medications (insulin, sulfonylureas, and meglitinides)) were also assessed.Research design and methodsDISCOVER is a 3-year observational study program of 15 992 people with type 2 diabetes initiating second-line glucose-lowering therapy in 38 countries. Data were collected at baseline (initiation of second-line therapy) and at 6, 12, and 24 months. Factors associated with an inappropriately intensive treatment or using high-risk medications were assessed using a hierarchical regression model.ResultsOf the 3344 older patients with baseline HbA1c data in our analytic cohort, 23.5% received inappropriate treatment intensification. Among those who had follow-up HbA1c data, 55.2%, 54.2%, and 53.5% were inappropriately tightly controlled at 6, 12, and 24 months, respectively, with higher proportions in high-income than in middle-income countries. The proportion of patients receiving high-risk medications was higher in middle-income countries than in high-income countries. Gross national income (per US$5000 increment) was associated with increased odds of inappropriately intensive treatment but with decreased odds of receiving high-risk medications.ConclusionsA large proportion of older DISCOVER patients received an inappropriately intensive glucose-lowering treatment across the 2 years of follow-up, with substantial regional variation. The use of high-risk medications in these patients is particularly concerning.

scholarly journals Effect of COVID-19 Pandemic on the Change in Skeletal Muscle Mass in Older Patients with Type 2 Diabetes: A Retrospective Cohort Study

2021 ◽  
Vol 18 (8) ◽  
pp. 4188
Author(s):  
Yuka Hasegawa ◽  
Fuyuko Takahashi ◽  
Yoshitaka Hashimoto ◽  
Chihiro Munekawa ◽  
Yukako Hosomi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Skeletal Muscle ◽  
Cohort Study ◽  
Muscle Mass ◽  
Retrospective Cohort Study ◽  
Older Patients ◽  
Retrospective Cohort ◽  
Skeletal Muscle Mass

Background: The aim of this study was to investigate the effect of the coronavirus disease (COVID-19) pandemic restrictions on the change in muscle mass in older patients with type 2 diabetes (T2D), who were not infected with COVID-19. Methods: In this retrospective cohort study, data were obtained from outpatients who underwent bioelectrical impedance analysis at least twice before April 2020 and at least once thereafter. Skeletal muscle mass index (SMI, kg/m2) was calculated as appendicular muscle mass (kg) divided by height squared (m2). Change in SMI (kg/m2/year) was calculated as (follow-up SMI—baseline SMI/follow-up period). The differences between the changes in SMI before and after the start of the COVID-19 pandemic were evaluated using paired t test. Results: This study recruited 56 patients, with a mean (SD) age of 75.2 (7.1) years. SMI changed from 6.7 (0.9) to 6.8 (0.9) kg/m2 before the COVID-19 pandemic, whereas SMI changed from 6.8 (0.9) to 6.6 (0.9) kg/m2 after the start of the COVID-19 pandemic. SMI decreased after the start of the COVID-19 pandemic compared with before the pandemic (−0.117 (0.240) vs. 0.005 (0.289) kg/m2/year, p = 0.049). This decrease was observed in men (−0.159 (0.257) vs. 0.031 (0.325) kg/m2/year, p = 0.038), patients with poor glycemic control (−0.170 (0.264) vs. 0.031 (0.285) kg/m2/year, p = 0.042), and those with a long diabetes duration (−0.153 (0.229) vs. 0.082 (0.291) kg/m2, p = 0.049). Conclusions: The COVID-19 pandemic restrictions caused muscle mass loss in older patents with T2D. Actions, including recommendation of exercise and adequate diet intake, are needed to prevent loss of muscle mass.

Predictors of mortality in patients with type 2 diabetes with or without diabetic nephropathy: a follow-up study

2007 ◽  
Vol 25 (12) ◽  
pp. 2479-2485 ◽  
Author(s):  
Anne Sofie Astrup ◽  
Flemming S Nielsen ◽  
Peter Rossing ◽  
Samir Ali ◽  
Jens Kastrup ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Nephropathy ◽  
Predictors Of Mortality ◽  
Follow Up Study

scholarly journals Predictors of mortality of patients newly diagnosed with clinical type 2 diabetes: a 5-year follow up study

2010 ◽  
Vol 10 (1) ◽  
Author(s):  
Niels de Fine Olivarius ◽  
Volkert Siersma ◽  
Anni BS Nielsen ◽  
Lars J Hansen ◽  
Lotte Rosenvinge ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Newly Diagnosed ◽  
Predictors Of Mortality ◽  
Follow Up Study ◽  
Clinical Type

Vitamin D Supplementation and Serum Levels of Magne-sium and Selenium in Type 2 Diabetes Mellitus Patients: Gender Dimorphic Changes

2014 ◽  
Vol 84 (1-2) ◽  
pp. 27-34 ◽  
Author(s):  
Nasser M. Al-Daghri ◽  
Khalid M. Alkharfy ◽  
Nasiruddin Khan ◽  
Hanan A. Alfawaz ◽  
Abdulrahman S. Al-Ajlan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Vitamin D ◽  
Type 2 Diabetes Mellitus ◽  
Serum Levels ◽  
Vitamin D Supplementation ◽  
Serum Selenium ◽  
Dependent Manner

The aim of our study was to evaluate the effects of vitamin D supplementation on circulating levels of magnesium and selenium in patients with type 2 diabetes mellitus (T2DM). A total of 126 adult Saudi patients (55 men and 71 women, mean age 53.6 ± 10.7 years) with controlled T2DM were randomly recruited for the study. All subjects were given vitamin D3 tablets (2000 IU/day) for six months. Follow-up mean concentrations of serum 25-hydroxyvitamin D [25-(OH) vitamin D] significantly increased in both men (34.1 ± 12.4 to 57.8 ± 17.0 nmol/L) and women (35.7 ± 13.5 to 60.1 ± 18.5 nmol/L, p < 0.001), while levels of parathyroid hormone (PTH) decreased significantly in both men (1.6 ± 0.17 to 0.96 ± 0.10 pmol/L, p = 0.003) and women (1.6 ± 0.17 to 1.0 ± 0.14 pmol/L, p = 0.02). In addition, there was a significant increase in serum levels of selenium and magnesium in men and women (p-values < 0.001 and 0.04, respectively) after follow-up. In women, a significant correlation was observed between delta change (variables at six months-variable at baseline) of serum magnesium versus high-density lipoprotein (HDL)-cholesterol (r = 0.36, p = 0.006) and fasting glucose (r = - 0.33, p = 0.01). In men, there was a significant correlation between serum selenium and triglycerides (r = 0.32, p = 0.04). Vitamin D supplementation improves serum concentrations of magnesium and selenium in a gender-dependent manner, which in turn could affect several cardiometabolic parameters such as glucose and lipids.

Hormonal factors and type 2 diabetes risk in women: a 22 year follow-up study on more than 83 000 women from the E3N cohort study

2019 ◽  
Author(s):  
Sopio Tatulashvili ◽  
Gaelle Gusto ◽  
Beverley Balkau ◽  
Emmanuel Cosson ◽  
Fabrice Bonnet ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Diabetes Risk ◽  
Hormonal Factors ◽  
Follow Up Study
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