Effects of Propionyl-Carnitine in Patients with Type 2 Diabetes and Peripheral Vascular Disease

Abstract Background Diabetes-related preventable hospitalizations (DRPHs) are indicators of primary care effective services. The aim of this study is to compute the trends of DRPHs, and to assess the risk factors for increased in-hospital length of stay (LOS) and costs in an Italian region. Methods DRPHs were computed following the AHRQ definitions, which include four types: short-term complications (PQI-1), long-term complications (PQI-3), uncontrolled diabetes (PQI-14), lower-extremity amputations (PQI-16). Trends were direct standardized on in-habitants in 2006. Negative binomial regression model was used. Results In the study period PQI-1 increased +426.9 %, PQI-3 +175.5%, PQI-14 +231.7% and PQI-16 decreased -26.2%. Prolonged LOS was related to type 2 diabetes (p < 0.001), peripheral vascular disease (p = 0.045), uncomplicated hypertension (p < 0.001), liver disease (p < 0.001) for PQI-1; type 2 diabetes (p < 0.001), uncomplicated hypertension (p < 0.001), complicated hypertension (p < 0.001) for PQI-3; type 2 diabetes (p < 0.001 ), complicated hypertension (p = 0.001), metastasis (p = 0.042) for PQI-14; female gender (p = 0.001), congestive heart failure (CHF) (p = 0.001), valvulopathy (p = 0.024), BPCO (p = 0.028), renal failure (p < 0.001), liver disease (p = 0.015) for PQI-16.Considerable factors affecting the costs were female gender (p = 0.005), peripheral vascular disease (p = 0.006), renal failure (p = 0.050) for PQI-1; type 2 diabetes (p = 0.002), arrhythmia (p = 0.002), peripheral vascular disease (p < 0.001), BPCO (p < 0.001), renal failure (p < 0.001) for PQI-3; peripheral vascular disease (p = 0.004), uncomplicated hypertension (p = 0.005), BPCO (p = 0.011), renal failure (p = 0.009), liver disease (p < 0.001), psychosis (p = 0.027) for PQI-14; CHF (p = 0.014), arrhythmia (p = 0.001 ), uncomplicated hypertension (p = 0.003), renal failure (p = 0.008), deficiency anemia (p = 0.032) for PQI-16. Conclusions DRPHs has been increasing and some comorbidities need to be better managed in outpatient setting to reduce LOS and costs. Key messages This study addresses the effect of multimorbidity on the burden of diabetes-related preventable hospitalizations using administrative data from an entire italian region over 10 years period. This study uses Prevention Quality Indicators to measure their burden on regional public health and produces useful evidences for the improvement of diabetes management in outpatient setting.

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Prevalence of asymptomatic peripheral vascular disease in patients with type 2 diabetes by color Doppler study

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20161454 ◽

2016 ◽

pp. 471-474

Author(s):

Sanda Rao ◽

Vemula Narendar

Keyword(s):

Type 2 Diabetes ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Color Doppler ◽

Peripheral Vascular ◽

Doppler Study

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Analysis of drug prescription appropriateness according to the STOPP/START criteria of the elderly patients with type 2 diabetes mellitus in the endocrinology department of a multi-speciality hospital

Russian Journal of Geriatric Medicine ◽

10.37586/2686-8636-1-2020-47-56 ◽

2020 ◽

pp. 47-56

Author(s):

A. I. Kochetkov ◽

V. A. De ◽

N. Yu. Voevodina ◽

M. V. Chachiashvili ◽

A. V. Grishina ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Elderly Patients ◽

Vascular Disease ◽

Peripheral Vascular Disease ◽

Peripheral Vascular ◽

Start Criteria ◽

History Of

To assess the appropriateness of prescribed drugs according to the STOPP/START criteria of elderly patients with type 2 diabetes mellitus (T2DM) in the endocrinology department of a multi-speciality hospital.Medical records of 136 patients ≥65 years old with T2DM hospitalized in the endocrinology department of the multi-speciality hospital (Moscow, Russia) were analyzed according to the «STOPP/START» criteria.The analysis of prescription leaflets has identified 30 potentially not recommended drugs (46 patients [33,8%]), the use of which should be avoided in certain clinical situations. Also the analysis has identified 175 medications that should be considered for elderly patients with certain conditions (89 patients [65,4%]). The most frequent identified STOPP criteria were: «Glibenclamide or chlorpropamide or glimepiride with T2DM» (23,3%); «Non-steroidal anti-inflammatory drug (NSAID) with history of peptic ulcer disease or gastro-intestinal bleeding, unless with concurrent histamine H2 receptor antagonist, proton pump inhibitors or misoprostol» (13,3%) and «NSAID with estimated glomerular filtration rate 20–50 ml/min/1.73m2» (3%). The most frequent START criteria were: «Statin therapy with a documented history of coronary, cerebral or peripheral vascular disease, where the patient’s functional status remains independent for activities of daily living and life expectancy is >5 years» (25,1%); «Сlopidogrel with a documented history of cerebral or peripheral vascular disease» (18,9%); «Aspirin with a documented history of atherosclerotic coronary disease in patients with sinus rhythm» (18,3%).In patients ≥ 65 years old with T2DM potentially not recommended drugs are often administrated and there are no prescriptions for some appropriate drugs required in certain clinical settings. The findings give evidence of the need to optimization of pharmacotherapy in elderly and senile patients with T2DM. This adaptation will improve the patients’ quality of life and avoid wasteful spending.

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