Association Between Awareness of Informal Caregivers and Falls in Elderly Patients with Uncontrolled Diabetes Mellitus

2020 ◽  
Vol 13 (1) ◽  
pp. 658-666
Author(s):  
Tossapon Chamnankit ◽  
Parichat Ong-artborirak ◽  
Jukkrit Wangrath

Background: Elderly people with uncontrolled diabetes mellitus (DM) are at risk of falls, which can lead to injury and disability. Not much is known of informal caregivers’ awareness of falls in elderly patients with DM. Objective: This study aims to identify an association between caregiver’s awareness and falls in elderly patients with DM. Methods: A total of 136 pairs of DM patients and their respective family caregivers were recruited from a clinical service center at Chiang Mai University, Thailand. The questionnaire regarding the caregiver’s awareness of the risk of falls in elderly patients was given via a face-to-face interview. Each elderly patient was asked about their history of falls in the prior year, and the risk of falls was assessed by Time Up & Go (TUG) test. Logistic regression analysis was performed to determine association. Results: The mean age of the DM patients was 65.7 years. Sixty-two patients (45.6%) had fallen at least once in the prior year. The mean TUG test result was 12.67±1.83 second. Most caregivers demonstrated a high level of awareness regarding the risk of falls in elderly patients. The results of the multivariable analysis showed that three variables – balance problems, risk of falls assessed by TUG test, and scores of caregiver’s awareness of risk of falls – were significantly related to falls in the previous year among elderly patients with DM (p-value<0.05). Conclusion: The caregivers’ awareness of fall risk may influence fall occurrence among older adults with DM. An intervention program to improve awareness among informal caregivers should be considered for fall prevention in elderly people.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2095-2095
Author(s):  
Brian T. Garibaldi ◽  
Rupal B. Malani ◽  
Hsin-Chieh Yeh ◽  
Deborah Michell ◽  
Evan J. Lipson ◽  
...  

Abstract Thrombocytopenia is a common clinical feature of HIV infection. Given the number of possible etiologies of thrombocytopenia in a patient with known HIV, a peripheral blood test effective in determining the likely pathophysiologic basis of the thrombocytopenia would be a valuable clinical tool. Immature platelets are released early from the bone marrow in response to increased platelet turnover. These platelets contain residual megakaryocyte mRNA and have been termed reticulated platelets. A new assay, the Immature Platelet Fraction (IPF), measures the reticulated platelet count in peripheral blood. Patients with increased destruction of platelets from such conditions as ITP consistently have a higher IPF percent, while patients with decreased platelet production have a low or normal IPF percent. The goal of our study was to determine the performance characteristics of the IPF assay in HIV patients with thrombocytopenia and to see if the IPF percent could be used to help elucidate the etiology of low platelet counts in this group of patients. All adult patients admitted to the Johns Hopkins Hospital with a diagnosis of HIV and a platelet count less than 150,000 were eligible for enrollment. 62 patients were identified from February 2007 to June 2007. 34 control samples were obtained from inpatients with HIV who were not thrombocytopenic. In addition, 81 samples were available from non-HIV historical controls with normal platelet counts. The mean platelet count in the HIV thrombocytopenic group was 92,000 while the mean platelet count in the HIV control group was 254,000 (p value &lt;.001). The mean platelet count in the non-HIV historical control group was 274 (p=.34 when compared to the HIV control group). The mean IPF percent in the HIV thrombocytopenic group was 10.2% as compared to 6.8% in the HIV control group (p=.001). The mean IPF in historical non-HIV controls was 3.1% (p&lt;.001 for both the HIV thrombocytopenic and the HIV control group). Univariate analyses were conducted to identify potential individual predictors of a high IPF percent. Backward selection was then performed using multivariate linear models with a threshold Wald test p-value of 0.05. ITP, diabetes mellitus and cirrhosis were significantly associated with a higher IPF percent with a co-efficient (95% confidence interval) of 6.98 (3.05–10.91), 4.73 (1.39–8.06), and 14.18 (9.7–18.66), respectively. CD4 count, HIV viral load, hepatitis C and reticulocyte count were not correlated with IPF percent. Our results suggest that patients with HIV have increased platelet turnover as compared to patients without HIV. Thrombocytopenic patients with HIV have increased platelet turnover relative to both non-thrombocytopenic HIV patients and to historical non-HIV controls. History of ITP, diabetes mellitus, and cirrhosis are predictive of an elevated IPF percent. Reticulocyte count is not correlated to IPF percent, suggesting that a low reticulocyte count is not a reliable marker for decreased bone marrow production in HIV thrombocytopenia. It is unlikely that the IPF assay alone can be used to determine the pathophysiologic basis of thrombocytopenia in any single patient with HIV. Further work needs to be done to clarify the utility of the IPF assay in this group of patients.


2021 ◽  
Vol 16 (3) ◽  
Author(s):  
Oliva Suyen Ningsih ◽  
Kornelia Romana Iwa ◽  
Maria Getrida Simon ◽  
Kataria Anastasia Sinar

The prevalence of diabetes mellitus in Manggarai Regency in 2019 is 535 people and some of them have diabetic foot ulcers. Patients with diabetic foot ulcers had a higher risk of falling than others.This study was to determine the risk factors for diabetic foot ulcers and the risk of falls in patients with type 2 diabetes mellitus. A quantitative study using a cross-sectional study was conducted at BLUD RSUD dr. Ben Mboi  in April-June 2020 (n = 51).The sampling technique used was purposive sampling with a questionnaire of diabetic foot screening and risk stratification form and Morse scale. Logistic regression results showed that there was a significant relationship between claudication (AOR: 8.409, 95% CI 1.664-42.500, p value 0.010), history of previous diabetic foot ulcers (AOR: 5,680, 95% CI 1,151-28,035, p value 0.033) with diabetic foot ulcers. There was a significant relationship between hypertension (AOR: 0.152, 95% CI 0.028-0.834, p value 0.030), diabetic foot ulcers (AOR: 11.392, 95% CI 1.277-101.651, p value 0.029) with the risk of falling for patients with type 2 diabetes mellitus.  Assessment of the risk of diabetic foot ulcers and the risk of falls should be done in patients with diabetes mellitus with or without neuropathy peripheral


2020 ◽  
Vol 7 (48) ◽  
pp. 2847-2851
Author(s):  
Sreenivasulu Uppara ◽  
Bhagyamma Sollapurappa Narayanaswamy ◽  
Rama Kishore Akula Venkata ◽  
Thanuja Ramanna ◽  
Shyam Prasad B.R

BACKGROUND The multi-organ disorder, diabetes mellitus (DM) continues to be one of the commonest and challenging health-related problems in the 20th century, prevalent in about 9.3 % of the world's population in 2019 and likely to affect 10.2 % by 2030. Diabetes mellitus is a group of chronic metabolic disorders of multiple aetiology, characterized by chronic hyperglycaemia due to derangement in carbohydrate, fat and protein metabolism. Electrolytes are crucial in maintaining various metabolic functions and play a pivotal role in maintaining a healthy state's body. Diabetic patients are more prone to and frequently develop a constellation of electrolyte disorders due to hyperglycaemia, polydipsia and polyuria. METHODS Our study comprised a total of 70 subjects in the age group of 35 - 60 years with age and sex-matched controls. They were grouped into two groups; the first group, group-1 (healthy controls) and the second group was group-2 (patients of diabetes mellitus on oral hypoglycaemic agents with poor control). 5 ml of fasting venous blood was collected in a plain vacutainer tube in the morning after a zerocalorie overnight 08 hours fast. Post collection, the blood sample was used as serum or plasma or whole blood to estimate plasma glucose, blood urea, serum creatinine, serum sodium, serum potassium, serum chloride by kit methods using an auto analyser. RESULTS Among the various parameters tested, the mean value of fasting plasma glucose, blood urea, serum creatinine, serum potassium, serum chloride were higher in group-2 (diabetic patients) compared to group-1 (healthy controls) with a p-value of < 0.0001. The value of the mean of serum sodium was lower in group-2 (diabetes mellitus) compared to group-1 (healthy controls) with a p-value of < 0.0001. CONCLUSIONS We conclude that electrolyte abnormalities are present in diabetic patients and maybe a root cause for associated morbidity or mortality. These disturbances are generally seen in decompensated Diabetes Mellitus patients, elderly individuals and in the presence of renal impairment. KEYWORDS Diabetes Mellitus, Serum Electrolytes, Fasting Blood Glucose


2015 ◽  
Vol 9 (3) ◽  
pp. 277
Author(s):  
Rikawarastuti Rikawarastuti ◽  
Eka Anggreni ◽  
Ngatemi Ngatemi

Penyakit periodontal merupakan masalah kesehatan gigi dan mulut dengan prevalensi cukup tinggi di Indonesia (60%). Diabetes melitus merupakan salah satu faktor predisposisi terjadinya penyakit periodontal. Tujuan penelitian adalah menganalisis hubungan diabetes melitus terhadap tingkat keparahan jaringan periodontal. Jenis penelitian observasional analitik potong lintang. Penelitian dilakukan di Puskesmas Kecamatan Jagakarsa Jakarta Selatan pada bulan Oktober - November 2014 dengan populasi penelitian adalah pengunjung Puskesmas Kecamatan Jagakarsa. Pengambilan sampel menggunakan simple random sampling sebanyak 122 orang. Status diabetes melitus didapat dari rekam medis poli penyakit tidak menular. Analisis data menggunakan kai kuadrat dan regresi logistik sederhana. Hasil penelitian menunjukkan proporsi penderita diabetes melitus usia > 50 tahun mengalami kerusakan jaringan periodontal yang lebih parah dibandingkan penderita diabetes melitus ≤ 50 tahun. Kelompok diabetes melitus berisiko 3,5 kali mengalami keparahan jaringan periodontal dibandingkan kelompok nondiabetes melitus, OR = 3,505 (1,609 – 7,634), nilai p = 0,002. Kelompok diabetes melitus tidak terkendali berisiko 2,5 kali mengalami keparahan jaringan periodontal dibandingkan kelompok diabetes melitus terkendali, nilai OR = 2,514 (0,892 – 7,085), nilai p = 0,12 disebabkan ukuran sampel terlalu kecil. Penderita diabetes melitus lebih berisiko mengalami keparahan jaringan periodontal dibandingkan dengan nondiabetes melitus. Pada diabetes melitus tidak terkendali, risiko penyakit periodontal semakin tinggi. Diabetes Melitus and Severity of Periodontal TissuePeriodontal disease is a teeth and oral health problem, with a quite high prevalence in Indonesia (66%). Diabetes mellitus one of predisposing factors of periodontal occurence. This study aimed to analyze relation between diabetes mellitus and the severity of periodontal tissue. The study was observational analytic study with cross-sectional design. The study was conducted in Jagakarsa District Primary Health Care of South Jakarta on October to November 2014 with the primary health care visitors as population. Sample was taken using simple random sampling as much as 122 respondents. Diabetes mellitus status was identified from the non-infectious disease medical record. Data analysis used chi-square and simple logistic regression. Results showed proportion of diabetes mellitus patients > 50 years suffered periodontal tissue damage more severe than ≤ 50 years old patients. Diabetes mellitus group had 3.5 times risk of suffering severe periodontal tissue than nondiabetes mellitus group, OR = 3.505 (1.609 - 7.634), p value = 0.002. Uncontrolled diabetes mellitus group had 2.5 times risk of suffering severe periodontal tissue than controlled diabetes mellitus group, OR = 2.514 (0.892 - 7.085), p value = 0.12 due too small size of sample. Diabetes mellitus sample patients were more risky to suffer severe periodontal tissue than nondiabetes mellitus patients. On uncontrolled diabetes mellitus, the risk of periodontal disease was getting higher.


Author(s):  
Abdul Muhith Muhith ◽  
Hannan Mujib Mujib ◽  
Dwi Helynarti S ◽  
M Himawan S ◽  
Ismawati S S ◽  
...  

Diabetes mellitus suffers from insulin deficiency which inhibited the transfer of glucose to cells in body tissues that cause starvation cells an in the increase in glucose in the blood that leads to muscle weakness thus disrupt the body’s balance and increase the risk of falling. Diabetic foot exercises aim to improved blood circulation in the feet of people with diabetes mellitus, so that nutrient smoothly to the network. The purpose of this study to determine the effect of diabetic foot gymnastics on body balance elderly people with diabetes mellitus in Diabetic Club Gatoel Hospital Mojokerto in the 27 February – 25 March 2017. This research used a Quasy Experimental method with Pretest-Posttest with Control Group Design. The sampling technique used Simple Random Sampling with the sample of 17 respondents for the control group and 17 respondents for the intervention group. Wilcoxon Signed Rank Test obtained p-value 0,000 < 0,05 concluded that there is an influence of diabetic foot exercises on body balance in elderly people with diabetes mellitus in Diabetic Club Gatoel Hospital Mojokerto. The study recommended that elderly people with diabetes mellitus is expected to take advantage of diabetic foot exercises as an effort to improve the balance of the body to reduce the incidence of fall.


2017 ◽  
Vol 5 (3) ◽  
pp. 316-318 ◽  
Author(s):  
Serdar Olt ◽  
Sabri ÖzdaÅŸ ◽  
Mehmet Åžirik

AIM: To investigate the effect of bariatric surgery on HbA1c and serum cortisol levels in morbidly obese patients without type 2 diabetes mellitus.MATERIALS AND METHODS: Twenty-nine patients who underwent sleeve gastrectomy and whose body mass index was> 40 were included in the present study. Patients' files were reviewed retrospectively. Those with diabetes mellitus and those with age <18 were excluded from the study. Pre-operative and 1-year post operative data were documented. The obtained data were analysed by SPSS statistical program.RESULTS: The mean age of the patients was 27.4 ± 8.4. 5 of the patients were male, and 24 were female. The mean body mass index of the patients was 44 ± 2.3. 1 patient [3.4%] had hypertension. Four patients [13.7%] had gastroesophageal reflux disease. The number of smokers was 7 [24.1%], and the number of alcohol users was 3 [10.3%]. There was a statistically significant decrease in HbA1c, body mass index values after operation [p value <0.01], but cortisol was not different [p value = 0.72].CONCLUSION: In this present study we found that bariatric surgery caused a significant decrease in HbA1c levels in non-diabetic patients, suggesting that bariatric surgery may prevent Type 2 Diabetes Mellitus in obese patients.


Author(s):  
Mahtab Ordooei ◽  
Nasim Namiranian ◽  
Saeedeh Jam-Ashkezari ◽  
Hadi Jalali ◽  
Azam Golzar

Background: This study was conducted to determine whether type 1 diabetes mellitus (T1DM) is associated with ABO & Rhesus (Rh) blood groups. Materials and Methods: This analytical cross sectional study was carried out on 77 patients suffering from T1DM and 96 healthy children less than 18 years old referring to Yazd Diabetes Research Center from April 2018 to May 2019. The ABO blood group and Rh factor in both groups were determined. Fasting blood sugar (FBS) and hemoglobin A1C (HbA1c) were measured at baseline, 12 weeks, and 24 weeks in these patients, and the mean of FBS and HbA1C in three-time assessments were considered as the FBS and HbA1C variables. The statistical analysis was performed by SPSS software version 22. Results: About 46.8% in T1DM and 36.5% in the control groups were male. There was a significant difference between groups regarding blood groups (p-value: 0.042). Although the frequency of B+ was 33.8% and 19.8% in the T1DM and controls, respectively, AB+ and O+ were more prevalent in the controls. The mean of FBS was significantly different between groups (p-value: 0.023). Conclusions: The findings revealed that patients with blood group B are more likely to develop T1DM whereas those with blood group O showed a lower tendency towards diabetes.


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