scholarly journals Glucose Control, Sulfonylureas, and Insulin Treatment in Elderly People With Type 2 Diabetes and Risk of Severe Hypoglycemia and Death: An Observational Study

2021 ◽  
Author(s):  
Suping Ling ◽  
Francesco Zaccardi ◽  
Claire Lawson ◽  
Samuel I Seidu ◽  
Melanie J Davies ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Elderly People ◽  
Cardiovascular Mortality ◽  
Glucose Control ◽  
Insulin Treatment ◽  
Absolute Risk ◽  
Severe Hypoglycemia ◽  
Elderly Subjects ◽  
Glucose Levels

Objective: To estimate the relative and absolute risk of severe hypoglycemia and mortality associated with glucose control, sulphonylurea and insulin treatment in elderly people with type 2 diabetes. <p>Research Design and Methods: We identified elderly subjects (≥70 years) with type 2 diabetes between 2000 and 2017 in the UK CPRD primary care database with linkage to hospitalization and death data. Subjects with three consecutive HbA<sub>1c</sub> <7% (53 mmol/mol) while on insulin and/or sulphonylurea within 60 days prior to the third HbA<sub>1c</sub> (exposed) were matched to not exposed. Hazard ratios (HRs) and absolute risks were estimated for hospitalizations for severe hypoglycemia and cardiovascular and non-cardiovascular-related mortality. </p> <p>Results: Among 22,857 included subjects (6288 [27.5%] exposed, of which 5659 [90.0%] on sulphonylurea), 10,878 (47.6%) deaths and 1392 (6.1%) severe hypoglycemic episodes occurred during the follow-up. Compared to non-exposed, the adjusted HR in exposed was 2.52 (95% CI: 2.23, 2.84) for severe hypoglycemia; 0.98 (0.91, 1.06) for cardiovascular mortality; and 1.05 (0.99, 1.11) for non-cardiovascular mortality. In a 70-, 75-, 80- and 85-year-old subject, the 10-year risk of severe hypoglycemia was 7.7%, 8.1%, 8.6%, and 8.4% higher than non-exposed while differences for non-cardiovascular mortality ranged from 1.2% (-0.1, 2.5) in a 70-year-old to 1.6% (-0.2, 3.4) in an 85-year-old subject. Sulphonylurea and insulin were more relevant predictors of severe hypoglycemia and death than glucose levels.</p> Conclusions: Elderly subjects with type 2 diabetes and low HbA<sub>1c</sub> on sulphonylurea or insulin treatment experienced a substantially higher risk of hospitalization for severe hypoglycemia but had no clear evidence of increased risks of mortality.

scholarly journals Glucose Control, Sulfonylureas, and Insulin Treatment in Elderly People With Type 2 Diabetes and Risk of Severe Hypoglycemia and Death: An Observational Study

2021 ◽  
Author(s):  
Suping Ling ◽  
Francesco Zaccardi ◽  
Claire Lawson ◽  
Samuel I Seidu ◽  
Melanie J Davies ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Elderly People ◽  
Cardiovascular Mortality ◽  
Glucose Control ◽  
Insulin Treatment ◽  
Absolute Risk ◽  
Severe Hypoglycemia ◽  
Elderly Subjects ◽  
Glucose Levels

Objective: To estimate the relative and absolute risk of severe hypoglycemia and mortality associated with glucose control, sulphonylurea and insulin treatment in elderly people with type 2 diabetes. <p>Research Design and Methods: We identified elderly subjects (≥70 years) with type 2 diabetes between 2000 and 2017 in the UK CPRD primary care database with linkage to hospitalization and death data. Subjects with three consecutive HbA<sub>1c</sub> <7% (53 mmol/mol) while on insulin and/or sulphonylurea within 60 days prior to the third HbA<sub>1c</sub> (exposed) were matched to not exposed. Hazard ratios (HRs) and absolute risks were estimated for hospitalizations for severe hypoglycemia and cardiovascular and non-cardiovascular-related mortality. </p> <p>Results: Among 22,857 included subjects (6288 [27.5%] exposed, of which 5659 [90.0%] on sulphonylurea), 10,878 (47.6%) deaths and 1392 (6.1%) severe hypoglycemic episodes occurred during the follow-up. Compared to non-exposed, the adjusted HR in exposed was 2.52 (95% CI: 2.23, 2.84) for severe hypoglycemia; 0.98 (0.91, 1.06) for cardiovascular mortality; and 1.05 (0.99, 1.11) for non-cardiovascular mortality. In a 70-, 75-, 80- and 85-year-old subject, the 10-year risk of severe hypoglycemia was 7.7%, 8.1%, 8.6%, and 8.4% higher than non-exposed while differences for non-cardiovascular mortality ranged from 1.2% (-0.1, 2.5) in a 70-year-old to 1.6% (-0.2, 3.4) in an 85-year-old subject. Sulphonylurea and insulin were more relevant predictors of severe hypoglycemia and death than glucose levels.</p> Conclusions: Elderly subjects with type 2 diabetes and low HbA<sub>1c</sub> on sulphonylurea or insulin treatment experienced a substantially higher risk of hospitalization for severe hypoglycemia but had no clear evidence of increased risks of mortality.

scholarly journals Glucose Control, Sulfonylureas, and Insulin Treatment in Elderly People With Type 2 Diabetes and Risk of Severe Hypoglycemia and Death: An Observational Study

Diabetes Care ◽  
2021 ◽  
pp. dc200876
Author(s):  
Suping Ling ◽  
Francesco Zaccardi ◽  
Claire Lawson ◽  
Samuel I. Seidu ◽  
Melanie J. Davies ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Observational Study ◽  
Elderly People ◽  
Glucose Control ◽  
Insulin Treatment ◽  
Severe Hypoglycemia

scholarly journals Effects of Glucose Control on Hematological Indices in Patients with Diabetes Mellitus

2014 ◽  
Vol 2 (1) ◽  
pp. 83-88
Author(s):  
Ceyhun Varım ◽  
Tezcan Kaya ◽  
Ahmet Nalbant ◽  
Ayşenur Uçar ◽  
Ali Tamer
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Glucose Control ◽  
Insulin Treatment ◽  
Treatment Modalities ◽  
Hematological Indices ◽  
Blood Indices ◽  
Insulin Group ◽  
Patients With Diabetes

Aim: We aimed to investigate the effects of diabetes treatment modalities on haematological parameters and leukocyte formula in patients with type 2 diabetes mellitus.Materials and Methods: The study included 102 patients with type 2 diabetes, out of which 51 receiving insulin treatment and 51 receiving oral antidiabetics (OAD). Hemogram data of insulin and OAD treated groups were compared.Results HbA1c levels were 11.12 ± 2.09 mg/dl in insulin group and 7.94 ± 2.1 mg/dl in OAD group p=0.001. Platelet counts were 27866.67 ± 77693 109/L before treatment and 258941.18 ± 69068.2 109/L in OAD group at six months, p: 0.015 whereas; 293011.76 ± 73711.21 109/L before treatment and 289492.86 ± 82631.49 109/L in insulin group at six months p: 0.821. Monocyte counts were 0.47 ± 0.12 109/L before the treatment and 0.57 ± 0.12 109/L in mix insulin therapy subgroup at six months, p:0.004; monocyte percentage was % 6.11 ± 1.74 before the treatment and %7.51 ± 2.57 in mix insulin subgroup at six months p:0.039;  Basophiles counts were 0.1 ±  0.02 109/L before treatment and 0.09 ± 0.04 109/L in intensive insulin therapy subgroup at six months, p: 0.005; Lymphocyte and basophils counts were significantly decreased at six months insulin treatment as compared to the pretreatment values.Conclusion: This study showed that, glucose control effects; blood indices HbA1C, basophiles, eosinophils, platelets and lymphocytes counts.

scholarly journals Relationship between instrumental activities of daily living and blood glucose control in elderly subjects with type 2 diabetes

2008 ◽  
Vol 37 (2) ◽  
pp. 222-225 ◽  
Author(s):  
S. Bossoni ◽  
G. Mazziotti ◽  
C. Gazzaruso ◽  
D. Martinelli ◽  
S. Orini ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Activities Of Daily Living ◽  
Glucose Control ◽  
Daily Living ◽  
Blood Glucose Control ◽  
Elderly Subjects ◽  
Instrumental Activities

scholarly journals Comparing effects of continuous glucose monitoring systems (CGMs) and self monitoring of blood glucose (SMBG) among adults with type 2 diabetes mellitus: A systematic review protocol

2020 ◽  
Author(s):  
Mingyue Zheng ◽  
Yunting Luo ◽  
Wei Lin ◽  
Adeel Khoja ◽  
Qian He ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glucose Control ◽  
Diabetes Management ◽  
Self Monitoring ◽  
Glucose Levels

Abstract Background: Continuous glucose monitors (CGMs) have been used to manage diabetes with reasonable glucose control among patients with type 2 diabetes (T2D) in recent decades. CGM systems measure interstitial fluid glucose levels to provide information about glucose levels, which identifies fluctuation that would not have been identified with conventional self-monitoring. Self-monitoring of blood glucose (SMBG) is a classical tool to achieve glycaemic control. However, the effectiveness of glucose control, costs, and quality of life are needed to evaluate and compare CGM and SMBG among adults with T2D.Methods: The review will compare the various forms of CGM systems (i.e flash-CGM, real-time-CGM, retrospective-CGM) versus SMBG/usual intervention regarding diabetes management among adults with T2D. The following databases will be searched: Cochrane Library, Science Direct, PubMed, EMBASE, CINAHL, PsycINFO, Scopus and grey literature for the identification of studies. The studies involving adults (aged ≥ 18 years old) will be included. We will include and summararize randomised clinical trials (RCTs) with respect to authors, publication type, year, status, and type of devices. Studies published in English between February 2010 and March 2020 will be included as the field of CGMs among T2D patients has emerged over the last decade. Primary outcomes that will be measured will be; HbA1c, body weight, time spent with hypoglycaemia or hyperglycaemia, blood pressure, quality of life. Secondary outcome measured will be morbidity, all-cause mortality, user satisfaction, and barriers. Study selection, data extraction, and risk of bias assessment will be conducted independently by at least two authors. A third author will determine and resolve discrepancies. Moreover, the quality of the evidence of the review will be assessed according to the Grading of Recommendations Assessment, Development and Evaluation Tool (GRADE).Discussion: The systematic review will synthesise evidence on the comparison between using CGMs and SMBG. The results will support researchers and health care professionals to determine the most effective methods/technologies in the overall diabetes management. Moreover, this review will provide more detailed information about the barriers of using CGMs to improve implementation.Systematic review registration: PROSPERO CRD42020149212

scholarly journals Ten years of NovoMix 30 in Russian and international clinical practice

2013 ◽  
Vol 16 (4) ◽  
pp. 101-107
Author(s):  
Elena Viktorovna Surkova
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Clinical Practice ◽  
Elderly People ◽  
Insulin Treatment ◽  
Therapeutic Goals ◽  
Biphasic Insulin

Insulin treatment for type 2 diabetes mellitus is challenging in elderly people. Biphasic insulin preparations technically simplify this task, but also increase compliance and facilitate the achievement of therapeutic goals.

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