Elderly Diabetic Patients Research Articles

Neutrophil-lymphocyte ratio and its relation to microvascular complication in geriatric patients with diabetes: a case-controlled study

BackgroundDiabetes mellitus is a complex chronic disease characterized by chronic hyperglycemia resulting from defective insulin secretion, defective insulin action, or both. Chronic hyperglycemia related to diabetes can lead to end-organ dysfunction or failure, and changes related to diabetes involving arterioles and capillaries are responsible for long-term microvascular complications in diabetic patients. The neutrophil-to-lymphocyte ratio (NLR) is a novel, simple, and inexpensive marker of subclinical inflammation.Aim of workTo evaluate the possibility that neutrophil-lymphocyte ratio (NLR) could be used as a predictor of microvascular complications during follow-up of elderly patients with type 2 diabetes.Patients and methodsSixty elderly diabetes patients ≥ 65 years old, diagnosed 16 according to ADA criteria, were collected from the endocrine clinic in Kasr El-Ainy Hospital. For every patient, full history and examination were done (including 18 neurological and fundus examinations). Labs (CBC with a differential in blood and 19 albumin/creatinine ratio in urine) were done and the neutrophil/lymphocyte ratio.ResultsWe found that NLR has a statistically significant difference in the detection of nephropathy and retinopathy. There is a significant correlation between nephropathy and NL ratio in all patients (r = 0.44, P < 0.001). Elderly diabetic patients (with or without hypertension) with microvascular complications had a higher NLR value than those without complications.ConclusionNLR value can be used as a non-invasive simple marker for predicting microvascular complications in elderly diabetics with/without hypertension.

노인 당뇨병 환자의 치료지시 불이행에 대한 개념분석

Purpose: The purpose of this study was to conceptually analyze non-compliance in elderly diabetic patients and its specific attributes. Method: Walker and Avant’s process of concept analysis was used. We searched databases using the keywords ‘older diabetes’, ‘patient compliance’, and ‘treatment non-compliance’. Result: The attributes of non-compliance in elderly diabetic patients were identified as follows: 1) Non-compliance with medication therapy, 2) Non-compliance with lifestyle therapy, and 3) Hospital visit non-compliance. The antecedents of non-compliance in elderly diabetic patients were as follows: 1) Lack of knowledge, 2) Low self-efficacy, and 3) Low social support. The consequences of non-compliance were: 1) Blood sugar control problems and 2) Diabetic complications. Conclusion: This concept analysis defined non-compliance in elderly diabetic patients based on theoretical evidence. The findings of this study will contribute to developing systematic programs to increase compliance in elderly diabetic patients.

Application of Grey Relational Analysis to Predict Dementia Tendency by Cognitive Function, Sleep Disturbances, and Health Conditions of Diabetic Patients.

Background: The number of elderly diabetic patients has been increasing recently, and these patients have a higher morbidity of dementia than those without diabetes. Diabetes is associated with an increased risk for the development of dementia in elderly individuals, which is a serious health problem. Objectives: The primary aim was to examine whether diabetes is a risk factor for dementia among elderly individuals. The secondary aim was to apply grey theory to integrate the results and how they relate to cognitive impairments in elderly diabetic patients and to predict which participants are at high risk of developing dementia. Methods: Two hundred and twenty patients aged 50 years or older who were diagnosed with diabetes mellitus were recruited. Information on demographics, disease characteristics, activities of daily living, Mini Mental State Examination, sleep quality, depressive symptoms, and health-related quality of life was collected via questionnaires. The grey relational analysis approach was applied to evaluate the relationship between the results and health outcomes. Results: A total of 13.6% of participants had cognitive disturbances, of whom 1.4% had severe cognitive dysfunction. However, with regard to sleep disorders, 56.4% had sleep disturbances of varying degrees from light to severe. Further investigation is needed to address this problem. A higher prevalence of sleep disturbances among diabetic patients translates to a higher degree of depressive symptoms and a worse physical and mental health-related quality of life. Furthermore, based on the grey relational analysis, the grey relation coefficient varies from 0.6217~0.7540. Among the subjects, Participant 101 had the highest value, suggesting a need for immediate medical care. In this study, we observed that 20% of the total participants, for whom the grey relation coefficient was 0.6730, needed further and immediate medical care.

Gender Impact on Diabetes Distress Focus at Medical Communication Concerns, Life and Interpersonal Stress.

along with the rapidly aging population in many countries around the world, the global prevalence of diabetes and suffering from diabetes-related depression have risen in middle-aged and elderly adults. However, given that psychological stress is deeply influenced by culture, gender inequality in these statistics is often exhibited and increases with age. The aim of this study was to explore the gender difference in diabetes distress among middle-aged and elderly diabetic patients. 395 participants from four hospitals were recruited for a cross-sectional survey. The Taiwan Diabetes Distress Scale (TDDS) was used to measure diabetes distress. Linear regression was conducted to assess the gender difference in different types of diabetes distress. there was significant gender difference in each diabetes distress domain. In particular, men who had received diabetes education in the past six months seemed to be more concerned about diabetes complications and felt pressured to communicate with doctors. In addition, women seemed to be more affected by diabetes distress because of their marital status, especially for married women. diabetes distress seems to have significant gender differences; however, more longitudinal research is needed on the causal relationship between gender and diabetes distress.

Fear of Falling and Functional Mobility in Elders with Diabetic Peripheral Neuropathy in Coastal Karnataka, India: A Hospital-Based Study.

Aging with diabetic neuropathy is likely to predispose people to falls. Despite being a high-risk population, estimates of falls and their associated factors are poorly documented in elderly diabetic neuropathy patients living in coastal Karnataka, India. To investigate fear of falling and functional mobility, as an approximate measure of clinical fall risk, and explore the associated risk factors in elderly diabetic neuropathy patients living in coastal Karnataka, India. A hospital-based cross-sectional study was conducted on 316 elders aged 60 to 80 with diabetic neuropathy. A detailed diabetic foot evaluation was done. Self-reported fear of fall and functional mobility was measured using the Falls Efficacy Scale- International and Timed Up and Go test, respectively, with published cut-points. Additionally, a recall of 12 months of fall history was recorded. Descriptive analysis showed that self-reported fear of fall and below-average functional mobility was present in 39% and 49% of the elders with diabetic neuropathy, respectively. Spearman's correlational analysis revealed that self-reported fall concerns and functional mobility are significantly interdependent. Regression analysis suggested female gender, the severity of neuropathy, and previous falls as significant modifiers for fear of falls and poor functional mobility. Half of the elders (49%) with diabetic neuropathy have poor functional mobility and 39% have a fear of falling. Improving physical function and addressing fall concerns of elders with diabetic neuropathy can result in greater confidence to participate in everyday activities and contribute to their better health. Hence, early fall risk identification is recommended for providing better health care to these individuals.

Correlation analysis of lipid level and cognitive function in middle-aged and elderly diabetic population from 2 communities in Beijing in 2017

To investigate the relationship between serum lipid level and cognitive function in middle-aged and elderly patients with type 2 diabetes mellitus(T2 DM). A cross-sectional study was implemented in 2017 to explore the correlation between lipid level and cognitive function in middle-aged and elderly diabetic patients. A random sample of 1526 middle-aged and elderly people were recruited from 2 communities in Beijing. Fasting blood samples were collected for blood lipid level detection, and the cognitive function of the subjects was assessed by the Montreal Cognitive Assessment Scale(MoCA). Logistic regression model was used to analyze the correlation between serum lipid levels and mild cognitive impairment(MCI) in elderly and T2 DM patients and control group. Compared with the control group, there were significant differences in blood lipid levels in T2 DM group. The levels of total cholesterol(TC) and high density lipoprotein cholesterol(HDL-C) in T2 DM group were lower than those in the control group, while triglyceride(TG) and low density lipoprotein cholesterol(LDL-C) were higher than those in the control group. Logistic regression analysis showed that high level of TC was a risk factor for MCI in patients with T2 DM, while high level of LDL-C was a protective factor, but no association was observed in the control population. Phenotype of T2 DM may affect the relationship between lipid level and cognitive function in middle-aged and elderly people.

Loneliness is associated with a reduced higher-level-function capacity in older diabetic patients

The present study examined the relationship between loneliness and higher-level functions in elderly diabetic patients. The subjects were diabetic patients ≥65 years old who were outpatients at Ise Red Cross Hospital. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC), a self-administered questionnaire, was used to assess higher-level functions. To evaluate loneliness, we used a shortened version of the Japanese version of the loneliness scale, a self-administered questionnaire. A multiple regression analysis with TMIG-IC scores as the dependent variable, loneliness as the explanatory variable, and adjustment variables was used to calculate the adjusted partial regression coefficients of loneliness on higher-level functions. One hundred and seventy patients were included in the present analysis. Ninety-one patients (53.5%) had loneliness, and the mean TMIG-IC score was 11.3. The unadjusted and adjusted partial regression coefficients of loneliness on higher-level functions were -1.61 (95% confidence interval [CI], -2.31 to -0.91; < 0.001) and -0.88 (95% CI, -1.52 to -0.23; P=0.008), respectively. Loneliness in elderly diabetic patients was found to be associated with lower higher-level functions. It is important to remind patients with diabetes mellitus who have loneliness about the risk of a decline in their higher-level functions.

Influence of Information-Based Continuous Care on Disease Control and Treatment Compliance of Elderly Diabetic Patients.

Background The incidence of diabetes is increasing year by year. For elderly diabetic patients, poor blood glucose control and worsening immune function greatly increase the risk of complications, which will seriously affect their quality of life. Purpose This paper primarily clarifies the influence of information-based continuous care on disease control and treatment compliance of elderly diabetic patients. Methods From December 2018 to December 2021, 106 elderly diabetic patients were selected, and their clinical data were retrospectively studied. Patients were grouped according to the type of care they received: an observation group (OG) comprising 56 cases receiving information-based continuous care and a control group (CG) including 50 cases treated with routine nursing. The two cohorts of patients were compared regarding disease control, treatment compliance, glucose and lipid metabolism (GLM), and self-management. Results After analysis, it was found that the disease control and treatment compliance were statistically higher in OG compared with CG. OG also showed significantly reduced fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPG), total cholesterol (TC), and triglyceride (TG) after nursing that were all lower compared with CG. In terms of self-management, OG outperformed CG in diet, exercise, blood glucose monitoring, and adherence to medical regimens. Conclusions Information-based continuous care has beneficial effects on disease control and treatment compliance of elderly diabetic patients and can help control blood sugar and optimize patients' self-management level, with high clinical promotion value.

Relationship between Depression with Physical Activity and Obesity in Older Diabetes Patients: Inflammation as a Mediator.

Obesity and physical activity (PA) may affect inflammation and are also related to depression. This study aimed to explore the association between depression, obesity, and PA in older diabetes patients mediated by inflammation. We conducted a cross-sectional study with 197 elderly diabetes patients (≥65 y/o). Participants were interviewed to gather demographic and lifestyle data. Assessment of depression was based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. High-sensitivity C-reactive protein was used as a marker of inflammation. Participants with a body mass index (kg/m2) ≥ 27 were considered to be obese. Our data indicated that among all participants with (n = 57) and without (n = 140) depression, older diabetes patients with depression had a lower intake of energy and protein and a lower prevalence of smoking and alcohol consumption than those without depression (p < 0.05). We also found that inflammation may be a partial mediator in the relationship between obesity and depression, and a significant mediator between PA and depression. Additionally, a regression model of obesity and PA showed that PA was a significant predictor of inflammation. However, the association between obesity and inflammation was not significant. When obesity, PA, and inflammation were included in a regression model together, inflammation significantly predicted depression (OR = 4.18, p = 0.004). The association between obesity and depression was also significant (OR = 2.45, p = 0.038). However, the association between PA and depression was not significant, and the mediating effect of inflammation was significant according to the Sobel test (z = −2.01, p = 0.045). In conclusion, the beneficial effects of PA may lower levels of inflammation produced by obesity, thus reducing inflammatory effects that may be related to depression. Overall, inflammation may mediate the relationship between depression and PA in older diabetes patients.

Age-related difference in the impact of diabetes mellitus on all-cause mortality after acute myocardial infarction

Abstract Background Diabetes mellitus (DM) is highly prevalent among individuals hospitalized with acute myocardial infarction (AMI) and is associated with increased risk for cardiovascular complications and short-term and long-term mortality. However, most existing data are from older patients. Little is known about the incidence of diabetes in individuals who experience AMI at a young age. Whether the presence of DM is associated with worse outcomes in these patients is not clear. Purpose To test the hypothesis that the impact of DM on clinical outcomes after AMI can vary by age. Methods A total of 12,600 AMI patients from the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) between November 2011 and December 2015 was classified into young (n=3,590 [28.5%]) and elderly (n=9,010 [71.5%]). Those less than 55 years of age were considered young. We performed comparisons of baseline characteristics, in-hospital treatments, and long-term clinical outcomes between patients with and without diabetes after stratification according to age group. Results The prevalence of diabetes mellitus was 26.5% in the young AMI group. In the multivariable-adjusted model of the entire cohort, diabetes mellitus was associated strongly with 3-year all-cause mortality (12.6% vs. 6.8%; adjusted hazard ratio [HR], 1.318; 95% confidence interval [CI], 1.138–1.526; P&amp;lt;0.001). When the entire cohort was subdivided into two age groups, young diabetic patients showed a 107.0% higher mortality rate than those without diabetes (adjusted HR, 2.070; 95% CI, 1.150–3.724; P=0.015). Meanwhile, elderly diabetic patients had a 25.3% higher risk of mortality than non-diabetic patients (adjusted HR, 1.253; 95% CI, 1.076–1.459; P=0.004). The interaction of diabetes with age was significant (adjusted P for interaction = 0.008). Conclusion DM is not uncommon in younger AMI patients, and the relative risk of long-term mortality is significantly higher in young patients than in older counterparts. More aggressive treatments are needed to prevent future cardiovascular events in younger patients after AMI. Funding Acknowledgement Type of funding sources: None.

A Retrospective Study on Outcome of Hemodialysis in Elderly Diabetic Patients

Background and Aim: Hemodialysis is a valuable treatment for elderly individuals progressing to chronic kidney disease (CKD). Globally, hemodialysis demand is increasing for elderly individuals as a life-sustaining therapy which might lead to prolonged suffering in geriatric patients. Therefore, the current study aimed to evaluate the outcomes of hemodialysis in elderly diabetic patients. Methodology: This retrospective study was carried out on 64 type 2 diabetic patients admitted to the Dialysis Unit at Social Security Hospital, Multan Road Lahore from January 2021 to April 2022. Ethical approval was taken from the institution research and ethical committee. All the type 2 diabetic patients above 65 years age having CKD on dialysis were included. Patients having disease that require immunosuppressive treatment, history of malignancy, and those who died within three months of initial treatment were excluded. Patient’s survival data and comorbidities such as cognitive, vascular, and autonomy were studied. Other comorbid conditions such as cerebrovascular disease, peripheral vascular disease (PVD), and coronary artery disease (CAD) were reviewed. SPSS version 25 was used for data analysis. Results: Of the total 64 diabetes patients, there were 34 (53.1%) males and 30 (46.9%) females. The overall mean age was 68.9±3.1 years whereas dialysis mean duration was 28±22 months. Cognitive impairment, lost autonomy, and prior cerebrovascular accident had significant association with mortality rate reported as 7.8% per year. The incidence of fistula or graft, depression, dementia, died, and bedridden cases were 39% (n=25), 18.8% (n=12), 15.6% (n=10), 12.5% (n=8), and 14.1% (n=9) respectively. Of the 25 cases of fistula or graft, about 9.5% used catheter. Conclusion: The present study found that mortality rate was 7.8% in elderly (&gt;65 years) diabetes patients. The high mortality risk was substantially related with cognitive disorder, cerebral vascular accident, and lost autonomy. Generally, hemodialysis practice varies with the region’s clinical pattern due to age variation in elderly patients. Keywords: Hemodialysis, Chronic kidney disease, Elderly, Diabetes

Education for Insulin Injection in Elderly Diabetic Patients

The number of elderly diabetes patients continues to increase. These patients experience decline in physical functions related to aging and various accompanying disease. These interrupt insulin selfinjection and self-management of diabetes. Therefore, it is necessary to understand the characteristics of elderly diabetes patients in order to provide proper insulin injection education.

Effects of Polypharmacy in Elderly Diabetic Patients: A Review.

Diabetes is a chronic condition brought on by either insufficient insulin production by the pancreas or inefficient insulin utilization by the body or both. A hormone called insulin controls blood sugar. Multiple co-morbidities can arise as a result of the progressive nature of diabetes, necessitating the use of numerous medications. As one or more medications may be used to treat each ailment, the older population with multimorbidity frequently uses many medications, also known as polypharmacy. Due to polypharmacy, harmful medication interactions, and food-drug interactions can occur. Because of the numerous co-morbidities that already exist, there is an increasing tendency of prescribing polypharmacy.

Prevalence of COVID-19 Among Older People with Type 2 Diabetes Mellitus: A Systematic Review

Background: On March 11, 2020, the WHO proclaimed the Coronavirus Disease 2019 (COVID-19) pandemic owing to coronavirus-2 (SARS-CoV-2). SARS-CoV-2 is a zoonotic virus that may be spread from bats to humans through airborne droplets and aerosols. SARS-CoV-2 spike protein has a high binding affinity for ACE2 receptors, widely expressed throughout the respiratory system, notably in epithelial lung cells. ACE2 receptors are found in intestinal mucosal, endothelial, heart, renal epithelial as well as cerebral neuronal cells, explaining COVID-19 extrapulmonary symptoms like diarrhea, nausea, vomiting, chest pain, heart failure, renal injury, headache, and confusion. Older persons with type2 diabetes mellitus and hypertension are more susceptible to SARS-CoV-2 infection as drugs by which they are treated promote ACE2 receptor expression. Moreover, comorbidities increase the probability of poor outcomes after infection by the SARS-CoV-2. Research links COVID-19 to hyperglycemia in the elderly with type 2 diabetes. Twenty percent of people with diabetes get severe pneumonia and a septic course from viral infections. Diabetes contributed to sickness severity and fatality in MERS (MERS-CoV). Epidemiological findings in SARS-CoV-2-affected regions, CDC data, and other national health centers and hospitals suggest that individuals with diabetes had a 50% greater chance of dying from COVID-19. Methods: This systematic review involves a critical and reproducible summary of the results of the available publications on COVID-19 and diabetic elderly patients’ topics and questions. Fourteen studies (6 retrospective cohorts, two prospective, two cohorts, one combined retrospective, one observational, one cross-sectional, and one hospital-based study) were included in this systematic review. Results: From all studies, the mean age of older adults with type 2 diabetes mellitus who suffered from COVID-19 was 50 to 89 years. The majority of the studies showed the male predominance of infection. The pooled prevalence of COVID-19 among diabetes mellitus elderly patients was 29.8%. Conclusions: Diabetes patients had a greater COVID-19 prevalence and severity, according to several explanations. Diabetes Mellitus increases the risk of infection due to innate and adaptive immunity deficiencies. Post COVID-19 complications arise due to a lack of equilibrium between pro-inflammatory and anti-inflammatory cytokine networks in type 2 diabetes mellitus, contributing to increased mortality. Therefore, this study necessitates a large investigational study to find out how to boost the immune response against SARS-CoV-2 infection in an equilibrium manner not to produce much inflammatory cytokine in type 2 diabetes mellitus individuals to reduce the risk of developing complications and mortality consequently. Keywords: COVID-19, Diabetes mellitus, Type-2 diabetes, Elderly.

Association between risk for fall and socio-demographic attributes among diabetic elderly patients

Background: With advancing age, we notice that the functional and physiological capacity of the musculoskeletal and nervous systems begins to decline gradually, which has a noticeable impact on the motor activity. This age-related deterioration significantly contributes to falls and frequent falls among the elderly. 1160 elderly people die daily as a result of falls, and thus falls become one of the most important public health problems in several countries of the world. Aims of the study: to find out corelation between the risk of falls and the social and demographic characteristics of elderly diabetic patients aged 60 years and over. Methodology: A correlation design was conducted to study the association between risk for fall and socio-demographic attributes among elderly diabetic patients at In the Endocrinology and Diabetes Center affiliated to Al-Hussein Teaching Hospital in Al-Muthanna Governorate from 18 / December /2021 to 1 /April /2022. A non-probability (purposive) sample of 107 elderly diabetic patients from Diabetes center. To measure the association between risk for fall and socio demographic attributes, the researcher used a questionnaire that consist of (7) items related to socio demographic attributes and to measure the risk for fall the researcher used the berg balance scale that included (14) items . To analyze the results, the researcher used descriptive statistics (frequencies, percentage, mean, standard deviation) and inferential statistics (hi-squared) test was used. Results: (37.4%) of participants within the age group (60-64) years old. (49.5%) was men, (50.5%) was women. Illiterate (33.6%), (64.5%) of the participants are married, (37.4%) are unemployed, (94.4%) are live with family and (59.8%) are live in Urban. (48.6%) of participants have moderate risk for fall. There was significant relationship between the risk of fall with age, occupation, place of residency. Conclusion: The study concluded that some of socio- demographic characteristic such as age, and occupation and place of residency Increase the risk of falling among elderly diabetic patients while there is no association between the risk of fall and with gender, level of education, marital status, living status among elderly diabetic patients. Recommendations: The study recommended the importance of implementingeducational programs on fall prevention in all centers visited by the elderly and the elderly home, because the country lacks such programs to reduce the incidence of falls. Conducting more research on the topic of falls to detect the risk factors of falls among the elderly to reduce these cases.

The Influence of Family Caregiver Knowledge and Behavior on Elderly Diabetic Patients' Quality of Life in Northern Thailand.

The quality of life (QoL) of elderly diabetic patients may be affected by caregiver factors, but this has received little empirical support. The objective of this cross-sectional study is to determine the influence of family caregivers’ diabetes knowledge and behavior on the QoL among elderly patients with diabetes mellitus (DM). The participants included 354 elderly patients with Type 2 DM and their family caregivers, who were recruited through multistage sampling from five districts in Chiang Mai, Thailand. Face-to-face interviews with DM patients were conducted using the Thai Simplified Diabetes Knowledge Scale (T-SDKS), the Thai version of the Diabetes Self-Management Questionnaire (DSMQ) for self-care behaviors, and the Thai version of the World Health Organization Quality of Life for Older People (WHOQOL-OLD) scale. For caregivers, their diabetes knowledge was measured by T-SDKS and patient-care or supportive behaviors were developed based on DSMQ. The results showed a moderate level of QoL among elderly diabetic patients. According to simple linear regression analysis, the QoL score among elderly DM patients was positively associated with their diabetes knowledge (B = 1.25), self-care behaviors (B = 3.00), caregivers’ knowledge (B = 0.97), and supportive behavior from caregivers (B = 2.92) at a significance level of p < 0.01. In the multivariable model, patients’ self-care behaviors (B = 1.58, p = 0.001), caregivers’ knowledge (B = 0.58, p = 0.001), and patient-care behaviors (B = 1.38, p = 0.004) were significantly associated with QoL among DM patients when controlling for patient factors, including age, body mass index (BMI), education, and living arrangements, which accounted for 27.0% of the variance. This indicates that caregivers’ adequate diabetes knowledge and appropriate supportive behaviors may impact the QoL of elderly diabetic patients. Health care providers should prioritize motivating and empowering family caregivers to pay more attention to the patient for the success goal.

Factors Associated with Cognitive Impairment in Elderly Diabetic Patients in Lagos University Teaching Hospital, Lagos

Cognitive Impairment (CI) complicates Diabetes Mellitus (T2DM) and increases its burden to the patients, their caregivers and the society at large. Preventing the development and progression of cognitive impairment is a key strategy in reducing this burden. This study sought to determine the prevalence of Cognitive impairment and identify its risk factors among diabetes patients attending endocrinology unit of Lagos University teaching hospital, Lagos.

Factors associated with higher falling risk in elderly diabetic patients with lacunar stroke

PurposeThe aim of this study is to explore the factors associated with the fall risk in type 2 diabetes (T2D) patients with a lacunar stroke.Materials and methodsWe compiled data of 146 T2D patients (mean age 68 years), including the Morse fall scale data (MFS), nutrition score, self-care scale, laboratory data, and data from continuous glucose monitoring system (CGMS) from 2019 to 2021 in Shanghai Pudong Hospital. Thereby, we evaluated the associations between MFS and other clinical parameters.ResultsThe analyses showed that there were significantly increased size and numbers of lacunar infarction (p < 0.05). Furthermore, the greater risk group had an older mean age (p < 0.05), and significant decreased estimated glomerular filtration rate (eGFR), total triglyceride (TG), while increased microalbuminuria, magnesium, lipoprotein A (LP(a)), anti-thyroid peroxidase antibody (TPOAb) (p < 0.05). However, the time in range (TIR) was very comparable (p > 0.05). The correlational study revealed the higher score of MFS was associated with the age (r = 0.41), number of lacunar infarction (r = 0.18), nutrition score (r = 0.20), self-care score (r = − 0.43), serum creatine level (r = 0.19), eGFR (r = − 0.26) (p < 0.05). The total numbers of lacunar infarction were associated with age (r = 0.36), eGFR (r = − 0.40), homocysteine level (r = 0.33) (p < 0.05).ConclusionsAge, nutrition, self-care ability, and renal function are all critical factors associated with the risk of fall in T2D with lacunar infarction. The age, eGFR, and homocysteine are closely associated with lacunar infarction, suggesting that in T2D, evaluation of kidney dysfunction, homocysteine level in the elderly can predict lacunar infarcts and falls.

Clinical Analysis of Blood Sugar Control of Elderly Diabetic Patients in Physical Examination Center

Clinical Analysis of Blood Sugar Control of Elderly Diabetic Patients in Physical Examination Center

Glycemic Control and its Associated Factors among Elderly Diabetic Patients in a Tertiary Hospital in Lagos, Nigeria

Background: Glycaemic control in the elderly diabetic patient is highly individualized and achieving desired targets in the presence of comorbid conditions could be very challenging. This study was conducted to assess the glycemic control of elderly diabetics and identify associated factors at the Lagos University Teaching Hospital (LUTH). Methods: A hospital-based, cross-sectional descriptive study involving 199 randomly selected elderly diabetic patients receiving care at LUTH. A pretested, interviewer-administered questionnaire was used in data collection, which include sociodemographic characteristics, clinical history, and glycaemic control. Glycemic control was assessed using glycated haemoglobin (HBA1C). HBA1C&lt;7.0% was tight; 7-8% targeted and &gt;8% poor glycaemic control. Associations between glycemic control and independent variables was assessed using the chi-square test and its predictors identified by logistic regression analysis. Level of significance was set at p&lt;0.05. Results: The mean age of the participants was 68.6 years ± 6.7 years. Tight and poor glycemic control was seen in 35.1% and 34.2% respectively. Significant associations existed between glycemic control, age (ꭓ2 =9.310; p – 0.010), and marital status (ꭓ2 = 9.934; p – 0.007). Independent predictors include &gt;2 antidiabetic medication (aOR – 2.55; p – 0.048) Conclusion: Poor glycaemic control was high among the elderly and there was a negative correlation between age and glycaemic control among the participants. Statistically significant association was also found between glycaemic control and marital status of the participants as well as the number of diabetic medications, the presence of co-morbid conditions and adherence to medications. The need for individualized care among elderly diabetics cannot be overemphasized in order to reduce the risk of hypoglycaemia, improve clinical outcome, while considering other factors which could have an impact on glycaemic control among the elderly.