Evidence-Informed Guidelines for Treating Frail Older Adults With Type 2 Diabetes: From the Diabetes Care Program of Nova Scotia (DCPNS) and the Palliative and Therapeutic Harmonization (PATH) Program

2013 ◽  
Vol 14 (11) ◽  
pp. 801-808 ◽  
Author(s):  
Laurie Herzig Mallery ◽  
Tom Ransom ◽  
Brian Steeves ◽  
Brenda Cook ◽  
Peggy Dunbar ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Nova Scotia ◽  
Diabetes Care ◽  
Care Program ◽  
Frail Older Adults

scholarly journals Listening to Older Adults' Values and Preferences for Type 2 Diabetes Care: A Qualitative Study

2014 ◽  
Vol 27 (1) ◽  
pp. 44-49 ◽  
Author(s):  
E. A. Beverly ◽  
L. A. Wray ◽  
C. L. LaCoe ◽  
R. A. Gabbay
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Qualitative Study ◽  
Diabetes Care

scholarly journals Sociodemographic and clinical functional factors in pre-frail and frail older adults with type 2 Diabetes Mellitus in relation to low levels of physical activity

2020 ◽  
Vol 23 (1) ◽  
Author(s):  
Ana Clara Teixeira Fernandes ◽  
Bartolomeu Fagundes de Lima Filho ◽  
Íkaro Felipe da Silva Patrício ◽  
Vanessa da Nóbrega Dias ◽  
Fabrícia Azevêdo da Costa Cavalcanti ◽  
...  
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Type 2 Diabetes Mellitus ◽  
Frail Older Adults ◽  
Functional Factors ◽  
Low Levels ◽  
Years Of Schooling

Abstract Objective: To determine the sociodemographic and clinical-functional factors related to low levels of physical activity in pre-frail and frail older adults with type 2 diabetes mellitus (DM2). Method: an observational, analytical, cross-sectional study was performed. The sample consisted of older adults aged 60 years or over with a clinical diagnosis of DM2 who were treated at the Onofre Lopes University Hospital (or HUOL). Sociodemographic and clinical-functional data were evaluated with the following instruments: the Timed Up and Go (TUG) test, the Mini Mental State Examination (MMSE), the 15-item Geriatric Depression Scale (GDS), the International Physical Activity Questionnaire (IPAQ) and the frailty phenotype. The Chi-square and Mann Whitney tests were used for data analysis. Results: the study sample consisted of 113 individuals classified as pre-frail (52.2%) and frail (47.8%). Low levels of physical activity were verified in 79.6% of the sample. The most closely related variables that showed a statistically significant difference with low levels of physical activity were: years of schooling (p=0.02), social participation (p=0.005), insulin therapy (p=0.02), pain in the lower limbs (p=0.03) and depressive symptoms (p=0.04). Also, significant differences were found between low levels of physical activity and age (p=0.04) and years of schooling (p=0.05). Conclusions: Low levels of physical activity are associated with certain sociodemographic and clinical-functional factors, some of which are modifiable. Identifying these is important for the development of appropriate health interventions for the prevention and treatment of both DM2 and the Frailty Syndrome (FS).

scholarly journals Prospective Monitoring of Newly Marketed Drugs in Frail Older Adults Using Real-World Databases

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 209-209
Author(s):  
Dae Kim ◽  
Elisabetta Patorno
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Real World ◽  
New Drugs ◽  
Frail Older Adults ◽  
Drug Benefits ◽  
Monitoring Framework ◽  
Prospective Monitoring

Abstract In recent years several new drugs have been approved for treatment of heart failure and type 2 diabetes. Despite their life-prolonging benefits, uptake of new drugs is often slow among older patients with frailty due to under-representation of frail older adults in pivotal clinical trials and concerns for adverse events. To optimize pharmacotherapy, timely evaluation of the drug benefits and risks is urgently needed. We propose a novel drug monitoring framework that prospectively evaluates the effectiveness and safety of newly marketed drugs for frail and non-frail patients in real-world databases. This framework utilizes a validated claims-based frailty index (CFI) (range: 0-1; frail if ≥0.20) to find early signals for effectiveness and safety of new drugs by updating the analysis at regular intervals as new data become available. In this symposium, we present early results of this prospective monitoring framework for 2 new drug classes using Medicare claims data from the approval date until the end of 2017: 1) angiotensin receptor-neprilysin inhibitor (ARNI) (approved in July 2015) for heart failure with reduced ejection fraction (HFrEF) and 2) sodium-glucose cotransporter-2 inhibitors (SGLT2i) (approved in March 2013) for type 2 diabetes. We first show the uptake of ARNI and SGLT2i over time among the eligible Medicare beneficiaries by clinical characteristics, including frailty. Subsequently we present the results of sequential cohort analysis for the effectiveness and safety results of ARNI and SGLT2i. After these presentations, the panel will discuss the strengths, limitations, and challenges of implementing our monitoring framework in real-world databases.

scholarly journals Motivational Strategies to Prevent Frailty in Older Adults with Diabetes: A Focused Review

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
J. A. Vaccaro ◽  
T. Gaillard ◽  
F. G. Huffman ◽  
E. R. Vieira
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Health Behavior ◽  
Lifestyle Changes ◽  
Health Care Use ◽  
Behavior Changes ◽  
Motivational Strategies ◽  
Frail Older Adults ◽  
Health Behavior Changes

The prevalence of diabetes among Americans aged 65 years and older is greater than 25%. Medical expenditures for persons with diabetes are more than twice as high as those for patients without diabetes. Diabetes in older adults often times coexists with frailty, resulting in reduced quality of life and increased health-care use. Many older adults with type 2 diabetes have mobility impairments and experience falls, which contributes to increased frailty. Exercise has a protective effect for frailty and falls, yet less than half of persons with diabetes exercise and approximately one-quarter meet exercise recommendations. In addition to exercise, nutrition may help reduce the risk for falls; however, nutritional interventions have not been tested as a fall-prevention intervention. According to a review, there is insufficient evidence to create nutritional guidelines specific for frail older adults with type 2 diabetes. There is a need to motivate and empower older adults with type 2 diabetes to make lifestyle changes to prevent frailty. The purpose of this review was to identify and integrate what is known and what still needs to be done for this population to be successful in making health behavior changes to reduce frailty. There is some evidence that motivational approaches have worked for older adults with various chronic disease conditions. However, studies applying motivational strategies are lacking for frail older adults with type 2 diabetes. A novel motivational approach was described; it combines aspects of the Health Belief Model and Motivational Interviewing. Intervention studies incorporating this model are needed to determine whether this client-driven strategy can help various racial/ethnic populations make the sustainable health behavior changes of increasing exercise and healthy eating while taking into consideration physiological, psychological, and economic barriers.

scholarly journals Comment on Samara et al. Metformin Use Is Associated With Slowed Cognitive Decline and Reduced Incident Dementia in Older Adults With Type 2 Diabetes: The Sydney Memory and Ageing Study. Diabetes Care 2020;43:2691–2701

Diabetes Care ◽  
2021 ◽  
Vol 44 (4) ◽  
pp. e73-e73
Author(s):  
Jorge Rafael Violante-Cumpa ◽  
Luis Alberto Pérez-Arredondo ◽  
José Gerardo González-González ◽  
Leonardo Guadalupe Mancillas-Adame
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Cognitive Decline ◽  
Diabetes Care ◽  
Incident Dementia ◽  
Ageing Study

Effectiveness of comprehensive diabetes care program in Taiwanese with type 2 diabetes

2008 ◽  
Vol 79 (2) ◽  
pp. 276-283 ◽  
Author(s):  
Kai-Jen Tien ◽  
Hsin-Chia Hung ◽  
Jeng-Yueh Hsiao ◽  
Shih-Chieh Hsu ◽  
Shih-Chieh Hsin ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetes Care ◽  
Care Program
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