Use of pain relieving drugs in community-dwelling older people with and without type 2 diabetes

2020 ◽  
Vol 14 (6) ◽  
pp. 736-740
Author(s):  
Merja Karjalainen ◽  
Hannu Kautiainen ◽  
Juha Saltevo ◽  
Maija Haanpää ◽  
Pekka Mäntyselkä ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older People ◽  
Community Dwelling ◽  
Community Dwelling Older People

scholarly journals Older People with Type 2 diabetes - Individualising Management wIth a SpecialisEd community team: Safety and feasibility study (OPTIMISES): protocol (Preprint)

2019 ◽  
Author(s):  
Rajna Ogrin ◽  
Sandra Neoh ◽  
Tracy Aylen ◽  
Ralph Audehm ◽  
Leonid Churilov ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older People ◽  
Diabetes Management ◽  
Home Visits ◽  
Tertiary Hospital ◽  
Community Dwelling ◽  
Current Management ◽  
Diabetes Educator ◽  
Community Team

BACKGROUND The prevalence of diabetes is rising in older people. Clinical guidelines recommend that diabetes management should be individualised, however, there is limited information regarding the current management patterns of diabetes in older people. Few individuals achieve optimal glycaemic levels in the general population which could potentially lead to adverse health outcomes and impact quality of life. OBJECTIVE To trial individualised diabetes management intervention for older people through home visits with a credentialed diabetes educator and telehealth consultations with an endocrinologist located at a tertiary hospital. METHODS This paper describes the design and methodology of a mixed methods feasibility and safety study to identify the current management of people 65 years or older with type 2 diabetes. We will implement and evaluate a personalised approach to management in the community of an Australian metropolitan city. This management approach will utilise flash glucose monitoring and home visits with the support of a community home nursing service credentialed diabetes educator and telehealth consultation with an endocrinologist located at a local tertiary hospital. RESULTS Not reported CONCLUSIONS This study is the first of its kind to explore individualised diabetes management for community dwelling older people, aimed to achieve optimal glycaemic levels. The data drawn from this project may be used to inform policy makers, service providers, clinicians and older adults living with diabetes. CLINICALTRIAL Australian Clinical Trial Registration: ACTRN12617000350325

Prioritization and management of calls from older people to GP out-of-hours services

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Suzanne Smith ◽  
Lucia Carragher
Keyword(s):  
Older People ◽  
Service Provision ◽  
Emergency Services ◽  
Oldest Old ◽  
Community Dwelling ◽  
Third Party ◽  
Older Person ◽  
Out Of Hours ◽  
Accident And Emergency ◽  
Community Dwelling Older People

Abstract Background Urgent out-of-hours medical care is necessary to ensure people can remain living at home into older age. However, older people experience multiple barriers to using out-of-hours services including poor awareness about the general practitioner (GP) out-of-hours (GPOOH) service and how to access it. In particular, older people are reluctant users of GPOOH services because they expect either their symptoms will not be taken seriously or they will simply be referred to hospital accident and emergency services. The aim of this study was to examine if this expectation was borne out in the manner of GPOOH service provision. Objective The objective was to establish the urgency categorization and management of calls to GPOOH , for community dwelling older people in Ireland. Methods An 8-week sample of 770 calls, for people over 65 years, to a GPOOH service in Ireland, was analysed using Excel and Nvivo software. Results Urgency categorization of older people shows 40% of calls categorized as urgent. Recognition of the severity of symptoms, prompting calls to the GPOOH service, is also reflected in a quarter of callers receiving a home visit by the GP and referral of a third of calls to emergency services. The findings also show widespread reliance on another person to negotiate the GPOOH system, with a third party making 70% of calls on behalf of the older person seeking care. Conclusion Older people are in urgent need of medical services when they contact GPOOH service, which plays an effective and patient-centred gatekeeping role, particularly directing the oldest old to the appropriate level of care outside GP office hours. The promotion of GPOOH services should be enhanced to ensure older people understand their role in supporting community living.

scholarly journals Vitamin Intake and Loss of Muscle Mass in Older People with Type 2 Diabetes: A Prospective Study of the KAMOGAWA-DM Cohort

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2335
Author(s):  
Fuyuko Takahashi ◽  
Yoshitaka Hashimoto ◽  
Ayumi Kaji ◽  
Ryosuke Sakai ◽  
Yuka Kawate ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Older People ◽  
Vitamin B12 ◽  
Muscle Mass ◽  
Vitamin B1 ◽  
Vitamin D Intake ◽  
Glucagon Like Peptide 1

The aim of this prospective cohort study was to examine the relationships between the intakes of various vitamins and the loss of muscle mass in older people with type 2 diabetes (T2DM). The change in skeletal muscle mass index (SMI, kg/m2) (kg/m2/year) was defined as follows: (SMI at baseline (kg/m2) − SMI at follow-up (kg/m2))/follow-up period (year). The rate of SMI reduction (%) was calculated as follows (the change in SMI (kg/m2/year)/SMI at baseline (kg/m2)) × 100. The rate of SMI reduction ≥ 1.2% was considered as the loss of muscle mass. Among 197 people with T2DM, 47.2% of them experienced the loss of muscle mass at the 13.7 ± 5.2 month follow-up. Vitamin B1 (0.8 ± 0.3 vs. 0.8 ± 0.3 mg/day, p = 0.031), vitamin B12 (11.2 ± 8.3 vs. 13.4 ± 7.5 μg/day, p = 0.049), and vitamin D (16.5 ± 12.2 vs. 21.6 ± 13.0 μg/day, p = 0.004) intakes in people with the loss of muscle mass were significantly lower than those without. Vitamin D intake was related to the loss of muscle mass after adjusting for sex, age, exercise, alcohol, smoking, body mass index, SMI, glucagon-like peptide-1 agonist, sodium glucose cotransporter-2 inhibitor, insulin, HbA1c, creatinine, energy intake, and protein intake (adjusted odds ratio 0.93, 95% confidence interval: 0.88–0.97, p = 0.003). This study showed that vitamin D intake was related to the loss of muscle mass in older people with T2DM. Vitamin B12 intake tended to be related to the loss of muscle mass, although vitamin A, vitamin B2, vitamin B6, vitamin C, and vitamin E intake were not related.

scholarly journals Depression-related weight change and incident diabetes in a community sample

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Eva Graham ◽  
Tristan Watson ◽  
Sonya S. Deschênes ◽  
Kristian B. Filion ◽  
Mélanie Henderson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Weight Gain ◽  
Weight Change ◽  
Short Form ◽  
Community Sample ◽  
Overweight And Obesity ◽  
Community Dwelling ◽  
Increased Risk

AbstractThis cohort study aimed to compare the incidence of type 2 diabetes in adults with depression-related weight gain, depression-related weight loss, depression with no weight change, and no depression. The study sample included 59,315 community-dwelling adults in Ontario, Canada. Depression-related weight change in the past 12 months was measured using the Composite International Diagnostic Interview—Short Form. Participants were followed for up to 20 years using administrative health data. Cox proportional hazards models compared the incidence of type 2 diabetes in adults with depression-related weight change and in adults with no depression. Adults with depression-related weight gain had an increased risk of type 2 diabetes compared to adults no depression (HR 1.70, 95% CI 1.32–2.20), adults with depression-related weight loss (HR 1.62, 95% CI 1.09–2.42), and adults with depression with no weight change (HR 1.39, 95% CI 1.03–1.86). Adults with depression with no weight change also had an increased risk of type 2 diabetes compared to those with no depression (HR 1.23, 95% CI 1.04–1.45). Associations were stronger among women and persisted after adjusting for attained overweight and obesity. Identifying symptoms of weight change in depression may aid in identifying adults at higher risk of type 2 diabetes and in developing tailored prevention strategies.

Ten‐year trends in lifestyle habits among community‐dwelling older people in Taiwan

2021 ◽  
Author(s):  
Hsiao‐Ting Tsou ◽  
Tai‐Yin Wu ◽  
Kuan‐Liang Kuo ◽  
Sheng‐Huang Hsiao ◽  
Sheng‐Jean Huang ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Lifestyle Habits ◽  
Community Dwelling Older People

scholarly journals Frailty Status and All-Cause Mortality in the Community-Dwelling Older People: An Umbrella Review

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 488-489
Author(s):  
A R M Saifuddin Ekram ◽  
Joanne Ryan ◽  
Carlene Britt ◽  
Sara Espinoza ◽  
Robyn Woods
Keyword(s):  
Older People ◽  
Systematic Reviews ◽  
Community Dwelling ◽  
Umbrella Review ◽  
Frailty Phenotype ◽  
Frailty Status ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Community Dwelling Older People ◽  
Meta Analyses

Abstract Frailty is increasingly recognised for its association with adverse health outcomes including mortality. However, various measures are used to assess frailty, and the strength of association could vary depending on the specific definition used. This umbrella review aimed to map which frailty scale could best predict the relationship between frailty and all-cause mortality among community-dwelling older people. According to the PRISMA guidelines, Medline, Embase, EBSCOhost and Web of Science databases were searched to identify eligible systematic reviews and meta-analyses which examined the association between frailty and all-cause mortality in the community-dwelling older people. Relevant data were extracted and summarised qualitatively. Methodological quality was assessed by AMSTAR-2 checklist. Five moderate-quality systematic reviews with a total of 374,529 participants were identified. Of these, two examined the frailty phenotype and its derivatives, two examined the cumulative deficit models and the other predominantly included studies assessing frailty with the FRAIL scale. All of the reviews found a significant association between frailty status and all-cause mortality. The magnitude of association varied between individual studies, with no consistent pattern related to the frailty measures that were used. In conclusion, regardless of the measure used to assess frailty status, it is associated with an increased risk of all-cause mortality.

scholarly journals The composition of the gut microbiome differs among community dwelling older people with good and poor appetite

2021 ◽  
Author(s):  
Natalie J. Cox ◽  
Ruth C.E. Bowyer ◽  
Mary Ni Lochlainn ◽  
Philippa M. Wells ◽  
Helen C. Roberts ◽  
...  
Keyword(s):  
Older People ◽  
Gut Microbiome ◽  
Community Dwelling ◽  
Poor Appetite ◽  
Community Dwelling Older People
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