American Diabetes Association Framework for Glycemic Control in Older Adults: Implications for Risk of Hospitalization and Mortality

Diabetes Care ◽  
2021 ◽  
pp. dc203045
Author(s):  
Mary R. Rooney ◽  
Olive Tang ◽  
Justin B. Echouffo Tcheugui ◽  
Pamela L. Lutsey ◽  
Morgan E. Grams ◽  
...  
Keyword(s):  
Older Adults ◽  
Glycemic Control ◽  
American Diabetes Association

scholarly journals American Diabetes Association Framework for Glycemic Control in Older Adults: Implications for Risk of Hospitalization and Mortality

2021 ◽  
Author(s):  
Mary R. Rooney ◽  
Olive Tang ◽  
Justin B. Echouffo Tcheugui ◽  
Pamela L. Lutsey ◽  
Morgan E. Grams ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Glycemic Control ◽  
American Diabetes Association ◽  
Cohort Analysis ◽  
Medication Use ◽  
Poor Health ◽  
Glucose Lowering ◽  
Atherosclerosis Risk In Communities ◽  
Intermediate Group

<u>Objective:</u> The 2021 American Diabetes Association (ADA) guidelines recommend different A1C targets in older adults based on comorbid health status. We assessed risk of mortality and hospitalizations in older adults with diabetes across glycemic control (A1C <7%, 7-<8%, ≥8%) and ADA-defined health status (healthy, complex/intermediate, very complex/poor) categories. <p><u>Research Design and Methods:</u> Prospective cohort analysis of older adults aged 66-90 years with diagnosed diabetes in the Atherosclerosis Risk in Communities (ARIC) Study. </p> <p><u>Results:</u> In the 1841 participants (56% were women, 29% Black), 32% were classified as healthy, 42% had complex/intermediate, and 27% had very complex/poor health<a>. Over a median 6-year follow-up, there were 409 (22%) deaths and 4130 hospitalizations (median, 25<sup>th</sup>-75<sup>th</sup>: 1, 0-3 per person). In the very complex/poor category, individuals with A1C≥8% (versus A1C<7%) had higher mortality risk (HR 1.76, 95%CI:1.15-2.71), even after adjustment for glucose-lowering medication use. Within the very complex/poor health category, individuals with A1C≥8% had more hospitalizations (incidence rate ratio (IRR) 1.41, 95%CI:1.03-1.94) than those with A1C<7%. In the complex/intermediate group, individuals with A1C≥8% (versus A1C<7%) had more hospitalizations even with adjustment for glucose-lowering medication use [IRR 1.64 (1.21-2.24)]. Results were similar, but imprecise, when the analysis was restricted to insulin or sulfonylurea users (n=663).</a></p> <u>Conclusions:</u> There were substantial differences in mortality and hospitalizations across ADA health status categories, but older adults with A1C<7% were not at elevated risk, regardless of health status. Our results support the 2021 ADA guidelines and indicate that <7% is a reasonable treatment goal in some older adults with diabetes.

1097-P: Glycemic Control and Safety Profile of Insulin Glargine 300 U/mL in Older Adults—REALI Pooled Data Analysis

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 1097-P
Author(s):  
RICCARDO C. BONADONNA ◽  
DIDAC MAURICIO ◽  
DIRK MÜLLER-WIELAND ◽  
NICK FREEMANTLE ◽  
GREGORY BIGOT ◽  
...  
Keyword(s):  
Older Adults ◽  
Data Analysis ◽  
Glycemic Control ◽  
Insulin Glargine ◽  
Safety Profile ◽  
Pooled Data

Impact of Activity Participation and Depression on Glycemic Control in Older Adults With Diabetes: Glycemic Control in Nursing Homes

2011 ◽  
Vol 29 (4) ◽  
pp. 139-144
Author(s):  
J. L. Bellissimo ◽  
R. M. Holt ◽  
S. M. Maus ◽  
T. L. Marx ◽  
F. L. Schwartz ◽  
...  
Keyword(s):  
Older Adults ◽  
Glycemic Control ◽  
Nursing Homes ◽  
Activity Participation

Proposed Mechanisms of Blood Flow Restriction Exercise for the Improvement of Type 1 Diabetes Pathologies

Diabetology ◽  
2021 ◽  
Vol 2 (4) ◽  
pp. 176-189
Author(s):  
Morgan T. Jones ◽  
Elroy J. Aguiar ◽  
Lee J. Winchester
Keyword(s):  
Blood Flow ◽  
Type 1 Diabetes ◽  
Glycemic Control ◽  
Resistance Exercise ◽  
American Diabetes Association ◽  
Blood Flow Restriction ◽  
Clinical Population ◽  
Muscular System ◽  
Flow Restriction

Individuals with type 1 diabetes suffer from impaired angiogenesis, decreased capillarization, and higher fatigability that influence their muscular system beyond the detriments caused by decreased glycemic control. In order to combat exacerbations of these effects, the American Diabetes Association recommends that individuals with type 1 diabetes participate in regular resistance exercise. However, traditional resistance exercise only induces hypertrophy when loads of ≥65% of an individual’s one repetition maximum are used. Combining blood flow restriction with resistance exercise may serve as a more efficient means for stimulating anabolic pathways that result in increased protein synthesis and angiogenesis at lower loads, while also promoting better glycemic control. The purpose of this paper is to provide a review on the literature surrounding the benefits of resistance exercise, specifically for individuals with type 1 diabetes, and postulate potential effects of combining resistance exercise with blood flow restriction in this clinical population.

scholarly journals American Association of Clinical Endocrinologists and American Diabetes Association Consensus Statement on Inpatient Glycemic Control

Diabetes Care ◽  
2009 ◽  
Vol 32 (6) ◽  
pp. 1119-1131 ◽  
Author(s):  
E. S. Moghissi ◽  
M. T. Korytkowski ◽  
M. DiNardo ◽  
D. Einhorn ◽  
R. Hellman ◽  
...  
Keyword(s):  
Glycemic Control ◽  
American Diabetes Association ◽  
Consensus Statement ◽  
American Association

scholarly journals Erratum to: Comparative Effectiveness for Glycemic Control in Older Adults with Diabetes

2017 ◽  
Vol 6 (3) ◽  
pp. 187-187
Author(s):  
Michael Quartuccio ◽  
Brian Buta ◽  
Rita Rastogi Kalyani
Keyword(s):  
Older Adults ◽  
Glycemic Control ◽  
Comparative Effectiveness

scholarly journals Glycated Hemoglobin Levels in Patients with Decompensated Cirrhosis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Jeffrey Nadelson ◽  
Sanjaya K. Satapathy ◽  
Satheesh Nair
Keyword(s):  
Glycemic Control ◽  
American Diabetes Association ◽  
Independent Predictor ◽  
Decompensated Cirrhosis ◽  
University Of Tennessee ◽  
Glucose Levels ◽  
Reliable Predictor ◽  
Group A ◽  
Group B ◽  
Hba1c Levels

Introduction. Aim of this study is to determine if HbA1c levels are a reliable predictor of glycemic control in patients with decompensated cirrhosis.Methods. 200 unique patients referred for liver transplantation at University of Tennessee/Methodist University Transplant Institute with a HbA1c result were included. Three glucose levels prior to the “measured” A1c (MA1c) were input into an HbA1c calculator from the American Diabetes Association website to determine the “calculated” A1c (CA1c). The differences between MA1c and CA1c levels were computed. Patients were divided into three groups: group A, difference of <0.5; group B, 0.51–1.5; and group C, >1.5.Results. 97 (49%) patients had hemoglobin A1c of less than 5%. Discordance between calculated and measured HbA1c of >0.5% was seen in 47% (n=94). Higher level of discordance of greater than >1.5 was in 12% of patients (n=24). Hemoglobin was an independent predictor for higher discordance (odds ratio 0.77 95%, CI 0.60–0.99, andpvalue 0.04). HbA1c was an independent predictor of occurrence of HCC (OR 2.69 955, CI 1.38–5.43, andpvalue 0.008).Conclusion. HbA1c is not a reliable predictor of glycemic control in patients with decompensated cirrhosis, especially in those with severe anemia.

scholarly journals Effects of low-intensity resistance training on muscular function and glycemic control in older adults with type 2 diabetes

2018 ◽  
Vol 10 (2) ◽  
pp. 331-338 ◽  
Author(s):  
Eri Takenami ◽  
ShinMin Iwamoto ◽  
Noriko Shiraishi ◽  
Akiko Kato ◽  
Yuichi Watanabe ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Resistance Training ◽  
Glycemic Control ◽  
Low Intensity ◽  
Muscular Function

scholarly journals Relationship Between Multiple Measures of Financial Hardship and Glycemic Control in Older Adults With Diabetes

2020 ◽  
pp. 073346482091154
Author(s):  
Rebekah J. Walker ◽  
Emma Garacci ◽  
Jennifer A. Campbell ◽  
Melissa Harris ◽  
Elise Mosley-Johnson ◽  
...  
Keyword(s):  
Older Adults ◽  
Glycemic Control ◽  
Financial Hardship ◽  
Financial Strain ◽  
Linear Regression Models ◽  
Medication Usage ◽  
Multiple Measures ◽  
Cumulative Score ◽  
Using Data ◽  
The Relationship

Aim: To examine the relationship between multiple measures of financial hardship and glycemic control in older adults with diabetes. Methods: Using data from Health and Retirement Study (HRS), we investigated four measures of financial hardship: difficulty paying bills, ongoing financial strain, decreasing food intake due to money, and taking less medication due to cost. Using linear regression models, we investigated the relationship between each measure, and a cumulative score of hardships per person, on glycemic control (HbA1c). Results: After adjustment, a significant relationship existed with each increasing number of hardships associated with increasing HbA1c (0.09, [95%CI 0.04, 0.14]). Difficulty paying bills (0.25, [95%CI 0.14, 0.35]) and decreased medication usage due to cost (0.17, [95%CI 0.03, 0.31]) remained significantly associated with HbA1c. Conclusion: In older adults, difficulty paying bills and cost-related medication nonadherence is associated with glycemic control, and every additional financial hardship was associated with an increased HbA1c by nearly 0.1%.

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