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Objective To observe the effect of insulin glargine combined with methimazole treatment of senile diabetes mellitus complicated with hyperthyroidism.MethodsThe clinical data of 80 cases in People's Hospital of Haiyan from May 2014 to May 2016 were elderly diabetic patients with hyperthyroidism were analyzed.ResultsThe combined treatment group of patients with fasting blood glucose, 2h postprandial blood glucose was significantly lower than the average water alone treatment group (P<0.05), TSH level was significantly higher than that of single treatment group (P<0.05), FT3, FT4, TGAb, TMAb levels were significantly lower than the single treatment group (P<0.05), the total efficiency of 85% treatment (34/40) was significantly higher than that of single the treatment group of 40% (16/40) (P<0.05), insulin was significantly less than single treatment group (P<0.05), blood glucose time, hospitalization time were significantly shorter than single treatment group (P<0.05), the incidence of adverse reactions was 12.5% (5/40) was significantly lower than that of single treatment group 47.5% (19/40) (P<0.05).ConclusionInsulin glargine combined with methimazole in treatment of elderly diabetes mellitus complicated with hyperthyroidism was better than insulin glargine treatment alone.
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Objective To evaluate the clinical value of psychological intervention in the treatment of anxiety in patients with diabetes mellitus insulin treatment.Methods To select from June 2015 to March 2017 in our hospital was basically stable after the hospital has been maintained with clinicians and nurses, 104 cases of complete and complete hospital and after follow-up data of patients as the research object, the design of control study, 52 cases received psychological intervention were included in the observation group, 52 cases of routine care of patients as control group, respectively, by using the self rating Anxiety Scale(SAS) before and after nursing in the quantitative evaluation of the psychological status of patients with.Results There was no significant difference between the observation group and the control group in the moderate and severe anxiety patients before nursing.The different degree of anxiety in patients after nursing in the observation group accounted for the proportion was 26.9%, 3.8% in the control group, the proportion was 36.5%, 21.2%, patients with anxiety level were significantly lighter than the control group(P<0.05).Conclusion Insulin treatment in elderly patients with diabetes is needed for clinical treatment of psychological intervention, psychological intervention is always running through them, so as to realize the effective to alleviate the anxiety of patients, and improve the treatment compliance of patients, promote the recovery of disease.
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Ninety-one patients over 60 year old with type 2 diabetes mellitus(T2DM) were selected from our outpatient department. The patients of experimental group uploaded their blood glucose data detected with glucometers, and obtained integrated management called " Mobile Health(M-health)" management such as medicines,diet,exercise from medical groups. The patients of control group got medical care in a traditional way without receiving other interventions. Regular follow-up was conducted in 2 groups every 3 months. The results showed that 3 months later,postprandial 2h plasma glucose in the experimental group was significantly improved compared with that of control group (P<0.05). Six months later, postprandial 2h plasma glucose and HbA1Clevels in the experimental group showed a decline comparing to the baseline, showing a statistical significance compared with control group(P<0.05). These results suggest that smartphone-based telemedicine is helpful of blood glucose control in elderly T2DM patients.
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Objective To observe the effects of buyang huanwu decoction combined with sarpogrelate hydrochloride in the treatment of elderly diabetes mellitus associated with lower extremity arteriosclerosis obliterans(ASO). Methods 102 patients with diabetic lower limb ASO enrolled in Tongde hospital from December 2014 to December 2016 were divided into the experimental group and the control group according to the treatment way, with 51 cases in each group. The control group was treated with sarpogrelate hydrochloride, the experimental group was treated with buyang huanwu decoction based on the basis of control group, both groups was treated for two months. The clinical curative effect, the dorsalis pedis artery blood flow, ankle brachial index, claudication distance, and adverse reactions occur was compared and observed between two groups. Results The total effective rate of the experimental group was 92.16% higher than 76.47% of the control group (P<0.05). The dorsalis pedis artery blood flow, ankle brachial index, claudication distance of experimental group was higher than the control group (P<0.05). There was no significant difference in adverse reactions between the two groups. Conclusion The effect of buyang huanwu decoction joint sarpogrelate hydrochloride in the treatment elderly diabetes ASO, can relieve body blood, blood fat, blood sugar state, promote patient recovery.
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Objective To investigate and analyze the effect of psychological intervention and insulin treatment on anxiety in elderly patients with diabetes mellitus. Methods 92 elderly patients with diabetes mellitus from January 2016 to January 2017 in the first affiliated hospital of Wenzhou medical university chengdu campus were randomly divided into the control group and the experimental group, 46 patients for each group. The control group was treated with conventional insulin therapy, the experimental group was given psychological intervention on the basis of the control group, strengthened communication and exchanges, increased confidence. The anxiety levels of two groups were compared and analyzed. Results After treatment, 46cases were satisfied in the experimental group, and 40 cases were satisfied in the control group. The satisfaction degree of nursing in the control group was 86.96%, significantly lower than 100.00% in the experimental group, which was statistically significance (P<0.05). After the intervention, the HAMA score of the experimental group was (10.54±5.40), significantly lower than (14.63±5.23) of the control group with statistical significance (P<0.05). Conclusion The application of psychological intervention combined with insulin treatment in elderly patients with diabetes could significantly improve the anxiety and the satisfaction of nursing, and has the significance of clinical promotion.
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Objective To observe the effects of buyang huanwu decoction combined with sarpogrelate hydrochloride in the treatment of elderly diabetes mellitus associated with lower extremity arteriosclerosis obliterans(ASO). Methods 102 patients with diabetic lower limb ASO enrolled in Tongde hospital from December 2014 to December 2016 were divided into the experimental group and the control group according to the treatment way, with 51 cases in each group. The control group was treated with sarpogrelate hydrochloride, the experimental group was treated with buyang huanwu decoction based on the basis of control group, both groups was treated for two months. The clinical curative effect, the dorsalis pedis artery blood flow, ankle brachial index, claudication distance, and adverse reactions occur was compared and observed between two groups. Results The total effective rate of the experimental group was 92.16% higher than 76.47% of the control group (P<0.05). The dorsalis pedis artery blood flow, ankle brachial index, claudication distance of experimental group was higher than the control group (P<0.05). There was no significant difference in adverse reactions between the two groups. Conclusion The effect of buyang huanwu decoction joint sarpogrelate hydrochloride in the treatment elderly diabetes ASO, can relieve body blood, blood fat, blood sugar state, promote patient recovery.
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Objective To investigate and analyze the effect of psychological intervention and insulin treatment on anxiety in elderly patients with diabetes mellitus. Methods 92 elderly patients with diabetes mellitus from January 2016 to January 2017 in the first affiliated hospital of Wenzhou medical university chengdu campus were randomly divided into the control group and the experimental group, 46 patients for each group. The control group was treated with conventional insulin therapy, the experimental group was given psychological intervention on the basis of the control group, strengthened communication and exchanges, increased confidence. The anxiety levels of two groups were compared and analyzed. Results After treatment, 46cases were satisfied in the experimental group, and 40 cases were satisfied in the control group. The satisfaction degree of nursing in the control group was 86.96%, significantly lower than 100.00% in the experimental group, which was statistically significance (P<0.05). After the intervention, the HAMA score of the experimental group was (10.54±5.40), significantly lower than (14.63±5.23) of the control group with statistical significance (P<0.05). Conclusion The application of psychological intervention combined with insulin treatment in elderly patients with diabetes could significantly improve the anxiety and the satisfaction of nursing, and has the significance of clinical promotion.
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Objective To explore the curative effect of insulin combined with An Er Shu in treatment ofⅡtoⅢ degree pressure sores of elderly patients with diabetes mellitus. Methods A total of 120 cases of elderly diabetes mellitus patients with Ⅱ to Ⅲ degree pressure sores were randomly divided into the control group (30 cases, conventional nursing treatment), the experimental group 1 (30 cases, insulin spray coating), the experimental group 2 (30 cases, An Er Shu brushing besmear), and the experimental group 3(30 cases, insulin combined An Er Shu). The curative effect and the healing time were observed. Results After four weeks treatment total effective rate was 60.0%(18/30) in the control group, 66.7%(20/30) in the experimental group 1, 76.7%(23/30) in the experimental group 2, 100.0%(30/30) in the experimental group 3, and there was significant difference in the 3 experimental groups comparing with the control group, the experimental group 1 and the experimental group 2, respectively (χ2=15.000, 12.000, 5.822, P<0.05 or 0.01). The healing time ofⅡdegree pressure sores was (19.03 ± 0.85) d in the control group, (18.90 ± 0.92) d in the experimental group 1, (18.43 ± 0.82) d in the experimental group 2, and (16.97 ± 1.25) d in the experimental group 3, and there was significant difference in the experimental group 3 comparing with the control group, experimental group 1 and experimental group 2, respectively (t=8.013, 7.918, 8.930, P<0.01), and in the experimental group 2 comparing with the control group (t=3.525, P<0.01). The healing time ofⅢdegree pressure sores was (24.17 ± 1.51) d in the control group, (23.63 ± 1.33) d in the experimental group 1, (23.47 ± 1.25) d in the experimental group 2, and (21.07 ± 1.46) d in the experimental group 3, and there was significant difference in the experimental group 3 comparing with the control group, experimental group 1 and experimental group 2, respectively (t=6.918, 7.048, 9.200, P<0.01). Pressure sores area reduction was (44.47 ± 37.63)%in the control group, (56.50 ± 39.64)%in the experimental group 1, (66.23 ± 37.54)%in the experimental group 2, and (96.52 ± 7.71) % in the experimental group 3, and there was significant difference in the experimental group 3 comparing with the control group, the experimental group 1 and the experimental group 2, respectively (Z=-4.274,-4.274,-3.400, P<0.01). Conclusions Insulin combined An Er Shu in treatment of pressure sores in elderly patients with diabetes mellitus can improve curative effect and shorten the healing time.
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Objective To investigate the achievement of HbAlc ( A) ,blood pressure ( B) ,and LDL-C ( C) control goals of diabetes and explore their association with indices of renal function among diabetics in community. Methods A total of 388 diabetes patients aged 45 years and older were enrolled who received physical examination in a community.In addition to blood pressure (BP),were measured fasting blood glucose,glycated hemoglobin ( HbAlc) ,serum lipid,creatinine,and urea nitrogen. Results In this investigation only 1.8%of diabetes patients achieved ABC goals.And 34.0% achieved none of the three and 45.9%reached only one of the three.In the 388 diabetes patients,54.6%had HbAlc<7%,25.0%LDL-C <2.6 mmol/L,and 8.2% BP<130/80 mmHg.The levels of serum creatinine and urea nitrogen were elevated with age and not found to have association with the achievement of ABC goals. Conclusion Poor achievement of ABC goals was among diabetics in community.The effective control of blood pressure and LDL contributes to improvement of comprehensive control levels for diabetics.
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Objective:To investigate the efficacy and safety of metformin in the treatment of elderly patients with diabetes. Meth-ods:Totally 72 cases of elderly patients with diabetes in our hospital from January 2012 to December 2012 were randomly divided into the observation group and the control group. The observation group was received metformin, and the control group was given repaglin-ide. The efficacy and safety of the two groups were compared. Results:After the treatment, blood sugar of fasting, 2h after meals and 10:00 p. m. in the observation group and the control group was significantly decreased (P0. 05). The HbA1c levels before and after the treatment in the observation group was with statistically significant differ-ence (P0. 05). The incidence of adverse reactions in the observation group was lower than that in the control group(P<0. 05). Conclusion:Effect of metformin in the treatment of elderly patients with diabetes is remarkable and safe, which is worthy of further promotion and application.
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In the near future, the majority of patients with diabetes will be adults aged 65 or older. Unlike young adults with diabetes, elderly diabetic people may be affected by a variety of comorbid conditions such as depression, cognitive impairment, muscle weakness (sarcopenia), falls and fractures, and physical frailty. These geriatric syndromes should be considered in the establishment of treatment goals in older adults with diabetes. Although there are several guidelines for the management of diabetes, only a few are specifically designed for the elderly with diabetes. In this review, we present specific conditions of elderly diabetes which should be taken into account in the management of diabetes in older adults. We also present advantages and disadvantages of various glucose-lowering agents that should be considered when choosing a proper regimen for older adults with diabetes.
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Adult , Aged , Humans , Young Adult , Depression , Diabetes Mellitus, Type 2 , Muscle Weakness , SarcopeniaABSTRACT
Objective:To investigate the changes of intestinal flora and the effects of antibiotics and micro-ecological agent on the intestinal flora in the elderly diabetes.Methods:Intestinal flora detection by Stool cultures,compared 55 diabetes with 184 non-diabetes.Those who need antibiotics were randomly divided into two groups:one group used micro-ecological agent(bacillus licheniformis capsules) and the other not.Their fecal were collected to detect intestinal flora before antibiotic used and at the 5th、10th and 15th day of antibiotic used.Results:Compared with non-diabetes,the quantity of Escherichia coli significantly increased(9.53?1.76 vs 9.14?1.29,P
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BACKGROUND: Hypoglycemia is the most common therapeutic complication of diabetes mellitus and especially in elderly diabetic patients with diminished cardiac and cerebral circulation can cause serious tissue damage. Though many studies have attempted to evaluate hypoglycemia in IDDM or adult diabetic patients, few studies in the elderly. We have compared clinical characteristics of severe hypoglycemia in elderly diabetes with adult diabetes. METHODS: This study include 56 severe hypoglycemic patients who have admitted to emergency department of National Medical Center from march 1, 1992 to december 31, 1997. they are divided two group (adult group; 21, elderly group; 35) and authors investigate the cause, the symptom, the time of severe hypoglycemia, degree of education, treatment method in each group. RESULTS: 1) DM education was not well done in severe hypoglycemic patients. 2) The frequency of severe hypoglycemia in the elderly was more than adult (adult: 21 (38%), elderly 35 (62%)). 3) In both population, the most common symptom of severe hypoglycemia was neuroglycopenic symptom, especially in the elderly (adult: 57%, elderly: 77%). 4) Decreased food intake (49%) in the elderly and overdose of insulin (38%) in the adult were the most common cause of severe hypoglycemia. 5) Severe hypoglycemia occurred more often between midnight and 6 AM in the adult, between noon and 6 PM in the elderly. 6) The treatment of diabetes mellitus is insulin (71%) and oral hypoglycemic agent (29%) in the adult, oral hypoglycemic agent (51%) and insulin (49%) in the elderly. CONCLUSION: For prevention of severe hypoglycemia, we should emphasize the importance of DM education and especially elderly diabetic patients should be educated about the symptoms of hypoglycemia, the self-management of hypoglycemia, the need for a regular carbohydrate intake and more easy and effective diet program is require in elderly diabetes.
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Adult , Aged , Humans , Diabetes Mellitus , Diabetes Mellitus, Type 1 , Diet , Eating , Education , Emergency Service, Hospital , Hypoglycemia , Insulin , Self CareABSTRACT
BACKGROUND: Some research viewed that effective dietary therapy was enough to control proper blood glucose level, but in the most patient, dietary therapy was not practiced and the most difficult part of managing their diabetes. The purpose of this research study was to investigate dietary practice adherence and perceived barriers among the elderly diabetes. METHODS: The survey was mailed to 852 persons with diabetes member via diabetic educator of 156 hospitals or clinics and 24 health centers. Questionnaire had background information of patients, meal regularity, food intake as a dietary practice adherence, barriers of 36 items which have 3 areas such as motive/attitude, knowledge, authority/resource. We asked the person with diabetes to rate barrier to dietary practice adherence. 432 questionnaire were returned the response. we selected 69 persons who were over 65 year old. RESULTS: 1) meal regularity was more satisfactory than food intake. 2) deficit of meal regularity were evening snack and resonable spacing between evening meal and evening snack. 3) deficit of food intake was serving of milk. 4) main barrier to dietary practice adherence was that of knowledge. CONCLUSION: For practice effectively dietary therapy to elderly diabetes, individual consultation or small group education must be pursued and more easily educational skills should be required.