Purpose
Assessment of the relationship between psychological and sociodemographic factors with the levels of glycated hemoglobin (HbA1c) and Body Mass Index (BMI) among people with advanced type 2 diabetes mellitus (T2DM).
Patients and Methods
A total of 2574 persons, among them 1381 (53.7%) women, with type 2 diabetes, during the period of switching from biphasic mixtures of human insulin to insulin analogues. The age of participants ranged from 22 to 94 years (M = 63.5; SD = 9.58), and their treatment period was in the time frame from 2 years to 43 years (M = 10.2; SD = 6.1). Participants filled out a Scale for Perception of Self-Influence on the Diabetes Course, Well-Being Index WHO-5, two questions from the Brief Method of Evaluating Coping with a Disease.
Results
Statistically significant correlations were found between the HbA1c levels and (1) disease duration (r
s
=0.067; p < 0.001); (2) number of complications (r
s
= 0.191,
p
< 0.001) (3) the perception of self-influence on the diabetes course (r
s
=- 0.16; p < 0.001); (4) well-being (risk of depression) (r
s
=- 0.10; p < 0.001). The regression analysis showed that 7% of HbA1c variability is explained by age, a perception of self-influence on the diabetes course, the number of complications, place of residence, education, BMI. The most important findings concerning BMI were found in regression analysis, which indicated a week relationship between BMI and a number of complications, perception of self-influence on the diabetes course and coping styles (3% of the resultes' variability). The group at high risk of depression had the highest levels of HbA1c.
Conclusion
Sociodemographic and psychological factors show weak but statistically significant relationships with the current levels of HbA1c and BMI.
The optimum treatment for periprosthetic joint infection (PJI) of the hip with substantial bone defects remains controversial. A retrospective assessment was performed for 182 patients treated for PJI with a two-stage protocol from 2005 to 2015. Implant removal and debridement were followed by Girdlestone arthroplasty or spacer implantation. The results of the Girdlestone and spacer groups were compared. There were 71 cases that received spacers, and 111 Girdlestone procedures were performed. After the first stage, 26.37% of cultures were negative, and among patients with a detected pathogen, methicillin-sensitive Staphylococcus aureus was the most common organism (41.79%). Acetabular and femoral bone defects, according to the Paprosky classification, were more severe in the Girdlestone group (P<0.05). During the follow-up (mean, 5.95 years), the overall incidence of complications was 21.42%. The mean Harris hip score was significantly lower in the Girdlestone group (68.39 vs 77.79; P<0.0001). The infection recurrence rate reached 8.79%. Despite satisfactory infection control, the number of complications and poor functional outcomes associated with resection arthroplasty indicate the necessity for development of different approaches for patients with advanced bone loss.
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