Continuity of diabetes care among elderly Japanese patients: a medical record review study in a specialized diabetes clinic

Tanaka, Rie; Motohashi, Shinobu; Morioka, Junko; Takahashi, Akimitsu; Yamazaki, K.; Kawai, Koichi

doi:10.1007/s13340-022-00569-y

Cited by 2 publications

(2 citation statements)

References 10 publications

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“…A study reported that longer duration of receiving treatment is associated with lower drug adherence rates ( 23 ). Previous studies in Japan demonstrated that the percentage of patients with DM who regularly received HbA1c testing was ≥60% ( 12 , 24 , 25 ), whereas it was ≤50% in the present study. The present study contained more elderly people, therefore the findings from our study might suggest the difficulty for elderly people to regularly visit outpatient clinics ( 24 ) and issues in preventive measures against worsening of DM in a rapidly aging society, including poor drug adherence and accessibility of medical services.…”

Section: Discussioncontrasting

confidence: 83%

“…Previous studies in Japan demonstrated that the percentage of patients with DM who regularly received HbA1c testing was ≥60% (12, 24, 25), whereas it was ≤50% in the present study. The present study contained more elderly people, therefore the findings from our study might suggest the difficulty for elderly people to regularly visit outpatient clinics (24) and issues in preventive measures against worsening of DM in a rapidly aging society, including poor drug adherence and accessibility of medical services. In addition, the complexity of the prescription including polypharmacy among DM patients with comorbidity might also influence to lower drug adherence and regularly prescribed medication.…”

Section: Current Status Of Access To Healthcare Services For Dmmentioning

confidence: 90%

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Status of screening and preventive efforts against diabetic kidney disease between 2013 and 2018: analysis using an administrative database from Kyoto-city, Japan

Tateyama

Shimamoto

Uematsu³

et al. 2023

Front. Endocrinol.

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BackgroundJapan has the second highest prevalence of dialysis use in the world. Approximately 40% of patients who begin dialysis have diabetic kidney disease (DKD). Local governments and medical facilities are required to provide preventive measures against worsening diabetes mellitus (DM). However, the percentage of patients with DM who receive such screening or interventions for DKD is unclear. This study aimed to reveal to what extent screening for DKD and preventive measures against worsening DKD are performed in patients with DM, using an administrative database in a municipality.MethodsThis was a cross-sectional study that used the Kyoto-city’s administrative medical and long-term care database. Patients with a diagnosis of DM and receiving antidiabetic medication between 2013 and 2018 were defined as patients with DM and included. Patients with DKD were defined as those diagnosed with diabetic nephropathy or those with chronic kidney disease. We described the characteristics of patients with DM, diabetic complications, and extent of DKD screenings and preventive efforts against worsening of DM by fiscal year.ResultsAcross fiscal years, 25.8% to 27.5% of patient with DM had DKD. More than 3% of patients were on dialysis due DM in each fiscal year; approximately 15% started receiving dialysis that year. The percentage of patients who were regularly prescribed antidiabetic medication and received glycosylated hemoglobin testing ranged from 64.0% to 67.2% and from 30.6% to 36.5%, respectively. Urine microalbuminuria testing at least once a year occurred in 9.3% to 10.0%. The percentage of patients who received nutritional guidance ranged from 19.0% to 21.0%. Approximately 1% of patients received guidance for preventing DM from progressing to a disease that requires dialysis each fiscal year.ConclusionThis study from Japan, where a super-aging society has developed, using an administrative database in a municipality covering most of the elderly population clearly demonstrated an evidence-practice gap in efforts to prevent worsening of DKD. Strengthening cooperation between government and medical facilities and support for providing preventive measures against DKD are urgently needed.

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Section: Discussioncontrasting

confidence: 83%

Section: Current Status Of Access To Healthcare Services For Dmmentioning

confidence: 90%

Status of screening and preventive efforts against diabetic kidney disease between 2013 and 2018: analysis using an administrative database from Kyoto-city, Japan

Tateyama

Shimamoto

Uematsu³

et al. 2023

Front. Endocrinol.

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Glycemic Control and Lung Function in Younger and Older Patients with Diabetes

Piya-amornphan,

Sanpakdee,

Permphet

2024

Advances in Public Health

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Background. Diabetic angiopathy has been reported to be a common complication in patients with diabetes mellitus. The lungs also have been reported to be the affected organ. The present study aimed to determine the impacts of glycemic control on lung function in younger and older patients with diabetes. Methods. One hundred twenty‐two patients were recruited to the present analytical observational study. HbA1c, patient’s medical history, and current health status obtained from the hospital medical records were collected. Spirometry was performed for the lung function test. Self‐reported respiratory symptoms were obtained. Regression analysis, odds ratio, and mean differences between groups were revealed. Results. Forced vital capacity (%predicted) in patients with diabetes was lower than 80%. It also was associated with the self‐reported respiratory symptoms. Regression analysis revealed that glycemic control influenced pulmonary function in patients with diabetes (standardized coefficient beta = −0.224, p value = 0.014). HbA1c level > 7% was a factor in reducing the forced vital capacity in the patients (odds ratio = 3.125; 95% CI, 1.401–6.964). With respect to age and glycemic control, forced vital capacity (%predicted) of patients aged ≥60 years old with poor glycemic control also was significantly lower than those with good glycemic control (p < 0.001).Conclusions. The pulmonary function test of the patients with diabetes indicates restrictive lungs. Poor glycemic control impairs lung function and may cause respiratory symptoms, especially in the elderly.

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Continuity of diabetes care among elderly Japanese patients: a medical record review study in a specialized diabetes clinic

Cited by 2 publications

References 10 publications

Status of screening and preventive efforts against diabetic kidney disease between 2013 and 2018: analysis using an administrative database from Kyoto-city, Japan

Status of screening and preventive efforts against diabetic kidney disease between 2013 and 2018: analysis using an administrative database from Kyoto-city, Japan

Glycemic Control and Lung Function in Younger and Older Patients with Diabetes

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