Diabetes Care for Patients Experiencing Homelessness: Beyond Metformin and Sulfonylureas

Brooks, Lauren K.; Kalyanaraman, Nilesh; Malek, Rana

doi:10.1016/j.amjmed.2018.10.033

Cited by 8 publications

(4 citation statements)

References 40 publications

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“…Choice of medication is important, and considerations should include medication cost and the ability to store medication and diabetes care supplies safely. Brooks et al provide a narrative review of considerations for diabetes treatment among individuals experiencing homelessness (101). (102).…”

Section: Housingmentioning

confidence: 99%

Social Determinants of Health and Diabetes: A Scientific Review

et al. 2020

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Decades of research have demonstrated that diabetes affects racial and ethnic minority and low-income adult populations in the U.S. disproportionately, with relatively intractable patterns seen in these populations' higher risk of diabetes and rates of diabetes complications and mortality (1). With a health care shift toward greater emphasis on population health outcomes and value-based care, social determinants of health (SDOH) have risen to the forefront as essential intervention targets to achieve health equity (2-4). Most recently, the COVID-19 pandemic has highlighted unequal vulnerabilities borne by racial and ethnic minority groups and by disadvantaged communities. In the wake of concurrent pandemic and racial injustice events in the U.S.,

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Section: Housingmentioning

confidence: 99%

Social Determinants of Health and Diabetes: A Scientific Review

et al. 2020

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“…Using shelters, where many patients experiencing homelessness reside, 3 as the place of health interventions as well as other social supports could help address the multilevel barriers to diabetes management, such as poor diet, access to medications and cost of diabetic care, inadequate healthcare resources and competing interests. 16 , 24 The stigma surrounding homelessness, provider prejudice, and the focus of the health system primarily on the provision of acute care for patients experiencing homelessness, could impact interactions and communication with providers and therefore diabetes management. 25 , 26 In addition, the mobility of this population lacking consistent housing could impact preventive care, adherence, and health education opportunities.…”

Section: Discussionmentioning

confidence: 99%

Diabetes care and its predictors among persons experiencing homelessness compared with domiciled adults with diabetes in New York City; An observational study

2022

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“…It may raise the risk of osteoporosis, which is mainly caused by the decreased insulin sensitivity or lack of insulin production in elderly male patients. Accordingly, interests of clinical studies are focused on exploring optimum therapies to control the blood glucose levels and meanwhile improve osteoporosis in elderly male patients with type 2 diabetes mellitus[ 3 , 4 ]. Currently, metformin is widely used in the treatment of type 2 diabetes.…”

Section: Introductionmentioning

confidence: 99%

Effects of different doses of metformin on bone mineral density and bone metabolism in elderly male patients with type 2 diabetes mellitus

Wang

et al. 2020

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BACKGROUND Diabetes is a chronic disease, which may cause various complications. Patients with diabetes are at high risk of bone and joint disorders, such as osteoporosis and bone fractures. In addition, it became widely accepted that diabetes has an important impact on bone metabolism. Metformin is a commonly used and effective first-line treatment for type 2 diabetes. Some glucose-lowering agents have been found to have an effect on bone metabolism. The present study explored if different doses of metformin have an effect on bone mineral density (BMD) and bone metabolism in type 2 diabetes. AIM To investigate the effects of different doses of metformin on BMD and bone metabolism in elderly male patients with type 2 diabetes mellitus. METHODS A total of 120 elderly male outpatients with type 2 diabetes mellitus who were admitted to our hospital were included in the study from July 2018 to June 2019. They were randomly assigned to an experimental group and a control group with 60 patients in each group. Patients in the experimental group were given high dose metformin four times a day 0.5 g each time for 12 wk. Patients in the control group were given low dose metformin orally twice a day 0.5 g each time for 12 wk. The changes in bone mineral density and bone metabolism before and after treatment and the efficacy rate of the treatment were compared between the two groups. RESULTS There was no significant difference in the efficacy rate between the two groups ( P > 0.05). Before the treatment, there was no significant difference in BMD and bone metabolism between the two groups ( P > 0.05). However, after the treatment, BMD and bone metabolism were improved in the two groups. Moreover, BMD and 25-hydroxyvitamin D were significantly higher in the experimental group than in the control group, and N-terminal/midregion and β-isomerized C-terminal telopeptides were significantly lower in the experimental group than in the control group (all P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). CONCLUSION Both high and low dose metformin can effectively control the blood glucose levels in elderly male patients with type 2 diabetes mellitus. However, the benefits of high dose metformin in improving BMD and bone metabolism level was more obvious in patients with type 2 diabetes mellitus.

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Diabetes Care for Patients Experiencing Homelessness: Beyond Metformin and Sulfonylureas

Cited by 8 publications

References 40 publications

Social Determinants of Health and Diabetes: A Scientific Review

Social Determinants of Health and Diabetes: A Scientific Review

Diabetes care and its predictors among persons experiencing homelessness compared with domiciled adults with diabetes in New York City; An observational study

Effects of different doses of metformin on bone mineral density and bone metabolism in elderly male patients with type 2 diabetes mellitus

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