Understanding 30-day Re-admission After Hospitalisation Of Older Patients For Diabetes: Identifying Those At Greatest Risk

Understanding 30-day re-admission after hospitalisation of older patients for diabetes: identifying those at greatest risk

Understanding 30-day re-admission after hospitalisation of older patients for diabetes: identifying those at greatest risk
Gillian E Caughey, Nicole L Pratt, John D Barratt, Sepehr Shakib, Anna R Kemp-Casey and Elizabeth E Roughead
Med J Aust 2017; 206 (4): 170-175. || doi: 10.5694/mja16.00671
Objective: To identify factors that contribute to older Australians admitted to hospital with diabetes being re-hospitalised within 30 days of discharge.
Design, setting and participants: A retrospective cohort study of Department of Veterans Affairs administrative data for all patients hospitalised for diabetes and discharged alive during the period 1 January 31 December 2012.
Main outcome measures: Causes of re-hospitalisation and prevalence of clinical factors associated with re-hospitalisation within 30 days of discharge.
Methods: Multivariate logistic regression analysis (backward stepwise) was used to identify characteristics predictive of 30-day re-hospitalisation.
Results: 848 people were hospitalised for diabetes; their median age was 87 years (interquartile range, 7789 years) and 60% were men. 209 patients (24.6%) were re-hospitalised within 30 days of discharge, of whom 77.5% were re-admitted within 14 days of discharge. 51 re-hospitalisations (24%) were for diabetes-related conditions; 41% of those re-admitted within 14 days had not seen their general practitioner between discharge and re-admission. Factors predictive of re-hospitalisation included comorbid heart failure (adjusted odds ratio [aOR], 1.49; 95% confidence interval [CI], 1.032.17; P = 0.036), numbers Continue reading

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Black-ish Hits a Sour Note When It Comes to Diabetes

Black-ish Hits a Sour Note When It Comes to Diabetes
The 'Sugar Daddy' episode is in 'collaboration' with Novo-Nordisk - maker of diabetes drugs - and minimizes the ways diet and exercise can help diabetics.
Do you like the TV show black-ish? I do. Its funny, and the acting is outstanding. But even better, every week the show uses its immense platform to educate the public on race issues. I admire the show and look forward to watching it.
Imagine my outrage when I watched the episode about type 2 diabetes entitled Sugar Daddy and realized the show had sold out to a pharmaceutical company. Oops, sorry, the TV network that carries the show, ABC, actor Anthony Anderson and the pharmaceutical company call it a collaboration. (Novo Nordisk sells multiple diabetes drugs and advertised on the episode. In addition, Novo Nordisk is the sponsor of the Get Real About Diabetes website and Facebook page . Anderson is a paid spokesperson for the company.)
The message in the episode completely overemphasizes the role of medication by suggesting that the most important aspect of diabetes care is using injectable insulin. Thats wrong, and thats harmful.
Type 2 diabetes is an excellent topic to address African Americans are twice as likely as Caucasians to get diabetes AND its one of the few diseases that can be minimized and often reversed, if caught and addressed before the pancreas stops creating insulin completely.
The writers, producers and the lead actor squandered their opportunity to help those most at risk for diabetes. Worse, so much worse, the episode mocked Dres first in Continue reading

Environmental/lifestyle factors in the pathogenesis and prevention of type 2 diabetes

Abstract
Environmental and lifestyle changes, in addition to the ageing of populations, are generally believed to account for the rapid global increase in type 2 diabetes prevalence and incidence in recent decades.
In this review, we present a comprehensive overview of factors contributing to diabetes risk, including aspects of diet quality and quantity, little physical activity, increased monitor viewing time or sitting in general, exposure to noise or fine dust, short or disturbed sleep, smoking, stress and depression, and a low socioeconomic status. In general, these factors promote an increase in body mass index. Since loss of β-cell function is the ultimate cause of developing overt type 2 diabetes, environmental and lifestyle changes must have resulted in a higher risk of β-cell damage in those at genetic risk. Multiple mechanistic pathways may come into play.
Strategies of diabetes prevention should aim at promoting a ‘diabetes-protective lifestyle’ whilst simultaneously enhancing the resistance of the human organism to pro-diabetic environmental and lifestyle factors. More research on diabetes-protective mechanisms seems warranted.
Background
Over the past decades, there has been a major increase in type 2 diabetes (T2D) prevalence in most regions of the world [1]. After adjusting for the impact of ageing populations, diabetes prevalence in adults (85–95% T2D) almost doubled between 1980 and 2014 worldwide. Increases were more pronounced in low- and middle-income countries and in men compared to women [1].
Recognition of the environmental and lifestyle facto Continue reading

Giving Thanks All Year Round

Well, Thanksgiving was nice. A day to feast with family and/or friends and give thanks for all we have. Felt good, didn’t it? Why not keep it going?
Gratitude expert Richard Emmons, PhD, and others have collected and conducted studies showing that giving thanks improves physical and psychological health. It improves self-esteem, social relationships, and sleep. Gratitude even helps people overcome trauma.
I believe gratitude is the surest, easiest path to happiness and a fulfilled life. The more thanks you give, the better you will feel. We don’t always have a feast to give thanks for, but we have so many things that enrich and enable our lives every day, things we rarely even think of.
Here are some you’re swimming in right now and probably haven’t noticed:
Air. This is not just an inanimate thing that happens to be there. It’s continuously created by every, animal, plant, and bacteria in the world. You could thank them, and the people who fight so hard to keep air breathable by controlling pollution.
Water. Not just the water you drink, cook, and clean with, but all the water inside you. Water is life. You’d be dead in a second without it.
Food. If you thanked all the plants and animals you eat; the insects that pollinate the plants; the bugs, worms, and germs that make the soil; the people who farm the food and get it to you; those who pay you the money you use to buy it; and so on; you’d never stop. And don’t forget the sun, whose energy you’re eating.
Warmth and shelter. If you have those, you’re truly lucky. Think about how you got it and how it’ Continue reading

Obesity and Type 2 Diabetes in Young People: A Matter of National Concern

Obesity and Type 2 Diabetes in Young People: A Matter of National Concern
Evidence-Based Diabetes Management > June 2017 Published on: June 27, 2017
Obesity and Type 2 Diabetes in Young People: A Matter of National Concern
A claims data review suggests new approaches are needed for prevention, screening, diagnosis, and treatment of obesity and type 2 diabetes in the pediatric population.
Type 2 diabetes (T2D) was once so rare in children that it was often called adult-onset diabetes to distinguish it from type 1 diabetes (juvenile diabetes). A growing body of evidence has shown, however, that the prevalence of T2D is increasing among the nations young people and that a major contributor to this increase is the epidemic of obesity in the same population.1,2 Our recent white paper, Obesity and Type 2 Diabetes as Documented in Private Claims Data: Spotlight on This Growing Issue Among the Nations Youth,3 examines these trends.
Consulting our FAIR Health database, which, at the time, included more than 21 billion privately billed healthcare claims nationwide (and has since grown to over 23 billion), we analyzed data from 2011 to 2015 to look for trends and patterns in obesity, T2D, and other obesity-related conditions in the nations pediatric population, which we defined as youth aged 0 to 22 years. As a point of comparison, we also studied adults 22 years or older. Claims data are a useful means of investigating public health issues because they reflect actual healthcare utilization and the information provided on claims indicates the assessments of providers, who are Continue reading