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The achievement of comprehensive control targets among type 2 diabetes mellitus patients of different ages.

ABSTRACT: OBJECTIVE:To evaluate achievement of comprehensive controls among patients with type 2 diabetes mellitus (T2DM) in different age groups. RESULTS:The elderly patients had higher control rates for BMI (44.36%), TC (50.83%) and LDL-C (48.27%) than those aged 60-80 years and younger patients (all P <0.05). Multiple logistic regression revealed that elderly patients were more likely to achieve control targets for HbA1c (odd ratio (OR) = 2.19), TC (OR = 1.32), HDL-C (OR = 1.35), and TG (OR = 1.74) than younger patients. This effect was stronger in males (ORHbA1c = 2.27; ORTC = 1.41; ORHDL-C = 1.51; ORTG = 1.80). By contrast, elderly females were only more likely to achieve HbA1c < 7.0% (OR=1.88). CONCLUSIONS:Our findings suggest that comprehensive control strategies still should be strengthened. METHODS:A total of 3126 T2DM patients were included, and detected blood pressure (BP), body mass index (BMI), glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C). We divided patients into three age groups (<60, 60-80 and ? 80 years), to assess the differences in achieving the control targets.

SUBMITTER: Yu Y

PROVIDER: S-EPMC7425513 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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The achievement of comprehensive control targets among type 2 diabetes mellitus patients of different ages.

Yu Yun Y Xie Kaipeng K Lou Qinglin Q Xia Hui H Wu Dan D Dai Lingli L Hu Cuining C Wang Kunlin K Shan Shan S Hu Yun Y Tang Wei W

Aging 20200722 14

<h4>Objective</h4>To evaluate achievement of comprehensive controls among patients with type 2 diabetes mellitus (T2DM) in different age groups.<h4>Results</h4>The elderly patients had higher control rates for BMI (44.36%), TC (50.83%) and LDL-C (48.27%) than those aged 60-80 years and younger patients (all <i>P</i> <0.05). Multiple logistic regression revealed that elderly patients were more likely to achieve control targets for HbA1c (odd ratio (OR) = 2.19), TC (OR = 1.32), HDL-C (OR = 1.35), ...[more]

PMID: 32699183

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Project description:Type 2 diabetes mellitus (T2DM) is a metabolic disease with increasing prevalence and mortality year by year. The purpose of this study was to explore new therapeutic targets and candidate drugs for multitargets by single-cell RNA expression profile analysis, network pharmacology, and molecular docking. Single-cell RNA expression profiling of islet β cell samples between T2DM patients and nondiabetic controls was conducted to identify important subpopulations and the marker genes. The potential therapeutic targets of T2DM were identified by the overlap analysis of insulin-related genes and diabetes-related genes, the construction of protein-protein interaction network, and the molecular complex detection (MCODE) algorithm. The network distance method was employed to determine the potential drugs of the target. Molecular docking and molecular dynamic simulations were carried out using AutoDock Vina and Gromacs2019, respectively. Eleven cell clusters were identified by single-cell RNA sequencing (scRNA-seq) data, and three of them (C2, C8, and C10) showed significant differences between T2DM samples and normal samples. Eight genes from differential cell clusters were found from differential cell clusters to be associated with insulin activity and T2DM. The MCODE algorithm built six key subnetworks, with five of them correlating with inflammatory pathways and immune cell infiltration. Importantly, CCR5 was a gene within the key subnetworks and was differentially expressed between normal samples and T2DM samples, with the highest area under the ROC curve (AUC) of 82.5% for the diagnosis model. A total of 49 CCR5-related genes were screened, and DB05494 was identified as the most potential drug with the shortest distance to CCR5-related genes. Molecular docking illustrated that DB05494 stably bound with CCR5 (-8.0 kcal/mol) through multiple hydrogen bonds (LYS26, TYR37, TYR89, CYS178, and GLN280) and hydrophobic bonds (TRP86, PHE112, ILE198, TRP248, and TYR251). This study identified CCR5 as a potential therapeutic target and screened DB05494 as a potential drug for T2DM treatment.

Project description:PurposeThe objective of our cross-sectional study is to explore the adherence behavior of patients with type 2 diabetes mellitus (T2DM) by examining the association between the various types of adherence. The success of diabetic therapy partly relies on patient motivation, psych-odemographic variables (self-efficacy, health literacy, and health locus of control [HLOC]), and adherence. The aim of our research was to explore the attitudes of T2DM patients toward medication and lifestyle therapy, thus gaining a deeper insight into the role of adherence-determining parameters in disease management.Patients and methodsThe sample for the present study consisted of 113 T2DM inpatients (75 women and 38 men) with a mean age of 60.56 years (SD=12.94, range: 20-85 years) diagnosed with T2DM for an average of 13 years (SD=8.23). Participants completed the Diabetes Adherence Questionnaire conceptualized by the research team in accordance with the mapping of psychological and psychosocial parameters. We examined the associations between variables using Spearman's rank correlation. Multivariate regression analysis was used to examine predictive variables for adherent behavior. In addition, we attempted to examine factors with a negative effect on adherence using factor analysis.ResultsBased on our results, a high level of medication adherence negatively correlated with lifestyle adherence. Multivariate regression analysis showed that blood glucose monitoring adherence is mostly predicted by social-external HLOC, diabetes self-efficacy, and internal HLOC, while dietary adherence is predicted by the patient's self-efficacy and duration of the illness. Additionally, understanding and following the diabetes treatment were significantly associated with dietary adherence and high levels of patient self-efficacy, while health literacy was mostly predicted by internal HLOC.ConclusionAdherence to medication, diet, glucose monitoring, and physical exercise showed different levels in T2DM patients and were in association with psychodemographic factors.

Project description:AimsType 2 diabetes (T2D) is a progressive disease often associated with comorbidities that complicate the management of T2D and affect the achievement of treatment targets. However, adherence to guidelines and individualized treatments can potentially improve treatment outcomes. This study assessed the association between different glucose lowering and lipid lowering medication lines and the achievement of treatment targets with different comorbidities among a T2D cohort in North Karelia, Finland (2011-12 to 2015-16).MethodsThe data on all diagnosed T2D patients (n = 10,190) in North Karelia were collated retrospectively from regional electronic health records (EHRs). Analyses were performed considering the age, sex, and comorbidities such as cardiovascular diseases (CVD) and any mental disorders (AMD). We analyzed the trends in using glucose lowering and lipid lowering medications and the effect of changes in medication on the achievement of treatment targets among different patient groups.ResultsMetformin was the most common treatment in all patient groups. The use of only metformin declined and the use of metformin and/or other non-insulin medications increased during the follow-up. A Combination of insulin and non-insulin medication was mostly used by T2D patients with both cardiovascular diseases and mental disorders (T2D + CVD + AMD), and the use of insulin increased among this group in follow-up. Achievement of the glucose treatment target deteriorated even after the intensification of medication among all patient groups during the follow-up. A considerably higher number of patients with T2D + AMD and T2D + CVD + AMD did not use lipid lowering medication when compared to the T2D + CVD patients both at baseline and follow-up. However, the achievement of the LDL treatment target improved during the follow-up.ConclusionAchievement of the glucose target deteriorated even after the intensification of treatment, and especially among patients with multiple diseases. Many T2D patients with AMD and CVD remained without lipid lowering medication, which needs further attention.

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The achievement of comprehensive control targets among type 2 diabetes mellitus patients of different ages.

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The achievement of comprehensive control targets among type 2 diabetes mellitus patients of different ages.

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