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The Phenotype of Elderly Patients with Type 2 Diabetes Mellitus and Poor Sleep Quality.

ABSTRACT: BACKGROUND:Sleep disturbances are a common problem among patients with Type 2 diabetes mellitus (T2DM). The aim of the study was to identify the phenotype of T2DM patients with poor sleep quality. METHODS:An observational, cross-sectional study was conducted between May 2013 and August 2015. One hundred and sixty consecutive patients with T2DM: 74 women and 86 men, with a median age of 69.50 years (59.00; 79.50 years) were enrolled in the study. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. RESULTS:Poor sleep quality was noted in 85 (53%) patients. Sleep disorders were associated with older age, as well as female gender, longer duration of diabetes, lower level of fasting plasma glucose, glycated hemoglobin A1c, estimated glomerular filtration rate, triglycerides, waist-to-hip ratio, and the presence of nephropathy. A multivariate logistic regression revealed that sleep disorders were associated with older age (Odd Ratio (OR) = 1.11, 95% Confidence Interval (CI) 1.07-1.15). Fifty-one patients (31.87%) were treated with sleeping pills. We found that older age, female gender, longer duration of diabetes, lower level of fasting plasma glucose, glycated hemoglobin A1c, estimated glomerular filtration rate, triglycerides, and the presence of nephropathy were linked with more frequent usage of hypnotics. A multivariate logistic regression demonstrated that older age (OR = 1.09, 95% CI 1.05-1.14) and nephropathy (OR = 2.79, 95% CI 1.24-6.28) were associated with a more frequent receiving the hypnotics, whereas male gender (OR = 0.30, 95% CI 0.13-0.71) has less frequent hypnotics usage. CONCLUSION:Although, we assessed a wide range of patients' characteristics, age had the most negative impact on the quality of sleep in patients with T2DM. We detected more frequent use of hypnotics in older females, with coexisting nephropathy.

SUBMITTER: Mikolajczyk-Solinska M

PROVIDER: S-EPMC7459960 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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The Phenotype of Elderly Patients with Type 2 Diabetes Mellitus and Poor Sleep Quality.

Mikołajczyk-Solińska Melania M Śliwińska Agnieszka A Kosmalski Marcin M Drzewoski Józef J

International journal of environmental research and public health 20200818 16

<h4>Background</h4>Sleep disturbances are a common problem among patients with Type 2 diabetes mellitus (T2DM). The aim of the study was to identify the phenotype of T2DM patients with poor sleep quality.<h4>Methods</h4>An observational, cross-sectional study was conducted between May 2013 and August 2015. One hundred and sixty consecutive patients with T2DM: 74 women and 86 men, with a median age of 69.50 years (59.00; 79.50 years) were enrolled in the study. Sleep quality was evaluated using t ...[more]

PMID: 32824748

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Project description:BackgroundAs a long-term chronic disease, Type 2 diabetes mellitus (T2DM) patients' quality of life is affected by both themselves and his/ her close relatives, requiring comprehensive support from family members to ensure that patients are able to manage disease. The objective of this study is to investigate the relationship between caregivers' sense of coherence, caregiver competence, and T2DM patients' quality of life, as well as to explore the factors affecting patients with T2DM patients.MethodsThis investigation was a cross-sectional study. Between October 2022 and July 2023, 392 participant-caregiver dyads from two hospitals in Jinzhou City, Liaoning Province, were researched. Participants were investigated by General Characteristics Questionnaire, Modified Barthel Index (MBI), Diabetes Specific Quality of Life Scale (DSQLS), Sense of Coherence scale-13 (SOC-13), and Family Caregiver Task Inventory (FCTI). Data were statistically analyzed using SPSS 25. Univariate and multivariate linear regression analyses were used to identify the independent factors associated with the quality of life of elderly patients with T2DM.ResultsThe average score of T2DM quality of life was 61.14 (SD = 7.37), quality of life was negatively correlated with sense of coherence (r=-0.344, P<0.01) and positively correlated with caregiver competence (r = 0.522, P<0.01). Furthermore, we found that age, disease duration, activities of daily living scores, sense of coherence, and caregiver competence scores were the main predictors of quality of life (R2 = 0.375, P < 0.001).ConclusionsThis study found that high levels of sense of coherence and caregiver competence in family caregivers were associated with better quality of life for patients. Furthermore, we also found that good quality of life was also related to younger age, shorter disease duration, and less dependence. This study offers a feasible example for policymakers to improve the quality of life from the perspective of T2DM patients' family caregivers.

Project description:Objectives: This study aimed to explore the relationship between glycaemic control and factors that may influence this among elderly type 2 diabetes mellitus (T2DM) patients in Lahore, Pakistan. Methods: This descriptive, cross-sectional study was conducted at the Jinnah and Sir Ganga Ram Hospitals, Lahore using convenience sampling techniques between 1 December 2015 and 28 February 2016. The sample consisted of elderly (>65 years) T2DM patients. Glycaemic values and patient characteristics were obtained from medical charts. Consenting patients were interviewed to complete the Barthel Index, Lawton Instrumental Activities of Daily Living Scale, Clinical Frailty Scale, Iowa Pain Thermometer Scale, Geriatric Depression Scale, Montreal Cognitive Assessment tool, Mini Nutritional Assessment Scale-Short Form and Self Care Inventory-Revised Version. Multiple logistic regression analysis was carried out to determine the predictors of poor glycaemic control. Results: A total of 490 patients were approached and 400 agreed to participate. Overall, nearly one-third (32.2%, n = 129) of patients had glycated haemoglobin (HbA1c) at the target level. Fasting and random plasma glucose levels were within the target range to much the same extent; (36.8%, n = 147) and (27%, n = 108), respectively. HbA1c levels were also higher in patients with co-morbidities (67.4%, n = 229) with diabetes-related complications (73.5%, n = 227). Significant predictors of impaired glycaemic control (HbA1c) included poor diabetes self-care (adjusted odds ratio (AOR) 0.96; 95% confidence interval (CI) 0.95, 0.98), not being prescribed oral hypoglycaemic agents (OHA) (AOR 6.22; 95% CI 2.09, 18.46), regular hypoglycaemic attacks (AOR 2.53; 95% CI 1.34, 4.81) and falling tendency (AOR 0.19; 95% CI 0.10, 0.36). Conclusions: Poor glycaemic control prevailed among the majority of elderly Pakistani diabetic patients in this study. Triggering factors of poor glycaemic control should be taken into consideration by the healthcare professionals in targeting multifaceted interventions to achieve good glycaemic control.

Project description:BackgroundShort sleep duration and poor sleep quality are important risk factors for atherosclerosis. The use of smart bracelets that measure sleep parameters, such as sleep stage, can help determine the effect of sleep quality on lower-extremity atherosclerosis in patients with type 2 diabetes.ObjectiveTo investigate the correlation between sleep disorders and lower-extremity atherosclerosis in patients with type 2 diabetes.MethodsAfter admission, all patients were treated with lower-extremity arterial ultrasound and graded as having diabetic lower-extremity vascular lesions according to the results. A smart bracelet was used to obtain the patient sleep data. The correlation between sleep patterns and diabetic lower-extremity atherosclerosis, diabetic foot, and various metabolic indices was verified.ResultsBetween August 2021 and April 2022, we screened 100 patients with type 2 diabetes, with 80 completing sleep monitoring. Univariate ordered logistic regression analysis indicated that patients with a sleep score below 76 (OR = 2.707, 95%CI: 1.127-6.488), shallow sleep duration of 5.3 h or more (OR=3.040, 95 CI: 1.005-9.202), wakefulness at night of 2.6 times or more (OR = 4.112, 95%CI: 1.513-11.174), and a deep sleep continuity score below 70 (OR = 4.141, 95%CI: 2.460-615.674) had greater risk of high-grade lower limb atherosclerosis. Multivariate ordinal logistic regression analysis revealed that the risk of high-grade lower limb atherosclerosis was higher in patients with 2.6 or more instances of nighttime wakefulness (OR = 3.975, 95%CI: 1.297-12.182) compared with those with fewer occurrences. The sleep duration curve of patients with different grades of diabetic lower-extremity atherosclerosis was U-shaped. According to the results of the one-way analysis of variance, the higher the deep sleep continuity score, the lower the Wagner scale score for diabetic foot (P < 0.05).ConclusionsSleep disorders (long, shallow sleep duration, frequent wakefulness at night, and poor continuity of deep sleep) can worsen lower limb atherosclerosis in patients with type 2 diabetes. This finding can provide a new method for medical professionals to prevent and treat diabetic lower-extremity vascular lesions.

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The Phenotype of Elderly Patients with Type 2 Diabetes Mellitus and Poor Sleep Quality.

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The Phenotype of Elderly Patients with Type 2 Diabetes Mellitus and Poor Sleep Quality.

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