Clinical complexity in middle-aged and older adults with diabetes: the Health and Retirement Study.

TitleClinical complexity in middle-aged and older adults with diabetes: the Health and Retirement Study.
Publication TypeJournal Article
Year of Publication2010
AuthorsBlaum, C, Cigolle, CT, Boyd, C, Wolff, JL, Tian, Z, Langa, KM, Weir, DR
JournalMed Care
Volume48
Issue4
Pagination327-34
Date Published2010 Apr
ISSN Number1537-1948
KeywordsAged, Cross-Sectional Studies, Diabetes Complications, Diabetes Mellitus, Type 2, Female, Glycemic Index, Health Status, Health Surveys, Humans, Male, Middle Aged, Quality of Health Care, Self Care, Severity of Illness Index, Treatment Failure, United States
Abstract

<p><b>BACKGROUND: </b>Some patients with diabetes may have health status characteristics that could make diabetes self-management (DSM) difficult and lead to inadequate glycemic control, or limit the benefit of some diabetes management interventions.</p><p><b>OBJECTIVE: </b>To investigate how many older and middle-aged adults with diabetes have such health status characteristics.</p><p><b>DESIGN: </b>Secondary data analysis of a nationally representative health interview survey, the Health and Retirement Study, and its diabetes mail-out survey.</p><p><b>SETTING/PARTICIPANTS: </b>Americans aged 51 and older with diabetes (n = 3506 representing 13.6 million people); aged 56 and older in diabetes survey (n = 1132, representing 9.9 million).</p><p><b>MEASUREMENTS: </b>Number of adults with diabetes and (a) relatively good health; (b) health status that could make DSM difficult (eg, comorbidities, impaired instrumental activities of daily living; and (c) characteristics like advanced dementia and activities of daily living dependency that could limit benefit of some diabetes management. Health and Retirement Study measures included demographics. Diabetes Survey included self-measured HbA1c.</p><p><b>RESULTS: </b>Nearly 22% of adults > or =51 with diabetes (about 3 million people) have health characteristics that could make DSM difficult. Another 10% (1.4 million) may receive limited benefit from some diabetes management. Mail-out respondents with health characteristics that could make DSM difficult had significantly higher mean HbA1c compared with people with relatively good health (7.6% vs. 7.3%, P < 0.04.).</p><p><b>CONCLUSIONS: </b>Some middle-aged as well as older adults with diabetes have health status characteristics that might make DSM difficult or of limited benefit. Current diabetes quality measures, including measures of glycemic control, may not reflect what is possible or optimal for all patient groups.</p>

URLhttp://proquest.umi.com.proxy.lib.umich.edu/pqdweb?did=1994987731andFmt=7andclientId=17822andRQT=309andVName=PQD
DOI10.1097/mlr.0b013e3181ca4035
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/20355264?dopt=Abstract

Endnote Keywords

Data analysis/Patients/Diabetes/Glycemic index/Older people/Middle age

Endnote ID

22430

Alternate JournalMed Care
Citation Key7452
PubMed ID20355264
PubMed Central IDPMC3153504
Grant ListF32 AG027649 / AG / NIA NIH HHS / United States
U01 AG009740 / AG / NIA NIH HHS / United States
R01 AG021493 / AG / NIA NIH HHS / United States
1F32 AG027649-01 / AG / NIA NIH HHS / United States
U01 AG09740 / AG / NIA NIH HHS / United States
R01 AG027010 / AG / NIA NIH HHS / United States
K23 AG032910 / AG / NIA NIH HHS / United States
R01 AG021493A / AG / NIA NIH HHS / United States
R01 AG021493-01A2 / AG / NIA NIH HHS / United States