Purpose: Diabetic patients aged 65 years or older are more likely to be frail than non-diabetic older adults. Adherence to therapeutic recommendations in the elderly suffering from diabetes and co-existent frailty syndrome may prevent complications such as micro- or macroangiopathy, as well as significantly affect prevention and reversibility of frailty. The study aimed at assessing the impact of frailty syndrome (FS) on the level of adherence to medication in elderly patients with type 2 diabetes (DM2). Patients and Methods: The research was carried out among 175 DM2 patients (87; 49.71% women and 88; 50.29% men) whose average age amounted to 70.25 ± 6.7. Standardized research instruments included Tilburg frailty indicator (TFI) to assess FS and adherence in chronic disease scale questionnaire (ACDS) to measure adherence to medications. Results: The group of 101 (57.71%) patients displayed medium, 39 (22.29%)—low, and 35 (20.00%)—high adherence. As many as 140 of them (80.00%) were diagnosed with frailty syndrome. The median of the average result of TFI was significantly higher in the low adherence group (p ˂ 0.001) (Mdn = 9, Q1–Q3; 7–10 pt.) than in the medium (Mdn = 6, Q1–Q3; 5–9 pt.) or high adherence (Mdn = 6.00, Q1–Q3; 4.5–8 pt.) ones. The independent predictors of the chance to be qualified to the non-adherence group included three indicators: TFI (OR 1.558, 95% CI 1.245–1.95), male gender (OR 2.954, 95% CI 1.044–8.353), and the number of all medications taken daily (each extra pill decreased the chance of being qualified to the non-adherence group by 15.3% (95% CI 0.728–0.954). Conclusion: Frailty syndrome in elderly DM2 patients influenced medical adherence in this group. The low adhesion group had higher overall TFI scores and separately higher scores in the physical and psychological domains compared to the medium and high adhesion groups.
This project aimed to analyze the impact of disease acceptance and selected demographic and clinical factors on the adherence to treatment recommendations in elderly type 2 diabetes mellitus patients. The observational study was performed using standardized research questionnaires: the Acceptance of Illness Scale (AIS), the Self-Care of Diabetes Inventory (SCODI), and the Adherence in Chronic Diseases Scale (ACDS). Two hundred patients with T2DM were studied (age M = 70.21 years, SD = 6.63 years). The median degree of disease acceptance was 29 (min–max = 8–40) and the median level of adherence was 24 (min–max = 13–28). Disease acceptance was a significant (p = 0.002) independent predictor of the odds of qualifying for non-adherence OR = 0.903, 95% CI = 0.846–0.963. The respondents gave the lowest scores for glycemic control (Mdn = 38.99, min–max = 8.33–150), and health control (Mdn = 55.88, min–max = 11.76–100). A one-way ANOVA showed that the non-adhering patients were significantly older compared to the adherence group and were taking significantly more diabetes pills per day. The level of disease acceptance was average, but it turned out to be an independent predictor of adherence. Therefore, it is justified to use psychological and behavioral interventions that are aimed at increasing the level of diabetes acceptance in elderly people with T2DM. It is important to have a holistic approach to the patient and to take actions that consider the patient’s deficits in the entire biopsychosocial sphere. The obtained result confirmed the legitimacy of interventions aimed at increasing the level of disease acceptance in this group of patients.
Background. the term "diabetes" refers not only to a single disease state, but also to a group of many chronic metabolic disorders. Lack of symptoms leads to late diagnosis and treatment of diabetes. Early detection of abnormalities and pre-diabetic status becomes a priority. Objectives. the aim of this work is to assess the prevalence of carbohydrate metabolism disorders amongst people capable of professional activity in the Lubuskie province. Materials and methods. the research was carried out as part of the Health Policy Program for the early detection and prevention of diabetes and its complications in persons capable of professional activity in the Lubuskie Voivodeship, from January to april 2018, in the basic health center in zielona Gora. Participants were selected using the recommended Findrisk questionnaire (idF) to perform the oGtt in a certified analytical laboratory. Participants with pre-diabetes were included in the educational program (third stage). the paper presents the analysis of preliminary data obtained in the first period of the program at the first and the second stage. the research covered 474 people aged 16 to 90 years. Results. in that 73.42% (348) of participants were classed as having high or very high risk of developing diabetes, 59% (205) completed the oGtt, in which 90 (43.9%) participant had a normal result, 16 (7.8%) participant had values in 120 min. below 70 mg/dl, 19 (9.27%) had diabetes, and 80 (39.03%) were found to be in a pre-diabetic state. Conclusions. the scale of the diagnosed condition of pre-diabetes among the inhabitants of the Lubuskie region confirms the general regional, national and global tendency that the problem of diabetes is constantly and dynamically increasing.
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