Identifying Persons with Diabetes Who Could Benefit from a Palliative Approach to Care

Johnston, Grace; Lethbridge, Lynn; Talbot, Pam; Dunbar, Margaret; Jewell, Laura; Henderson, David; d'Intino, Anne Frances; McIntyre, Paul

doi:10.1016/j.jcjd.2014.01.009

Cited by 7 publications

(12 citation statements)

References 43 publications

(50 reference statements)

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“…The similar and substantial rate of diabetes registry enrollment across all decedents means that all groups may need to consider diabetes care, including the moderation of glycemic control as death approaches. 16 Intensive blood glucose lowering can increase the risk of hypoglycemia. 15 Older adults are at higher risk of developing hypoglycemia and are less capable of responding well to hypoglycemic episodes that occur, especially among persons with dementia.…”

Section: Discussionmentioning

confidence: 99%

Increasing our understanding of dying of breast cancer: Comorbidities and care

Johnston

Urquhart

Lethbridge

et al. 2015

Progress in Palliative Care

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Background: Screening and treatment for breast cancer have improved. However, attention to palliative support and non-cancer co-morbidities has been limited. This study identified types of care for and co-morbidities of persons dying of breast cancer compared to persons dying from all cancers and from non-cancer causes. Methods: Linked administrative data from population-based registries were used to examine 121,458 deaths in Nova Scotia from 1995 to 2009. Results: Breast cancer decedents' mean age was similar to that of all cancer decedents (72.0 versus 72.1 years), but their age spread was greater (20–59 years: 23.1% versus 16.7%; 90+ years: 11.2% versus 6.5%). Among women dying of breast cancer, 15.6% were enrolled in the diabetes registry and 15.1% in the cardiovascular registry, indicating that they had these non-cancer conditions prior to their death. Compared to all cancer decedents, breast cancer decedents were twice as likely to have dementia as a cause of death, and were less likely to die in hospital but more likely to die in a nursing home. Breast cancer decedents had place of death rates more similar to non-cancer than cancer decedents. Conclusions: Rates of dementia and diabetes among the breast cancer decedents were particularly note-worthy in this novel study given that these comorbidities have not received much attention in the breast cancer research literature. Further collaboration with non-cancer disease programs is advised. The extent of adequate comprehensive palliative support for the 20% of the breast cancer decedents who are nursing home residents requires investigation.

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Section: Discussionmentioning

confidence: 99%

Increasing our understanding of dying of breast cancer: Comorbidities and care

Johnston

Urquhart

Lethbridge

et al. 2015

Progress in Palliative Care

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“…8 Being, in the higher percentage, deaths related to cardiovascular and renal complications; and only a small rate of up to 3% is directly related to the disease. 6 Although cardiovascular disease is not a single entity in diabetes, it accounts for up to 75% of deaths in patients with diabetes, 6 it has been corroborated by multiple studies that mention that diabetes doubles or quadruples the risk of cardiovascular disease. 9,10 In a recent study, it was found that individuals with diabetes compared with those without diabetes were at high risk of death from cardiovascular disease, dying from cancer, and death from any cause.…”

Section: Introductionmentioning

confidence: 97%

“…2,4 Diabetes is among the ten leading causes of death worldwide 1 considering that there is a death from diabetes every 6 seconds in the world 5 and conjunction with the cardiovascular diseases, cancer, and respiratory diseases, represents more than 80% of deaths from noncommunicable diseases. 1 There is a vast literature that relates to diabetes with an increase in morbidity and premature death 6 reducing life expectancy up to 6 years in people over 50 compared to people without diabetes 7 and, although a minority of people die early, up to 90% of people die after a long evolution of the disease. 8 Being, in the higher percentage, deaths related to cardiovascular and renal complications; and only a small rate of up to 3% is directly related to the disease.…”

Section: Introductionmentioning

confidence: 99%

“…14 The implementation of a palliative care plan at an early stage, even integrated into the usual diabetes care plan, can prepare the patient and his family members for the necessary changes in treatment when the end of life approaches. 5,6 Thus, Palliative care can have a positive effect on the disease, function, quality of life and the care burdens derived from care and treatment. 5 However, the notion of palliative care and its integration into the self-care program of patients with diabetes are not considered by many health providers.…”

Section: Introductionmentioning

confidence: 99%

“…5 However, the notion of palliative care and its integration into the self-care program of patients with diabetes are not considered by many health providers. 6…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Perspective and general approach of diabetes in palliative care

Javier¹

2018

HPMIJ

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ObjectiveThe objective of this review is to provide an overview of palliative care in patients with diabetes. Describe the relationship between diabetes and co-morbidity, its impact on the prognosis and the different strategies to carry out the treatment plan for patients who enter the end-of-life scenario. AbstractThe progressive aging of the population and the increase in chronic diseases means that we are facing more and more patients who require palliative care. It is necessary to reinforce the multidisciplinary work and the coordination between first level care and hospital care. In addition to changes in health policies, it is required to train health professionals more in communication skills and in the ethical and humanitarian perspective of the care of patients in the process of dying. For patients with diabetes, adequate assessment of their prognosis and the adequacy and management of their medications should be reinforced in all patients who enter the care phase at the end of life to minimize the side effects and complications derived from them. Medications and maintain comfort and quality of life as best as possible. Properly communicate changes to family members and patients to decide together the best treatment strategy.

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