| Title: | The agreement between measured HbA1c and optimized target HbA1c based on the Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) : A cross-sectional study of elderly patients with diabetes |
| Authors: | Miya, Aika Browse this author →KAKEN DB |
| Nakamura, Akinobu Browse this author →KAKEN DB |
| Yokota, Isao Browse this author →KAKEN DB |
| Cho, Kyu Yong Browse this author |
| Kameda, Hiraku Browse this author →KAKEN DB |
| Nomoto, Hiroshi Browse this author →KAKEN DB |
| Takase, Takahiro Browse this author |
| Omori, Kazuno Browse this author |
| Ono, Mayuko Browse this author |
| Nagai, So Browse this author |
| Taneda, Shinji Browse this author |
| Miyoshi, Hideaki Browse this author →KAKEN DB |
| Atsumi, Tatsuya Browse this author →KAKEN DB |
| Keywords: | DASC-8 |
| diabetes |
| elderly patient |
| guideline |
| HbA1c |
| Issue Date: | Aug-2022 |
| Publisher: | John Wiley & Sons |
| Journal Title: | Geriatrics & gerontology international |
| Volume: | 22 |
| Issue: | 8 |
| Start Page: | 560 |
| End Page: | 567 |
| Publisher DOI: | 10.1111/ggi.14415 |
| Abstract: | Aim To investigate the achievement of individualized target HbA1c based on the Japanese guideline after geriatric assessment with the Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) and to evaluate patient characteristics acting as barriers to achieving the target HbA1c in elderly outpatients with diabetes. Methods This cross-sectional study enrolled 303 Japanese outpatients aged >= 65 years with diabetes. Their health status was measured using the DASC-8. The target HbA1c was optimized for each patient by the guideline based on the DASC-8 score and use of drugs potentially associated with severe hypoglycemia. Patient characteristics related to the agreement between measured HbA1c and target HbA1c were extracted by multivariate logistic regression analysis. Results The mean age was 73.0 years and the mean body mass index (BMI) was 24.2 kg/m(2). The agreement between measured HbA1c and target HbA1c was 43.9% (95% confidence interval: 38.4%-50.0%). In multivariate logistic regression analysis, the agreement in patients with drugs potentially associated with severe hypoglycemia was significantly lower than in those without these drugs (37.8% vs. 60.5%, P = 0.0004). In patients with these drugs, higher BMI (P = 0.0271) and higher fasting plasma glucose (P = 0.0034) were independent related factors for measured HbA1c being higher than target HbA1c. Vulnerable elderly patients (P = 0.0116) and not taking sodium glucose co-transporter-2 (SGLT2) inhibitor (P = 0.0186) were independent related factors for inappropriately lower HbA1c. Conclusions The agreement between measured HbA1c and target HbA1c was low in elderly patients with diabetes. Geriatr Gerontol Int 2022; center dot center dot: center dot center dot-center dot center dot. |
| Rights: | This is the peer reviewed version of the following article: Miya, A, Nakamura, A, Yokota, I, et al. The agreement between measured HbA1c and optimized target HbA1c based on the Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8): A cross-sectional study of elderly patients with diabetes. Geriatr. Gerontol. Int. 2022; 22: 560– 567. which has been published in final form at 10.1111/ggi.14415. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited. |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/90290 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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