TY - JOUR
T1 - Effects of a diabetes-specific care model for hip fractured older patients with diabetes
T2 - A randomized controlled trial
AU - Tseng, Ming Yueh
AU - Liang, Jersey
AU - Wang, Jong Shyan
AU - Yang, Ching Tzu
AU - Wu, Chi Chuan
AU - Cheng, Huey Shinn
AU - Chen, Ching Yen
AU - Lin, Yueh E.
AU - Wang, Woan Shyuan
AU - Shyu, Yea Ing L.
N1 - Publisher Copyright:
© 2019
PY - 2019/10/15
Y1 - 2019/10/15
N2 - Objectives: To examine the effects of a diabetes-specific care model for hip fractured elderly with diabetes mellitus (DM). Methods: A randomized controlled trial was implemented in a 3000-bed medical center in northern Taiwan. Older adults (age ≥ 60) with DM who had hip-fracture surgery (N = 176) were recruited and randomly assigned to diabetes-specific care (n = 88) and usual care (n = 88). Usual care entailed one or two in-hospital rehabilitation sessions. Diabetes-specific care comprised an interdisciplinary care (including geriatric consultation, discharge planning, and in-home rehabilitation) and diabetes-specific care (including dietary and diabetes education, blood pressure control, dyslipidemia management, a glycemic treatment regimen, and rehabilitation exercises). Outcomes including heart rate variability; rehabilitation outcomes; activities of daily living and instrumental activities of daily living were assessed before discharge and 1, 3, 6, 12, 18, 24 months afterwards. Results: Patients who received diabetes-specific care had significantly higher hip-flexion range of motion (b = 5.24, p <.01), peak-force quadriceps strength of the affected limb (b = 2.13, p <.05), higher total heart rate variability in terms of the time-domain parameter for the mean squared difference between two adjacent normal R–R intervals (b = 11.35, p <.05), and frequency-domain parameters, such as low frequency (b = 42.17, p <.05), and the high frequency-to-low frequency ratio (b = 0.11, p <.01). Conclusions: Our diabetes-specific care model enhanced hip-flexion range of motion, peak quadriceps strength of the affected limb, and overall heart rate variability, indicating dynamic responses to environmental changes during the 24 months following hospital discharge, above and beyond the effects of usual care.
AB - Objectives: To examine the effects of a diabetes-specific care model for hip fractured elderly with diabetes mellitus (DM). Methods: A randomized controlled trial was implemented in a 3000-bed medical center in northern Taiwan. Older adults (age ≥ 60) with DM who had hip-fracture surgery (N = 176) were recruited and randomly assigned to diabetes-specific care (n = 88) and usual care (n = 88). Usual care entailed one or two in-hospital rehabilitation sessions. Diabetes-specific care comprised an interdisciplinary care (including geriatric consultation, discharge planning, and in-home rehabilitation) and diabetes-specific care (including dietary and diabetes education, blood pressure control, dyslipidemia management, a glycemic treatment regimen, and rehabilitation exercises). Outcomes including heart rate variability; rehabilitation outcomes; activities of daily living and instrumental activities of daily living were assessed before discharge and 1, 3, 6, 12, 18, 24 months afterwards. Results: Patients who received diabetes-specific care had significantly higher hip-flexion range of motion (b = 5.24, p <.01), peak-force quadriceps strength of the affected limb (b = 2.13, p <.05), higher total heart rate variability in terms of the time-domain parameter for the mean squared difference between two adjacent normal R–R intervals (b = 11.35, p <.05), and frequency-domain parameters, such as low frequency (b = 42.17, p <.05), and the high frequency-to-low frequency ratio (b = 0.11, p <.01). Conclusions: Our diabetes-specific care model enhanced hip-flexion range of motion, peak quadriceps strength of the affected limb, and overall heart rate variability, indicating dynamic responses to environmental changes during the 24 months following hospital discharge, above and beyond the effects of usual care.
KW - Aged
KW - Diabetes mellitus
KW - Heart rate variability
KW - Hip fractures
KW - Patient discharge
UR - http://www.scopus.com/inward/record.url?scp=85070686863&partnerID=8YFLogxK
U2 - 10.1016/j.exger.2019.110689
DO - 10.1016/j.exger.2019.110689
M3 - 文章
C2 - 31404623
AN - SCOPUS:85070686863
SN - 0531-5565
VL - 126
JO - Experimental Gerontology
JF - Experimental Gerontology
M1 - 110689
ER -