PMID- 37152098
OWN - NLM
STAT- MEDLINE
DCOM- 20230509
LR  - 20230509
IS  - 2314-6753 (Electronic)
IS  - 2314-6745 (Print)
VI  - 2023
DP  - 2023
TI  - Diabetes Management and Outcomes among Patients with Type 2 Diabetes Attending a 
      Renal Service.
PG  - 1969145
LID - 10.1155/2023/1969145 [doi]
LID - 1969145
AB  - BACKGROUND: Patients with comorbid type 2 diabetes mellitus (T2DM) and renal 
      disease, particularly those treated with insulin, often require complex 
      pharmacological treatment and management of other diabetes complications. AIMS: 
      To assess the achievement of metabolic targets and compare the current management 
      of renal service attenders with insulin- and noninsulin-treated T2DM. METHODS: 
      Single-centre retrospective cross-sectional study involving medical record review 
      of patients with T2DM aged >/=18 years who visited a metropolitan renal outpatient 
      clinic in 2017. Univariable analysis and multivariable logistic regression were 
      used to identify factors associated with insulin treatment. RESULTS: Among 268 
      patients (45.5% insulin-treated), mean HbA1c was higher in insulin-treated vs. 
      noninsulin-treated patients (8.0 +/- 1.8% (64 mmol/mol) vs. 6.8 +/- 1.2% 
      (51 mmol/mol), p < 0.001). Significantly fewer insulin-treated patients had HbA1c 
      </= 7.0% (53 mmol/mol; 31.8% vs. 69.3%, p < 0.001). More insulin-treated patients 
      had ischaemic heart disease (46.7% vs. 33.6%, p = 0.028), diabetic foot disease 
      (15.6% vs. 4.8%, p = 0.003), retinopathy (40.2% vs. 11.0%, p < 0.001), and 
      emergency attendance for severe hypoglycaemia (3.8% vs. 0% p = 0.042). Insulin 
      treatment was more associated with chronic kidney disease stages 4-5 (adjusted 
      odds ratio (aOR) 2.41, 95% CI 1.07-5.43), retinopathy (aOR 3.10, 95% CI 
      1.04-9.27), and podiatry review (aOR 5.06, 95% CI 1.20-21.38). Only 38 (14.2%) 
      individuals were seen by a colocated public multidisciplinary diabetes service in 
      2017. CONCLUSIONS: Renal clinic attenders with T2DM, particularly if 
      insulin-treated, remained at increased risk of diabetes-related complications, 
      including severe hypoglycaemia, with limited input from the colocated hospital 
      diabetes team. Approaches to increase coordination of diabetes care among renal 
      patients should be investigated.
CI  - Copyright (c) 2023 Elizabeth Skalkos et al.
FAU - Skalkos, Elizabeth
AU  - Skalkos E
AUID- ORCID: 0000-0002-8493-2969
AD  - School of Medicine, Western Sydney University, Sydney, Australia.
FAU - Rajagopal, Rohit
AU  - Rajagopal R
AD  - Macarthur Diabetes Service, Sydney, Australia.
FAU - Simmons, David
AU  - Simmons D
AUID- ORCID: 0000-0003-0560-0761
AD  - School of Medicine, Western Sydney University, Sydney, Australia.
AD  - Macarthur Diabetes Service, Sydney, Australia.
LA  - eng
PT  - Journal Article
DEP - 20230426
PL  - England
TA  - J Diabetes Res
JT  - Journal of diabetes research
JID - 101605237
RN  - 0 (Hypoglycemic Agents)
RN  - 0 (Glycated Hemoglobin)
RN  - 0 (Insulin)
SB  - IM
MH  - Humans
MH  - Adolescent
MH  - Adult
MH  - *Diabetes Mellitus, Type 2/complications/drug therapy/epidemiology
MH  - Hypoglycemic Agents/therapeutic use
MH  - Glycated Hemoglobin
MH  - Retrospective Studies
MH  - Cross-Sectional Studies
MH  - Insulin/therapeutic use
MH  - *Hypoglycemia/chemically induced
MH  - *Retinal Diseases/chemically induced
PMC - PMC10156453
COIS- The authors declare that they have no conflicts of interest.
EDAT- 2023/05/08 06:42
MHDA- 2023/05/09 06:42
PMCR- 2023/04/26
CRDT- 2023/05/08 03:58
PHST- 2022/03/08 00:00 [received]
PHST- 2023/03/06 00:00 [revised]
PHST- 2023/03/25 00:00 [accepted]
PHST- 2023/05/09 06:42 [medline]
PHST- 2023/05/08 06:42 [pubmed]
PHST- 2023/05/08 03:58 [entrez]
PHST- 2023/04/26 00:00 [pmc-release]
AID - 10.1155/2023/1969145 [doi]
PST - epublish
SO  - J Diabetes Res. 2023 Apr 26;2023:1969145. doi: 10.1155/2023/1969145. eCollection 
      2023.