Obesity and diabetes – trajectories of occurrence in acutely hospitalized seniors and the dynamics of their changes over 27 years
Authors:
Weber Pavel; Kubešová Matějovská Hana; Weberová Dana; Meluzínová Hana; Polcarová Vlasta; Bielaková Katarína
Authors‘ workplace:
Klinika interní, geriatrie a praktického lékařství LF MU a FN Brno
Published in:
Geriatrie a Gerontologie 2022, 11, č. 4: 153-158
Category:
Original Article
Overview
Objective: Obesity is closely related to type 2 diabetes (T2DM). More than 80 % of these diabetics are obese.
Methodology: A retrospective cohort study aimed to analyze and compare epidemiological data collected over 27 years. The monitored parameters were age, occurrence of diabetes, overweight and obesity. Between 1995 and 2021, we treated a total of 29,435 people aged 65 to 105. Of this number, there were 18,758 women with an average age of 81.7 ± 7.7 years, while only 10,685 men with an average age of 79.0 ± 7.6 years were hospitalized during this period. Hospitalized women were almost 3 years older on average compared to men. For men, the average age is increasing, while for women, there is a slight decrease over the course of 27 years.
Results: For both sexes, it is clear that there is a decrease in hospitalizations among younger seniors (65-74 years old) (the trends have a significant downward tendency), while for the oldest seniors (85 and over), on the contrary, there is an upward trend in both sexes. T2DM was present in ¹⁄³ of acutely hospitalized seniors. Overweight (BMI ≥ 25 and < 30) in the mentioned period of 27 years was rather in a slight decrease in men from 29 to 23 % and in women from 31 to 25 %. Obesity (BMI ≥30) shows an obvious upward trend for both sexes in the mentioned period (for men and women – 12 to 13 % and 30 to 35 % now).
Conclusion: Our data point to the importance of monitoring the occurrence of both obesity and diabetes in acutely hospitalized seniors.
Keywords:
obesity – type 2 diabetes – geriatricization of medicine – population aging – acute hospitalization of the elderly
Sources
1. Pelikánová T, Bartoš V: Praktická diabetologie. Praha: Maxdorf 2018.
2. Hainer V a kol.: Základy klinické obezitologie. Praha: Grada 2022.
3. Comer A, Fettig L, Torke AM. Identifying Goals of Care. Med Clin North Am 2020; 104(5): 767–775.
4. Hariharan R, Odjidja EN, Scott D, et al. The dietary inflammatory index, obesity, type 2 diabetes, and cardiovascular risk factors and diseases. Obes Rev 2022; 23(1): e13349.
5. Zang BY, Li-Xia H, Ling X. Intermittent Fasting: Potential Bridge of Obesity and Diabetes to Health? Nutrients 2022; 14(5): 981.
6. Crimmins EM, Shim H, Zhang YS and Kim JK. Differences between Men and Women in Mortality and the Health Dimensions of the Morbidity Process. Clin Chem 2019; 65(1): 135–145.
7. Bhupathiraju SN, Hu FB. Epidemiology of Obesity and Diabetes and Their Cardiovascular Complications. Circ Res 2016; 118(11): 1723–1735.
8. Diabetes and obesity. https:// www.diabetes.co.uk
9. van Vuuren J, Thomas B, Agarwal G, et al. Reshaping healthcare delivery for elderly patients: the role of community paramedicine; a systematic review. BMC Health Serv Res 2021; 21(1): 29.
10. Lesley, KB, James DP, Kunal S, et al. Oxford Handbook of Geriatric Medicine. Oxford University Press, UK, 2019.
11. Weber P. Stárnutí staré společnosti (seniorizace) a geriatrizace medicíny. Geriatrie a gerontologie 2018; 7(4): 152–155
12. Fillit, HM, Rockwood, K, Young, JB. Brocklehurst‘s Textbook of Geriatric Medicine and Gerontology. Philadelphia: Elsevier Health Sciences 2016.
13. Balsa A. Social interactions in health behaviors and conditions. Takahashi PY, Leppin AL, Hanson GJ. Hospital to Community Transitions for Older Adults: An Update for the Practicing Clinician.
14. Krajčík Š a kol. Geriatria. Bratislava: Herba 2022.
15. Obezita 2013. STEM/MARK & VZP. Dostupné z: www.stemmark.cz
16. Kastner M, Cardoso R, Lai Y, et al. Effectiveness of interventions for managing multiple high-burden chronic diseases in older adults: a systematic review and meta-analysis. CMAJ 2018; 190(34): E1004–E1012.
17. Pathy MS John, Finucane P (eds.). Geriatric Medicine: Problems and Practice paperback. NY: Springer 2014.
18. Fried LP, Ferrucci L, Darer J, et al. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004; 59 (3): 255–263.
19. Smailhodzic E, Hooijsma W, Boonstra A and Langley DJ. Social media use in healthcare: A systematic review of effects on patients and on their relationship with healthcare professionals. BMC Health Services Research 2016; 16: 442.
20. Jain Sachin H. All Health Care Is Social: The Increasing Significance Of Social Interaction And Health. Dostupné z: https: //www. forbes.com › sites › sachinjain › 2018/04/30.
21. Boles A, Kandimalla R, Reddy PH. Dynamics of diabetes and obesity. Epidemiological perspective. Biochim Biophys Acta Mol Basis Dis. 2017; 63(5): 1026–1036.
22. Owen K, Turner H, et al. Oxford Handbook of Endocrinology & Diabetes (Oxford Medical Handbooks). Oxford University Press 2022.
23. Branca F, Nikogosain H, Lobstein T. Challenge of the obesity in the WHO European Region and the strategie for response. OMS 2007; 339.
24. Borai A, Livingstone C, Abdelaal F, et al. The relationship between glycosylated haemoglobin (HbA1c) and measures of insulin resistance across a range of glucose tolerance. Scand J Clin Lab Invest 2011; 71(2): 168–172.
25. Otero M, Lago R, Lago F, et al. Leptin, from fat to inflammation: old questions and new insights. FEBS Lett 2005; 579(2): 295–301.
26. Calle EE, Thun MJ, Petrelli JM, et al. Body-Mass Index and Mortality in a Prospective Cohort of U.S. Adults. N Engl J Med 1999; 341(12): 1097–1105.
27. de Hollander EL, Zutphen M Van, Bogers RS, et al. The impact of body mass index in old age on cause-specific mortality. J Nutr Health Aging 2012; 16(1): 100– 106.
28. Kvamme J-M, Holmen J, Wilsgaard T, et al. Body mass index and mortality in elderly men and women: the Tromso and HUNT studies. J Epidemiol Community Health 2012; 66(7): 611–617.
29. Flicker L, McCaul KA, Hankey GJ, et al. Body mass index and survival in men and women aged 70 to 75. J Am Geriatr Soc 2010; 58(2): 234–241.
30. Alharbi TA, Paudel S, Gasevic D, et al. The association of weight change and all-cause mortality in older adults: a systematic review and meta-analysis. Age Ageing 2021; 50(3): 697–704.
31. Holme I, Tonstad S. Survival in elderly men in relation to midlife and current BMI. Age Ageing 2015; 44(3): 434–439.
32. Overcoming obesity: An initial economic analysis. Dostupné z: https://www.mckinsey.com
33. Han ChY, Miller M, Yaxley A, et al. Effectiveness of combined exercise and nutrition interventions in prefrail or frail older hospitalised patients: a systematic review and meta-analysis. BMJ Open 2020; 10(12): e040146.
34. Jørgensen R, Brabrand M. Screening of the frail patient in the emergency department: A systematic review. Eur J Intern Med 2017; 45: 71-73.
35. Takahashi PY, Leppin AL, Hanson GJ. Hospital to Community Transitions for Older Adults: An Update for the Practicing Clinician. Mayo Clin Proc 2020; 95(10): 2253– 2262.
36. Nooijen CFJ, Blom V, Ekblom O, al. The effectiveness of multi-component interventions targeting physical activity or sedentary behaviour amongst office workers: a three-arm cluster randomised controlled trial. BMC Public Health 2020; 20(1): 1329.
37. Berkeley B. Relationship between Health Provider Status and Social Interaction. Open Access Library Journal 2017; 4: 1–7.
38. Rodríguez-Romero R, Herranz-Rodríguez C, Kostov B, et al. Intervention to reduce perceived loneliness in community-dwelling older people. Scand J Caring Sci 2021; 35(2): 366–374.
39. Laurindo LF, Barbalho SM, Guiguer EL, et al. GLP-1a: Going beyond Traditional Use. Int J Mol Sci 2022; 23(2): 739.
40. Fitchett D, Inzucchi SE, Cannon CP, et al. Empagliflozin Reduced Mortality and Hospitalization for Heart Failure Across the Spectrum of Cardiovascular Risk in the EMPA- REG OUTCOME Trial. Circulation 2019; 139(11): 1384–1395.
41. Leite KM, Long AM, Ostroff ML, et al. A Review of the Renoprotective Effects of Novel Antidiabetic Agents. J Pharm Pract 2021; 34(1): 141–148.
42. Zelniker TA, Wiviott SD, Raz I, et al. Comparison of the Effects of Glucagon-Like Peptide Receptor Agonists and Sodium-Glucose Cotransporter 2 Inhibitors for Prevention of Major Adverse Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus. Circulation 2019; 139(17): 2022–2031.
43. Bae JH, Eun-Gee Park, Kim S, et al. Comparative Renal Effects of Dipeptidyl Peptidase-4 Inhibitors and Sodium-Glucose Cotransporter 2 Inhibitors on Individual Outcomes in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis. Endocrinol Metab (Seoul) 2021; 36(2): 388–400.
44. Mahaffey KW, Neal B, Perkovic V, et al. CANVAS Program Collaborative Group. Canagliflozin for Primary and Secondary Prevention of Cardiovascular Events: Results From the CANVAS Program (Canagliflozin Cardiovascular Assessment Study). Circulation 2018; 137(4): 323–334.
45. Wiviott SD, Raz I, Bonaca MP, et al. The design and rationale for the Dapagliflozin Effect on Cardiovascular Events (DECLARE)-TIMI 58 Trial. Am Heart J 2018; 200: 83–89.
46. Chun-Xing Li, Shuo Liang, Lingyan Gao, Hua Liu. Cardiovascular outcomes associated with SGLT-2 inhibitors versus other glucose-lowering drugs in patients with type 2 diabetes: A real-world systematic review and meta-analysis. PLoS One 2021; 16(2): e0244689. eCollection 2021.
Labels
Geriatrics General practitioner for adults Orthopaedic prostheticsArticle was published in
Geriatrics and Gerontology
2022 Issue 4
Most read in this issue
- A Pilot Study of the Mini-Cog Czech version in Czech Adults
- Opioid analgesics in the pain management of geriatric patients
- Vybrané faktory prevence u seniorů
- The association between diabetes mellitus 2 and geriatric syndromes – the results of international studies