Search

Background: To investigate the risk of endophthalmitis after cataract surgery in patients with diabetes mellitus (DM) and evaluate the dose–response relationship. Methods: This retrospective cohort study enrolled patients who underwent bilateral cataract surgeries from 2000 to 2017 in Taiwan National Health Insurance Research Database. The endophthalmitis rates within 3 months after cataract surgery were compared between DM and non‐DM cohorts using a generalised estimating equation. The diabetes complications severity index (DSCI) score was adopted to assess the dose–response effect on the endophthalmitis rate. Results: A total of 883 398 patients (1 766 796 eyes) were included. Patients with DM had an increased risk of endophthalmitis after cataract surgery than patients without DM (0.261% vs. 0.242%, adjusted odds ratio = 1.09, 95% confidence interval = 1.03–1.16). The higher endophthalmitis rate in the DM group than in the non‐DM group remains after excluding those with prior vitrectomy or intravitreal injection (IVI), and took IVI between the cataract surgery and endophthalmitis (p = 0.0156, 0.0048, and 0.0139). There was a significant dose–response relationship on the likelihood of endophthalmitis in DM patients when DCSI score >10. The endophthalmitis rate is highest among DM complications in patients with metabolic disorders (0.342%). Conclusion: DM was a risk factor for endophthalmitis after cataract surgery after adjusting for age, sex, common systemic disorders, and excluding those with prior vitrectomy or IVI and having IVI between cataract surgery and endophthalmitis. A dose–response relationship was noted in DM patients with a DCSI score >10. [ABSTRACT FROM AUTHOR]

Objectives Type 2 diabetes mellitus (T2DM) is a risk factor for deep neck infection (DNI) and leads to complications and poor outcomes. Our study aimed to investigate the risk, prognosis, and complications of peritonsillar abscess (PTA) in patients with T2DM. Methods We extracted data of patients newly diagnosed as having T2DM between January 2000 and December 2011 from Taiwan’s National Health Insurance Research Database. These patients were matched with patients without T2DM, and PTA incidence was compared between both cohorts. Results In total, 67,852 patients with and 135,704 patients without T2DM were enrolled. PTA incidence was significantly higher in patients with T2DM (incidence rate ratio, 1.91; P5 years after T2DM diagnosis. Cox regression analysis showed that patients with T2DM had an approximately 2-fold higher PTA risk (adjusted hazard ratio [aHR]: 1.89, P

Introduction: The prevalence of type 2 diabetes (T2D) represents a rising burden in the US and worldwide, with the condition shown to be associated with relatively large human and economic costs. Part of the reason for such high costs associated with T2D is that the condition is often accompanied by additional health-related complications. The goal of this research is to examine the association between glycemic control and diabetes-related complications for individuals with T2D. Methods: The Optum Clinformatics® Data Mart (CDM) database from 2007 to 2020 was used to identify adults with T2D. Individuals were classified as having sustained glycemic control (all hemoglobin A1c [HbA1c] < 7%) or poor glycemic control (all HbA1c ≥ 7%) over the 5-year post-period, and diabetes-related complications were identified based upon the Diabetes Complications Severity Index. Multivariable analyses examined the association between sustained glycemic control and diagnosis of a diabetes-related complication in the post-period. Results: Maintaining HbA1c < 7% over the 5-year post-period, compared to maintaining HbA1c ≥ 7%, was associated with reduced odds of the diabetes-related complications of cardiovascular disease (odds ratio [OR] = 0.76, 95% confidence interval [CI] 0.61–0.94), metabolic disease (OR = 0.37, 95% CI 0.22–0.600), neuropathy (OR = 0.62, 95% CI 0.45–0.84), nephropathy (OR = 0.81, 95% CI 0.69–0.94), and peripheral vascular disease (OR = 0.52, 95% CI 0.33–0.83). There was no statistically significant association between sustained glycemic control and cerebrovascular disease. Conclusions: Sustained glycemic control was found to be associated with significant reductions in the odds of being diagnosed with diabetes-related complications over a 5-year post-period. [ABSTRACT FROM AUTHOR]

Background Studies have shown that patients with type 2 diabetes mellitus (T2DM) tend to have poorer outcomes associated with COVID-19, including increased rates of hospitalization, ICU admission, need for ventilatory support, and mortality. Methods We performed a retrospective cohort study that included all non-pregnant adult patients who were hospitalized as a result of COVID-19 in a Southwest Virginia health system between March 18, 2020, and August 31, 2022. T2DM status was treated as a binary variable. T2DM severity was assessed using the Diabetes Complications Severity Index (DCSI). Multivariate logistic regression was used to assess the relationship between T2DM status and COVID-19 severity outcomes. Multivariate logistic regression was also used to assess the relationship between DCSI score and COVID-19 severity outcomes among patients with an established diagnosis of T2DM at the time of COVID-19 hospital admission. Results Patients with T2DM had 1.27 times the odds of experiencing a poor COVID-19 clinical outcome (95% CI: 1.13, 1.43) and 1.35 times the odds of in-hospital mortality (95% CI: 1.14, 1.59) compared to patients without diabetes. Among patients with T2DM, increasing DCSI score was significantly associated with increased odds of experiencing a poor COVID-19 clinical outcome and in-hospital mortality. Conclusions Diabetic patients in our sample were at increased odds of experiencing poor COVID-19 clinical outcomes and in-hospital mortality compared to individuals without diabetes. Amongst patients with T2DM, increasing DCSI score was associated with worse COVID-19 outcomes. Clinical decision support tools may be able to utilize DCSI scores as an indicator of COVID-19 severity risk to facilitate decisions regarding treatment aggressiveness and resource allocation., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Bendetson et al.)

Aims: To gather real-world data on treatment characteristics and comorbidity progression in patients with newly-diagnosed type 2 diabetes (T2D) and evaluate differences by patient age.Methods: Retrospective analysis of a US administrative claims database including 16,950 subjects with newly-diagnosed T2D in 2006 and a baseline Diabetes Complications Severity Index (DCSI) score of 0. Patients were categorized by DCSI score at year 8 (0, 1-2, or ≥3) and comparatively analyzed based on demographic variables, drug usage, and diabetes-related comorbidities.Results: Year 8 DCSI score distribution was 0 (29.9%), 1-2 (36.2%), and ≥3 (33.9%). The highest DCSI score subgroup (≥3) was characterized by a significantly greater percentage of males, older age at T2D diagnosis, and higher Medicare enrollment. DCSI progressed most rapidly in the oldest age group (≥65). Among all subjects at year 8, insulin use was significantly highest among subjects with DCSI ≥3 compared with those having a lower DCSI. However, for subjects with DCSI ≥3, insulin use was lower among those in the oldest age group (≥65) relative to younger age groups.Conclusions: These real-world data suggest a relationship between age at T2D diagnosis and disease progression based on comorbidity burden and lower usage of injectable therapies in older patients. [ABSTRACT FROM AUTHOR]

Abstract: Background: The aim of the present study was to assess the longitudinal accumulation of diabetes‐related complications and the effect of glycemic control on the Diabetes Complications Severity Index (DCSI) score in people with newly diagnosed type 2 diabetes (T2D). Methods: A retrospective cohort study was conducted using electronic health records from a large integrated healthcare system. People with newly diagnosed T2D were identified between 2005 and 2016 and stratified by initial HbA1c category (<7%, <8%, ≥8%). The DCSI scores were determined for each study year, and the cumulative incidence of diabetes‐related complications was assessed. A Cox proportional hazard model was used to evaluate the effect of baseline HbA1c and worsening glycemic (HbA1c) control on longitudinal changes in DCSI scores. Results: Of 32 174 people identified as having newly diagnosed T2D, 14 016 (44%), 21 657 (67%), and 9983 (31%) had an initial or baseline HbA1c <7%, <8%, and ≥8%, respectively. Ten years after diabetes diagnosis, retinopathy, chronic kidney disease, coronary heart disease, and neuropathy were diagnosed in 22%, 29%, 24%, and 36% of people. Baseline HbA1c did not affect the observed trend in longitudinal changes in DCSI scores throughout the 11‐year period. For people in each of the initial HbA1c groups (<7%, <8%, ≥8%), worsening or persistently poor glycemic control was significantly associated with a 10%, 19%, or 16% increase in the risk of experiencing an increased DCSI score, respectively (all P < 0.01). Conclusions: Baseline glycemic control had no apparent effect on longitudinal changes in DCSI score. Worsening or persistently poor glycemic control was associated with an increased risk of an increase in the DCSI score. [ABSTRACT FROM AUTHOR]

• Diabetes mellitus and osteoporosis are both diseases of epidemic proportions. • Fragility hip fractures (FHF) are associated with elevated morbidity and mortality. • The diabetes complications severity index predicts increased mortality following FHF. • Cerebrovascular events were nearly 5 times more prevalent in diabetic FHF patients. • Diabetic patients require specialized care during the peri-operative period of FHFs. Aims: Diabetes mellitus (DM) and osteoporosis are both diseases of epidemic proportions with an increasing incidence worldwide. Fragility hip fractures (FHF) are associated with elevated morbidity, mortality, social burden and medical costs. The aim of this study was to determine whether patients with DM have worse medical and surgical outcomes following FHFs and whether the Diabetes Complications Severity Index (DCSI) can predict in-hospital complications and one-year mortality. Methods: A single centre retrospective cohort study including 1343 patients older than 65 years who underwent surgery for FHFs was conducted. The data collected included length of hospital stay, time-to-surgery, blood loss, complications and mortality during the first post-operative year. Results: 408 patients with a DM diagnosis were compared with 935 without DM. Pre-operatively, patients with DM had lower haemoglobin levels, higher platelet counts and worse renal function. Following surgery, patients with DM were more likely to be transferred to another department or intensive care. One-year mortality was significantly higher in the DM group [23.3% vs. 17.1%, odds ratio 1.36 (CI 1.029–1.799, p = 0.03)]. Higher DCSI scores were related with elevated one-year mortality rates in the DM group. Cerebrovascular events were found to be nearly five times more prevalent in the DM group. Patients with DM were more likely to continue treatment in a rehabilitation centre and had a higher probability to be re-hospitalized in the first post-operative year (p.<0.001). Conclusions: Our results emphasize the increased vulnerability of this patient population and the importance of specialized care during the peri-operative period of FHFs. [ABSTRACT FROM AUTHOR]

Background: We report on a retrospective population study aimed at identifying and validating the progression of adapted Diabetes Complications Severity Index (DCSI) for acute coronary syndrome (ACS), ischemic stroke, and mortality in Asian people with type 2 diabetes mellitus (DM)., Methods: Utilizing a Taiwanese national dataset, we included 84 450 type 2 diabetic individuals between 2000 and 2011. The area under the receiver operating characteristic curve (C statistics of logistic model) and the C statistics of the Cox model were used to evaluate whether the progression of diabetic complication status could be a predictor of ACS, ischemic stroke, and death. The optimum threshold for adverse outcomes risk stratification were obtained using Youden's J statistic as the cutoff that gives the highest threshold., Results: Among the study patients, the C statistics of the logistic model of the progression of the score predictive of ACS, ischemic stroke, and death were 0.72 (95% confidence interval [CI]: 0.71-0.73), 0.84 (95% CI: 0.84-0.85), and 0.66 (95% CI: 0.65-0.67), respectively. The progression of adapted DCSI had moderate discrimination for ACS, ischemic stroke, and death (C statistics = 0.71, 0.72, and 0.75, respectively) based on Cox regression analysis (Harrell C). The optimum threshold of the progression of the score for ACS, ischemic stroke, and death in type 2 DM patients were 0.30, 0.36, and 0.39, respectively., Conclusions: The acceptable discriminative power of the progression of adapted DCSI for Asian people affected by type 2 DM was demonstrated in a large cohort in Taiwan., (© 2018 Wiley Periodicals, Inc.)