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Effects of a diabetes-specific care model for hip fractured older patients with diabetes: A randomized controlled trial
- Source :
- Experimental gerontology. 126
- Publication Year :
- 2019
-
Abstract
- To examine the effects of a diabetes-specific care model for hip fractured elderly with diabetes mellitus (DM).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.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).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.
- Subjects :
- 0301 basic medicine
Male
Aging
medicine.medical_specialty
Activities of daily living
medicine.medical_treatment
Arthroplasty, Replacement, Hip
Taiwan
Biochemistry
law.invention
03 medical and health sciences
Fracture Fixation, Internal
0302 clinical medicine
Endocrinology
Randomized controlled trial
law
Heart Rate
Diabetes mellitus
Activities of Daily Living
Genetics
medicine
Heart rate variability
Humans
Range of Motion, Articular
Molecular Biology
Geriatric Assessment
Glycemic
Aged
Patient Care Team
Rehabilitation
business.industry
Delivery of Health Care, Integrated
Hip Fractures
Cell Biology
Middle Aged
medicine.disease
Patient Discharge
Self Care
030104 developmental biology
Treatment Outcome
Diabetes Mellitus, Type 2
Physical therapy
Female
Hip Joint
business
Range of motion
030217 neurology & neurosurgery
Dyslipidemia
Subjects
Details
- ISSN :
- 18736815
- Volume :
- 126
- Database :
- OpenAIRE
- Journal :
- Experimental gerontology
- Accession number :
- edsair.doi.dedup.....07539a5fc57c6949cfe957585dd7c096