当前位置： SCI文献检索 > JOURNAL OF THE AMERICAN GERIATRICS SOCIETY期刊下所有文献 > A real-world study of the effect of timing of insulin initiation on outcomes in older medicare beneficiaries with type 2 diabetes mellitus.

A real-world study of the effect of timing of insulin initiation on outcomes in older medicare beneficiaries with type 2 diabetes mellitus.

Abstract：

OBJECTIVES:To compare clinical and economic outcomes of early insulin initiation with those of delayed initiation in older adults with type 2 diabetes mellitus (T2DM). DESIGN:Retrospective cohort study. SETTING:Humana Medicare Advantage health insurance plan. PARTICIPANTS:Older (≥65) Medicare beneficiaries with T2DM. MEASUREMENTS:Subjects were grouped according to number of classes of oral antidiabetes drugs (OADs) they had taken before initiation of insulin: one (early insulin initiators), two, or three or more (delayed insulin initiators). One-year follow-up outcomes included change in glycosylated hemoglobin (HbA1c), percentage of older adults with HbA1c less than 8.0%, hypoglycemic events, and total healthcare costs. RESULTS:Overall, 14,669 individuals were included in the analysis. Baseline and 1-year follow-up HbA1c levels were available for 4,028 (27.5%) individuals. Insulin was initiated early in 32% and delayed in 20%. At follow-up, unadjusted reduction in HbA1c was 0.9±3.7% for the group with one OAD, 0.7±2.4% for those with two, and 0.5±3.6% for those with three or more. Early insulin initiation was associated with significantly greater reduction in HbA1c (0.4%; adjusted P<.001), 30% greater likelihood of achieving HbA1c less than 8.0% (adjusted odds ratio=1.30, 95% confidence interval=1.18-1.43), and no significant differences in total costs or hypoglycemia events (11.5% of early initiators vs 10.2% of delayed initiators; P=.32). CONCLUSION:This study suggests beneficial effects of early insulin initiation in older adults with T2DM who do not have adequate glycemic control, without increasing the risk of hypoglycemia or greater total direct healthcare costs.

journal_name

J Am Geriatr Soc

journal_title

Journal of the American Geriatrics Society

authors

Bhattacharya R,Zhou S,Wei W,Ajmera M,Sambamoorthi U

doi

10.1111/jgs.13388

subject

Has Abstract

pub_date

2015-05-01 00:00:00

pages

893-901

issue

5

eissn

0002-8614

issn

1532-5415

journal_volume

63

pub_type

杂志文章

相关文献

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY文献大全
  • Demographic characteristics and healthcare use of centenarians: a population-based cohort study.

    abstract：OBJECTIVES:To better understand how centenarians use the healthcare system as an important step toward improving their service delivery. DESIGN:Population-based retrospective cohort study using linked health administrative data. SETTING:Ontario--Canada's largest province. PARTICIPANTS:All individuals living in Ontar...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/jgs.12613

    authors： Rochon PA,Gruneir A,Wu W,Gill SS,Bronskill SE,Seitz DP,Bell CM,Fischer HD,Stephenson AL,Wang X,Gershon AS,Anderson GM

    更新日期：2014-01-01 00:00:00

  • Speech perception in older adults: the importance of speech-specific cognitive abilities.

    abstract：OBJECTIVE:To provide a critical evaluation of studies examining the contribution of changes in language-specific cognitive abilities to the speech perception difficulties of older adults. DESIGN:A review of the literature on aging and speech perception. CONCLUSIONS:The research considered in the present review sugges...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章,评审

    doi：10.1111/j.1532-5415.1997.tb03101.x

    authors： Sommers MS

    更新日期：1997-05-01 00:00:00

  • Asymptomatic bacteriuria, urinary antibody, and survival in the institutionalized elderly.

    abstract：OBJECTIVE:To compare clinical status of elderly institutionalized subjects with asymptomatic bacteriuria and normal urinary antibody to those with elevated urinary antibody to the major outer membrane of Escherichia coli. DESIGN:Retrospective review. SETTING:Long term facility for the elderly. PARTICIPANTS:Convenien...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.1992.tb02112.x

    authors： Nicolle LE,Brunka J,McIntyre M,Murray D,Harding GK

    更新日期：1992-06-01 00:00:00

  • Does walking speed mediate the association between visual impairment and self-report of mobility disability? The Salisbury Eye Evaluation Study.

    abstract：OBJECTIVES:To determine whether performance speeds mediate the association between visual impairment and self-reported mobility disability over an 8-year period. DESIGN:Longitudinal analysis. SETTING:Salisbury, Maryland. PARTICIPANTS:Salisbury Eye Evaluation Study participants aged 65 and older (N=2,520). MEASUREME...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/jgs.12937

    authors： Swenor BK,Bandeen-Roche K,Muñoz B,West SK

    更新日期：2014-08-01 00:00:00

  • Cost-Effectiveness of Pneumococcal Vaccination Policies and Uptake Programs in US Older Populations.

    abstract：BACKGROUND/OBJECTIVES:Recently revised vaccination recommendations for US adults, aged 65 years and older, include both 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13), with PCV13 now recommended for immunocompetent older people based on shared decision making...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/jgs.16373

    authors： Wateska AR,Nowalk MP,Lin CJ,Harrison LH,Schaffner W,Zimmerman RK,Smith KJ

    更新日期：2020-06-01 00:00:00

  • Objectively Measured Physical Activity Reduces the Risk of Mortality among Brazilian Older Adults.

    abstract：OBJECTIVES:Use of objectively measured physical activity (PA) in older adults to assess relationship between PA and risk of all-causes mortality is scarce. This study evaluated the associations of PA based on accelerometry and a questionnaire with the risk of mortality among older adults from a city in Southern Brazil....

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/jgs.16180

    authors： Bielemann RM,LaCroix AZ,Bertoldi AD,Tomasi E,Demarco FF,Gonzalez MC,Crespo da Silva PA,Wendt A,Mohnsam da Silva IC,Brage S,Ekelund U,Pratt M

    更新日期：2020-01-01 00:00:00

  • Risks and Benefits of Screening for Dementia in Primary Care: The Indiana University Cognitive Health Outcomes Investigation of the Comparative Effectiveness of Dementia Screening (IU CHOICE)Trial.

    abstract：BACKGROUND/OBJECTIVE:The benefits and harms of screening of Alzheimer disease and related dementias (ADRDs) are unknown. This study addressed the question of whether the benefits outweigh the harms of screening for ADRDs among older adults in primary care. DESIGN, SETTING, AND PARTICIPANTS:Single-blinded, two-arm, ran...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章,随机对照试验

    doi：10.1111/jgs.16247

    authors： Fowler NR,Perkins AJ,Gao S,Sachs GA,Boustani MA

    更新日期：2020-03-01 00:00:00

  • Developing a geriatric business plan for an academic medical center.

    abstract：:Leaders of geriatric programs at academic health centers (AHCs) face several challenges in seeking support for clinical program development. These challenges relate to how revenues from Medicare activities flow within AHCs. Typically, clinical departments such as the Department of Medicine see a very small proportion ...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1046/j.1532-5415.2002.50174.x

    authors： Goodwin JS

    更新日期：2002-04-01 00:00:00

  • Family perceptions of end-of-life care for long-term care residents with dementia: differences between the United States and the Netherlands.

    abstract：OBJECTIVES:To examine cross-national care and outcomes related to end-of-life experiences. DESIGN:Postdeath interviews and self-administered questionnaires completed with family caregivers of residents with dementia who died in long-term care settings or shortly after transfer. SETTING:One hundred eighty-three nursin...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.2011.03816.x

    authors： Cohen LW,van der Steen JT,Reed D,Hodgkinson JC,van Soest-Poortvliet MC,Sloane PD,Zimmerman S

    更新日期：2012-02-01 00:00:00

  • Home environmental hazards and the risk of fall injury events among community-dwelling older persons. Study to Assess Falls Among the Elderly (SAFE) Group.

    abstract：OBJECTIVE:To determine if home environmental hazards increase the risk of fall injury events among community-dwelling older persons. DESIGN:Population-based case-control study. SETTING:South Miami Beach, Florida. PARTICIPANTS:270 persons aged 65 years and older who sought treatment at six area hospitals for injuries...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.1998.tb03799.x

    authors： Sattin RW,Rodriguez JG,DeVito CA,Wingo PA

    更新日期：1998-06-01 00:00:00

  • Emergency department visits by nursing home residents in the United States.

    abstract：OBJECTIVES:To characterize emergency department (ED) use by nursing home residents in the United States. DESIGN:Analysis of the National Hospital Ambulatory Medical Care Survey. SETTING:U.S. EDs from 2005 to 2008. PARTICIPANTS:Individuals visiting U.S. EDs stratified according to nursing home residency. MEASUREMENT...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.2011.03587.x

    authors： Wang HE,Shah MN,Allman RM,Kilgore M

    更新日期：2011-10-01 00:00:00

  • Alzheimer's disease: assessment of functional status.

    abstract：:The initial assessments of cognitive, psychologic, and behavioral functioning of 17 adults enrolled in a day care program for victims of Alzheimer's disease are described. These evaluations by the staff, the patients themselves, and their primary caregivers made use of standardized quantitative measures, thus permitti...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.1983.tb03398.x

    authors： Winogrond IR,Fisk AA

    更新日期：1983-12-01 00:00:00

  • Serum IL-6 level and the development of disability in older persons.

    abstract：BACKGROUND:The serum concentration of interleukin 6 (IL-6), a cytokine that plays a central role in inflammation, increases with age. Because inflammation is a component of many age-associated chronic diseases, which often cause disability, high circulating levels of IL-6 may contribute to functional decline in old age...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.1999.tb01583.x

    authors： Ferrucci L,Harris TB,Guralnik JM,Tracy RP,Corti MC,Cohen HJ,Penninx B,Pahor M,Wallace R,Havlik RJ

    更新日期：1999-06-01 00:00:00

  • Hyponatremia and arginine vasopressin dysregulation: mechanisms, clinical consequences, and management.

    abstract：:Hyponatremia, the most common electrolyte disorder, occurs frequently in older people and in hospitalized patients. Physiological changes of aging that interact with diseases and drugs commonly present in older people put this population at greater risk for hyponatremia. It can accompany central nervous system disorde...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章,评审

    doi：10.1111/j.1532-5415.2005.00609.x

    authors： Miller M

    更新日期：2006-02-01 00:00:00

  • Psychoactive medications and crash involvement requiring hospitalization for older drivers: a population-based study.

    abstract：OBJECTIVES:To determine the association between psychoactive medications and crash risk in drivers aged 60 and older. DESIGN:Retrospective population-based case-crossover study. SETTING:A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme. PARTICIP...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.2011.03561.x

    authors： Meuleners LB,Duke J,Lee AH,Palamara P,Hildebrand J,Ng JQ

    更新日期：2011-09-01 00:00:00

  • Health Forums and Twitter for Dementia Research: Opportunities and Considerations.

    abstract：BACKGROUND/OBJECTIVES:Social media platforms are promising sources for large quantities of participant-driven research data and circumvent some common challenges when conducting dementia research. This study provides a summary of key considerations and recommendations about using these platforms as research tools for d...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/jgs.16790

    authors： Mehta N,Zhu L,Lam K,Stall NM,Savage R,Read SH,Wu W,Pop P,Faulkner C,Bronskill SE,Rochon PA

    更新日期：2020-12-01 00:00:00

  • The renal effects of nonsteroidal anti-inflammatory drugs in older people: findings from the Established Populations for Epidemiologic Studies of the Elderly.

    abstract：OBJECTIVE:To determine whether older people who use nonsteroidal anti-inflammatory agents (NSAIDs) have increased levels of blood urea nitrogen (BUN), serum creatinine, and BUN:serum creatinine ratio. DESIGN:Cross-sectional, secondary data analysis. SETTING:Older people living in the communities of East Boston, MA, N...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.1999.tb02561.x

    authors： Field TS,Gurwitz JH,Glynn RJ,Salive ME,Gaziano JM,Taylor JO,Hennekens CH

    更新日期：1999-05-01 00:00:00

  • Picture-based memory impairment screen for dementia.

    abstract：OBJECTIVES:To develop and validate a picture-based memory impairment screen (PMIS) for the detection of dementia. DESIGN:Cross-sectional. SETTING:Outpatient clinics, Baby Memorial Hospital, Kozhikode city in the southern Indian state of Kerala. PARTICIPANTS:Three hundred four community-residing adults aged 55 to 94 ...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.2012.04191.x

    authors： Verghese J,Noone ML,Johnson B,Ambrose AF,Wang C,Buschke H,Pradeep VG,Abdul Salam K,Shaji KS,Mathuranath PS

    更新日期：2012-11-01 00:00:00

  • Self-reported sleep and nap habits and risk of mortality in a large cohort of older women.

    abstract：OBJECTIVES:To determine the association between self-reported sleep and nap habits and mortality in a large cohort of older women. DESIGN:Study of Osteoporotic Fractures prospective cohort study. SETTING:Four communities within the United States. PARTICIPANTS:Eight thousand one hundred one Caucasian women aged 69 an...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章,多中心研究

    doi：10.1111/j.1532-5415.2008.02171.x

    authors： Stone KL,Ewing SK,Ancoli-Israel S,Ensrud KE,Redline S,Bauer DC,Cauley JA,Hillier TA,Cummings SR

    更新日期：2009-04-01 00:00:00

  • Patterns of self-rated health in older adults before and after sentinel health events.

    abstract：OBJECTIVES:To describe and compare patterns of change in self-rated health for older adults before death and before and after stroke, myocardial infarction, congestive heart failure, cardiac procedure, hospital admission for cancer, and hip fracture. DESIGN:"Event cohort," measuring time in months before and after the...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章,多中心研究

    doi：10.1046/j.1532-5415.2001.49007.x

    authors： Diehr P,Williamson J,Patrick DL,Bild DE,Burke GL

    更新日期：2001-01-01 00:00:00

  • Iatrogenic disease in hospitalized elderly veterans.

    abstract：:To help determine whether or not the elderly are at unusually high risk for hospital-related complications, a study was made of consecutive admissions involving 48 patients less than 65 years old (mean 50.3 years) and 174 patients more than 65 years old (mean 73.1 years). They were prospectively followed during their ...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.1982.tb02837.x

    authors： Jahnigen D,Hannon C,Laxson L,LaForce FM

    更新日期：1982-06-01 00:00:00

  • American Geriatrics Society identifies another five things that healthcare providers and patients should question.

    abstract：:Since 2012, the American Geriatrics Society (AGS) has also been collaborating with the American Board of Internal Medicine (ABIM) Foundation, joining its "Choosing Wisely" campaign on two separate lists of Five Things Healthcare Providers and Patients Should Question. The campaign is designed to engage healthcare orga...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章,评审

    doi：10.1111/jgs.12770

    authors： AGS Choosing Wisely Workgroup.

    更新日期：2014-05-01 00:00:00

  • The incidence of perioperative myocardial infarction with transurethral resection of the prostate.

    abstract：:We performed a prospective study of 250 men undergoing transurethral resection of the prostate to determine the incidence of perioperative myocardial infarction. The prevalence of coronary artery disease in the study group was 27%. Patients had measurement of total creatine kinase and its MB isoenzyme and electrocardi...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.1989.tb01251.x

    authors： Ashton CM,Lahart CJ,Wray NP

    更新日期：1989-07-01 00:00:00

  • The Competing Risk of Death in Longitudinal Geriatric Outcomes.

    abstract：OBJECTIVES:To address the competing risk of death in longitudinal studies of older persons, we demonstrate sensitivity analyses that evaluate robustness of associations between exposures and three outcome types: dichotomous, count, and time to event. DESIGN:A secondary analysis of data from a prospective cohort study....

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/jgs.15697

    authors： Murphy TE,Gill TM,Leo-Summers LS,Gahbauer EA,Pisani MA,Ferrante LE

    更新日期：2019-02-01 00:00:00

  • A multidisciplinary program for delivering primary care to the underserved urban homebound: looking back, moving forward.

    abstract：:The coming decades will see a dramatic rise in the number of homebound adults. These individuals will have multiple medical conditions requiring a team of caregivers to provide adequate care. Home-based primary care (HBPC) programs can coordinate and provide such multidisciplinary care. Traditionally, though, HBPC pro...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章,评审

    doi：10.1111/j.1532-5415.2006.00835.x

    authors： Smith KL,Ornstein K,Soriano T,Muller D,Boal J

    更新日期：2006-08-01 00:00:00

  • Cost-Effectiveness of the 4 Pillars Practice Transformation Program to Improve Vaccination of Adults Aged 65 and Older.

    abstract：OBJECTIVES:To estimate the cost-effectiveness of an intervention to increase pneumococcal, influenza, and pertussis-containing vaccine uptake in adults aged 65 and older in primary care practices. DESIGN:Markov decision analysis model, comparing the cost-effectiveness of the 4 Pillars Practice Transformation Program w...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章,多中心研究,随机对照试验

    doi：10.1111/jgs.14588

    authors： Smith KJ,Zimmerman RK,Nowalk MP,Lin CJ

    更新日期：2017-04-01 00:00:00

  • Rating the importance of nursing home residents' quality of life.

    abstract：OBJECTIVES:To assess how various stakeholders involved with nursing home care rate the importance of various quality-of-life (QoL) items for hypothetical residents with varying types of impairment. DESIGN:A community-based exploratory description of a convenience sample. SETTING:Eleven nursing homes in Florida, New J...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章,多中心研究

    doi：10.1111/j.1532-5415.2005.00493.x

    authors： Kane RL,Rockwood T,Hyer K,Desjardins K,Brassard A,Gessert C,Kane R

    更新日期：2005-12-01 00:00:00

  • Handgrip strength and mortality in older Mexican Americans.

    abstract：OBJECTIVES:To examine the association between handgrip strength and mortality in older Mexican American men and women. DESIGN:A 5-year prospective cohort study. SETTING:Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS:A population-based sample of 2,488 noninstitutionalized...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1046/j.1532-5415.2002.50312.x

    authors： Al Snih S,Markides KS,Ray L,Ostir GV,Goodwin JS

    更新日期：2002-07-01 00:00:00

  • The geriatric floating interdisciplinary transition team.

    abstract：:Older adults often receive suboptimal care during hospitalizations and transitions to postacute settings. Inpatient geriatric services have been shown to increase care quality but have not improved patient outcomes consistently. Acute Care for the Elderly units improve patient outcomes but are resource intensive. Tran...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/j.1532-5415.2009.02682.x

    authors： Arbaje AI,Maron DD,Yu Q,Wendel VI,Tanner E,Boult C,Eubank KJ,Durso SC

    更新日期：2010-02-01 00:00:00

  • Multimorbidity Frameworks Impact Prevalence and Relationships with Patient-Important Outcomes.

    abstract：OBJECTIVES:To explore how different frameworks and categories of chronic conditions impact multimorbidity (defined as two or more chronic conditions) prevalence estimates and associations with patient-important functional outcomes. DESIGN:Baseline data from a population-based cohort study. SETTING:National sample of ...

    journal_title：Journal of the American Geriatrics Society

    pub_type： 杂志文章

    doi：10.1111/jgs.15921

    authors： Griffith LE,Gilsing A,Mangin D,Patterson C,van den Heuvel E,Sohel N,St John P,van den Akker M,Raina P

    更新日期：2019-08-01 00:00:00