Clinical Significance and Prevalence of Frailty Syndrome in Type 2 Diabetes Patients

Yıl 2022, Cilt: 44 Sayı: 2, 169 - 176, 28.02.2022

Betül Alaca , Mehmet Zahid Koçak , Müjgan Gürler

https://doi.org/10.20515/otd.986794

Öz

In this study, we aimed to evaluate the prevalence of frailty in type 2 diabetes mellitus (T2DM) and to investigate the relations between frailty and T2DM. One hundred twenty-five patients with T2DM diagnosis were included in the study. According to the Fried's frailty scale, the patients were grouped as frail, pre-frail and non-frail, and their prevalence was determined. Demographic data, anthropometric measurements and laboratory data were compared between the groups. The harmonic mean of the group sizes is used as the group size was not equal. The frail patients’ number was 11 (8%), the pre-frail patients’ number was 83 (66%), and the non-frail patients’ number was 31 (26%) in the study. The median age of the frail group was 65 (51-88) years, the pre-frail group was 61 (50-78) years, and the non-frail group was 61 (50-80) years (p = 0.15). There was no statistically significant difference between in body mass index, diabetes duration, systolic and diastolic blood pressure, and co-morbidity between the groups (p> 0.05 for all). Fasting plasma glucose, HbA1c, triglyceride, hand grip strength and gait speed were statistically significantly different between groups (p< 0.05 for all). Impaired glucose regulation, low gait speed and hand grip strength test were detected in patients with pre-frail T2DM. Patients with T2DM are candidates for frailty at an earlier age.

Anahtar Kelimeler

frailty, gait speed, handgrip strength, type 2 diabetes mellitus

Destekleyen Kurum

yok

Proje Numarası

-

Teşekkür

-

Tip 2 Diyabetli Hastalarda Kırılganlık Sendromunun Sıklığı ve Klinik Önemi

Öz

Bu çalışmada tip 2 diyabetes mellitusta (T2DM) kırılganlık sendromunun sıklığını ve kırılganlık ile T2DM arasındaki ilişkiyi değerlendirmeyi amaçladık. Çalışmaya T2DM tanılı yüz yirmi beş hasta dahil edildi. Fried'in kırılganlık ölçeğine göre hastalar kırılgan, pre-kırılgan ve kırılgan olmayan olarak gruplandırıldı ve sıklıkları belirlendi. Gruplar arasında demografik veriler, antropometrik ölçümler ve laboratuvar verileri karşılaştırıldı. Grup büyüklüğü eşit olmadığı için grup büyüklüklerinin harmonik ortalaması kullanılmıştır. Çalışmada kırılgan hasta sayısı 11 (%8), pre-kırılgan hasta sayısı 83 (%66), kırılgan olmayan hasta sayısı 31 (%26) idi. Kırılgan grubun ortanca yaşı 65 (51-88) yıl, pre-kırılgan grubun 61 (50-78) yıl ve kırılgan olmayan grup 61 (50-80) yıl (p=0.15) idi. Gruplar arasında vücut kitle indeksi, diyabet süresi, sistolik ve diyastolik kan basıncı ve komorbidite açısından istatistiksel olarak anlamlı fark yoktu (hepsi için p> 0.05). Açlık plazma glukozu, HbA1c, trigliserit, el kavrama gücü ve yürüme hızı gruplar arasında istatistiksel olarak farklı bulundu (tümü için p< 0.05). Pre-frail T2DM'li hastalarda bozulmuş glukoz regülasyonu, düşük yürüme hızı ve el kavrama gücü saptandı. T2DM'li hastalar daha erken yaşta kırılganlık için adaydır.

Anahtar Kelimeler

kırılganlık, yürüme hızı, el kavrama gücü, tip 2 diabetes mellitus

Proje Numarası

-

Kaynakça

• Referans1. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabet Res Clin Pract. 2010;87(1):4-14.
• Referans2. Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin Diabet. 2008;26(2):77-82.
• Referans3. Wong E, Backholer K, Gearon E et al. Diabetes and risk of physical disability in adults: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2013;1(2):106-14.
• Referans4. Clegg A, Young J, Iliffe S et al. Frailty in elderly people. Lancet. 2013;381(9868):752-62.
• Referans5. Morley J, Kim M, Haren M et al. Frailty and the aging male. Aging Male. 2005;8(3-4):135-40.
• Referans6. Kojima G, Iliffe S, Walters K. Frailty index as a predictor of mortality: a systematic review and meta-analysis. Age Ageing. 2018;47(2):193-200.
• Referans7. Apóstolo J, Cooke R, Bobrowicz-Campos E et al. Effectiveness of interventions to prevent pre-frailty and frailty progression in older adults: a systematic review. JBI Database System Rev Implement Rep. 2018;16(1):140.
• Referans8. Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol. 2014;2(10):819-29.
• Referans9. Yoon SJ, Kim KI. Frailty and Disability in Diabetes. Ann Geriatr Med Res. 2019;23(4):165-9.
• Referans10. Ottenbacher KJ, Graham JE, Al Snih S et al. Mexican Americans and frailty: findings from the Hispanic established populations epidemiologic studies of the elderly. Am J Pub Healt. 2009;99(4):673-9.
• Referans11. Cacciatore F, Testa G, Galizia G et al. Clinical frailty and long-term mortality in elderly subjects with diabetes. Acta Diabetol. 2013;50(2):251-60.
• Referans12. Hubbard R, Andrew M, Fallah N et al. Comparison of the prognostic importance of diagnosed diabetes, co‐morbidity and frailty in older people. Diabet Med. 2010;27(5):603-6.
• Referans13. Saum K-U, Dieffenbach AK, Müller H et al. Frailty prevalence and 10-year survival in community-dwelling older adults: results from the ESTHER cohort study. Eur J Epidemiol.2014;29(3):171-9.
• Referans14. Bouillon K, Kivimäki M, Hamer M et al. Diabetes risk factors, diabetes risk algorithms, and the prediction of future frailty: the Whitehall II prospective cohort study. J Am Med Dir Assoc. 2013;14(11):851. e1-. e6.
• Referans15. Crow RS, Lohman MC, Titus AJ et al. Mortality risk along the frailty spectrum: data from the National Health and Nutrition Examination Survey 1999 to 2004. J Am Geriatr Soc. 2018;66(3):496-502.
• Referans16. Fried LP, Tangen CM, Walston J et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-M57.
• Referans17. Chhetri JK, Zheng Z, Xu X et al. The prevalence and incidence of frailty in Pre-diabetic and diabetic community-dwelling older population: results from Beijing longitudinal study of aging II (BLSA-II). BMC Geriatr. 2017;17(1):47.
• Referans18. Sinclair AJ, Abdelhafiz A, Dunning T et al. An international position statement on the management of frailty in diabetes mellitus: summary of recommendations 2017. J Frailty Aging. 2018;7(1):10-20.
• Referans19. Hoogendijk EO, Afilalo J, Ensrud KE et al. Frailty: implications for clinical practice and public health. Lancet. 2019;394(10206):1365-75.
• Referans20. Baumgartner RN. Body composition in healthy aging. Ann N Y Acad Sci 2000;904(1):437-48.
• Referans21. Quartuccio M, Buta B, Kalyani RR. Comparative effectiveness for glycemic control in older adults with diabetes. Curr Geriatr Rep. 2017;6(3):175-86.
• Referans22. Steiner G. Treating lipid abnormalities in patients with type 2 diabetes mellitus. Am J Cardiol. 2001;88(12):37-40.
• Referans23. Kocak MZ. Letter to the editor regarding the article ‘Frailty and skeletal muscle in older adults with cancer’. J Geriatr Oncol. 2020;11(6):1041.
• Referans24. Peterson MD, McGrath R, Zhang P et al. Muscle weakness is associated with diabetes in older Mexicans: the Mexican health and aging study. J Am Med Dir Assoc. 2016;17(10):933-8.
• Referans25. Peterson MD, Zhang P, Choksi P et al. Muscle weakness thresholds for prediction of diabetes in adults. . Sport Med. 2016;46(5):619-28.
• Referans26. McGrath R, Vincent BM, Al Snih S et al. The association between muscle weakness and incident diabetes in older Mexican Americans. J Am Med Dir Assoc. 2017;18(5):452. e7-. e12.
• Referans27. Kocak MZ. Comment on “Frailty screening by Geriatric-8 and 4-meter gait speed test is feasible and predicts postoperative complications in elderly colorectal cancer patients”. J Geriatr Oncol. 2021.
• Referans28. Machii N, Kudo A, Saito H, Tanabe H et al. Walking Speed is the Sole Determinant Criterion of Sarcopenia of Mild Cognitive Impairment in Japanese Elderly Patients with Type 2 Diabetes Mellitus. J Clin Med. 2020;9(7):2133.