Journal of the American Medical Directors Association
JAMDA OnlineOriginal StudyA Short Easy Test Can Detect Ability for Autonomous Insulin Injection by the Elderly With Diabetes Mellitus
Section snippets
Patients and Methods
One hundred patients with type 2 diabetes mellitus from 6 specific centers were successively included in the study (t0). Two patients withdrew their consent, thus 98 patients were finally included in the statistical analysis (female 65.3%). Inclusion criteria were geriatric patients with insulin-treated type 2 diabetes, and at discharge aged 65 years or older as defined by the Central Association of Geriatrics. According to the definition of 1990, patients showed multimorbidity as well as the
Results
At the follow-up examination (t2), 39 (53.4%) of 73 patients injected insulin autonomously, 28 patients (38.4%) did not. Four patients (5.5%) injected insulin with assistance. Two patients (2.7%) were no longer on insulin therapy and were switched to oral antidiabetic therapy. The patient characteristics of the 39 patients who were able to perform their insulin therapy autonomously, and the 32 patients who could not inject insulin themselves or only with assistance, are presented in Table 4.
Discussion
The TTMC seems to be a suitable predictor for ability to inject insulin autonomously after receiving diabetes education. Indeed, the specificity is 70.0% and the positive predictive value is 78.7% if patients perform the tests within a time period of less than 46 seconds. The TTMC offers a substantial advantage in that it is a very short and nonchallenging performance test. The expenditure of time is only about 5 minutes and it helps to identify patients with diabetes who are able to inject
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2014, Patient Education and CounselingCitation Excerpt :Besides learning programs both peer education support groups and empowerment programs may help to reduce fear of insulin injection [19]. Comprehensive geriatric assessment (CGA), in particular screening for depression and assessment of cognitive, visual and functional ability by using the timed test of money-counting of Nikolaus et al. is helpful to detect patients ability for insulin self-injection [20]. Furthermore insulin-naïve patients who have switched to insulin therapy have had fewer physical complaints, less worry about the future, a reduced daily struggle and less fear of hypoglycemia, while patients already on insulin therapy showed no improvement [17].
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Financial Support for this study was provided by BBraun LTD; there were no conflicts of interest, corporate involvement, or patent holdings regarding this study.