IMPACT OF DEMOGRAPHIC AND OTHER FACTORS

Published: 2017-12-02 14:42:09
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Introduction
This project describes the management of diabetes, according to certain demographic factors via the monitoring of HbA1c results over a three-year period (2012-2014). The impact of these factors including age, gender, diagnosis, and referral location on glycemia was established. Patient history records were analyzed to determine factors associated with the lower glycemia levels throughout the two-year period.
Aims
‚Äʬ†To¬†characterize¬†glycemia¬†in¬†individual¬†patients¬†attending¬†Kuwaiti¬†Inpatient¬†and¬†Outpatient¬†facilities¬†over¬†a¬†two-year¬†period
‚Äʬ†To¬†establish¬†associations¬†of¬†glycemia¬†with¬†demographic¬†factors¬†(age,¬†sex),¬†clinical¬†diagnosis¬†(diabetes¬†and¬†other¬†medical¬†conditions),¬†and¬†referral¬†location
Methods
A retrospective observational study of glycemia was performed in a population of patients attending Kuwaiti hospital and outpatient facilities between 2012 and 2014. Information collected included age, sex, clinical diagnosis, and referral location. Glycemia was assessed by measurement of non-fasting glycated hemoglobin (HbA1c). Associations of glycemia with demographic and other factors were established-tests and other statistical processes were performed.
Results
HbA1c¬†measurements¬†were¬†made¬†in¬†854¬†patients¬†between¬†January¬†2012¬†and¬†September¬†2014.¬†Patients¬†were¬†omitted¬†depending¬†on¬†the¬†information¬†available¬†for¬†the¬†various¬†categories.¬†The¬†calculated¬†mean¬†and¬†standard¬†deviation¬†(SD)¬†HbA1c¬†of¬†all¬†patients¬†was¬†7.81%¬Ī1.98.
In¬†total,¬†305¬†male¬†patients¬†were¬†analyzed¬†ranging¬†from¬†13¬†years¬†old¬†to¬†89¬†years¬†old.¬†Their¬†mean¬†HbA1c¬†was¬†8.06%¬†with¬†an¬†SD¬†of¬†¬Ī0.11.
Overall,¬†297¬†female¬†patients¬†were¬†analyzed¬†with¬†ages¬†ranging¬†from¬†10¬†years¬†old¬†to¬†90¬†years¬†old.¬†Their¬†mean¬†HbA1c¬†was¬†7.89%¬†with¬†an¬†SD¬†of¬†¬Ī0.33.
Although females experienced more fluctuations in their glycemic control from 2012-2014, they had lower glycemic levels overall compared to the male patients.
The¬†lower¬†HbA1c¬†levels¬†with¬†a¬†decreasing¬†glycemic¬†level¬†trend¬†belonged¬†to¬†the¬†twenty-one¬†to¬†thirty-year-old¬†patients;¬†twelve¬†patients¬†were¬†analyzed¬†and¬†found¬†to¬†have¬†an¬†average¬†HbA1c¬†of¬†7.96%¬†with¬†an¬†SD¬†of¬†¬Ī0.86.¬†They¬†achieved¬†one¬†of¬†the¬†lowest¬†glycemic¬†values¬†compared¬†to¬†the¬†other¬†age¬†ranges.¬†In¬†the¬†data¬†collected¬†for¬†three¬†years,¬†their¬†HbA1c¬†level¬†continuously¬†decreased¬†to¬†a¬†stable¬†range.
Because¬†the¬†inpatient¬†and¬†polyclinic¬†patients¬†experienced¬†many¬†fluctuations¬†with¬†their¬†results¬†increasing¬†and¬†decreasing¬†in¬†glycemic¬†values,¬†the¬†outpatient¬†patients¬†maintained¬†lower¬†glycemic¬†levels.¬†The¬†outpatient¬†location¬†started¬†with¬†poor¬†HbA1c¬†values¬†of¬†9.2%¬†and¬†10.4%respectively,¬†but¬†then¬†decreased¬†thelevels¬†and¬†maintained¬†a¬†rather¬†stable¬†level¬†of¬†glycemia¬†with¬†an¬†average¬†HbA1c¬†value¬†of¬†7.5%¬†in¬†2014.¬†The¬†overall¬†average¬†for¬†this¬†group¬†was¬†8.04%¬†with¬†a¬†standard¬†deviation¬†of¬†¬Ī0.99.
Patients¬†categorized¬†as¬†diabetics¬†under¬†the¬†diagnosis¬†portion¬†of¬†their¬†request¬†forms¬†managed¬†their¬†glycemic¬†levels¬†over¬†a¬†three-year¬†period¬†(2012-2014).¬†¬†The¬†patients¬†in¬†this¬†group¬†decreased¬†their¬†glycemic¬†levels¬†gradually¬†over¬†the¬†period¬†of¬†this¬†study.¬†The¬†average¬†HbA1c¬†value¬†from¬†2012-2013¬†was¬†8.37%¬†with¬†an¬†SD¬†of¬†¬Ī0.24¬†for¬†the¬†diabetic¬†patients,¬†while¬†from¬†2013-2014¬†the¬†average¬†HbA1c¬†for¬†diabetic¬†patients¬†was¬†8.11%¬†with¬†an¬†SD¬†of¬†¬Ī0.11¬†with¬†a¬†P-value¬†of¬†0.96¬†which¬†concludes¬†an¬†insignificant¬†difference.
Conclusion
Female patients (n=297) had lower glycemia than male patients (n=305). This might be because of more hormonal changes in females than males and the lifestyle changes more females tend to make such as dieting. Lower Glycemia was observed in 21-30-year-old patients than any other age group. Glycemia was higher in inpatients than in outpatients because inpatients are more reliant on medications that may alter their glucose levels or be used to maintain a healthy glucose level. HbA1c gradually decreased in glycemic levels for diabetic patients than it did for any other diagnosis. Therefore, as study portrayed the HbA1c levels in various broad categories, future studies ought to focus on one of the groups and analyze it with detail in order to help maintain healthy glycemic levels.

CHAPTER ONE
Abstract
Introduction
This project describes the management of diabetes, according to certain demographic factors via the monitoring of HbA1c results over a three-year period (2012-2014). The impact of these factors including age, gender, diagnosis, and referral location on glycemia was established. Patient history records were analyzed to determine factors associated with the lower glycemia levels throughout the two-year period.
Aims
‚Äʬ†To¬†characterize¬†glycemia¬†in¬†individual¬†patients¬†attending¬†Kuwaiti¬†Inpatient¬†and¬†Outpatient¬†facilities¬†over¬†a¬†two-year¬†period
‚Äʬ†To¬†establish¬†associations¬†of¬†glycemia¬†with¬†demographic¬†factors¬†(age,¬†sex),¬†clinical¬†diagnosis¬†(diabetes¬†and¬†other¬†medical¬†conditions),¬†and¬†referral¬†location
Methods
A retrospective observational study of glycemia was performed in a population of patients attending Kuwaiti hospital and outpatient facilities between 2012 and 2014. Information collected included age, sex, clinical diagnosis, and referral location. Glycemia was assessed by measurement of non-fasting glycated hemoglobin (HbA1c). Associations of glycemia with demographic and other factors were established-tests and other statistical processes were performed.
Results
HbA1c¬†measurements¬†were¬†made¬†in¬†854¬†patients¬†between¬†January¬†2012¬†and¬†September¬†2014.¬†Patients¬†were¬†omitted¬†depending¬†on¬†the¬†information¬†available¬†for¬†the¬†various¬†categories.¬†The¬†calculated¬†mean¬†and¬†standard¬†deviation¬†(SD)¬†HbA1c¬†of¬†all¬†patients¬†was¬†7.81%¬Ī1.98.
In¬†total,¬†305¬†male¬†patients¬†were¬†analyzed¬†ranging¬†from¬†13¬†years¬†old¬†to¬†89¬†years¬†old.¬†Their¬†mean¬†HbA1c¬†was¬†8.06%¬†with¬†an¬†SD¬†of¬†¬Ī0.11.
Overall,¬†297¬†female¬†patients¬†were¬†analyzed¬†with¬†ages¬†ranging¬†from¬†10¬†years¬†old¬†to¬†90¬†years¬†old.¬†Their¬†mean¬†HbA1c¬†was¬†7.89%¬†with¬†an¬†SD¬†of¬†¬Ī0.33.
Although females experienced more fluctuations in their glycemic control from 2012-2014, they had lower glycemic levels overall compared to the male patients.
The¬†lower¬†HbA1c¬†levels¬†with¬†a¬†decreasing¬†glycemic¬†level¬†trend¬†belonged¬†to¬†the¬†twenty-one¬†to¬†thirty-year-old¬†patients;¬†twelve¬†patients¬†were¬†analyzed¬†and¬†found¬†to¬†have¬†an¬†average¬†HbA1c¬†of¬†7.96%¬†with¬†an¬†SD¬†of¬†¬Ī0.86.¬†They¬†achieved¬†one¬†of¬†the¬†lowest¬†glycemic¬†values¬†compared¬†to¬†the¬†other¬†age¬†ranges.¬†In¬†the¬†data¬†collected¬†for¬†three¬†years,¬†their¬†HbA1c¬†level¬†continuously¬†decreased¬†to¬†a¬†stable¬†range.
Because¬†the¬†inpatient¬†and¬†polyclinic¬†patients¬†experienced¬†many¬†fluctuations¬†with¬†their¬†results¬†increasing¬†and¬†decreasing¬†in¬†glycemic¬†values,¬†the¬†outpatient¬†patients¬†maintained¬†lower¬†glycemic¬†levels.¬†The¬†outpatient¬†location¬†started¬†with¬†poor¬†HbA1c¬†values¬†of¬†9.2%¬†and¬†10.4%respectively,¬†but¬†then¬†decreased¬†thelevels¬†and¬†maintained¬†a¬†rather¬†stable¬†level¬†of¬†glycemia¬†with¬†an¬†average¬†HbA1c¬†value¬†of¬†7.5%¬†in¬†2014.¬†The¬†overall¬†average¬†for¬†this¬†group¬†was¬†8.04%¬†with¬†a¬†standard¬†deviation¬†of¬†¬Ī0.99.
Patients¬†categorized¬†as¬†diabetics¬†under¬†the¬†diagnosis¬†portion¬†of¬†their¬†request¬†forms¬†managed¬†their¬†glycemic¬†levels¬†over¬†a¬†three-year¬†period¬†(2012-2014).¬†¬†The¬†patients¬†in¬†this¬†group¬†decreased¬†their¬†glycemic¬†levels¬†gradually¬†over¬†the¬†period¬†of¬†this¬†study.¬†The¬†average¬†HbA1c¬†value¬†from¬†2012-2013¬†was¬†8.37%¬†with¬†an¬†SD¬†of¬†¬Ī0.24¬†for¬†the¬†diabetic¬†patients,¬†while¬†from¬†2013-2014¬†the¬†average¬†HbA1c¬†for¬†diabetic¬†patients¬†was¬†8.11%¬†with¬†an¬†SD¬†of¬†¬Ī0.11¬†with¬†a¬†P-value¬†of¬†0.96¬†which¬†concludes¬†an¬†insignificant¬†difference.
Conclusion
Female patients (n=297) had lower glycemia than male patients (n=305). This might be because of more hormonal changes in females than males and the lifestyle changes more females tend to make such as dieting. Lower Glycemia was observed in 21-30-year-old patients than any other age group. Glycemia was higher in inpatients than in outpatients because inpatients are more reliant on medications that may alter their glucose levels or be used to maintain a healthy glucose level. HbA1c gradually decreased in glycemic levels for diabetic patients than it did for any other diagnosis. Therefore, as study portrayed the HbA1c levels in various broad categories, future studies ought to focus on one of the groups and analyze it with detail in order to help maintain healthy glycemic levels. 

sheldon

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