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At least 199 records · Page 11Linked to original sources
PubMed1992

Modeling recovery from stumbles: preliminary data on variable selection and classification efficacy.

OBJECTIVE: The primary purpose of this preliminary investigation was to determine the functional relationship between selected information processing time and response execution variables and measures of postural stability in elderly women. A secondary purpose was to explore the efficacy of a neuromotor model using selected variables to retrospectively identify subjects with a self-reported history of falling. DESIGN: Descriptive, retrospective, cohort. SETTING: General community. SUBJECTS: Convenience sample of 17 community-dwelling females with a mean age of 72.2 years. MAIN OUTCOME MEASURES: Postural stability variables included the amplitude and frequency of postural sway during static vision-aided no-vision conditions. Information processing and response execution variables were collected using a simple-choice reaction time paradigm for an isometric knee extension task. RESULTS: Postural stability and information processing variables were functionally independent. Based upon significant intergroup differences, simple and choice pre-motor reaction time and non-vision aided anterior posterior sway amplitude were selected for inclusion in a discriminant analysis. The resulting discriminant function was significant (P = 0.01), correctly categorizing all of the subjects with a self-reported history of falling and identifying six out of seven of the non-fallers. CONCLUSIONS: These preliminary results suggest that it is feasible to identify a predisposition to falling by detecting an inability to respond successfully to a postural disturbance.

Accidental Falls↗
PubMed2003

C-reactive protein predicts the deterioration of glycemia in chinese subjects with impaired glucose tolerance.

OBJECTIVE: Recent studies have shown that C-reactive protein (CRP) predicts future risk of diabetes in healthy Caucasians. We determined whether plasma CRP level was elevated in Chinese subjects with impaired glucose tolerance (IGT) and whether CRP level could be used to predict progression to type 2 diabetes or reversion to normal glucose tolerance (NGT) in these high-risk individuals. RESEARCH DESIGN AND METHODS: A total of 228 subjects with IGT at baseline from the Hong Kong Cardiovascular Risk Factors Prevalence Study underwent repeat oral glucose tolerance testing after 2 years. Plasma high-sensitivity CRP was measured from their stored baseline samples and from 228 subjects with NGT matched for age and BMI by an immunoturbidimetric assay. RESULTS: Subjects with IGT at baseline had higher plasma CRP levels than subjects with NGT: 1.18 mg/l (0.52-2.52) vs. 0.87 mg/l (0.37-1.84), median (interquartile range), P = 0.01. At 2 years, 117 subjects with IGT reverted to NGT, 84 remained in IGT, and 21 progressed to diabetes. Individuals who progressed to diabetes had the highest plasma CRP levels at baseline (P < 0.0001). Those with baseline CRP levels in the third and top quartile had a relative risk of remaining in IGT or progressing to diabetes of 2.87 (95% CI 1.06-7.82) and 2.76 (1.06-7.31), respectively, after adjusting for anthropometric measure and lifestyle factors. CONCLUSIONS: CRP independently predicts the risk of remaining in IGT or progressing to diabetes in Chinese subjects with IGT. CRP might provide an adjunctive measure for identifying subjects with the highest risk of progression to diabetes who would derive the greatest benefits from preventive interventions.

Adult↗
PubMed1999

[Analysis of olfactory disorders in aging].

AGING EFFECT: The effect of aging on the olfactory system is generally observed in subjects over the age of 65 and is the number one cause of olfactory disorders. Several studies taking into account the state of the naso-sinus system and possible early stage of developing dementia have examined the precise effects of aging on olfaction. AGE-RELATED CHANGES: Aging affects olfactory thresholds, estimation of the intensity of an olfactory stimulation, and identification and memorization of odors. The elderly subject identifies food and other odors less easily than the young subject although elderly subjects can learn to improve their performance. Changes in the nasal cavity, particularly an alteration of the processes involved in neuron distribution in the olfactory neuroepithelium, may be involved. IMPACT OF OLFACTORY DEFICIENCY: There is much morphological and experimental evidence showing the effect of aging on both peripheral and central olfactory pathways allowing a better understanding of the functional impact of the sensorial deficit. Olfactory deficiency can explain in part the eating problems encountered in elderly patients.

Aged↗
PubMed2002

[Chronic obstructive pulmonary disease in inhabitants of Zabrze].

In 2001 a modified MRC questionnaire and spirometry were performed in the inhabitants of Zabrze (Poland). Two hundred and thirty-nine men and 320 women aged 19-69 years were studied. Forty percent of men and 23% of women were smokers. In men but not in women a decline in smoking habit was observed as compared with previous studies in Zabrze carried out in the eighties. More men (32%) than women (19%) gave up smoking. The prevalence of chronic productive cough was closely related to smoking habit. Dyspnea and wheezing were also related to smoking but less strongly than productive cough. The prevalence of COPD (diagnosed according to GOLD criteria) was 10.2%. COPD was more common in smokers than in non-smokers, especially among men (19% and 2% respectively). Persistent productive cough, wheezing and advanced dyspnoea as well as intensive smoking (more than 40 pack years) were strongly connected with the prevalence of COPD. COPD was previously diagnosed in more than 50% of subjects identified as having COPD in this study. Almost 80% of subjects with COPD were not given any treatment in the past year.

Adult↗
PubMed1987

Radiologic appearance of gallstones and its relationship with biliary symptoms and awareness of having gallstones. Observations during epidemiological studies. Rome Group for the Epidemiology and Prevention of Cholelithiasis (GREPCO).

In the course of two cross-sectional epidemiological surveys carried out by the Rome Group for Epidemiology and Prevention of Cholelithiasis (GREPCO), cholecystography was performed in 82 of 126 subjects identified by means of ultrasonography as having gallstones. In four subjects gallstones were not detected by cholecystography. The x-ray characteristics of the gallbladder and gallstones of the remaining 78 subjects were related to age, sex, presence of biliary symptoms in the five years prior to the study, and awareness of having gallstones. Twenty-three of the 78 gallstone subjects (29.5%) showed a nonvisualized gallbladder. Among the 55 subjects with visualized gallbladder, 16 (29.1%) and 28 (50.9%) showed radiopaque and solitary stones, respectively. The mean diameter of the largest stone was 19.7 mm +/- 11.2 (SD). Age was related inversely to the number of stones. X-ray characteristics of gallstones did not differ between men and women. Presence of biliary symptoms in the five years prior to the study or awareness of having gallstones were not related to any radiologic feature, either in univariate or multivariate statistical analysis which included age, sex, weight, and height as possible confounding variables. Nineteen (24.3%) of the 78 subjects showed gallstones which would have been suitable for medical therapy with bile acids (ie, radiolucent, with a diameter of less than 20 mm, and in a visualized gallbladder).

Adult↗
PubMed1984

Medication problems among outpatients. A study with emphasis on the elderly.

When patients ascribe adverse symptoms to their medications, the medical care process can be affected. To investigate how often medical outpatients link various adverse symptoms with their medications and to learn what actions they take in response, 299 randomly selected medical outpatients were interviewed. Thirty percent of the subjects identified at least one medication as causing an undesirable symptom. Subjects 65 years or older attributed a lower mean number of adverse symptoms to their medications than did younger subjects. Subjects rarely reported modifying their medication regimens due to adverse symptoms, a finding supported by multiple regression analysis. Approximately one in four subjects did not discuss their symptoms with their providers. These results have important implications for medical care in general, and for the elderly in particular.

Aged↗
PubMed2004

Identifying congenital hearing impairment. Personal experience based on selective hearing screening.

If all degrees of permanent uni- or bilateral hypoacusis are taken into consideration, hearing impairment is the most common congenital disease. Early detection of permanent infantile hearing impairment has become extremely important in preventive medicine, since steps can be taken with hearing aids and rehabilitation to ensure better development of language and higher cognitive functions. Aim of this study is to provide a critical review of the time of diagnosis of hypoacusis at our audiology laboratory, where two methods were used to screen hearing of children with/without risk indicators. Results of approximately 10 years' work were re-examined during which time outpatient screening was conducted on children referred by colleagues in neonatology and paediatrics. All were carriers of congenital risk indicators associated with sensorineural and/or conductive hearing loss, based on the Joint Committee on Infant Hearing findings, or were suspected of being hypoacusic even if they had no known congenital risk factors. Hearing screening was conducted in hospital on newborns with no risk factors, within the first few days of birth. Results of the present study showed that when selective hearing screening was performed, the mean age of high-risk patients diagnosed with hypoacusis was slightly higher than that in international guidelines. Moreover, these patients represent approximately half the hypoacusic population identified in the study period. The other half of congenital hypoacusic subjects identified had no risk indicators and there was a significant delay in diagnosis due to later manifestation of symptoms indicating hypoacusis, and thus, in turn, delayed referral for hearing tests. In contrast, subjects without risk indicators who underwent in-hospital hearing screening and proved to be hypoacusic, were diagnosed early. In our experience, however, universal screening has considerable disadvantages, such as difficulty in covering the entire population, difficulty in follow-up after discharge from hospital, and last, but by no means least, significant organisational and professional commitments, making it impossible to perform in all hospitals. In order to ensure effective hearing screening for congenital hearing loss and, thus permit prompt identification of hypoacusic children, use of hearing aids and rehabilitation screening should incorporate two aspects. First, selection should be compulsory, thereby reducing waiting time between collecting case histories and performing outpatient tests; second, hospital screening of children without risk factors should be performed whenever possible. Integrating these two aspects would make it possible to approach the "utopia" of universal hearing screening.

Child, Preschool↗
PubMed1986

Apolipoprotein C-II deficiency syndrome. Clinical features, lipoprotein characterization, lipase activity, and correction of hypertriglyceridemia after apolipoprotein C-II administration in two affected patients.

Two patients (brother and sister, 41 and 39 yr of age, respectively) have been shown to have marked elevation of plasma triglycerides and chylomicrons, decreased low density lipoproteins (LDL) and high density lipoproteins (HDL), a type I lipoprotein phenotype, and a deficiency of plasma apolipoprotein C-II (apo C-II). The male patient had a history of recurrent bouts of abdominal pain often accompanied by eruptive xanthomas. The female subject, identified by family screening, was asymptomatic. Hepatosplenomegaly was present in both subjects. Analytical and zonal ultracentrifugation revealed a marked increase in triglyceride-rich lipoproteins including chylomicrons and very low density lipoproteins, a reduction in LDL, and the presence of virtually only the HDL3 subfraction. LDL were heterogeneous with the major subfraction of a higher hydrated density than that observed in plasma lipoproteins of normal subjects. Apo C-II levels, quantitated by radioimmunoassay, were 0.13 mg/dl and 0.12 mg/dl, in the male and female proband, respectively. A variant of apo C-II (apo C-IIPadova) with lower apparent molecular weight and more acidic isoelectric point was identified in both probands by two-dimensional gel electrophoresis. The marked hypertriglyceridemia and elevation of triglyceride-rich lipoproteins were corrected by the infusion of normal plasma or the injection of a biologically active synthesized 44-79 amino acid residue peptide fragment of apo C-II. The reduction in plasma triglycerides after the injection of the synthetic apo C-II peptide persisted for 13-20 d. These results definitively established that the dyslipoproteinemia in this syndrome is due to a deficiency of normal apo C-II. A possible therapeutic role for replacement therapy of apo C-II by synthetic or recombinant apo C-II in those patients with severe hypertriglyceridemia and recurrent pancreatitis may be possible in the future.

Adult↗
PubMed2000

Coupling of regional activations in a human brain during an object and face affect recognition task.

Magnetic field tomography (MFT) was used to extract estimates for distributed source activity from average and single trial MEG signals recorded while subjects identified objects (including faces) and facial expressions of emotion. Regions of interest (ROIs) were automatically identified from the MFT solutions of the average signal for each subject. For one subject the entire set of MFT estimates obtained from unaveraged data was also used to compute simultaneous time series for the single trial activity in different ROIs. Three pairs of homologous areas in each hemisphere were selected for further analysis: posterior calcarine sulcus (PCS), fusiform gyrus (FM), and the amygdaloid complex (AM). Mutual information (MI) between each pair of the areas was computed from all single trial time series and contrasted for different tasks (object or emotion recognition) and categories within each task. The MI analysis shows that through feed-forward and feedback linkages, the "computation" load associated with the task of identifying objects and emotions is spread across both space (different ROIs and hemispheres) and time (different latencies and delays in couplings between areas)-well within 200 ms, different objects separate first in the right hemisphere PCS and FG coupling while different emotions separate in the right hemisphere FG and AM coupling, particularly at latencies after 200 ms.

Brain↗
PubMed2004

Admission blood glucose level as risk indicator of death after myocardial infarction in patients with and without diabetes mellitus.

BACKGROUND: High admission blood glucose levels after acute myocardial infarction (AMI) are common and associated with an increased risk of death in subjects with and without known diabetes. Recent data indicate a high prevalence of abnormal glucose metabolism in patients with unknown diabetes at the time of AMI. We investigated the predictive value of admission blood glucose levels after AMI for long-term prognosis in patients with and without previously diagnosed diabetes mellitus, particularly in those with unknown diabetes but with blood glucose levels in the diabetic range. METHODS: In a retrospective study with prospective follow-up, 846 patients (737 without and 109 with known diabetes) were eligible for follow-up during a median of 50 months (range, 0-93 months). RESULTS: During follow-up, 208 nondiabetic patients (28.2%) and 47 diabetic patients (43.1%) died (P =.002). An increase of 18 mg/dL (1 mmol/L) in glucose level was associated with a 4% increase of mortality risk in nondiabetic patients and 5% in diabetic patients (both P<.05). Of the 737 previously nondiabetic subjects, 101 had admission blood glucose levels of 200 mg/dL (11.1 mmol/L) or more, and mortality in these patients was comparable to that in patients who had established diabetes (42.6% vs 43.1%). CONCLUSIONS: Admission blood glucose level after AMI is an independent predictor of long-term mortality in patients with and without known diabetes. Subjects with unknown diabetes and admission glucose levels of 200 mg/dL (11.1 mmol/L) or more after AMI have mortality rates comparable to those of subjects with established diabetes. Admission blood glucose level may serve to identify subjects at high long-term mortality risk, in particular among those with unknown diabetes.

Aged↗
PubMed1993

Does snoring intensity predict flow limitation or respiratory effort during sleep?

We tested whether snoring sound intensity could be an accurate predictor of the degree of respiratory effort or the decrease of inspiratory volume during partially obstructed breathing in sleep. Six snorers were investigated with nocturnal polygraphic monitoring including measurement of esophageal pressure (Pes), airflow (pneumotachometer and face mask, indicating tidal volume [VT]), and snoring sound intensity (SSI) measured in decibels. SSI was a poor predictor of flow limitation during snoring. Considerable between- and within-subject variance did not allow establishment of models for the interdependence between VT and SSI. The increase in peak-negative inspiratory efforts was better predicted by SSI. Individual multiple correlation analyses of Pes on SSI indicated a positive interdependence in all subjects. Calculation of ecological correlations with subject means of Pes and SSI was performed. SSI significantly predicted the level of peak-negative inspiratory effort during obstructed, noisy breathing for a given subject. Monitoring of snoring sound intensity may be a useful indicator identifying subjects performing high peak negative inspiratory efforts with obstructed, noisy breathing during sleep.

Analysis of Variance↗
PubMed1996

Deviant olfactory experiences as indicators of risk for psychosis.

Olfactory hallucinations, although relatively rare, are reportedly indicative of serious psychopathology and poor prognosis in psychotic patients. This article describes the development of a rating scale for assessing olfactory experiences of psychotic and psychoticlike deviancy. The scale is modeled after Chapman and Chapman's rating scales for other psychoticlike experiences, which have been found to predict psychosis and psychosis-proneness. In a longitudinal study, college students who reported deviant olfactory experiences at their initial assessment (n = 31) exceeded the remaining subjects (n = 477) on DSM-III-R psychosis and on measures of psychosis proneness at a 10-year followup. Furthermore, hypothetically psychosis-prone subjects identified by the Perceptual Aberration and Magical Ideation scales exceeded control subjects on ratings of olfactory experiences at both initial and followup assessments.

Analysis of Variance↗
PubMed2002

Tendon or joint disorders in children after treatment with fluoroquinolones or azithromycin.

BACKGROUND: Fluoroquinolones (FQs) have been infrequently used in children, largely because of concern that these agents can cause lesions of the cartilage in juvenile animals. However, the relevance of this laboratory observation to children treated with FQs is unknown. A retrospective, observational study was conducted to assess the incidence and relative risk of tendon or joint disorders (TJDs) that occur after use of selected FQs compared with azithromycin (AZ), a drug with no known effect on cartilage or tendons in humans or animals. METHODS: An automated database was searched to identify patients younger than 19 years who had been prescribed ofloxacin (OFX), levofloxacin, ciprofloxacin (CPX), or AZ. Potential cases of TJD occurring within 60 days of a prescription of one of the study drugs were identified based on assignment of a claims diagnosis consistent with a TJD within this period. Verified cases were identified by a blinded review of abstracts of medical records from subjects identified as potential cases. RESULTS: The incidence of verified TJD was 0.82% for OFX (13 of 1593) and CPX (37 of 4531) and was 0.78% for AZ (118 of 15,073). The relative risk of TJD for OFX and CPX compared with AZ was 1.04 (95% confidence interval, 0.55 to 1.84) and 1.04 (95% confidence interval, 0.72 to 1.51), respectively. The distributions of claims diagnoses and time to onset of TJD were comparable for all groups. The most frequently reported category of TJD involved the joint followed by tendon, cartilage and gait disorder. CONCLUSIONS: In this observational study involving more than 6000 FQ-treated children, the incidence of TJD associated with selected FQ use in children was <1% and was comparable with that of the reference group, children treated with AZ.

Adolescent↗
PubMed1998

Family history and age-related maculopathy: the Blue Mountains Eye Study.

PURPOSE: To assess the associations between stages of age-related maculopathy (ARM) and reported family history of this eye disease. METHODS: A cross-sectional study of 3654 subjects from a defined geographical area west of Sydney (NSW, Australia) identified subjects with late age-related macular degeneration (AMD) and early ARM from masked detailed grading of retinal photographs. Interviewer-administered questionnaires provided data on family history of ARM. Logistic regression was used to assess associations, adjusting for other known risk factors. RESULTS: A family history of ARM was significantly associated with both late AMD (odds ratio (OR) 3.92; 95% confidence interval (CI) 1.34-11.46) and early ARM (OR 2.17; 95% CI 1.04-4.55). The association was highest for neovascular AMD. CONCLUSIONS: These findings provide persuasive evidence that a stated family history of ARM is an important risk factor for ARM.

Aged↗
PubMed1996

Sleep-disordered breathing and systemic hypertension in the older male.

OBJECTIVE: To investigate the relationship between sleep-disordered breathing (SDB) and essential hypertension in a population of older male hypertensives. PATIENTS: One-hundred forty consecutive older hypertensive males. MEASUREMENTS: Monitoring of sleep-related breathing abnormality with a portable sleep apnea monitor (level III device). Assessment of complaints related to sleep quality using a validated questionnaire. Systemic arterial blood pressure according to WHO standards and biochemical analyses. SDB was defined as more than 10 abnormal respiratory events per hour of sleep. DESIGN: Prospective investigation on a retrospective cohort. SETTING: Veterans Administrations hypertension clinic. MAIN RESULTS: SDB was diagnosed in 80% of this older, hypertensive, male population. Thirty-four percent of all study subjects presented with severe SDB, with more than 30 abnormal respiratory events per hour of sleep. Subjects with SDB were significantly heavier (BMI = 30.0 +/- 5.2 kg/m2) than subjects without SDB (BMI = 26.8 +/- 5.1 kg/m2, P = .004). Furthermore, subjects with SDB slept significantly longer (by a mean of 46 minutes/night, P = .027) and complained significantly more often of daytime sleepiness than subjects without SDB (P = .018). Fifty percent of all 140 subjects snored more than 10% of the total sleep time, and 26% snored for more than one-third of the night. No significant differences in blood pressure values were observed in subjects with compared with subjects without sleep-disordered breathing. However, a considerable number of subjects presenting with hypertensive blood pressure values despite treatment could be identified. Subjects presenting with hypertensive blood pressure values had a significantly higher severity index of SDB than subjects with normotensive blood pressure values (P = .047). CONCLUSIONS: This investigation supports data showing that undiagnosed SDB is a common phenomenon in older male individuals, leading to impaired daytime functioning and impairment of overall quality of life. More importantly, our data suggests that untreated SDB may have an adverse effect on the efficacy of antihypertensive treatment in hypertensive individuals with sleep-disordered breathing.

Aged↗
PubMed2004

Anticoagulant use for atrial fibrillation in the elderly.

OBJECTIVES: To determine the influence of advanced age on anticoagulant use in subjects with atrial fibrillation and to explore the extent to which risk factors for stroke and contraindications to anticoagulant therapy predict subsequent use. DESIGN: Retrospective cohort study. SETTING: The Veterans Affairs Boston Healthcare System. PARTICIPANTS: A total of 2,217 subjects with nonvalvular atrial fibrillation. MEASUREMENTS: Administrative databases were use to identify subject's age, anticoagulant use, and the presence of a diagnosis of atrial fibrillation, cerebrovascular accident, hypertension, diabetes mellitus, congestive heart failure, or gastrointestinal or cerebral hemorrhage. RESULTS: Unadjusted analysis showed no difference in warfarin use between those aged 75 and older and younger subjects regardless of the presence (33.9% vs 35.7%, P=.37) or absence (33.4% vs 34.7%, P=.58) of contraindications to anticoagulant therapy. Multivariate modeling demonstrated a 14% reduction (95% confidence interval (CI)=4-22%) in anticoagulant use with each advancing decade of life. Intracranial hemorrhage was a significant deterrent (odds ratio (OR)=0.27 95% CI=0.06-0.85). History of hypertension (OR=2.90, 95% CI=2.15-3.89), congestive heart failure (OR=1.70, 95% CI=1.41-2.04), and cerebrovascular accident (OR=1.54, 95% CI=1.25-1.89) were significant independent predictors for anticoagulant use. CONCLUSION: Despite consensus guidelines to treat all atrial fibrillation patients aged 75 and older with anticoagulants, advancing age was found to be a deterrent to warfarin use. Better estimates of the risk:benefit ratio for oral anticoagulant therapy in older patients with atrial fibrillation are needed to optimize decision-making.

Aged↗
PubMed1999

Sulphur dioxide sensitivity and plasma antioxidants in adult subjects with asthma.

OBJECTIVES: To screen adult subjects with asthma for sensitivity to inhaled sulphur dioxide (SO2) and identify subject characteristics associated with that sensitivity. Medication use, symptoms, and plasma antioxidant nutrients between SO2 responders and non-responders were compared. METHODS: Adult subjects (ages 18-39 years) with asthma were exposed to 0.5 ppm SO2 for 10 minutes during moderate exercise. Pulmonary function tests and symptom ratings were assessed before and after exposure (n = 47). A subject was classified as sensitive to SO2 if forced expiratory volume in 1 second (FEV1) showed a drop > or = 8% over baseline. Blood samples were obtained from subjects (n = 38) before the SO2 challenge; plasma ascorbate, alpha-tocopherol, retinol, carotenoids, and lipids were measured. RESULTS: Of the 47 subjects screened, 53% had a drop in FEV1 > or = 8% (ranging from -8% to -44%). Among those 25 subjects, the mean drop in FEV1 was -17.2%. Baseline pulmonary function indices (FEV1% of predicted and FEV1/FVC% (forced vital capacity)) did not predict sensitivity to SO2. Although use of medication was inversely related to changes in pulmonary function after SO2 (p < 0.05), both SO2 responders and non-responders were represented in each medication category. Total symptom scores after exposure were significantly correlated with changes in FEV1 (p < 0.05), FVC (p < 0.05), and peak expiratory flow (PEF) (p < 0.01) but not forced expiratory flow between 25% and 75% vital capacity (FEF25-75). Plasma beta-carotene concentrations were inversely associated with PEF values and ascorbate concentrations were inversely associated with FEV1 and FEV1/FVC (p = 0.05 in all cases). High density lipoprotein concentrations were positively correlated with FEV1% of predicted (p < 0.05) and inversely correlated with change in FEF25-75 (p < 0.05) after SO2. CONCLUSION: These results show that the response to SO2 among adults with mild to moderate asthma is very diverse. Severity of asthma defined by medication category was not a predictor of sensitivity to SO2. Lung function values were associated with beta-carotene and ascorbate concentrations in plasma; however, plasma antioxidant nutrient concentrations were not associated with sensitivity to inhaled SO2.

Adolescent↗
PubMed2006

Utilization of diabetes medication and cost of testing supplies in Saskatchewan, 2001.

The purpose of this study was to describe the patterns of antidiabetic medication use and the cost of testing supplies in Canada using information collected by Saskatchewan's Drug Plan (DP) in 2001. The diabetes cohort (n = 41,630) included individuals who met the National Diabetes Surveillance System (NDSS) case definition. An algorithm was then used to identify subjects as having type 1 or type 2 diabetes. Among those identified as having type 2 diabetes (n = 37,625), 38% did not have records for antidiabetic medication in 2001. One-third of patients with type 2 diabetes received monotherapy. Metformin, alone or in combination with other medications, was the most commonly prescribed antidiabetic medication. Just over one-half of the all patients with diabetes had a DP records for diabetes testing supplies. For individuals (n = 4,005) with type 1 diabetes, 79% had a DP record for supplies, with an average annual cost of 472 +/- 560 dollars. For type 2 diabetes, 50% had records for testing supplies, with an average annual cost of 122 +/- 233 dollars. Those individuals with type 2 diabetes who used insulin had higher testing supply costs than those on oral antidiabetic medication alone (359 vs 131 dollars; p < 0.001).

Adult↗