Demographics, diabetes type, and degree of rehabilitation in diabetic patients on maintenance hemodialysis in Brooklyn.
A point prevalence study of 232 uremic diabetics undergoing maintenance hemodialysis was conducted at fourteen facilities in Brooklyn, NY, to ascertain extent of rehabilitation, diabetes type, and immediate family history of diabetes according to the diabetes type in the proband. The majority of patients were black (138, 59%) and female (131, 56%). When grouped by diabetes type, insulin-dependent (Type I) diabetics were a small minority (31, 13.4%) of the total study population. With the exception of those with onset of diabetes in childhood, there was no difference between the interval between diagnosis of diabetes and development of renal failure in Type I (15.3 +/- 8.6 years) and the overall group of diabetics (14.9 +/- 9.3 years). A history of diabetes in an immediate family member was found in 114 (49.1%) of the entire group and was approximately the same in Type I (41.9%) and Type II (52.5%) diabetics. Rehabilitation was poor for the group as a whole, with a mean Karnofsky score of 64.9 +/- 14.3, which is a level indicative of the need for assistance in everyday living, and there was an inverse correlation between increasing age and declining Karnofsky score. Factors inhibiting rehabilitation included serious vision loss in 137 (59.1%) subjects, limb amputation, and prior myocardial infarction and stroke. Only 7 of the 153 patients (4.8%) of those younger than age 65 were gainfully employed outside of the home, and only 27% of surveyed patients were able to attend to activities beyond self care. Maintenance hemodialysis, although life extending, does not induce substantive rehabilitation for the uremic diabetic.
Lowder
G M
GM
Department of Medicine, State University of New York, Brooklyn 11203.
Perri
N A
NA
Friedman
E A
EA
D000203:Activities of Daily Living; D000328:Adult; D001766:Blindness; D003710:Demography; D003922:Diabetes Mellitus, Type 1 / Q000534:rehabilitation / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000534:rehabilitation / Q000628:therapy; D003928:Diabetic Nephropathies / Q000534:rehabilitation* / Q000628:therapy; D003930:Diabetic Retinopathy / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009519:New York City; D006435:Renal Dialysis / Q000534:rehabilitation*; D014511:Uremia / Q000534:rehabilitation* / Q000628:therapy; D014785:Vision, Ocular