Diabetes Management in End of Life: A Preliminary Report Stemming From Clinical Experience.
The increasing coexistence of cancer and diabetes within the elderly population requires specific palliative care skills on diabetes treatment. We report our experience of diabetes management in a palliative care setting. In our retrospective 3-year activity sample (n = 563), 27.2% of patients have a diagnosis of diabetes mellitus: 80% have cancer whereas 20% have a main diagnosis of other severe chronic diseases. As to the presence/absence of diabetes, no differences emerge in the examined clinical indicators and global survival, with the exception of body mass index and days of hospitalization. At lifetime analysis, Barthel index and palliative prognostic index are the only parameters significantly related to death. Even if diabetes seems not to modify the prognosis, it significantly influences the health care burden and the team engagement.
Palliative Care Unit, San Martino Hospital Mede-Salvatore Maugeri Foundation IRCCS Montescano (PV), Italy.
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Dionisio
Palliative Care Unit, San Martino Hospital Mede-Salvatore Maugeri Foundation IRCCS Montescano (PV), Italy Psychology Unit, Salvatore Maugeri Foundation IRCCS, Scientific Institute of Montescano (PV), Italy.
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Giardini
Unit of Internal Medicine and Endocrinology-Salvatore Maugeri Foundation IRCCS, Pavia, Italy.
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De Cata
Unit of Internal Medicine and Endocrinology-Salvatore Maugeri Foundation IRCCS, Pavia, Italy.
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Pirali
Palliative Care Unit, San Martino Hospital Mede-Salvatore Maugeri Foundation IRCCS Montescano (PV), Italy.
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Rossi
Palliative Care Unit, San Martino Hospital Mede-Salvatore Maugeri Foundation IRCCS Montescano (PV), Italy.
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Negri
Palliative Care Unit, San Martino Hospital Mede-Salvatore Maugeri Foundation IRCCS Montescano (PV), Italy pietro_ferrari@ospedali.pavia.it.
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Ferrari
Palliative Care Unit, San Martino Hospital Mede-Salvatore Maugeri Foundation IRCCS Montescano (PV), Italy.
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Preti
D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000628:therapy*; D012189:Retrospective Studies; D013727:Terminal Care / Q000379:methods*
cancer; diabetes management; end of life; palliative care; personalized antidiabetic therapy