One-minute mental status examination for category fluency is more useful than mini-mental state examination to evaluate the reliability of insulin self-injection in elderly diabetic patients.
OBJECTIVE
We investigated the factors associated with the reliability of insulin self-injection in elderly diabetic patients receiving insulin therapy.


METHODS
We enrolled diabetic patients aged ≥65 years and receiving insulin therapy, and assessed their cognitive function by the mini-mental state examination and 1-min mental status examination for category fluency. We also observed their technique of insulin self-injection, and evaluated whether or not patients were able to inject insulin by themselves according to nine defined details in terms of insulin self-injection. The predictive factors for the reliability of insulin self-injection were determined by univariate and multivariate logistic regression analysis. There were 278 participants (135 males, 143 females) enrolled in the present study.


RESULTS
According to multivariate logistic regression analysis, only the 1-min mental status examination score was found to be a significant independent predictor of the reliability of insulin self-injection (odds ratio 0.75; 95% confidence interval 0.62-0.90; P = 0.002).


CONCLUSIONS
The 1-min mental status examination for category fluency can be considered more useful than mini-mental state examination to evaluate the reliability of insulin self-injection in elderly diabetic patients receiving insulin therapy.
Department of Internal Medicine Federation of National Public Service Personnel Mutual Aid Associations Tachikawa Hospital Kanagawa Japan.
Ken
K
Yajima
Department of Diabetology, Endocrinology and Metabolism Tokyo Medical University Hachioji Medical Center Kanagawa Japan.
Takaya
T
Matsushita
Division of Endocrinology and Metabolism Tachikawa Sogo Hospital Kanagawa Japan.
Hidetaka
H
Sumitomo
Department of Geriatric Medicine Tokyo Medical University Hospital Kanagawa Japan.
Hirofumi
H
Sakurai
Katayama Naika Clinic Kanagawa Japan.
Takashi
T
Katayama
Kanno Clinic Kanagawa Japan.
Kazuo
K
Kanno
Department of Medicine Ryokufuso Hospital Kanagawa Japan.
Masashi
M
Sakai
Division of Endocrinology and Metabolism Showa General Hospital Kanagawa Japan.
Masayuki
M
Shigeta
H. E. C. Science Clinic Kanagawa Japan.
Shinichiro
S
Shirabe
Department of Diabetology Mitsubishi Kyoto Hospital Kyoto Japan.
Tadasumi
T
Nakano
Department of Clinical Nutrition Ryokufuso Hospital Tokyo Japan.
Kazuhiro
K
Nishimura
Department of Diabetology, Endocrinology and Metabolism Tokyo Medical University Hachioji Medical Center Kanagawa Japan.
Akio
A
Ueki
Division of Endocrinology and Metabolism Showa General Hospital Kanagawa Japan ; Nonprofit Organization West Tokyo Diabetic Association Tokyo Japan.
Masafumi
M
Kitaoka
Elderly; Insulin; Self medication