Does diabetes influence a person’s functional independence whilst in hospital? (#291)
Background
Diabetes, particularly Type 2 Diabetes Mellitus (T2DM) is a growing global endemic, with an estimated 5% of Australians known to have T2DM. However, this is believed to be under-reported, as a high number of the population are currently not diagnosed. Growing evidence suggests that patients with T2DM are at risk of functional decline whilst in hospital. This has been demonstrated specifically in patients in the rehabilitation inpatient setting, however it is unknown if this is accurate for an acute hospital admission.
Aim
To determine if patients with T2DM have a different physical function in an acute hospital setting.
Methods
A point-prevalence study was conducted on one day in September 2015. Data was collected for all available inpatients at Royal Melbourne Hospital (RMH) including, diabetes diagnosis, weights, heights, and functional status (obtained from the medical record or patient assessment). The Functional Independence Measure (FIM) was completed by the Physiotherapist who was FIM trained.
Results
Of the patients admitted to RMH on that day, 76% (n=329) were available to be included. A rate of 25% (n=81) had a diagnosis of T2DM, which was found to be lower than the estimated Australian rate. Patients with T2DM had lower FIM 2 scores (mean difference 0.82, 95% CI 0.17-1.48, p=0.014), higher BMI (mean difference 2.72, 95%CI 0.73-4.70, p<0.005) and were younger (mean difference 11.1 years, 95%CI 6.6-15.6, p=0.007) than patients without T2DM. In the whole cohort (n=329), patients with higher FIM scores were more likely to be younger (r = 0.20, p<0.005), and have a shorter hospital length of stay (r = 0.20, p<0.005).
Conclusions
Acute hospital inpatients’ with T2DM have poorer physical function than the general inpatient population. This patient group may be important to target with Physiotherapy. Further research is required to determine the impact of Physiotherapy services for inpatients with T2DM.