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- Malmberg, K, et al.
(författare)
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Randomised trial of insuline-glucose infusion followed by subcutaneous insulin treatment in diabetic patients with acute myocardial infarction (DIGAMI-Study) Effects on mortality at 1 year
- 1995
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Ingår i: Journal of the American College of Cardiology. - : Elsevier Inc.. - 0735-1097 .- 1558-3597. ; 26:1, s. 57-65
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. We tested how insulin-glucose infusion followed by multidose insulin treatment in diabetic patients with acute myocardial infarction affected mortality during the subsequent 12 months of follow-up. Background. Despite significant improvements in acute coronary care, diabetic patients with acute myocardial infarction still have a high mortality rate. Methods. A total of 620 patients were studied : 306 randomized to treatment with insulin-glucose infusion followed by multidose subcutaneous insulin for ≥3 months and 314 to conventional therapy. Results. The two groups were well matched for baseline characteristics. Blood glucose decreased from 15.4 ± 4.1 to 9.6 ± 3.3 mmol/liter (mean ± SD) in the infusion group during the 1st 24 h, and from 15.7 ± 4.2 to 11.7 ± 4.1 among control patients (p < 0.0001). After 1 year 57 subjects (18.6%) in the infusion group and 82 (26.1%) in the control group had died (relative mortality reduction 29%, p = 0.027). The mortality reduction was particularly evident in patients who had a low cardiovascular risk profile and no previous insulin treatment (3-month mortality rate 6.5% in the infusion group vs. 13.5% in the control group [relative reduction 52%, p = 0.046] ; 1-year mortality rate 8.6% in the infusion group vs. 18.0% in the control group [relative reduction 52%, p = 0.020]). Conclusions. Insulin-glucose infusion followed by a multidose insulin regimen improved long-term prognosis in diabetic patients with acute myocardial infarction.
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- Ronnberg, L, et al.
(författare)
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Mental impairment and utilization of community services: a study of the elderly in a parish of Stockholm
- 1996
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Ingår i: Scandinavian journal of social medicine. - : SAGE Publications. - 0300-8037. ; 24:3, s. 185-192
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Tidskriftsartikel (refereegranskat)abstract
- Before the implementation of the health care reform of 1992 (The Ädel Reform), a study of the frequency of mental impairment of people in different residential and care services was conducted in a parish of Stockholm. All residents, 65 years or older, registered with Primary Care Centres, Geriatric Hospitals and other institutions were assessed with respect to cognitive function according to the seven stage “Global Deterioration Scale” (GDS). The age-specific frequencies of mental impairment were similar to prevalences reported in earlier studies. The frequency of cognitive dysfunction of non-institutionalized and institutionalized elderly was 42% and 52%, respectively, and higher for women than for men. There was considerable variation in the prevalence of cognitive dysfunction among subjects in different types of accommodation. For the different stages of mental impairment the average age was about the same. With increasing need and demand for services, and limited resources, these variations in cognitive dysfunction have important implications for structuring appropriate support systems in a population with a rapidly rising proportion of elderly people.
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