Diabetes Mellitus in Individuals With Spinal Cord Injury or Disorder

Abstract Background/Objective: To examine diabetes prevalence, care, complications, and characteristics of veterans with a spinal cord injury or disorder (SCI/D). Methods: A national survey of veterans with an SCI/D was conducted using Behavioral Risk Factor Surveillance System (BRFSS) survey questions. Data were compared with national Centers for Disease Control and Prevention BRFSS data for veteran and nonveteran general populations. Results: Overall prevalence of diabetes in individuals with an SCI/D was 20% (3 times higher than in the general population). Veterans with an SCI/D and veterans, in general, had a higher prevalence of diabetes across all age groups; however, those with an SCI/D who were 45 to 59 years of age had a higher prevalence than other veterans. One fourth of the persons with an SCI/D and diabetes reported that diabetes affected their eyes or that they had retinopathy (25%), and 41 % had foot sores that took more than 4 weeks to heal. More veterans, both with (63%) and without an SCI/D (60%), took a class on how to manage their diabetes than the general population (50%). Veterans with an SCI/D and diabetes were more likely to report other chronic conditions and poorer quality of life than those without diabetes. Conclusions: Diabetes prevalence is greater among veterans with an SCI/D compared with the civilian population, but is similar to that of other veterans, although it may occur at a younger age in those with an SCI/D. Veterans with an SCI/D and diabetes reported more comorbidities, more slow-healing foot sores, and poorer quality of life than those without diabetes. Efforts to prevent diabetes and to provide early intervention in persons with SCI/D are needed.

[1]  Enrique Luis Graue Wiechers,et al.  Facts and Figures at a Glance , 2007 .

[2]  F. Weaver,et al.  Prevalence of Obesity and High Blood Pressure in Veterans with Spinal Cord Injuries and Disorders: A Retrospective Review , 2007, American journal of physical medicine & rehabilitation.

[3]  A. Morris,et al.  The annual incidence of diabetic complications in a population of patients with Type 1 and Type 2 diabetes , 2005, Diabetic medicine : a journal of the British Diabetic Association.

[4]  Abla M Albsoul,et al.  Diabetic heel ulcers: a major risk factor for lower extremity amputation. , 2004, Ostomy/wound management.

[5]  Donald R. Miller,et al.  Who has diabetes? Best estimates of diabetes prevalence in the Department of Veterans Affairs based on computerized patient data. , 2004, Diabetes care.

[6]  T. Koepsell,et al.  Diabetes in nonveterans, veterans, and veterans receiving Department of Veterans Affairs health care. , 2004, Diabetes care.

[7]  J. Sowers,et al.  Epidemiology of Diabetes , 2004, Journal of clinical pharmacology.

[8]  W. Duckworth,et al.  Factors affecting diabetes knowledge in Type 2 diabetic veterans , 2003, Diabetologia.

[9]  Mary Ann McColl,et al.  Lifestyle risks for three disease outcomes in spinal cord injury , 2002, Clinical rehabilitation.

[10]  A. Spungen,et al.  Invited Review Carbohydrate And Lipid Metabolism In Chronic Spinal Cord Injury , 2001 .

[11]  A. Spungen,et al.  The effect of residual neurological deficit on oral glucose tolerance in persons with chronic spinal cord injury , 1999, Spinal Cord.

[12]  D Smith,et al.  Is immobilization associated with an abnormal lipoprotein profile? Observations from a diverse cohort , 1999, Spinal Cord.

[13]  C. Cherpitel,et al.  Drinking patterns and problems, drug use and health services utilization: a comparison of two regions in the US general population. , 1999, Drug and alcohol dependence.

[14]  E. Powell-Griner,et al.  State-and sex-specific prevalence of selected characteristics--behavioral risk factor surveillance system, 1994 and 1995. , 1997, MMWR. CDC surveillance summaries : Morbidity and mortality weekly report. CDC surveillance summaries.

[15]  P. Campbell Population projections: states, 1995 - 2025. , 1997, Current population reports. Series P-25, Population estimates and projections.

[16]  A. Everett,et al.  Alcohol and drug abuse in patients with physical disabilities. , 1996, The American journal of drug and alcohol abuse.

[17]  P. Cavanagh,et al.  Assessment and management of foot disease in patients with diabetes. , 1994, The New England journal of medicine.

[18]  A. Spungen,et al.  Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: a model of premature aging. , 1994, Metabolism: clinical and experimental.

[19]  D. Tate ALCOHOL USE AMONG SPINAL CORD-INJURED PATIENTS , 1993, American journal of physical medicine & rehabilitation.

[20]  R. Glasgow,et al.  Evaluating Diabetes Education: Are we measuring the most important outcomes? , 1992, Diabetes Care.

[21]  F. Strack,et al.  The impact of administration mode on response effects in survey measurement , 1991 .

[22]  W. Duckworth,et al.  Glucose Intolerance Due to Insulin Resistance in Patients with Spinal Cord Injuries , 1980, Diabetes.

[23]  A. Stein,et al.  Aging with spinal cord injury. , 2005, Physical medicine and rehabilitation clinics of North America.

[24]  Trauma: crosscutting breakout session. Physical Disabilities through the Lifespan Conference. , 2005, Neurorehabilitation and Neural Repair.

[25]  Michael M. Priebe,et al.  The Medical Management of Pressure Ulcers , 2003 .

[26]  Arshag D Mooradian,et al.  Evidence-based nutrition principles and recommendations for the treatment and prevention of diabetes and related complications. , 2002, Diabetes care.

[27]  W. Bauman,et al.  Carbohydrate and lipid metabolism in chronic spinal cord injury. , 2001, The journal of spinal cord medicine.

[28]  Andrzej Bartke,et al.  The Endocrine System , 1998, Alcohol health and research world.

[29]  S. Levitus,et al.  US Government Printing Office , 1998 .

[30]  S. Wilking,et al.  Pressure ulcers. , 1998, Journal of the American Academy of Dermatology.