Does diabetes influence a person’s functional independence whilst in hospital?

Ms Jacqueline Kay1, Doctor Catherine Granger1,2, Ms Samantha Plumb3

1Melbourne Health Physiotherapy Department, Parkville, Australia, 2University of Melbourne, Parkville, Australia, 3Melbourne Health, Parkville, Australia

Aim: Type 2 Diabetes Mellitus (T2DM) is an increasing global endemic, with growing evidence that these patients are at risk of functional decline whilst in hospital. This has been demonstrated for only the rehabilitation inpatient setting. The aim is to determine if patients with T2DM have different physical functioning in an acute hospital setting.

Method: 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 that day, 76% (n=329) were available to be included. A rate of 25% (n=81) had a T2DM diagnosis, which was found to be lower than estimated Australian rates. 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).

Significance of the findings to allied health: Acute hospital inpatients’ with T2DM have poorer physical function than the general inpatient population. This patient group may be important to target with Allied Health. Further research is required to determine the impact of Allied Health services for inpatients with T2DM.