Jessica Harding - Academia.edu (original) (raw)

Papers by Jessica Harding

Diabetes, 2020

Diabetes is the leading cause of non-traumatic lower extremity amputation (NLEA) in the United St... more Diabetes is the leading cause of non-traumatic lower extremity amputation (NLEA) in the United States. After a period of decline, some U.S. data show that diabetes-related NLEA has recently increased, particularly among young and middle-aged adults. However, the trend for older adults is less clear. To examine NLEA trends among older adults with diabetes (≥67 years), we used 100% Medicare claims for beneficiaries enrolled in Parts A and B during 2000-2017. NLEA was defined as the highest-level amputation per patient per calendar year. NLEA rates were stratified by sex, race and ethnicity, and NLEA level. All rates were age-sex standardized to the 2000 Medicare population. Trends over time were assessed using Joinpoint regression and annual percent change (APC) reported. NLEA rates (per 1,000 persons) halved from 8.5 in 2000 to 4.4 in 2009 (APC -7.9, p value<0.001). However, from 2009 to 2017 NLEA rates increased slightly to 4.8 (APC 1.2, p-value<0.001). Trends were similar acr...

Diabetes, 2020

Non-traumatic lower extremity amputations (NLEA) are an important complication of diabetes. After... more Non-traumatic lower extremity amputations (NLEA) are an important complication of diabetes. After a period of decline, some national U.S. data show that rates of diabetes-related NLEA have recently increased. Whether this varies by state is unknown. We used 100% Medicare claims for beneficiaries enrolled in Parts A and B during 2000-2017 to examine state-specific NLEA trends among adults ≥67 years with diabetes. NLEA was defined as the highest-level amputation per patient per calendar year. All rates were age-sex standardized to the 2000 study population. Trends were assessed using Joinpoint regression. National diabetes-related NLEA rates (per 1,000 persons) decreased from 8.5 in 2000 to 4.4 in 2009 (APC - 7.9, p<0.001), and then increased to 4.8 in 2017 (APC 1.2, p<0.001). However, standardized state-specific rates varied considerably over the entire time period from a maximum of 12.5 in Louisiana to a minimum of 2.6 in Hawaii. Many states showed an initial decline followed ...

Systematic Reviews, 2012

Background: Diabetes and increased age are known risk factors for physical disability. With the i... more Background: Diabetes and increased age are known risk factors for physical disability. With the increasing prevalence of diabetes within our aging population, the future burden of disability is expected to increase. To date, there has not been a pooled estimate of the risk for disability associated with diabetes or its precursor states, impaired glucose tolerance and impaired fasting glucose. We aim to conduct a systematic review and meta-analysis of the association between prediabetes and diabetes with disability, and quantify the risk of association. Methods/design: We will search for relevant studies in Medline via Pubmed, Embase, Cochrane library and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as scan reference lists from relevant reviews and publications included in our review. We will review all publications that include studies on human adults (18 years and older) where information is included on diabetes status and at least one measure of disability (Activities of Daily Living (ADL), Instrumental ADL (IADL) or functional/mobility limitation), and where a risk association is available for the relationship between diabetes and/or prediabetes with disability, with reference to those without diabetes. We will further conduct a meta-analysis to pool estimates of the risk of disability associated with prediabetes and diabetes. Sensitivity analysis will be conducted to assess for publication bias and study quality.Findings from this systematic review and meta-analysis will be widely disseminated through discussions with stake-holders, publication in a peer-reviewed journal and conference presentation.

Diabetes, 2020

Diabetes is the leading cause of non-traumatic lower extremity amputation (NLEA) in the United St... more Diabetes is the leading cause of non-traumatic lower extremity amputation (NLEA) in the United States. After a period of decline, some U.S. data show that diabetes-related NLEA has recently increased, particularly among young and middle-aged adults. However, the trend for older adults is less clear. To examine NLEA trends among older adults with diabetes (≥67 years), we used 100% Medicare claims for beneficiaries enrolled in Parts A and B during 2000-2017. NLEA was defined as the highest-level amputation per patient per calendar year. NLEA rates were stratified by sex, race and ethnicity, and NLEA level. All rates were age-sex standardized to the 2000 Medicare population. Trends over time were assessed using Joinpoint regression and annual percent change (APC) reported. NLEA rates (per 1,000 persons) halved from 8.5 in 2000 to 4.4 in 2009 (APC -7.9, p value<0.001). However, from 2009 to 2017 NLEA rates increased slightly to 4.8 (APC 1.2, p-value<0.001). Trends were similar acr...

Diabetes, 2020

Non-traumatic lower extremity amputations (NLEA) are an important complication of diabetes. After... more Non-traumatic lower extremity amputations (NLEA) are an important complication of diabetes. After a period of decline, some national U.S. data show that rates of diabetes-related NLEA have recently increased. Whether this varies by state is unknown. We used 100% Medicare claims for beneficiaries enrolled in Parts A and B during 2000-2017 to examine state-specific NLEA trends among adults ≥67 years with diabetes. NLEA was defined as the highest-level amputation per patient per calendar year. All rates were age-sex standardized to the 2000 study population. Trends were assessed using Joinpoint regression. National diabetes-related NLEA rates (per 1,000 persons) decreased from 8.5 in 2000 to 4.4 in 2009 (APC - 7.9, p<0.001), and then increased to 4.8 in 2017 (APC 1.2, p<0.001). However, standardized state-specific rates varied considerably over the entire time period from a maximum of 12.5 in Louisiana to a minimum of 2.6 in Hawaii. Many states showed an initial decline followed ...

Systematic Reviews, 2012

Background: Diabetes and increased age are known risk factors for physical disability. With the i... more Background: Diabetes and increased age are known risk factors for physical disability. With the increasing prevalence of diabetes within our aging population, the future burden of disability is expected to increase. To date, there has not been a pooled estimate of the risk for disability associated with diabetes or its precursor states, impaired glucose tolerance and impaired fasting glucose. We aim to conduct a systematic review and meta-analysis of the association between prediabetes and diabetes with disability, and quantify the risk of association. Methods/design: We will search for relevant studies in Medline via Pubmed, Embase, Cochrane library and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as scan reference lists from relevant reviews and publications included in our review. We will review all publications that include studies on human adults (18 years and older) where information is included on diabetes status and at least one measure of disability (Activities of Daily Living (ADL), Instrumental ADL (IADL) or functional/mobility limitation), and where a risk association is available for the relationship between diabetes and/or prediabetes with disability, with reference to those without diabetes. We will further conduct a meta-analysis to pool estimates of the risk of disability associated with prediabetes and diabetes. Sensitivity analysis will be conducted to assess for publication bias and study quality.Findings from this systematic review and meta-analysis will be widely disseminated through discussions with stake-holders, publication in a peer-reviewed journal and conference presentation.