1
|
Widayanti AW, Sigalingging KK, Dewi FP, Widyakusuma NN. Issues Affecting Medication-Taking Behavior of People with Type 2 Diabetes in Indonesia: A Qualitative Study. Patient Prefer Adherence 2021; 15:989-998. [PMID: 34040353 PMCID: PMC8139640 DOI: 10.2147/ppa.s301501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 04/21/2021] [Indexed: 11/23/2022] Open
Abstract
PURPOSE It has been widely acknowledged that non-adherence to medication among people with type 2 diabetes is a significant problem worldwide. Studies have suggested that non-adherence to medication may be caused by the complexity of issues surrounding medication use which further created burdens related to medication. However, studies on this topic in the Indonesian context were still limited. This study aimed to understand the experiences of people with type 2 diabetes in medication-taking and explore any practical issues that potentially affect their behavior when taking medication. METHODS Qualitative phenomenological study with semi-structured interviews was applied. The participants were purposefully recruited and selected from some primary healthcare facilities in Yogyakarta Province. The eligibility criteria included: diagnosed with type 2 diabetes by healthcare professionals for at least six months and were able to comprehend information. Information about the study was explained, and written informed consent was collected. The interviews were recorded, transcribed verbatim, and analyzed with a deductive qualitative content analysis method. RESULTS Fifty-one people with type 2 diabetes were involved in this study. Most of the participants were between 40 and 59 years old, and many of them were female and housewives. The thematic analysis found some practical issues that affected people's behavior in taking type 2 diabetes medication. These included individual's mealtime, characteristics of the medications, accessibility of healthcare services, experiences of side effects and social activities. CONCLUSION The practical issues identified in this study can be resolved by improving the role of healthcare providers in managing people with diabetes. Future research needs to be conducted to evaluate the effectiveness of interventions developed based on understanding of the practical factors identified.
Collapse
Affiliation(s)
- Anna Wahyuni Widayanti
- Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | | | - Furi Patriana Dewi
- Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Niken Nur Widyakusuma
- Department of Pharmaceutics, Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia
| |
Collapse
|
2
|
Enang O, Omoronyia O, Asibong U, Ayuk A, Nwafor K, Legogie A. A case-control study of pattern and determinants of quality of life of patients with diabetes in a developing country. J Egypt Public Health Assoc 2021; 96:2. [PMID: 33507391 PMCID: PMC7843869 DOI: 10.1186/s42506-020-00061-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 11/04/2020] [Indexed: 01/15/2023]
Abstract
Background Globally, diabetes is a leading cause of impairment of quality of life. In the sub-Saharan African region, there is a need for studies that provide more valid assessment of effect of diabetes on quality of life (QoL). This study aimed at assessing quality of life among patients with diabetes attending a tertiary health service in Nigeria. Methods The study design was a case-control. Diabetic cases were randomly recruited from the University of Calabar Teaching Hospital, while non-diabetic controls were civil servants and retirees. The validated and pretested WHOQoL-BREF instrument was used to assess quality of life, with higher scores indicating higher quality of life. Results Three hundred and thirty subjects were studied, with mean ages of males and females of 55.2 ± 4.8 and 51.8 ± 6.3 years, respectively. The mean total QoL score was 75.77 ± 11.2, with no significant difference between males and females. Among male and female cases, the mean score of the physical health domain was significantly lower for cases compared with controls (p = 0.05). Male cases compared with controls had higher scores for the environment domain (p < 0.05). Older age and higher systemic blood pressure were associated with lower QoL scores for both sexes (p < 0.05). Unmarried status, obesity, and poor glycemic control (HbA1c > 7%) were associated with lower QoL scores (p < 0.05). Fasting blood sugar (FBS) level and lipid profile were not significantly correlated with QoL score in both sexes (p > 0.05). Conclusion Diabetes contributes to low quality of life among males and females, with significant differences in the affected domains. Diabetes care providers should identify affected domains during clinic consultation, in order to improve provision of more effective care.
Collapse
Affiliation(s)
- Ofem Enang
- Department of Internal Medicine, University of Calabar, Calabar, Nigeria
| | - Ogban Omoronyia
- Department of Community Medicine, University of Calabar, Calabar, Nigeria.
| | - Udeme Asibong
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
| | - Agam Ayuk
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
| | - Kenneth Nwafor
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
| | - Annette Legogie
- Department of Family Medicine, University of Calabar, Calabar, Nigeria
| |
Collapse
|
3
|
Muchiri JW, Gericke GJ, Rheeder P. Stakeholders’ perceptions of dietary and related self-management challenges and education programme preferences for type 2 diabetes adults. JOURNAL OF ENDOCRINOLOGY METABOLISM AND DIABETES OF SOUTH AFRICA 2018. [DOI: 10.1080/16089677.2018.1541211] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- JW Muchiri
- Department of Human Nutrition, University of Pretoria, Pretoria, South Africa
| | - GJ Gericke
- Department of Human Nutrition, University of Pretoria, Pretoria, South Africa
| | - P Rheeder
- Department of Internal Medicine, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
4
|
Biernatzki L, Kuske S, Genz J, Ritschel M, Stephan A, Bächle C, Droste S, Grobosch S, Ernstmann N, Chernyak N, Icks A. Information needs in people with diabetes mellitus: a systematic review. Syst Rev 2018; 7:27. [PMID: 29444711 PMCID: PMC5813383 DOI: 10.1186/s13643-018-0690-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/17/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The purpose of this study was to identify and analyse currently available knowledge on information needs of people with diabetes mellitus, also considering possible differences between subgroups and associated factors. METHODS Twelve databases including MEDLINE, EMBASE and the Cochrane Library were searched up until June 2015. Publications that addressed self-reported information needs of people with diabetes mellitus were included. Each study was assessed by using critical appraisal tools, e.g. from the UK National Institute for Health and Care Excellence. Extraction and content analysis were performed systematically. RESULTS In total, 1993 publications were identified and 26 were finally included. Nine main categories of information needs were identified, including 'treatment-process', 'course of disease', 'abnormalities of glucose metabolism' and 'diabetes through the life cycle'. Differences between patient subgroups, such as type of diabetes or age, were sparsely analysed. Some studies analysed associations between information needs and factors such as participation preferences or information seeking. They found, for example, that information needs on social support or life tasks were associated with information seeking in Internet forums. CONCLUSION Information needs in people with diabetes mellitus, appear to be high, yet poorly investigated. Research is needed regarding differences between diverse diabetes populations, including gender aspects or changes in information needs during the disease course. SYSTEMATIC REVIEW REGISTRATION The review protocol has been registered at Prospero ( CRD42015029610 ).
Collapse
Affiliation(s)
- Lisa Biernatzki
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Silke Kuske
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Jutta Genz
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Michaela Ritschel
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Astrid Stephan
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Christina Bächle
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Sigrid Droste
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
| | - Sandra Grobosch
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Nicole Ernstmann
- Center for Health Communication and Health Services Research (CHSR), Department for Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, Sigmund-Freud-Str. 25, 53127 Bonn, Germany
| | - Nadja Chernyak
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
| | - Andrea Icks
- Institute for Health Services Research and Health Economics, Centre for Health and Society, Faculty of Medicine, Heinrich Heine University, Moorenstraße 5, 40225 Düsseldorf, Germany
- Institute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Institute for Diabetes Research, at Heinrich Heine University Düsseldorf, Auf’m Hennekamp 65, 40225 Düsseldorf, Germany
- German Center for Diabetes Research (DZD), Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| |
Collapse
|
5
|
Boniol M, Dragomir M, Autier P, Boyle P. Physical activity and change in fasting glucose and HbA1c: a quantitative meta-analysis of randomized trials. Acta Diabetol 2017; 54:983-991. [PMID: 28840356 DOI: 10.1007/s00592-017-1037-3] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 08/02/2017] [Indexed: 11/26/2022]
Abstract
AIMS A systematic review was conducted of randomized trials which evaluated the impact of physical activity on the change in fasting glucose and HbA1c. METHODS A literature search was conducted in PubMed until December 2015. Studies reporting glucose or HbA1c at baseline and at the end of study were included, and the change and its variance were estimated from studies with complete data. Mixed-effect random models were used to estimate the change of fasting glucose (mg/dl) and HbA1c (%) per additional minutes of physical activity per week. RESULTS A total of 125 studies were included in the meta-analysis. Based on 105 studies, an increase of 100 min in physical activity per week was associated with an average change of -2.75 mg/dl of fasting glucose (95% CI -3.96; -1.55), although there was a high degree of heterogeneity (83.5%). When restricting the analysis on type 2 diabetes and prediabetes subjects (56 studies), the average change in fasting glucose was -4.71 mg/dl (95% CI -7.42; -2.01). For HbA1c, among 76 studies included, an increase of 100 min in physical activity per week was associated with an average change of -0.14% of HbA1c (95% CI -0.18; -0.09) with heterogeneity (73%). A large degree of publication bias was identified (Egger test p < 0.001). When restricting the analysis on type 2 diabetes and prediabetes subjects (60 studies), the average change in HbA1c was -0.16% (95% CI -0.21; -0.11). CONCLUSIONS This analysis demonstrates that moderate increases in physical activity are associated with significant reductions in both fasting glucose and HbA1c.
Collapse
Affiliation(s)
- Mathieu Boniol
- Strathclyde Institute of Global Public Health at iPRI, Espace Européen d'Ecully, Bâtiment G, Allée Claude Debussy, 69130, Ecully Ouest Lyon, France
- International Prevention Research Institute, 95 cours Lafayette, 69006, Lyon, France
| | - Miruna Dragomir
- International Prevention Research Institute, 95 cours Lafayette, 69006, Lyon, France.
| | - Philippe Autier
- Strathclyde Institute of Global Public Health at iPRI, Espace Européen d'Ecully, Bâtiment G, Allée Claude Debussy, 69130, Ecully Ouest Lyon, France
- International Prevention Research Institute, 95 cours Lafayette, 69006, Lyon, France
| | - Peter Boyle
- Strathclyde Institute of Global Public Health at iPRI, Espace Européen d'Ecully, Bâtiment G, Allée Claude Debussy, 69130, Ecully Ouest Lyon, France
- International Prevention Research Institute, 95 cours Lafayette, 69006, Lyon, France
| |
Collapse
|
6
|
Vanstone M, Rewegan A, Brundisini F, Giacomini M, Kandasamy S, DeJean D. Diet modification challenges faced by marginalized and nonmarginalized adults with type 2 diabetes: A systematic review and qualitative meta-synthesis. Chronic Illn 2017; 13:217-235. [PMID: 27884930 DOI: 10.1177/1742395316675024] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Diet modification is an important part of the prevention and treatment of type 2 diabetes, but sustained dietary change remains elusive for many individuals. This paper describes and interprets the barriers to diet modification from the perspective of people with type 2 diabetes, paying particular attention to the experiences of people who experience social marginalization. Methods A systematic review of primary, empirical qualitative research was performed, capturing 120 relevant studies published between 2002 and 2015. Qualitative meta-synthesis was used to provide an integrative analysis of this knowledge. Results Due to the central role of food in social life, dietary change affects all aspects of a person's life, and barriers related to self-discipline, emotions, family and social support, social significance of food, and knowledge were identified. These barriers are inter-linked and overlapping. Social marginalization magnifies barriers; people who face social marginalization are trying to make the same changes as other people with diabetes with fewer socio-material resources in the face of greater challenges. Discussion A social-ecological model of behavior supports our findings of challenges at all levels, and highlights the need for interventions and counseling strategies that address the social and environmental factors that shape and sustain dietary change.
Collapse
Affiliation(s)
- Meredith Vanstone
- 1 Department of Family Medicine, McMaster University, Hamilton, ON, Canada.,2 Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
| | - Alex Rewegan
- 3 MA Program in Social Anthropology, York University, Hamilton, ON, Canada
| | - Francesca Brundisini
- 2 Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.,4 Health Policy PhD Program, McMaster University, Hamilton, ON, Canada
| | - Mita Giacomini
- 2 Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.,5 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Sujane Kandasamy
- 5 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Deirdre DeJean
- 2 Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.,5 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
7
|
Breaking Barriers to Effective Type 2 Diabetes Management: Findings from the use of the OPTIMA© Questionnaire in Clinical Practice. Adv Ther 2016; 33:1033-48. [PMID: 27193870 PMCID: PMC4920846 DOI: 10.1007/s12325-016-0341-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Indexed: 11/15/2022]
Abstract
Background The OPTIMA© (MSD, Courbevoie, France) questionnaire was developed to promote shared decisions and the set-up of specific micro-objectives in clinical practice by optimizing communication between type 2 diabetes (T2DM) patients and their physicians. The present study aimed to assess OPTIMA in clinical practice. Methods A cross-sectional multicenter observational study was conducted in France from 2012 to 2014. During routine consultation, patients completed one of the five modules of the OPTIMA questionnaire (Physical activity, Diet, Treatment, Knowledge of the disease or Self-monitoring of blood glucose). The rate of SMART (specific, measurable, acceptable, realistic, timely) micro-objective set-up following the use of the questionnaire was assessed. Data on how patients felt about their diabetes management (beliefs concerning actions, how easy they were to do and how often they were done in practice) were gathered. Finally, patients’ and physicians’ opinions on OPTIMA were assessed using the PRAgmatic Content and face validity Test (PRAC-Test© (Mapi, Lyon, France) evaluation questionnaire. Results Overall, 807 patients were included by 186 physicians. While 92.7 % of consultations led to the set-up of a micro-objective, only 22.3 % were SMART micro-objectives: Physical activity module (34.3 %), Diet module (9.6 %), Treatment module (16.4 %), Knowledge of the disease module (25.2 %), and self-monitoring of blood glucose module (29.5 %). Among patients completing the Physical activity module, 79.0 % reported that they believed physical activity was useful, 35.0 % that it was easy, and 25.8 % that they regularly practised it. PRAC-Test results showed that OPTIMA was a useful and easy-to-use questionnaire that promotes communication between physicians and their patients according to 92.8 % of patients and 69.4 % of physicians. Conclusion The OPTIMA questionnaire facilitates communication between patients and their physicians and promotes the set-up of micro-objectives concerning T2DM management. The Physical activity module was the most likely of the five modules in the questionnaire to lead to the set-up of SMART micro-objectives. Funding MSD France. Electronic supplementary material The online version of this article (doi:10.1007/s12325-016-0341-6) contains supplementary material, which is available to authorized users.
Collapse
|
8
|
Brundisini F, Vanstone M, Hulan D, DeJean D, Giacomini M. Type 2 diabetes patients' and providers' differing perspectives on medication nonadherence: a qualitative meta-synthesis. BMC Health Serv Res 2015; 15:516. [PMID: 26596271 PMCID: PMC4657347 DOI: 10.1186/s12913-015-1174-8] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 11/17/2015] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Poor adherence to medication regimens increases adverse outcomes for patients with Type 2 diabetes. Improving medication adherence is a growing priority for clinicians and health care systems. We examine the differences between patient and provider understandings of barriers to medication adherence for Type 2 diabetes patients. METHODS We searched systematically for empirical qualitative studies on the topic of barriers to medication adherence among Type 2 diabetes patients published between 2002-2013; 86 empirical qualitative studies qualified for inclusion. Following qualitative meta-synthesis methods, we coded and analyzed thematically the findings from studies, integrating and comparing findings across studies to yield a synthetic interpretation and new insights from this body of research. RESULTS We identify 7 categories of barriers: (1) emotional experiences as positive and negative motivators to adherence, (2) intentional non-compliance, (3) patient-provider relationship and communication, (4) information and knowledge, (5) medication administration, (6) social and cultural beliefs, and (7) financial issues. Patients and providers express different understandings of what patients require to improve adherence. Health beliefs, life context and lay understandings all inform patients' accounts. They describe barriers in terms of difficulties adapting medication regimens to their lifestyles and daily routines. In contrast, providers' understandings of patients poor medication adherence behaviors focus on patients' presumed needs for more information about the physiological and biomedical aspect of diabetes. CONCLUSIONS This study highlights key discrepancies between patients' and providers' understandings of barriers to medication adherence. These misunderstandings span the many cultural and care contexts represented by 86 qualitative studies. Counseling and interventions aimed at improving medication adherence among Type 2 diabetes might become more effective through better integration of the patient's perspective and values concerning adherence difficulties and solutions.
Collapse
Affiliation(s)
- Francesca Brundisini
- Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4 K1, Canada.
| | - Meredith Vanstone
- Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4 K1, Canada.
| | - Danielle Hulan
- Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4 K1, Canada.
| | - Deirdre DeJean
- Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4 K1, Canada.
| | - Mita Giacomini
- Department of Clinical Epidemiology and Biostatistics, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4 K1, Canada.
| |
Collapse
|
9
|
Effect of a nutrition education programme on clinical status and dietary behaviours of adults with type 2 diabetes in a resource-limited setting in South Africa: a randomised controlled trial. Public Health Nutr 2015; 19:142-55. [DOI: 10.1017/s1368980015000956] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjectiveTo evaluate the effect of a participant-customised nutrition education programme on glycated Hb (HbA1c), blood lipids, blood pressure, BMI and dietary behaviours in patients with type 2 diabetes mellitus.DesignA randomised controlled trial. The control group (n 41) received education materials. The intervention group (n 41) received the same education materials and participated in eight weekly (2–2·5 h) group nutrition education sessions and follow-up sessions. Outcomes were assessed at 6 and 12 months. An intention-to-treat analysis was conducted. ANCOVA compared the groups (adjustments for baseline values, age, sex and clinic).SettingTwo community health centres, Moretele sub-district (North West Province), South Africa.SubjectsAdults (aged 40–70 years) with type 2 diabetes, HbA1c ≥8 %.ResultsDifferences in HbA1c (primary outcome) were −0·64 % (P=0·15) at 6 months and −0·63 % (P=0·16) at 12 months in favour of the intervention group. Starchy-food intake was significantly lower in the intervention group, 9·3 v. 10·8 servings/d (P=0·005) at 6 months and 9·9 v. 11·9 servings/d (P=0·017) at 12 months. Median energy intake was significantly lower in the intervention group at 12 months (5988 v. 6946 kJ/d, P=0·017). No significant group differences in BMI, lipid profile, blood pressure and intakes of macronutrients, vegetables and fruits were observed.ConclusionsNutrition education was not efficacious on HbA1c; however, it improved specific dietary behaviours. Group education and hands-on activities appeared to contribute to the improvement. Optimal goal setting and self-efficacy training/assessment could benefit future nutrition education programmes for people with type 2 diabetes mellitus in resource-limited settings.
Collapse
|
10
|
The association between types of eating behaviour and dispositional mindfulness in adults with diabetes. Results from Diabetes MILES. The Netherlands. Appetite 2015; 87:288-95. [DOI: 10.1016/j.appet.2015.01.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 01/07/2015] [Accepted: 01/09/2015] [Indexed: 11/23/2022]
|
11
|
Tong WT, Vethakkan SR, Ng CJ. Why do some people with type 2 diabetes who are using insulin have poor glycaemic control? A qualitative study. BMJ Open 2015; 5:e006407. [PMID: 25633285 PMCID: PMC4316456 DOI: 10.1136/bmjopen-2014-006407] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To explore factors influencing poor glycaemic control in people with type 2 diabetes using insulin. RESEARCH DESIGN A qualitative method comprising in-depth individual interviews. A semistructured interview guide was used. The interviews were audiorecorded, transcribed verbatim and analysed using a thematic approach. PARTICIPANTS Seventeen people with type 2 diabetes using insulin with glycated haemoglobin (HbA1c) ≥9% for >1 year. SETTING The Primary Care Clinic and Diabetes Clinic in the University of Malaya Medical Centre (UMMC), Malaysia. RESULTS Data analysis uncovered four themes: lifestyle challenges in adhering to medical recommendations; psychosocial and emotional hurdles; treatment-related factors; lack of knowledge about and self-efficacy in diabetes self-care. CONCLUSIONS Factors that explain the poor glycaemic control in people with type 2 diabetes using insulin were identified. Healthcare providers could use these findings to address patients' concerns during consultations and help to improve glycaemic control.
Collapse
Affiliation(s)
- Wen Ting Tong
- Faculty of Medicine, Department of Primary Care Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Chirk Jenn Ng
- Faculty of Medicine, Department of Primary Care Medicine, University of Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
12
|
Wennberg AL, Lundqvist A, Högberg U, Sandström H, Hamberg K. Women's experiences of dietary advice and dietary changes during pregnancy. Midwifery 2013; 29:1027-34. [DOI: 10.1016/j.midw.2012.09.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 08/17/2012] [Accepted: 09/17/2012] [Indexed: 11/17/2022]
|
13
|
Penn L, Moffatt SM, White M. Participants' perspective on maintaining behaviour change: a qualitative study within the European Diabetes Prevention Study. BMC Public Health 2008; 8:235. [PMID: 18616797 PMCID: PMC2491611 DOI: 10.1186/1471-2458-8-235] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2008] [Accepted: 07/10/2008] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The European Diabetes Prevention Study (EDIPS) is an RCT of diet and exercise interventions in people with impaired glucose tolerance. We undertook a qualitative study, nested within the EDIPS in Newcastle-upon-Tyne, UK, aiming to understand the experience of participants who maintained behaviour change, in order to inform future interventions. METHODS Participants were purposively sampled, according to success criteria for diet and physical activity change maintenance, and invited to attend individual semi-structured interviews. Fifteen participants completed an interview and reflected on their experience over three to five years. We used the Framework method to analyse the transcribed data. RESULTS Main themes were identified as factors that help (props) and those that hinder (burdens) behaviour change maintenance at different organisational levels: individual (both physical and psychological), social and environmental. Pre-existing physical conditions (such as arthritis) and social demands (such as caring for an ageing relative) hindered, whereas the benefits of becoming fitter and of having social and professional support helped, participants in maintaining behaviour change. Participants' long term experiences highlighted the salience of the continuous change in their physical, social and environmental conditions over time. CONCLUSION The construct of props and burdens facilitates a holistic view of participants' behaviour. Efforts to encourage behaviour change maintenance should take account of context and the way this changes over time, and should include strategies to address these issues. The experience of participants who maintain behaviour change highlights the challenges for the wider implementation of diabetes prevention strategies. TRIAL REGISTRATION (ISRCTN 15670600).
Collapse
Affiliation(s)
- Linda Penn
- Public Health Research Programme, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
| | | | | |
Collapse
|
14
|
Robertson JL, Akhtar S, Petrie JR, Brown FJ, Jones GC, Perry CG, Paterson KR. How do people with diabetes access information? ACTA ACUST UNITED AC 2005. [DOI: 10.1002/pdi.818] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
15
|
Current literature in diabetes. Diabetes Metab Res Rev 2002; 18:419-26. [PMID: 12397584 DOI: 10.1002/dmrr.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|