1
|
Butt MD, Ong SC, Rafiq A, Kalam MN, Sajjad A, Abdullah M, Malik T, Yaseen F, Babar ZUD. A systematic review of the economic burden of diabetes mellitus: contrasting perspectives from high and low middle-income countries. J Pharm Policy Pract 2024; 17:2322107. [PMID: 38650677 PMCID: PMC11034455 DOI: 10.1080/20523211.2024.2322107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
Abstract
Introduction Diabetes increases preventative sickness and costs healthcare and productivity. Type 2 diabetes and macrovascular disease consequences cause most diabetes-related costs. Type 2 diabetes greatly costs healthcare institutions, reducing economic productivity and efficiency. This cost of illness (COI) analysis examines the direct and indirect costs of treating and managing type 1 and type 2 diabetes mellitus. Methodology According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, Cochrane, PubMed, Embase, CINAHL, Scopus, Medline Plus, and CENTRAL were searched for relevant articles on type 1 and type 2 diabetes illness costs. The inquiry returned 873 2011-2023 academic articles. The study included 42 papers after an abstract evaluation of 547 papers. Results Most articles originated in Asia and Europe, primarily on type 2 diabetes. The annual cost per patient ranged from USD87 to USD9,581. Prevalence-based cost estimates ranged from less than USD470 to more than USD3475, whereas annual pharmaceutical prices ranged from USD40 to more than USD450, with insulin exhibiting the greatest disparity. Care for complications was generally costly, although costs varied significantly by country and problem type. Discussion This study revealed substantial heterogeneity in diabetes treatment costs; some could be reduced by improving data collection, analysis, and reporting procedures. Diabetes is an expensive disease to treat in low- and middle-income countries, and attaining Universal Health Coverage should be a priority for the global health community.
Collapse
Affiliation(s)
- Muhammad Daoud Butt
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, USM, Penang, Malaysia
- Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Siew Chin Ong
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, USM, Penang, Malaysia
| | - Azra Rafiq
- Department of Biological Sciences, Middle East Technical University, Ankara, Turkey
- Department of Pharmacy, Riphah International University, Lahore, Pakistan
| | - Muhammad Nasir Kalam
- Department of Pharmacy, The Sahara University, Narowal, Pakistan
- Faculty of Pharmacy, The University of Lahore, Lahore, Pakistan
| | - Ahsan Sajjad
- Ibn Sina Community Clinic, South Wilcrest Drive, Houston, Texas, USA
| | - Muhammad Abdullah
- Department of Pharmacy, Punjab University College of Pharmacy, Lahore, Pakistan
| | - Tooba Malik
- Department of Public Health, Health Services Academy, Islamabad, Pakistan
| | - Fatima Yaseen
- National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan
- Department of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan
| | | |
Collapse
|
2
|
Alzubaidi H, Oliveira VH, Samorinha C, Mc Namara K, Shaw JE. Acculturation and glycaemic control in Arab immigrants with type 2 diabetes in Australia. Diabetologia 2024; 67:663-669. [PMID: 38214713 PMCID: PMC10904404 DOI: 10.1007/s00125-023-06081-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/21/2023] [Indexed: 01/13/2024]
Abstract
AIMS/HYPOTHESIS This study aimed to investigate acculturation's direct and mediated effects on HbA1c levels in individuals with type 2 diabetes from Arabic-speaking countries that are members of the Arab League who have emigrated to Australia. METHODS In this multicentre cross-sectional study, we recruited 382 Arabic-speaking immigrants who were born in any of the 22 countries of the Arab League and who had type 2 diabetes from different healthcare settings in Australia. HbA1c levels were retrieved from medical records. A validated self-report questionnaire was used to assess behavioural and psychosocial outcomes. Acculturation was measured using the General Acculturation Index and the Adherence to Traditional Values tool. We used structural equation modelling to test mediation hypotheses. RESULTS Participants had a mean HbA1c value of 63.9 mmol/mol (8.0%), a low acculturation level (mean±SD: 1.9±0.6; range: 1-5) and highly adhered to traditional values (mean General Acculturation Index value: 3.7±0.7; range: 1-5). Higher HbA1c was associated with lower acculturation levels (Pearson correlation coefficient [r] = -0.32, p<0.01) and higher adherence to traditional values (r=0.35, p<0.01). Self-efficacy, health literacy and self-care activities partially mediated the relationship between acculturation and HbA1c. CONCLUSIONS/INTERPRETATION Among Arab immigrants in Australia with type 2 diabetes, the degree of acculturation is related to glycaemic control, suggesting possible avenues for new interventions.
Collapse
Affiliation(s)
- Hamzah Alzubaidi
- Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates.
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates.
- School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, Warrnambool, VIC, Australia.
| | - Vitor H Oliveira
- inED Centre for Research and Innovation in Education, School of Education, Polytechnic of Porto, Porto, Portugal
| | - Catarina Samorinha
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Kevin Mc Namara
- School of Medicine, Deakin Rural Health, Deakin University Faculty of Health, Warrnambool, VIC, Australia.
| | - Jonathan E Shaw
- Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
3
|
Zhang YY, Li W, Sheng Y, Wang Q, Zhao F, Wei Y. Prevalence and Correlators of Diabetes Distress in Adults with Type 2 Diabetes: A Cross-Sectional Study. Patient Prefer Adherence 2024; 18:111-130. [PMID: 38234632 PMCID: PMC10793120 DOI: 10.2147/ppa.s442838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/09/2024] [Indexed: 01/19/2024] Open
Abstract
Purpose To address the prevalence of diabetes distress (DD) and its correlators in adults with type 2 diabetes. Patients and Methods During 2021 and 2022, we conducted a cross-sectional study in three Class A tertiary comprehensive hospitals in China, and received 947 participants who completed a printed survey covering DD, demographic, diabetic, physiological, and psychosocial factors. We used Jonckheere-Terpstra, chi-square, and Fisher's exact tests to assess intergroup differences between different levels of DD. We used ordinal logistic regression analysis to analyze correlators of DD further. Results The prevalence of DD was 34.64%. In univariate analysis, those with lower satisfaction with financial status, longer durations of diabetes, more complications, higher glycemia, more severe insomnia, treatment by medications only, poorer lifestyle interventions, fewer self-care activities, more types and frequencies of insulin injections, and spending more money and time on treatment were susceptible to DD. Type D personality, negative illness perceptions, negative coping styles, and psychological effects of major life events were related to higher DD. Hope, self-efficacy, positive coping styles, and social support can reduce DD. In ordinal logistic regression analysis, hypoglycemic episode (β=-1.118, p=0.019, "have hypoglycemic" as reference) and Brief Illness Perception Questionnaire (β=0.090, p<0.001) were significant positive correlators for DD, while diet intervention (β=0.803, p=0.022, "have diet intervention" as reference), money spent on diabetes treatment (β<-0.001, p=0.035), and SES (β=-0.257, p<0.001) were significant negative correlators. Conclusion More than one-third of Chinese adults with type 2 diabetes experience moderate or high levels of DD. DD was associated with financial, diabetic, physiological, and psychosocial status.
Collapse
Affiliation(s)
- Yu-Yun Zhang
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Wei Li
- Department of Endocrinology, Peking Union Medical College Hospital, Beijing, People’s Republic of China
| | - Yu Sheng
- School of Nursing, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, People’s Republic of China
| | - Qun Wang
- Endocrinology and Metabolism Department, Peking University Third Hospital, Beijing, People’s Republic of China
| | - Fang Zhao
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, People’s Republic of China
| | - Ying Wei
- Department of Endocrinology, China-Japan Friendship Hospital, Beijing, People’s Republic of China
| |
Collapse
|
4
|
Pettersson S, Klompstra L, Jirwe M, Jaarsma T. Developing a Culturally Appropriate Tool to Support Self-Care in Migrants with Type 2 Diabetes - A Co-Design Study. Patient Prefer Adherence 2023; 17:2557-2567. [PMID: 37854029 PMCID: PMC10581012 DOI: 10.2147/ppa.s426908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/08/2023] [Indexed: 10/20/2023] Open
Abstract
Introduction Migrants, especially from the Middle East, experience poorer health outcomes and face greater difficulties in accessing healthcare compared to native populations and there is a need for culturally appropriate education for this vulnerable group. The purpose of this study is to describe the process of developing a culturally appropriate tool to support self-care in migrants with type 2 diabetes. Methods In this Co-design study, a tool for supporting self-care in migrants with type 2 diabetes was developed. Migrant patients with type 2 diabetes, healthcare providers and researchers participated in the process, which was based on six elements; engage, plan, explore, develop, decide and change. From February 2021 to December 2022, idea groups were conducted, and a tool was developed through brainstorming, prioritizing and prototyping. Results In total, 14 migrant patients, ten health care providers and four researchers participated in the Co-design process. The patients wished to receive information about type 2 diabetes self-care behaviour in their own languages. The healthcare providers asked for clear instructions on where to guide their patients regarding reliable information about diabetes in the patient's own language. All participants agreed that information can be presented in different formats, either: text (paper or online), audio-visual via recorded videos and/or lectures and pictures. Discussion The Co-design process led to several important insights and experiences related to the importance of diverse cultural backgrounds. When conducting a Co-design study with end-users as stakeholders, it is significant that the stakeholders have a diverse background in experiences, both as patients as well as those who deliver or implement the health service. In this study it was of great importance to include patients with diverse backgrounds regarding; gender, age, health literacy, occupation, years living in Sweden and duration of diabetes.
Collapse
Affiliation(s)
- Sara Pettersson
- Linkoping University, Department of Health, Medicine and Caring Sciences, Linkoping, Sweden
| | - Leonie Klompstra
- Linkoping University, Department of Health, Medicine and Caring Sciences, Linkoping, Sweden
| | - Maria Jirwe
- Red Cross University College, Department of Health Sciences, Huddinge, Sweden
| | - Tiny Jaarsma
- Linkoping University, Department of Health, Medicine and Caring Sciences, Linkoping, Sweden
| |
Collapse
|
5
|
Xu X, Yang W, Deng Y, Liu L, Zhang X, Long C, Dong T, Zeng J, Kui J, Wu X. Association of socioeconomic status with glycated haemoglobin level and risk factors for diabetic retinopathy: a cross-sectional study in Sichuan, western China. BMJ Open 2023; 13:e067475. [PMID: 36797020 PMCID: PMC9936295 DOI: 10.1136/bmjopen-2022-067475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
OBJECTIVE Diabetes affects 1 in 10 adults in China. Diabetic retinopathy (DR) is a diabetes-related complication that, if untreated, impairs vision and causes blindness. Evidence on DR diagnosis and risk factors is limited. This study aimed to add evidence from socioeconomic factors. DESIGN A cross-sectional survey of people with diabetes conducted in 2019 was analysed by using logistic regression to evaluate the association of socioeconomic factors with the glycated haemoglobin (HbA1c) level and DR. SETTING Five counties/districts of western China (Sichuan) were included. PARTICIPANTS Registered participants with diabetes aged from 18 to 75 years were selected, and at last 2179 participants were included in the analysis. RESULTS In this cohort, 37.13% (adjusted value 36.52%), 19.78% (adjusted value 19.59%) and 17.37% of participants had HbA1c<7.0%, DR (24.96% of those in the high-HbA1c group) and non-proliferative DR, respectively. Participants with higher social health insurance coverage (urban employee insurance (UEI)), higher income and urban residents tended to have glycaemic control (HbA1c) compared with their counterparts (OR: 1.48, 1.08 and 1.39, respectively). Participants with UEI or higher income had a lower risk of DR (OR: 0.71 and 0.88, respectively); higher education was associated with a 53%-69% decreased risk of DR. CONCLUSION This study shows disparities in the effect of socioeconomic factors on glycaemic (HbA1c) management and DR diagnosis among people with diabetes in Sichuan. Lower socioeconomic (especially non-UEI) status conferred a higher risk of high HbA1c and DR. The insights from this study indicate the need for national programmes to implement community-level measures to facilitate access to better HbA1c management and early detection of DR in patients with lower socioeconomic status and diabetes. TRIAL REGISTRATION NUMBER Chinese Clinical Trial Registry (ChiCTR1800014432).
Collapse
Affiliation(s)
- Xinyin Xu
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
- Department of Global Health & Social Medicine, King's College London, London, UK
| | - Wei Yang
- Department of Global Health & Social Medicine, King's College London, London, UK
| | - Yin Deng
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Lingling Liu
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Xin Zhang
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Chengxu Long
- Department of Global Health & Social Medicine, King's College London, London, UK
| | - Ting Dong
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Jing Zeng
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Ji Kui
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| | - Xianping Wu
- Department of Chronic Noncommunicable Disease Control and Prevention, Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China
| |
Collapse
|
6
|
Duarte-Díaz A, Perestelo-Pérez L, Rivero-Santana A, Peñate W, Álvarez-Pérez Y, Ramos-García V, González-Pacheco H, Goya-Arteaga L, de Bonis-Braun M, González-Martín S, Ramallo-Fariña Y, Carrion C, Serrano-Aguilar P. The relationship between patient empowerment and related constructs, affective symptoms and quality of life in patients with type 2 diabetes: a systematic review and meta-analysis. Front Public Health 2023; 11:1118324. [PMID: 37139389 PMCID: PMC10150112 DOI: 10.3389/fpubh.2023.1118324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
Introduction The aim of this systematic review is to assess the relationship between patient empowerment and other empowerment-related constructs, and affective symptoms and quality of life in patients with type 2 diabetes. Methods A systematic review of the literature was conducted, according to the PRISMA guidelines. Studies addressing adult patients with type 2 diabetes and reporting the association between empowerment-related constructs and subjective measures of anxiety, depression and distress, as well as self-reported quality of life were included. The following electronic databases were consulted from inception to July 2022: Medline, Embase, PsycINFO, and Cochrane Library. The methodological quality of the included studies was analyzed using validated tools adapted to each study design. Meta-analyses of correlations were performed using an inverse variance restricted maximum likelihood random-effects. Results The initial search yielded 2463 references and seventy-one studies were finally included. We found a weak-to-moderate inverse association between patient empowerment-related constructs and both anxiety (r = -0.22) and depression (r = -0.29). Moreover, empowerment-related constructs were moderately negatively correlated with distress (r = -0.31) and moderately positively correlated with general quality of life (r = 0.32). Small associations between empowerment-related constructs and both mental (r = 0.23) and physical quality of life (r = 0.13) were also reported. Discussion This evidence is mostly from cross-sectional studies. High-quality prospective studies are needed not only to better understand the role of patient empowerment but to assess causal associations. The results of the study highlight the importance of patient empowerment and other empowerment-related constructs such as self-efficacy or perceived control in diabetes care. Thus, they should be considered in the design, development and implementation of effective interventions and policies aimed at improving psychosocial outcomes in patients with type 2 diabetes. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020192429, identifier CRD42020192429.
Collapse
Affiliation(s)
- Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Department of Clinical Psychology, Psychobiology and Methodology, Universidad de La Laguna, (ULL), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Lilisbeth Perestelo-Pérez
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
- *Correspondence: Lilisbeth Perestelo-Pérez
| | - Amado Rivero-Santana
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Wenceslao Peñate
- Department of Clinical Psychology, Psychobiology and Methodology, Universidad de La Laguna, (ULL), Tenerife, Spain
| | - Yolanda Álvarez-Pérez
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Vanesa Ramos-García
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Himar González-Pacheco
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Libertad Goya-Arteaga
- Multiprofessional Unit of Family and Community Care of La Laguna-Norte, Tenerife, Spain
| | - Miriam de Bonis-Braun
- Multiprofessional Unit of Family and Community Care of La Laguna-Norte, Tenerife, Spain
| | | | - Yolanda Ramallo-Fariña
- Canary Islands Health Research Institute Foundation (FIISC), Tenerife, Spain
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
| | - Carme Carrion
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- eHealth Lab Research Group, School of Health Sciences, Universitat Oberta de Catalunya (UOC), Barcelona, Spain
| | - Pedro Serrano-Aguilar
- Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Madrid, Spain
- The Spanish Network of Agencies for Health Technology Assessment and Services of the National Health System (RedETS), Madrid, Spain
- Evaluation Unit (SESCS), Canary Islands Health Service (SCS), Tenerife, Spain
| |
Collapse
|