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Lum ZK, Tan JY, Wong CSM, Kok ZY, Kwek SC, Tsou KYK, Gallagher PJ, Lee JYC. Reducing economic burden through split-shared care model for people living with uncontrolled type 2 diabetes and polypharmacy: a multi-center randomized controlled trial. BMC Health Serv Res 2024; 24:760. [PMID: 38907254 PMCID: PMC11193226 DOI: 10.1186/s12913-024-11199-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND Interprofessional collaborative care such as a split-shared care model involving family physicians and community pharmacists can reduce the economic burden of diabetes management. This study aimed to evaluate the economic outcome of a split-shared care model between family physicians and community pharmacists within a pharmacy chain in managing people with uncontrolled type 2 diabetes and polypharmacy. METHOD This was a multi-center, parallel arm, open label, randomized controlled trial comparing the direct and indirect economic outcomes of people who received collaborative care involving community pharmacists (intervention) versus those who received usual care without community pharmacist involvement (control). People with uncontrolled type 2 diabetes, defined as HbA1c > 7.0% and taking ≥ 5 chronic medications were included while people with missing baseline economic data (such as consultation costs, medication costs) were excluded. Direct medical costs were extracted from the institution's financial database while indirect costs were calculated from self-reported gross income and productivity loss, using Work Productivity Activity Impairment Global Health questionnaire. Separate generalized linear models with log link function and gamma distribution were used to analyze changes in direct and indirect medical costs. RESULTS A total of 175 patients (intervention = 70, control = 105) completed the trial and were included for analysis. The mean age of the participants was 66.9 (9.2) years, with majority being male and Chinese. The direct medical costs were significantly lower in the intervention than the control group over 6 months (intervention: -US$70.51, control: -US$47.66, p < 0.001). Medication cost was the main driver in both groups. There were no significant changes in productivity loss and indirect costs in both groups. CONCLUSION Implementation of split-shared visits with frontline community partners may reduce economic burden for patient with uncontrolled type 2 diabetes and polypharmacy. TRIAL REGISTRATION Clinicaltrials.gov Reference Number: NCT03531944 (Date of registration: June 6, 2018).
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Affiliation(s)
- Zheng Kang Lum
- Department of Pharmacy and Pharmaceutical Sciences, Faculty of Science, MD1, Tahir Foundation Building, National University of Singapore, 12 Science Drive #06-03, Singapore, 117549, Singapore
| | - Jia Yeong Tan
- Keat Hong Family Medicine Clinic, Trilink Healthcare Private Limited, 2 Choa Chu Kang Loop, Singapore, #03-02, Singapore
| | - Cynthia Sze Mun Wong
- Bukit Batok Polyclinic, National University Polyclinics, 50 Bukit Batok West Ave 3, Singapore, 659164, Singapore
| | - Zi Yin Kok
- Keat Hong Family Medicine Clinic, Trilink Healthcare Private Limited, 2 Choa Chu Kang Loop, Singapore, #03-02, Singapore
| | - Sing Cheer Kwek
- Bukit Batok Polyclinic, National University Polyclinics, 50 Bukit Batok West Ave 3, Singapore, 659164, Singapore
| | - Keith Yu Kei Tsou
- Bukit Batok Polyclinic, National University Polyclinics, 50 Bukit Batok West Ave 3, Singapore, 659164, Singapore
| | - Paul John Gallagher
- Department of Pharmacy and Pharmaceutical Sciences, Faculty of Science, MD1, Tahir Foundation Building, National University of Singapore, 12 Science Drive #06-03, Singapore, 117549, Singapore.
| | - Joyce Yu-Chia Lee
- Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University of California, 101 Theory, Suite 100, Irvine, CA, 92697, USA.
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Alrasasimah WA, Alsabaani A. Predictors of Diabetes Self-Management Behaviour Among Type 2 Diabetics in Saudi Arabia: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2024; 17:2371-2384. [PMID: 38881694 PMCID: PMC11179637 DOI: 10.2147/dmso.s455193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 06/01/2024] [Indexed: 06/18/2024] Open
Abstract
Background Type 2 Diabetes Mellitus (T2DM) requires effective self-care behaviors and social support to manage the condition and prevent complications. This study aimed to examine the influence of demographic characteristics and perceived social support on diabetes self-management behaviors in individuals with T2DM. Methods An analytical cross-sectional design was employed to collect data from 300 T2DM patients using validated questionnaires from April to May 2023. Self-care behaviors were assessed using a Summary of Diabetes Self-Care Activities-Arabic (SDSCA-Arabic), while perceived social support was measured using a Diabetes Care Profile (DCP) using an Arabic Social Support subscale. Descriptive statistics, correlation analysis, and regression analysis were performed to examine the relationships and predictors of self-care behaviors. Results Patients exhibited varying levels of self-care behaviors, with exercise and blood sugar testing being the most frequently reported activities. Additionally, the findings revealed that health education on self-examining regarding the feet, exercising, comorbidities, perceived social support, medical insurance, and gender were significant predictors of diabetes self-management behaviors. These factors collectively accounted for 21.2% of the variance in self-management behavior levels. Specifically, health education on self-examining regarding the feet (β = -0.286, p = 0.001) and exercising (β = -0.175, p = 0.001) showed a negative association, while perceived social support (β = 0.235, p = 0.001) demonstrated a positive association with self-management behaviors. Conclusion The study highlights the importance of comprehensive health education programs that address multiple aspects of diabetes management and the role of social support in fostering better self-management behaviors. It also emphasizes the influence of demographic factors on self-management, with individuals with higher comorbidities exhibiting better self-management behaviors and those with medical insurance showing poorer self-management behaviors. These findings have implications for nursing practice, suggesting the need for tailored interventions, effective education, and support networks to enhance self-management behaviors in T2DM patients.
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Affiliation(s)
- Waad Alhumaidi Alrasasimah
- Master of Public Health, College of Applied Medical Sciences, King Khalid University, Khamis Mushait, Saudi Arabia
| | - Abdullah Alsabaani
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
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Harkare HV, Osetinsky B, Ginindza N, Cindzi BT, Mncina N, Akomolafe B, Marowa LR, Ntshalintshali N, Tediosi F. Human and financial resource needs for universal access to WHO-PEN interventions for diabetes and hypertension care in Eswatini: results from a time-and-motion and bottom-up costing study. HUMAN RESOURCES FOR HEALTH 2024; 22:32. [PMID: 38802811 PMCID: PMC11131333 DOI: 10.1186/s12960-024-00913-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 05/16/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND Eswatini faces persistent challenges in providing care for diabetes and hypertension, exacerbated by a shortage of healthcare workers. The implementation of WHO-PEN interventions aimed to address these issues, yet their effects on healthcare worker time requirements and associated costs remain unclear. METHODS This study employed a time-and-motion analysis and a bottom-up cost assessment to quantify the human and financial resources required for scaling up WHO-PEN interventions nationally in Eswatini for all estimated diabetic and hypertensive patients. RESULTS Findings reveal that healthcare workers in intervention-arm clinics reported longer workday durations compared to those in control-arm clinics, yet spent less time per patient while seeing more patients. The implementation of WHO-PEN interventions increased the workload on healthcare workers but also led to a notable increase in patient care utilization. Furthermore, a morning peak in patient visits was identified, suggesting potential opportunities for optimizing patient flow. Notably, scaling up care provision nationally with WHO-PEN interventions proved to be more cost saving than expanding standard-of-care treatment. CONCLUSION WHO-PEN interventions hold promise in improving access to diabetes and hypertension care in Eswatini while offering an efficient solution. However, addressing challenges in healthcare workforce creation and retention is crucial for sustained effectiveness. Policy makers must consider all aspects of the WHO-PEN intervention for informed decision-making. Trial registration US Clinical Trials Registry. NCT04183413. Trial registration date: December 3, 2019. https://ichgcp.net/clinical-trials-registry/NCT04183413.
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Affiliation(s)
- Harsh Vivek Harkare
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
| | - Brianna Osetinsky
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | - Ntombifuthi Ginindza
- Ministry of Health in Eswatini, Ministry of Justice & Constitutional Affairs Building, Mhlambanyatsi Road, Mbabane, Eswatini
| | - Bongekile Thobekile Cindzi
- Clinton Health Access Initiative, Mbhilibhi House, Plot 170, Corner Tsekwane/Mbhilibhi Street, Mbabane, Eswatini
| | - Nomfundo Mncina
- Clinton Health Access Initiative, Mbhilibhi House, Plot 170, Corner Tsekwane/Mbhilibhi Street, Mbabane, Eswatini
| | - Babatunde Akomolafe
- Clinton Health Access Initiative, Mbhilibhi House, Plot 170, Corner Tsekwane/Mbhilibhi Street, Mbabane, Eswatini
| | - Lisa-Rufaro Marowa
- Clinton Health Access Initiative, Mbhilibhi House, Plot 170, Corner Tsekwane/Mbhilibhi Street, Mbabane, Eswatini
| | - Nyasatu Ntshalintshali
- Clinton Health Access Initiative, Mbhilibhi House, Plot 170, Corner Tsekwane/Mbhilibhi Street, Mbabane, Eswatini
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Arshad MS, Alqahtani F, Rasool MF. A Systematic Review of the Economic Burden of Diabetes in Eastern Mediterranean Region Countries. Diabetes Metab Syndr Obes 2024; 17:479-487. [PMID: 38318449 PMCID: PMC10840556 DOI: 10.2147/dmso.s440282] [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: 09/14/2023] [Accepted: 01/11/2024] [Indexed: 02/07/2024] Open
Abstract
Diabetes Mellitus (DM) is a highly prevalent non-communicable disease with high mortality and morbidity, which imposes a significant financial impact on individuals and the healthcare system. The identification of various cost components through cost of illness analysis could be helpful in health-care policymaking. The current systematic review aims to summarize the economic burden of DM in the Eastern Mediterranean Region (EMR) countries. The original studies published in the English language between January 2010 and June 2023 reported the cost of DM was identified by searching four different databases (Google Scholar, PubMed, Science Direct, and Cochrane Central). Two reviewers independently screened the search results and extracted the data according to a predefined format, whereas the third reviewer's opinion was sought to resolve any discrepancies. The costs of DM reported in the included studies were converted to USD dates reported in the studies. After the systematic search and screening process, only 10 articles from EMR countries met the eligibility criteria to be included in the study. There are substantial variations in the reported costs of DM and the methodologies used in the included studies. The mean annual cost per patient of DM (both direct and indirect cost) ranged from 555.20 USD to 1707.40 USD. The average annual direct cost ranged from 155.8 USD to 5200 USD and indirect cost ranged from 93.65 USD to 864.8 USD per patient. The studies included in the review obtained a median score of 8.65 (6.5 ─ 11.5) on the quality assessment tool based on Alison's checklist for evaluation of cost of illness studies. There is a significant economic burden associated with DM, which directly affects the patients and healthcare system. Future research should focus on refining cost estimation methodologies, improving the understanding of study findings, and making it easier to compare studies.
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Affiliation(s)
- Muhammad Subhan Arshad
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan
- Department of Pharmacy, Southern Punjab Institute of Health Sciences, Multan, 60000, Pakistan
| | - Faleh Alqahtani
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, 60800, Pakistan
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Karpov DS, Sosnovtseva AO, Pylina SV, Bastrich AN, Petrova DA, Kovalev MA, Shuvalova AI, Eremkina AK, Mokrysheva NG. Challenges of CRISPR/Cas-Based Cell Therapy for Type 1 Diabetes: How Not to Engineer a "Trojan Horse". Int J Mol Sci 2023; 24:17320. [PMID: 38139149 PMCID: PMC10743607 DOI: 10.3390/ijms242417320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023] Open
Abstract
Type 1 diabetes mellitus (T1D) is an autoimmune disease caused by the destruction of insulin-producing β-cells in the pancreas by cytotoxic T-cells. To date, there are no drugs that can prevent the development of T1D. Insulin replacement therapy is the standard care for patients with T1D. This treatment is life-saving, but is expensive, can lead to acute and long-term complications, and results in reduced overall life expectancy. This has stimulated the research and development of alternative treatments for T1D. In this review, we consider potential therapies for T1D using cellular regenerative medicine approaches with a focus on CRISPR/Cas-engineered cellular products. However, CRISPR/Cas as a genome editing tool has several drawbacks that should be considered for safe and efficient cell engineering. In addition, cellular engineering approaches themselves pose a hidden threat. The purpose of this review is to critically discuss novel strategies for the treatment of T1D using genome editing technology. A well-designed approach to β-cell derivation using CRISPR/Cas-based genome editing technology will significantly reduce the risk of incorrectly engineered cell products that could behave as a "Trojan horse".
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Affiliation(s)
- Dmitry S. Karpov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; (D.S.K.); (A.O.S.); (M.A.K.); (A.I.S.)
| | - Anastasiia O. Sosnovtseva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; (D.S.K.); (A.O.S.); (M.A.K.); (A.I.S.)
| | - Svetlana V. Pylina
- Endocrinology Research Centre, 115478 Moscow, Russia; (S.V.P.); (A.N.B.); (D.A.P.); (A.K.E.)
| | - Asya N. Bastrich
- Endocrinology Research Centre, 115478 Moscow, Russia; (S.V.P.); (A.N.B.); (D.A.P.); (A.K.E.)
| | - Darya A. Petrova
- Endocrinology Research Centre, 115478 Moscow, Russia; (S.V.P.); (A.N.B.); (D.A.P.); (A.K.E.)
| | - Maxim A. Kovalev
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; (D.S.K.); (A.O.S.); (M.A.K.); (A.I.S.)
| | - Anastasija I. Shuvalova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia; (D.S.K.); (A.O.S.); (M.A.K.); (A.I.S.)
| | - Anna K. Eremkina
- Endocrinology Research Centre, 115478 Moscow, Russia; (S.V.P.); (A.N.B.); (D.A.P.); (A.K.E.)
| | - Natalia G. Mokrysheva
- Endocrinology Research Centre, 115478 Moscow, Russia; (S.V.P.); (A.N.B.); (D.A.P.); (A.K.E.)
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Cost-Effectiveness of Dulaglutide Versus Liraglutide for Management of Type 2 Diabetes Mellitus in Iran. Value Health Reg Issues 2022; 32:54-61. [PMID: 36087364 DOI: 10.1016/j.vhri.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/24/2022] [Accepted: 07/25/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Diabetes mellitus (DM), as one of the most common metabolic diseases, is the ninth leading cause of death globally and imposes heavy costs on the health systems including both costs of treatment and management of secondary complications. This study intended to investigate the cost-effectiveness of dulaglutide compared with liraglutide in the management of patients with type 2 DM in Iran. METHOD We conducted a cost-utility analysis using a 5-state Markov model from the health system perspective, over a 10-year time horizon, in 2018 in Iran. Sensitivity of the model has been evaluated through tornado diagram and using one-way sensitivity analysis. In addition, probabilistic sensitivity analysis has been accomplished using Monte Carlo simulation. RESULTS The average costs of treatment of patients with type 2 DM using the dulaglutide and liraglutide treatment regimens are 17 577.09 and 18 517.54 US dollars per patient, respectively, over a 10-year time horizon. In terms of effectiveness, the average discounted quality-adjusted life-year rates are estimated at 5.560 and 5.403 for the dulaglutide and liraglutide treatment regimens, respectively. The model is mostly sensitive to the price of dulaglutide and liraglutide, the hemoglobin A1c reduction of liraglutide, and the utility resulting from less injection frequency of dulaglutide, respectively. CONCLUSION Dulaglutide, in addition to being more effective, providing 0.156 more quality-adjusted life-years for the patients, reduces costs by 940.45 US dollars per patient over a 10-year time horizon. Therefore, due to the greater effectiveness and lower cost, it is concludable that dulaglutide is the cost-effective (incremental cost-effectiveness ratio = -6028.52) treatment alternative from the health system perspective.
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Suleiman N, Alkasem M, Al Amer Z, Salameh O, Al-Thani N, Hamad MK, Baagar K, Abdalhakam I, Othman M, Dughmosh R, Al-Mohanadi D, Al Sanousi A, Bashir M, Chagoury O, Taheri S, Abou-Samra AB. Qatar Diabetes Mobile Application Trial (QDMAT): an open-label randomised controlled trial to examine the impact of using a mobile application to improve diabetes care in type 2 diabetes mellitus-a study protocol. Trials 2022; 23:504. [PMID: 35710428 PMCID: PMC9205079 DOI: 10.1186/s13063-022-06334-5] [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] [Received: 05/23/2021] [Accepted: 04/23/2022] [Indexed: 11/22/2022] Open
Abstract
Background Mobile health (mHealth) is increasingly advocated for diabetes management. It is unclear if mobile applications are effective in improving glycaemic control, clinical outcomes, quality of life and overall patient satisfaction in patients with type 2 diabetes (T2DM). A new mobile application was specifically built for people with T2DM with the help of the local expertise. The objective of the study was to evaluate the effectiveness of the mobile app. Methods The planned study is an ongoing open-label randomised controlled trial in which adults living with T2DM treated with insulin will be randomised 1:1 to the use of this diabetes application versus current standard care. The primary outcome will be the difference in mean HbA1c from baseline to 6 months. Other outcome measures include anthropometric measures, hypoglycaemic events, medication adjustments, number of clinical interactions and missed appointments and patient perceptions of their disease and diabetes self-management. The study will randomise 180 subjects for assessment of the primary outcome. Discussion We hypothesise that the diabetes-specific mobile application will improve glycaemic control, increase patient empowerment for self-management of diabetes and improve interaction between patients and healthcare providers. If the Qatar Diabetes Mobile Application Trial (QDMAT) demonstrates this, it will inform clinical services for the future self-management of T2DM. Trial registration ClinicalTrials.gov Identifier: NCT03998267. Registered on 26 June 2019
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Affiliation(s)
- Noor Suleiman
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar. .,Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar. .,Department of Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar.
| | - Meis Alkasem
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar
| | - Zaina Al Amer
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Obada Salameh
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Noora Al-Thani
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Khair Hamad
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Khaled Baagar
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | | | - Manal Othman
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Ragae Dughmosh
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Dabia Al-Mohanadi
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar
| | - Ali Al Sanousi
- Clinical Information Systems Department, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Bashir
- Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Odette Chagoury
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar
| | - Shahrad Taheri
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.,Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - New York, New York, USA
| | - Abdul-Badi Abou-Samra
- Qatar Metabolic Institute, Hamad Medical Corporation, Doha, Qatar.,Department of Diabetes and Endocrinology, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - Qatar, Doha, Qatar.,Department of Medicine, Weill Cornell Medicine - New York, New York, USA
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Development and evaluation of a new questionnaire to assess social cognitive factors of self-management in patients with type 2 diabetes: a psychometric study. J Diabetes Metab Disord 2022; 21:483-492. [PMID: 35673441 PMCID: PMC9167319 DOI: 10.1007/s40200-022-00999-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/30/2022] [Indexed: 10/19/2022]
Abstract
Background Self-care behaviors are essential to control blood sugar and to prevent mortality and complications of diabetes. The evidence suggests that social cognitive factors play a crucial role in adopting self-care behaviors. This study aimed to develop and examine the psychometric properties of the Diabetes Self-Management Questionnaire based on the social cognitive theory (DSMQ-SCT). Methods The present methodological cross-sectional study investigated 460 patients with T2DM referred to the Isfahan Endocrine and Metabolism Research Centre, Isfahan, Iran using the convenience sampling method. We assessed the reliability (internal consistency), content validity, convergent validity and construct validity. Construct validity was evaluated using exploratory factor analysis (calibration sample = 230) and confirmatory factor analysis (validation sample = 230). Results In the EFA with the varimax rotation, we extracted four factors that could explain 65.9% of the total variance of the DSMQ-SCT scale. The CFA exhibited a satisfactory fit level for the four-factor structure extracted from the EFA with the following measures. CFI: .971, IFI: .971, NFI: .942, TLI: .966, RMSEA: .046).Internal consistency was good (Cronbach's alpha coefficient for the whole scale: 0.88; the subscales: 0.85 to 0.92). The convergent validity showed significant negative correlations between DSMQ-SCT subscales and HbA1c. Conclusion DSMQ-SCT is a valid and reliable instrument to assess social cognitive factors associated with self-management behaviors in patients with T2DM. Therefore, this instrument can be used in both future research and clinical practices.
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Zalan A, Sheikh-Muhammad A, Khatib M, Sharkia R. The Current and Forecasted Status of Type 2 Diabetes in the Arab Society of Israel. Curr Diabetes Rev 2021; 17:e050421192659. [PMID: 33820521 DOI: 10.2174/1573399817666210405100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 01/20/2021] [Accepted: 02/13/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes mellitus (DM) is considered one of the main causes of mortality, morbidity, and health care expenditures. Effectively treating this disease is of crucial importance and imposes a global challenge. The incidence of Type 2 DM (T2DM) is rapidly rising in both developing and developed countries. The Arab community in Israel is a distinct ethnic group with unique characteristics. Recently, this community has undergone major changes in its lifestyle, adopting the Westernized one, which could have caused an increase in the T2DM incidence rate. OBJECTIVE This review aims to shed light on various studies undertaken to explore the prevalence of diabetes and determine its current status in the Arab society of Israel, resting on previous and current data. It is presented to highlight the status of diabetes globally and to focus on its current situation in the Arab society of Israel, attempting to forecast its direction in the upcoming decade. METHODS Data were obtained from our previous comprehensive socio-economic and health crosssectional surveys for successive periods from 2004 to 2017. These surveys were conducted on the Arab society of Israel by the Galilee Society. RESULTS Our results showed a progressive increase in the prevalence of T2DM from 3.4% to 7.6% in the Arab society of Israel. This trend is expected to continue rising in the coming decade, and based on our predictions, may exceed 12% in 2030. CONCLUSION Substantial and practical health-related actions must be initiated to prevent an increasing number of adults from developing diabetes and its complications.
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Affiliation(s)
- Abdelnaser Zalan
- Unit of Human Biology and Genetics, The Triangle Regional Research and Development Center, Kfar-Qari, Israel
| | - Ahmad Sheikh-Muhammad
- The Galilee Society - The Arab National Society for Research and Health Services, Shefa-Amr, Israel
| | - Mohammad Khatib
- The Galilee Society - The Arab National Society for Research and Health Services, Shefa-Amr, Israel
| | - Rajech Sharkia
- Unit of Human Biology and Genetics, The Triangle Regional Research and Development Center, Kfar-Qari, Israel
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