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Matrook KA, Cowman S, Pertl M, Whitford D. Nurse-led family-based approach in primary health care for patients with type 2 diabetes mellitus: a qualitative study. Int J Qual Stud Health Well-being 2024; 19:2323060. [PMID: 38446054 PMCID: PMC10919304 DOI: 10.1080/17482631.2024.2323060] [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: 09/09/2023] [Accepted: 02/21/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE The prevalence of Type 2 diabetes is rapidly increasing, with 537 million people estimated to have diabetes in 2021. The literature suggests that nurses can deliver effective person-centred diabetes care and that families can be essential in supporting patients. Thus, a Nurse-led Family-based (NLFB) approach may be particularly effective. This study aims to explore the perceptions of nurses, adults with type 2 diabetes, and family members regarding the NLFB intervention. METHODS Guided by the UK Medical Research Council Framework, this seminal study adopted a qualitative, descriptive approach with content analysis. Data were obtained through 16 semi-structured, in-depth interviews. Themes emerged based on an inductive process using constant comparison (Graneheim and Lundman 2004). The COREQ checklist was used in ensuring rigour. RESULTS Three main themes emerged includes: (1) nurses' experiences with current diabetes care practices, (2) stakeholders' views on the development of a NLFB approach, and (3) merging the nurse-led family aspects into the diabetes care. The key challenges are the dominant medical model, lack of specialist nurses, and time. The key facilitators are knowledge and social support. CONCLUSION The study recommends stakeholders embrace nursing empowerment strategies and involve families to enhance the nurses' advanced roles and family inclusion in healthcare.
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Affiliation(s)
- Khadija A. Matrook
- Royal College of Surgeons in Ireland, Medical University of Bahrain, Busaiteen, Bahrain
| | - Seamus Cowman
- School of Nursing and Midwifery, Faculty of Medicine and Health Sciences Royal College of Surgeons, Dublin 2, Ireland
| | - Maria Pertl
- Department of Health Psychology, Faculty of Medicine and Health Sciences Royal College of Surgeons, Dublin 2, Ireland
| | - David Whitford
- Department of General Practice, RCSI & UCD Malaysia Campus, George Town, Pulau Pinang, Malaysia
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Ageru TA, Le CN, Wattanapisit A, Woticha EW, Truong NT, Stanikzai MH, Abiso TL, Suwanbamrung C. Diabetes self-care intervention strategies and their effectiveness in Sub-Saharan Africa: A systematic review. PLoS One 2024; 19:e0305860. [PMID: 39405277 PMCID: PMC11478876 DOI: 10.1371/journal.pone.0305860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/05/2024] [Indexed: 10/19/2024] Open
Abstract
BACKGROUND Diabetes poses a significant public health challenge, predominantly affecting low-and middle-income countries (LMICs), including in Sub-Saharan Africa (SSA). The evolving landscape characterized by resource constraints, gaps in availability and functionality of healthcare system, and socio-demographic impediments has compounded these challenges. As an example, self-care interventions have played a crucial role in diabetes care. However, the effectiveness of these interventions in the SSA remains insufficiently explored. Therefore, this systematic review evaluated the effectiveness and implementation approach of diabetes self-care interventions in SSA. METHOD A comprehensive search was conducted across electronic databases including PubMed, Scopus, and Google Scholar, to identify studies focusing on diabetes self-care interventions in SSA from 2013 to 2023. The included studies reported interventions targeting dietary adherence, physical activity, medication adherence, blood glucose monitoring, foot care, and educational or support programs. The quality of the studies was assessed using the JBI checklist. Effectiveness was assessed through outcomes including glycemic control, adherence rate, complication reduction, and improvement in patient outcomes. RESULT Overall, 38.5% of interventions result showed positive changes in either primary or secondary outcomes. Studies that employed diabetes self-management education showed positive changes in approximately 28.6% of cases. However, SMS text messaging interventions did not demonstrate significant changes in the measured outcomes. Of the 13 studies reviewed, 12 used randomized controlled trial designs, whereas one study employed a quasi-experimental approach. The total of participants across intervention and control groups was 3172 adults with diabetes. The interventions employed various strategies including diabetes self-management education led by nurses and other professionals, SMS text messaging for treatment adherence, and other targeted approaches. The duration of these interventions varied from 2 to 12 months. Specific interventions, such as glucose machine provision with training, family support with culturally tailored educations, and periodontal treatment, exhibited notable improvement in adherences and reductions in HbA1c levels. CONCLUSION The review underscores the significance of diabetes self-care interventions in SSA, showing varying effectiveness levels across different strategies. It emphasizes the importance of tailored approaches and highlight interventions that have shown promising outcomes, providing insights for future research, policy, and healthcare strategies in the region.
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Affiliation(s)
- Temesgen Anjulo Ageru
- Public Health Research Program, School of Public Health, Walailak University, Nakhon Si Thamarata, Thailand
- Excellent Center of Dengue and Community Public Health (EC for DACH), Walailak University, Nakhon Si Thamarata, Thailand
- Wolaita Sodo University College of Medicine and Health Sciences, Wolaita Sodo, Ethiopia
| | - Cua Ngoc Le
- Public Health Research Program, School of Public Health, Walailak University, Nakhon Si Thamarata, Thailand
- Excellent Center of Dengue and Community Public Health (EC for DACH), Walailak University, Nakhon Si Thamarata, Thailand
| | | | | | - Nam Thanh Truong
- Public Health Research Program, School of Public Health, Walailak University, Nakhon Si Thamarata, Thailand
- Excellent Center of Dengue and Community Public Health (EC for DACH), Walailak University, Nakhon Si Thamarata, Thailand
- Faculty of Public Health, Can Tho University of Medicine and Pharmacy, Can Tho city, Vietnam
| | - Muhammad Haroon Stanikzai
- Public Health Research Program, School of Public Health, Walailak University, Nakhon Si Thamarata, Thailand
- Excellent Center of Dengue and Community Public Health (EC for DACH), Walailak University, Nakhon Si Thamarata, Thailand
- Faculty of Medicine, Department of Public Health, Kandahar University, Kandahar, Afghanistan
| | - Temesgen Lera Abiso
- Wolaita Sodo University College of Medicine and Health Sciences, Wolaita Sodo, Ethiopia
| | - Charuai Suwanbamrung
- Public Health Research Program, School of Public Health, Walailak University, Nakhon Si Thamarata, Thailand
- Excellent Center of Dengue and Community Public Health (EC for DACH), Walailak University, Nakhon Si Thamarata, Thailand
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Riangkam C, Ruksakulpiwat S, Jariyasakulwong P, Panichpathom V, Phianhasin L. Educational Interventions for Individuals with Insulin-Treated Type 2 Diabetes Mellitus: A Systematic Review. Patient Prefer Adherence 2024; 18:1831-1843. [PMID: 39262821 PMCID: PMC11389829 DOI: 10.2147/ppa.s482882] [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: 06/15/2024] [Accepted: 08/21/2024] [Indexed: 09/13/2024] Open
Abstract
Objective To evaluate and synthesize evidence on the impact of educational interventions for individuals with insulin-treated type 2 diabetes mellitus (T2DM). Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, five electronic databases (Scopus, PubMed, Medline, CINAHL Plus with Full Text, and Web of Science) were systematically searched in February 2024. The search focused on studies published between 2019 and 2024 that investigated the impact of educational interventions on individuals with insulin-treated T2DM. Reference lists of the included studies were also manually searched. Titles and abstracts were screened for eligibility, and relevant full texts were assessed. Results Out of 1,032 identified records, 11 studies met the inclusion criteria. According to the data synthesized using a convergent integrated analysis framework, five major themes have emerged: 1) Glycemic control (including subthemes improving HbA1C, decreasing postprandial plasma glucose, and decreasing fasting plasma glucose), 2) Insulin-related complications (including subthemes reducing hypoglycemic events and reducing the size of lipohypertrophy), 3) Knowledge, Attitude, and Practice (including subthemes engaging in self-management, improving insulin injection technique, improving knowledge, and improving attitude toward insulin treatment), 4) Optimal dose of insulin, and 5) Improving quality of life. Conclusion Educational interventions are crucial for improving diabetes-related outcomes and reducing complications in individuals with insulin-treated T2DM. These interventions enhance knowledge, attitudes, and self-management practices, leading to better glycemic control and quality of life. Healthcare settings should develop and provide tailored educational programs for individuals with insulin-treated T2DM to optimize outcomes and minimize complications.
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Affiliation(s)
- Chontira Riangkam
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Suebsarn Ruksakulpiwat
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | | | - Varaporn Panichpathom
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
| | - Lalipat Phianhasin
- Department of Medical Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand
- Department of Behavioral Nursing and Health Informatics, School of Nursing, University of Washington, Seattle, WA, USA
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Aldahmashi H, Maneze D, Molloy L, Salamonson Y. Nurses' adoption of diabetes clinical practice guidelines in primary care and the impacts on patient outcomes and safety: An integrative review. Int J Nurs Stud 2024; 154:104747. [PMID: 38531197 DOI: 10.1016/j.ijnurstu.2024.104747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/26/2024] [Accepted: 02/29/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Complications related to diabetes mellitus impose substantial health and economic burdens to individuals and society. While clinical practice guidelines improve diabetes management in primary care settings, the variability in adherence to these guidelines persist. Hence, there is a need to comprehensively review existing evidence regarding factors influencing nurses' adherence to implementation of clinical practice guidelines to improve clinical care and patient safety. OBJECTIVE This integrative review seeks to investigate nurses' adherence to clinical guidelines for diabetes management in primary healthcare settings and to explore factors influencing effective implementation, focusing on the role of nurses and impacts on patient outcomes. METHODS A comprehensive search was conducted in March 2023 across six electronic databases. The search targeted studies that examined the use of Type 2 diabetes mellitus guidelines by nurses in primary healthcare settings with a focus on clinical management outcomes related to diabetes care or patient safety. Included studies were classified using the Effective Practice and Organisation of Care taxonomy, synthesised narratively and presented thematically. Reporting of the review adhered to PRISMA guidelines. (PROSPERO ID CRD42023394311). RESULTS The review included ten studies conducted between 2000 and 2020, and the results were categorised into three themes. These were: (i) Implementation strategies to promote clinical practice guidelines adherence, including health professional development, reminders for clinicians, patient-mediated interventions, health information systems, role expansion, and comprehensive package-of-care. A multifaceted educational approach emerged as the most effective strategy. (ii) Impact of guidelines adherence: These strategies consistently improved clinical management, lowering HbA1c levels, improving blood pressure and lipid profiles, and enhancing patient self-care engagement, along with increased nurses' adherence to diabetes clinical guidelines. (iii) The role of nurses in guideline implementation, enabling independent practice within multidisciplinary teams. Their roles encompassed patient education, collaborative practice with fellow healthcare professionals, program planning and execution, and comprehensive documentation review. Nurse-led interventions were effective in improving patient outcomes, underscoring the necessity of empowering nurses with greater autonomy in providing primary diabetes care. CONCLUSION Implementing a diverse range of strategies, focusing on comprehensive education for healthcare providers, is paramount for enhancing guideline adherence in diabetes care, to improve clinical management towards optimal patient health outcomes. Tailoring these strategies to meet local needs adds relevance to the guidelines. Empowering nurses to take a leading role in primary care not only enhances patient safety but also promotes quality of care, resulting in improved overall outcomes. TWEETABLE ABSTRACT In primary care, empowering nurses with diabetes guideline education and tailoring strategies to local needs enhance guideline adherence and improve patient outcomes.
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Affiliation(s)
- Hadwan Aldahmashi
- School of Nursing, University of Wollongong, Wollongong, Sydney, Australia; College of Applied Medical Sciences, University of Hafr Albatin, Saudi Arabia.
| | - Della Maneze
- School of Nursing, University of Wollongong, Wollongong, Sydney, Australia; School of Nursing and Midwifery, Western Sydney University, Australia; Australian Centre for Integration of Oral Health, Australia.
| | - Luke Molloy
- School of Nursing, University of Wollongong, Wollongong, Sydney, Australia.
| | - Yenna Salamonson
- School of Nursing, University of Wollongong, Wollongong, Sydney, Australia; Australian Centre for Integration of Oral Health, Australia.
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Zhu X, Ren B, Liu W, Lei S, Lin S, Liu Q, Yin L, Feng B. The short- and long-term effects of community-family-doctor-based type 2 diabetes self-management interventions. Public Health 2024; 230:96-104. [PMID: 38521030 DOI: 10.1016/j.puhe.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/27/2024] [Accepted: 02/16/2024] [Indexed: 03/25/2024]
Abstract
OBJECTIVES The popularity of contracted family doctor services in China has been growing in recent years, but community-family-doctor-based type 2 diabetes mellitus (T2DM) intervention programs have yet to be adequately studied. This study was to evaluate the short- and long-term effects of community-family-doctor-based self-management interventions for T2DM and to explore strategies for long-term glycemic control. STUDY DESIGN This was a randomized controlled trial. METHODS A total of 144 eligible participants were randomly assigned to intervention and control groups. The control group received only routine community diabetes care, and the intervention group received community-family-doctor-based interventions involving the same standard of care. The interventions lasted for 3 months, and the follow-up was continued for 15 months. Intention-to-treat analysis and generalized estimation equations were then used to determine the short- and long-term effects of the interventions on glycated hemoglobin (HbA1c), diabetes self-management, and medication adherence. RESULTS There were statistically significantly greater improvements in all aspects of the intervention group after 3 months of intervention. Compared with baseline, changes in the attitude (β = 0.384, 95% confidence interval [CI; 0.194, 0.574], P < 0.001), practice (β = 1.751, 95% CI [0.762, 2.739], P = 0.001), and knowledge, attitudes, practice total scores (β = 2.338, 95% CI [0.682, 3.995], P = 0.006) of patients in the intervention group were statistically significant after 15 months, and the HbA1c (8.19 ± 1.73%), knowledge (16.42 ± 3.21), and medication adherence (5.53 ± 1.76) scores were slightly better than those at baseline, although not statistically significant (P > 0.05). CONCLUSIONS T2DM self-management interventions based on community family doctors improved patients' HbA1c, diabetes self-management, and medication adherence, did not do so significantly in the long term.
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Affiliation(s)
- Xiaoying Zhu
- The Department of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Biqi Ren
- The Department of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China; Xi'an People's Hospital (Xi'an Fourth Hospital), Xi'an, Shaanxi, China
| | - Wei Liu
- The Department of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shuang Lei
- The Department of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Shuzhi Lin
- The Department of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qian Liu
- The Department of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Lin Yin
- The Department of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Bianling Feng
- The Department of Pharmacy Administration, School of Pharmacy, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
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Teli M, Thato R, Hasan F, Rias YA. Effectiveness of Family-Based Diabetes Management Intervention on Glycated Haemoglobin Among Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Biol Res Nurs 2024; 26:315-333. [PMID: 38063030 DOI: 10.1177/10998004231218887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2024]
Abstract
BACKGROUND Glycated hemoglobin (HbA1c) control is a crucial goal in the management of type 2 diabetes mellitus (T2DM), requiring lifelong commitment and family support. This study aimed to assess the effectiveness of family-based diabetes management intervention on HbA1c among adults with T2DM. METHODS From inception up to 2022, a comprehensive literature search was conducted across PubMed, ProQuest, Scopus, CORE, and the Cochrane Library. The quality of studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal tools. Effect sizes were calculated using standard deviations (SD), while the degree of heterogeneity was evaluated using the Higgins I2 test. Subgroup analyses were performed to explore factors contributing to sources of heterogeneity among trials. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed, and the protocol was registered with PROSPERO CRD42022384034. RESULTS A total of 18 randomized controlled trials (RCTs) involving 2815 participants indicated that family-based diabetes management intervention had a statistically significant impact on improving HbA1c (Mean Difference [MD] = -.47; 95% Confidence Interval [CI]: -.64 to -.30, p < .001) with a moderate level of heterogeneity (I2 = 59%). Subgroup analysis indicated that family-based diabetes management intervention among adults with T2DM in developing regions was more effective in improving HbA1c levels compared to developed countries. CONCLUSION Family-based diabetes management interventions improved HbA1c. Further research is required to develop diabetes management strategies with a family focus that clearly defines the family's involvement.
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Affiliation(s)
- Margareta Teli
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Nursing School, Polytechnic of Health Ministry of Health Kupang, Kupang, Indonesia
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Faizul Hasan
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Yohanes Andy Rias
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Faculty of Health, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
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Holloway D, James S, Ekinci E, Craft J. Systematic review of the effectiveness of nurse-led care in reducing glycated haemoglobin in adults with Type 1 or 2 diabetes. Int J Nurs Pract 2023; 29:e13135. [PMID: 36733216 DOI: 10.1111/ijn.13135] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 01/05/2023] [Accepted: 01/09/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Type 1 and 2 diabetes care, especially within primary health-care settings, has traditionally involved doctor-led clinics. However, with increasing chronic disease burden, there is scope for nurses to expand their role in assisting diabetes self-management. AIMS This study aimed to determine the effectiveness of nurse-led care in reducing glycated haemoglobin in adults with Type 1 or 2 diabetes. METHODS Methodology from the Joanna Briggs Institute Method for Systematic Review Research and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, including identifying publications, assessing study quality, summarizing evidence and interpreting findings. The search strategy involved using the Medical Subject Headings and keyword variations when searching MEDLINE (Ovid), Scopus, PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases. Inclusion criteria were samples with Type 1 or 2 diabetes, mean age of ≥18 years, English language studies and publication date of January 2011-December 2021. RESULTS Overall, 34 articles from 16 countries met inclusion criteria. Though not always clinically significant, results indicated that nurse-led care had beneficial impacts on glycated haemoglobin values, with reductions from 0.03% to 2.0%. This was evident when nurses received formal training, used treatment algorithms, had limited medical support, utilized technology and offered defined culturally sensitive and appropriate diabetes care. CONCLUSIONS Findings support nurse-led Type 1 and 2 diabetes care. Although further research is required, changes may necessitate increased recognition of nurse-led care and funding. Nurse-led care models should differ according to health-care settings.
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Affiliation(s)
- Danielle Holloway
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Caboolture, Queensland, Australia
| | - Steven James
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Petrie, Queensland, Australia
| | - Elif Ekinci
- Department of Medicine, Austin Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Judy Craft
- School of Nursing, Midwifery and Paramedicine, University of the Sunshine Coast, Caboolture, Queensland, Australia
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Chane-Po D, Gatina JH, Leruste S, Legrand F. Knowledge of type 2 diabetic patients followed for less than 5 years in primary care in the western region of Reunion Island: a cross-sectional pilot study. PEC INNOVATION 2023; 2:100122. [PMID: 37214534 PMCID: PMC10194262 DOI: 10.1016/j.pecinn.2023.100122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 12/15/2022] [Accepted: 01/13/2023] [Indexed: 05/24/2023]
Abstract
Background The learning needs of newly diagnosed diabetic patients followed up in medical offices in Reunion Island are unknown, although necessary for the improvement of education programmes and disease control. Aim To assess the knowledge of type 2 diabetic patients in primary care followed for less than 5 years. Method A cross-sectional study was carried out, using a self-questionnaire to assess patients' knowledge of diabetes, complications, follow-up, diet and physical activity. Patients were recruited from medical offices in the western region of Reunion Island. Results From 23rd April to 31st July 2021, 89 patients were included. The knowledge level of the total sample was moderate (mean correct answers 65 % ± 17). The best knowledge levels were in the areas "generalities on diabetes" and "complications", while the lowest levels were in the categories "follow-up" and "diet and physical activity". Glycated haemoglobin, libido disorders, frequency of urinalysis and dental consultation, and the recommended diet for patients with diabetes which is the same as for the general population, were the least known concepts. Conclusion This study revealed gaps in patients' knowledge that could be used to improve education programmes which in turn could reduce or prevent diabetes complications.
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Affiliation(s)
- David Chane-Po
- Université de La Réunion – UFR Santé – Département Universitaire de Médecine Générale, Site de l’IES, CHU Réunion, Terre Sainte BP 350, 97448, Saint Pierre, France
| | - Jean-Hugues Gatina
- Service de Diabétologie-Endocrinologie, Centre Hospitalier Ouest Réunion, 97460, Saint Paul, Réunion
| | - Sébastien Leruste
- Université de La Réunion – UFR Santé – Département Universitaire de Médecine Générale, Site de l’IES, CHU Réunion, Terre Sainte BP 350, 97448, Saint Pierre, France
- Institut national de la santé et de la recherche médicale (INSERM), CIC 1410, Saint Pierre, Réunion
| | - Florian Legrand
- Université de La Réunion – UFR Santé – Département Universitaire de Médecine Générale, Site de l’IES, CHU Réunion, Terre Sainte BP 350, 97448, Saint Pierre, France
- Institut de recherche pour le développement (IRD), laboratoire CEPED — Unité mixte de recherche (UMR) 196, Université de Paris, 45, rue des Saints-Pères, 75006 Paris, France
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Clark KK, Gutierrez J, Cody JR, Padilla BI. Implementation of Diabetic Retinopathy Screening in Adult Patients With Type 2 Diabetes in a Primary Care Setting. Clin Diabetes 2023; 42:223-231. [PMID: 38694241 PMCID: PMC11060615 DOI: 10.2337/cd23-0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2024]
Abstract
Diabetic retinopathy (DR) is a microvascular complication of type 2 diabetes and the leading cause of blindness globally. Although diabetes-related eye exams are widely recognized as an effective method for early detection of DR, which can help to prevent eventual vision loss, adherence to screening exams in the United States is suboptimal. This article describes a quality improvement project to increase DR screening rates and increase knowledge and awareness of DR in adults with type 2 diabetes in a primary care setting using mobile DR screening units. This project addressed gaps of care and demonstrated that primary care settings can increase access to DR screening through a patient-centered process and thereby help to prevent irreversible outcomes of DR and improve quality of life.
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Alkubati SA, Albagawi B, Alharbi TA, Alharbi HF, Alrasheeday AM, Llego J, Dando LL, Al-Sadi AK. Nursing internship students' knowledge regarding the care and management of people with diabetes: A multicenter cross-sectional study. NURSE EDUCATION TODAY 2023; 129:105902. [PMID: 37459829 DOI: 10.1016/j.nedt.2023.105902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 06/24/2023] [Accepted: 07/12/2023] [Indexed: 08/14/2023]
Abstract
BACKGROUND Nursing students in their final year of study will soon become responsible for the care and management of people with diabetes, and they need to be knowledgeable to provide adequate information. OBJECTIVES The aim of this study was to assess nursing students' knowledge regarding diabetes care and management. DESIGN A descriptive cross-sectional multicenter study. SETTINGS AND PARTICIPANTS A convenience sample of all nursing students' internship enrolled at three government universities in Saudi Arabia. METHODS 306 Saudi nursing students were surveyed with a self-administered questionnaire of the sociodemographic characteristics of the participants. The second part contained 23 multiple-choice questions of the Michigan Diabetes Knowledge Test. Data were collected from July to September 2022. RESULTS The overall percentage of correct responses was 49.28 %. There was a significant difference between sex, the university attended, attendance in courses related to diabetes, and diabetes management guidelines in any course and their knowledge about diabetes care and management (p = 0.024, 0.001, 0.036, and 0.038, respectively). There was a significant difference between nursing students' general knowledge and insulin use knowledge (p = 0.001). A multiple regression analysis revealed that the university attended was the only statistically significant factor (p = 0.001). CONCLUSION Nursing internship students are likely to be responsible for providing people with diabetes care and management once they qualify. Inappropriate knowledge negatively affects the care and management of people with diabetes. Information related to diabetic insulin therapy should be provided in more detail in the nursing curriculum.
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Affiliation(s)
- Sameer A Alkubati
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail City, Saudi Arabia; Department of Nursing, Faculty of Medicine and Health Sciences, Hodeida University, Hodeida, Yemen.
| | - Bander Albagawi
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail City, Saudi Arabia
| | - Talal A Alharbi
- Department of Community, Psychiatric and Mental Health Nursing, College of Nursing, Qassim University, Buraidah, Saudi Arabia
| | - Hanan F Alharbi
- Maternity and Child Health Nursing Department, College of Nursing, Princess Nourah bint Abdulrahman University. P.O. Box 84428, Riyadh 11671, Saudi Arabia
| | - Awatif M Alrasheeday
- Nursing Administration Department, College of Nursing, University of Hail, Hail, Saudi Arabia
| | - Jordan Llego
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail City, Saudi Arabia
| | - Lea L Dando
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail City, Saudi Arabia
| | - Ahmad K Al-Sadi
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail City, Saudi Arabia
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Albagawi B, Alkubati SA, Abdul-Ghani R. Levels and predictors of nurses' knowledge about diabetes care and management: disparity between perceived and actual knowledge. BMC Nurs 2023; 22:342. [PMID: 37770877 PMCID: PMC10537144 DOI: 10.1186/s12912-023-01504-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/12/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Nurses have a crucial role in managing, educating, and caring for diabetic patients. However, their knowledge should be regularly assessed to avoid preventable complications and reduce costs. Therefore, the present study assessed the perceived and actual knowledge about diabetes among nurses in Hail province of Saudi Arabia and investigated predictors of such knowledge. METHODS A cross-sectional study was conducted among 325 conveniently sampled nurses from all public hospitals and primary healthcare centres in Hail province from September to December 2022. A pre-designed questionnaire was used to collect demographic and practice-related characteristics of the nurses. In addition, data on nurses' perceived and actual knowledge about diabetes were collected using the Diabetes Self-Report Tool (DSRT) and Diabetes Basic Knowledge Tool (DBKT) self-report questionnaires, respectively. The mean knowledge scores for demographic and practice-related variables were compared using the independent-samples t-test and one-way analysis of variance. Multiple linear regression was used to identify significant predictors of perceived and actual knowledge. The correlation between perceived and actual knowledge was investigated using Pearson's correlation coefficient. A P-value ˂0.05 was considered statistically significant. RESULTS Based on a highest maximum score of 60 using the DSRT, the mean score of perceived knowledge was 38.4 ± 12.0, corresponding to a percentage mean score of 64%. On the other hand, based on a highest maximum score of 49 using the DBKT, the mean score of actual knowledge was 23.2 ± 9.6, corresponding to a percentage mean score of 47.3% of correct responses. Being Indian, having a diploma or a bachelor's degree, and having a poor or fair self-perception of competence in diabetes care were predictors of lower perceived knowledge scores, whereas having no access to diabetes guidelines was a predictor of higher scores. However, being non-Saudi and having experience of at least 16 years were predictors of higher actual knowledge scores. The correlation between actual and perceived knowledge about diabetes was negligible and statistically non-significant (r = 0.011, P = 0.055). CONCLUSION Nurses affiliated with public health facilities in Hail province lack adequate knowledge about diabetes, with no correlation between what is perceived to be known and what is actually known. Indian citizenship, having a diploma or bachelor's degree, not having access to diabetes guidelines, not attending courses/workshops, and having a poor or fair self-perception of competence in diabetes care can significantly predict nurses' perceived knowledge. However, being non-Saudi (Filipino or Indian) and having at least 16 years of experience can significantly predict their actual knowledge of diabetes.
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Affiliation(s)
- Bander Albagawi
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail City, Saudi Arabia
| | - Sameer A Alkubati
- Department of Medical Surgical Nursing, College of Nursing, University of Hail, Hail City, Saudi Arabia.
- Department of Nursing, Faculty of Medicine and Health Sciences, Hodeida University, Hodeida, Yemen.
| | - Rashad Abdul-Ghani
- Faculty of Medicine and Health Sciences, Sana'a University, Sana'a, Yemen
- Tropical Disease Research Center, Faculty of Medicine and Health Sciences, University of Science and Technology, Sana'a, Yemen
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12
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Diriba DC, Suen LKP, Leung DYP. Effects of a culturally tailored, family-supported, community-based self management education and support programme on clinical outcomes among adults with type 2 diabetes in Western Ethiopia: A pilot randomised controlled trial. Diabet Med 2023:e15094. [PMID: 36995364 DOI: 10.1111/dme.15094] [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: 06/23/2022] [Revised: 03/09/2023] [Accepted: 03/27/2023] [Indexed: 03/31/2023]
Abstract
AIM To examine the preliminary effects of a culturally tailored, family-supported, community-based diabetes self management education and support (DSMES) programme for Ethiopian people with type 2 diabetes on glycosylated haemoglobulin (HbA1c ), blood pressure, body mass index and lipid profiles. METHODS A two-arm pilot randomised controlled trial (RCT) was conducted involving 76 participant-caregiver dyads from Western Ethiopia, which were randomly allocated to the intervention arm to receive 12 h of DSMES intervention guided by social cognitive theory on top of usual care, or to the control group, which received usual care. While HbA1c was a primary outcome, the blood pressure, body mass index and lipid profiles were secondary outcomes. Primary outcome was the change in HbA1c between baseline and 2-month follow-up between the groups. Generalised estimating equations was used to test the preliminary effect of the DSMES programme on the outcomes at baseline, post-intervention and at 2-month follow-up for secondary outcomes. Cohen's d was used to estimate the between-group effect sizes of the intervention. RESULTS The DSMES produced significant improvement in HbA1c with large effect size (β = -1.667, p < 0.001, d = -0.81) and triglycerides with medium effect size (d = -0.50). HbA1c in the intervention group was decreased by 12 mmol/mol (1.1%). Although nonsignificant, the DSMES also had small to moderate effects (d = -0.123 to 0.34) on blood pressure, body mass index, total cholesterol, low-density and high-density lipoproteins when compared with usual care. CONCLUSION A culturally tailored, social cognitive theory-guided, family-supported, community-based DSME programme could have a benefit on HbA1c and triglycerides. A full RCT is warranted to test the effectiveness of the DSMES programme.
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Affiliation(s)
| | | | - Doris Y P Leung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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13
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Hills S, Terry D, Gazula S, Browning C. Practice nurses' communication with people living with type 2 diabetes: A scoping review. PATIENT EDUCATION AND COUNSELING 2022; 105:2664-2670. [PMID: 35393227 DOI: 10.1016/j.pec.2022.03.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 01/05/2022] [Accepted: 03/27/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To identify the key characteristics of practice nurses' communication with people living with Type 2 Diabetes (T2D) where lifestyle activities are discussed. METHODS A scoping review of the peer-reviewed literature was conducted. Reflexive thematic analysis was used to identify key themes that emerged. The PRISMA-ScR checklist was followed. RESULTS 25 studies were retained in the final review. Nurses who were committed to engaging in lifestyle discussions created supportive environments and built rapport to enable change conversations. However, this was present in just 20% of the studies. In most studies, (60%) nurses continued to use traditional health education communication styles, had little understanding of behaviour change theories, lacked skills in behaviour change counselling and were reluctant to engage in behaviour change discussions with people with T2D . CONCLUSIONS Nurses require a deeper understanding of behavioural change theories and skills in behavioural counselling. PRACTICE IMPLICATIONS Practice nurses have a unique opportunity to facilitate T2D remission by engaging in evidence-based behaviour change communication. A behaviour change training intervention is needed that recognises the environment of practice nurse consultations. It needs to be pragmatic and fully consider the enablers and barriers to addressing behaviour change in both the nurse and the person with T2D.
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Affiliation(s)
- Sharon Hills
- Federation University Australia, Institute of Health and Wellbeing, PO Box 663, Ballarat, VIC 3353, Australia.
| | - Daniel Terry
- Federation University Australia, Institute of Health and Wellbeing, PO Box 663, Ballarat, VIC 3353, Australia.
| | - Swapnali Gazula
- Federation University Australia, Institute of Health and Wellbeing, PO Box 663, Ballarat, VIC 3353, Australia.
| | - Colette Browning
- Federation University Australia, Institute of Health and Wellbeing, PO Box 663, Ballarat, VIC 3353, Australia; Australia Research School of Population Health, Australian National University; Health Innovation and Transformation Centre, Federation University.
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14
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Talavera Pérez ML, Fontseré Casadesús AM, Raya Tena A. [Primary care nurses: role and responsabilities]. Aten Primaria 2022; 54:102345. [PMID: 35605381 PMCID: PMC9126776 DOI: 10.1016/j.aprim.2022.102345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 02/25/2022] [Indexed: 12/03/2022] Open
Affiliation(s)
- María Luz Talavera Pérez
- Centre de Salut Joan Mirambell i Folch, Institut Català de la Salut (ICS), Caldes de Montbui, Barcelona, España.
| | | | - Antonia Raya Tena
- Centre de Salud Raval Nord, Institut Català de la Salut (ICS), Barcelona, España
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15
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Qin W, Ren X, Zhao L, Guo L. Exposure to perfluorooctane sulfonate reduced cell viability and insulin release capacity of β cells. J Environ Sci (China) 2022; 115:162-172. [PMID: 34969446 DOI: 10.1016/j.jes.2021.07.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/05/2021] [Accepted: 07/05/2021] [Indexed: 05/20/2023]
Abstract
Per- and polyfluoroalkyl substances (PFAS) are found to have multiple adverse outcomes on human health. Recently, epidemiological and toxicological studies showed that exposure to PFAS had adverse impacts on pancreas and showed association with insulin abnormalities. To explore how PFAS may contribute to diabetes, we studied impacts of perfluorooctane sulfonate (PFOS) on cell viability and insulin release capacity of pancreatic β cells by using in vivo and in vitro methods. We found that 28-day administration with PFOS (10 mg/(kg body weight•day)) caused reductions of pancreas weight and islet size in male mice. PFOS administration also led to lower serum insulin level both in fasting state and after glucose infusion among male mice. For cell-based in vitro bioassay, we used mouse β-TC-6 cancer cells and found 48-hr exposure to PFOS decreased the cell viability at 50 μmol/L. By measuring insulin content in supernatant, 48-hr pretreatment of PFOS (100 μmol/L) decreased the insulin release capacity of β-TC-6 cells after glucose stimulation. Although these concentrations were higher than the environmental concentration of PFOS, it might be reasonable for high concentration of PFOS to exert observable toxic effects in mice considering mice had a faster removal efficiency of PFOS than human. PFOS exposure (50 μmol/L) to β-TC-6 cells induced intracellular accumulation of reactive oxidative specie (ROS). Excessive ROS induced the reactive toxicity of cells, which eventually invoke apoptosis and necrosis. Results in this study provide evidence for the possible causal link of exposure to PFOS and diabetes risk.
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Affiliation(s)
- Weiping Qin
- State Key Laboratory of Environmental Chemistry and Eco-toxicology, Research Center for Eco-environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Xiaomin Ren
- State Key Laboratory of Environmental Chemistry and Eco-toxicology, Research Center for Eco-environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Lixia Zhao
- State Key Laboratory of Environmental Chemistry and Eco-toxicology, Research Center for Eco-environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Lianghong Guo
- Institute of Environmental and Health Sciences, China Jiliang University, Hangzhou 310018, China.
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16
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Effectiveness of Strategies for Nutritional Therapy for Patients with Type 2 Diabetes and/or Hypertension in Primary Care: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074243. [PMID: 35409925 PMCID: PMC8998242 DOI: 10.3390/ijerph19074243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/05/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023]
Abstract
A central aspect to the management of type 2 Diabetes Mellitus (T2DM) and hypertension is promoting a healthy lifestyle, and nutritional therapy (NT) can support patients achieving glycemic control and blood pressure targets. This systematic review aimed to evaluate the effectiveness of NT in the management of patients with T2DM and/or hypertension in primary care. Primary outcomes were HbA1c, systolic blood pressure (SBP) and diastolic blood pressure (DBP). Thirty-nine studies were included, thirty on T2DM and nine on hypertension. With a moderate quality of evidence, educational/counseling programs and food replacement programs in primary care likely reduce HbA1c on patients with T2DM (mean difference (MD): −0.37, 95% CI: −0.57 to −0.17, 7437 patients, 27 studies; MD: −0.54, 95% CI: −0.75 to −0.32, 440 patients, 2 studies, respectively). Mediterranean diet for T2DM was accessed by one study, and no difference between the groups was found. Educational and counseling programs likely reduce DBP in patients with hypertension (MD: −1.79, 95% CI: −3.46, −0.12, 2840 patients, 9 studies, moderate quality of the evidence), but the effect in SBP was unclear due to risk of bias and imprecision. Nutritional therapy strategies (i.e., educational/counseling programs and food replacement programs) in primary care improved HbA1c in patients with T2DM and DBP in individuals with hypertension.
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17
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Singh S, Zettel S. Nurse-led dialogue-driven digital platform-based personalised education programmes may improve diabetes management of patients on basal insulin therapy. Evid Based Nurs 2022; 25:ebnurs-2021-103496. [PMID: 35346979 DOI: 10.1136/ebnurs-2021-103496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2022] [Indexed: 06/14/2023]
Affiliation(s)
- Shaminder Singh
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Alberta, Canada
| | - Stephanie Zettel
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, Alberta, Canada
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18
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Othman MM, Khudadad H, Dughmosh R, Furuya-Kanamori L, Abou-Samra AB, Doi SAR. Towards a better understanding of self-management interventions in type 2 diabetes: A concept analysis. Prim Care Diabetes 2022; 16:142-149. [PMID: 34556438 DOI: 10.1016/j.pcd.2021.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 08/22/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Diabetes self-management educational (DSME) interventions can vary considerably, and it is unclear what is the operational conceptualization of the ideal delivery to individuals with type 2 diabetes (T2D). DESIGN From a search conducted concurrently we extracted and evaluated the 50 most recently published DSME intervention studies. Based on an analysis of these studies, we undertook a concept analysis using the Walker and Avant framework. RESULTS Five attributes describing the concept were recognized and organized into two groups. Group (a): skills related attributes that included (1) decision making, (2) problem solving and (3) taking action. Group (b): information related attributes that included (4) patient-provider interaction and (5) resource utilization. CONCLUSIONS The outcomes of this study make the operational conceptualization of the ideal DSME intervention measurable through its attributes and hence clarifies its delivery. This will improve the implementation of the key attributes in diabetes self-management intervention programs for T2D.
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Affiliation(s)
- Manal M Othman
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar; Medicine Department, Hamad General Hospital, Doha, Qatar.
| | - Hanan Khudadad
- Department of Clinical Research, Primary Health Care Corporation, Doha, Qatar.
| | - Ragae Dughmosh
- Medicine Department, Hamad General Hospital, Doha, Qatar.
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia.
| | - Abdul-Badi Abou-Samra
- Qatar Metabolic Institute and Medicine Department, Hamad Medical Corporation, Doha, Qatar.
| | - Suhail A R Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
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19
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Zhang H, Zhang Q, Luo D, Cai X, Li R, Zhang Y, Lu Y, Liu J, Gu J, Li M. The effect of family-based intervention for adults with diabetes on HbA1c and other health-related outcomes: Systematic review and meta-analysis. J Clin Nurs 2021; 31:1488-1501. [PMID: 34888968 DOI: 10.1111/jocn.16082] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/11/2021] [Accepted: 10/03/2021] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES To evaluate the effectiveness of family-based intervention for adults with diabetes on glycosylated haemoglobin and other health-related outcomes. BACKGROUND The impact of family-based intervention on adults with diabetes has been evaluated in various studies, but there is uncertainty about their effect on health-related outcomes for adults with diabetes. DESIGN A systematic review and meta-analysis of randomised controlled trials. METHODS A review was performed and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Six relevant databases were searched from inception to 5 March 2021. Heterogeneity between studies was quantified by using Higgins' I2 test. Sensibility and subgroup analyses were used to explore potential heterogeneity. RESULTS The review included 23 studies (3,114 participants). Family-based intervention had a significant effect on improving glycosylated haemoglobin levels, body mass index, blood pressure, fasting glucose, diabetes self-care, diabetes self-efficacy, diabetes distress and positive family support. Non-significant results were obtained for blood lipid, body weight, depression and negative family support. In particular, subgroup analyses indicated that family-based intervention in Asian regions was more effective in improving glycosylated haemoglobin levels than in other areas. CONCLUSION Family-based intervention may improve diabetes control, diabetes self-care, psychological well-being and positive family support in adults with diabetes and is especially effective in Asian regions. Given the limitations in current studies, further studies are recommended to combine family theory with family-based intervention, and to examine the effectiveness of such intervention for family members. RELEVANCE TO CLINICAL PRACTICE This review and meta-analysis provides evidence that family-based intervention can improve positive family support, which has a good effect on diabetes control and psychological well-being in adults with diabetes, and it is especially effective in Asian regions. Findings suggested that unreinforced participation by family members and integrating flexible strategies into family-based intervention may be equally effective.
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Affiliation(s)
- Huijing Zhang
- School of Nursing, Peking University, Beijing, China
| | - Qi Zhang
- School of Nursing, Peking University, Beijing, China
| | - Dan Luo
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xue Cai
- Nursing Department, ZhongDa Hospital Southeast University, Nanjing, China
| | - Ruxue Li
- School of Nursing, Peking University, Beijing, China
| | - Yating Zhang
- School of Nursing, Peking University, Beijing, China
| | - Yanhui Lu
- School of Nursing, Peking University, Beijing, China
| | - Jiajia Liu
- School of Nursing, Peking University, Beijing, China
| | - Jiaxin Gu
- School of Nursing, Peking University, Beijing, China
| | - Mingzi Li
- School of Nursing, Peking University, Beijing, China
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20
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Othman MM, Khudadad H, Dughmosh R, Syed A, Clark J, Furuya-Kanamori L, Abou-Samra AB, Doi SAR. Towards a better understanding of self-management interventions in type 2 diabetes: A meta-regression analysis. Prim Care Diabetes 2021; 15:985-994. [PMID: 34217643 DOI: 10.1016/j.pcd.2021.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/31/2021] [Accepted: 06/17/2021] [Indexed: 01/15/2023]
Abstract
AIMS Attributes that operationally conceptualize diabetes self-management education (DSME) interventions have never been studied previously to assess their impact on relevant outcomes of interest in people with type 2 diabetes (T2D). The aim of this study was to determine the impact of existing interventions classified by their delivery of skills or information related attributes on immediate (knowledge), intermediate (physical activity), post-intermediate (HbA1c), and long-term (quality of life) outcomes in people with T2D. METHODS PubMed, Embase, PsycINFO, and Cochrane Library/Cochrane CENTRAL as well as the grey literature were searched to identify interventional studies that examined the impact of DSME interventions on the four different outcomes. Eligible studies were selected and appraised independently by two reviewers. A meta-regression analysis was performed to determine the impact of delivery of the skills- and information-related attributes on the chosen outcomes. RESULTS 142 studies (n = 25,511 participants) provided data, of which 39 studies (n = 5278) reported on knowledge, 39 studies (n = 8323) on physical activity, 99 studies (n = 17,178) on HbA1c and 24 studies (n = 5147) on quality of life outcomes. Meta-regression analyses demonstrated that skills-related attributes had an estimated effect suggesting improvement in knowledge (SMD [standardized mean difference] increase of 0.80; P = 0.025) and that information-related attributes had an estimated effect suggesting improvement in quality of life (SMD increase of 0.96; P = 0.405). Skill- and information-related attributes did not have an estimated effect suggesting improvement in physical activity or in HbA1c. CONCLUSIONS The study findings demonstrate that the skills and information related attributes contribute to different outcomes for people with T2D. This study provides, for the first time, preliminary evidence for differential association of the individual DSME attributes with different levels of outcome.
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Affiliation(s)
- Manal M Othman
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar; Medicine Department, Hamad Medical Corporation, Doha, Qatar.
| | - Hanan Khudadad
- Department of Clinical Research, Primary Health Care Corporation, Doha, Qatar.
| | - Ragae Dughmosh
- Medicine Department, Hamad Medical Corporation, Doha, Qatar.
| | - Asma Syed
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
| | - Justin Clark
- The Centre for Research into Evidence Based Practice, Bond University, Gold Coast, Queensland, Australia.
| | - Luis Furuya-Kanamori
- UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia.
| | - Abdul-Badi Abou-Samra
- Qatar Metabolic Institute and Medicine Department, Hamad Medical Corporation, Doha, Qatar.
| | - Suhail A R Doi
- Department of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
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21
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Abu-Shennar JA, Bayraktar N. The Effect of Educational Program on Pain Management, Self-Efficacy Behavior, and Quality of Life among Adult Diabetic Patients with Peripheral Neuropathy Pain: A Randomized Controlled Trial. Exp Clin Endocrinol Diabetes 2021; 130:509-518. [PMID: 34448177 DOI: 10.1055/a-1561-8392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Jordan has a high prevalence of painful diabetic peripheral neuropathy (PDPN), leg complications, and amputations due to diabetes. This study evaluated the effect of educational programs on pain management, self-efficacy behaviors, and quality of life (QoL) among adult patients with PDPN. METHODS The randomized controlled trial study was conducted at the Jordanian Ministry of Health hospitals between October 2019 - March 2020. Seventy-two adult patients with PDPN were randomized to an experimental group of 36 patients who attended an educational program and a control group who followed routine diabetic care in the study setting. The data were collected using a socio-demographic and diabetes clinical/laboratory data form, the numeric rating scale (NRS), diabetes self-efficacy scale (DSES), and the quality-of-life questionnaire (EQ-5D). The intervention program consisted of four educational sessions at weekly intervals. Pre-test and post-test evaluations were conducted. RESULTS After the educational intervention, the mean scores of the NRS (p=0.020), DSES (p<0.001), and EQ-5D (p<0.001) in the experimental group improved significantly improved compared to those in the control group. Additionally, while there were no significant correlations between the three study outcomes in the pre-test stage, correlations were observed to be significant after the educational intervention. CONCLUSION This study shows that the design and implementation of educational intervention combined with routine diabetic care facilitate effective pain management, self-efficacy behaviors, and QoL of patients with PDPN. The health care providers are recommended to use the educational programs for such patients at various levels of services in both health centers and diabetes clinics.
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22
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Martos-Cabrera MB, Gómez-Urquiza JL, Cañadas-González G, Romero-Bejar JL, Suleiman-Martos N, Cañadas-De la Fuente GA, Albendín-García L. Nursing-Intense Health Education Intervention for Persons with Type 2 Diabetes: A Quasi-Experimental Study. Healthcare (Basel) 2021; 9:832. [PMID: 34356210 PMCID: PMC8307700 DOI: 10.3390/healthcare9070832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 11/04/2022] Open
Abstract
Type 2 diabetes mellitus (DM2) is a highly prevalent disease, the progression of which depends on high blood glucose levels, which are reflected in the level of glycosylated haemoglobin (HbA1c). Appropriate health education equips patients with the knowledge and skills to control their glucose and HbA1c levels to avoid long-term complications. This study was set up to compare the results of an intensive (360 min) educational intervention to improve HbA1c parameters in patients with DM2 with those of a usual 90 min intervention. For this purpose, healthcare personnel led a quasi-experimental study of 249 diabetics: 171 in the control group, and 78 in the intervention group. In the control group, the mean HbA1c value decreased from 6.97 to 6.75, while in intervention group it fell from 8.97 to 8.06. The before and after mean difference between both groups was compared with a Wilcoxon test, and the results statistically significant (W = 4530; p < 0.001), indicating a higher reduction of HbA1c in the intervention group. We concluded that the intensive health education provided by nurses during the consultation helped improve HBA1c levels in persons with DM2.
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Affiliation(s)
- María Begoña Martos-Cabrera
- Neonatal Intensive Care Unit, University Hospital San Cecilio, Avenida del Conocimiento, 18016 Granada, Spain;
| | - José Luis Gómez-Urquiza
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016 Granada, Spain; (J.L.G.-U.); (N.S.-M.); (G.A.C.-D.l.F.)
| | - Guillermo Cañadas-González
- Support Device South Area of Cordoba, Andalusian Health Service, Av. Góngora, 9B, Cabra, 14940 Córdoba, Spain;
| | - José Luis Romero-Bejar
- Department of Statistics and Operational Research, University of Granada, 18071 Granada, Spain
| | - Nora Suleiman-Martos
- Faculty of Health Sciences, University of Granada, Avenida de la Ilustración, 60, 18016 Granada, Spain; (J.L.G.-U.); (N.S.-M.); (G.A.C.-D.l.F.)
| | | | - Luis Albendín-García
- Casería de Montijo Health Center, Granada Metropolitan District, Andalusian Health Service, Calle Virgen de la Consolación, 12, 18015 Granada, Spain;
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Individualized Health Care for Older Diabetes Patients from the Perspective of Health Professionals and Service Consumers. J Pers Med 2021; 11:jpm11070608. [PMID: 34199022 PMCID: PMC8306441 DOI: 10.3390/jpm11070608] [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: 05/29/2021] [Revised: 06/17/2021] [Accepted: 06/25/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Individualized nursing care as a form of person-centered care delivery is a well-known approach in the health care context and is accepted as best practice by organizations and professionals, yet its implementation in everyday practice creates serious challenges. The aim was to assess and compare the perceptions of health professionals and older diabetes patients on their individual care in regard to the patient’s clinical situation, personal life situation, and decisional control. Methods: The quantitative study with a cross-sectional survey design was conducted from March 2019 until January 2021. The Individualized Care Scale was applied for the data collection. Health professionals (nurses and physicians, n = 70) and older diabetes patients (n = 145) participated in the study. The average duration of diabetes was 15.8 years (SD = 10.0) and type 2 diabetes was the most common (89.0%). The current glucose-lowering therapy for 51.0% of the patients was oral medications, 37.9% used injected insulin, and 11.1% were treated by combined therapy. Results: The highest-rated aspects of individualized care on both dimensions of the scale from the health professionals’ perspective related to the clinical situation, and the scores for provision were significantly higher than those for support. The highest means of patients’ ratings on the support dimension related to the clinical situation and the decisions over care sub-scale; for the care provision dimension, the highest individuality in care was assigned to the decisions over care sub-scale. The lowest ratings of individualized care, both in the health professionals’ and patients’ samples, related to the personal life situation sub-scale. Conclusions: Health professionals are more positive in regard to individualized care support and provisions for older diabetes patients than the patients themselves. Patient characteristics, such as the type of glucose-lowering therapy, education, and nutritional status, make a difference in patients’ understanding and experience of individuality in care.
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Samudera WS, Efendi F, Indarwati R. Effect of community and peer support based healthy lifestyle program (CP-HELP) on self care behavior and fasting blood glucose in patient with type 2 Diabetes Mellitus. J Diabetes Metab Disord 2021; 20:193-199. [PMID: 34178831 PMCID: PMC8212258 DOI: 10.1007/s40200-021-00729-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/01/2021] [Indexed: 10/22/2022]
Abstract
Type 2 diabetes mellitus (T2DM) was one of chronic disease that remain global concern including in Indonesia. Healthy lifestyle is a part of diabetes mellitus treatment to achieve the highest health status and to prevent diabetes complication. PURPOSE This study aimed to examine the effect of community and peer support based healthy lifestyle program (CP-HELP) on self-care behavior and fasting blood glucose in patient with T2DM. METHODS The research design was used quasi experimental pre and post-test design. 163 participants with T2DM were divided into two groups, 83 participants as intervention group were given CP-HELP intervention and 80 participants as control group were given usual care. Measurement of self-care behavior used Diabetes Self-Management Questionnaire (DSMQ). Furthermore, measurement of fasting blood glucose was measured by capillary blood test. This study was used paired t test and multivariate analysis of variance. RESULTS An increase of mean value of self-care behavior was occurred in both of group intervention and control. A significant different between pre-test and post-test in intervention group (p = 0.000). Results of statistical test used paired t test in control group, was not showed significantly different (p = 0.249). Improved of fasting blood glucose only occurred in intervention group (p = 0.020). Results of multivariate statistic test was showed in both outcomes obtained significant value less than 0.05, self-care behavior (p = 0.010), fasting blood glucose (p = 0.042). CONCLUSION CP-HELP may be a promising interventional strategy to improve self-care behavior and improving of fasting blood glucose in patient with T2DM. The research results can be used as an important reference for improving self care behavior and fasting blood glucose in patient with type 2 Diabetes Mellitus.
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Affiliation(s)
- Wahyu Sukma Samudera
- Master of Nursing Study Program, Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Ferry Efendi
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
| | - Retno Indarwati
- Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia
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Diriba DC, Leung DYP, Suen LKP. The effects of diabetes self-management interventions on physiological outcomes in people living with diabetes in Africa: A systematic review and meta-analysis. Diabet Med 2021; 38:e14501. [PMID: 33341999 DOI: 10.1111/dme.14501] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/19/2020] [Accepted: 12/16/2020] [Indexed: 12/26/2022]
Abstract
AIM To examine the effects of diabetes self-management interventions on physiological outcomes among people living with diabetes in Africa compared with patients receiving usual care. METHODS Relevant databases including PubMed, CINAHL Complete, Scopus, the Cochrane Library and Google Scholar were searched from inception to 28 September 2019, for randomised controlled trials (RCTs) involving adults living with diabetes in Africa. Nine RCTs were included in the review, and the quality of the studies was assessed using Cochrane's collaboration risk of bias tools. RESULTS A meta-analysis of the outcomes showed the significant effects of diabetes self-management interventions on blood pressure, total cholesterol and body mass index, whereas non-significant and inconclusive results were obtained for waist circumference and glycosylated haemoglobin, respectively. CONCLUSIONS The diabetes self-management interventions (DSM) effectively improved many physiological outcomes, but their effectiveness in HbA1c was inconclusive, suggesting a need for modifications in DSM interventions for African people living with diabetes.
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Affiliation(s)
| | - Doris Y P Leung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Lorna K P Suen
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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Yuan Z, Jiao N, Liu X, Liu C. The effect of web-based educational intervention on psychological status and blood glucose in newly diagnosed patients with diabetes type 2 in rural China: A protocol for randomized trial. Medicine (Baltimore) 2021; 100:e24937. [PMID: 33663132 PMCID: PMC7909169 DOI: 10.1097/md.0000000000024937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/04/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND No studies were located which used a web-based educational intervention to improve the knowledge about newly diagnosed type 2 diabetes mellitus (T2DM). Therefore, the primary objective of the present study was to evaluate the efficacy of web-based educational intervention on psychological outcomes and glycemic control in newly diagnosed T2DM in rural China. METHODS This work is a part of a comprehensive research project to assess and provide educational intervention that potentially improve psychological status and blood glucose among patients with T2DM. Eligibility criteria for the study includes newly diagnosed with T2DM, adult patients (age ≥30 years) regardless of gender; speak and understand Chinese languages; having no significant comorbidity; being not involved in any trial/study related to diabetes during last 3 months and able to attend regular visits. Eligible participants were divided into 2 groups according to completely randomized design: education group and control group. The outcomes included fasting blood glucose level, EQ-5D-3L questionnaire, Self-rating Anxiety Scale, and Self-rating Depression Scale. RESULTS This protocol will provide a reliable theoretical basis for the following research. CONCLUSION The sample came from a single health centre. Therefore, the results can not be generalized for the entire population. TRIAL REGISTRATION This study protocol was registered in Research Registry (researchregistry6511).
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Affiliation(s)
| | | | - Xiaoli Liu
- Department of Endocrinology, Chengyang People's Hospital, Qingdao, China
| | - Changjiang Liu
- Department of Endocrinology, Chengyang People's Hospital, Qingdao, China
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O'Halloran P. Methodological and reporting issues in a randomised controlled trial: Comment on de la Fuente et al (2020). Int J Nurs Stud 2020; 107:103585. [DOI: 10.1016/j.ijnurstu.2020.103585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 03/21/2020] [Indexed: 10/24/2022]
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Villas Boas GR, Rodrigues Lemos JM, de Oliveira MW, dos Santos RC, Stefanello da Silveira AP, Barbieri Bacha F, Ito CNA, Bortolotte Cornelius E, Brioli Lima F, Sachilarid Rodrigues AM, Belmal Costa N, Francisco Bittencourt F, Freitas de Lima F, Meirelles Paes M, Gubert P, Oesterreich SA. Aqueous extract from Mangifera indica Linn. (Anacardiaceae) leaves exerts long-term hypoglycemic effect, increases insulin sensitivity and plasma insulin levels on diabetic Wistar rats. PLoS One 2020; 15:e0227105. [PMID: 31914140 PMCID: PMC6948748 DOI: 10.1371/journal.pone.0227105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/18/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Diabetes mellitus is one of the most common todays public health problems. According to a survey by the World Health Organization, this metabolic disorder has reached global epidemic proportions, with a worldwide prevalence of 8.5% in the adult population. OBJECTIVES The present study aimed to investigate the hypoglycemic effect of aqueous extract of Mangifera indica (EAMI) leaves in streptozotocin-induced diabetic rats. METHODS Sixty male rats were divided into 2 groups: Normoglycemic and Diabetic. Each group was subdivided into negative control, glibenclamide 3 or 10 mg/kg, EAMI 125, 250, 500, and 1000 mg/kg. Intraperitoneal injection of streptozotocin 100 mg/kg was used to DM induction. The hypoglycemic response was assessed acutely after two and four weeks of treatment. After a 6-hour fasting period, the fasting blood glucose of animals was verified, and 2.5 g/kg glucose solution was orally administered. The insulin tolerance test and plasma insulin levels assessment were performed in the morning after fasting of 12 to 14 hours. RESULTS AND CONCLUSION The chemical analysis of EAMI showed high levels of phenolic compounds. There was no significant difference in fasting blood glucose between normoglycemic and diabetic groups, and that EAMI did not have an acute effect on diabetes. After two and four weeks of treatment, the extract significantly reduced blood glucose levels, exceeding glibenclamide effects. EAMI was effective in maintaining the long-term hypoglycemic effect, as well as, significantly increased the sensitivity of diabetic animals to insulin and the plasma insulin level.
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Affiliation(s)
- Gustavo Roberto Villas Boas
- Research Group on Development of Pharmaceutical Products (P&DProFar), Center for Biological and Health Sciences, Federal University of Western Bahia, Barreiras, Bahia, Brazil
- Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | | | | | | | | | - Flávia Barbieri Bacha
- Faculty of Health Sciences, University Center of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Caren Naomi Aguero Ito
- Faculty of Health Sciences, University Center of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | | | - Fernanda Brioli Lima
- Faculty of Health Sciences, University Center of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | | | - Nathália Belmal Costa
- Faculty of Health Sciences, University Center of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | | | - Fernando Freitas de Lima
- Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Mato Grosso do Sul, Brazil
| | - Marina Meirelles Paes
- Research Group on Development of Pharmaceutical Products (P&DProFar), Center for Biological and Health Sciences, Federal University of Western Bahia, Barreiras, Bahia, Brazil
| | - Priscila Gubert
- Research Group on Development of Pharmaceutical Products (P&DProFar), Center for Biological and Health Sciences, Federal University of Western Bahia, Barreiras, Bahia, Brazil
- Department of Biochemistry, Laboratory of Imunopathology Keizo Asami, Federal University of Pernambuco, Recife, Brazil
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