Assessment of patient medication adherence among the type 2 diabetes mellitus population with peripheral diabetic neuropathy in South India

Impact of Glycemic Control on Shoulder Proprioception in Type 2 Diabetes Mellitus: Mediating the Connection - Insights from a Cross-Sectional Analysis

Introduction

Shoulder proprioception is vital and this cross-sectional study investigated the association between glycemic control and shoulder joint proprioception in Type 2 Diabetes Mellitus (T2DM).

Methods

A total of 120 participants, including 60 with T2DM and 60 healthy individuals, were assessed for shoulder joint position sense (JPS) using a digital inclinometer. The T2DM group exhibited significantly greater mean shoulder joint position errors in flexion (4.32° vs 2.15°), abduction, medial rotation, and lateral rotation compared to the healthy group (p < 0.001).

Results

The study found significantly greater shoulder joint position errors in the T2DM group compared to the healthy group, highlighting notable proprioceptive deficits in individuals with T2DM. Additionally, a significant positive correlation was found between HbA1c levels and shoulder joint position errors in the T2DM group, suggesting a link between long-term glycemic control and proprioceptive accuracy.

Discussion

The significant positive correlation between HbA1c levels and shoulder joint position errors suggests that poor glycemic control is associated with impaired proprioception in T2DM patients. This underscores the need for comprehensive management strategies to mitigate proprioceptive deficits and improve the quality of life in individuals with T2DM.

Self-care behaviours among people with type 2 diabetes mellitus in South Asia: A systematic review and meta-analysis

Background

The burden of Type 2 Diabetes Mellitus (T2DM) in South Asian countries is increasing rapidly. Self-care behaviour plays a vital role in managing T2DM and preventing complications. Research on self-care behaviours among people with T2DM has been widely conducted in South Asian countries, but there are no systematic reviews that assess self-care behaviour among people with T2DM in South Asia. This study systematically assessed the studies reporting self-care behaviours among people with T2DM in South-Asia.

Methods

Adhering to the PRISMA guidelines, we searched six bibliographic databases (Scopus, PubMed, CINAHL, Embase, Web of Science, and PsychInfo) to identify the relevant articles published between January 2000 through March 2022. Eligibility criteria included all observational and cross-sectional studies reporting on the prevalence of self-care behaviours (ie, diet, physical activity, medication adherence, blood glucose monitoring, and foot care) conducted in South Asian countries among people with T2DM.

Results

The database search returned 1567 articles. After deduplication (n = 758) and review of full-text articles (n = 192), 92 studies met inclusion criteria and were included. Forward and backward reference checks were performed on included studies, which resulted in an additional 18 articles. The pooled prevalence of adherence to blood glucose monitoring was 65% (95% CI = 49-80); 64% for medication adherence (95% CI = 53-74); 53% for physical activity (95% CI = 39-66); 48% for diet (95% CI = 38-58); 42% for foot care (95% CI = 30-54). About a quarter of people with T2DM consumed alcohol (25.2%, IQR = 13.8%-38.1%) and were using tobacco products (18.6%, IQR = 10.6%-23.8%).

Conclusions

Our findings suggest that the prevalence of self-care behaviours among people with T2DM in South Asia is low. This shows an urgent need to thoroughly investigate the barriers to the practising of self-care and design and implement interventions to improve diabetes self-care behaviour among people with T2DM in South Asia.

Adherence to and persistence with antidiabetic medications and associations with clinical and economic outcomes in people with type 2 diabetes mellitus: A systematic literature review

We designed a systematic literature review to identify available evidence on adherence to and persistence with antidiabetic medication in people with type 2 diabetes (T2D). Electronic screening and congress searches identified real-world noninterventional studies (published between 2010 and October 2020) reporting estimates of adherence to and persistence with antidiabetic medication in adults with T2D, and associations with glycaemic control, microvascular and/or macrovascular complications, hospitalizations and healthcare costs. Ninety-two relevant studies were identified, the majority of which were retrospective and reported US data. The proportions of patients considered adherent (median [range] 51.2% [9.4%-84.3%]) or persistent (median [range] 47.7% [16.9%-94.0%]) varied widely across studies. Multiple studies reported an association between greater adherence/persistence and greater reductions in glycated haemoglobin levels. Better adherence/persistence was associated with fewer microvascular and/or macrovascular outcomes, although there was little consistency across studies in terms of which outcomes were improved. More adherent and more persistent patients were typically less likely to be hospitalized or to have emergency department visits/admissions and spent fewer days in hospital annually than less adherent/persistent patients. Greater adherence and persistence were generally associated with lower hospitalization costs, higher pharmacy costs and lower or budget-neutral total healthcare costs compared with lower adherence/persistence. In conclusion, better adherence and persistence in people with T2D is associated with lower rates of microvascular and/or macrovascular outcomes and inpatient hospitalization, and lower or budget-neutral total healthcare expenditure. Education and treatment strategies to address suboptimal adherence and persistence are needed to improve clinical and economic outcomes.

Determinants of peripheral neuropathy among diabetic patients under follow-up in chronic care clinics of public hospitals at Gamo and Gofa zones, southern Ethiopia

BACKGROUND

Peripheral neuropathy is a leading cause of morbidity and increased mortality among diabetic patients. It is characterized by significant deficits in vibration and tactile sensation. With an annual incidence of 2%, it affects as many as 110 million people worldwide. The aim of this study was to assess factors associated with peripheral neuropathy among diabetic patients in chronic care clinic in Gamo and Gofa zone, South Ethiopia.

METHODS

An institution- based unmatched case control study was employed among 528 randomly selected participants using a pre-tested, interviewer-administered, and structured questionnaire. Bivariate and multivariable logistic regression analysis was conducted to identifiy determinants of peripheral neuropathy using IBM SPSS version 25.

RESULT

The odds of being an urban dweller was 2.67 times higher among cases than controls [AOR = 2.67 (1.27, 5.63)]. The likelihood of fasting blood glucose level between 203 and 282 and 282 and above was 2.55 and 3.88 times higher among cases than controls [AOR = 2.55 (1.91, 7.16)] and [AOR = 3.88 (1.42, 10.60)] respectively. The probability of living with diabetes mellitus for 10 and more years was 3.88 times higher among cases than controls [AOR = 3.88 (1.42, 10.60)]. The odds of controlling glucose level after developing symptom was 5.33 times higher among cases than controls [AOR = 5.33 (1.28, 12.24)]. The probability of having high blood pressure was 2.36 times higher among cases than controls [AOR = 2.36 (1.26, 4.43)]. The likelihood of having a family history of complication from diabetes mellitus was 5.60 times higher among cases than controls [AOR = 5.60 (2.03, 15.43)]. The odds of exercising 3 times per week for 15 to 30 minutes and for less than 15 minutes were 2.96 and 4.92 times higher among cases than controls respectively [AOR = 2.96 (1.32, 6.61)] and AOR = 4.92, 95% CI (1.85, 13.04) respectively. The likelihood of having a waist circumference greater than or equal to 40 inch was 2.72 times higher among cases than controls [AOR = 2.72 (1.07, 6.94)].

CONCLUSION

This study showed that residence, duration of diabetic mellitus, family history of complication from diabetic mellitus, level of fasting blood glucose, method of glycemic control, having a high blood pressure/hypertension/, frequency and duration of physical activity and waist circumference were found to be determinants of peripheral neuropathy. Thus, the concerned health authorities and health professionals should target on these factors in their efforts to prevent peripheral neuropathy among diabetics in the study area.

Association of Demographic Variables with the Awareness of Type 2 Diabetes Mellitus Patients (T2DM) among the Northwest Population in Saudi Arabia

The chronic hyperglycemia in diabetes is associated with long-term damage, dysfunction, and failure of different organs. Lack of patient education and knowledge about these complications can worsen the quality of a patient's life. Hence, more efforts are needed to improve patient's education especially in rural areas. Aim. Our objective is to explore the association between demographic variables and the knowledge of self-care practices in type 2 diabetes mellitus. Methods. We used observational cross-sectional descriptive study using a validated self-administered questionnaire in both Arabic and English languages as well. A descriptive correlation design analyzed the questionnaire completed by a convenience sample meeting the inclusion criteria. Results. A total of 100 patients met the inclusion criteria for the analysis out of 3251 patients who completed the questionnaire. The study population has low moderate knowledge in diabetes, moderate knowledge in self-care practices, and good knowledge about complications of nephropathy and cardiovascular disease. No significant association between demographic variables. However, better knowledge observed in male (p = 0.028) and self-care practices with female (p = 0.020). Further, educational status is significantly influencing the knowledge of diabetic patients. Conclusion. The study emphasizing irrespective of demographic variable and the importance of patient education to achieve well glycemic control.