1
|
Wang Y, Xu Y, Shan H, Pan H, Chen J, Yang J. Health state utility values of type 2 diabetes mellitus and related complications: a systematic review and meta-regression. Health Qual Life Outcomes 2024; 22:74. [PMID: 39244536 PMCID: PMC11380328 DOI: 10.1186/s12955-024-02288-1] [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: 05/17/2024] [Accepted: 08/26/2024] [Indexed: 09/09/2024] Open
Abstract
BACKGROUND This study aimed to synthesize and quantitatively examine Health State Utility Values (HSUVs) for Type 2 Diabetes Mellitus (T2DM) and its complications, providing a robust meta-regression framework for selecting appropriate HSUV estimates. METHOD We conducted a systematic review to extract HSUVs for T2DM and its complications, encompassing various influencing factors. Relevant literature was sourced from a review spanning 2000-2020, supplemented by literature from PubMed, Embase, and the Web of Science (up to March 2024). Multivariate meta-regression was performed to evaluate the impact of measurement tools, tariffs, health status, and clinical and demographic variables on HSUVs. RESULTS Our search yielded 118 studies, contributing 1044 HSUVs. The HSUVs for T2DM with complications varied, from 0.65 for cerebrovascular disease to 0.77 for neuropathy. The EQ-5D-3L emerged as the most frequently employed valuation method. HSUV differences across instruments were observed; 15-D had the highest (0.89), while HUI-3 had the lowest (0.70) values. Regression analysis elucidated the significant effects of instrument and tariff choice on HSUVs. Complication-related utility decrement, especially in diabetic foot, was quantified. Age <70 was linked to increased HSUVs, while longer illness duration, hypertension, overweight and obesity correlated with reduced HSUVs. CONCLUSION Accurate HSUVs are vital for the optimization of T2DM management strategies. This study provided a comprehensive data pool for HSUVs selection, and quantified the influence of various factors on HSUVs, informing analysts and policymakers in understanding the utility variations associated with T2DM and its complications.
Collapse
Affiliation(s)
- Yubo Wang
- Department of Pharmacy, 1/F, Science and Technology Building, The First Affiliated Hospital of Xinjiang Medical University, No.137 Liyushan Road, Xinshi District, Urumqi, Xinjiang Uygur Autonomous Region, China
- Xinjiang Key Laboratory of Clinical Drug Research, No.137 Liyushan Road, Xinshi District, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Yueru Xu
- School of Pharmacy, Xinjiang Medical University, No.393 XinYi Road, Xinshi District, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Huiting Shan
- Department of Pharmacy, 1/F, Science and Technology Building, The First Affiliated Hospital of Xinjiang Medical University, No.137 Liyushan Road, Xinshi District, Urumqi, Xinjiang Uygur Autonomous Region, China
- Xinjiang Key Laboratory of Clinical Drug Research, No.137 Liyushan Road, Xinshi District, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Huimin Pan
- Department of Pharmacy, 1/F, Science and Technology Building, The First Affiliated Hospital of Xinjiang Medical University, No.137 Liyushan Road, Xinshi District, Urumqi, Xinjiang Uygur Autonomous Region, China
- Xinjiang Key Laboratory of Clinical Drug Research, No.137 Liyushan Road, Xinshi District, Urumqi, Xinjiang Uygur Autonomous Region, China
| | - Ji Chen
- Department of Pharmacy, 1/F, Science and Technology Building, The First Affiliated Hospital of Xinjiang Medical University, No.137 Liyushan Road, Xinshi District, Urumqi, Xinjiang Uygur Autonomous Region, China.
- Xinjiang Key Laboratory of Clinical Drug Research, No.137 Liyushan Road, Xinshi District, Urumqi, Xinjiang Uygur Autonomous Region, China.
| | - Jianhua Yang
- Department of Pharmacy, 1/F, Science and Technology Building, The First Affiliated Hospital of Xinjiang Medical University, No.137 Liyushan Road, Xinshi District, Urumqi, Xinjiang Uygur Autonomous Region, China.
- Xinjiang Key Laboratory of Clinical Drug Research, No.137 Liyushan Road, Xinshi District, Urumqi, Xinjiang Uygur Autonomous Region, China.
| |
Collapse
|
2
|
Nickzad S, Foroutan M, Hedayati AH, Pourmohseni MR, Asl NS. The relationship between the duration of diabetes and dimensions of general health and quality of life associated with the health of diabetic patients. J Family Med Prim Care 2024; 13:2927-2933. [PMID: 39228615 PMCID: PMC11368344 DOI: 10.4103/jfmpc.jfmpc_1377_23] [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: 08/22/2023] [Revised: 11/02/2023] [Accepted: 01/09/2024] [Indexed: 09/05/2024] Open
Abstract
Introduction Diabetes is one of the most common chronic diseases in the world. Diabetes has a major impact on the quality of life of patients. The purpose of this study is the relationship between the duration of diabetes and dimensions of general health and quality of life associated with the health of diabetic patients. Materials and Methods In this cross-sectional-analytical study, diabetic patients with more than 1-year history who were not suffering from other chronic diseases were included in the study. Then, using 15 questions for diabetes quality of life, questionnaires and GHQ28 general health were investigated in terms of quality of life and general health. The data were statistically analyzed using SPSS version 24 software. Results The average age was equal to 42.8 ± 14.4 years (with a median of 40 years). The average duration of the disease in the patients was equal to 7.7 ± 7.2 years (with a median of 5 years). The average quality of life score of the patients was equal to 50.3 ± 7.8 (out of 75). A negative and significant correlation between age and quality of life of patients was observed (P < 0.001). The duration of the disease had a direct and significant relationship with the general health score. But a significant difference between the quality of life of married and single people was not observed (P = 0.613). A direct and significant relationship between duration of disease, age with physical symptoms (P < 0.001), anxiety and insomnia (P = 0.001), social activity failure (P = 0.013), and depression (P = 0.001) was observed and was also observed with the overall score of general health (P < 0.001). Discussion and Conclusion The duration of diabetes disease affects the quality of life and general health of diabetic patients, and discomfort, depression, and anxiety are the main problems that affect the quality of life of diabetic patients.
Collapse
Affiliation(s)
- Sepehr Nickzad
- Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran
| | - Majid Foroutan
- Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Amir Hossain Hedayati
- Department of Internal Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Nemat Sotodeh Asl
- Department of Psychology, Semnan Branch, Islamic Azad University, Semnan, Iran
| |
Collapse
|
3
|
Dang AK, Vu BN, Lam TP, Ho TKT, Nguyen AKT, Le HT, Mamun AA, Phung D, Thai PK. Progress toward universal health coverage in Vietnam: Evidence on dispensing trends of diabetes medications from 2015 to 2021. Diabetes Res Clin Pract 2024; 212:111691. [PMID: 38710288 DOI: 10.1016/j.diabres.2024.111691] [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: 03/16/2024] [Revised: 04/26/2024] [Accepted: 05/01/2024] [Indexed: 05/08/2024]
Abstract
AIMS This study aims to investigate the trends in treatment coverage through dispensing diabetes medications in Vietnam from 2015 to 2021. The findings will serve to inform health policies to mitigate the health burden of Type 2 diabetes mellitus (T2DM). METHODS We collected information on major antidiabetic medicines from General Department of Vietnam Customs and payments for antidiabetics via the National Health Insurance Program. We applied ordinary least squares models, accounting for economic and health outcome characteristics, to estimate the association between the annual mass of medications and related factors. RESULTS Nationally, the total mass/doses of all antidiabetic drugs increased rapidly from 2015 to 2021, based on both databases. Metformin was the most frequently prescribed medicine, with the total mass increasing nearly threefold over the study period. Gliclazide, a Sulfonylureas drug, ranked second. In the multivariate regression analysis, a one-unit increase in adults with diabetes (in 1,000 s) was associated with 0.11 % (95 %CI = 0.0005; 0.0076) and 0.13 % (95%CI = 0.0007; 0.0242) higher mass of Metformin and Glimepiride, respectively. CONCLUSION Our data suggested that policies changes were related to significant increase in antidiabetic medication dispenses in Vietnam. The high treatment coverage indicates impressive progress in achieving universal health coverage in Vietnam, meeting the UN Sustainable Development Goal (SDG).
Collapse
Affiliation(s)
- Anh Kim Dang
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba 4102, Brisbane, Australia; Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Viet Nam.
| | - Binh Ngan Vu
- Faculty of Analytical Chemistry and Drug Quality Control, Hanoi University of Pharmacy, 13-15 Le Thanh Tong, Hanoi, Viet Nam.
| | - Toi Phung Lam
- Health Strategy and Policy Institute, Hanoi, Viet Nam
| | | | - Anh Kieu Thi Nguyen
- Faculty of Analytical Chemistry and Drug Quality Control, Hanoi University of Pharmacy, 13-15 Le Thanh Tong, Hanoi, Viet Nam
| | - Huong Thi Le
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Viet Nam
| | - Abdullah A Mamun
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba 4102, Brisbane, Australia; Poche Centre for Indigenous Health, The University of Queensland, Indooroopilly, Queensland 4068, Australia; ARC Centre of Excellence for Children and Families Over the Life Course (The Life Course Centre), The University of Queensland, Indooroopilly, Queensland 4068, Australia
| | - Dung Phung
- School of Public Health, Faculty of Medicine, The University of Queensland, Herston, Queensland 4006, Australia
| | - Phong K Thai
- Queensland Alliance for Environmental Health Sciences (QAEHS), The University of Queensland, 20 Cornwall Street, Woolloongabba 4102, Brisbane, Australia
| |
Collapse
|
4
|
Tan MHP, Ong SC, Tahir NAM, Ali AM, Mustafa N. Health state utility values ranges across varying stages and severity of type 2 diabetes-related complications: A systematic review. PLoS One 2024; 19:e0297589. [PMID: 38574169 PMCID: PMC10994347 DOI: 10.1371/journal.pone.0297589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/09/2024] [Indexed: 04/06/2024] Open
Abstract
INTRODUCTION Health state utility values (HSUV) for Type 2 diabetes mellitus (T2DM) complications are useful in economic evaluations to determine cost effectiveness of an intervention. However, there is a lack of reference ranges for different severity and stages of individual complications. This study aimed to provide an overview of HSUV decrement ranges for common T2DM complications focusing on different severity and stages of complications. METHOD A systematic search was conducted in MEDLINE, SCOPUS, WEB OF SCIENCE. (Jan 2000 to April 2022). Included studies for HSUV estimates were from outpatient setting, regardless of treatment types, complication stages, regions and HRQoL instruments. Health Related Quality of Life (HRQoL) outcomes was to be presented as HSUV decrement values, adjusted according to social demographics and comorbidities. Adjusted HSUV decrements were extracted and compiled according to individual complications. After which, subsequently grouped into mild or severe category for comparison. RESULTS Searches identified 35 studies. The size of the study population ranged from 160 to 14,826. The HSUV decrement range was widest for cerebrovascular disease (stroke): -0.0060 to -0.0780 for mild stroke and -0.035 to -0.266 for severe stroke; retinopathy: mild (-0.005 to -0.0862), moderate (-0.0030 to -0.1845) and severe retinopathy (-0.023 to -0.2434); amputation: (-0.1050 to -0.2880). Different nature of complication severity defined in studies could be categorized into: those with acute nature, chronic with lasting effects, those with symptoms at early stage or those with repetitive frequency or episodes. DISCUSSION Overview of HSUV decrement ranges across different stages of each T2DM diabetes-related complications shows that chronic complications with lasting impact such as amputation, severe stroke with sequelae and severe retinopathy with blindness were generally associated with larger HSUV decrement range. Considerable heterogeneities exist across the studies. Promoting standardized complication definitions and identifying the most influential health state stages on HSUV decrements may assist researchers for future cost-effectiveness studies.
Collapse
Affiliation(s)
- Michelle Hwee Pheng Tan
- Pharmacy Department, Hospital Canselor Tuanku Muhriz, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Science, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Siew Chin Ong
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Science, Universiti Sains Malaysia, Pulau Pinang, Malaysia
| | - Nurul Ain Mohd Tahir
- Department of Pharmacy, Kampus Kuala Lumpur Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Adliah Mhd Ali
- Department of Pharmacy, Kampus Kuala Lumpur Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norlaila Mustafa
- Department of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
5
|
Almohaimeed GM, Alonazi AS, Bin Dayel AF, Alshammari TK, Alghibiwi HK, Alamin MA, Almotairi AR, Alrasheed NM. Interplay between Senescence and Macrophages in Diabetic Cardiomyopathy: A Review of the Potential Role of GDF-15 and Klotho. Biomedicines 2024; 12:759. [PMID: 38672115 PMCID: PMC11048311 DOI: 10.3390/biomedicines12040759] [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: 02/24/2024] [Revised: 03/19/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a critical health problem, with 700 million diagnoses expected worldwide by 2045. Uncontrolled high blood glucose levels can lead to serious complications, including diabetic cardiomyopathy (DCM). Diabetes induces cardiovascular aging and inflammation, increasing cardiomyopathy risk. DCM is characterized by structural and functional abnormalities in the heart. Growing evidence suggests that cellular senescence and macrophage-mediated inflammation participate in the pathogenesis and progression of DCM. Evidence indicates that growth differentiation factor-15 (GDF-15), a protein that belongs to the transforming growth factor-beta (TGF-β) superfamily, is associated with age-related diseases and exerts an anti-inflammatory role in various disease models. Although further evidence suggests that GDF-15 can preserve Klotho, a transmembrane antiaging protein, emerging research has elucidated the potential involvement of GDF-15 and Klotho in the interplay between macrophages-induced inflammation and cellular senescence in the context of DCM. This review explores the intricate relationship between senescence and macrophages in DCM while highlighting the possible contributions of GDF-15 and Klotho.
Collapse
Affiliation(s)
- Ghada M. Almohaimeed
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (G.M.A.); (A.S.A.); (A.F.B.D.); (T.K.A.); (H.K.A.); (M.A.A.)
| | - Asma S. Alonazi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (G.M.A.); (A.S.A.); (A.F.B.D.); (T.K.A.); (H.K.A.); (M.A.A.)
| | - Anfal F. Bin Dayel
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (G.M.A.); (A.S.A.); (A.F.B.D.); (T.K.A.); (H.K.A.); (M.A.A.)
| | - Tahani K. Alshammari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (G.M.A.); (A.S.A.); (A.F.B.D.); (T.K.A.); (H.K.A.); (M.A.A.)
| | - Hanan K. Alghibiwi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (G.M.A.); (A.S.A.); (A.F.B.D.); (T.K.A.); (H.K.A.); (M.A.A.)
| | - Maha A. Alamin
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (G.M.A.); (A.S.A.); (A.F.B.D.); (T.K.A.); (H.K.A.); (M.A.A.)
| | - Ahmad R. Almotairi
- Department of Pathology, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia;
| | - Nouf M. Alrasheed
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (G.M.A.); (A.S.A.); (A.F.B.D.); (T.K.A.); (H.K.A.); (M.A.A.)
| |
Collapse
|
6
|
Zayed MG, Karsan W, Peto T, Saravanan P, Virgili G, Preiss D. Diabetic Retinopathy and Quality of Life: A Systematic Review and Meta-Analysis. JAMA Ophthalmol 2024; 142:199-207. [PMID: 38300578 PMCID: PMC10835609 DOI: 10.1001/jamaophthalmol.2023.6435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/28/2023] [Indexed: 02/02/2024]
Abstract
Importance The association between diabetic retinopathy (DR) and quality of life (QoL) has not been thoroughly investigated. Objective To investigate the association between DR and both vision-related QoL (VRQoL) and general health-related QoL (HRQoL). Data Sources MEDLINE, EBSCO, Embase, and Web of Science were searched from their inception to April 2022. Study Selection Studies included adults with DR and a measure of QoL. Data Extraction and Synthesis Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Two assumption-free meta-analyses were conducted. Analysis 1 included studies with participants without DR as the referent group to which QoL scores of participants with DR, grouped according to DR severity, were compared. Analysis 2 included all studies with participants with DR and a measure of QoL. QoL scores were pooled within categories of DR severity, and comparisons were made between these categories. Main Outcome and Measures QoL measured using HRQoL and VRQoL scales. Results A total of 93 articles were included: 79 in the meta-analyses and 14 in the narrative results. VRQoL was recorded in 54 studies, HRQoL in 26, and both in 13 studies. The most commonly used scales were the National Eye Institute 25-item Visual Function Questionnaire (VFQ-25) (n = 49) for VRQoL and the Short Form (SF) Health Survey (n = 18) for HRQoL. Thirty-five studies reported VFQ-25 composite scores. Analysis 1 consisted of 8 studies including 1138 participants with DR and 347 participants without DR. Compared with participants without DR, the composite VFQ-25 score was 3.8 (95% CI, 1.0-6.7) points lower in those with non-vision-threatening DR (NVTDR), 12.5 (95% CI, 8.5-16.5) lower in those with any DR, and 25.1 (95% CI, 22.8-27.2) lower in VTDR (P < .001 for trend). Analysis 2 consisted of 35 studies including 6351 participants with DR. The pooled mean VFQ-25 composite score was 91.8 (95% CI, 91.0-92.7) for participants with NVTDR, 77.6 (95% CI, 76.9-78.3) for any DR, and 73.2 (95% CI, 72.6-73.7) for VTDR (P < .001 for trend). HRQoL scores had weak or no associations with NVTDR and strong associations with VTDR. Conclusions and Relevance This study found that VRQoL declined with the presence and severity of DR. Interventions to reduce progression of DR at both early and more advanced stages could improve VRQoL.
Collapse
Affiliation(s)
- Mohammed G. Zayed
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Waseem Karsan
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| | - Tunde Peto
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
- Department of Ophthalmology, Belfast Health and Social Care Trust, Belfast, United Kingdom
| | - Ponnusamy Saravanan
- Populations, Evidence and Technologies, Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Diabetes, Endocrinology and Metabolism, George Eliot Hospital NHS Trust, Nuneaton, United Kingdom
| | - Gianni Virgili
- AOU Careggi, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Firenze, Florence, Italy
- Ophthalmology, IRCCS-Fondazione Bietti, Rome, Italy
| | - David Preiss
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
7
|
Zan H, Meng Z, Li J, Zhang X, Liu T. Factors associated with quality of life among elderly patients with type 2 diabetes mellitus: the role of family caregivers. BMC Public Health 2024; 24:539. [PMID: 38383369 PMCID: PMC10880260 DOI: 10.1186/s12889-024-17917-z] [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: 08/30/2023] [Accepted: 01/29/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND As a long-term chronic disease, Type 2 diabetes mellitus (T2DM) patients' quality of life is affected by both themselves and his/ her close relatives, requiring comprehensive support from family members to ensure that patients are able to manage disease. The objective of this study is to investigate the relationship between caregivers' sense of coherence, caregiver competence, and T2DM patients' quality of life, as well as to explore the factors affecting patients with T2DM patients. METHODS This investigation was a cross-sectional study. Between October 2022 and July 2023, 392 participant-caregiver dyads from two hospitals in Jinzhou City, Liaoning Province, were researched. Participants were investigated by General Characteristics Questionnaire, Modified Barthel Index (MBI), Diabetes Specific Quality of Life Scale (DSQLS), Sense of Coherence scale-13 (SOC-13), and Family Caregiver Task Inventory (FCTI). Data were statistically analyzed using SPSS 25. Univariate and multivariate linear regression analyses were used to identify the independent factors associated with the quality of life of elderly patients with T2DM. RESULTS The average score of T2DM quality of life was 61.14 (SD = 7.37), quality of life was negatively correlated with sense of coherence (r=-0.344, P<0.01) and positively correlated with caregiver competence (r = 0.522, P<0.01). Furthermore, we found that age, disease duration, activities of daily living scores, sense of coherence, and caregiver competence scores were the main predictors of quality of life (R2 = 0.375, P < 0.001). CONCLUSIONS This study found that high levels of sense of coherence and caregiver competence in family caregivers were associated with better quality of life for patients. Furthermore, we also found that good quality of life was also related to younger age, shorter disease duration, and less dependence. This study offers a feasible example for policymakers to improve the quality of life from the perspective of T2DM patients' family caregivers.
Collapse
Affiliation(s)
- Haijing Zan
- School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, No.40,Section 3, Songpo Road, Jinzhou, Liaoning Province, People's Republic of China
| | - Zhixing Meng
- School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, No.40,Section 3, Songpo Road, Jinzhou, Liaoning Province, People's Republic of China
| | - Jing Li
- School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, No.40,Section 3, Songpo Road, Jinzhou, Liaoning Province, People's Republic of China
| | - Xinjian Zhang
- School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, No.40,Section 3, Songpo Road, Jinzhou, Liaoning Province, People's Republic of China
| | - Tao Liu
- School of Nursing, Jinzhou Medical University, Linghe District Jinzhou City, No.40,Section 3, Songpo Road, Jinzhou, Liaoning Province, People's Republic of China.
| |
Collapse
|
8
|
Badi S, Suliman SZ, Almahdi R, Aldomah MA, Ahmed MH, Elkheir HK, Ibrahim MIM. The Impact of Diabetes Education by Clinical Pharmacist on Quality of Life and Treatment Satisfaction of Sudanese Individuals With Type II Diabetes Mellitus: Randomized, Double-Blind, Controlled Trial. J Prim Care Community Health 2024; 15:21501319241279681. [PMID: 39279353 PMCID: PMC11406634 DOI: 10.1177/21501319241279681] [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: 06/01/2024] [Revised: 08/07/2024] [Accepted: 08/15/2024] [Indexed: 09/18/2024] Open
Abstract
BACKGROUND Patients' satisfaction with their treatment directly impacts the control of their diabetes. Quality of life is crucial for patients with diabetes mellitus to maintain long-term health and minimize complications. The current study aimed to evaluate the impact of diabetes education on quality of life (QoL) and treatment satisfaction of patients with type 2 diabetes mellitus. METHODS The current study was a randomized controlled trial. Patients with type 2 diabetes who were attending the diabetes clinic for 1 year were recruited. The overall sample in this study was 364 participants; 182 controls 182 cases. The interventional and control group participants were assigned randomly by simple random sampling technique. Controls were managed per usual care while cases were managed per usual care plus education done by the researcher. Pre-structured standardized questionnaires were used to collect the data. Data were processed and analyzed by using SPSS; version 28. RESULTS More than three-fourth of the participants; 76.4% were females. The average (±SD) age of the cases was 54.5 (±10) years, while was 56 (±9.8) years for controls. The overall median (IQR) years of DM diagnosis for all participants was 8 (4-14) years. The results showed a statistically significant difference between the mean satisfaction score from baseline to 12 months in the cases compared the controls (P < .001). Furthermore, there are statistically insignificant differences between the changes of mean overall QoL score from baseline to 12 months among the 2 groups. CONCLUSION The education provided improved self-reported treatment-satisfaction among individuals with diabetes .A statistically insignificant differences in QoL between the 2 groups compared to baseline have been shown at the study end.The trial registration number is PACTR202311766174946 which was registered by pan African clinical trials registry, https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=26928.
Collapse
Affiliation(s)
- Safaa Badi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan
| | | | - Rayan Almahdi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan
| | - Mohammed A. Aldomah
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan
| | - Mohamed H. Ahmed
- Department of Medicine and HIV Metabolic Clinic, and Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK
- Honorary Senior Lecturer of the Faculty of Medicine and Health Sciences, University of Buckingham, UK
| | - Habab Khalid Elkheir
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum, Sudan
- Department of Clinical Pharmacy, University of Science and Technology, Khartoum, Sudan
| | | |
Collapse
|
9
|
Lim LL, S H Lau E, Pheng Chan S, Ji L, Lim S, Sirinvaravong S, Unnikrishnan AG, O Y Luk A, Cortese V, Durocher A, C N Chan J. Real-world evidence on health-related quality of life in patients with type 2 diabetes mellitus using sulphonylureas: An analysis of the Joint Asia Diabetes Evaluation (JADE) Register. Diabetes Res Clin Pract 2023; 203:110855. [PMID: 37517776 DOI: 10.1016/j.diabres.2023.110855] [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: 04/13/2023] [Revised: 07/10/2023] [Accepted: 07/25/2023] [Indexed: 08/01/2023]
Abstract
AIMS To describe health-related quality of life (HRQoL) and identify associated factors in patients with type 2 diabetes mellitus (T2DM) treated with oral glucose-lowering drugs (OGLDs). METHODS This retrospective, cross-sectional analysis included adults with T2DM from 11 Asian countries/regions prospectively enrolled in the Joint Asian Diabetes Evaluation (JADE) Register (2007-2019) with available EuroQol-5D (EQ-5D-3L) data. RESULTS Of 47,895 included patients, 42,813 were treated with OGLDs + lifestyle modifications (LSM) and 5,082 with LSM only. Among those treated with OGLDs, 60% received sulphonylureas (SUs), of whom 47% received gliclazide. The OGLD + LSM group had a lower mean EQ-5D-3L index score than the LSM-only group (p < 0.001). The most affected EQ-5D-3L dimensions in OGLD + LSM-treated patients were pain/discomfort (26.2%) and anxiety/depression (22.6%). On multivariate analysis, good HRQoL was positively associated with male sex, education level, balanced diet and regular exercise, and negatively with complications/comorbidities, self-reported hypoglycaemia, smoking, HbA1c, age, body mass index and disease duration. Patients receiving gliclazide vs non-gliclazide SUs had lower HbA1c and better HRQoL in all dimensions (p < 0.001). CONCLUSIONS Demographic, physical and psychosocial-behavioural factors were associated with HRQoL in patients with T2DM. Our real-world data add to previous evidence that gliclazide is an effective OGLD, with most treated patients reporting good HRQoL. A plain language summary of this manuscript is available here.
Collapse
Affiliation(s)
- Lee-Ling Lim
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region; Asia Diabetes Foundation, Shatin, Hong Kong Special Administrative Region
| | - Eric S H Lau
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region; Asia Diabetes Foundation, Shatin, Hong Kong Special Administrative Region
| | - Siew Pheng Chan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking, China
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Sirinart Sirinvaravong
- Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - A G Unnikrishnan
- Department of Endocrinology, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Andrea O Y Luk
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region; Asia Diabetes Foundation, Shatin, Hong Kong Special Administrative Region; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region
| | - Viviana Cortese
- Global Medical and Patient Affairs, Servier Affaires Médicales, Suresnes, France
| | - Alexandra Durocher
- Global Medical and Patient Affairs, Servier Affaires Médicales, Suresnes, France
| | - Juliana C N Chan
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region; Asia Diabetes Foundation, Shatin, Hong Kong Special Administrative Region; Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region; Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong Special Administrative Region.
| |
Collapse
|
10
|
Eljazzar S, Abu-Hijleh H, Alkhatib D, Sokary S, Ismail S, Al-Jayyousi GF, Tayyem R. The Role of Copper Intake in the Development and Management of Type 2 Diabetes: A Systematic Review. Nutrients 2023; 15:nu15071655. [PMID: 37049495 PMCID: PMC10096611 DOI: 10.3390/nu15071655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 03/19/2023] [Accepted: 03/27/2023] [Indexed: 03/30/2023] Open
Abstract
Diabetes mellitus is a worldwide public health issue with numerous complications. Several risk factors are associated with diabetes, mainly due to patients following an unhealthy lifestyle. Copper is a crucial trace element, with various physiological actions. Different intake levels of copper might contribute to diabetes development due to its dual action as both an anti- and pro-oxidant. Aim: Due to the inconclusive findings regarding the relationship between copper consumption and the management of diabetes, we decided to conduct this extensive systematic review. Up to this date, no similar study has been available in the literature. In this review, we used the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Relevant articles were identified by searching the electronic databases CINAHL, EMBASE and Medline from their respective index dates to September 2022 using keywords such as “Copper Intake” and “Type 2 Diabetes”. Any paper that has investigated copper exposure through supplementation or any other method that indicates copper intake in human subjects with type 2 diabetes and measures at least one of the outcomes of interest related to diabetes was included in this review. This review is comprised of 4 cross-sectional studies, 3 cohort studies, 2 RCTs, and 2 interventional studies. Two cohort studies found positive associations between copper intake and the risk of developing T2DM, while no significant association was found in the third study. Regarding diabetes outcomes in the four cross-sectional studies, two found inverse associations, one found a positive relationship, and one found no significant association. In interventional studies, all studies found a protective effect of copper, including the RCT, while one found no significant association. The results are inconsistent concerning the association between copper consumption and the likelihood of developing diabetes are inconsistent. Individuals should receive an adequate dietary amount of copper that is within the RDA levels (900 µg/day) to avoid copper deficiency or toxicity. Further studies, especially RCTs, are strongly needed to enable researchers to elucidate more robust conclusions regarding this association.
Collapse
Affiliation(s)
- Sereen Eljazzar
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Haya Abu-Hijleh
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Dana Alkhatib
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Sara Sokary
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Shrooq Ismail
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Ghadir Fakhri Al-Jayyousi
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
| | - Reema Tayyem
- Department of Human Nutrition, College of Health Sciences, QU Health, Qatar University, Doha P.O. Box 2713, Qatar
- Correspondence:
| |
Collapse
|
11
|
Sendekie AK, Dagnew EM, Tefera BB, Belachew EA. Health-related quality of life and its determinants among patients with diabetes mellitus: a multicentre cross-sectional study in Northwest Ethiopia. BMJ Open 2023; 13:e068518. [PMID: 36697040 PMCID: PMC9884918 DOI: 10.1136/bmjopen-2022-068518] [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] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This study assessed the health-related quality of life (HRQoL) and its determinants in patients with diabetes. DESIGN AND SETTING An institutional-based multicentre prospective cross-sectional study design was conducted in diabetes follow-up clinics of selected hospitals in Northwest Ethiopia from April to July 2022. PARTICIPANTS All eligible adult patients with diabetes at the selected facilities. MAIN OUTCOME MEASURES HRQoL was measured using EuroQol 5-dimensions 5-levels (EQ-5D-5L) and the EuroQol-Visual Analogue Scales (EQ-VAS) instruments. A lower EQ-5D-5L utility mean score for each dimension and/or an overall lower utility score of EQ-5D-5L and EQ-VAS scores are intended to show poor HRQoL. Linear regression analysis was used to identify the association of HRQoL and other variables. RESULTS Out of the 422 samples approached, 402 (95.3%) participated in the study. Most of the participants (>85%) reported having moderate-to-severe problems in all five EQ dimensions. The overall EQ-5D-5L utility and EQ-VAS scores were 0.56 (±0.11) and 56.7 (±10.1), respectively. A higher body mass index (BMI) (p < 0.001), a higher number of medications (p = 0.037), a high level of blood glucose (p < 0.001), the presence of comorbidities and/or complications (p = 0.031), hypoglycaemia (p = 0.043) and taking insulin (p < 0.001) were associated with worsened HRQoL, whereas practicing self-monitoring of blood glucose (p = 0.002) and taking aspirin (p = 0.008) had a significant association with increased HRQoL. CONCLUSION This study concluded that the HRQoL of patients was compromised in all five measuring dimensions. The EQ-5D-5L utility and EQ-VAS scores were far lower than other findings. Clinical and medication-related variables, such as a higher BMI, a higher number of medications, the presence of comorbidities and/or complications, hypoglycaemia and insulin use were associated with poor HRQoL in patients with diabetes. As a result, interventions should be individualised and focused on determinant factors.
Collapse
Affiliation(s)
- Ashenafi Kibret Sendekie
- Department of Clinical Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Ephrem Mebratu Dagnew
- Department of Pharmacy, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Bereket Bahiru Tefera
- Department of Pharmacy, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Eyayaw Ashete Belachew
- Department of Clinical Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
12
|
Homady A, Albasheer O, Bajawi A, Hamdi S, Awaf A, Madkhali T, Sabai A, Zaino MR, Somaili M. Health-related Quality of Life among Type 2 Diabetes Patients in Southern Province of Saudi Arabia using WHOQOL-BREF: A Cross-section Study. Curr Diabetes Rev 2023; 19:e211222212099. [PMID: 36545722 DOI: 10.2174/1573399819666221221160136] [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: 06/12/2022] [Revised: 11/01/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Quality of life has become a more important health outcome with advancements in medical therapies and disease management, leading to better lives for people in general, particularly those living with chronic diseases. Diabetes has a direct impact on the physical, psychological, and social aspects of personal health. This study aimed to determine healthrelated quality of life (HRQOL) and its predictors in patients with type 2 diabetes. METHODS A cross-sectional study was carried out on 420 patients with type 2 diabetes who presented to primary healthcare centers in Samtah Town, Saudi Arabia, from March 2017 to February 2018. The HRQOL of the study participants was determined using the World Health Organization Quality of Life-BREF. Multi-level linear regression was employed to ascertain the factors associated with HRQOL among patients with type 2 diabetes. RESULTS Female sex was significantly associated with higher HbA1c, anxiety, depression, and stress scores and a lower HRQL in the physical, psychological, and environmental health subscales than males (P<0.001). All subscales of HRQOL were significantly lower in the > 50 years age group. When compared to those with low levels of education (illiterate, primary, or elementary school), patients with secondary and bachelor's degrees had significantly higher HRQOL in all subscales (P<0.001). In addition, there were significant differences in glycemic control and HRQL with a longer duration of diabetes, the presence of one or more diabetes complications, and the presence of comorbid hypertension (P<0.001). However, no significant differences in the Depression Anxiety and Stress Scale (DASS) index were observed with a longer duration of diabetes and the presence of comorbid hypertension. Patients with diabetes on combined therapy and healthy diet and exercise showed significantly higher HRQOL on physical functioning (P<0.001). CONCLUSION Type 2 diabetes was significantly associated with impaired health-related quality of life and mental health among study participants. Females appeared to have worse quality of life and mental health than males. Age, duration of diabetes, comorbid hypertension, diabetes complications, and level of education were significantly associated with lower HRQOL and mental health scores. Healthy diet and exercise, when combined with hypoglycemic and insulin therapy, were found to improve HRQOL and mental health among patients with diabetes. Scales based on a broad definition of health, such as the WHOQOL-BREF, are appropriate for use in primary care settings and can enhance patient management and care.
Collapse
Affiliation(s)
- Areej Homady
- Family Medicine and Primary Health Care, Ministry of Health, Jazan, Saudi Arabia
| | - Osama Albasheer
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| | - Amenah Bajawi
- Family Medicine and Primary Health Care, Ministry of Health, Jazan, Saudi Arabia
| | - Shatha Hamdi
- Health Educator, Ministry of Health, Jazan, Saudi Arabia
| | - Aisha Awaf
- Family Medicine and Primary Health Care, Ministry of Health, Jazan, Saudi Arabia
| | - Tahani Madkhali
- Family Medicine and Primary Health Care, Ministry of Health, Jazan, Saudi Arabia
| | - Abdallah Sabai
- Consultant of Community Medicine, Ministry of Health, Jazan, Saudi Arabia
| | - Mohammad R Zaino
- Physical Therapy Department, Faculty of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Mohammed Somaili
- Department of Medicine, Faculty of Medicine, Jazan University, Jazan, Saudi Arabia
| |
Collapse
|
13
|
Teli M, Thato R, Rias YA. Predicting Factors of Health-Related Quality of Life Among Adults With Type 2 Diabetes: A Systematic Review. SAGE Open Nurs 2023; 9:23779608231185921. [PMID: 37448972 PMCID: PMC10336768 DOI: 10.1177/23779608231185921] [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] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 05/10/2023] [Accepted: 06/15/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction One of the most important outcomes of diabetes care and treatment is an improvement in patients' health-related quality of life (HRQoL). Objective This study aimed to review the empirical evidence regarding the predictors of HRQoL among adults with type 2 diabetes mellitus (T2DM). Methods To find all English-language articles published between 2012 and 2022, a comprehensive literature search was conducted using ProQuest, Scopus, PubMed, Science Direct, and CORE. Cross-sectional studies were the focus of this analysis. Search terms included "type 2 diabetes" OR "T2DM" AND "health-related quality of life" OR "HRQoL" AND ("predicting factors" OR "influencing factors" OR "associated factors"). The original search yielded a total of 1,089 studies, from which 35 met the review's inclusion criteria. The systematic review protocol was registered with PROSPERO CRD42023431229. Results The final analysis comprised 24,346 people with type 2 diabetes and used data from 35 cross-sectional studies conducted during the preceding decade. Socio-demographic factors (age, marital status, gender, monthly income, education, area of residence, and religiosity), patient-centered factors (diabetes knowledge and self-efficacy), disease characteristics (comorbidities, duration of diabetes, and insulin treatment), self-management behaviors (physical activity, medication adherence, and frequent glucose checks), and family support were found to be predictors of HRQoL. Conclusion A diabetes program to enhance the HRQoL among people with T2DM is highly encouraged to address these factors, which can be focused on promoting self-management behaviors, diabetes distress management, and encourage family support.
Collapse
Affiliation(s)
- Margareta Teli
- Faculty of Nursing, Chulalongkorn University Bangkok, Bangkok, Thailand
- Nursing School, Polytechnic of Ministry of Health-Kupang, East Nusa Tenggara, Indonesia
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University Bangkok, Bangkok, Thailand
| | - Yohane Andy Rias
- Faculty of Nursing, Chulalongkorn University Bangkok, Bangkok, Thailand
- Institut Ilmu Kesehatan Bhakti Wiyata Kediri, Kediri, Jawa Timur, Indonesia
| |
Collapse
|
14
|
GOKDEMIR O, BULUT BATUR Ü, GÜRKAN A. Type 2 diabetes and atrial fibrillation could cause transient ischemic attack. CUKUROVA MEDICAL JOURNAL 2022. [DOI: 10.17826/cumj.1170881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Diabetes mellitus (DM) is still one of the common chronic problems not only in rural but also the urban cities. While the regulation of blood sugar metabolism is one of the target points, living with DM can trammel primary care physicians.
64 years old female patient who was diagnosed with DM and hypertension for at least 5 years has attended the surgery for nuisance and dysuria. Bacteriuria has detected and blood sugar was 550 mg/dl WBC= 12,48 CRP: 7 HbA1C: 10,4 % Her neurologic examination was normal except she has got urinary incontinence. She was hospitalized with a diagnosis of DM, HT, and cystitis. Metformin 2x1gr, 1x 40 mg, ceftriaxone 2x1gr, and insulin glargine were ordered. Diabetic patient education has been performed. During follow-up, her blood sugar regulation has been settled but she complained of palpitation, ECG has been performed and diagnosed as AF (atrial fibrillation). Her blood pressure was 120/80 and metoprolol infusion was made. INR: 1,44 sec PT=17sn creatine=0,9 mg/dl. Control ECG was at sinus rhythm. While she was in time of recovery, internal medicine consultation has performed and she was planned to discharge. She complained about "could not talk". In her neurologic examination, her left arm has lost strength (3/5) and she could hear and understand what was told but couldn't speak. She was transferred to another health center for detection and treatment as pre-diagnose of Transient Ischemic Attack (TIA).
DM never walks alone. At primary health care centers physicians should be aware of chronic conditions as well as the new onset problems to manage.
Collapse
|
15
|
Geng J, Bao H, Feng Z, Meng J, Yu X, Yu H. Investigating patients' preferences for new anti-diabetic drugs to inform public health insurance coverage decisions: a discrete choice experiment in China. BMC Public Health 2022; 22:1860. [PMID: 36199056 PMCID: PMC9533494 DOI: 10.1186/s12889-022-14244-z] [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: 06/03/2022] [Accepted: 09/21/2022] [Indexed: 11/15/2022] Open
Abstract
Background Diabetes is a major public health concern with a considerable impact on healthcare expenditures. Deciding on health insurance coverage for new drugs that meet patient needs is a challenge facing policymakers. Our study aimed to assess patients’ preferences for public health insurance coverage of new anti-diabetic drugs in China. Methods We identified six attributes of new anti-diabetic drugs and used the Bayesian-efficient design to generate choice sets for a discrete choice experiment (DCE). The DCE was conducted in consecutive samples of type 2 diabetes patients in Jiangsu Province. The mixed logit regression model was applied to estimate patient-reported preferences for each attribute. The interaction model was used to investigate preference heterogeneity. Results Data from 639 patients were available for analysis. On average, the most valued attribute was the improvement in health-related quality of life (HRQoL) (β = 1.383, p < 0.001), followed by positive effects on extending life years (β = 0.787, p < 0.001), and well-controlled glycated haemoglobin (β = 0.724, p < 0.001). The out-of-pocket cost was a negative predictor of their preferences (β = -0.138, p < 0.001). Elderly patients showed stronger preferences for drugs with a lower incidence of serious side effects (p < 0.01) and less out-of-pocket costs (p < 0.01). Patients with diabetes complications favored more in the length of extended life (p < 0.01), improvement in HRQoL (p < 0.05), and less out-of-pocket costs (p < 0.001). Conclusion The new anti-diabetic drugs with significant clinical effectiveness and long-term health benefits should become the priority for public health insurance. The findings also highlight the value of accounting for preference heterogeneity in insurance policy-making. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14244-z.
Collapse
Affiliation(s)
- Jinsong Geng
- Medical School of Nantong University, 226001, Nantong, Jiangsu, China.
| | - Haini Bao
- Medical School of Nantong University, 226001, Nantong, Jiangsu, China.,The First People's Hospital of Lianyungang, 222061, Lianyungang, Jiangsu, China
| | - Zhe Feng
- Medical School of Nantong University, 226001, Nantong, Jiangsu, China
| | - Jingyi Meng
- Medical School of Nantong University, 226001, Nantong, Jiangsu, China
| | - Xiaolan Yu
- Medical School of Nantong University, 226001, Nantong, Jiangsu, China
| | - Hao Yu
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, 02215, Boston, MA, USA
| |
Collapse
|
16
|
Selvakumar G, Lonchin S. Bioactive functional collagen-oxidized pullulan scaffold loaded with polydatin for treating chronic wounds. BIOMATERIALS ADVANCES 2022; 140:213078. [PMID: 35964388 DOI: 10.1016/j.bioadv.2022.213078] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 06/15/2023]
Abstract
Prolonged inflammation, elevated matrix metalloproteinases, hypoxia, decreased vascularization, increased oxidative stress, and bacterial infection are typical signs of chronic non-healing diabetic wounds. Any agent that improves one or all factors could offer enhanced opportunities for better healing of diabetic wounds. In this study, a polyphenol (polydatin) incorporated collagen scaffold was prepared using a biocompatible crosslinker, oxidized pullulan (Col-OxP3-Po), to treat diabetic wounds. The scaffolds were characterized using SEM, FTIR, antioxidant activity, in vitro and in vivo wound healing assay, gene expression, and immunohistopathological studies. Polydatin incorporated scaffold exhibited 75 % antioxidant activity, hemostatic and erythrocyte adhesion properties. FTIR results proved the incorporation of polydatin in the Col-OxP3-Po scaffold. They were also non-toxic to the 3 T3 fibroblasts with a viability of 93 % and good cell attachment. In vivo, normal and diabetic wound healing studies showed that the Col-OxP3-Po scaffold treated group healed on days 16 and 21. The histological and immunohistochemistry analyses of the granulation tissues showed improved epithelialization, angiogenesis and enhanced collagen deposition by modulating TGF-β3 and MMP - 9 gene expressions favorable for better healing. Thus, this scaffold could be a newer treatment strategy for chronic non-healing wounds.
Collapse
Affiliation(s)
- Gopika Selvakumar
- Biochemistry and Biotechnology Laboratory, CSIR - Central Leather Research Institute, Adyar, Chennai 600 020, India; University of Madras, Chepauk, Chennai 600005, India
| | - Suguna Lonchin
- Biochemistry and Biotechnology Laboratory, CSIR - Central Leather Research Institute, Adyar, Chennai 600 020, India.
| |
Collapse
|
17
|
Ndjaboue R, Ngueta G, Rochefort-Brihay C, Delorme S, Guay D, Ivers N, Shah BR, Straus SE, Yu C, Comeau S, Farhat I, Racine C, Drescher O, Witteman HO. Prediction models of diabetes complications: a scoping review. J Epidemiol Community Health 2022; 76:jech-2021-217793. [PMID: 35772935 DOI: 10.1136/jech-2021-217793] [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: 08/11/2021] [Accepted: 06/08/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Diabetes often places a large burden on people with diabetes (hereafter 'patients') and the society, that is, in part attributable to its complications. However, evidence from models predicting diabetes complications in patients remains unclear. With the collaboration of patient partners, we aimed to describe existing prediction models of physical and mental health complications of diabetes. METHODS Building on existing frameworks, we systematically searched for studies in Ovid-Medline and Embase. We included studies describing prognostic prediction models that used data from patients with pre-diabetes or any type of diabetes, published between 2000 and 2020. Independent reviewers screened articles, extracted data and narratively synthesised findings using established reporting standards. RESULTS Overall, 78 studies reported 260 risk prediction models of cardiovascular complications (n=42 studies), mortality (n=16), kidney complications (n=14), eye complications (n=10), hypoglycaemia (n=8), nerve complications (n=3), cancer (n=2), fracture (n=2) and dementia (n=1). Prevalent complications deemed important by patients such as amputation and mental health were poorly or not at all represented. Studies primarily analysed data from older people with type 2 diabetes (n=54), with little focus on pre-diabetes (n=0), type 1 diabetes (n=8), younger (n=1) and racialised people (n=10). Per complication, predictors vary substantially between models. Studies with details of calibration and discrimination mostly exhibited good model performance. CONCLUSION This rigorous knowledge synthesis provides evidence of gaps in the landscape of diabetes complication prediction models. Future studies should address unmet needs for analyses of complications n> and among patient groups currently under-represented in the literature and should consistently report relevant statistics. SCOPING REVIEW REGISTRATION: https://osf.io/fjubt/.
Collapse
Affiliation(s)
- Ruth Ndjaboue
- Faculty of Medicine, Université Laval, Quebec, Quebec, Canada
- School of social work, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- CIUSSS de l'Estrie, Research Centre on Aging, Sherbrooke, Quebec, Canada
| | - Gérard Ngueta
- Université de Sherbrooke Faculté des Sciences, Sherbrooke, Quebec, Canada
| | | | | | - Daniel Guay
- Diabetes Action Canada, Toronto, Ontario, Canada
| | - Noah Ivers
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Department of Family Medicine and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Baiju R Shah
- Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Catherine Yu
- Knowledge Translation, St. Michael's Hospital, Li Ka Shing Knowledge Institute, Toronto, Ontario, Canada
| | - Sandrine Comeau
- Université Laval Faculté de médecine, Quebec, Quebec, Canada
| | - Imen Farhat
- Université Laval Faculté de médecine, Quebec, Quebec, Canada
| | - Charles Racine
- Université Laval Faculté de médecine, Quebec, Quebec, Canada
| | - Olivia Drescher
- Université Laval Faculté de médecine, Quebec, Quebec, Canada
| | - Holly O Witteman
- Family and Emergency Medicine, Laval University, Quebec City, Quebec, Canada
| |
Collapse
|
18
|
Hamman LL, Garba SH, Jacks TW, Zirahei JV, Dibal NI, Attah MOO. Zingiber officinale ameliorates diabetic nephropathy and hepatotoxicity in rats by preventing tissue injury and controlling liver/kidney function. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2022. [DOI: 10.3233/mnm-211557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Chronic hyperglycemia results in decrease glucose metabolism leading to nephropathy, hepatotoxicity and neuropathy. Diabetic complications are regarded globally as one of the leading cause of disability and mortality. OBJECTIVE: The study aims to evaluate the role of Zingiber officinale (ZO) on diabetic nephropathy and hepatotoxicity in rats. METHODS: Thirty diabetic rats and six non-diabetic rats were distributed into six groups (n = 6). Group 1 & 2 (nondiabetic and diabetic) received distilled water at 1 ml/kg. Groups 3–5 received (12.5, 25& 50) mg/kg of ZO respectively while group 6 received 100 mg/kg metformin. All treatments lasted for 28 days and rats were euthanized on day 29. Biochemical parameters, kidney and liver histology were evaluated. RESULTS: No significant change (P > 0.05) was noticed in blood glucose and creatinine levels of diabetic rats treated with 25 mg/kg ZO compared to control. The liver of 25 mg/kg ZO treated diabetic rats showed mild distortion of hepatocytes while kidneys of ZO treated diabetic rats showed mild distortion of renal tubules with few collagen deposits and intact Bowman’s capsule. CONCLUSIONS: ZO ameliorates diabetic complications by regulating biochemical parameters and preventing renal tubules and hepatocytes damage in rats.
Collapse
Affiliation(s)
| | - Sani Hyedima Garba
- Department of Human Anatomy, University of Maiduguri, Maiduguri, Nigeria
| | | | | | - Nathan Isaac Dibal
- Department of Human Anatomy, University of Maiduguri, Maiduguri, Nigeria
| | | |
Collapse
|
19
|
Gebremariam GT, Biratu S, Alemayehu M, Welie AG, Beyene K, Sander B, Gebretekle GB. Health-related quality of life of patients with type 2 diabetes mellitus at a tertiary care hospital in Ethiopia. PLoS One 2022; 17:e0264199. [PMID: 35180266 PMCID: PMC8856533 DOI: 10.1371/journal.pone.0264199] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 02/06/2022] [Indexed: 01/12/2023] Open
Abstract
Background Type 2 diabetes mellitus (T2DM) and its treatment impact patients’ physical health as well as emotional and social wellbeing. This study aimed to assess health-related quality of life (HRQoL) and associated factors among patients with T2DM at a tertiary care hospital in Ethiopia. Methods A face-to-face cross-sectional survey was conducted among patients with T2DM at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. We collected data using a validated Amharic version of the 5-level EuroQoL-5 dimensions (EQ-5D-5L) questionnaire. Descriptive statistics were used to present patient characteristics. Kruskal-Wallis and Mann-Whitney U tests were performed to explore differences in the median scores of EQ-5D-5L utility and visual analog scale (EQ-VAS). Multivariable Tobit regression models were used to identify predictors of HRQoL. Utility scores were calculated using disutility weights of the Ethiopian general population. Statistical significance was determined at p < 0.05. Results A total of 360 patients with T2DM participated. Mean (SD) age was 64.43(10.61) years. Reported health problems were mostly in the pain/discomfort (67.3%) dimension followed by mobility (60.5%), whereas the usual activities domain (34.1%) was the least health problem being reported. The median (IQR) EQ-5D-5L utility and EQ-VAS scores were 0.95 (0.88–0.96) and 80 (75.0–85.0), respectively. In multivariable Tobit regression models older age, having poor glycemic control, longer duration of diabetes, insulin usage, obesity, and having diabetes-related complications were significant negative predictors of HRQoL. Conclusions Overall, patients with T2DM had lower HRQoL than the general population, which was attributed to being older age, longer duration of diabetes, insulin use, obesity, inadequate glycemic control, and diabetes-related complications. The utility index we generated can be used in future economic evaluations to inform decisions about alternative interventions and resource allocation.
Collapse
Affiliation(s)
- Girma Tekle Gebremariam
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | - Selam Biratu
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Metasebia Alemayehu
- School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | | | - Kebede Beyene
- School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | - Beate Sander
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Public Health Ontario, Toronto, Ontario, Canada
| | - Gebremedhin Beedemariam Gebretekle
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Toronto Health Economics and Technology Assessment (THETA) Collaborative, University Health Network, Toronto, Ontario, Canada
- Centre for Vaccine-Preventable Diseases, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| |
Collapse
|
20
|
Factors Associated with Quality of Life in Patients with Type 2 Diabetes of South Benin: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042360. [PMID: 35206551 PMCID: PMC8871979 DOI: 10.3390/ijerph19042360] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 01/27/2023]
Abstract
Background: Type 2 diabetes (T2D) adversely affects health-related quality of life (QoL). However, little is known about the QoL of diabetic patients in Benin, where the disease is a growing concern. Thus, this study aims to assess the QoL and its associated factors among T2D patients in Cotonou, southern Benin. Methods: A total of 300 T2D patients (age > 18 years) were enrolled, and the diabetes-specific quality of life (DQoL) and Natividad self-care behaviors’ (SCB) instruments were used for data collection. DQoL scores were calculated, and factors associated with DQoL explored using logistic regression. Results: The mean of patients’ DQoL was 38.1 ± 4.1, with 43% having low QoL. In terms of DQoL, 56.3% reported a high diabetes impact, followed by low life satisfaction (53%) and high worry about diabetes (32.7%). In the logistic regression analysis, education, marital status, occupation, family history of diabetes, complications, and social support were associated with DQoL. SCB factors, including healthy eating, problem-solving, coping strategies, and risk reduction, were significant predictors of DQoL. Conclusions: Patients’ empowerment, starting with self-management education, is essential to improve the QoL of T2D patients in Cotonou. However, the programs need to target low education, low socioeconomic status, low social support, and overweight patients.
Collapse
|
21
|
Zhang Y, Li S, Liu H, Shi F, Li J, Hu X, Yang Z. Dual-strategy biosensing of glucose based on multifunctional CuWO 4 nanoparticles. Analyst 2022; 147:4049-4054. [DOI: 10.1039/d2an01003h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The multifunctional CuWO4 NPs were prepared and exhibit large specific surface area, good conductivity and excellent peroxidase-like activity, which was exploited for electrochemical and colorimetric dual-strategy biosensing of glucose.
Collapse
Affiliation(s)
- Yu Zhang
- School of Nursing, Yangzhou University, Yangzhou 225000, PR China
| | - Shuang Li
- School of Nursing, Yangzhou University, Yangzhou 225000, PR China
| | - Hongyuan Liu
- School of Nursing, Yangzhou University, Yangzhou 225000, PR China
| | - Feng Shi
- College of Chemistry and Chemical Engineering, Yangzhou University, Yangzhou 225002, PR China
| | - Juan Li
- College of Chemistry and Chemical Engineering, Yangzhou University, Yangzhou 225002, PR China
| | - Xiaoya Hu
- College of Chemistry and Chemical Engineering, Yangzhou University, Yangzhou 225002, PR China
| | - Zhanjun Yang
- College of Chemistry and Chemical Engineering, Yangzhou University, Yangzhou 225002, PR China
| |
Collapse
|
22
|
Chen CC, Chen JH, Chen CL, Lai TJ, Ko Y. Health Utilities in Patients with Type 2 Diabetes in Taiwan. Healthcare (Basel) 2021; 9:healthcare9121672. [PMID: 34946402 PMCID: PMC8701244 DOI: 10.3390/healthcare9121672] [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: 11/08/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/16/2022] Open
Abstract
We aimed to measure health utilities in patients with diabetes mellitus (DM) in Taiwan and to estimate the impact of common DM-related complications and adverse effects (AEs) on health utilities. The present study was a cross-sectional survey of DM patients at a metropolitan hospital. Respondents’ health-related quality of life (HRQoL) was assessed by the EQ-5D-5L, and ordinary least-squares (OLS) regression was used to estimate the impact of self-reported DM-related complications and AEs on health utilities after controlling for age, gender, and duration of DM. A total of 506 eligible adults with type 2 DM (T2DM) were enrolled. The EQ-5D index values in our study sample ranged from −0.13 to 1, with a mean ± standard deviation of 0.88 ± 0.20. As indicated by the negative regression coefficients, the presence of any complication or AE was associated with lower EQ-5D index values, and the greatest impact on the score was made by amputation (−0.276), followed by stroke (−0.211), and blindness (−0.203). In conclusion, the present study elicited health utilities in patients with T2DM in Taiwan using the EQ-5D-5L. These estimated utility decrements provided essential data for future DM cost–utility analyses that are needed as a result of the increasing prevalence and health expenditures of DM.
Collapse
Affiliation(s)
- Chia-Chia Chen
- Department of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan;
| | - Jin-Hua Chen
- Graduate Institute of Data Science, College of Management, Taipei Medical University, Taipei 11031, Taiwan;
- Statistics Center, Office of Data Science, Taipei Medical University, Taipei 11031, Taiwan
| | - Chien-Lung Chen
- Division of Nephrology, Landseed International Hospital, Taoyuan 32449, Taiwan;
| | - Tzu-Jung Lai
- Center for Drug Evaluation, Taipei 11557, Taiwan;
| | - Yu Ko
- Department of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan;
- Research Center for Pharmacoeconomics, College of Pharmacy, Taipei Medical University, Taipei 11031, Taiwan
- Correspondence: ; Tel.: +886-2-2736-1661 (ext. 6174)
| |
Collapse
|
23
|
Inhibition of Advanced Glycation End Product Formation in Rat Tail Tendons by Polydatin and p-Coumaric acid: an In Vitro Study. Appl Biochem Biotechnol 2021; 194:339-353. [PMID: 34855112 DOI: 10.1007/s12010-021-03762-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 11/08/2021] [Indexed: 12/22/2022]
Abstract
Advanced glycation end products (AGEs) formed through non-enzymatic glycosylation between a protein and sugar molecule are highly harmful to the human body. In hyperglycemic patients, AGE formation is more due to high glucose circulating in the blood, causing inter and intra molecular cross-linking of collagen leading to reduction of collagen elasticity. This cross-linked collagen develops resistance to matrix metalloproteinases leading to impaired collagen turnover. The aim of this work is to determine the anti-glycation effects of polydatin and p-coumaric acid in preventing collagen cross-linking by incubating rat tail tendons (RTTs) as collagen source in high glucose concentration (50 mM) for a week. The RTTs were then characterized for tensile strength, cross-linking efficiency, circular dichroism spectrometry, collagen, glucose, and aldehyde contents. Electrophoresis was carried out to evaluate the level of cross-linking in collagen and the results confirmed the ability of the drugs in preventing complex intermolecular cross-link formation induced by non-enzymatic glycosylation. CD data showed alteration in the secondary structure of collagen where AGE formation had occurred. More collagen was extracted by pepsin from RTTs treated with glucose alone (6.88 mg/10 mg tendon) when compared with drug-treated groups (4.25, 2.56 mg/10 mg tendon for polydatin and p-coumaric acid, respectively). Tensile strength (20.66% and 18.95%), cross-linking percentage (32.5% and 29.84%), and glucose content (2.3 and 1.8 mg/100 mg) of drug-treated groups were similar to the positive control (19.07%, 30.13%, and 2.61 mg/100 mg) thus proving the anti-glycation potential of the drugs. Hence, both polydatin and p-coumaric acid could play a pivotal role in preventing AGE formation.
Collapse
|
24
|
Kuo S, Yang C, Chen H, Ou H. Valuing health states of people with type 2 diabetes: Analyses of the nationwide representative linked databases. J Diabetes Investig 2021; 12:1749-1758. [PMID: 33539655 PMCID: PMC8409834 DOI: 10.1111/jdi.13520] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/29/2021] [Accepted: 02/02/2021] [Indexed: 11/27/2022] Open
Abstract
AIMS/INTRODUCTION To estimate preference-based measures of health-related quality of life associated with sociodemographic and clinical characteristics in type 2 diabetes patients. MATERIALS AND METHODS Individuals with EuroQol-5 dimensions-3 levels data were identified from Taiwan's National Health Interview Survey in 2009 and 2013. Status of diabetes, comorbidities, complications and treatments were ascertained through data linkage to Taiwan's National Health Insurance Research Database. Multivariable ordinary least squares, Tobit and median regression analyses were used to estimate the coefficients that represented independent impacts of patients' characteristics on health-related quality of life. RESULTS The mean health utility score for 2,104 participants was 0.838. Being female, aging, divorced/widowed, never worked or underweight, or having a lower monthly household income, injectable glucose-lowering therapy, comorbid connective tissue disease or depression were associated with lower health utilities. Having an amputation led to the largest reduction by 0.288 in health utilities, followed by debilitating stroke (0.266), heart failure (0.237), other coronary heart disease (0.185), kidney dialysis/transplant (0.148), coronary revascularizations (0.093), transient ischemic attack/stroke (0.078), diabetic neuropathy (0.062), polyneuropathy (0.055) and other neuropathy (0.043). CONCLUSIONS Major vascular complications, connective tissue disease and depression are associated with considerably worse health-related quality of life. These health utility estimates can facilitate health economic evaluations to determine cost-effective strategies for diabetes management.
Collapse
Affiliation(s)
- Shihchen Kuo
- Division of Metabolism, Endocrinology & DiabetesDepartment of Internal MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Chun‐Ting Yang
- Institute of Clinical Pharmacy and Pharmaceutical SciencesCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Hsuan‐Ying Chen
- Institute of Clinical Pharmacy and Pharmaceutical SciencesCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
| | - Huang‐Tz Ou
- Institute of Clinical Pharmacy and Pharmaceutical SciencesCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of PharmacyCollege of MedicineNational Cheng Kung UniversityTainanTaiwan
- Department of PharmacyNational Cheng Kung University HospitalTainanTaiwan
| |
Collapse
|
25
|
Mok CH, Kwok HHY, Ng CS, Leung GM, Quan J. Health State Utility Values for Type 2 Diabetes and Related Complications in East and Southeast Asia: A Systematic Review and Meta-Analysis. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2021; 24:1059-1067. [PMID: 34243830 DOI: 10.1016/j.jval.2020.12.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/18/2020] [Accepted: 12/29/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVES East and Southeast Asia has the greatest burden of diabetes in the world. We sought to derive a reference set of utility values for type 2 diabetes without complication and disutility (utility decrement) values for important diabetes-related complications to better inform economic evaluation. METHODS A systematic review to identify utility values for diabetes and related complications reported in East and Southeast Asia. We searched MEDLINE (OVID) from inception to May 26, 2020 for utility values elicited using direct and indirect methods. Identified studies were assessed for quality based on the National Institute of Health and Care Excellence guidelines. Utility and disutility estimates were pooled by meta-analyses with subgroup analyses to evaluate differences by nationality and valuation instrument. (PROSPERO: CRD42020191075). RESULTS We identified 17 studies for the systematic review from a total of 13 035 studies in the initial search, of which 13 studies met the quality criteria for inclusion in the meta-analyses. The pooled utility value for diabetes without complication was 0.88 (95% CI 0.83-0.93), with the pooled utility decrement for associated complications ranged from 0.00 (for excess BMI) to 0.18 (for amputation). The utility values were consistently more conservative than previous estimates derived in Western populations. Utility decrements were comparable for SF-6D and EQ-5D valuation instruments and for Chinese and other Asian groups. CONCLUSIONS A reference set of pooled disutility and utility values for type 2 diabetes and its complications in East and Southeast Asian populations yielded more conservative estimates than Western populations.
Collapse
Affiliation(s)
- Chiu Hang Mok
- Division of Health Economics, Policy, and Management, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Harley H Y Kwok
- Division of Health Economics, Policy, and Management, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Carmen S Ng
- Division of Health Economics, Policy, and Management, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| | - Gabriel M Leung
- Division of Health Economics, Policy, and Management, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China; Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong SAR, China
| | - Jianchao Quan
- Division of Health Economics, Policy, and Management, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
26
|
Arab-Zozani M, Safari H, Dori Z, Afshari S, Ameri H, Namiranian N, Hoseini E, Jafari A. Estimating Utility Values for Health States of DFU Patients Using EQ-5D-5L and cTTO. INT J LOW EXTR WOUND 2021; 21:41-49. [PMID: 33939495 DOI: 10.1177/15347346211014392] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Health-state utility values of diabetic foot ulcer (DFU) patients are necessary for clinical praxis and economic modeling. The purpose of this study was to estimate utility values in DFU patients using the EuroQol-5-dimension-5-level (EQ-5D-5L) and composite time trade-off (cTTO). The EQ-5D-5L and cTTO were used for estimating utility values. Data were collected from 228 patients referred to the largest governmental diabetes center in the South of Iran, Yazd province. When appropriate, independent sample t-test or analysis of variance test was used to test the difference in the utility values in each of the demographic and clinical characteristics of the patients. Finally, the BetaMix was used to identify predictors of the utility values. The means of EQ-5D-5L and cTTO values were 0.55(SD 0.21) and 0.67(SD 0.23), respectively. Anxiety and pain were the most common problems reported by the patients. The difference between the mean EQ-5D-5L values was significant for age, grade of ulcer, number of comorbidities, and having complications. In addition, variables of gender, age, grade of ulcer, and having complications were significant predictors of the EQ-5D-5L. The difference between the mean cTTO values was significant for age, employment status, grade of ulcer, number of comorbidities, and having complications. Moreover, variables of gender, age, grade of ulcer, number of comorbidities, and developing complications were significant predictors of cTTO. The current study provided estimates of utility values for DFU patients for clinical praxis and economic modeling. These estimates, similar to utilities reported in other studies, were low. Identifying strategies to decrease anxiety/depression and pain in patients is important to improve the utility values.
Collapse
Affiliation(s)
- Morteza Arab-Zozani
- 125609Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Hossein Safari
- 440827Health Promotion Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Zoha Dori
- 48516Health Policy and Management Research Center, Department of Health Services Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Somayeh Afshari
- 48439Department of Health Management and Economics, School of Public Health, Tehran University of Medical Science, Tehran, Iran
| | - Hosein Ameri
- 48516Health Policy and Management Research Center, Department of Health Services Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nasim Namiranian
- 48516Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Elham Hoseini
- 48516Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Abdolkhalegh Jafari
- 48516Diabetes Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
27
|
Pai LW, Chiu SC, Liu HL, Chen LL, Peng T. Effects of a health education technology program on long-term glycemic control and self-management ability of adults with type 2 diabetes: A randomized controlled trial. Diabetes Res Clin Pract 2021; 175:108785. [PMID: 33781794 DOI: 10.1016/j.diabres.2021.108785] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 11/20/2022]
Abstract
AIMS This study aimed to explore the effects of a health technology education program on long-term glycemic control and the self-management ability of adults with type 2 diabetes (T2D). METHODS The study was a randomized controlled trial with repeated measures design. The experimental group (n = 53) received a novel health technologies education program plus focus groups and routine shared care, the control group (n = 55) received routine shared care. Glycosylated hemoglobin (HbA1c) level and self-management ability were the primary and secondary outcomes. Subject self-management ability was evaluated using the Chinese version of Perceived Diabetes Self-Management Scale (PDSMS). A linear mixed-effect model for repeated measures was used to analyze changes in HbA1c level and self-management ability after controlling for pretest effects. RESULTS The mean HbA1c levels in the experimental group decreased by 0.692% (7.564 mmol/mol) and 0.671% (7.332 mmol/mol) at 3 and 6 months after the intervention (p < 0.05) while the mean increase in the PDSMS scores at 3 and 6 months after the intervention were significantly higher than those in the control group (p < 0.05). CONCLUSION The health technology education program was more effective than routine shared care alone in lowering HbA1c and increasing self-management ability in T2D patients.
Collapse
Affiliation(s)
- Lee-Wen Pai
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
| | - Shu-Ching Chiu
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
| | - Hsin-Li Liu
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
| | - Li-Li Chen
- School of Nursing, China Medical University, Taichung, Taiwan; Department of Nursing, China Medical University Hospital, Taichung, Taiwan.
| | - Tien Peng
- Department of Nursing, Central Taiwan University of Science and Technology, Taichung, Taiwan.
| |
Collapse
|
28
|
The association between diabetic complications and health-related quality of life in patients with type 2 diabetes: a cross-sectional study from Iran. Qual Life Res 2021; 30:1963-1974. [PMID: 33900519 DOI: 10.1007/s11136-021-02792-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This study aimed to investigate the health-related quality of life (HRQoL) of type 2 diabetic patients and its relationship with the complications of diabetes in Farashband County, Fars, Iran. METHODS Data of this cross-sectional study were collected by a researcher-made demographic questionnaire, EuroQol-5 Dimensions questionnaire (EQ-5D) and Visual Analog Scale (VAS) and also from patient records. Multivariate regression model was used to investigate the net effect of diabetes complications on HRQoL after controlling for other independent variables. RESULTS A total of 685 patients with a mean age of 58.36 and a disease duration of 7.64 years participated in the study. The mean EQ-5D and EQ-VAS scores of all patients were 0.64 and 56.53, respectively. The HRQoL dimensions in which the largest portions of the population had problems were Pain/Discomfort (77.23%) and Anxiety/Depression (63.50%). Among the studied diabetic patients, women, divorcees, and widows were more likely to report problems in all dimensions of HRQoL, and people without complications, people with university degrees, and employed people were more likely to report fewer problems in these dimensions (P < 0.05). After controlling for the effect of all independent variables in the multivariate regression model, a significant negative relationship was found between diabetes complications and EQ-5D: β = - 0.149 (95% CI - 0.186, - 0.112) and EQ-VAS: β = - 6.697 (95% CI - 9.947, - 3.747). This indicates that for each additional diabetic complication, 0.149 and 6.697 units of EQ-5D Index and EQ-VAS were reduced, respectively. CONCLUSION This study indicated that type 2 diabetic patients in the studied region, especially those with complications, suffer from poor HRQoL. Therefore, more attention should be paid to the main determinants of HRQoL when adopting policies for diabetes management in order to ultimately improve the HRQoL of these patients.
Collapse
|
29
|
Abdelkader RY, Abdelrazek MA, Attallah A, Farid K, El-Far M. High blood glucose levels are associated with fibrosis/cirrhosis progression in chronic hepatitis C. J Immunoassay Immunochem 2021; 42:559-570. [PMID: 33886414 DOI: 10.1080/15321819.2021.1911813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Chronic hepatitis C (CHC) leads eventually to liver fibrosis, advanced hepatic disease and related deaths. Therefore, it is very important to assess clinical risk factors associated with rapid CHC and hepatic fibrosis progression. Former studies reported diabetes mellitus synergistic interactions with other host factors to fibrosis progression. Here, we aimed to evaluate the association between elevated blood glucose levels and CHC progression according to METAVIR system in patients chronically infected with HCV-genotype 4 and to evaluate the correlation between elevated glucose levels and liver- and viral-related biochemical parameters. A total of 160 patients with CHC (80 with liver fibrosis and 80 with cirrhosis) and 40 healthy volunteers, negative for HCV, were included. Our results revealed that cirrhotic patients had high (P = .0001) fasting (169.1 ± 50.2 mg/dL), postprandial (208 (123-320) mg/dL), and random (176.8 ± 51 mg/dL) glucose levels compared to patients with liver fibrosis (105.0 ± 32, 120 (105-135), and 113.5 ± 35 mg/dL, respectively). Mean serum fasting, postprandial and random glucose levels were significantly (P = .0001) increased with an increase in fibrosis stages, F1< F2< F3< F4. Blood glucose levels were also significantly (P < .05) correlated with liver disease related biological parameters and HCV-Ab titer. In conclusion, our results highlighted the fibrogenic impact of elevated glucose levels on CHC patients.
Collapse
Affiliation(s)
- Reem Y Abdelkader
- Research and Development Department, Biotechnology Research Centre, New Damietta, Egypt
| | - Mohamed A Abdelrazek
- Research and Development Department, Biotechnology Research Centre, New Damietta, Egypt
| | - Abdelfattah Attallah
- Research and Development Department, Biotechnology Research Centre, New Damietta, Egypt
| | - Khaled Farid
- Tropical Medicines Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Mohamed El-Far
- Chemistry Department, Biochemistry Division, Faculty of Science, Mansoura University, Mansoura, Egypt
| |
Collapse
|
30
|
Bawadi H, Al-Shahwani A, Arafeh D, Al-Asmar D, Moawad J, Shi Z, Daher-Nashif S. Depressive Symptoms among Patients with Diabetes in Qatar: Frequency and Potential Determinants. Healthcare (Basel) 2021; 9:healthcare9030302. [PMID: 33803134 PMCID: PMC7999723 DOI: 10.3390/healthcare9030302] [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: 02/03/2021] [Revised: 02/26/2021] [Accepted: 03/01/2021] [Indexed: 12/16/2022] Open
Abstract
Background: Diabetes is a highly prevalent chronic disease that is associated with major complications. Findings regarding risk of depression among patients with diabetes are controversial. This study aimed to determine the prevalence and determinants of depressive symptoms among Qatari patients with type 2 diabetes. Methods: This cross-sectional study was based on Qatar Biobank (QBB) data of 2448 Qatari adults with diabetes aged 21–60 years old. Data regarding age, gender, education, income, body mass index (BMI), medication use, glycated hemoglobin (HbA1c) were retrieved. Patients’ responses to the Patient Health Questionnaire-9 (PHQ-9) were also obtained. Data analyses was performed using STATA 16, and statistical significance was considered at a p-value of <0.05. Results: Of the 2448 participants, 15.4% (n = 378) had self-reported depressive symptoms. Depressive symptoms were frequent among females (69.6%), smokers (15.9%), and participants with a higher level of education (47.1%). Average age of participants who reported depressive symptoms was significantly less that among participants without depressive symptoms (44.8 vs. 52.9 years). Qatari women with diabetes seem to be at higher risk of depression when compared to men (OR = 1.819, 95% CI: 1.42–2.33); The odds of reporting depressive symptoms were 35% higher among patients with more advanced educational qualifications (OR = 1.351, 95% CI: 1.00, 1.82). Smokers were twice as likely to report depressive symptoms as their non-smoking counterparts. There was no significant relationship between depression and poor glycemic control, physical activity, BMI, or insulin use. Conclusions: In summary, the study results suggest that several sociodemographic factors, such as age, gender, and level of education were associated with the risk of depressive symptoms among Qataris with diabetes.
Collapse
Affiliation(s)
- Hiba Bawadi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar; (H.B.); (A.A.-S.); (D.A.); (D.A.-A.); (J.M.); (Z.S.)
| | - Alanood Al-Shahwani
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar; (H.B.); (A.A.-S.); (D.A.); (D.A.-A.); (J.M.); (Z.S.)
| | - Dana Arafeh
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar; (H.B.); (A.A.-S.); (D.A.); (D.A.-A.); (J.M.); (Z.S.)
| | - Daniah Al-Asmar
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar; (H.B.); (A.A.-S.); (D.A.); (D.A.-A.); (J.M.); (Z.S.)
| | - Joyce Moawad
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar; (H.B.); (A.A.-S.); (D.A.); (D.A.-A.); (J.M.); (Z.S.)
| | - Zumin Shi
- Department of Human Nutrition, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar; (H.B.); (A.A.-S.); (D.A.); (D.A.-A.); (J.M.); (Z.S.)
| | - Suhad Daher-Nashif
- Population Medicine Department, College of Medicine, QU-Health, Qatar University, Doha 2713, Qatar
- Correspondence:
| |
Collapse
|
31
|
Tran Kien N, Phuong Hoa N, Minh Duc D, Wens J. Health-related quality of life and associated factors among patients with type II diabetes mellitus: A study in the family medicine center (FMC) of Agricultural General Hospital in Hanoi, Vietnam. Health Psychol Open 2021; 8:2055102921996172. [PMID: 33747536 PMCID: PMC7905732 DOI: 10.1177/2055102921996172] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The current study aimed to examine the health-related quality of life (HRQoL) and to identify its related factors amongst adult patients with type 2 diabetes mellitus (T2DM). This cross-sectional study recruited randomly 519 patients diagnosed with T2DM for at least 6 months in the Family medicine center (FMC) of Agricultural General Hospital in Hanoi, Vietnam. The Short Form 36 (SF-36) health survey was used to measure their HRQoL. The female patients had lower physical and mental scores than the male patients. Patients with older age, comorbidity, and insulin treatment were more likely to have lower HRQoL. Meanwhile, educational attainment and having frequent exercise were positively associated with HRQoL.
Collapse
|
32
|
Zhu YY, Yang ZY, Li P, Huang XY, Zhang XH, Ji LN, Tang JL. Comparing the incidence of major cardiovascular events and severe microvascular complications in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. World J Meta-Anal 2020; 8:400-410. [DOI: 10.13105/wjma.v8.i5.400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/09/2020] [Accepted: 10/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) causes both macrovascular and microvascular complications. However, currently, selection of glycemic measures and their thresholds to diagnose T2DM, and efficacy outcomes in evaluation of anti-diabetic drugs is predominantly informed by the relation of T2DM to microvascular complications. We can be severely mistaken on T2DM by neglecting macrovascular complications which are generally more severe, if they also occur more commonly than microvascular complications.
AIM To compare the incidence of major cardiovascular events (MACEs) and severe microvascular complications (SMICs) in T2DM patients.
METHODS MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched from inception to September 2017. Cohort studies or trials of T2DM patients aged 18 years or older that reported incidence of both MACEs and SMICs were included. MACEs were defined as nonfatal myocardial infarction and stroke, and cardiovascular death, while SMICs included serious retinopathy, nephropathy and diabetic disorder. The relative risk (RR) was estimated as the incidence of MACEs divided by that of SMICs in same patients and combined with meta-analysis in a random-effect model.
RESULTS Twelve studies with a total of 16 cohorts and 387376 patients were included, and the combined RR was 2.02 (95%CI: 1.46–2.79). The higher incidence of MACEs remained in various subgroup and sensitivity analyses.
CONCLUSION Patients with T2DM are much more likely to develop MACEs than SMICs. By taking more serious consequences and relatively higher incidence into consideration, macrovascular complications deserve more emphasis in developing the diagnostic criteria of T2DM and in evaluating the efficacy of anti-diabetic drugs.
Collapse
Affiliation(s)
- Ying-Ying Zhu
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Zu-Yao Yang
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Ping Li
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xin-Ying Huang
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Xue-Hong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, United States
| | - Li-Nong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, Peking University Diabetes Centre, Beijing 100044, China
| | - Jin-Ling Tang
- Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| |
Collapse
|
33
|
Zare F, Ameri H, Madadizadeh F, Reza Aghaei M. Health-related quality of life and its associated factors in patients with type 2 diabetes mellitus. SAGE Open Med 2020; 8:2050312120965314. [PMID: 33996077 PMCID: PMC8107944 DOI: 10.1177/2050312120965314] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/18/2020] [Indexed: 12/12/2022] Open
Abstract
Background: Assessing the health-related quality of life in patients with type 2 diabetes
mellitus is important for evaluation of treatment outcome. The purpose of
this study was to evaluate the health-related quality of life in type 2
diabetes mellitus patients and its related factors in Yazd. Methods: Data were gathered by using the EuroQoL-five-dimension-5 level instrument as
well as using medical records of 734 outpatients with type 2 diabetes
mellitus who were referred to the largest governmental diabetes center in
South of Iran, Yazd province. When appropriate, the Kruskal–Wallis test or
the Wilcoxon test was used to test the difference in the health-related
quality-of-life scores in each factor. Finally, the adjusted limited
dependent variable mixture model was developed to investigate factors
associated with health-related quality-of-life scores. Results: The mean and median of the EuroQoL-five-dimension-5 level index values of 717
patients who completed the questionnaires were 0.75 ± 0.006 and 0.72 ± 0.20,
respectively, and those of the Visual Analogue Scale scores were
69.25 ± 0.63 and 75 ± 30, respectively. The mean scores for health-related
quality of life were significantly higher for employed, educated, single,
and male patients, as well as patients without comorbidities,
diabetes-related complications, and hemoglobin A1c level >7%. Adjusted
limited dependent variable mixture model showed that gender, age, marital
status, and diabetes-related complications are significant independent
predictors of EuroQoL-five-dimension-5 level index value. Conclusion: The mean scores for health-related quality of life in patients with type 2
diabetes mellitus were moderate in this study, and this finding is
consistent with health-related quality-of-life scores reported in other
studies conducted in the Middle East region. Therefore, health-related
quality of life should be the most important consideration in the management
of patients. In parallel, some factors, especially gender, should be
considered to improve health-related quality of life.
Collapse
Affiliation(s)
- Forouzan Zare
- Department of Health Technology
Assessment, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hosein Ameri
- Department of Health Technology
Assessment, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
- Hosein Ameri, Department of Health
Technology Assessment, Shahid Sadoughi University of Medical Sciences, Yazd,
Iran.
| | - Farzan Madadizadeh
- Department of Epidemiology and
Biostatistics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohammad Reza Aghaei
- Yazd Diabetic Research Center, Shahid
Sadoughi University of Medical Sciences, Yazd, Iran
| |
Collapse
|
34
|
Medveczky DM, Kodsi R, Skelsey K, Grudzinskas K, Bueno F, Ho V, Kormas N, Piya MK. Class 3 Obesity in a Multidisciplinary Metabolic Weight Management Program: The Effect of Preexisting Type 2 Diabetes on 6-Month Weight Loss. J Diabetes Res 2020; 2020:9327910. [PMID: 32832564 PMCID: PMC7422012 DOI: 10.1155/2020/9327910] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 06/24/2020] [Accepted: 07/10/2020] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION Class 3 obesity (BMI ≥ 40 kg/m2) is a growing health problem worldwide associated with considerable comorbidity including Type 2 diabetes mellitus (T2DM). The multidisciplinary medical management of obesity can be difficult in T2DM due to potential weight gain from medications including sulphonylureas and insulin. However, newer weight-neutral/losing diabetes medications can aid additional weight loss. The aim of this study was to compare weight loss outcomes of patients with and without T2DM, and in patients with T2DM, to compare diabetes outcomes and change in medications at 6 months. METHODS All patients entering a multidisciplinary weight management metabolic program in a publicly funded hospital clinic in Sydney between March 2018 and March 2019, with BMI ≥ 40 kg/m2 and aged ≥18 years were included. Data was collected from patient clinical and electronic notes at baseline and 6 months. RESULTS Of the 180 patients who entered the program, 53.3% had T2DM at baseline. There was no difference in percentage weight loss in those with or without T2DM (4.2 ± 4.9% vs. 3.6 ± 4.7%, p = 0.35). Additionally, T2DM patients benefited from a 0.47% reduction in HbA1c (p < 0.01) and a reduction in the number of medications from baseline to 6 months (1.8 ± 1.0/patient vs. 1.0 ± 1.2/patient, p < 0.001). T2DM patients who started on weigh-neutral/losing medications in the program lost more weight than those started on weight-gaining medications (7.7 ± 5.3% vs. 2.4 ± 3.8%, p = 0.015). CONCLUSIONS Patients with class 3 obesity had significant weight loss at 6 months in this program. Patients with T2DM at baseline had comparable weight loss at 6 months, a significant improvement in glycaemic control, and a reduction in diabetes medication load. Additionally, patients with T2DM who were started on weight-neutral/losing medications lost significantly more weight than those started on weight-gaining medications, and these medications should be preferentially used in class 3 obesity and comorbid T2DM.
Collapse
Affiliation(s)
| | - Raymond Kodsi
- South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden Hospital, NSW, Australia
| | - Kathryn Skelsey
- South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden Hospital, NSW, Australia
| | - Kathy Grudzinskas
- South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden Hospital, NSW, Australia
| | - Flavia Bueno
- School of Medicine, Western Sydney University, NSW, Australia
- South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden Hospital, NSW, Australia
| | - Vincent Ho
- School of Medicine, Western Sydney University, NSW, Australia
- South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden Hospital, NSW, Australia
| | - Nic Kormas
- South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden Hospital, NSW, Australia
| | - Milan K. Piya
- School of Medicine, Western Sydney University, NSW, Australia
- South Western Sydney Metabolic Rehabilitation and Bariatric Program, Camden Hospital, NSW, Australia
| |
Collapse
|