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Subba R, Fasciolo G, Geremia E, Muscari Tomajoli MT, Petito A, Carrella S, Mondal AC, Napolitano G, Venditti P. Simultaneous induction of systemic hyperglycaemia and stress impairs brain redox homeostasis in the adult zebrafish. Arch Biochem Biophys 2024; 759:110101. [PMID: 39029645 DOI: 10.1016/j.abb.2024.110101] [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: 04/21/2024] [Revised: 07/15/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
For diabetic patients it is crucial to constantly monitor blood glucose levels to mitigate complications due to hyperglycaemia, including neurological issues and cognitive impairments. This activity leads to psychological stress, called "diabetes distress," a problem for most patients living with diabetes. Diabetes distress can exacerbate the hyperglycaemia effects on brain and negatively impact the quality of life, but the underlying mechanisms remain poorly explored. We simulated diabetes distress in adult zebrafish by modelling hyperglycaemia, through exposure to dextrose solution, along with chronic unpredictable mild stress (CUMS), and evaluated brain redox homeostasis by assessing reactive oxygen species (ROS) content, the antioxidant system, and effects on mitochondrial biogenesis and fission/fusion processes. We also evaluated the total, cytosolic and nuclear content of nuclear factor erythroid 2-related factor 2 (NRF2), a critical regulator of redox balance, in the whole brain and total NRF2 in specific brain emotional areas. The combined CUMS + Dextrose challenge, but not the individual treatments, reduced total NRF2 levels in the entire brain, but strongly increased its levels in the nuclear fraction. Compensatory upregulation of antioxidant genes appeared inadequate to combat elevated levels of ROS, leading to lowering of the reduced glutathione content and total antioxidant capacity. CUMS + Dextrose treatment also upregulated transcription factors implicated in mitochondrial biogenesis and dynamics with a predominance of fission, which is consistent with increased oxidative stress. In conclusion, this study highlights the close interplay between hyperglycaemia and psychological distress causing overriding oxidative stress in the brain, rendering the organism vulnerable to the development of disease complications.
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Affiliation(s)
- Rhea Subba
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India, 110067
| | - Gianluca Fasciolo
- Department of Biology, University of Naples Federico II, Naples, Italy; Ecosustainable Marine Biotechnology Department, Stazione Zoologica Anton Dohrn, Via Acton 55, Napoli, 80133, Italy
| | - Eugenio Geremia
- International PhD Programme, UNESCO Chair "Environment, Resources and Sustainable Development", Department of Science and Technology, Parthenope University of Naples, 80143, Naples, Italy
| | - Maria Teresa Muscari Tomajoli
- International PhD Programme, UNESCO Chair "Environment, Resources and Sustainable Development", Department of Science and Technology, Parthenope University of Naples, 80143, Naples, Italy
| | - Adriana Petito
- Department of Biology, University of Naples Federico II, Naples, Italy
| | - Sabrina Carrella
- Ecosustainable Marine Biotechnology Department, Stazione Zoologica Anton Dohrn, Via Acton 55, Napoli, 80133, Italy
| | - Amal Chandra Mondal
- Laboratory of Cellular and Molecular Neurobiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India, 110067.
| | - Gaetana Napolitano
- International PhD Programme, UNESCO Chair "Environment, Resources and Sustainable Development", Department of Science and Technology, Parthenope University of Naples, 80143, Naples, Italy.
| | - Paola Venditti
- Department of Biology, University of Naples Federico II, Naples, Italy.
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Kollin SR, Gratz KL, Lee AA. The role of emotion dysregulation in self-management behaviors among adults with type 2 diabetes. J Behav Med 2024; 47:672-681. [PMID: 38671288 PMCID: PMC11291593 DOI: 10.1007/s10865-024-00483-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 02/27/2024] [Indexed: 04/28/2024]
Abstract
Suboptimal disease self-management among adults with type 2 diabetes is associated with greater risk of diabetes related health complications and mortality. Emotional distress has been linked with poor diabetes self-management; however, few studies have examined the role of emotion dysregulation in diabetes management. The purpose of this study was to examine the relations between different facets of emotion dysregulation and diabetes self-management behaviors among a sample of 373 adults with type 2 diabetes. Separate median regression and binary logistic regression models were used to examine the association of emotion dysregulation facets and each diabetes self-care behavior (i.e., medication nonadherence, diet, exercise, self-monitoring of blood glucose (SMBG), foot care, and smoking). Generally, greater difficulties in emotion regulation were associated with poorer self-management behaviors. However, several facets of emotion dysregulation were linked with better self-management behaviors. Addressing emotion dysregulation among adults with type 2 diabetes has the potential to improve diabetes related self-management.
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Affiliation(s)
- Sophie R Kollin
- Department of Psychology, University of Mississippi, 304 University Circle, Oxford, 38677, MS, England
| | - Kim L Gratz
- Lyra Health, Burlingame, CA, USA
- Department of Psychology, University of Toledo, Toledo, OH, USA
| | - Aaron A Lee
- Department of Psychology, University of Mississippi, 304 University Circle, Oxford, 38677, MS, England.
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3
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Huang X, Wu M, Lin J, Mou L, Zhang Y, Jiang J. Gastrointestinal safety evaluation of semaglutide for the treatment of type 2 diabetes mellitus: A meta-analysis. Medicine (Baltimore) 2024; 103:e38236. [PMID: 38787986 PMCID: PMC11124640 DOI: 10.1097/md.0000000000038236] [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: 01/17/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Semaglutide, as an innovative weekly formulation, has attracted much attention. Nevertheless, the predominant occurrence of gastrointestinal adverse events (GIAEs) poses a noteworthy challenge linked to the use of this medication, substantially affecting its clinical applicability and the overall well-being of patients. Therefore, this systematic review aims to comprehensively discuss the GIAEs, providing a basis for clinical therapeutic decisions. METHODS We systematically searched 4 independent databases for randomized controlled trials investigating the application of semaglutide in managing type 2 diabetes mellitus. The search period spanned from the inception of the databases to December 2023. We conducted a comprehensive meta-analysis, employing Review Manager 5.4.1 software, to systematically analyze and evaluate potential biases. Our primary emphasis was on assessing the gastrointestinal safety profile of semaglutide. RESULTS The outcomes unveiled a noteworthy rise in the collective occurrence of GIAEs across all dosage groups of semaglutide in comparison with the control group (P < .05). Upon further analysis, it was observed that semaglutide showed a heightened occurrence of GIAEs in contrast to the placebo. However, statistically significant distinction was not observed when compared to the reduction of conventional doses or the transition to other types of glucagon-like peptide-1 receptor agonist. Additionally, an extended treatment duration with semaglutide (>30 weeks) demonstrated an association with a certain degree of decrease in the incidence of gastrointestinal events. Funnel plot assessment for publication bias demonstrated high-quality inclusion of studies with no apparent publication bias. CONCLUSION The frequency of GIAEs in using semaglutide was observed to be elevated in comparison to the control group. However, it was comparable to other glucagon-like peptide-1 receptor agonist or low-dose treatment regimens. Additionally, an extended treatment duration played a role in decreasing the frequency of GIAEs. These findings provide valuable insights for clinical practice. Nonetheless, further research is crucial to explore supplementary data indicators, informing clinical practices and better serving the interests of patients.
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Affiliation(s)
- Xiaoyan Huang
- Department of Endocrinology, Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian, China
| | - Miaohui Wu
- School of Pharmacy, Fujian Medical University, Fujian, China
| | - Jiaojiao Lin
- Department of Endocrinology, Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian, China
| | - Lunpan Mou
- Department of Endocrinology, Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian, China
| | - Yaping Zhang
- Department of Endocrinology, Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian, China
| | - Jianjia Jiang
- Department of Endocrinology, Quanzhou First Hospital Affiliated to Fujian Medical University, Fujian, China
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Hoogendoorn CJ, Krause-Steinrauf H, Uschner D, Wen H, Presley CA, Legowski EA, Naik AD, Golden SH, Arends VL, Brown-Friday J, Krakoff JA, Suratt CE, Waltje AH, Cherrington AL, Gonzalez JS. Emotional Distress Predicts Reduced Type 2 Diabetes Treatment Adherence in the Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE). Diabetes Care 2024; 47:629-637. [PMID: 38227900 PMCID: PMC10973907 DOI: 10.2337/dc23-1401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/18/2023] [Indexed: 01/18/2024]
Abstract
OBJECTIVE We examined longitudinal associations between emotional distress (specifically, depressive symptoms and diabetes distress) and medication adherence in Glycemia Reduction Approaches in Diabetes: A Comparative Effectiveness Study (GRADE), a large randomized controlled trial comparing four glucose-lowering medications added to metformin in adults with relatively recent-onset type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS The Emotional Distress Substudy assessed medication adherence, depressive symptoms, and diabetes distress in 1,739 GRADE participants via self-completed questionnaires administered biannually up to 3 years. We examined baseline depressive symptoms and diabetes distress as predictors of medication adherence over 36 months. Bidirectional visit-to-visit relationships were also examined. Treatment satisfaction, beliefs about medication, diabetes care self-efficacy, and perceived control over diabetes were evaluated as mediators of longitudinal associations. RESULTS At baseline, mean ± SD age of participants (56% of whom were White, 17% Hispanic/Latino, 18% Black, and 66% male) was 58.0 ± 10.2 years, diabetes duration 4.2 ± 2.8 years, HbA1c 7.5% ± 0.5%, and medication adherence 89.9% ± 11.1%. Higher baseline depressive symptoms and diabetes distress were independently associated with lower adherence over 36 months (P < 0.001). Higher depressive symptoms and diabetes distress at one visit predicted lower adherence at the subsequent 6-month visit (P < 0.0001) but not vice versa. Treatment assignment did not moderate relationships. Patient-reported concerns about diabetes medications mediated the largest percentage (11.9%-15.5%) of the longitudinal link between emotional distress and adherence. CONCLUSIONS Depressive symptoms and diabetes distress both predict lower adherence to glucose-lowering medications over time among adults with T2DM. Addressing emotional distress and concerns about anticipated negative effects of taking these treatments may be important to support diabetes treatment adherence.
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Affiliation(s)
- Claire J. Hoogendoorn
- Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
| | - Heidi Krause-Steinrauf
- Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | - Diane Uschner
- Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | - Hui Wen
- Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | - Caroline A. Presley
- General Internal and Preventive Medicine, Department of Medicine, University of Alabama, Birmingham, Birmingham, AL
| | - Elizabeth A. Legowski
- Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | - Aanand D. Naik
- Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VA Medical Center, Houston, TX
- University of Texas Health Science Center (UTHealth) School of Public Health, Houston, TX
- Consortium on Aging, University of Texas Health Science Center (UTHealth), Houston, TX
| | - Sherita Hill Golden
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Valerie L. Arends
- Advanced Research and Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN
| | - Janet Brown-Friday
- Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Jonathan A. Krakoff
- Obesity and Diabetes Clinical Research Section, National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, AZ
| | - Colleen E. Suratt
- Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD
| | | | - Andrea L. Cherrington
- General Internal and Preventive Medicine, Department of Medicine, University of Alabama, Birmingham, Birmingham, AL
| | - Jeffrey S. Gonzalez
- Endocrinology, Department of Medicine, Albert Einstein College of Medicine, Bronx, NY
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
- New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY
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5
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Ali SA, Salih SM, Abdelmola A, Makeen AM, Solan YM, Mohammed Ali MM. Association of Anxiety and Depressive Symptoms and Treatment Adherence Among Patients With Type 2 Diabetes Mellitus in Jazan, Saudi Arabia: A Cross-Sectional Study. Cureus 2024; 16:e56068. [PMID: 38618389 PMCID: PMC11009697 DOI: 10.7759/cureus.56068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND Diabetes mellitus is a serious public health concern. It is associated with many psychological problems, such as depression, anxiety, and eating disorders. These co-morbidities are associated with improper adherence to treatment, self-care, poor glycemic control, more complications, and worse outcomes. METHODS This study aimed to measure the level of medication adherence among type 2 diabetics in Jazan, Saudi Arabia, and to find its association with their psychological status (specifically, depression and anxiety). A cross-sectional descriptive design was used among adults with type 2 diabetes at the Diabetes and Endocrinology Center in Jazan, Saudi Arabia. The estimated sample size was 480 patients. The General Medication Adherence Scale and Patient Health Questionnaire-4 (PHQ-4) were used as tools to achieve the study objectives. RESULTS A total of 449 diabetic patients completed the survey (93.5% response rate). Patients with poor, low, and partial adherence account for 337 (75%) of patients and only 112 (25%) have good and high medication adherence. Employment and duration of illness were highly significant with a positive relationship to treatment adherence (p = 0.010 and 0.000, respectively). On the other hand, age and disease duration had a significant relationship with psychological disorders (p = 0.029 and 0.002, respectively). Of the patients, 64 (14.3%) had high scores on the PHQ-4, with depressive symptoms in 46 (10.24%) and anxiety symptoms in 75 (16.7%). Correlation analysis reveals that there is a highly significant negative correlation between psychological disorders and adherence to medications (r = -0.288, p = 0.000). CONCLUSION A negative correlation between psychological disorders and adherence to medications was found. The findings indicate the importance of psychological support for diabetic patients for better treatment adherence.
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Affiliation(s)
- Suhaila A Ali
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Sarah M Salih
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Amani Abdelmola
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Anwar M Makeen
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan, SAU
| | - Yahia M Solan
- Department of Family Medicine, Jazan Diabetes and Endocrinology Center, Jazan, SAU
| | - Mona M Mohammed Ali
- Department of Pediatric Endocrinology, Jazan Diabetes and Endocrinology Center, Jazan, SAU
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Adugnew M, Fetene D, Assefa T, Kedir S, Asmamaw K, Feleke Z, Gomora D, Mamo H. Diabetes-related distress and its associated factors among people with type 2 diabetes in Southeast Ethiopia: a cross-sectional study. BMJ Open 2024; 14:e077693. [PMID: 38176868 PMCID: PMC10773350 DOI: 10.1136/bmjopen-2023-077693] [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: 07/12/2023] [Accepted: 12/18/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Diabetes-related distress lowers the motivation for self-care, often leading to lowered physical and emotional well-being, poor diabetes control, poor medication adherence and increased mortality among individuals with diabetes. OBJECTIVE To assess factors associated with diabetes-related distress among people living with type 2 diabetes in Southeast Ethiopia. DESIGN Institution-based cross-sectional study was conducted. SETTING Six diabetic follow-up care units at public hospitals in Southeast Ethiopia. PARTICIPANTS All adult people living with type 2 diabetes from the diabetic follow-up clinic. THE MAIN OUTCOME MEASURES Diabetes Distress Scale-17 questionnaire was used to assess diabetes-related distress. RESULTS Out of the total 871 study participants intended, 856 participated in the study with a response rate of 98.3%. The findings showed that about 53.9% (95% CI 50.4% to 57.2%) of the patients have diabetes-related distress. Physical activity (adjusted OR, AOR 2.22; 95% CI 1.36 to 3.63), social support (AOR 4.41; 95% CI 1.62 to 12.03), glycaemic control (AOR 2.36; 95% CI 1.35 to 4.12) and other comorbidities (AOR 3.94; 95% CI 2.01 to 7.73) were factors that significantly associated with diabetes-related distress at p<0.05. CONCLUSION This study demonstrated that more than half of the participants had diabetes-related distress. Therefore, the identified factors of diabetes-related distress need to be a concern for health institutions and clinicians in the management of people living with type 2 diabetes.
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Affiliation(s)
| | | | | | - Sana'a Kedir
- Nursing, Madda Walabu University, Goba, Ethiopia
| | | | | | | | - Hailye Mamo
- Nursing, Madda Walabu University, Goba, Ethiopia
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Lekha PPS, Azeez EPA. Psychosocial Facilitators and Barriers to Type 2 Diabetes Management in Adults: A Meta-Synthesis. Curr Diabetes Rev 2024; 20:110-123. [PMID: 38310483 DOI: 10.2174/0115733998283436231207093250] [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: 10/04/2023] [Revised: 11/10/2023] [Accepted: 11/29/2023] [Indexed: 02/05/2024]
Abstract
BACKGROUND Globally, the cases of type 2 diabetes are increasing, and this is largely attributed to lifestyle changes. Though diabetes is primarily a metabolic disease determined by biological factors, psychosocial aspects play a crucial role in its progression and management. However, the literature on psychosocial dimensions of diabetes management is minuscule and scattered. OBJECTIVE This synthesis sought to understand the psychosocial facilitators and barriers to type 2 diabetes management and coping among adults. METHODS We have adopted a meta-synthesis to review available qualitative studies using Pub- Med and Scopus databases. Based on inclusion criteria, we have chosen 24 studies published between 2010 and 2023. We have considered studies across countries, among which 63% of the studies included were from Western countries, and most have employed qualitative descriptive design. The selected studies were analyzed thematically using a deductive framework. RESULTS Six themes emerged as the psychosocial barriers and facilitators of managing and coping with type 2 diabetes: 1) cognitive-emotional factors, 2) faith, 3) constraints to behavioural change, 4) social constraints and support, 5) healthcare provider-patient relationship, and 6) awareness. Further, a conceptual framework was developed from the synthesis. CONCLUSION The patients' experiences evident from this synthesis signify the crucial role of psychosocial factors in diabetes management and coping. This evidence emphasizes the need for integrated care so that psychosocial aspects are addressed by healthcare providers and behavioural health professionals, which may lead to the promotion of facilitators and the minimization of barriers.
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Affiliation(s)
- P Padma Sri Lekha
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, India
| | - E P Abdul Azeez
- School of Social Sciences and Languages, Vellore Institute of Technology, Vellore, India
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8
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Tamuhla T, Raubenheimer P, Dave JA, Tiffin N. Routine health data describe adherence and persistence patterns for oral diabetes medication for a virtual cohort in the Khayelitsha sub-district of Cape Town, South Africa. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002730. [PMID: 38127875 PMCID: PMC10734983 DOI: 10.1371/journal.pgph.0002730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 11/29/2023] [Indexed: 12/23/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is managed with combined lifestyle modifications and antidiabetic drugs, but people on treatment often fail to reach glycaemic control. Adherence is important for achieving optimal glycaemic control, and management of diabetes with drugs is a lifelong process, so understanding adherence through analysis of longitudinal medications data is important. Using retrospective routine health data and metformin dispensing records as a proxy for medication use, we describe longitudinal persistence and adherence to oral diabetes medication in a virtual cohort of 10541 people with diabetes (PLWD) in Khayelitsha subdistrict, Cape Town. Adherence was measured in 120-day sliding windows over two years and used to estimate metformin adherence trajectories. Multinomial logistic regression identified factors influencing these trajectories. Analysis of pharmacy dispensing records showed varying medication refill patterns: while some PLWD refilled prescriptions consistently, others had treatment gaps with periods of non-persistence and multiple treatment episodes-from one to five per individual across two years. There was a general trend of decreasing adherence over time across all sliding windows in the two-year period, with only 25% of the study population achieved medication adherence (> = 80% adherence) after two years. Four adherence trajectories; 'low adherence gradual decline (A), 'high adherence rapid decline' (B), 'low adherence gradual increase (C) and 'adherent' (D) were identified. Only trajectory D represented participants who were adherent at treatment start and remained adherent after two years. Taking HIV antiretroviral treatment before or concurrently with diabetes treatment and taking metformin in combination with sulphonylurea and/or insulin were associated with the long-term adherence (trajectory D). Routine data shows real life medication implementation patterns which might not be seen under controlled study conditions. This study illustrates the utility of these data in describing longitudinal adherence patterns at both an individual and population level.
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Affiliation(s)
- Tsaone Tamuhla
- Division of Computational Biology, Integrative Biomedical Sciences Department, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
- South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa
| | - Peter Raubenheimer
- Division of Endocrinology, Department of Medicine, Faculty of Health Sciences, University of Cape Town (UCT), Cape Town, South Africa
| | - Joel A. Dave
- Division of Endocrinology, Department of Medicine, Faculty of Health Sciences, University of Cape Town (UCT), Cape Town, South Africa
| | - Nicki Tiffin
- South African National Bioinformatics Institute, University of the Western Cape, Cape Town, South Africa
- Wellcome Centre for Infectious Disease Research in Africa, Institute of Infectious Diseases and Molecular Medicine, University of Cape Town, Cape Town, South Africa
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9
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Opoku R, Ackon SK, Kumah E, Botchwey COA, Appiah NE, Korsah S, Peprah M. Self-care behaviors and associated factors among individuals with type 2 diabetes in Ghana: a systematic review. BMC Endocr Disord 2023; 23:256. [PMID: 37993843 PMCID: PMC10664613 DOI: 10.1186/s12902-023-01508-x] [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: 06/15/2023] [Accepted: 11/08/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Self-care remains an effective model for diabetes management and care in low-and-middle-income countries due to the limited resources available for the clinical management of the disease and its complications This study examined adherence to self-care behaviors and associated factors among people with type 2 diabetes in Ghana. METHODS PubMed, PsycINFO, Scopus, Web of Science, Embase and Google scholar were used to identify quantitative observational studies published between 1990 and September 30, 2023. Studies exclusive to persons with type 2 diabetes ≥ 18 years of age in a Ghanaian setting were included in this review. Findings of primary studies were analyzed using narrative synthesis. RESULTS Twelve studies, presenting data on a total of 2,671 persons with type 2 diabetes, were included. All the studies were published in the last decade (2015-2022) and a majority of them were from the Greater Accra Region. The mean number of days (per week) participants adhered to a self-care behavior were in the ranges of 3.9-4.4 for diet, 4.2-4.8 for physical activity, 0.5-2.2 for self-monitoring of blood glucose (SMBG), and 2.9-5.0 for foot care. Adherence rates for medication were in the range of 33.5-84.5%. Patient-related factors, sociodemographic/economic-related factors, condition-related factors, and healthcare system-related factors were associated with various self-care behaviors. CONCLUSION Adherence to self-care behaviors among persons with type 2 diabetes in Ghana remains an ongoing challenge with significant variations in adherence among patients with different characteristics.
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Affiliation(s)
- Richmond Opoku
- Department of Health Administration and Education, University of Education, Winneba, Ghana
| | - Solomon Kwesi Ackon
- Department of Health Administration and Education, University of Education, Winneba, Ghana
| | - Emmanuel Kumah
- Department of Health Administration and Education, University of Education, Winneba, Ghana.
| | | | - Nana Esi Appiah
- Maxillofacial Surgery Unit, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Shadrach Korsah
- Mastercard Foundation Scholars Program, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Peprah
- Department of Health Administration and Education, University of Education, Winneba, Ghana
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Kiarie JN, Mambo SN, Kamundi GK. A cross-sectional study on the association between varied social support modalities and glycemic levels amongst diabetic patients residing in Machakos County, Kenya. Pan Afr Med J 2023; 45:99. [PMID: 37692985 PMCID: PMC10491716 DOI: 10.11604/pamj.2023.45.99.39472] [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: 02/28/2023] [Accepted: 06/09/2023] [Indexed: 09/12/2023] Open
Abstract
Introduction diabetes is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. While there's increasing evidence that social support from caregivers improves health outcomes in chronic illness management, the potential associations of the different types of social support and glycemic control among Type II diabetes clients have largely been ignored in Kenya. This cross-sectional study sought to establish the association between tangible, emotional, and informational social support and glycemic levels among clients diagnosed with Type II diabetes in Machakos County, Kenya. Methods semi-structured interviews were conducted with 726 randomly selected Type II diabetes clients enrolled in diabetes care and treatment programs in government-owned public health facilities in Masinga and Matungulu sub-counties, Machakos, Kenya. Descriptive statistics and multinomial logistic regression were conducted to elucidate any associations. Results seventy-three percent (73%) of the respondents were female, and 27% were male, with the majority (77.9%) being above 50 years and having lived with diabetes for over 3 years (61.5%). Opportunities for social support existed, with 62% of the respondents living with more than 2 persons above 18 in their households. From the Random Blood Glucose test analysis, 38.9% of the clients had high glycemic levels, partly because the majority (66.9%) of the respondents did not practice good diabetes self-management practices at the time of the study. While all three types of social support were reported as provided, only 30.6% reported receiving adequate social support. An association was found between social support and glycemic levels with respondents receiving adequate informational- P<0.05, OR 1.92, emotional -P<0.05, OR 3.7, and tangible support -P<0.05, OR 4.1 more likely to have better glycemic control than those with inadequate support. Conclusion clients receiving adequate informational, emotional, and tangible social support were 2, 4, and 4 times, respectively, likely to have better glycemic control than those with inadequate support. Of the three types of social support, tangible support was most needed. Ultimately, a greater understanding of these interactions through longitudinal studies is required to identify solutions and optimize glycaemic control for diabetes clients in Kenya and beyond.
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Affiliation(s)
- Jackline Njeri Kiarie
- School of Public Health, Department of Environmental Health and Disease Control, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Susan Njoki Mambo
- School of Public Health Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
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11
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Shahabi N, Fakhri Y, Aghamolaei T, Hosseini Z, Homayuni A. Socio-personal factors affecting adherence to treatment in patients with type 2 diabetes: A systematic review and meta-analysis. Prim Care Diabetes 2023; 17:205-220. [PMID: 37012162 DOI: 10.1016/j.pcd.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/16/2023] [Accepted: 03/19/2023] [Indexed: 04/03/2023]
Abstract
PURPOSE The purpose of study was to identify the socio-personal factors affecting adherence to the treatment of patients with type 2 diabetes. METHODS Cross-sectional articles were extracted from databases such as Web of Science, PubMed, Elsevier. A meta-analysis was performed using integrated odds ratios (OR) and 95% confidence interval (CIs) for age, BMI, depression, educational level, gender, employment status, marital status, smoking status. STATA 12.0 was used to estimate pooled RR in definite subgroups. The quality of the studies included was evaluated using the STROBE checklist. RESULTS Thirty-one studies out of 7407 extracted articles were finally selected for the meta-analysis. The results showed that younger people had a 17% higher risk than older people, smokers had a 22% higher risk than non-smokers, and the employed had a 15% higher risk of non-adherence to treatment. CONCLUSION In conclusion, older age, smoking and employment can lead to non-adherence to T2D treatment. Interventions are suggested to be made besides common health care considering the socio-personal features on type 2 diabetes patients' treatment adherence.
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Affiliation(s)
- Nahid Shahabi
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Yadolah Fakhri
- Food Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Teamur Aghamolaei
- Cardiovascular Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Zahra Hosseini
- Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
| | - Atefeh Homayuni
- Student Research Committee, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
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Alharbi S, Alhofaian A, Alaamri MM. Illness Perception and Medication Adherence among Adult Patients with Type 2 Diabetes Mellitus: A Scoping Review. Clin Pract 2023; 13:71-83. [PMID: 36648847 PMCID: PMC9844476 DOI: 10.3390/clinpract13010007] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 12/25/2022] [Accepted: 12/28/2022] [Indexed: 01/06/2023] Open
Abstract
(1) Background: Type 2 diabetes mellitus (T2DM) is a global disease with a compelling impact on developed and developing economies across the globe. The World Health Organization (WHO) (2020) reported a global prevalence of 8.5% in 2014 among adults aged at least 18 years. Consequently, the condition led to a 5% increase in premature mortality from 2000 to 2016. Aim: The scoping review sought to examine illness perception and medication adherence among adult patients with T2DM. (2) Methods: The study was conducted in 2021 and covered articles published in English in the last five years. PubMed, MEDLINE, CINAHL, and ScienceDirect were the primary search engines used to generate the required scholarly records. A total of 20 studies met the inclusion criteria. (3) Results: The 20 studies selected for the scoping review covered different themes on the overall concept of illness perception and medication adherence in adults with Type 2 Diabetes Mellitus. Each study presented unique implications for research and influence on the policymaking relating to the treatment or the management of type 2 diabetes mellitus in adults of different aged groups. (4) Conclusions: The studies reveal both high and low adherence to medications in adults with type 2 diabetes mellitus. The management and treatment of the condition depend on the uptake of oral hypoglycemic agents or insulin as well as the recommended therapies to enhance the clinical outcomes of the patients.
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Khashayar P, Shirzad N, Zarbini A, Esteghamati A, Hemmatabadi M, Sharafi E. Diabetes-related distress and its association with the complications of diabetes in Iran. J Diabetes Metab Disord 2022; 21:1569-1575. [PMID: 35915591 PMCID: PMC9328774 DOI: 10.1007/s40200-022-01103-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 07/04/2022] [Indexed: 11/24/2022]
Abstract
Purpose Diabetes-related distress (DRD) has negative emotional effects on the patients’ quality of life. This is while the condition often goes undiagnosed despite it being common among diabetic patients. This study investigated the prevalence of DRD and its association with diabetes complications among a group of Iranian type 2 diabetic patients (T2DM). Methods This descriptive-analytical cross-sectional study was conducted on 186 T2DM patients referred to a diabetes clinic in a teaching hospital from the beginning of May 2019 to the end of April 2020. Two questionnaires on disease-related information and diabetes distress screening scale (DDS) were filled out for each patient. The latter was divided into four domains, emotional burden (EB), diabetes-related interpersonal distress (ID), physician-related distress (PD), and regimen-related distress (RD). In addition to the frequency of DRD and its association with age, sex, body mass index (BMI), hypertension, hemoglobin A1C, duration of disease, and type of medication regimen (oral, insulin, or mix) along with the history of cardiovascular disease (CVDs), retinopathy, nephropathy, and diabetic foot were assessed. Results DRD was reported in 47% of the patients. Being female, old age, hypertension, high hemoglobin A1C levels, nephropathy, and retinopathy were significantly associated with DRD (P-value = < 0.001, 0.013, 0.014, 0.007, 0.001, and 0.004, respectively). The history of the diabetic foot had a significant relationship with PD and ID (P-value = 0.007 and < 0.001, respectively). Multivariate regression showed gender and the existence of complications to have a direct effect on the development of DRD. Conclusion DRD prevalence is relatively high and requires screening to identify and treat high-risk patients. Further studies are needed to study diabetes, its complications and their relation with DRD to help reduce such conditions and improve the patient’s quality of life.
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Affiliation(s)
- Pouria Khashayar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Nooshin Shirzad
- Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, P. O. Box, Tehran, 13145-784 Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Aghil Zarbini
- Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Esteghamati
- Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, P. O. Box, Tehran, 13145-784 Iran
| | - Mahboobeh Hemmatabadi
- Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, P. O. Box, Tehran, 13145-784 Iran
| | - Elham Sharafi
- Department of Psychiatry, Psychosomatic Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Fayed A, AlRadini F, Alzuhairi RM, Aljuhani AE, Alrashid HR, Alwazae MM, Alghamdi NR. Relation between diabetes related distress and glycemic control: The mediating effect of adherence to treatment. Prim Care Diabetes 2022; 16:293-300. [PMID: 34922848 DOI: 10.1016/j.pcd.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 11/19/2022]
Abstract
AIMS Diabetes related distress (DRD) is a negative emotional reaction to stresses associated with diabetes mellitus (DM) and its management. This study estimated the burden of DRD and self-reported adherence to treatment (SRAT) among patients with DM and investigated their relationship with glycemic control. METHODS A cross sectional study of consented 157 diabetics was conducted using the17-item Diabetes Distress Scale (DDS). It measures distress at four subscales: Emotional Burden (EB), Physician-related (PD), Regimen-related (RD) and Interpersonal Distress (ID). SRAT was assessed using Morisky's scale. Glycemic control was assessed using the most recent HbA1c results. Multivariable linear regression analysis was used for adjustment of confounders and bootstrap Confidence Interval was used to test for the occurrence of mediating effect. RESULTS Average age was 44.5 ± 16.0 years, 65% were females, 79% had type 2 DM and nearly 55% has had DM for more than 7 years and the average HbA1c was 8.9 ± 2.2%. Clinically significant DRD was reported by 37% of the participants, EB and RD in 40.8%, PD in 46.5%, and ID among 32.5%. Younger patients showed higher level of stress compared to older participants and patients with type 1 DM showed higher level of stress in all DRD domains. Only 46% of patients were defined as having satisfactory SRAT and improvement of SRAT significantly enhanced the glycemic control (r = -0.32, p < 0.01). DRD and low SRAT negatively correlated with HbA1c; increasing the DRD by one point may increase the HbA1c on average by 0.41 (C.I. 0.02-0.80) and will indirectly raise the HbA1c by 0.24 (C.I. 0.04-0.47) through the mediating effect of low SRAT. CONCLUSION DRD and low SRAT are commonly reported among DM patients and both are indirectly correlated. The mediating effect of low SRAT highlights the clinical role of DRD and clarifies the process by which distress affect the outcome of DM management.
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Affiliation(s)
- Amel Fayed
- Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, PO Box 84428, Saudi Arabia
| | - Faten AlRadini
- Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, PO Box 84428, Saudi Arabia.
| | - Ruba Mohammed Alzuhairi
- Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, PO Box 84428, Saudi Arabia
| | - Afrah Eid Aljuhani
- Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, PO Box 84428, Saudi Arabia
| | - Hana Rashid Alrashid
- Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, PO Box 84428, Saudi Arabia
| | - Manal Mohsen Alwazae
- Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, PO Box 84428, Saudi Arabia
| | - Nuha Ramadan Alghamdi
- Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh 11671, PO Box 84428, Saudi Arabia
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Worsa KT, Zinab B, Teshome MS. Dietary Practice among Type 2 Diabetic Ppatients in Southern Ethiopia. Int J Endocrinol 2021; 2021:1359792. [PMID: 34987574 PMCID: PMC8723874 DOI: 10.1155/2021/1359792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/05/2021] [Accepted: 12/13/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Diabetic patients' dietary practice is critical to improve glycemic, lipid, and blood pressure control. However, a significant number of patients had poor dietary practice. In Ethiopia, more than half of diabetic patients were not practicing a healthy dietary approach. Therefore, this study assessed variables that were hardly addressed in previous studies. The aim of this study was to assess dietary practice and associated factors among patients with type 2 diabetes. METHODS A facility-based cross-sectional study was performed among patients with type 2 diabetes in Arba Minch General Hospital from April 21 to May 20, 2020. A systematic sampling technique was used to select 352 patients. The data were entered into EpiData version 3.1 and exported to SPSS version 21 for cleaning and analysis. Descriptive statistics were performed. All variables in bivariate analysis with p-value <0.25 were entered into a multivariable logistic regression model, and statistical significance was declared at a p-value of less than 0.05. RESULTS The prevalence of poor dietary practice was found to be 40.6% (95%CI (35.7-46.0)). After adjusting for other variables in multivariable analysis, not attending formal education (AOR = 3.0; 95%CI (1.6-5.5)), being at primary education level (AOR = 2.2; 95%CI (1.1-4.4)), being moderately food insecure (AOR = 5.3; 95%CI (2.8-9.9)), having depression (AOR = 5.9; 95%CI (3.0-11.4)), and not having nutrition education (AOR = 2.2; 95% (1.1-4.6)) were factors associated with poor dietary practice. CONCLUSIONS A significant proportion of patients had poor dietary practice. The poor dietary practice was significantly higher among those with no formal education, at the primary education level, from the moderately food-insecure household, having depression, and not having nutrition education. The results imply the need for strengthening health information dissemination concerning healthy dietary practice in the form of a package.
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Affiliation(s)
- Kidus Temesgen Worsa
- School of Public Health, College of Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Beakal Zinab
- Department of Nutrition and Dietetics, Faculty of Public Health, Health Institute, Jimma University, Jimma, Ethiopia
| | - Melese Sinaga Teshome
- Department of Nutrition and Dietetics, Faculty of Public Health, Health Institute, Jimma University, Jimma, Ethiopia
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Tasya Z, Amiruddin R, Syam A, Thamrin Y. Psychotherapy intervention diabetes distress in diabetes patients: A systematic review. ENFERMERIA CLINICA 2021. [DOI: 10.1016/j.enfcli.2021.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Factors Associated with Diabetes-Related Distress in Patients with Type 2 Diabetes Mellitus. JOURNAL OF INTERDISCIPLINARY MEDICINE 2021. [DOI: 10.2478/jim-2021-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction: The aim of this study was to identify factors associated with diabetes-related distress (DRD) in adult patients with type 2 diabetes mellitus (T2DM).
Material and Methods: This was an analysis of data previously obtained from two cross-sectional studies, in which medical charts review and direct interviews were employed to obtain medical and demographic data. Vital status assessment and anthropometric measurements were performed. The patients filled out specific questionnaires for DRD (DDS-17), symptoms of depression (PHQ-9), and of anxiety (GAD-7). A clinical meaningful threshold for DRD was set at ≥2.0 points. Symptoms of depression and anxiety, number of chronic complications, therapy for T2DM, anthropometric and cardio-metabolic parameters, as well as demographic, socio-economic data, and lifestyle habits were evaluated as factors possibly associated with DRD by univariate and multiple regression analyses.
Results: A total of 271 patients with T2DM were included in this analysis, of whom 25.1% presented a DDS-17 score ≥2 points (and 9.96% a DDS-17 score ≥3). Subjects with a DDS-17 score ≥2 had higher HbA1c levels (p = 0.018), PHQ-9 and GAD-7 scores (p <0.0001 for both). The multiple regression model indicated that anxiety (p = 0.026), depression (p = 0.001), and ethnicity (p = 0.002) were significantly correlated with DRD (p <0.0001). With regards to subscales, the HbA1c (p = 0.005) and PHQ-9 score (p <0.0001) were significantly associated with emotional burden, ethnicity (p = 0.001) and depression (p = 0.004) with regimen-related distress, whereas ethnicity (p = 0.010) and GAD-7 score (p = 0.012) with interpersonal distress.
Conclusions: Psychosocial factors like depression, anxiety, or ethnicity significantly contribute to DRD in patients with T2DM, and worse glycemic control is associated with emotional burden.
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Li T, Quan H, Zhang H, Lin L, Ou Q, Chen K. Silencing cyclophilin A improves insulin secretion, reduces cell apoptosis, and alleviates inflammation as well as oxidant stress in high glucose-induced pancreatic β-cells via MAPK/NF-kb signaling pathway. Bioengineered 2021; 11:1047-1057. [PMID: 32970961 PMCID: PMC8291783 DOI: 10.1080/21655979.2020.1823729] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cyclophilin A is increased in the plasm of diabetic patients, while its effects on high glucose (HG)-stimulated pancreatic β-cells are still pending. The aim of this research is to investigate the effects of cyclophilin A inhibition on HG-challenged pancreatic β-cells. For investigating the effects of cyclophilin A decrease on HG-induced pancreatic β-cells, the cells were separated into normal glucose (NG), Mannitol, HG, HG + shRNA-NC, and HG + shRNA-Cyclophilin A-1 groups. The protein and mRNA expression were detected via Western blot and qRT-PCR. CCK-8 assay and flow cytometry were employed for assessing cell viability and apoptosis. The levels of oxidative stress, inflammation, and insulin secretion were detected by corresponding kits. The cyclophilin A was higher in HG group. Knockdown of cyclophilin A was able to increase insulin secretion, decrease cell apoptosis, and alleviate inflammation as well as oxidant stress in HG-treated pancreatic β-cells via MAPK/NF-kb pathway. Taken together, Cyclophilin A, highly expressed in pancreatic β-cells induced by HG, is a promising therapeutic target for diabetes. Knockdown of cyclophilin A has protective effects against HG-challenged pancreatic β-cells via regulation of MAPK/NF-kb pathway. The findings in this study provided a new strategy for diabetic treatment and paved the way for future researches on diabetes treatment.
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Affiliation(s)
- Tangying Li
- Department of Health Care Centre, Hainan General Hospital , Haikou, Hainan, China
| | - Huibiao Quan
- Department of Endocrinology, Hainan General Hospital , Haikou, Hainan, China
| | - Huachuan Zhang
- Department of Endocrinology Laboratory, Hainan General Hospital , Haikou, Hainan, China
| | - Leweihua Lin
- Department of Endocrinology, Hainan General Hospital , Haikou, Hainan, China
| | - Qianying Ou
- Department of Endocrinology, Hainan General Hospital , Haikou, Hainan, China
| | - Kaining Chen
- Department of Endocrinology, Hainan General Hospital , Haikou, Hainan, China
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Patra S, Acharya SP, Taywade M, Bandyopadhyay D, Patro BK. Prevalence and Psychosocial Correlations of COVID-19-Related Worries in People with Diabetes Mellitus Seeking Services from East Indian Tertiary Care Center: A Cross-Sectional Survey Results. CURRENT MEDICAL ISSUES 2021; 19:157-161. [PMID: 37358963 PMCID: PMC10290775 DOI: 10.4103/cmi.cmi_39_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
Context Patients with diabetes are more prone to psychosocial problems which are known to adversely impact clinical outcomes of diabetes. COVID-19 is understood to further worsen the psychosocial problems of patients with diabetes. Aims We carried out this cross-sectional telephonic survey of COVID-19-related worries in patients with diabetes mellitus to understand the prevalence and correlates of COVID-19-related worries. Settings and Design This was a telephonic survey of patients seeking care from noncommunicable disease clinic of a tertiary care medical center. Subjects and Methods We used a structured questionnaire to assess sociodemographic, clinical, psychological variables and COVID-19-related worries. Statistical Analysis Used We used SPSS 20.0 for descriptive statistics keeping significance levels at 0.05. Between-group comparisons of continuous variables were made with independent t-test and two-way ANOVA; correlations were carried out with Pearson correlation test. Results Two hundred and nine patients completed the telephonic survey conducted from September to November 2020. The prevalence of diabetes-related worries in our sample was 80%. Younger age (P < 0.001), unemployment (P = 0.029), and the presence of mental disorder (P < 0.001) were associated with higher diabetes-related worries. Poor glycemic control (0.008) and symptoms of COVID-19 (0.03) were associated with diabetes-related worries. Diabetes-related worries correlated with diabetes distress (ρ =0.441, P < 0.001), social isolation (ρ =0.401, P < 0.001), and perception of social support (ρ = -0.158, P < 0.001). Conclusions A large proportion of our patients with diabetes are at high risk to experience COVID-19-related worries especially, younger people, unemployed and those with mental illness. Furthermore, the presence of diabetes distress and the perception of social isolation increase COVID-19 worries.
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Affiliation(s)
- Suravi Patra
- Department of Psychiatry, AIIMS, Bhubaneswar, Odisha, India
| | | | - Manish Taywade
- Department of Community Medicine and Family Medicine, AIIMS, Bhubaneswar, Odisha, India
| | | | - Binod Kumar Patro
- Department of Community Medicine and Family Medicine, AIIMS, Bhubaneswar, Odisha, India
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Wolde AK. Diabetic Distress Among Diabetic Patients in the Amhara Regional State, Ethiopia. INTERNATIONAL QUARTERLY OF COMMUNITY HEALTH EDUCATION 2021; 43:171-181. [PMID: 33823688 DOI: 10.1177/0272684x211004931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Diabetes distress is a psychological reaction to the threat of diabetes, when an individuals diagnosed with diabetes consider the coping resources they possess as insufficient to manage the illness threat, thus triggering emotional distress specific to diabetes. Research conducted in Ethiopia regarding diabetes-related distress is scant. The main purpose of this study was to assess the status of diabetic distress among diabetic patients in the hospitals of the Amhara Region. A hospital-based cross-sectional survey research approach was employed. A total of 14 hospitals was included in the study using stratified simple random sample methods. The participans of the study were 532 diabetic patients who were selected using systematic simple random sampling methods. The pertinent data were collected using diabetic distress scale-17 (DDS-17). The instrument of the study was rated, piloted, and finally validated. Both descriptive and inferential techniques were used to analyze the data. The cutoff for low, moderate, and high distress level was <2, 2-2.9, and >3, respectively. The study revealed that the participant in the study area experienced a moderate level of distress. The status of diabetic distress for the diabetic sub-scale was also determined for emotional burden, physician-related distress, regimen-related distress, and interpersonal distress, it was also found to be (2.79 ± 0.85), (3.14 ± 0.87), (3.19 ± 0.81), and (3.04 ± 0.93) respectively. The most important domain in measuring diabetic distress was regimen-related distress. Statistically, a significant difference was detected in the level of diabetic distress among diabetic patients concerning marital status, educational status, the experience of living with diabetes, and having habits of planned physical exercise. Statistically, a significant difference was not observed for age, sex, and occupational status. Diabetic distress was a solemn psychological problem among diabetic patients in the hospitals of the Amhara Region. A strong policy document is required to bind the physical treatment with psychological elements to reduce distress.
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Affiliation(s)
- Abraham Kebede Wolde
- Department of Psychology, College of Education and Behavioral Sciences, Bahir Dar University, Amhara, Ethiopia
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21
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Geleta BA, Dingata ST, Emanu MD, Eba LB, Abera KB, Tsegaye D. Prevalence of Diabetes Related Distress and Associated Factors Among Type 2 Diabetes Patients Attending Hospitals, Southwest Ethiopia, 2020: A Cross-Sectional Study. Patient Relat Outcome Meas 2021; 12:13-22. [PMID: 33542669 PMCID: PMC7850978 DOI: 10.2147/prom.s290412] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/03/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Diabetes related distress is the most common psychological co-morbid condition among type 2 diabetes patients. However, although the number of people living with diabetes has continued to increase over the last 10 years, information regarding diabetes related distress is limited in Ethiopia. OBJECTIVE The present study aimed to assess the prevalence of diabetes related distress and associated factors among type 2 diabetes patients attending hospitals in Southwest Ethiopia. METHODS A cross-sectional study was employed on 360 type 2 diabetes patients attending hospitals from January 1 to March 30, 2020. Convenient sampling technique was used to select study participants. Data were entered into EpiData manager version 4.2.2 and exported to Statistical Package for the Social Sciences (SPSS) version 20.0 and analyzed using descriptive statistics, bivariate and multivariate logistic regressions. The statistical significance was set at P < 0.05. RESULTS Out of a total 360 patients recruited, 321 (89.2%) patients (201 male and 120 female) were involved in the study. The mean age of the participants was 41.3 (SD = 12.8) years. The prevalence of diabetes related distress was 118 (36.8%) in which emotional distress was the most prevalent (43.6%) domain. Level of education [AOR 4.55; 95% CI: 1.28-16.19], family or social support [AOR 0.62; 95% CI: 0.33-1.06], duration of diabetes [AOR 0.75; 95% CI: 0.35-1.55], having diabetes complications [AOR 1.98; 95% CI: 1.0-3.86], smoking status [AOR 1.6; 95% CI: 1.12-2.97] and alcohol consumption status [AOR 1.4; 95% CI: 1.07-2.53] were the identified factors of diabetes related distress. CONCLUSION Diabetes related distress was highly prevalent in type 2 diabetes patients. Healthcare providers need to address this through integrating psychosocial care with collaborative medical care.
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Affiliation(s)
- Bonsa Amsalu Geleta
- Department of Nursing, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | | | - Milkias Dugassa Emanu
- Department of Nursing, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | - Lemi Bacha Eba
- Department of Nursing, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | - Kebebe Bidira Abera
- Department of Nursing, College of Health Sciences, Mettu University, Mettu, Ethiopia
| | - Dereje Tsegaye
- Department of Public Health, College of Health Sciences, Mettu University, Mettu, Ethiopia
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Asiedu-Danso M, Kretchy IA, Sekyi JK, Koduah A. Adherence to Antidiabetic Medications among Women with Gestational Diabetes. J Diabetes Res 2021; 2021:9941538. [PMID: 34395632 PMCID: PMC8363457 DOI: 10.1155/2021/9941538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 07/06/2021] [Accepted: 07/19/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Optimal adherence to prescribed medications in women with gestational diabetes is relevant for perinatal outcomes. OBJECTIVE To summarize available information on the prevalence and factors contributing to medication adherence in women with gestational diabetes from the biological and psychosocial perspectives. METHODS A literature search on adherence in gestational diabetes was conducted in PubMed/MEDLINE, CINAHL, Scopus, and the Directory of Open Access Journals for studies published on the topic. The Arksey and O'Malley framework for scoping reviews was used to explore and summarize the evidence. RESULTS A total of 2395 studies were retrieved of which 13 fully met the eligibility criteria. The studies were reported in Zimbabwe (n = 5), Iran (n = 1), Mexico (n = 1), South India (n = 1), the United States of America (n = 4), and one multinational study covering Australia, Europe, North and South America. The main types of antidiabetic medications used were insulin (n = 6), metformin (n = 4), and glyburide (n = 2). The prevalence of adherence ranged from 35.6% to 97%, with the assessment tool being self-report measures (n = 8). The main factors associated with nonadherence included worsening pregnancy symptoms, side effects of medications, perceived risks, mental health symptoms, poor social support, and socioeconomic status. Recommendations that evolved from the studies to improve adherence included education, counselling, improved support networks, and social interventions, while the main reported interventional study employed continuous education on the impact of adherence on perinatal outcomes. CONCLUSION Medication nonadherence in gestational diabetes seems to be influenced by multiple factors with some educational interventions positively impacting adherence behaviours. Thus, future research in women with gestational diabetes could consider interventions from a multifactorial perspective to improve therapeutic outcomes.
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Affiliation(s)
- Michelle Asiedu-Danso
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P. O. Box LG, 43 Legon, Ghana
| | - Irene A. Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P. O. Box LG, 43 Legon, Ghana
| | - Jeremiah Kobby Sekyi
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P. O. Box LG, 43 Legon, Ghana
| | - Augustina Koduah
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, University of Ghana, P. O. Box LG, 43 Legon, Ghana
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Kobos E, Szewczyk A, Świątkowska T, Kryczka T, Sienkiewicz Z. Relationship between loneliness and blood glucose control in diabetes. BMC Public Health 2020; 20:1140. [PMID: 32689971 PMCID: PMC7372778 DOI: 10.1186/s12889-020-09241-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/12/2020] [Indexed: 12/21/2022] Open
Abstract
Background The data of the International Diabetes Federation show that about 463 million people have diabetes. Better understanding of psychosocial aspects of life with this disease has become one of healthcare priorities in this group of patients. The aim of this study was to assess the relationships between loneliness and blood glucose control in diabetic patients. Methods The study included 250 hospitalized patients with type 1 and 2 diabetes. The patients included in the study were those who had had diabetes for at least 1 year and received pharmacotherapy. Standardized Revised UCLA Loneliness Scale (R-UCLA) and an analysis of patient test results including 10 indicators of blood glucose control were used for data collection. Correlation analysis, i.e. Pearson’s linear correlation coefficient (r, parametric method), was used for hypothesis verification. Results Less than one-fifth (16%) of the patients included in the study had higher loneliness index (based on the R-UCLA scale), and this loneliness index (total result) was significantly correlated with higher blood pressure. No significant correlations were demonstrated between loneliness and the other 9 indicators of blood glucose control. Conclusions Systolic blood pressure was significantly correlated with loneliness in patients with diabetes. Further studies are needed to confirm these findings.
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Affiliation(s)
- Ewa Kobos
- Department of Development of Nursing, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091, Warsaw, Poland. .,Polish Federation for Education in Diabetology, Żegańska 21/23, 03-823, Warsaw, Poland.
| | - Alicja Szewczyk
- Polish Federation for Education in Diabetology, Żegańska 21/23, 03-823, Warsaw, Poland.,The Children's Memorial Health Institute, Clinic of Endocrinology and Diabetology, Al. Dzieci Polskich 20, 04-730, Warsaw, Poland
| | - Teresa Świątkowska
- Clinic of Endocrinology and Diabetology, Teaching Clinical Hospital, Marii Skłodowskiej Curie 9, 85-094, Bydgoszcz, Poland
| | - Tomasz Kryczka
- Department of Development of Nursing, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091, Warsaw, Poland
| | - Zofia Sienkiewicz
- Department of Development of Nursing, Social and Medical Sciences, Faculty of Health Sciences, Medical University of Warsaw, Żwirki i Wigury 61, 02-091, Warsaw, Poland
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