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Nielsen MH, Jensen AL, Pedersen ML, Seibæk L. Living with chronic obstructive pulmonary disease or type 2 diabetes in Greenland - a qualitative interpretive description study. Int J Circumpolar Health 2024; 83:2296706. [PMID: 38127836 PMCID: PMC10763871 DOI: 10.1080/22423982.2023.2296706] [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: 10/10/2023] [Accepted: 12/14/2023] [Indexed: 12/23/2023] Open
Abstract
Non-communicable diseases such as chronic obstructive pulmonary disease (COPD) and type 2 diabetes mellitus (T2D) represent major challenges for health systems all over the world. In an interview study, we explored patient experiences and perspectives of being diagnosed and living with COPD or T2D in Greenland. Participants (n = 24) were selected by purposeful sampling and recruited by phone. We conducted individual semi-structured interviews at the National Hospital in Nuuk and the four regional hospitals. Interviews were audio-recorded, transcribed verbatim, and analysed using interpretive description. Three themes emerged: shock and shame on receiving the diagnosis, coping with a changed life, and varying needs for care and communication. We found that being diagnosed with COPD or T2D required a rapid change in the participants' everyday lives and lifestyle behaviours. Some self-managed their disease well and were able to transfer their knowledge and integrate it into their daily lives, while others struggled to make lifestyle changes. Additionally, living with COPD or T2D could be related to silence and shame. The findings contribute to a better understanding of living with COPD or T2D in the Arctic region and the development of future, culturally-adapted patient education initiatives.
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Affiliation(s)
- Maja Hykkelbjerg Nielsen
- Queen Ingrid’s Hospital, Steno Diabetes Center Greenland, Nuuk, Greenland
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Annesofie Lunde Jensen
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - Michael Lynge Pedersen
- Queen Ingrid’s Hospital, Steno Diabetes Center Greenland, Nuuk, Greenland
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lene Seibæk
- Greenland Center for Health Research, Department of Health and Nature, Ilisimatusarfik/University of Greenland, Nuuk, Greenland
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark
- Department of Gynaecology and Obstetrics, Aarhus University Hospital, Aarhus, Denmark
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Chan JCN, Mbanya JC, Chantelot J, Shestakova M, Ramachandran A, Ilkova H, Deplante L, Rollot M, Melas‐Melt L, Gagliardino JJ, Aschner P. Patient-reported outcomes and treatment adherence in type 2 diabetes using natural language processing: Wave 8 of the Observational International Diabetes Management Practices Study. J Diabetes Investig 2024; 15:1306-1316. [PMID: 38840439 PMCID: PMC11363103 DOI: 10.1111/jdi.14228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/17/2024] [Accepted: 04/20/2024] [Indexed: 06/07/2024] Open
Abstract
AIMS/INTRODUCTION We analyzed patient-reported outcomes of people with type 2 diabetes to better understand perceptions and experiences contributing to treatment adherence. MATERIALS AND METHODS In the ongoing International Diabetes Management Practices Study, we collected patient-reported outcomes data from structured questionnaires (chronic treatment acceptance questionnaire and Diabetes Self-Management Questionnaire) and free-text answers to open-ended questions to assess perceptions of treatment value and side-effects, as well as barriers to, and enablers for, adherence and self-management. Free-text answers were analyzed by natural language processing. RESULTS In 2018-2020, we recruited 2,475 patients with type 2 diabetes (43.3% insulin-treated, glycated hemoglobin (HbA1c) 8.0 ± 1.8%; 30.9% with HbA1c <7%) from 13 countries across Africa, the Middle East, Europe, Latin America and Asia. Mean ± standard deviation scores of chronic treatment acceptance questionnaire (acceptance of medication, rated out of 100) and Diabetes Self-Management Questionnaire (self-management, rated out of 10) were 87.8 ± 24.5 and 3.3 ± 0.9, respectively. Based on free-text analysis and coded responses, one in three patients reported treatment non-adherence. Overall, although most patients accepted treatment values and side-effects, self-management was suboptimal. Treatment duration, regimen complexity and disruption of daily routines were major barriers to adherence, whereas habit formation was a key enabler. Treatment-adherent patients were older (60 ± 11.6 vs 55 ± 11.7 years, P < 0.001), and more likely to have longer disease duration (12 ± 8.6 vs 10 ± 7.7 years, P < 0.001), exposure to diabetes education (73.1% vs 67.8%, P < 0.05), lower HbA1c (7.9 ± 1.8% vs 8.3 ± 1.9%, P < 0.001) and attainment of HbA1c <7% (29.7% vs 23.3%, P < 0.01). CONCLUSIONS Patient perceptions/experiences influence treatment adherence and self-management. Patient-centered education and support programs that consider patient-reported outcomes aimed at promoting empowerment and developing new routines might improve glycemic control.
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Affiliation(s)
- Juliana CN Chan
- Department of Medicine and TherapeuticsHong Kong Institute of Diabetes and Obesity and Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales HospitalHong Kong SARChina
| | - Jean Claude Mbanya
- Doctoral School of Life Sciences, Health and Environment, and Department of Medicine and Specialties, Faculty of Medicine and Biomedical SciencesUniversity of Yaoundé IYaoundéCameroon
| | | | | | - Ambady Ramachandran
- India Diabetes Research Foundation, Dr. A. Ramachandran's Diabetes HospitalsChennaiIndia
| | | | - Lucille Deplante
- Quinten HealthParisFrance
- Present address:
49 Avenue Jean Jaurès38500VoironFrance
| | | | | | | | - Pablo Aschner
- Javeriana University School of Medicine and San Ignacio University HospitalBogotáColombia
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Jones KF, Long DM, Bair MJ, Agil D, Browne L, Burkholder G, Clay OJ, Conder K, Durr AL, Farel CE, King K, Johnson B, Liebschutz JM, Demonte W, Leone M, Mullen L, Orris SM, Thomas T, Johnson M, Napravnik S, Merlin JS. Efficacy of a Pain Self-Management Intervention Tailored to People With HIV: A Randomized Clinical Trial. JAMA Intern Med 2024; 184:1074-1082. [PMID: 39008317 PMCID: PMC11250263 DOI: 10.1001/jamainternmed.2024.3071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/17/2024] [Indexed: 07/16/2024]
Abstract
Importance Chronic pain is a common condition for which efficacious interventions tailored to highly affected populations are urgently needed. People with HIV have a high prevalence of chronic pain and share phenotypic similarities with other highly affected populations. Objective To evaluate the efficacy of a behavioral pain self-management intervention called Skills to Manage Pain (STOMP) compared to enhanced usual care (EUC). Design, Setting, and Participants This randomized clinical trial included adults with HIV who experienced at least moderate chronic pain for 3 months or more. The study was set at the University of Alabama at Birmingham and the University of North Carolina-Chapel Hill large medical centers from August 2019 to September 2022. Intervention STOMP combined 1-on-1 skill-building sessions delivered by staff interventionists with group sessions co-led by peer interventionists. The EUC control group received the STOMP manual without any 1-on-1 or group instructional sessions. Main Outcomes and Measures The primary outcome was pain severity and the impact of pain on function, measured by the Brief Pain Inventory (BPI) summary score. The primary a priori hypothesis was that STOMP would be associated with a decreased BPI in people with HIV compared to EUC. Results Among 407 individuals screened, 278 were randomized to STOMP intervention (n = 139) or EUC control group (n = 139). Among the 278 people with HIV who were randomized, the mean (SD) age was 53.5 (10.0) years; 126 (45.0%) identified as female, 146 (53.0%) identified as male, 6 (2.0%) identified as transgender female. Of the 6 possible 1-on-1 sessions, participants attended a mean (SD) of 2.9 (2.5) sessions. Of the 6 possible group sessions, participants attended a mean (SD) of 2.4 (2.1) sessions. Immediately after the intervention compared to EUC, STOMP was associated with a statistically significant mean difference for the primary outcome, BPI total score: -1.25 points (95% CI, -1.71 to -0.78 points; P < .001). Three months after the intervention, the mean difference in BPI total score remained statistically significant, favoring the STOMP intervention -0.62 points (95% CI, -1.09 to -0.14 points; P = .01). Conclusion and Relevance The findings of this randomized clinical trial support the efficaciousness of STOMP as an intervention for chronic pain in people with HIV. Future research will include implementation studies and work to understand the optimal delivery of the intervention. Trial Registration ClinicalTrials.gov Identifier: NCT03692611.
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Affiliation(s)
- Katie Fitzgerald Jones
- New England Geriatric Research Education and Clinical Center, Section of Palliative Care, VA Boston Healthcare System, Boston, Massachusetts
| | - Dustin M. Long
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Matthew J. Bair
- VA HSR&D Center for Health Information and Communication, Department of Medicine, Indiana University School of Medicine, Indianapolis
| | - Deana Agil
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill
| | - Lindsay Browne
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill
| | - Greer Burkholder
- Division of Infectious Disease, Department of Medicine, University of Alabama at Birmingham
| | - Olivio J. Clay
- Department of Psychology, University of Alabama at Birmingham
| | - Kendall Conder
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill
| | - Amy L. Durr
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill
| | - Claire E. Farel
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill
| | - Kiko King
- Division of Infectious Disease, Department of Medicine, University of Alabama at Birmingham
| | - Bernadette Johnson
- Division of Infectious Disease, Department of Medicine, University of Alabama at Birmingham
| | - Jane M. Liebschutz
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Mireille Leone
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill
| | - LaToya Mullen
- Division of Infectious Diseases, Department of Medicine, Center for AIDS Research, University of North Carolina at Chapel Hill
| | - Sarah Margaret Orris
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Tammi Thomas
- Division of Infectious Disease, Department of Medicine, University of Alabama at Birmingham
| | - Mallory Johnson
- Center for AIDS Prevention Studies, University of San Francisco, San Francisco, California
| | - Sonia Napravnik
- Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill
| | - Jessica S. Merlin
- Division of General Internal Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
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Karimi M, Mofidi Nejad M, Tabaeifard R, Omid N, Rezaei Z, Azadbakht L. The association between dietary habits and self-care behavior of pregnant women with pregnancy complications. Sci Rep 2024; 14:19681. [PMID: 39181929 PMCID: PMC11344835 DOI: 10.1038/s41598-024-70162-7] [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: 09/03/2023] [Accepted: 08/13/2024] [Indexed: 08/27/2024] Open
Abstract
Pregnancy as a sensitive period has a critical effect on the mother and infant's life. It is well understood that dietary habits and mother awareness can improve health status and prevent pregnancy complications such as gestational diabetes, pre-eclampsia, and nausea and vomiting. The current study was conducted to investigate the association between dietary habits and self-care behaviors with pregnancy complications. This cross-sectional study was conducted across 300 pregnant women in their third trimester referred to healthcare centers and Yas hospital in Tehran, Iran. Dietary habits and self-care behaviors were assessed by valid and reliable questionnaires. Dietary intake and physical activity were evaluated using valid and reliable Food Frequency Questionnaires and Pregnancy Physical Activity questionnaires, respectively. Women with self-care behaviors had a lower rate of pre-eclampsia (P = 0.9). Regarding food habits, pregnant women who ate their meals faster had a non-significantly higher rate of gestational diabetes and pre-eclampsia. Pregnant women who consumed red meat on a daily frequency had a significantly higher rate of nausea and vomiting (OR 1.85; 95% CI 1.05-3.28, P = 0.03). Also, there was a significant positive association between the mother's pre-pregnancy BMI and gestational diabetes and pre-eclampsia [(OR 2.03; 95% CI 1.03-3.98, P = 0.03) and (OR 4.23; 95% CI 1.12-16.0, P = 0.03) respectively]. There was no significant association between pregnant women's dietary habits and GDM and pre-eclampsia. However, pregnant women with pre-pregnancy overweight and obesity had increased odds of gestational diabetes and pre-eclampsia significantly.
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Affiliation(s)
- Mehdi Karimi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Mofidi Nejad
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Razieh Tabaeifard
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Noushin Omid
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Zahra Rezaei
- Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Hamdan S, Taybeh E, Alsous MM. Determinants of self-care among Jordanian children with type 1 diabetes mellitus. J Egypt Public Health Assoc 2024; 99:19. [PMID: 39160425 PMCID: PMC11333684 DOI: 10.1186/s42506-024-00166-8] [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: 09/10/2023] [Accepted: 07/21/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND Diabetes Self-Care Management (DSCM) is crucial for managing diabetes mellitus and improving patients' well-being. Research on the young age group in Jordan is limited, and there is a lack of studies using an evaluation tool for understanding diabetes pharmacotherapy. This study intends to fill the information gap by examining young Jordanian patients' knowledge and comprehension of type 1 diabetes mellitus (T1DM) and its treatment modalities, evaluating their psychological well-being, and examining the relationship between children's psychological health and self-care. METHODS This cross-sectional study was conducted in the Jordanian Ministry of Health hospitals in Amman from June 2021 to January 2022. A convenience sampling method was used to select Arabic-speaking diabetic patients aged 11-a8 years who provided signed consent. A sample size of 400 was estimated. A self-administered questionnaire was developed based on a literature review to assess sociodemographic characteristics and diabetes and insulin knowledge, and validated scales were used to assess self-management (SMOD-A) and psychological well-being (ChilD-S). RESULTS Analysis of the questionnaire responses revealed varying levels of knowledge among the participants. Approximately half of the children (49.0%) demonstrated a lack of knowledge of diabetes pharmacotherapy. Psychological well-being indicators indicated moderate levels of happiness and feeling fine. The analysis of self-management indicators highlighted areas for improvement. Positive weak but significant correlations were found between children's knowledge about diabetes (r = 0.255, p < 0.01), diabetes pharmacotherapy knowledge (r = 0.125, p < 0.05), psychological well-being (r = 0.112, p < 0.05), and their diabetic self-management scores. A multivariate regression analysis identified predictors of self-management, including the child's school year (p = 0.035), ability to express feelings (p = 0.039), recent HbA1c levels (p = 0.028), and diabetes knowledge score (p < 0.001). CONCLUSION Participants exhibited varying levels of knowledge about diabetes pharmacotherapy and self-management. Knowledge about diabetes was identified as a predictor for effective self-management. Moreover, glycemic control and diabetes mellitus awareness majorly impact overall self-management behaviors. Tailored education programs are necessary to fill knowledge gaps and enhance diabetes management among children.
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Affiliation(s)
- Salam Hamdan
- Faculty of Pharmacy, Isra University, Amman, Jordan
| | - Esra' Taybeh
- Faculty of Pharmacy, Isra University, Amman, Jordan
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6
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Deo PS, Barber TM, Gotts C, Villarreal M, Randeva H, Brown S, Bath J, O'Hare P, Chaggar S, Hanson P. A pilot study to assess the feasibility and uptake of MindDEC, a mindfulness-based self-management course for type 2 diabetes. Complement Ther Med 2024; 83:103059. [PMID: 38821377 DOI: 10.1016/j.ctim.2024.103059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/07/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024] Open
Abstract
OBJECTIVE The study aimed to investigate the feasibility of a remote mindfulness based self-management intervention for individuals with type 2 diabetes. It is important to further our understanding of how to improve self-management to improve health outcomes and low levels of uptake to self-management courses. METHOD 29 participants with type 2 diabetes were recruited from the University Hospital Coventry and Warwickshire NHS trust. Three groups of participants engaged with a remote mindfulness based self-management intervention, which were delivered sequentially. After each intervention was complete, patient feedback was retrieved and implemented into the following intervention. The quantitative analysis comprised of descriptive statistics, independent sample t-test, paired sample t-test and multiple regression analysis. A qualitative analysis was also conducted through reflexive thematic analysis (RTA) to understand participant's perspective on the intervention. RESULTS There was a total of 17 who attended the course (59 %) and a total drop out of 12 participants over the three courses (41 %). The qualitative findings reported three main themes: (1) Eating to manage my emotions rather than my diabetes (2) Implementing mindfulness has helped me manage my emotions (3) Medication rather than self-management behaviours control my diabetes. The focus group feedback included participants' appreciation of the community aspect of the intervention and their perception that the current course was more interactive compared to previous interventions. In addition, participants highlighted the importance of offering the course at an earlier stage of diagnosis to provide further support at the beginning of their diabetes journey. No significant findings were reported for the independent sample t-test, paired sample t-test and multiple regression analysis. CONCLUSION The qualitative findings suggested that the course was beneficial, especially in demonstrating how mindfulness could aid self-management for individuals living with type 2 diabetes. Further funding and trials are warranted to improve the quality of technology used and to assess impact on diabetes control and mental health.
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Affiliation(s)
- P S Deo
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; University of the West of England, Bristol BS16 1QY, UK
| | - T M Barber
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - C Gotts
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - M Villarreal
- Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - H Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK; Aston University, Birmingham B4 7ET, UK
| | - S Brown
- University of the West of England, Bristol BS16 1QY, UK
| | - J Bath
- University of the West of England, Bristol BS16 1QY, UK
| | - P O'Hare
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - S Chaggar
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK
| | - P Hanson
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; NIHR CRF Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire, Clifford Bridge Road, Coventry CV2 2DX, UK; Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Coventry, UK.
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Vinayagam R, Tanner C, Harley D, Karatela S, Brooker K. "My Autism is Linked with Everything": at the Crossroads of Autism and Diabetes. J Autism Dev Disord 2024; 54:3122-3132. [PMID: 37480434 PMCID: PMC11300468 DOI: 10.1007/s10803-023-06033-3] [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] [Accepted: 05/30/2023] [Indexed: 07/24/2023]
Abstract
Autistic adults experience stark health disparities and difficulties accessing health care. Their realities of managing complex health conditions are unknown. Our research explored the experience of Autistic adults self-managing diabetes. Interviews with Autistic adults with diabetes and their support people were thematically analysed to identify three key themes. The Autistic experience influenced diabetes self-management, including autism-unique challenges and strengths. Participants prioritised avoiding Autistic burnout over diabetes self-management; mitigating the psychosocial pressures of neurotypical systems took precedence. Health professionals often separated autism and diabetes subsequently overlooking key factors impacting diabetes self-management. To better meet the needs of Autistic adults, diabetes care and health management more broadly should be considered within the context of autism, including supports for self-management during Autistic burnout.
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Affiliation(s)
- Ritwika Vinayagam
- Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute-UQ, The University of Queensland, Level 2, 39 Annerley Rd, South Brisbane, QLD, 4101, Australia.
- The Cooperative Research Centre for Living with Autism (Autism CRC), Level 3, Foxtail Building UQ Long Pocket Campus, 80 Meiers Rd, Indooroopilly, QLD, 4068, Australia.
| | - Christopher Tanner
- Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute-UQ, The University of Queensland, Level 2, 39 Annerley Rd, South Brisbane, QLD, 4101, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Level 3, Foxtail Building UQ Long Pocket Campus, 80 Meiers Rd, Indooroopilly, QLD, 4068, Australia
| | - David Harley
- UQ Centre for Clinical Research, Royal Brisbane & Women's Hospital Campus, Building 71/918, Herston, QLD, 4029, Australia
| | - Shamshad Karatela
- School of Pharmacy, The University of Queensland, Level 4/20 Cornwall St, Woolloongabba, QLD, 4102, Australia
- Australian Institute of Tropical Health and Medicine (AITHM), James Cook University, Building 48 1 James Cook Drive, Douglas, QLD, 4811, Australia
| | - Katie Brooker
- Queensland Centre for Intellectual and Developmental Disability (QCIDD), Mater Research Institute-UQ, The University of Queensland, Level 2, 39 Annerley Rd, South Brisbane, QLD, 4101, Australia
- The Cooperative Research Centre for Living with Autism (Autism CRC), Level 3, Foxtail Building UQ Long Pocket Campus, 80 Meiers Rd, Indooroopilly, QLD, 4068, Australia
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Ghasemi M, Savabi-Esfahani M, Noroozi M, Sattari M. Predicting cervical cancer screening participation using self-care behaviors among women in Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:257. [PMID: 39310013 PMCID: PMC11414853 DOI: 10.4103/jehp.jehp_704_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 08/06/2023] [Indexed: 09/25/2024]
Abstract
BACKGROUND Cervical cancer screening is an effective and accessible method for preventing this cancer. However, low participation rates among women have been reported. Self-care is one of the solutions to improve access to health services. This study was conducted to determine the prediction of cervical cancer screening participation using self-care behaviors among women in Iran. MATERIALS AND METHODS This cross-sectional study was conducted on 310 eligible women who were referred to comprehensive health centers and women's clinics in teaching hospitals in Isfahan, Iran, from November 2020 to April 2021. Participants were enrolled using convenience sampling. The data collection tool included researcher-made questionnaires on personal and fertility characteristics, participation in cervical cancer screening, and self-care behaviors related to cervical cancer and its screening. Descriptive and inferential statistical methods were used for data analysis using the Statistical Package for the Social Sciences (SPSS) version 22 software. RESULTS The results showed that the intention to undergo screening was low among individuals who had not undergone screening. Lack of awareness and not having enough time were the most common barriers to screening. The results of logistic regression analysis indicated that self-efficacy was the significant predictor of cervical cancer screening. With an increase in the self-care score, the 12% chance of doing a Pap smear increases significantly (P = 0.002). Furthermore, the results of multiple regression showed that with an increase in the self-care score, the chance of women who refer to screening every year, every 2-3 years, and every 4-5 years is increased to 25% (P = 0.001), 34% (P < 0.001), and 11% (P = 0.032), respectively, compared with non-referral. DISCUSSION According to the results, self-care was a predictor of performing a Pap smear, and it was related to its regular performance of Pap smear too. Therefore, designing and implementing necessary interventions to increase self-care behaviors can improve women's participation in cervical cancer screening and its regularity.
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Affiliation(s)
- Marzieh Ghasemi
- Department of Midwifery, Faculty of Medical Sciences, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran and Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mitra Savabi-Esfahani
- Department of Midwifery and Reproductive Health, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahnaz Noroozi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Sattari
- Department of Health Information Technology, Health Information Technology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Alshaikh AA, Mahmood SE, Riaz F, Assiri AS, Abdulrahman MA, Asiri MYA, Alnakhli GRA, A Alshabab MQ, Alsaleh SSA, Alshahrani MY, H Alharthi AS, Al Qahtani AA. Knowledge of Diabetes Mellitus and Practices Regarding Lifestyle Factors and Diabetes Management in a General Adult Population of Aseer Region, Saudi Arabia. Diabetes Metab Syndr Obes 2024; 17:2775-2787. [PMID: 39077554 PMCID: PMC11284134 DOI: 10.2147/dmso.s461807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 07/16/2024] [Indexed: 07/31/2024] Open
Abstract
Introduction Many studies report a lack of public awareness of the risk factors and complications of Diabetes Mellitus. Adequate glycemic control is crucial in preventing or delaying the onset of type 2 diabetes complications, and medication adherence is one of the key factors in achieving this goal. This study aimed to measure the knowledge about diabetes mellitus and practices regarding lifestyle factors and diabetes management in the study population in the Aseer region, of Saudi Arabia. Material and Methods A descriptive cross-sectional survey was conducted in Abha, a city in the Aseer region of Saudi Arabia. The general population of 18 years of age and above, who were residing in the study area during the period of study, ie, January 2023 to June 2023, were included. The questionnaire was distributed through social media and e-mail for data collection. The descriptive variables were presented using frequency, percentage, and graphs. Pearson's chi-square test was used at a 5% level of significance. Multivariate tests were applied to further explore the findings of univariate analysis. The data were analyzed using SPSS version 20.0. Results Out of the total 348 participants, a higher proportion was males (56.3%). About 78.7% of the participants were ever diagnosed with diabetes mellitus and 21.3% were never diagnosed with diabetes mellitus. Nearly 31.6% knew that the major cause of diabetes mellitus was obesity and 31.3% knew that it was a hereditary disease. About 42.2% of respondents exercised regularly and 27.6% were smokers. Adherence to prescribed anti-diabetic medications was seen in 63.2% of the respondents. Self-alterations in the timing and dose of prescribed anti-diabetic drugs were seen in 36.5% and 34.8%, respectively. About 60.1% had a moderate level of self-rated knowledge about Diabetes Mellitus, and 27.6% and 12.4% had good and poor self-rated knowledge levels of Diabetes mellitus, respectively. On multivariate analysis, the age group 60-69 years had significant variations as compared to the other age groups on DM, bachelor's degree holders had significant variations as compared to other education variables, being married had significant differences as compared to those unmarried, those employed had significant variations as compared to the other occupation categories, and smokers had a significant impact on DM as compared to non-smokers. Conclusion Findings indicated less number of respondents exercised regularly, low adherence to prescribed anti-diabetic medications and low levels of self-rated knowledge of diabetes mellitus. Enhancing the patients' knowledge of diabetes mellitus and improving their self-management and adherence to its medications is necessary through public health education.
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Affiliation(s)
- Ayoub Ali Alshaikh
- Department of Family & Community Medicine, College of Medicine, King Khalid University, Abha, 62529, Saudia Arabia
| | - Syed Esam Mahmood
- Department of Family & Community Medicine, College of Medicine, King Khalid University, Abha, 62529, Saudia Arabia
| | - Fatima Riaz
- Department of Family & Community Medicine, College of Medicine, King Khalid University, Abha, 62529, Saudia Arabia
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10
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Oliveira D, Costa A, Henriques A, Curado MA, Schmitt A, Nogueira P. Validation of the Portuguese version of the diabetes self-management questionnaire-revised (DSMQ-R) in people with type 2 diabetes mellitus. BMC Psychol 2024; 12:405. [PMID: 39044279 PMCID: PMC11267859 DOI: 10.1186/s40359-024-01900-9] [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: 05/20/2024] [Accepted: 07/11/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Reflecting people with diabetes' self-management activities is often required in both research and clinical practice. This study evaluated the measurement properties of the Portuguese version of the Diabetes Self-Management Questionnaire-Revised (DSMQ-R) on a sample of people with type 2 diabetes mellitus (T2DM). METHODS Translation and cultural adaptation were conducted according to guidelines for cross-cultural adaptation and validation of healthcare measurement instruments. A cross-sectional study was performed including 365 people with T2DM in primary care. Reliability, construct validity, and criterion validity were analyzed. RESULTS The total scale of the translated DSMQ-R revealed sufficient internal consistency (alpha = 0.82), and most of the subscales performed adequately. The exploratory factor structure was robust, and confirmatory analysis showed a good model fit with the scale structure of the original scale. The scale scores correlated with the participants' last HbA1c estimates, supporting convergent validity, and convergence was confirmed by the adequate average variance extracted. CONCLUSIONS The Portuguese version of the DSMQ-R is a reliable and valid tool for gauging self-management behaviors in people with T2DM and their relationship with glycemic values.
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Affiliation(s)
- Dulce Oliveira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), School of Nursing of Lisbon (ESEL), Lisbon, Portugal.
- Local Health Unit of Amadora/Sintra, E.P.E., Primary Health Care of Amadora, Amadora, Portugal.
- Istituto de Saúde Ambiental (ISAMB), Lisbon University, Lisbon, Portugal.
| | - Andreia Costa
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), School of Nursing of Lisbon (ESEL), Lisbon, Portugal
- Istituto de Saúde Ambiental (ISAMB), Lisbon University, Lisbon, Portugal
- School of Nursing of Lisbon (ESEL), Lisbon, Portugal
| | - Adriana Henriques
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), School of Nursing of Lisbon (ESEL), Lisbon, Portugal
- Istituto de Saúde Ambiental (ISAMB), Lisbon University, Lisbon, Portugal
- School of Nursing of Lisbon (ESEL), Lisbon, Portugal
| | - Maria Alice Curado
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), School of Nursing of Lisbon (ESEL), Lisbon, Portugal
- Istituto de Saúde Ambiental (ISAMB), Lisbon University, Lisbon, Portugal
- School of Nursing of Lisbon (ESEL), Lisbon, Portugal
| | - Andreas Schmitt
- Diabetes Center Mergentheim, Research Institute Diabetes Academy Mergentheim, Bad Mergentheim, Germany
| | - Paulo Nogueira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), School of Nursing of Lisbon (ESEL), Lisbon, Portugal
- Istituto de Saúde Ambiental (ISAMB), Lisbon University, Lisbon, Portugal
- School of Nursing of Lisbon (ESEL), Lisbon, Portugal
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11
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Zeidalkilani JM, Milhem YA, Shorafa RN, Taha S, Koni AA, Al-Jabi SW, Zyoud SH. Factors associated with patient activation among patients with diabetes on hemodialysis: a multicenter cross-sectional study from a developing country. BMC Nephrol 2024; 25:232. [PMID: 39033115 PMCID: PMC11265049 DOI: 10.1186/s12882-024-03674-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: 08/12/2023] [Accepted: 07/15/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND Diabetes mellitus (DM) is a major public health concern with considerable morbidity and mortality. DM affects patients' quality of life and can lead to multiple complications, including chronic kidney disease (CKD) and the need for dialysis. Higher patient activation can improve health outcomes in hemodialysis patients with DM. This study aimed to explore the factors associated with higher patient activation and health-related quality of life (HRQoL) among hemodialysis patients with DM. METHODS This was a cross-sectional, questionnaire-based study conducted on hemodialysis patients with DM in Palestine. The quota sampling method was utilized to draw samples from six dialysis centers. The questionnaire consists of three sections. The first section includes demographic, socioeconomic and clinical questions. The second section utilizes the patient activation measure-13 (PAM-13) to measure patient activation, while the third section assesses HRQoL using the EQ-5D-5 L tool and the visual analog scale (VAS). Mann‒Whitney and Kruskal‒Wallis tests were employed to examine the relationships between variables at the bivariate level, and multiple regression analysis was employed at the multivariate level. RESULTS Of the 200 patients who were approached, 158 were included. The median PAM, EQ-5D index, and VAS score were low at 51.0, 0.58, and 60.0, respectively. A higher PAM score was independently associated with a higher household income level and taking medications independently. A higher EQ-5D index was associated with taking more than eight medications, taking medications independently, living with fewer than three comorbid conditions, and having a higher PAM. A higher VAS score was associated with being married, and receiving less than 3.5 hours of hemodialysis. CONCLUSIONS A higher patient activation level was associated with a higher income level and independence in taking medications. Interventions designed to improve patient activation, such as medication management programs, should address these factors among the target population. Longitudinal studies are needed to assess the time effect and direction of causation between health status and patient activation.
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Affiliation(s)
- Jehad M Zeidalkilani
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Yazan A Milhem
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Reem N Shorafa
- Department of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Sari Taha
- An-Najah Global Health Institute (GHI), An-Najah National University, Nablus, 44839, Palestine
- Department of Public Health, Faculty of Medicine and Health Sciences, An-Najah National University, P.O. Box 7, Nablus, Palestine
- Department of Anatomy, Biochemistry and Genetics, An-Najah National University, Nablus, 44839, Palestine
| | - Amer A Koni
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
- Division of Clinical Pharmacy, Department of Hematology and Oncology, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Samah W Al-Jabi
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
| | - Sa'ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Poison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
- Clinical Research Centre, An-Najah National University Hospital, Nablus, 44839, Palestine.
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12
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Barrio-Cortes J, Mateos-Carchenilla MP, Martínez-Cuevas M, Beca-Martínez MT, Herrera-Sancho E, López-Rodríguez MC, Jaime-Sisó MÁ, Ruiz-López M. Comorbidities and use of health services in people with diabetes mellitus according to risk levels by adjusted morbidity groups. BMC Endocr Disord 2024; 24:115. [PMID: 39010042 PMCID: PMC11251131 DOI: 10.1186/s12902-024-01634-0] [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: 10/23/2022] [Accepted: 06/25/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND People with diabetes mellitus frequently have other comorbidities and involve greater use of primary and hospital care services. The aim of this study was to describe the comorbidities and use of primary and hospital care services of people with diabetes according to their risk level by adjusted morbidity groups (AMG) and to analyse the factors associated with the utilisation of these services. METHODS Cross-sectional study. People with diabetes were identified within the population of patients with chronic conditions of an urban health care centre by the AMG stratification tool integrated into the primary health care electronic clinical record of the Community of Madrid. Sociodemographic, functional, clinical characteristics and annual health care services utilisation variables were collected. Univariate, bivariate and Poisson regression analyses were performed. RESULTS A total of 1,063 people with diabetes were identified, representing 10.8% of patients with chronic conditions within the health centre. A total of 51.4% were female, the mean age was 70 years, 94.4% had multimorbidity. According to their risk level, 17.8% were high-risk, 40.6% were medium-risk and 41.6% were low-risk. The most prevalent comorbidities were hypertension (70%), dyslipidaemia (67%) and obesity (32.4%). Almost 50% were polymedicated. Regarding health services utilisation, 94% were users of primary care, and 59.3% were users of hospital care. Among the main factors associated with the utilisation of both primary and hospital care services were AMG risk level and complexity index. In primary care, utilisation was also associated with the need for primary caregivers, palliative care and comorbidities such as chronic heart failure and polymedication, while in hospital care, utilisation was also associated with comorbidities such as cancer, chronic obstructive pulmonary disease or depression. CONCLUSIONS People with diabetes were older, with important needs for care, many associated comorbidities and polypharmacy that increased in parallel with the patient's risk level and complexity. The utilisation of primary and hospital care services was very high, being more frequent in primary care. Health services utilization were principally associated with functional factors related to the need of care and with clinical factors such as AMG medium and high-risk level, more complexity index, some serious comorbidities and polymedication.
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Affiliation(s)
- Jaime Barrio-Cortes
- Foundation for Biosanitary Research and Innovation in Primary Care, Madrid, Spain.
- Primary Care Investigation Unit, Gerencia Asistencial de Atención Primaria, Madrid, Spain.
- Faculty of Health, Universidad Camilo José Cela, Madrid, Spain.
| | - María Pilar Mateos-Carchenilla
- Faculty of Health, Universidad Camilo José Cela, Madrid, Spain
- V Centenario Healthcare Centre, Gerencia Asistencial de Atención Primaria, San Sebastián de los Reyes, Madrid, Spain
| | | | | | - Elvira Herrera-Sancho
- Ciudad Jardín Healthcare Centre, Gerencia Asistencial de Atención Primaria, Madrid, Spain
| | | | | | - Montserrat Ruiz-López
- Nursing School, Fundación Jiménez Diaz Hospital, Universidad Autónoma de Madrid, Madrid, Spain
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13
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Kobamo MM, Bekele FB, Simachew Y, Abebe MT, Abore KW. Self-care practice and associated factors among patients with diabetes on follow-up at Yirgalem General Hospital, Sidama, Ethiopia: a cross-sectional study. BMC Endocr Disord 2024; 24:111. [PMID: 38987698 PMCID: PMC11238438 DOI: 10.1186/s12902-024-01647-9] [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: 03/21/2023] [Accepted: 07/04/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Self-care practice is an integral and efficient part of comprehensive diabetes management, which could be influenced by various socio-demographic, clinical, and lifestyle factors. OBJECTIVE The study aimed to assess the level of diabetes self-care practice and its associated factors among patients with diabetes on follow-up at Yirgalem General Hospital, Yirgalem, Sidama, Ethiopia. METHODOLOGY An Institution-based cross-sectional study was conducted from February 15 to May 10, 2022, involving 298 patients with diabetes on follow-up at Yirgalem General Hospital. A pre-tested interviewer-administered questionnaire was utilized to collect data from patients. A descriptive analysis was conducted to determine the level of good self-care practice. Bivariate and multivariable binary logistics regression were performed to determine factors associated with good diabetic self-care practice. Associations with a p-value < 0.05 were considered statistically significant. RESULT The overall good diabetic self-care practice among patients was 59.4%. Regarding the specific domains of care, 15 (5%) participants had good self-glucose monitoring care, 228 (76.5%) had good exercise self-care, 268 (89.9%) had good dietary self-care, 228 (76.5%) had good foot self-care, and 260 (87.2%) had good diabetic medication adherence. Single marital status (AOR = 5.7, 95% CI: (1.418, 22.915), urban residence (AOR = 2.992, 95% CI: (1.251, 7.153)), and having a glucometer (AOR = 2.273, 95% CI: (1.083, 4.772)) were factors that were significantly associated with good diabetic self-care practice. CONCLUSION Good diabetic self-care practices among participants was low. Marital status, place of residence, and having a glucometer were statistically significant predictors of good diabetic self-care practices. Targeted intervention addressing those patients from rural areas to increase awareness and practice of self-care, as well as the promotion of having a glucometer at home for self-glucose monitoring is recommended.
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Affiliation(s)
| | - Fanuel Belayneh Bekele
- School of Public health, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
| | - Yilkal Simachew
- School of Public health, College of Medicine and Health Science, Hawassa University, Hawassa, Ethiopia
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14
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Kalra S, Bhattacharya S, Kapoor N. Counseling for Insulin Icodec: A Proposed Practitioner's Guide. Diabetes Ther 2024; 15:1491-1499. [PMID: 38743307 PMCID: PMC11211307 DOI: 10.1007/s13300-024-01600-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
Despite insulin being a lifesaving medication, insulin distress, insulin hesitancy, and insulin inertia remain oft-repeated themes in diabetes discourse. The current model lists three issues: temperament, troublesomeness, and technicality, which contribute to insulin perceptions. Therapeutic patienteducation (TPE), value-added therapy (VAT), and medication counseling are concepts that assist in optimizing insulin perceptions. Insulin icodec is a basal insulin with a half-life of 196 h and a once-weekly or circaseptan frequency of administration. Insulin icodec reduces the frequency of basal insulin administration to one-seventh, which along with the lower requirement of glucose monitoring, reduces the burden of plastic and ancillary supply disposal. Because of its unique frequency of injection, insulin icodec usage requires appropriate counseling and education. This reader-friendly counseling guide helps practitioners offer VAT, as well as TPE while prescribing icodec and other insulins.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India.
- University Center for Research and Development, Chandigarh University, Mohali, India.
| | | | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India
- Non Communicable Disease Unit, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
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15
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Bekele NT, Habtewold EM, Deybasso HA, Mekuria Negussie Y. Poor self-care practices and contributing factors among adults with type 2 diabetes in Adama, Ethiopia. Sci Rep 2024; 14:13660. [PMID: 38871734 DOI: 10.1038/s41598-024-63524-8] [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: 10/30/2023] [Accepted: 05/29/2024] [Indexed: 06/15/2024] Open
Abstract
Diabetes mellitus (DM) is a prominent global health challenge, characterized by a rising prevalence and substantial morbidity and mortality, especially evident in developing nations. Although DM can be managed with self-care practices despite its complexity and chronic nature, the persistence of poor self-care exacerbates the disease burden. There is a dearth of evidence on the level of poor self-care practices and contributing factors among patients with DM in the study area. Thus, this study assessed the proportion of poor self-care practices and contributing factors among adults with type 2 DM in Adama, Ethiopia. An institution-based cross-sectional study was conducted among 404 patients. Self-care practice was assessed by the summary of diabetes self-care activities questionnaires. Binary logistic regression was used to identify factors associated with poor self-care practices. An adjusted odds ratio with a 95% confidence interval was used to assess the strength of associations. The statistical significance was declared for a p-value < 0.05. The proportion of poor self-care practices was 54% [95% CI 49.1, 58.6]. Being divorced (AOR = 3.5; 95% CI 1.0, 12.2), having a lower level of knowledge (AOR = 1.70; 95% CI 1.0, 2.8), being on insulin (AOR = 6.3; 95% CI 1.9, 20.6), taking oral medication (AOR = 8.6; 95% CI 3.0, 24.5), being unaware of fasting blood sugar (AOR = 2.9; 95% CI 1.6, 5.2), not a member of a diabetic association (AOR = 3.6; 95% CI 1.7, 7.5), a lack of social support (AOR = 2.9; 95% CI 1.7, 4.9), and having a poor perceived benefit of self-care practices (AOR = 1.84; 95% CI 1.0, 3.2) were associated with poor self-care practices. Overall, this finding demonstrated that a significant percentage of participants (54%) had poor self-care practices. Being divorced, having a low level of knowledge about diabetes and fasting blood sugar, lacking social support, relying on oral medication, perceiving limited benefits from self-care practices, and not being a member of diabetic associations were identified as independent factors of poor self-care.
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Affiliation(s)
| | | | - Haji Aman Deybasso
- Department of Public Health, Adama Hospital Medical College, Adama, Ethiopia
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16
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Fonseca LM, Schmidt JJ, Snoek FJ, Weinstock RS, Chaytor N, Stuckey H, Ryan CM, van Duinkerken E. Barriers and Facilitators of Self-Management in Older People with Type 1 Diabetes: A Narrative Review Focusing on Cognitive Impairment. Diabetes Metab Syndr Obes 2024; 17:2403-2417. [PMID: 38872713 PMCID: PMC11175657 DOI: 10.2147/dmso.s410363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 05/30/2024] [Indexed: 06/15/2024] Open
Abstract
Over the past decades, life expectancy of people with type 1 diabetes has increased considerably, which brings potential challenges due to the process of aging. Cognitive aging and dementia, as well as reductions in visual acuity, hearing and dexterity, can influence the frequency and quality of daily self-management activities, including medication taking and insulin dosing, glucose self-monitoring, and healthy eating. This can increase the risk for hypo- and hyperglycemic events, which, in turn, may contribute to cognitive decline. Because there is a gap in understanding the barriers and facilitators of self-management in older adults with type 1 diabetes and the relationship to cognitive functioning, the authors 1) review the available literature on cognitive aging and type 1 diabetes, 2) describe what self-management in later adulthood entails and the cognitive functions required for effective self-management behaviors, 3) analyze the interaction between type 1 diabetes, cognition, aging, and self-management behaviors, and 4) describe the barriers and facilitators for self-management throughout the life span and how they may differ for older people. Potential evidence-based practices that could be developed for older adults with type 1 diabetes are discussed. There is need for further studies that clarify the impact of aging on T1D self-management, ultimately to improve diabetes care and quality of life.
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Affiliation(s)
- Luciana Mascarenhas Fonseca
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
- Programa Terceira Idade (PROTER, Old Age Research Group), Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Juliana Janeiro Schmidt
- Post-Graduate Program in Neurology, Universidade Federal Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Frank J Snoek
- Department of Medical Psychology, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands
| | - Ruth S Weinstock
- Department of Medicine, Upstate Medical University, Syracuse, NY, USA
| | - Naomi Chaytor
- Department of Community and Behavioral Health, Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, USA
| | - Heather Stuckey
- Department of Medicine, Penn State University College of Medicine, Hershey, PA, USA
| | - Christopher M Ryan
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Eelco van Duinkerken
- Post-Graduate Program in Neurology, Universidade Federal Do Estado Do Rio de Janeiro, Rio de Janeiro, Brazil
- Department of Medical Psychology, Amsterdam University Medical Center, Vrije Universiteit, Amsterdam, the Netherlands
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17
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Nyström T. Key results from observational studies and real-world evidence of sodium-glucose cotransporter-2 inhibitor effectiveness and safety in reducing cardio-renal risk. Diabetes Obes Metab 2024. [PMID: 38859661 DOI: 10.1111/dom.15696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 05/09/2024] [Accepted: 05/20/2024] [Indexed: 06/12/2024]
Abstract
Sodium-glucose cotransporter 2 (SGLT2) inhibitors, originally designed to manage blood sugar levels in individuals with type 2 diabetes (T2D), have emerged as a crucial class of drugs for managing cardio-renal diseases. These drugs work by targeting the SGLT2 protein in the kidneys, promoting the excretion of glucose and influencing metabolic pathways beyond glucose control. The relationship between cardio-renal diseases and SGLT2 inhibitors has been explored through landmark trials and real-world evidence (RWE) studies, demonstrating significant reductions in cardio-renal complications. This review discusses the importance of RWE studies alongside randomized controlled trials in understanding the real-world effectiveness and safety of SGLT2 inhibitors. It outlines the advantages and disadvantages of RWE compared to RCTs, highlighting their complementary roles in providing comprehensive insights into treatment outcomes. By examining a range of RWE studies, the review underscores the cardio-renal benefits of SGLT2 inhibitors across various patient populations. Safety assessments indicate that SGLT2 inhibitors are generally well tolerated, with severe adverse events being rare. Common issues, such as genital mycotic infections and urinary tract infections, are acknowledged, alongside less frequent but significant adverse events including diabetic ketoacidosis, lower-limb amputations, and bone fractures. In summary, SGLT2 inhibitors show promising cardio-renal protective effects in real-world scenarios across diverse populations in T2D, indicating their potential as early intervention measures. Continued research is essential for gaining a thorough understanding of their long-term effects and safety profiles.
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Affiliation(s)
- Thomas Nyström
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
- Department of Internal Medicine, Section of Endocrinology and Diabetology, Södersjukhuset, Stockholm, Sweden
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18
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Wijeweera C, Muhfaza U, Lord RV, Petocz P, Chen J, Preda V. Socioeconomic status and the effect of prolonged pandemic confinement on anthropometric and glycaemic outcomes in adults with type 2 diabetes mellitus. Prim Care Diabetes 2024; 18:308-318. [PMID: 38448261 DOI: 10.1016/j.pcd.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/03/2023] [Accepted: 02/09/2024] [Indexed: 03/08/2024]
Abstract
AIM This systematic review and meta-analysis aimed to investigate the impact of COVID19 lockdown on the anthropometric and glycaemic outcomes of adults with type 2 diabetes mellitus (T2DM) and assess whether socioeconomic status (SES) was relevant to these changes. METHODS A search of three databases was conducted. Meta-analyses using random effects models were undertaken to combine anthropometric and glycaemic measures pre- and post-confinement. Subgroup analyses according to SES were also conducted. RESULTS This systematic review of 19 articles demonstrated that prolonged pandemic-related confinement is associated with a deterioration in both anthropometric and glycaemic outcomes among adults with T2DM. Furthermore, SES was found to be relevant to these changes. Specifically, BMI (kg/m2) showed an increase in mean difference of 0.72 (95% CI; 0.13, 1.31; p<0.05) between pre and post lockdown cohorts. High income countries displayed a greater increase in BMI compared to their lower middle-income counterparts. Regarding, fasting blood glucose (FBG), a statistically significant difference was observed in the upper middle-income group (mean difference: 5.10; 95% CI: 2.92, 7.27), and high-income group (mean difference: 6.03; 95% CI: 0.04, 12.02). There were no significant changes to weight, waist circumference, or HbA1C over the lockdown period. CONCLUSION Our findings suggest adults with T2DM may have received less effective care over the lockdown period, particularly in high income countries. Clinics and care providers may need to adopt more intensive contact and treatment plans in the post lockdown period to prevent lasting impacts on disease progression and metabolic sequelae.
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Affiliation(s)
- Chandana Wijeweera
- Macquarie University Faculty of Medicine and Health Sciences, Australia.
| | - Ummul Muhfaza
- Healthy Weight Clinic, Macquarie University Hospital, Macquarie Park, Australia
| | - Reginald V Lord
- Department of Surgery, University of Notre Dame School of Medicine, Sydney Australia
| | - Peter Petocz
- Macquarie University, Department of Statistics, Macquarie Park, Australia
| | - Juliana Chen
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Veronica Preda
- Healthy Weight Clinic, Macquarie University Hospital, Macquarie Park, Australia
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Yoldi-Vergara C, Conget-Donlo I, Cardona-Hernandez R, Ramon-Krauel M. Influence of socioeconomic factors on glycemic control, therapeutic adherence and quality of life in children and adolescents with type 1 diabetes. ENDOCRINOL DIAB NUTR 2024; 71:253-262. [PMID: 38942702 DOI: 10.1016/j.endien.2024.04.003] [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: 02/05/2024] [Revised: 03/11/2024] [Accepted: 04/07/2024] [Indexed: 06/30/2024]
Abstract
OBJECTIVE To stablish the relationship between socioeconomic status of a cohort of children and adolescents with type 1 diabetes (T1D) with glycemic control, therapeutic adherence and diabetes quality of life (DQoL). PATIENTS Y METHODS A cross-sectional, observational study with consecutive inclusion was carried out. Participants aged 8-18 years with T1D duration >1 year. Data on family structure, family income, parents' educational level and parental role on primary diabetes care supervision were registered. Adherence (DMQ-Sp) and DQoL (PedsQl) were analyzed. Linear and logistic regression models adjusted for demographics, family structure and parental role on primary diabetes care responsibility were applied. RESULTS A total of 323 patients (T1D duration 5,3 ± 3,3 years; HbA1c 7,7 ± 1,0%; age 13,3 ± 2,8 years; 49,8% females) were included. Patients living in a nuclear family and those whose main diabetes care supervision was shared by both parents showed lower HbA1c [adjusted for demographics and family structure (7,06; CI 95% 6,52-7,59); adjusted for demographics and role on primary diabetes care supervision (7,43; CI 95% 6,57-8,28)]. DMQ-Sp score (adjusted for demographics and role on main supervision) was higher in patients whose parents shared the diabetes care supervision (84,56; CI 95% 73,93-95,19). Parents sharing diabetes care supervision showed a significantly higher PedsQl score (both 74,63 ± 12,70 vs mother 68,53 ± 14,59; p = 0,001). CONCLUSIONS Children and adolescents with T1D had lower HbA1c, better therapeutic adherence and better DQoL when lived in a nuclear family, with higher socioeconomic status and the responsibility for supervising diabetes care was shared by both parents.
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Affiliation(s)
- Carmen Yoldi-Vergara
- Servicio de Endocrinología Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain.
| | - Ignacio Conget-Donlo
- Servicio de Endocrinología y Nutrición, Hospital Clinic i Universitari, Barcelona, Spain; Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Madrid, Spain; Institut d'investigacions biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | - Marta Ramon-Krauel
- Servicio de Endocrinología Pediátrica, Hospital Sant Joan de Déu, Barcelona, Spain; Institut de Recerca Sant Joan de Déu, Barcelona, Spain
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Aldosari M, Archer HR, Almutairi FT, Alzuhair SH, Aldosari MA, Kennedy E. Utilization of dental care and dentate status in diabetic and nondiabetic patients across US states: An analysis using the 2020 Behavioral Risk Factor Surveillance System. J Public Health Dent 2024; 84:187-197. [PMID: 38599647 DOI: 10.1111/jphd.12613] [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: 06/28/2023] [Revised: 02/15/2024] [Accepted: 03/08/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVE This study examines the differences, by state, in dental care utilization and tooth retention between adults with and without diabetes mellitus (DM). METHODS We conducted a secondary analysis of data from the 2020 Behavioral Risk Factor Surveillance System, an annual, state-based, random telephone survey of noninstitutionalized US civilian adults. The predictor variable was DM status. The outcome variables were time since the last dental appointment and tooth loss. We utilized multiple multinomial logistic regression models followed by postestimation procedures to determine state-level adjusted proportions for dental visits within the last year and complete teeth retention among DM and non-DM adults. RESULTS Among adults with DM, 60.0% reported dentist visits within a year of survey participation, while 53.6% had complete tooth retention. As education and income levels increased, dental attendance and tooth retention increased among adults with DM. Most Southern states had a higher prevalence of DM, a lower proportion of dentist visits, and worse tooth retention among DM adults. Nationally, DM individuals were 4.3 percentage points less likely to visit a dentist and were 7 percent less likely to have complete teeth retention than non-DM adults. Compared with the national average, 25/50 states had greater disparities in dental visits between DM and non-DM adults, and 27/50 states had greater disparities in tooth loss between DM and non-DM adults. CONCLUSION State-level variations indicate geographical and dental coverage influences on DM and dental outcomes. There is a need for state-specific interventions to improve dental access and outcomes for adults with DM.
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Affiliation(s)
- Muath Aldosari
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- Department of Health Policy and Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, Massachusetts, USA
| | - Hannah R Archer
- Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | | | - Saud H Alzuhair
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | | | - Erinne Kennedy
- Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- College of Dental Medicine, Kansas City University, Joplin, Missouri, USA
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21
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Bagheri S, Salari N, Khoshay A, Abdi A. Assessment of the relationship between self-efficacy criteria and rate of lower limb amputation in diabetic patients; a cross-sectional study. J Diabetes Metab Disord 2024; 23:665-671. [PMID: 38932902 PMCID: PMC11196471 DOI: 10.1007/s40200-023-01331-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 10/10/2023] [Indexed: 06/28/2024]
Abstract
Background According to the high prevalence of diabetes Mellitus (DM), as a harmful metabolic disease, the adoption of self-care (SC) behaviors along with modern medications seems necessary for diabetes Mellitus patients (DMPs). Since self-efficacy (SE) affects the quality of SC behaviors in DMPs to prevent limb amputation as one of the most common DM-related complications, the present study aimed to investigate the probable relationship between the effect of the Diabetes Management Self-Efficacy (DMSE) with limb amputation rate in DMPs. Methods DMPs with ages of 18-65 years were selected and divided into two groups of the case (DMPs with experiences of DM ≥ 4 years and limb amputation, n = 300), and control (DMPs with no experience of limb amputation, n = 600). Data were collected through demographics, clinical checklists, and the DMSES tool, and were analyzed using SPSS (v.25). Results The mean age of DMPs was 55.2 ± 8.2 years, and 59.3% and 40.7% of patients had type I and type II DM, respectively. A significant relationship was found between the mean of DMSES in terms of groups of the case (Mean: 60.6) and control (mean 67.7) (P = 0.001), living place, education, family background in non-close relatives, underlying disease, high blood pressure, hyperlipidemia, and the type of DM. The odds ratio (OR) of amputation was also found higher in DMPs with a lower mean of DMSES OR = 1.03, CI 95%=1.01-1.04, P = 0.001). Conclusion In this study, DMSE had a significant relationship with reducing limb amputation rate in DMPs. Furthermore, The average self-efficacy score according to gender, place of residence, education, family history in non-close relatives, underlying disease, and type of diabetes was significantly difference. It is suggested, that self-efficacy would be enhanced through systematic education in diabetes clinics. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01331-0.
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Affiliation(s)
- Sajad Bagheri
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ahmad Khoshay
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- Nursing and Midwifery School, Kermanshah University of Medical Sciences, Kermanshah, Iran
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22
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Grant V, Litchfield I. Acceptability of community health worker and peer supported interventions for ethnic minorities with type 2 diabetes: a qualitative systematic review. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2024; 5:1306199. [PMID: 38836261 PMCID: PMC11148349 DOI: 10.3389/fcdhc.2024.1306199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/26/2024] [Indexed: 06/06/2024]
Abstract
Objective Ethnic minority groups in high income countries in North America, Europe, and elsewhere are disproportionately affected by T2DM with a higher risk of mortality and morbidity. The use of community health workers and peer supporters offer a way of ensuring the benefits of self-management support observed in the general population are shared by those in minoritized communities. Materials and methods The major databases were searched for existing qualitative evidence of participants' experiences and perspectives of self-management support for type 2 diabetes delivered by community health workers and peer supporters (CHWPs) in ethnically minoritized populations. The data were analysed using Sekhon's Theoretical Framework of Acceptability. Results The results are described within five domains of the framework of acceptability collapsed from seven for reasons of clarity and concision: Affective attitude described participants' satisfaction with CHWPs delivering the intervention including the open, trusting relationships that developed in contrast to those with clinical providers. In considering Burden and Opportunity Costs, participants reflected on the impact of health, transport, and the responsibilities of work and childcare on their attendance, alongside a lack of resources necessary to maintain healthy diets and active lifestyles. In relation to Cultural Sensitivity participants appreciated the greater understanding of the specific cultural needs and challenges exhibited by CHWPs. The evidence related to Intervention Coherence indicated that participants responded positively to the practical and applied content, the range of teaching materials, and interactive practical sessions. Finally, in examining the impact of Effectiveness and Self-efficacy participants described how they changed a range of health-related behaviours, had more confidence in dealing with their condition and interacting with senior clinicians and benefitted from the social support of fellow participants and CHWPs. Conclusion Many of the same barriers around attendance and engagement with usual self-management support interventions delivered to general populations were observed, including lack of time and resource. However, the insight of CHWPs, their culturally-sensitive and specific strategies for self-management and their development of trusting relationships presented considerable advantages.
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Affiliation(s)
- Vivene Grant
- Birmingham Medical School, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Ian Litchfield
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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Chowdhury HA, Joham AE, Kabir A, Rahman AKMF, Ali L, Harrison CL, Billah B. Exploring type 2 diabetes self-management practices in rural Bangladesh: facilitators, barriers and expectations-a qualitative study protocol. BMJ Open 2024; 14:e081385. [PMID: 38697759 PMCID: PMC11086285 DOI: 10.1136/bmjopen-2023-081385] [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: 10/26/2023] [Accepted: 03/25/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a global public health crisis impacting low-income and middle-income countries such as Bangladesh. While self-management is encouraged for individuals with T2DM, there is a significant lack of knowledge regarding the factors of facilitators, barriers and expectations associated with T2DM self-management in Bangladesh. This research aims to investigate the potential elements that support, impede and are anticipated in the effective practice of self-management for T2DM in rural areas of Bangladesh. METHODS AND ANALYSIS This study will use an exploratory qualitative approach. 16 focus group discussions, 13 in-depth interviews and 9 key informant interviews will be conducted among multilevel stakeholders, including people with T2DM, their caregivers, healthcare providers, health managers/administrators and policy planners. Interviews will be audio-recorded, transcribed, translated and analysed using thematic analysis. ETHICS AND DISSEMINATION This research project has been approved by the Monash University Human Research Ethics Committee (project reference number: 39483) and the Ethical Review Committee of the Centre for Injury Prevention and Research, Bangladesh (Memo: CIPRB/ERC/2023/14). Research findings will be disseminated in peer-reviewed journals and conference presentations. Published reports will include group data. Individual data privacy will be strictly maintained.
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Affiliation(s)
- Hasina Akhter Chowdhury
- School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Anju E Joham
- Monash Centre for Health Research and Implementation-MCHRI, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
- Department of Diabetes, Monash University, Melbourne, Victoria, Australia
| | - Ashraful Kabir
- School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - A K M Fazlur Rahman
- Centre for Injury Prevention and Research Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Liaquat Ali
- Pothikrit Institute of Health Studies (PIHS), Dhaka, Bangladesh
| | - Cheryce L Harrison
- Monash Centre for Health Research and Implementation-MCHRI, Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia
| | - Baki Billah
- School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Al-Hadhrami R, Al-Rawajfah OM, Muliira JK, Khalaf A. Glycaemic control and its associated factors among adult Omanis with type 1 diabetes mellitus: a cross-sectional survey. Expert Rev Endocrinol Metab 2024; 19:279-285. [PMID: 38099952 DOI: 10.1080/17446651.2023.2295483] [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: 07/01/2023] [Accepted: 11/16/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVES This study aimed to investigate the relationship between glycemic control and diabetes self-management (DSM) and other associated factors among adult Omanis with Type-1 Diabetes Mellitus (T1DM). METHODS A cross-sectional, descriptive design was used to collect data among 210 adult Omanis with T1DM who were conveniently recruited. All tools were self-reported, whereas the HbA1c was collected from the patient's electronic medical records. RESULTS The HbA1c mean value was 8.6 (SD = 2.5), 30.5% had optimal glycemic control (<7.0). A significant negative relationship between HbA1c and DSM (r = - 0.191, p = 0.006) and diabetes knowledge (r = - 0.153, p = 0.026) was found. Furthermore, the mean HbA1c was significantly lower for persons with a single marital status, have higher education level, have children, are unemployed, were not admitted to the hospital in the last year, and have a health care professional as a family member. Additionally, marital status, level of education, DSM, and social support were significant predictors of glycemic control. CONCLUSIONS The results suggested that better glycemic control could be achieved by optimizing DSM, social support, and diabetes knowledge. Sociodemographic factors should be considered when treating individuals with T1DM to reach good glycemic control.
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Affiliation(s)
- Rajaa Al-Hadhrami
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | - Joshua K Muliira
- School of Nursing, College of Health, Ball State University, Muncie, IN, USA
| | - Atika Khalaf
- Department of Nursing, Fatima College of Health Sciences, Ajman Campus, Ajman, United Arab Emirates
- The PRO-CARE Group, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
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Tabarraei Y, Keshtkar AA, Yekaninejad MS, Rahimi N, Dowlatabadi Y, Azam K. A Longitudinal Examination of Blood Sugar Dynamics in Diabetes and Non-Diabetes Using Growth Curve Model: The Sabzevar Persian Cohort Study. Adv Biomed Res 2024; 13:30. [PMID: 39234430 PMCID: PMC11373718 DOI: 10.4103/abr.abr_406_23] [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: 10/13/2023] [Revised: 01/08/2024] [Accepted: 01/10/2024] [Indexed: 09/06/2024] Open
Abstract
Background Diabetes mellitus is a chronic metabolic disorder with substantial implications for public health. Understanding the factors influencing blood sugar fluctuations is crucial for effective diabetes management and prevention. This study aimed to evaluate factors associated with blood sugar changes in diabetic patients and healthy individuals attending the Sabzevar Persian Cohort Center, employing the growth curve model. Materials and Methods Data related to 589 diabetic patients and 589 non-diabetic patients participating in the Persian cohort study of Sabzevar were used. Due to the repetition of blood sugar measurements for each individual over time, we use the conditional latent growth curve model to examine intra-individual changes and variables that affect these changes over time. Results The linear latent growth curve model, fitted with independent variables, exhibited a superior fit. The slope of the line for the diabetic group was measured at 1.78, while for the non-diabetic group, it was estimated to be -0.29. Within the diabetic group, the influence of age, the presence of fatty liver, and history of congenital heart disease (CHD) had a significant impact on the baseline (the intercept), and the effect of body mass index (BMI) on the changing trend of the response variable (slope) was also significant. In the non-diabetic group, significant effects were observed for age variables, BMI, family history of diabetes, and history of stroke in the family. Conclusion Overall, the linear latent growth curve model showed good performance in the evaluation of the factors related to blood sugar changes in diabetic patients and healthy people.
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Affiliation(s)
- Yaser Tabarraei
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics and Epidemiology, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Abbas Ali Keshtkar
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Najme Rahimi
- Department of Internal Medicine, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Yousef Dowlatabadi
- School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kamal Azam
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Lai PK, Teng CL, Mustapha FI. Diabetes knowledge among Malaysian adults: A scoping review and meta-analysis. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2024; 19:26. [PMID: 38725609 PMCID: PMC11081772 DOI: 10.51866/rv.304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Introduction Optimal self-care promotes glycaemic control and prevents diabetes complications. Its performance is facilitated by an adequate level of diabetes knowledge. This review aimed to evaluate diabetes knowledge among Malaysians by assessing diabetes knowledge scores and their associated factors. Methods A comprehensive bibliographic search for Malaysian studies on diabetes knowledge was conducted in PubMed, Scopus and Google Scholar. Relevant literature was systematically selected and described; pertinent data were extracted; and data on diabetes knowledge levels and their associated factors were synthesised. The quality of the identified studies was assessed using a Joanna Briggs Institute critical appraisal tool. Results Thirty Malaysian cross-sectional studies that measured diabetes knowledge levels were retrieved. Nineteen of them used a named diabetes knowledge measurement tool, with 14 using the 14-item Michigan Diabetes Knowledge Test. A low knowledge level was prevalent among patients with diabetes mellitus (pooled mean knowledge score=6.92, proportion of patients with a low knowledge level=47.97%). The knowledge score was associated with some sociodemographic variables, health literacy, self-care and glycaemic control. Conclusion The association of diabetes knowledge with diabetes outcomes (e.g. self-care and glycaemic control) reflects the potential of the former as a target of intervention. Periodic measurement of diabetes knowledge in healthcare settings and among populations can help in assessing the effectiveness of diabetes educational interventions. Concerted efforts to improve diabetes knowledge among Malaysians have the potential to fill knowledge-practice gaps.
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Affiliation(s)
- Pei Kuan Lai
- Nursing (Hons), MSc in Medical and Health Sciences, PhD in Medical and Health Sciences, Institute for Research, Development and Innovation (IRDI), International Medical University (IMU), No.126, Jalan Jalil Perkasa 19, Bukit Jalil, Kuala Lumpur, Malaysia.
| | - Cheong Lieng Teng
- School of Medicine, International Medical University (IMU), Clinical Campus Seremban, Jalan Rasah, Bukit Rasah, Negeri Sembilan, Seremban, Malaysia
| | - Feisul Idzwan Mustapha
- Deputy Director (Non-Communicable Diseases), Disease Control Division, Ministry of Health, Malaysia
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Al-Qerem W, Jarab A, Eberhardt J, Alasmari F, Alkaee SM, Alsabaa ZH. Development and Validation of the Jordanian Diabetic Health Literacy Questionnaire: Enhancing Diabetes Management in Arabic-Speaking Populations. Healthcare (Basel) 2024; 12:801. [PMID: 38610223 PMCID: PMC11011997 DOI: 10.3390/healthcare12070801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/04/2024] [Accepted: 04/04/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: Amidst the global rise in type 2 diabetes mellitus (T2DM), effective management of the disease has become increasingly important. Health literacy, particularly in non-English speaking populations, plays a crucial role in this management. To address the lack of suitable tools for Arabic-speaking diabetic patients, this study developed and validated the Jordanian Diabetic Health Literacy Questionnaire (JDHLQ). (2) Methods: A sample of 400 diabetic patients from Jordan, with a balance in gender, age, and educational background, was recruited from an endocrinology outpatient clinic. The JDHLQ, consisting of informative and communicative sections, underwent rigorous validation. Utilizing principal component analysis and Rasch analysis, the JDHL's reliability and validity were evaluated. (3) Results: The results showed moderate proficiency in understanding and communicating diabetes-related information and confirmed the reliability and validity of the JDHLQ. (4) Conclusions: These findings emphasize the importance of culturally appropriate health literacy tools in enhancing patient understanding, engagement, and overall management of T2DM in Arabic-speaking communities.
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Affiliation(s)
- Walid Al-Qerem
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan;
| | - Anan Jarab
- College of Pharmacy, Al Ain University, Abu Dhabi 112612, United Arab Emirates;
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi 112612, United Arab Emirates
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid 22110, Jordan
| | - Judith Eberhardt
- Department of Psychology, School of Social Sciences, Humanities and Law, Teesside University, Borough Road, Middlesbrough TS1 3BX, UK;
| | - Fawaz Alasmari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 12372, Saudi Arabia;
| | - Safa M. Alkaee
- Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman 11733, Jordan;
| | - Zein H. Alsabaa
- Department of Pharmacy, Faculty of Pharmacy, Petra University, Amman 11196, Jordan;
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Embick R, Jackson M, Stewart R. The impact of stigma on the management of type 1 diabetes: A systematic review. Diabet Med 2024; 41:e15299. [PMID: 38361327 DOI: 10.1111/dme.15299] [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: 10/12/2023] [Revised: 01/18/2024] [Accepted: 01/20/2024] [Indexed: 02/17/2024]
Abstract
AIMS To systematically review the literature investigating the links between stigma and the management of type 1 diabetes. METHODS A systematic literature review was conducted in accordance with PRISMA guidelines. Both quantitative and qualitative data were considered. Included papers were subject to quality assessment using the Mixed Methods Appraisal Tool (MMAT), and a narrative synthesis of results was reported. RESULTS Nineteen articles met the inclusion criteria and were included in the final analysis. Amongst these, one study used mixed methods, nine were qualitative, and nine were quantitative. All studies found a negative relationship between stigma and type 1 diabetes management. Qualitative studies provided a further understanding of the effects observed in the quantitative studies and found that stigma can affect self-care activities, disclosure of diabetes, and the uptake of diabetes technology. Systemic causes of stigma and intersectional stigma were also observed. CONCLUSIONS This review highlights that people with type 1 diabetes are negatively affected by stigma, irrespective of their age, gender, culture, or use of diabetes technology. Quantitative studies were limited, in that all studies were cross-sectional, and there was a lack of standardisation across outcome measures. There is a need for interventions to target stigma on both an individual and a systemic level, particularly where people experience multiple intersecting stigmas.
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Affiliation(s)
- Ronda Embick
- North Wales Clinical Psychology Programme, School of Psychology, Bangor University, Bangor, UK
| | - Mike Jackson
- North Wales Clinical Psychology Programme, School of Psychology, Bangor University, Bangor, UK
| | - Rose Stewart
- Gladstone Centre, Wrexham Maelor Hospital, Betsi Cadwaladr University Health Board, Bangor, UK
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Smalls BL, Kruse-Diehr A, Ortz CL, Douthitt K, McLouth C, Shelton R, Taylor Z, Williams E. Older adults using social support to improve self-care (OASIS): Adaptation, implementation and feasibility of peer support for older adults with T2D in appalachia: A feasibility study protocol. PLoS One 2024; 19:e0300196. [PMID: 38498512 PMCID: PMC10947915 DOI: 10.1371/journal.pone.0300196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 02/21/2024] [Indexed: 03/20/2024] Open
Abstract
INTRODUCTION The prevalence of type 2 diabetes (T2D) is 17% higher in rural dwellers compared to their urban counterparts, and it increases with age, with an estimated 25% of older adults (≥ 65 years) diagnosed. Appropriate self-care is necessary for optimal clinical outcomes. Overall, T2D self-care is consistently poor among the general population but is even worse in rural-dwellers and older adults. In rural Kentucky, up to 23% of adults in Appalachian communities have been diagnosed with T2D and, of those, 26.8% are older adults. To attain optimal clinical outcomes, social environmental factors, including social support, are vital when promoting T2D self-care. Specifically, peer support has shown to be efficacious in improving T2D self-care behaviors and clinical and psychosocial outcomes related to T2D; however, literature also suggests self-selected social support can be obstructive when engaging in healthful activities. Currently available evidence-based interventions (EBIs) using peer support have not been used to prioritize older adults, especially those living in rural communities. METHOD To address this gap, we conducted formative research with stakeholders, and collaboratively identified an acceptable and feasible peer support EBI-peer health coaching (PHC)-that has resulted in improved clinical and psychosocial T2D-related outcomes among participants who did not reside in rural communities nor were ≥65 years. The goal of the proposed study is to use a 2x2 factorial design to test the adapted PHC components and determine their preliminary effectiveness to promote self-care behaviors and improve glycemic control among older adults living in Appalachian Kentucky. Testing the PHC components of the peer support intervention will be instrumental in promoting care for older adults in Appalachia, as it will allow for a larger scale intervention, which if effective, could be disseminated to community partners in Appalachia. TRIAL REGISTRATION This study was registered at www.clinicaltrials.gov (NCT06003634) in August 2023.
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Affiliation(s)
- Brittany L. Smalls
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Aaron Kruse-Diehr
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Courtney L. Ortz
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Key Douthitt
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Christopher McLouth
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, KY, United States of America
| | - Rachel Shelton
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Zoe Taylor
- Department of Family and Community Medicine, College of Medicine, University of Kentucky, Lexington, KY, United States of America
| | - Edith Williams
- Center for Community Health and Prevention, School of Medicine and Dentistry, University of Rochester, Rochester, NY, United States of America
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Nam HJ, Yoon JY. Pathways linking health literacy to self-care in diabetic patients with physical disabilities: A moderated mediation model. PLoS One 2024; 19:e0299971. [PMID: 38484001 PMCID: PMC10939260 DOI: 10.1371/journal.pone.0299971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/19/2024] [Indexed: 03/17/2024] Open
Abstract
INTRODUCTION Health literacy is widely considered to be a determinant of self-care behavior in people with diabetes. However, the mechanisms underlying how health literacy is linked to self-care behaviors have not been clearly elucidated. The aim of the present study was to explore the mediating roles of access to healthcare, provider-patient interaction, motivation, self-efficacy in the effect of health literacy on diabetes self-care behaviors among diabetic patients with physical disabilities and investigate the moderating effect of age in a moderated mediation model. METHODS The online survey was participated by a total of 214 diabetic patients with physical disabilities from November to December 2021. The moderated mediation analysis was examined using the Hayes' PROCESS macro modeling tool based on the bias-corrected bootstrapping method. RESULTS After controlling for education, the results yielded a significant indirect effect of health literacy on diabetes self-care through motivation and self-efficacy. A partially mediating relationship also was confirmed, as there is a positive direct effect of health literacy on diabetes self-care. Furthermore, age groups (i.e., age <40 and ≥ 40) functioned as a moderator of the mediating effects of motivation and self-efficacy between health literacy and diabetes self-care. CONCLUSION This study emphasized the important role of motivation and self-efficacy which play in linking health literacy and self-care behavior, especially for younger diabetic patients with physical disabilities. In the light of these findings, a health-literacy tailored motivation and self-efficacy enhancing program may be key targets for interventions promoting diabetes self-care behaviors in people with physical disabilities.
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Affiliation(s)
- Hye Jin Nam
- College of Nursing, Seoul National University, Seoul, South Korea
| | - Ju Young Yoon
- College of Nursing, Seoul National University, Seoul, South Korea
- Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Seoul National University, Seoul, South Korea
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Banu B, Khan MMH, Ali L, Barnighausen T, Sauerborn R, Souares A. Pattern and predictors of non-adherence to diabetes self-management recommendations among patients in peripheral district of Bangladesh. Trop Med Int Health 2024; 29:233-242. [PMID: 38221661 DOI: 10.1111/tmi.13966] [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] [Indexed: 01/16/2024]
Abstract
OBJECTIVES This study was designed to determine the extent of non-adherence to the different dimensions of diabetes self-management and to identify the factors influencing non-adherence among peripheral patients in Bangladesh. METHODS A cross-sectional study was conducted among 990 adult diabetic patients residing in Thakurgaon district, Bangladesh. Data were collected through face-to-face interviews including socio-demographic information, disease and therapeutic, health services, knowledge and adherence to self-management components. RESULTS The proportion of non-adherence to drug prescription was 66.7%, dietary regimen (68.9%), physical exercise (58.0%), follow-up visit/blood glucose test (88.2%), stopping tobacco (50.6%), and regular foot care (93.9%). Significant predictors for non-adherence to drug were poorest socio-economic status (OR = 2.47), absence of diabetic complications (OR = 1.43), using non-clinical therapy (OR = 5.61), and moderate level of knowledge (OR = 1.87). Non-adherence to dietary recommendations was higher for women (OR = 1.72), poorest socio-economic status (OR = 3.17), and poor technical knowledge (OR = 4.68). Non-adherence to physical exercise was lower for women (OR = 0.62), combined family (OR = 0.63), middle socio-economic status (OR = 0.54), and moderate knowledge on physical exercise (OR = 0.55). Non-adherence to follow-up visits/blood glucose test was higher among patients who did not have diabetic complications (OR = 1.81) and with own transport (OR = 2.57), and respondents from high-income group (OR = 0.23) were less likely to be non-adherent. Non-adherence to stopping tobacco was higher for older individuals (OR = 1.86); but lower for women (OR = 0.48), individuals with higher education level (OR = 0.17) and patients sick for a longer time (OR = 0.52). Non-adherence to foot care was higher for patients who needed longer time to go to hospital (OR = 4.07) and had poor basic knowledge on diabetes (OR = 17.80). CONCLUSION An alarmingly high proportion of diabetic patients did not adhere to diabetes self-management. Major predictors for non-adherence were related to patient's demographic characteristics and their experience with disease, treatment and health care services.
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Affiliation(s)
- Bilkis Banu
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
- Department of Public Health, Northern University Bangladesh, Dhaka, Bangladesh
| | | | - Liaquat Ali
- Pothikrit Institute of Health Studies, Dhaka, Bangladesh
| | - Till Barnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Rainer Sauerborn
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
| | - Aurélia Souares
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany
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Kim B, Hu J. The Effectiveness of Cognitive-Focused Interventions for Adults With Diabetes: A Systematic Review. West J Nurs Res 2024; 46:236-247. [PMID: 38205721 DOI: 10.1177/01939459231221939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
BACKGROUND Adults with diabetes and impaired memory and executive functions are more likely to experience difficulties in diabetes self-management and achieving glycemic targets. The purpose of this systematic review was to evaluate the evidence of the effects of cognitive-focused interventions on cognitive ability, diabetes self-management, and management of glycemic levels for middle-aged adults and older adults with diabetes. METHODS A systematic review of randomized controlled/clinical trials published in English between 2012 and 2022 was conducted. A search was performed using 5 databases (PubMed, CINAHL, Embase, Web of Science, and Scopus) in addition to hand-searching. The search terms included diabetes, adults, cognitive-focused intervention, cognition, self-management, and hemoglobin A1C (HbA1C). RESULTS Eleven studies met the inclusion criteria. Cognitive ability and diabetes self-management were assessed using different measurements, and glycemic levels were measured with HbA1C. Nine studies applied cognitive training, one provided working memory training, and one used occupational therapy. Eight studies combined cognitive training with a co-intervention, including self-efficacy, lifestyle management, physical training, chronic disease self-management program, square-stepping exercise, psychoeducational intervention, and empowerment. Eight studies showed statistically significant improvements in at least one cognitive domain. CONCLUSIONS Cognitive-focused interventions have a positive effect on improving memory and executive function. However, the evidence of cognitive-focused interventions on diabetes self-management and glycemic levels has not been established. Future studies to improve cognition using effective strategies to improve cognitive function enhancing diabetes self-management behaviors and managing glycemic levels are warranted.
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Affiliation(s)
- Bohyun Kim
- The Ohio State University, College of Nursing, Columbus, OH, USA
| | - Jie Hu
- The Ohio State University, College of Nursing, Columbus, OH, USA
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Chavda VP, Teli D, Balar PC, Davidson M, Bojarska J, Vaghela DA, Apostolopoulos V. Self-assembled peptide hydrogels for the treatment of diabetes and associated complications. Colloids Surf B Biointerfaces 2024; 235:113761. [PMID: 38281392 DOI: 10.1016/j.colsurfb.2024.113761] [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: 07/25/2023] [Revised: 11/27/2023] [Accepted: 01/14/2024] [Indexed: 01/30/2024]
Abstract
Diabetes is a widespread epidemic that includes a number of comorbid conditions that greatly increase the chance of acquiring other chronic illnesses. Every year, there are significantly more people with diabetes because of the rise in type-2 diabetes prevalence. The primary causes of illness and mortality worldwide are, among these, hyperglycemia and its comorbidities. There has been a lot of interest in the creation of peptide-based hydrogels as a potentially effective platform for the treatment of diabetes and its consequences. Here, we emphasize the use of self-assembled hydrogel formulations and their unique potential for the treatment/management of type-2 diabetes and its consequences. (i.e., wounds). Key aspects covered include the characteristics of self-assembled peptide hydrogels, methods for their preparation, and their pre-clinical and clinical applications in addressing metabolic disorders such as type-2 diabetes.
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Affiliation(s)
- Vivek P Chavda
- Department of Pharmaceutics and Pharmaceutical Technology, L.M. College of Pharmacy, Ahmedabad, India.
| | - Divya Teli
- Department of Pharmaceutical Chemistry, L. M. College of Pharmacy, Ahmedabad 380009, Gujarat, India
| | - Pankti C Balar
- Pharmacy section, L.M. College of Pharmacy, Ahmedabad, India
| | - Majid Davidson
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia
| | - Joanna Bojarska
- Institute of General and Ecological Chemistry, Faculty of Chemistry, Lodz University of Technology, 116 Zeromski S.t, 90-924 Lodz, Poland.
| | - Dixa A Vaghela
- Pharmacy section, L.M. College of Pharmacy, Ahmedabad, India
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Victoria University, Melbourne, VIC, Australia; Immunology Program, Australian Institute for Musculoskeletal Science, Melbourne, VIC, Australia.
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Anderson MN, Gallo CA, Passalugo SW, Nimeh JM, Edgar R, Yengo-Kahn AM, Neitz K, Terry DP, Zuckerman SL, Broglio SP, McCrea M, McAllister T, Pasquina P, Buckley TA. Collegiate Athletes With Diabetes: Baseline Medical Comorbidities and Preseason Concussion Testing Performance. J Athl Train 2024; 59:297-303. [PMID: 37655803 DOI: 10.4085/1062-6050-0202.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
CONTEXT People with diabetes mellitus (DM) are at increased risk for adverse health events and complications throughout their lifetime. Whether DM significantly affects collegiate athletes' concussion baseline testing performance remains unclear. OBJECTIVES To (1) describe the prevalence of DM and associated comorbidities and (2) compare concussion baseline testing performance between student-athletes with DM and student-athletes without DM (NoDM). DESIGN Retrospective, cross-sectional study. SETTING University. PATIENTS OR OTHER PARTICIPANTS Using the Concussion, Assessment, Research and Education (CARE) Consortium research database, we matched athletes with self-reported DM (N = 229) by institution, sex, age, sport, position, testing year, and concussion history to athletes with NoDM (N = 229; total sample mean age = 19.6 ± 1.4 years, women = 42%). MAIN OUTCOME MEASURE(S) Descriptive statistics and χ2 tests of independence with subsequent odds ratios were calculated. Independent-samples t tests compared baseline symptoms, neurocognitive testing, and balance performance between athletes with DM and athletes with NoDM. Effect sizes were determined for significant group differences. RESULTS At baseline, athletes with DM had higher rates of self-reported pre-existing balance disorders, sleep disorders, seizure disorders, motion sickness, learning disorders, vision and hearing problems, psychiatric disorders, depression, bipolar disorder, nonmigraine headaches, and meningitis than athletes with NoDM (P values < .05). We found balance differences between groups (P = .032, Cohen d = 0.17) such that, on average, athletes with DM had 1 additional error on the Balance Error Scoring System (DM = 13.4 ± 6.5; NoDM = 12.1 ± 5.9). No other comparisons yielded significant results. CONCLUSIONS Although athletes with DM had high rates of self-reported balance disorders, sleep disorders, seizures, and meningitis, their baseline neurocognitive testing results were largely identical to those of athletes with NoDM. Our findings suggested that nonclinically meaningful differences were present in concussion baseline balance testing but no significant differences were noted in cognitive testing; however, the effect of DM on concussion recovery remains unknown.
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Affiliation(s)
| | - Caitlin A Gallo
- Kinesiology and Applied Physiology, University of Delaware, Newark
| | | | - Jake M Nimeh
- Department of Biological Sciences, University of Delaware, Newark
| | | | | | | | | | | | | | | | | | - Paul Pasquina
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Thomas A Buckley
- Kinesiology and Applied Physiology, University of Delaware, Newark
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Shaban MM, Sharaa HM, Amer FGM, Shaban M. Effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of adult clients with diabetes. BMC Nurs 2024; 23:130. [PMID: 38378505 PMCID: PMC10877800 DOI: 10.1186/s12912-024-01787-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 02/01/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND In recent years, there has been growing interest in the use of Digital Based Nursing Intervention to support diabetes management. This study aimed to evaluate the effect of digital based nursing intervention on knowledge of self-care behaviors and self-efficacy of clients with diabetes. METHODS Employing a quasi-experimental design, a sample of 120 adult participants diagnosed with type 2 diabetes, aged more than 18 years with focus on older adults was drawn from outpatient clinics at Cairo University Hospital. The intervention was approved and registered by the ethical committee of the faculty of nursing with IRB number: RHDIRB2019041701. The intervention group (n = 60) received a digital-based nursing intervention, while the control group (n = 60) received standard care. Data were collected using adopted standardized tools including the Diabetes Knowledge Test, the Diabetes Self-Efficacy Scale, and the Summary of Diabetes Self-Care Activities. Demographic characteristics were analyzed, and pre- and post-intervention scores were compared using paired t-tests were statistical methods. RESULTS The digital-based nursing intervention resulted in significant enhancements in participants with diabetes knowledge and self-efficacy levels. Moreover, the intervention group demonstrated marked improvements in various self-care behaviors encompassing diet, exercise, medication adherence, blood glucose testing, and foot care. While the control group also exhibited some progress, the effects were less pronounced. Regression analyses highlighted age as a consistent factor associated with knowledge, self-efficacy, and specific self-care behaviors. CONCLUSION This study underscores the potential of tailored digital nursing interventions to complement traditional care approaches, empowering patients with type 2 diabetes to actively engage in self-management. The findings suggest that digital-based nursing interventions hold promise for enhancing patient knowledge, confidence, and proactive health behaviors. Nevertheless, limitations, including the relatively short intervention duration and a sample from a single clinic, warrant consideration. Future research should address these limitations to bolster the validity and applicability of the study's conclusions.
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Affiliation(s)
- Marwa Mamdouh Shaban
- Lecturer of Community Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt.
| | - Heba Magdy Sharaa
- Professor of Community Health Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt
| | | | - Mostafa Shaban
- Lecturer of Geriatric Nursing, Faculty of Nursing, Cairo University, Cairo, Egypt
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Asefa A, Belete AM, Talarge F, Molla D. Self-care practice and its barriers among diabetes patients in North East Ethiopia: A facility-based cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0002036. [PMID: 38359029 PMCID: PMC10868755 DOI: 10.1371/journal.pgph.0002036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 01/09/2024] [Indexed: 02/17/2024]
Abstract
Diabetes prevention and management through self-care practice is critical to reducing severe complications and death due to diabetes. Data on the prevalence of self-care practices will help us to design and implement prevention and management strategies to foster adherence and compliance with the interventions. This study was intended to assess self-care preparation and its barriers among diabetes patients in Northeast Ethiopia. A facility-based cross-sectional study was conducted among diabetes patients visiting Debre Berhan Town Public Health Institutions from March 10, 2021- April 10, 2021. A systematic random sampling technique was utilized to select 392 samples. Data were collected using a structured questionnaire adapted from Summary of Diabetes Self-Care Activities Measures. Reliability analysis was done using Cronbach's alpha test, and the Hosmer and Lemeshow test also checked for model fitness. Bivariate and multivariable binary logistic regression was done to identify the factors associated with dietary practices. For all statistically significant tests, p- a value < 0.05 was used as a cut-off point. The mean age of the respondents was 47.1 years, with a standard deviation (SD) of ± 13.4 years. The mean adherence to self-care practice was 29.00 ± 10.37 SD. More than half, 218 (61.1%) of the study subjects had poor self-care practices. In the multivariable logistic regression analysis, being a governmental worker (AOR = 7.06 (1.61-30.9) and having social support from partners (AOR = 5.83(3.01-11.3) showed a statistically significant association with good self-care practice. The current study showed that the overall level of self-care practice of study subjects was poor. Therefore, health facilities should provide adequate health education and promotion activities to enhance patients' level of adherence. In addition, families, partners, or friends of diabetes patients should be informed about their essential roles in patients' self-care practice.
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Affiliation(s)
- Adisu Asefa
- Communicable and Non-Communicable Disease Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
| | - Abebe Muche Belete
- Department of Biomedical Science, College of Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Feredegn Talarge
- Department of Biomedical Science, College of Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Daniel Molla
- Department of Biomedical Science, College of Medicine, Debre Berhan University, Debre Berhan, Ethiopia
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Ghosh Dastidar M, Murugappan K, R Nisbet D, Tricoli A. Simultaneous electrochemical detection of glycated and human serum albumin for diabetes management. Biosens Bioelectron 2024; 246:115876. [PMID: 38039734 DOI: 10.1016/j.bios.2023.115876] [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: 09/18/2023] [Revised: 10/26/2023] [Accepted: 11/22/2023] [Indexed: 12/03/2023]
Abstract
Developing highly selective and sensitive biosensors for diabetes management blood glucose monitoring is essential to reduce the health risks associated with diabetes. Assessing the glycation (GA) of human serum albumin (HSA) serves as an indicator for medium-term glycemic control, making it suitable for assessing the efficacy of blood glucose management protocols. However, most biosensors are not capable of simultaneous detection of the relative fraction of GA to HSA in a clinically relevant range. Here, we report an effective miniaturised biosensor architecture for simultaneous electrochemical detection of HSA and GA across relevant concentration ranges. We immobilise DNA aptamers specific for the detection of HSA and GA on gold nanoislands (Au NIs) decorated screen-printed carbon electrodes (SPCEs), and effectively passivate the residual surface sites. We achieve a dynamic detection range between 20 and 60 mg/mL for HSA and 1-40 mg/mL for GA in buffer solutions. The analytical utility of our HSA and GA biosensor architectures are validated in mice serum indicating immediate potential for clinical applications. Since HSA and GA have similar structures, we extensively assess our sensor specificity, observing high selectivity of the HSA and GA sensors against each other and other commonly present interfering molecules in blood such as glucose, glycine, ampicillin, and insulin. Additionally, we determine the glycation ratio, which is a crucial metric for assessing blood glucose management efficacy, in an extensive range representing healthy and poor blood glucose management profiles. These findings provide strong evidence for the clinical potential of our biosensor architecture for point-of-care and self-assessment of diabetes management protocols.
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Affiliation(s)
- Monalisha Ghosh Dastidar
- Nanotechnology Research Laboratory, Research School of Chemistry, College of Science, Australian National University, Canberra, ACT, 2601, Australia
| | - Krishnan Murugappan
- Nanotechnology Research Laboratory, Research School of Chemistry, College of Science, Australian National University, Canberra, ACT, 2601, Australia; CSIRO, Mineral Resources, Private Bag 10, Clayton South, Victoria, 3169, Australia.
| | - David R Nisbet
- The Graeme Clark Institute, The University of Melbourne, Melbourne, Australia; Department of Biomedical Engineering, Faculty of Engineering and Information Technology, The University of Melbourne, Melbourne, Australia; Melbourne Medical School, Faculty of Medicine, Dentistry and Health Science, The University of Melbourne, Melbourne, Australia
| | - Antonio Tricoli
- Nanotechnology Research Laboratory, Research School of Chemistry, College of Science, Australian National University, Canberra, ACT, 2601, Australia; Nanotechnology Research Laboratory, Faculty of Engineering, University of Sydney, Sydney, NSW, 2006, Australia.
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Chowdhury HA, Harrison CL, Siddiquea BN, Tissera S, Afroz A, Ali L, Joham AE, Billah B. The effectiveness of diabetes self-management education intervention on glycaemic control and cardiometabolic risk in adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis. PLoS One 2024; 19:e0297328. [PMID: 38306363 PMCID: PMC10836683 DOI: 10.1371/journal.pone.0297328] [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: 07/11/2023] [Accepted: 01/01/2024] [Indexed: 02/04/2024] Open
Abstract
Diabetes mellitus (DM) poses a significant challenge to public health. Effective diabetes self-management education (DSME) interventions may play a pivotal role in the care of people with type 2 diabetes mellitus (T2DM) in low- and middle-income countries (LMICs). A specific up-to-date systematic review is needed to assess the effect of DSME interventions on glycaemic control, cardiometabolic risk, self-management behaviours, and psychosocial well-being among T2DM across LMICs. The MEDLINE, Embase, CINAHL, Global Health, and Cochrane databases were searched on 02 August 2022 and then updated on 10 November 2023 for published randomised controlled trials (RCTs) and quasi-experimental studies. The quality of the studies was assessed, and a random-effect model was used to estimate the pooled effect of diabetes DSME intervention. Heterogeneity (I2) was tested, and subgroup analyses were performed. Egger's regression test and funnel plots were used to examine publication bias. The risk of bias of the included studies was assessed using the Cochrane risk-of-bias tool for randomized trial (RoB 2). The overall assessment of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation approach. A total of 5893 articles were retrieved, and 44 studies (n = 11838) from 21 LMICs met the inclusion criteria. Compared with standard care, pooled analysis showed that DSME effectively reduced the HbA1c level by 0.64% (95% CI: 0.45% to 0.83%) and 1.27% (95% CI: -0.63% to 3.17%) for RCTs and quasi-experimental design studies, respectively. Further, the findings showed an improvement in cardiometabolic risk reduction, diabetes self-management behaviours, and psychosocial well-being. This review suggests that ongoing support alongside individualised face-to-face intervention delivery is favourable for improving overall T2DM management in LMICs, with a special emphasis on countries in the lowest income group.
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Affiliation(s)
- Hasina Akhter Chowdhury
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Centre for Injury Prevention and Research, Bangladesh (CIPRB), Dhaka, Bangladesh
| | - Cheryce L. Harrison
- Monash Centre for Health Research and Implementation–MCHRI, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Bodrun Naher Siddiquea
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sanuki Tissera
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Afsana Afroz
- Department of Biochemistry and Pharmacology, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Liaquat Ali
- Pothikrit Institute of Health Studies (PIHS), Dhaka, Bangladesh
| | - Anju E. Joham
- Monash Centre for Health Research and Implementation–MCHRI, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Departments of Endocrinology and Diabetes, Monash Health, Melbourne, Australia
| | - Baki Billah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Tasleem M, Ullah S, Halim SA, Urooj I, Ahmed N, Munir R, Khan A, El-Kott AF, Taslimi P, Negm S, Al-Harrasi A, Shafiq Z. Synthesis of 3-hydroxy-2-naphthohydrazide-based hydrazones and their implications in diabetic management via in vitro and in silico approaches. Arch Pharm (Weinheim) 2024; 357:e2300544. [PMID: 38013251 DOI: 10.1002/ardp.202300544] [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: 09/27/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023]
Abstract
Diabetes mellitus (DM) has prevailed as a chronic health condition and has become a serious global health issue due to its numerous consequences and high prevalence. We have synthesized a series of hydrazone derivatives and tested their antidiabetic potential by inhibiting the essential carbohydrate catabolic enzyme, "α-glucosidase." Several approaches including fourier transform infrared, 1 H NMR, and 13 C NMR were utilized to confirm the structures of all the synthesized derivatives. In vitro analysis of compounds 3a-3p displayed more effective inhibitory activities against α-glucosidase with IC50 in a range of 2.80-29.66 µM as compared with the commercially available inhibitor, acarbose (IC50 = 873.34 ± 1.67 M). Compound 3h showed the highest inhibitory potential with an IC50 value of 2.80 ± 0.03 µM, followed by 3i (IC50 = 4.13 ± 0.06 µM), 3f (IC50 = 5.18 ± 0.10 µM), 3c (IC50 = 5.42 ± 0.11 µM), 3g (IC50 = 6.17 ± 0.15 µM), 3d (IC50 = 6.76 ± 0.20 µM), 3a (IC50 = 9.59 ± 0.14 µM), and 3n (IC50 = 10.01 ± 0.42 µM). Kinetics analysis of the most potent compound 3h revealed a concentration-dependent form of inhibition by 3h with Ki value = 4.76 ± 0.0068 µM. Additionally, an in silico docking approach was applied to predict the binding patterns of all the compounds, which indicates that the hydrazide and the naphthalene-ol groups play a vital role in the binding of the compounds with the essential residues (i.e., Glu277 and Gln279) of the α-glucosidase enzyme.
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Affiliation(s)
- Mussarat Tasleem
- Institute of Chemical Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - Saeed Ullah
- Natural and Medical Sciences Research Centre, University of Nizwa, Birkat Al Mauz, Nizwa, Sultanate of Oman
| | - Sobia Ahsan Halim
- Natural and Medical Sciences Research Centre, University of Nizwa, Birkat Al Mauz, Nizwa, Sultanate of Oman
| | - Ifra Urooj
- Institute of Chemical Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - Nadeem Ahmed
- Institute of Chemical Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - Rabia Munir
- Institute of Chemical Sciences, Bahauddin Zakariya University, Multan, Pakistan
| | - Ajmal Khan
- Natural and Medical Sciences Research Centre, University of Nizwa, Birkat Al Mauz, Nizwa, Sultanate of Oman
| | - Attalla F El-Kott
- Department of Biology, College of Science, King Khalid University, Abha, Saudi Arabia
- Department of Zoology, Faculty of Science, Damanhour University, Damanhour, Egypt
| | - Parham Taslimi
- Department of Biotechnology, Faculty of Science, Bartin University, Bartin, Turkey
| | - Sally Negm
- Department of Life Sciences, College of Science and Art Mahyel Aseer, King Khalid University, Abha, Saudi Arabia
| | - Ahmed Al-Harrasi
- Natural and Medical Sciences Research Centre, University of Nizwa, Birkat Al Mauz, Nizwa, Sultanate of Oman
| | - Zahid Shafiq
- Institute of Chemical Sciences, Bahauddin Zakariya University, Multan, Pakistan
- Department of Pharmaceutical & Medicinal Chemistry, University of Bonn, Bonn, Germany
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Lee D, Lee H, Shin Y, Park G. Effectiveness of Non-pharmacological Interventions for Adolescents With Type 1 Diabetes in the Last Five Years: A Systematic Review and Meta-analysis. Asian Nurs Res (Korean Soc Nurs Sci) 2024; 18:51-59. [PMID: 38307162 DOI: 10.1016/j.anr.2024.01.008] [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: 09/11/2023] [Revised: 01/14/2024] [Accepted: 01/29/2024] [Indexed: 02/04/2024] Open
Abstract
PURPOSE Evidence on non-pharmacological interventions for adolescents with type 1 diabetes is unclear. This review aimed to evaluate the effectiveness of non-pharmacological intervention in adolescents with type 1 diabetes. METHODS We conducted a search on databases from November 11 to 19, 2022, for randomized controlled trials for the effects of non-pharmacological intervention in adolescents with type 1 diabetes. To identify recent research trends, we included studies published from 2017 to November 2022. The risk of bias was assessed using the Cochrane risk-of-bias tool 2.0. To estimate the effect size, a meta-analysis was performed using RevMan 5.4 program and R Studio. RESULTS A total of 45 studies were included in the systematic review. Among those, 30 studies were included in the meta-analysis. Non-pharmacological interventions were significantly effective in improving Glycated hemoglobin (HbA1c) (standardized mean difference [SMD] = -0.26, 95% confidence interval [CI]: -0.42, -0.09), quality of life (SMD = 0.44, 95% CI: 0.13 to 0.76), and anxiety (SMD = -0.91, 95% CI: -1.26, -0.56). Subgroup analysis showed that duration of intervention was not a covariate related to HbA1c levels. CONCLUSIONS Non-pharmacological interventions have shown effectiveness in improving the HbA1c, quality of life, and anxiety in adolescents with type 1 diabetes. Future studies with more rigorous methodology are needed to confirm and strengthen the validity of these findings. Additionally, attention to changes in the lipid profile and self-care motivation among adolescents with type 1 diabetes is warranted. TRIAL REGISTRATION NUMBER Prospective Register of Systematic Reviews (CRD42022382190).
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Affiliation(s)
- DaeEun Lee
- College of Nursing, Pusan National University, South Korea
| | - Haejung Lee
- College of Nursing/Research Institute of Nursing Science, Pusan National University, South Korea.
| | - YoonYoung Shin
- College of Nursing, Pusan National University, South Korea
| | - Gaeun Park
- College of Nursing/Research Institute of Nursing Science, Pusan National University, South Korea
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Mphasha MH, Skaal L, Mothibal T. Diet and exercise knowledge and practices for diabetes care within families in Senwabarwana. S Afr Fam Pract (2004) 2024; 66:e1-e8. [PMID: 38299525 PMCID: PMC10839224 DOI: 10.4102/safp.v66i1.5767] [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: 05/01/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Family members (FMs) are a valuable source of support, as the bulk of daily diabetes treatment occurs at home. Family members' insufficient understanding of patient support can lead to poor diabetes outcomes. Lack of knowledge about good diet and exercise can lead to unhealthy food preparation and sedentary lifestyles, affecting patients and increasing the risk of diabetes. This study aims to fill the gap in the level of knowledge of FMs relating to appropriate care for diabetic patients under their care. This will relate specifically to diet and exercise. METHODS A cross-sectional survey conducted in Senwabarwana, Limpopo province, involved 200 FMs caring for diabetic patients for at least 6 months. Their experience could offer valuable insights into the competence of their care. Data were collected regarding knowledge and practice using a close-ended questionnaire, with Likert scale responses and SPSS analysis, including descriptive statistics and chi-squared tests. Knowledge was assessed on a scale ranging from poor to excellent: poor (0% - 50%), fair (51% - 60%), good (61% - 74%) and excellent ( 75%). Practice was assessed as poor (0% - 50%), fair (51% - 69%) and good (70% - 100%). RESULTS Thirty-one percent of participants demonstrated excellent knowledge and only 9% demonstrated good practice. Unfortunately, 53% stated that obese patients with diabetes should skip meals to lose weight. Only 3.5% and 19%, respectively, are familiar with recommendations for exercise and glucose monitoring. Barely 35.5% of FMs eat breakfast every day, while 87.5% report exercising. CONCLUSION Few FMs possess excellent diabetes management knowledge but still indulge in bad practices, increasing their risk of developing diabetes. Additionally, they may potentially cause health problems for patients.Contribution: Family-centred behaviour change intervention is recommended.
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Affiliation(s)
- Mabitsela H Mphasha
- Department of Public Health, Faculty of Healthcare Sciences, University of Limpopo, Polokwane.
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Jafari A, Moshki M, Ghelichi-Ghojogh M, Nejatian M. Role of diabetes health literacy, psychological status, self-care behaviors, and life satisfaction in predicting quality of life in type 2 diabetes. Sci Rep 2024; 14:1635. [PMID: 38238365 PMCID: PMC10796649 DOI: 10.1038/s41598-024-51245-x] [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: 02/07/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024] Open
Abstract
One of the factors that can affect the quality of life is the psychological status of people. Also, the psychological status of individuals can be affected by other variables. Therefore, this study was aimed to determine the role of diabetes health literacy, psychological status, self-care behaviors, and life satisfaction in predicting the quality of life in Iranian patients with type 2 diabetes. This cross-sectional study was conducted in Iran in 2021 among 300 patients with type 2 diabetes. The method of selecting the participants in this study was the proportional stratified sampling method. Data collection instruments included six questionnaires of demographic questionnaire and diabetes status, DASS-21 questionnaire (depression, anxiety, and stress), diabetes health literacy scale, self-care behavior questionnaire, satisfaction with life scale (SWLS), and quality of life questionnaire. Statistical methods such as independent sample t test, one-way analysis of variance, linear regression test, and Pearson correlation were used to analyze the data. Based on the results of Pearson correlation test, there was a positive and significant correlation between diabetes health literacy (r = 0.438, p < 0.001), depression (r = - 0.380, p < 0.001), anxiety (r = - 0.355, p < 0.001), stress (r = - 0.423, p < 0.001), and SWLS (r = 0.265, p < 0.001) with quality of life. Based on the results of linear regression, variables of diabetes health literacy, life satisfaction, self -care behaviors, depression, stress, anxiety, age of onset of diabetes and diabetes duration were able to predict 31% of the quality of life (p < 0.001). The results of this study indicated that diabetes health literacy, life satisfaction, stress and the duration of diabetes are able to predict the quality of life of patients with diabetes. Therefore, it is necessary to pay more attention to these effective variables training programs, especially health literacy, the effect of which is very obvious in this study.
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Affiliation(s)
- Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahdi Moshki
- Department of Health Education and Health Promotion, School of Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mousa Ghelichi-Ghojogh
- Neonatal and Children's Health Research Center, Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahbobeh Nejatian
- Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
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Vashist K, Frediani JK, Weber MB, Ali MK, Narayan KMV, Patel SA. Changes in Diabetes Care and Management Practices during the COVID-19 Pandemic. RESEARCH SQUARE 2024:rs.3.rs-3849240. [PMID: 38313263 PMCID: PMC10836114 DOI: 10.21203/rs.3.rs-3849240/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Background Evidence suggests diabetes management was negatively impacted early in the pandemic. However, the impact of the pandemic on key healthcare services for diabetes control and diabetes self-management practices is less known. We examined changes in diabetes care and management practices before and during the COVID-19 pandemic. Methods Population-based data regarding 4 diabetes-related healthcare engagement and 4 self-management indicators were obtained from adults with diabetes surveyed in 19 US States and Washington DC through the Behavioral Risk Factor Surveillance System. Using logistic regression, we estimated changes in the prevalence of each indicator, overall and by sociodemographic subgroups, before (2019; n = 15,307) and during (2021; n = 13,994) the COVID-19 pandemic. Results Between 2019 and 2021, the prevalence of biannual HbA1c tests reduced by 2.6 percentage points (pp, 95% CI :-4.8, -0.4), from 75.4-73.1%, and prevalence of annual eye exams fell by 4.0 pp (-6.2, -2.8), from 72.2-68.7%. The composite indicator of engagement with healthcare for diabetes control fell by 3.5 pp (-5.9, -1.1), from 44.9-41.9%. Reductions in engagement with healthcare were largely seen across sex, age, education, employment status, marital status, insurance status, and urbanicity; and were more pronounced among those aged 18-34 and the uninsured. Reductions in engagement with healthcare were seen in several states, with Delaware and Washington DC reporting the largest decrease. Of self-management behaviors, we only observed change in avoidance of smoking, an increase of 2.0 pp (0.4, 3.6) from 84.7-87.1%. Conclusions The pandemic had mixed impacts on diabetes care and self-management. The findings suggest a deterioration of the uptake of evidence-based, preventive health services requiring laboratory services and clinical examination for diabetes control during the pandemic. On the other hand, smoking rates decreased, suggesting potential positive impacts of the pandemic on health behaviors in people with diabetes.
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Gosak L, Stiglic G. Cognitive and Emotional Perceptions of Illness in Patients Diagnosed with Type 2 Diabetes Mellitus. Healthcare (Basel) 2024; 12:199. [PMID: 38255089 PMCID: PMC10815883 DOI: 10.3390/healthcare12020199] [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: 11/26/2023] [Revised: 12/29/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
Type 2 diabetes mellitus (T2DM) affects a patient's physical, social, and mental well-being. Perceptions of the illness are linked to quality of life. The aim of this study was to assess illness perception in patients diagnosed with T2DM and to validate the Brief Illness Perception Questionnaire in the Slovenian language. A cross-sectional study involved 141 patients diagnosed with T2DM. We performed a content analysis of the questionnaire and estimated the S-CVI, I-CVI, kappa coefficient. We also used Cronbach's alpha to assess the reliability. Participants did not have a very threatening perception of T2DM, but being overweight and having cardiovascular disease were significant contributors to a more threatening perception. The most frequently indicated factors influencing the onset and development of T2DM were heredity and genetics, stress and other psychological distress, and poor and inadequate nutrition. I-CVI ranged from 0.833 to 1.00, while the kappa is greater than 0.74, confirming the excellent validity of the questions. The content validity assessment of the questionnaire further confirms that the questionnaire is suitable for use with the target population in Slovenia. The questionnaire proved to be a valid and reliable tool that can be used to assess the relationship between illness perception and self-management of T2DM.
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Affiliation(s)
- Lucija Gosak
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia;
| | - Gregor Stiglic
- Faculty of Health Sciences, University of Maribor, 2000 Maribor, Slovenia;
- Faculty of Electrical Engineering and Computer Science, University of Maribor, 2000 Maribor, Slovenia
- Usher Institute, University of Edinburgh, Edinburgh EH8 9YL, UK
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Kurdi SM, Alamer A, Albaggal A, Alsuwaiket M, Alotaibi FM, Asiri IM, Alshayban DM, Alsultan MM, Alshehail B, Almalki BA, Hussein D, Alotaibi MM, Alfayez OM. The Association between Self-Care Activities and Depression in Adult Patients with Type 2 Diabetes in Saudi Arabia: A Cross-Sectional Web-Based Survey Study. J Clin Med 2024; 13:419. [PMID: 38256553 PMCID: PMC10816728 DOI: 10.3390/jcm13020419] [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: 12/24/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
This study examined the level of adherence to self-care behaviors among individuals with type 2 diabetes in Saudi Arabia and its connection with depression and demographic factors. A cross-sectional survey was conducted among diabetes patients using the Patient Health Questionnaire (PHQ-9) to measure depression and the Summary of Diabetes Self-Care Activities (SDSCA) to evaluate diabetes self-care activities. Among the 252 participants who completed the survey, 43.2% were older than 55 and 59% were men. The ordinal regression model showed an association between the PHQ-9 and SDSCA scores with an OR of 0.83 (95% CI: 0.71 to 0.96, p = 0.013). The PHQ-9 score was significantly associated with blood sugar monitoring (OR: 0.90 [95% CI: 0.82 to 0.99, p = 0.003]), exercise (OR: 0.88 [95% CI: 0.79 to 0.98, p = 0.002]), and diet (OR: 0.94 [95% CI: 0.85 to 1.03, p = 0.045]). Of all the diabetes-related factors, only a history of hospitalization and receiving diabetes education were found to be associated with improved self-care behaviors. In conclusion, a negative association was found between PHQ-9 scores and the SDSCA mean score and most daily diabetic self-care behavior components.
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Affiliation(s)
- Sawsan M. Kurdi
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.); (M.A.); (F.M.A.); (I.M.A.); (D.M.A.); (M.M.A.); (B.A.); (B.A.A.)
| | - Ahmad Alamer
- Department of Clinical Pharmacy, Prince Sattam bin Abdulaziz University, Alkharj 16273, Saudi Arabia;
| | - Aya Albaggal
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.); (M.A.); (F.M.A.); (I.M.A.); (D.M.A.); (M.M.A.); (B.A.); (B.A.A.)
| | - Marwa Alsuwaiket
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.); (M.A.); (F.M.A.); (I.M.A.); (D.M.A.); (M.M.A.); (B.A.); (B.A.A.)
| | - Fawaz M. Alotaibi
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.); (M.A.); (F.M.A.); (I.M.A.); (D.M.A.); (M.M.A.); (B.A.); (B.A.A.)
| | - Ibrahim M. Asiri
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.); (M.A.); (F.M.A.); (I.M.A.); (D.M.A.); (M.M.A.); (B.A.); (B.A.A.)
| | - Dhfer M. Alshayban
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.); (M.A.); (F.M.A.); (I.M.A.); (D.M.A.); (M.M.A.); (B.A.); (B.A.A.)
| | - Mohammed M. Alsultan
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.); (M.A.); (F.M.A.); (I.M.A.); (D.M.A.); (M.M.A.); (B.A.); (B.A.A.)
| | - Bashayer Alshehail
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.); (M.A.); (F.M.A.); (I.M.A.); (D.M.A.); (M.M.A.); (B.A.); (B.A.A.)
| | - Bassem A. Almalki
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam 34221, Saudi Arabia; (A.A.); (M.A.); (F.M.A.); (I.M.A.); (D.M.A.); (M.M.A.); (B.A.); (B.A.A.)
| | - Dania Hussein
- Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman bin Faisal University, Dammam 34221, Saudi Arabia;
| | - Mansour M. Alotaibi
- Pharmacy Practice Department, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia;
| | - Osamah M. Alfayez
- Department of Pharmacy Practice, College of Pharmacy, Qassim University, Qassim 51911, Saudi Arabia;
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Badi S, Suliman SZ, Almahdi R, Aldomah MA, Marzouq MEL, Ibrahim EEM, Ahmed M, Ahmed MH, Elkheir HK, Ibrahim MIM. The Impact of Clinical Pharmacist Diabetes Education on Medication Adherence in Patients with Type 2 Diabetes Mellitus: An Interventional Study from Khartoum, Sudan. J Pers Med 2024; 14:74. [PMID: 38248775 PMCID: PMC10817637 DOI: 10.3390/jpm14010074] [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: 10/11/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Continuous therapeutic care with good medication adherence is the cornerstone of management of all chronic diseases including diabetes. This study aimed to evaluate the impact of clinical pharmacist intervention on the medication adherence in individuals with type 2 diabetes (T2DM). METHODS This was a randomized, double-blind, controlled trial conducted at a diabetes clinic located at Omdurman Military Hospital, Sudan. Individuals with T2DM attending the diabetes clinic within 1 year were selected. The sample size was 364 participants (182 control and 182 interventional group). We used a pre-structured standardized questionnaire and checklist to collect the data. Data were analyzed by using the Statistical Package for the Social Sciences (SPSS) (version 28). RESULTS Majority, 76.4% (n = 278) were females, and they consisted of 80.8% (n = 147) of the interventional group and 72% of the controls. The mean age of the interventional group was 54.5 (±10) years; 31.9% (n = 58) of the interventional group had diabetes for 6-10 years, compared with 26.4% (n = 48) of the control group. Among the control group, the mean adherence score was 6.8 (±1.7) at baseline and it was 6.7 (±1.6) at the end of the study (p < 0.001), while in the interventional group, the mean adherence score was 6.8 (±1.7) at baseline and it was 7.4 (±1.5) at the end of the study (p < 0.001). CONCLUSION Adherence score among the intervention group was increased significantly from baseline to the end of the study when compared to the control group.
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Affiliation(s)
- Safaa Badi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum 14415, Sudan; (S.Z.S.); (R.A.); (M.A.A.); (M.E.M.); (E.E.M.I.); (H.K.E.)
| | - Sara Zainelabdein Suliman
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum 14415, Sudan; (S.Z.S.); (R.A.); (M.A.A.); (M.E.M.); (E.E.M.I.); (H.K.E.)
| | - Rayan Almahdi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum 14415, Sudan; (S.Z.S.); (R.A.); (M.A.A.); (M.E.M.); (E.E.M.I.); (H.K.E.)
| | - Mohammed A. Aldomah
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum 14415, Sudan; (S.Z.S.); (R.A.); (M.A.A.); (M.E.M.); (E.E.M.I.); (H.K.E.)
| | - Mohamed ELsir Marzouq
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum 14415, Sudan; (S.Z.S.); (R.A.); (M.A.A.); (M.E.M.); (E.E.M.I.); (H.K.E.)
| | - Eiman Eltayeb M. Ibrahim
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum 14415, Sudan; (S.Z.S.); (R.A.); (M.A.A.); (M.E.M.); (E.E.M.I.); (H.K.E.)
| | - Musaab Ahmed
- College of Medicine, Ajman University, Ajman P.O. Box 346, United Arab Emirates;
| | - Mohamed H. Ahmed
- Department of Medicine and HIV Metabolic Clinic, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK;
- Department of Geriatric Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes MK6 5LD, UK
| | - Habab Khalid Elkheir
- Department of Clinical Pharmacy, Faculty of Pharmacy, Omdurman Islamic University, Khartoum 14415, Sudan; (S.Z.S.); (R.A.); (M.A.A.); (M.E.M.); (E.E.M.I.); (H.K.E.)
- Department of Clinical Pharmacy, University of Science and Technology, Khartoum 14411, Sudan
| | - Mohamed Izham Mohamed Ibrahim
- Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha P.O. Box 2713, Qatar;
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Sousa S, Pereira AM, Santiago LM. Patient-Centered Medicine and Self-Care of Patients with Type 2 Diabetes: A Cross-Sectional Study. ACTA MEDICA PORT 2024; 37:3-9. [PMID: 37000414 DOI: 10.20344/amp.18584] [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: 05/18/2022] [Accepted: 12/12/2022] [Indexed: 04/01/2023]
Abstract
INTRODUCTION Even though the prevalence rate of diabetes in Portugal is one of the highest in Europe, no studies on the association between patient centered medicine, diabetes self-care, and glycemic control have been published. Assuming that patient centered medicine increases adherence to treatment through the improvement of the doctor-patient relationship, the aim of this study was to assess the influence of patient-centered medicine on the self-care of patients with type 2 diabetes patients' (T2DM) in two Family Health Units in Central Portugal, according to gender and age. MATERIAL AND METHODS A cross-sectional study was conducted in two Family Health Units in Central Portugal between the 25th November 2021 and the 15th January 2022. Patients with type 2 diabetes were invited to fill in the Patient-Centered Medicine questionnaire, for patients (PCM-p) (where higher values represent worse results) and the Summary of Diabetes Self-Care Activities Measure (SDSCAM), (where higher values represent better results), while healthcare professionals filled in the epidemiologic variables on pre-defined days. RESULTS A sample of 298 patients with type 2 diabetes was studied. Linear regressions for the association between SDSCAM scale factors and PCM-p showed significant associations for general diet (β = -0.07, p < 0.001), specific diet (β = -0.10, p < 0.001), exercise (β = -0.03, p = 0.008), foot care (β = -0.11, p < 0.001) and medication adherence in general (β = -0.06, p = 0.001). Multiple linear regression including the association between glycated hemoglobin (HbA1c) and the SDSCAM scale dimensions showed that specific diet was associated with lower HbA1c levels (β = -0.01, p = 0.007) and blood sugar testing (β = 0.01, p < 0.001) and that a higher score in PCMp was associated with higher HbA1c levels (β = 0.06, p < 0.001). Male patients (β = -6.93, p = 0.007) and older patients (β = -0.42, p = 0.001) were associated with lower scores in the specific diet. The male gender was associated with higher scores in exercise (β = 7.62, p = 0.029), lower scores in foot care (β = -6.06, p = 0.029) and lower scores in medication adherence to injectable medicines/6.2 (β = -0.73, p = 0.018). Age was associated with a lower score in medication (β = -0.03, p = 0.045) and a higher PCMp total score (β = 0.07, p = 0.030). CONCLUSION Patient-centered medicine in type 2 diabetics is associated with better self-care behaviors in patients with type 2 diabetes. Gender and age differences were observed in self-care behaviors and age differences were observed in Patient Centered Medicine.
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Affiliation(s)
- Solange Sousa
- Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
| | - Albino Miguel Pereira
- Mondego Family Health Unit; General Practice Clinic. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
| | - Luiz Miguel Santiago
- General Practice Clinic. Faculdade de Medicina. Universidade de Coimbra. Coimbra. Portugal
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Muniyapillai T, Kulothungan K, Aswin A, R A, G G, Z HK, M HB, B H. Effect of Self-Care Activities and Behaviors on Glycemic Control in Patients With Diabetes at a Tertiary Care Hospital in Perambalur, South India: A Cross-Sectional Study. Cureus 2024; 16:e52188. [PMID: 38348008 PMCID: PMC10859554 DOI: 10.7759/cureus.52188] [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: 01/12/2024] [Indexed: 02/15/2024] Open
Abstract
Background The complications of type 2 diabetes mellitus (T2DM) continue to cause significant morbidity and mortality, resulting in a substantial economic burden on both individual patients and society. The adoption of self-care practices leads to enhanced glycemic control, decreased complications, and an elevated quality of life. This study aimed to examine self-care activities and their association with glycemic control among individuals with diabetes. Materials and methods A cross-sectional study was conducted, involving 150 previously diagnosed T2DM patients who visited the tertiary care hospital in Perambalur, Tamilnadu, India, from March 2023 to May 2023. The collection of data involved conducting a semi-structured interview using the diabetes self-management questionnaire (DSMQ) over an eight-week period. Following the input of the data into MS Excel (Microsoft® Corp., Redmond, WA), SPSS Statistics version 26.0 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp) was used for data analysis. Results The mean age of the patients was 58.35±11.97 years, and 54.7% (n=82) of them were male. Nearly 65% of diabetic patients (n=98) were on orally administered antihyperglycemic agents. Fifty-nine percent (n=89) of the patients were observed to possess self-care behaviors that met the criteria for adequacy, as the DSMQ scores were dichotomized into "adequate" (≥6) and "inadequate" (<6) categories. We observed that 65% (n=98) of the patients had uncontrolled T2DM, characterized by an HbA1C level above 7.5%. Out of the four subscales of self-care behaviors assessed in this study, "glucose management" scored the highest (5.27±1.30), followed by "dietary control" (5.09±1.53), "healthcare use" (4.86±1.50), and "physical activity" (3.27±1.42). The proportion of diabetic patients who had adequate self-management (55%, n=49) had better glycemic control compared to diabetic patients who had inadequate self-management (4.91%, n=3), and this difference in proportion was statistically significant by the chi-square test (p-value 0.001). Similarly, a statistically significant association was noted between glycemic control and the subscales of DSMQ, namely glucose management, dietary control, physical activity, and healthcare utilization. Conclusion The findings in this study indicate that a noticeable proportion of T2DM patients practice inadequate self-care behaviors. According to the DSMQ, diabetic patients with adequate self-management had better glycemic control than diabetic patients with inadequate self-management. According to this research, patients with good glycemic control also tend to exercise better self-care management and show a greater concern for their illness.
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Affiliation(s)
| | | | - A Aswin
- Community Medicine, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, IND
| | - Abinaya R
- Community Medicine, Panimalar Medical College Hospital and Research Institute, Chennai, IND
| | - Guruvenkat G
- Community Medicine, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, IND
| | - Hafeeza Kulthum Z
- Community Medicine, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, IND
| | - Hajira Beevi M
- Community Medicine, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, IND
| | - Harigovindh B
- Community Medicine, Dhanalakshmi Srinivasan Medical College and Hospital, Perambalur, IND
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49
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Lee HF, Liao PH. The development and impact of an app for a smart drug interaction reminder system. Technol Health Care 2024; 32:1595-1608. [PMID: 37840509 PMCID: PMC11091626 DOI: 10.3233/thc-230650] [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: 05/22/2023] [Accepted: 08/26/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Improved access to media and medical knowledge has elicited stronger public health awareness. OBJECTIVE This study developed a smart drug interaction reminder system for patients to increase knowledge and reduce nurse workload. METHODS This study used a single-group pre-test/post-test design and applied mining techniques to analyze the weight and probability of interaction among various medicines. Data were collected from 258 participants at a teaching hospital in northern Taiwan using convenience sampling. An app was used to give patients real-time feedback to obtain access to information and remind them of their health issues. In addition to guiding the patients on medications, this app measured the nurses' work satisfaction and patients' knowledge of drug interaction. RESULTS The results indicate that using information technology products to assist the app's real-time feedback system promoted nurses' work satisfaction, improved their health education skills, and helped patients to better understand drug interactions. CONCLUSION Using information technology to provide patients with real-time inquiring functions has a significant effect on nurses' load reduction. Thus, smart drug interaction reminder system apps can be considered suitable nursing health education tools and the SDINRS app can be integrated into quantitative structure-activity relationship intelligence in the future.
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Affiliation(s)
- Hung-Fu Lee
- School of Nursing
- Department of Neurosurgery, Cheng Hsin General Hospital, Taipei City, Taiwan
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50
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van Leersum CM, Konrad KE, Bults M, den Ouden ME. Living with my diabetes - introducing eHealth into daily practices of patients with type 2 diabetes mellitus. Digit Health 2024; 10:20552076241257052. [PMID: 39148810 PMCID: PMC11325462 DOI: 10.1177/20552076241257052] [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] [Received: 10/05/2023] [Accepted: 05/07/2024] [Indexed: 08/17/2024] Open
Abstract
Objective Diabetes patients can draw on an increasing number of eHealth apps to support them in the self-management of their disease. While studies so far have focused on patients with type 1 diabetes, we explored how patients with type 2 diabetes mellitus (T2DM) integrate eHealth apps into their practices aimed at managing and coping with the disease, which aspects were considered particularly valuable and which challenges users encountered. Methods Semi-structured interviews and focus group sessions were conducted to explore how patients cope with T2DM in their daily lives and their attitude towards eHealth. In a further step, four eHealth apps were tested by patients and their expectations and experiences studied by way of qualitative interviews and focus groups. Results The analysis showed that the study participants valued in particular the possibility to use eHealth apps to sense and gain a better understanding of their own body, to learn about specific responses of their body to nutrition and physical activity, and to support changes in daily routines and lifestyle. Key challenges encountered related to difficulties in interpreting the data, matching the data to other bodily sensations, getting overly occupied with the disease and difficulties in integrating the apps into personal, family, and care practices. Conclusion Under certain conditions, eHealth can play an important role for patients in developing a nuanced, personal understanding of their body and coping with T2DM. A prerequisite is that eHealth needs to be fitted into the specific practices of users, and patients desire a strong role by their care professionals in providing support in interpretation of data.
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Affiliation(s)
- Catharina M van Leersum
- Department of Technology, Policy, and Society, Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, The Netherlands
- Faculty of Humanities, Open Universiteit Nederland, Heerlen, The Netherlands
| | - Kornelia E Konrad
- Department of Technology, Policy, and Society, Faculty of Behavioural, Management, and Social Sciences, University of Twente, Enschede, The Netherlands
| | - Marloes Bults
- Technology, Health & Care Research Group, Saxion University of Applied Sciences, Enschede, The Netherlands
| | - Marjolein Em den Ouden
- Technology, Health & Care Research Group, Saxion University of Applied Sciences, Enschede, The Netherlands
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