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Ameh MO, Kaswa RP, Cawe B. Healthcare workers' views on type 2 diabetes mellitus management at selected clinics in Mthatha. Afr J Prim Health Care Fam Med 2024; 16:e1-e10. [PMID: 39099269 PMCID: PMC11304201 DOI: 10.4102/phcfm.v16i1.4382] [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: 10/29/2023] [Revised: 03/19/2024] [Accepted: 03/25/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Diabetes is a non-communicable disease of global public health importance. Healthcare workers play a vital role in the management of this disease. AIM This study aimed to explore healthcare workers' views on managing patients with type 2 diabetes at primary health care facilities. SETTING The study was conducted at two primary health care facilities in Mthatha, South Africa. METHODS This exploratory descriptive qualitative study included 28 primary health care workers. Data were collected through individual interviews and focus group discussions and analysed using a thematic analysis approach. RESULTS Study participants' views of poor control of type 2 diabetes mellitus were categorised under patient- and healthcare system-related factors. The patient-related factors included poor adherence to an ideal diabetic diet, poor medication adherence, a lack of personal glucometers, and dearth of support systems. The healthcare system-related factors identified were inadequate patient education, long waiting times at the health facilities, high patient volumes, limited resources, and delayed service provision. Proposed solutions to address poor control of diabetes included improving patient health education, providing diabetic patients with glucometers, multi-stakeholder management of diabetes, allocating designated areas for patients with chronic illnesses, improved resource allocation, and regular staff training. CONCLUSION Study participants perceived an improved level of control of diabetes among patients managed at the Community Health Centres. When designing interventions for the management of diabetes, both patient and healthcare system-related factors and the proposed solutions should be considered.Contribution: This study's findings could promote better management of diabetes at the primary health care level.
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Affiliation(s)
- Michael O Ameh
- Department of Family Medicine and Rural Health, Faculty of Health Sciences, Walter Sisulu University, Mthatha.
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Bencze B, Cavalcante BGN, Romandini M, Róna V, Váncsa S, Varga G, Kivovics M, Szabó B, Agócs G, Géczi Z, Hermann P, Hegyi P, Végh D. Prediabetes and poorly controlled type-2 diabetes as risk indicators for peri-implant diseases:A systematic review and meta-analysis. J Dent 2024; 146:105094. [PMID: 38788918 DOI: 10.1016/j.jdent.2024.105094] [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: 02/14/2024] [Revised: 05/18/2024] [Accepted: 05/21/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVE The study answers the PECO question: "In adults with dental implants (P), do subjects suffering from type-2 diabetes or prediabetes (E) have worse peri-implant conditions (O) than subjects without type-2 diabetes and prediabetes (C)?". Prediabetes (5.7-6.4 % HbA1c), and the different qualities of glycemic control in type-2 diabetes; well-controlled (>8 % HbA1c), and poorly controlled (>8 % HbA1c) individuals; were classified according to the recommendations of the American Diabetes Association. DATA Predefined search keys were used with search terms including: Dental implant, diabetes mellitus, glycemic control and HbA1c. SOURCES An electronic search in the MEDLINE, Embase, and Cochrane libraries were conducted without any filters or language restrictions. Additionally, manual search of the reference lists were carried out to identify all relevant articles. STUDY SELECTION Eligibility criteria were cohort, case-control and cross-sectional studies that answerd our PECO question with at least 1 year of follow-up. From a total of 2660 records, 35 articles (1761 individuals) were included in the analysis. Meta-analytic difference in means for crestal bone loss was 1.2 mm [95 % CI=0.4; 2.1] in patients with prediabetes, 1.8 mm [CI=1.0; 2.7] in poorly controlled patients, whereas 0.4 mm [CI=-0.3; 1.1] in well-controlled individuals. Meta-regression showed that 1 % increase in HbA1c increased crestal bone loss by 0.24 mm. CONCLUSIONS Within the limitations of the study, patients with poorly controlled type-2 diabetes or prediabetes may have worse peri-implant conditions compared to patients without diabetes and well-controlled type-2 diabetes. Well-controlled type-2 diabetes is not a risk indicator for peri-implant diseases. CLINICAL SIGNIFICANCE Clinicians should measure blood HbA1c levels when planning implant-supported restorations, thus patients with undiagnosed or poorly controlled type-2 diabetes can be identified, that allows for glycemic level adjustment prior to dental implant surgery, ensuring peri-implant health. PROTOCOL REGISTRATION NUMBER: (CRD42022375263).
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Affiliation(s)
- Bulcsú Bencze
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | | | - Mario Romandini
- Department of Periodontology, University of Oslo, Oslo, Norway
| | - Virág Róna
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Szilárd Váncsa
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Oral Biology, Semmelweis University, Budapest, Hungary
| | - Márton Kivovics
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Community Dentistry, Semmelweis University, Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Gergely Agócs
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary
| | - Zoltán Géczi
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary; Institute of Pancreatic Diseases, Semmelweis University, Budapest, Hungary; Medical School, Institute for Translational Medicine, University of Pécs, Hungary
| | - Dániel Végh
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Budapest, Hungary.
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Abdo B, Abdullah M, AlShoaibi IA, Ahmed F, Alawdi R, Alzanen K, Algaadi K. Relationship Between Glycated Hemoglobin (HbA1c) and Vitamin D Levels in Type 2 Diabetes Patients: A Retrospective Cross-Sectional Study. Cureus 2024; 16:e62468. [PMID: 39015860 PMCID: PMC11250245 DOI: 10.7759/cureus.62468] [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: 06/16/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND Significant links between low serum levels of vitamin D3 and insufficient glycemic control in patients with type 2 diabetes mellitus (T2DM) have been reported previously in the literature. However, there is no exciting evidence on the association between glycated hemoglobin (HbA1c) and vitamin D levels in T2DM individuals in our nation (Yemen). This study aimed to investigate the relationship between HbA1c and vitamin D levels in T2DM patients in a resource-limited setting. METHOD A retrospective cross-sectional study was conducted at the Al-Raffa Center, Ibb, Yemen between June 2018 and September 2023 including 396 patients diagnosed with T2DM. The patient characteristics, comorbidities, HbA1c, and vitamin D levels were gathered from patients' medical profiles. Linear regression analysis was used to find the factors associated with vitamin D deficiency (serum 25(OH)D levels < 20 ng/mL) among T2DM patients. Subsequently, the correlation between HbA1c and vitamin D levels was examined using receiver operating characteristic (ROC) curve analysis. RESULTS The mean age was 44.6 ±14.6 years and most of them (n= 227, 57.3%) were female and from a rural area (n= 229, 57.8%). Comorbidities were hypertension, dyslipidemia disease, and cardiovascular disease in 176 (44.4%), 63 (15.9%), and 88 (22.2%) cases, respectively. The mean HbA1c was 8.1 ±2.5%. The mean vitamin D level was 26.9 ±16.5 ng/mL and low vitamin D was present in 260 (65.7%) (vitamin D deficiency in 160 (40.4%) and vitamin D insufficiency in 100 (25.3%) cases). In regression analysis, obesity (>30 kg/m2) (odds ratio (OR): 299.49; 95% confidence interval (CI): 72.66 - 1234.42, p <0.0001), higher HbA1c levels (OR: 1.61; 95% CI: 1.26 - 2.05, p =0.0001), and urban residence (OR: 23.98; 95% CI: 5.62 - 102.42, p <0.0001) were associated with vitamin D deficiency. There was a negative correlation between the vitamin D level and HbA1c which was statistically significant (correlation coefficient r: -0.5452; 95% CI: -0.6109 to -0.4720, p <0.0001). Using the ROC analysis, the serum vitamin D value of ≤18.42 ng/ml was the best cut-off point to predict hyperglycemia (area under the curve: 0.633, 95% CI: 0.672 to 0.770, sensitivity: 52%, specificity: 84.71 %, Yoden's index: 0.3671, p <0.001). Based on this cut-off, 39.4% of individuals (37.5% in the normoglycemic group and 90.9% in the hyperglycemic group) were vitamin D deficient. CONCLUSION In this study, low vitamin D was common among T2DM patients, especially those with poor glycemic control. We observed a link between HbA1c levels, urban residency, and BMI with vitamin D deficiency in T2DM patients. The association was distinguished by low vitamin D levels and elevated HbA1c. Additionally, we found that the serum vitamin D value of ≤18.42 ng/ml was the best cut-off point to predict hyperglycemia in T2DM patients with moderate agreement. To manage their disease, patients with T2DM should take their medications as prescribed and live a healthy lifestyle. This will increase their overall health, especially their vitamin D levels.
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Affiliation(s)
- Basheer Abdo
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | - Mohammed Abdullah
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | - Ismaeel A AlShoaibi
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | | | - Redwan Alawdi
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | - Khaled Alzanen
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
| | - Kamal Algaadi
- Department of Internal Medicine, School of Medicine, Ibb University, Ibb, YEM
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Alshaikh AA, Al-Qahtani FS, Alqahtani SAM, AlFarhan AA, Al Nuwayhidh AM, Madkhali AM, AlQahtani RS, AlAsmari AF, Alserhani AS, Alqubaisi HA, Saeed Aldawh ZS, Al Bin Ahmad AK, Ghazy RM. Exploring the self-efficacy of patients with diabetes: its role as a predictor of diabetes management and well-being. Front Endocrinol (Lausanne) 2024; 15:1347396. [PMID: 38841304 PMCID: PMC11151748 DOI: 10.3389/fendo.2024.1347396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/22/2024] [Indexed: 06/07/2024] Open
Abstract
Background Self-efficacy is a popular psychological concept that refers to an individual's perception or belief in his ability to perform specific actions. This study aimed to assess the predictive value of self-efficacy, measured using the Self-Efficacy for Managing Chronic Disease 6-Item Scale (SEM6S) questionnaire, for diabetes management and overall well-being in patients with diabetes. Subject and methods An anonymous online cross-sectional study was conducted to evaluate the self-efficacy of diabetic patients in the Asser region of Saudi Arabia. The participants were requested to upload their most recent glycated hemoglobin A1C (HbA1C) measurements taken in the last three months, which helped in the accurate categorization of their diabetes as either controlled or uncontrolled. We used the valid Arabic version of the SEM6S and WHO-5 well-being questionnaires to assess patient self-efficacy and well-being. Results A cohort of 342 patients was enrolled in the study, 67.25% were married, their mean age was 43.17 ± 17.61 years, and 52.69% had university-level or higher education. Among the participants, 46.0% exhibited well-being, while 24.9% reported poor well-being, including 9.4% who were identified as experiencing depression. The mean scores of self-efficacy and well-being were significantly higher among those with controlled diabetes versus uncontrolled diabetes (40.86 ± 13.26 vs. 36.48 ± 13.26) and (67.35 ± 21.22 vs. 60.93 ± 25.05), respectively. The predictors of glycemic control were self-efficacy [Odds ratio (OR)=1.03 (95%CI, 1.01-1.06, P=0.002], having other chronic diseases [OR=3.25 (95%CI), P<0.001], having type 1 diabetes [OR=7.16, 95%CI, P=0.005], being Saudi [OR=7.67, (95%CI, P=0.027], working in a public sector [OR=0.15, (95%CI, 0.05-0.44), P=0.005], being unemployed [OR=0.19, (95%CI, 0.06-0.59), P=0.005], being a smoker [OR=0.44, 95%CI, 0.19-0.98, P=0.048], and duration of diabetes between 6-10 years [OR= 0.33, 95%CI, 0.11-0.95), P=0.043] or more than 10 years OR=0.32, 95%CI, 0.12-0.86), P=0.026]. The main determinants of well-being were having self-efficacy [OR=1.07 (95%CI, 1.04-1.09), P = 0.0001], having public health insurance [OR=4.36 (95%CI, P=0.015], and education level (read and write) [OR=0.13 (95%CI,.02-.70), P=0.021]. Conclusions The study reveals that non-modifiable and modifiable factors, including self-efficacy, play a crucial role in diabetes control. The study recommends providing targeted educational interventions, using different social media platforms, psychosocial support programs, and inclusive healthcare policies to improve diabetes control and mental well-being among diabetic patients.
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Affiliation(s)
- Ayoub Ali Alshaikh
- Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Faisal Saeed Al-Qahtani
- Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Saif Aboud M. Alqahtani
- Internal Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Ahmad Ali AlFarhan
- Medical Colleague, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | | | | | - Ali Fayez AlAsmari
- Medical Colleague, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | | | - Hatim Ahmed Alqubaisi
- Clinical pharmacist Intern, College of Pharmacy, King Khalid University, Abha, Saudi Arabia
| | | | | | - Ramy Mohamed Ghazy
- Family and Community Medicine Department, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Oliveira Hashiguchi L, Ferrer JP, Suzuki S, Faguer BN, Solon JA, Castro MC, Ariyoshi K, Cox SE, Edwards T. Glycemic control during TB treatment among Filipinos: The Starting Anti-Tuberculosis Treatment Cohort Study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003156. [PMID: 38696522 PMCID: PMC11065219 DOI: 10.1371/journal.pgph.0003156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 04/03/2024] [Indexed: 05/04/2024]
Abstract
Poor TB treatment outcomes are observed in patients with type 2 diabetes mellitus (DM) comorbidity and glycemic control throughout treatment may play a role. The objective of this study was to investigate glycemic control longitudinally among Filipino adults undergoing TB treatment using mixed-effects linear and logistic regression. Analyses were conducted in 188 DM-TB patients out of 901 enrolled in the Starting Anti-TB Treatment (St-ATT) cohort, with a median baseline glycosylated hemoglobin (HbA1c) of 8.2% (range 4.5-13.3%). Previous versus new DM diagnosis was associated with higher mean HbA1c (worse glycemic control) during treatment, with a smaller effect amongst those with central obesity (coefficient 0.80, 95% confidence interval [CI] 0.26, 1.57, P = 0.043) than amongst those without central obesity (coefficient 3.48, 95% CI 2.16, 4.80, P<0.001). In those with a new DM diagnosis, central obesity was associated with higher blood glucose (coefficient 1.62, 95% CI 0.72, 2.53, P = 0.009). Of 177 participants with ≥2 HbA1c results, 40% had uncontrolled glycemia (≥2 HbA1c results ≥8%). Of 165 participants with ≥3 HbA1c results, 29.9% had consistently-controlled glycemia, 15.3% had initially-uncontrolled glycemia, and 18.6% had consistently-uncontrolled glycemia. Previous versus new DM diagnosis and glucose-lowering medication use versus no use were associated with having uncontrolled versus controlled glycemia (adjusted odds ratio [aOR] 2.50 95%CI 1.61, 6.05, P = 0.042; aOR 4.78 95% CI 1.61,14.23, P<0.001) and more likely to have consistently-uncontrolled versus consistently-controlled glycemia (adjusted relative risk ratio [aRRR] 5.14 95% CI 1.37, 19.20, P = 0.015; aRRR 10.24 95% CI 0.07, 0.95, P = 0.003). Relapse cases of TB were less likely than new cases to have uncontrolled (aOR 0.20 95%CI 0.06, 0.63, P = 0.031) or consistently-uncontrolled (aRRR 0.25 95%CI 0.07, 0.95, P = 0.042) versus controlled glycemia. Those with long-term DM, suggested by previous diagnosis, glucose-lowering medication use and possibly central obesity, may require additional support to manage blood glucose during TB treatment.
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Affiliation(s)
- Lauren Oliveira Hashiguchi
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, United Kingdom
- School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan
| | | | - Shuichi Suzuki
- School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan
| | - Benjamin N. Faguer
- School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan
| | - Juan Antonio Solon
- Nutrition Center of the Philippines, Muntinlupa City, Manila, Philippines
| | | | - Koya Ariyoshi
- School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan
| | - Sharon E. Cox
- School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Tuberculosis Unit, United Kingdom Health Security Agency, London, United Kingdom
| | - Tansy Edwards
- School of Tropical Medicine & Global Health, Nagasaki University, Nagasaki, Japan
- Medical Research Council International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom
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Shareef J, Apidechkul T, Srichan P. Prevalence of and factors associated with suboptimal glycemic control among patients with type 2 diabetes mellitus attending public hospitals in the Greater Male' Region, Maldives: a hospital-based cross-sectional study. BMC Public Health 2024; 24:1166. [PMID: 38664794 PMCID: PMC11047027 DOI: 10.1186/s12889-024-18693-6] [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: 08/17/2023] [Accepted: 04/23/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Suboptimal glycemic control of type 2 diabetes mellitus (T2DM) which is defined as having HbA1c greater than 7% is a major public health problem in several countries, including the Maldives. The study aimed to estimate the prevalence and determine factors associated with suboptimal glycemic control among T2DM patients. METHODS A hospital-based cross-sectional was applied to collect data from T2DM patients who attended public hospitals in the Greater Male' Region, Maldives where were one of the highest reports of T2DM and suboptimal glycemic control cases in the country between January to March 2023 by a validated questionnaire and anthropometric measurements. Five (5) ml blood specimens were collected to measure the glycated hemoglobin (HbA1c) level. Univariable and multivariable logistic regressions were employed to determine factors associated with suboptimal glycemic control of T2DM at a significant level of α = 0.05. RESULTS A total of 341 participants were recruited for the study: 65.7% were female, 42.5% were aged 40-60 years, and 42.2% were married. The overall prevalence of suboptimal glycemic control was 50.7%. Ten variables were found to be associated with suboptimal glycemic control in multivariable logistic regression. Those aged 40-60 years (AOR = 3.35, 95% CI = 1.78-6.30), being single (AOR = 2.53, 95% CI = 1.21-5.30), preparation of food using more than three tablespoons of cooking oil (AOR = 2.78, 95% CI = 1.46-5.28), preparation of food with more than three tablespoons of sugar (AOR = 2.55, 95% CI = 1.31-4.93), no exercise (AOR = 2.04, 95% CI = 1.15-3.61), DM diagnosed with more than twenty years prior (AOR = 2.59, 95% CI = 1.34-4.99), obese body mass index (BMI) (AOR = 3.82, 95% CI = 1.75-8.32), high total cholesterol (AOR = 2.43, 95% CI = 1.36-4.35), high triglycerides (AOR = 3.43, 95% CI = 1.93-6.11), and high-level stress (AOR = 2.97, 95% CI = 1.48-5.93) were having a greater odds of having suboptimal glycemic control than those who did not have these characteristics. CONCLUSION A large proportion of T2DM patients in the Greater Male' Region fail to control their blood glucose. Effective public health interventions should be introduced, especially interventions focused on reducing cooking oil and sugar in daily cooking practices, encouraging regular exercise, and maintaining cholesterol levels, particularly for those diagnosed with diabetes mellitus for more than 20 years prior.
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Affiliation(s)
- Jeehana Shareef
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
| | - Tawatchai Apidechkul
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.
- Center of Excellence for the Hill tribe Health Research, Mae Fah Luang University, Chiang Rai, 57100, Thailand.
| | - Peeradone Srichan
- School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand
- Center of Excellence for the Hill tribe Health Research, Mae Fah Luang University, Chiang Rai, 57100, Thailand
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Teli M, Thato R, Hasan F, Rias YA. Effectiveness of Family-Based Diabetes Management Intervention on Glycated Haemoglobin Among Adults With Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Biol Res Nurs 2024; 26:315-333. [PMID: 38063030 DOI: 10.1177/10998004231218887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2024]
Abstract
BACKGROUND Glycated hemoglobin (HbA1c) control is a crucial goal in the management of type 2 diabetes mellitus (T2DM), requiring lifelong commitment and family support. This study aimed to assess the effectiveness of family-based diabetes management intervention on HbA1c among adults with T2DM. METHODS From inception up to 2022, a comprehensive literature search was conducted across PubMed, ProQuest, Scopus, CORE, and the Cochrane Library. The quality of studies was evaluated using the Joanna Briggs Institute (JBI) Critical Appraisal tools. Effect sizes were calculated using standard deviations (SD), while the degree of heterogeneity was evaluated using the Higgins I2 test. Subgroup analyses were performed to explore factors contributing to sources of heterogeneity among trials. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed, and the protocol was registered with PROSPERO CRD42022384034. RESULTS A total of 18 randomized controlled trials (RCTs) involving 2815 participants indicated that family-based diabetes management intervention had a statistically significant impact on improving HbA1c (Mean Difference [MD] = -.47; 95% Confidence Interval [CI]: -.64 to -.30, p < .001) with a moderate level of heterogeneity (I2 = 59%). Subgroup analysis indicated that family-based diabetes management intervention among adults with T2DM in developing regions was more effective in improving HbA1c levels compared to developed countries. CONCLUSION Family-based diabetes management interventions improved HbA1c. Further research is required to develop diabetes management strategies with a family focus that clearly defines the family's involvement.
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Affiliation(s)
- Margareta Teli
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Nursing School, Polytechnic of Health Ministry of Health Kupang, Kupang, Indonesia
| | - Ratsiri Thato
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Faizul Hasan
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
| | - Yohanes Andy Rias
- Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
- Faculty of Health, College of Nursing, Institut Ilmu Kesehatan Bhakti Wiyata, Kediri, Indonesia
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Ghazaiean M, Najafi B, Zamanfar D, Alipour MJ. Risk factors for suboptimal glycemic control in pediatrics with type 1 diabetes mellitus: a cross-sectional study. Sci Rep 2024; 14:7492. [PMID: 38553464 PMCID: PMC10980686 DOI: 10.1038/s41598-024-57205-9] [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: 12/22/2023] [Accepted: 03/15/2024] [Indexed: 04/02/2024] Open
Abstract
The objective of this research is to analyze the influence of various factors on glycemic control in pediatrics with type 1 diabetes mellitus (T1DM). The study, a cross-sectional analysis, involved 221 T1DM patients below 18 years old who visited our clinic between 2011 and 2020, predating the COVID-19 outbreak. Out of the initial pool, 204 participants were chosen based on specific criteria. By computing odds ratios and 95% confidence intervals, we determined the correlation between these factors and achieving optimal glycemic control (HbA1c < 7.5%). Of the 204 individuals, 55.9% (113 patients) were female. The average age at diagnosis was 6.93 ± 3.9 years. Mean HbA1c (A1C) level of optimal and suboptimal groups were 6.97, 95% CI 6.84 to 7.1 and 8.86, 95% CI 8.68 to 9.03, respectively (p-value < 0.001). Fifty patients had optimal glycemic control and 154 people experienced suboptimal glycemic control during the follow-up that the prevalence of each of them was 24.51, 95% CI 18.7 to 31 and 75.49, 95% CI 68.99 to 81.22, respectively. In the assessment of risk factors associated with suboptimal glycemic control, patients aged 10-14 years had the highest likelihood of experiencing suboptimal glycemic control (crude odds ratio [COR] 3.12, 95% CI 1.04 to 9.3), followed by duration of diabetes (COR 2.85, 95% CI 1.2 to 6.8), which both were significant. By utilizing multivariable logistic regression analysis, a noteworthy finding emerged. It was revealed that patients aged 10-14 years exhibited a significant association with suboptimal glycemic control, [adjusted odds ratio (AOR) 4.85, 95% CI 1.32 to 17.7]. Additionally, a statistically significant correlation was identified between individuals with a body mass index (BMI) falling within the ≥ 95th percentile category and suboptimal glycemic control, Cramer's V = 0.21, p-value = 0.01. Our research has revealed a significant correlation between patients aged 10-14 years and obese individuals (BMI ≥ 95th) with suboptimal glycemic control. It is crucial to consider these factors as they can offer valuable insights during diagnosis, highlighting the increased risk of long-term suboptimal glycemic control.
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Affiliation(s)
- Mobin Ghazaiean
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Gut and Liver Research Center, Non-Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Behnam Najafi
- Gastrointestinal Research Center, Non-Communicable Disease Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Daniel Zamanfar
- Department of Pediatric Endocrinology, Diabetes Research Center of Mazandaran, Mazandaran University of Medical Sciences, Sari, Iran.
| | - Mohammad Javad Alipour
- Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Safary E, Beran D, Vetter B, Lepeska M, Abdraimova A, Dunganova A, Besançon S, Lazo-Porras M, Portocarrero Mazanett J, Pérez-León S, Maixenchs M, Nchimbi H, Ramaiya K, Munishi C, Martínez-Pérez GZ. User requirements for non-invasive and minimally invasive glucose self-monitoring devices in low-income and middle-income countries: a qualitative study in Kyrgyzstan, Mali, Peru and Tanzania. BMJ Open 2024; 14:e076685. [PMID: 38367964 PMCID: PMC10875487 DOI: 10.1136/bmjopen-2023-076685] [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: 06/14/2023] [Accepted: 01/30/2024] [Indexed: 02/19/2024] Open
Abstract
AIMS Development of non-invasive and minimally invasive glucose monitoring devices (NI-MI-GMDs) generally takes place in high-income countries (HICs), with HIC's attributes guiding product characteristics. However, people living with diabetes (PLWD) in low-income and middle-income countries (LMICs) encounter different challenges to those in HICs. This study aimed to define requirements for NI-MI-GMDs in LMICs to inform a target product profile to guide development and selection of suitable devices. METHODS This was a multiple-methods, exploratory, qualitative study conducted in Kyrgyzstan, Mali, Peru and Tanzania. Interviews and group discussions/activities were conducted with healthcare workers (HCWs), adults living with type 1 (PLWD1) or type 2 diabetes (PLWD2), adolescents living with diabetes and caregivers. RESULTS Among 383 informants (90 HCW, 100 PLWD1, 92 PLWD2, 24 adolescents, 77 caregivers), a range of differing user requirements were reported, including preferences for area of glucose measurement, device attachment, data display, alert type and temperature sensitivity. Willingness to pay varied across countries; common requirements included ease of use, a range of guiding functions, the possibility to attach to a body part of choice and a cost lower than or equal to current glucose self-monitoring. CONCLUSIONS Ease-of-use and affordability were consistently prioritised, with broad functionality required for alarms, measurements and attachment possibilities. Perspectives of PLWD are crucial in developing a target product profile to inform characteristics of NI-MI-GMDs in LMICs. Stakeholders must consider these requirements to guide development and selection of NI-MI-GMDs at country level, so that devices are fit for purpose and encourage frequent glucose monitoring among PLWD in these settings.
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Affiliation(s)
- Elvis Safary
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - David Beran
- Division of Tropical and Humanitarian Medicine, University of Geneva, Geneva, Switzerland
- Geneva University Hospitals, Geneva, Switzerland
| | - Beatrice Vetter
- Foundation for Innovative New Diagnostics, Geneva, Switzerland
| | - Molly Lepeska
- Health Action International, Amsterdam, The Netherlands
| | | | | | | | - Maria Lazo-Porras
- Division of Tropical and Humanitarian Medicine, University of Geneva, Geneva, Switzerland
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Silvana Pérez-León
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Maria Maixenchs
- ISGlobal, Hospital Clínic-Universitat de Barcelona, Barcelona, Spain
| | - Happy Nchimbi
- Tanzania NCD Alliance, Dar es Salaam, Tanzania, United Republic of
| | - Kaushik Ramaiya
- Tanzania NCD Alliance, Dar es Salaam, Tanzania, United Republic of
| | - Castory Munishi
- Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania, United Republic of
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Kassaw H, Hussein K, Gebre A, Seid AA, Ammie M. Determinants of Overweight Among Type Two Diabetes Mellitus Patients Attending Public Hospitals At Awusi Resu Zone of Afar Region: Unmatched Case-Control Study. Diabetes Metab Syndr Obes 2024; 17:759-767. [PMID: 38371388 PMCID: PMC10874190 DOI: 10.2147/dmso.s436957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/25/2024] [Indexed: 02/20/2024] Open
Abstract
Background Diabetes is a major cause of morbidity and mortality; affecting More than 415 million people. Objective The primary aim of this study was to assess the determinants of being overweight among Type 2 Diabetic patients attending diabetic clinics of public Hospitals in the Awusi resu zone of Afar region, Northeast Ethiopia. Methods A hospital-based unmatched case-control study design was conducted from May 5 to June 5/2021 by systematic random sampling 286 study participants were involved in the study (96 cases and 190 controls); Logistic regression analysis was performed to identify the best model of factors leading to overweight. The odds ratio and 95% confidence interval were used as a measure of association. Results Those who have attended college and above have an AOR; of 10.30 CI: (4.16-25.50) ten times higher odds of being overweight when compared to those unable/able to read. Only those who have a family history of diabetes AOR: 3.10 CI (1.04-9.30) have three folds of being overweight when compared to their counterparts. Of those who use insulin for controlling blood glucose (AOR: 0.14 CI (0.03-0.74) 96% at less likely to be overweight compared to those who use exercise. Conclusion and Recommendation In this study, educational level, Family History, and type of blood glucose controlling mechanism were important predictors of overweight on T2DM. Moreover the diabetes patients were recommended to use insulin for controlling blood glucose.
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Affiliation(s)
- Huzeyfa Kassaw
- School of Public Health, College of Medicine and Health Science, Samara University, Samara, Ethiopia
| | - Kedir Hussein
- School of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Abel Gebre
- School of Public, College of Medicine and Health Science, Samara University, Samara, Ethiopia
| | - Anwar Ali Seid
- Department of Nursing, College of Medicine and Health Science, Samara University, Samara, Ethiopia
| | - Mohammed Ammie
- Zonal Carter Center Project Coordinator, Kemissie, Amhara Region, Ethiopia
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Tegegne KD, Gebeyehu NA, Yirdaw LT, Yitayew YA, Kassaw MW. Determinants of poor glycemic control among type 2 diabetes in Ethiopia: a systematic review and meta-analysis. Front Public Health 2024; 12:1256024. [PMID: 38375333 PMCID: PMC10876054 DOI: 10.3389/fpubh.2024.1256024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/08/2024] [Indexed: 02/21/2024] Open
Abstract
Introduction Prior primary studies have examined the prevalence and factors associated with glycaemic control among patients with type 2 diabetes mellitus, but studies with evidence-based synthesis of the primary data remained unknown. Hence, we aimed to determine the prevalence of poor glycemic control and identify determinants of poor glycemic control in patients with type 2 diabetes in Ethiopia. Methods We performed searches in the online databases of PubMed, Google Scholar, Scopus, Science Direct, and the Cochrane Library. Microsoft Excel was used to extract data, and STATA statistical software (v. 16) was used for analysis. Publication bias was explored by forest plots, Begg's rank test, and Egger's regression test. To check for heterogeneity, I2 was computed. Subgroup analysis was conducted based on region and publication year. In addition, the pooled odds ratio for associated factors was calculated. Results Out of 1,045 studies assessed, 23 studies were included fulfilling our inclusion criteria. In all, 6,643 individuals were enrolled in the study. It was estimated that 61.11% of type 2 diabetes patients had poor glycemic control (95% CI, 57.14-65.19). The subgroup analysis by study region and publication year revealed that the highest prevalence was observed in the Addis Ababa region (68.57%) and studies published before 2019 (61.76%), respectively. Poor glycemic control was associated with older age > 50 years (AOR = 2.12; 95% CI: 1.27-2.97), not attending formal education (AOR = 3.60; 95% CI: 2.75, 4.46), having diabetes for longer duration (10 years; AOR = 2.57; 95% CI: 1.65-3.49), having comorbidity (AOR = 2.43; 95% CI: 2.05-2.80), and low adherence to diabetes management (AOR = 3.67; 95% CI: 2.41-4.92). Conclusion Our findings indicate a high prevalence of poor glycemic control among people with type 2 diabetes in Ethiopia. Being older, not attending formal education, having a longer duration of diabetes, having comorbidity, and having low adherence to diabetes management were all associated. Therefore, we recommend health organizations implement measures to monitor and control patients' blood glucose levels. Patient education and training of healthcare professionals could serve as a short-term strategy to achieve adequate glycemic control. Systematic review registration PROSPERO, identifier CRD42022349792, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022349792.
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Affiliation(s)
- Kirubel Dagnaw Tegegne
- Department of Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia
| | - Lehulu Tilahun Yirdaw
- Department of Emergency Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Yibeltal Asmamaw Yitayew
- Department of Pediatrics and Child Health Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Mesfin Wudu Kassaw
- School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
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Massey M, Stewart MP, LaManna JB, Park C, Ng BP. Food insecurity and glycemic goals among Medicare beneficiaries with type 2 diabetes. Chronic Illn 2023:17423953231217346. [PMID: 38031412 DOI: 10.1177/17423953231217346] [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] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To examine the association between food insecurity and achieving glycemic goals among Medicare beneficiaries with type 2 diabetes. METHODS This study analyzed the nationally representative 2019 Medicare Current Beneficiary Survey of 1340 beneficiaries aged ≥65 years with type 2 diabetes. The binary dependent variable was whether beneficiaries' blood glucose was at target (A1C ≤ 7.5% or average fasting blood glucose of ≤140 mg/dL, all/most of the time). Food insecurity, a binary variable, was adapted based on the USDA's food security questions. A survey-weighted multivariable logistic model, adjusted for sociodemographics and comorbidities, was conducted to estimate predictive margins for comparing prevalence of having above-target blood glucose levels across groups. RESULTS Of study beneficiaries, 20.9% reported not achieving glycemic targets. The predictive marginal prevalence of having higher than target blood glucose levels was significantly greater in females over males (23.8% [95% confidence interval [CI], 20.1-27.4] vs 17.6% [14.3-20.9]); those with less than high school education over those with college education (31.0% [23.6-38.3] vs 18.6% [14.8-22.3]); and those reporting food insecurity over their counterparts (33.4% [24.5-42.3] vs 19.1% [16.6-21.7]). CONCLUSIONS Sociodemographic disparities related to achieving blood glucose goals were observed. Screening for food insecurity and related interventions should be considered for at-risk beneficiaries with diabetes.
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Affiliation(s)
- McKayla Massey
- College of Medicine, University of Central Florida, Orlando, FL, USA
| | - Morgan P Stewart
- College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
| | | | - Chanhyun Park
- College of Pharmacy, The University of Texas at Austin, Austin, TX, USA
| | - Boon Peng Ng
- College of Nursing, University of Central Florida, Orlando, FL, USA
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA
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13
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Alqahtani RM, Alsulami EF. The Association Between Glycated Hemoglobin (HbA1c) Level and Vitamin D Level in Diabetes Mellitus Patients: A Cross-Sectional Study. Cureus 2023; 15:e47166. [PMID: 38022364 PMCID: PMC10652031 DOI: 10.7759/cureus.47166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Prior research has established noteworthy correlations between inadequate glycemic management and a multitude of problems in individuals diagnosed with diabetes mellitus (DM). METHODS This is a cross-sectional retrospective study that was conducted at the Jeddah Center for the Care of Diabetes and Blood Pressure Patients, Jeddah, Kingdom of Saudi Arabia. The medical records of patients diagnosed with DM between 2015 and 2022 were identified and reviewed for the purpose of this study. Pearson correlation coefficient was used to examine the correlation between glycated haemoglobin (HbA1c) and vitamin D levels. Multiple linear regression analysis was applied to identify the association between HbA1c and vitamin D levels. RESULTS A total of 152 patients were included in this study. The mean HbA1c level for the patients in this study was 8.2% (SD: 1.7). The median vitamin D level for the patients was 20.9 ng/ml (interquartile range (IQR): 13-30.4). More than half of the patients (n= 92; 60.5%) were found to have vitamin D insufficiency. Pearson correlation coefficient identified that there is an inverse correlation between the level of HbA1c and vitamin D level (r= -0.21 (95%CI -0.36 to -0.06; p-value= 0.007). Multiple linear regression analysis (adjusting for age and type of DM) identified that poor glycaemic control has a negative association with vitamin D level (regression coefficient (B) = -0.027; 95%CI -0.053 to - 0.001; p-value= 0.039). CONCLUSION Poor glycaemic control is associated with vitamin D deficiency in DM patients. It is recommended that patients with DM adhere to their medications and maintain a healthy lifestyle in order to manage their condition. This will improve their overall health, specifically their vitamin D status.
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Ewid M, Algoblan AS, Elzaki EM, Muqresh MA, Al Khalifa AR, Alshargabi AM, Alotaibi SA, Alfayez AS, Naguib M. Factors associated with glycemic control and diabetes complications in a group of Saudi patients with type 2 diabetes. Medicine (Baltimore) 2023; 102:e35212. [PMID: 37747025 PMCID: PMC10519521 DOI: 10.1097/md.0000000000035212] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 09/26/2023] Open
Abstract
Poor glycemic control is a risk factor for micro and macrovascular complications of diabetes. The aim of this study was to assess the prevalence and factors related to suboptimal glycemic control and diabetes complications in a group of patients with type 2 diabetes mellitus (T2DM). This cross-sectional descriptive study conducted in Al Qassim region, Saudi Arabia. Two hundred patients with T2DM were enrolled. Demographic, social, and self-care behavior data were collected. A thorough clinical evaluation was done. Glycated hemoglobin, lipid, and kidney profile results were recorded. Mann-Whitney test was used to compare different groups. For comparing categorical data, Chi-square (χ2) test was performed. Multivariate logistic regression analyses used to detect predictors of poor glycemic control and macrovascular and microvascular complications. The median age of patients was 58 years, and 62% of them were males. Only 22.5% of patients had glycated hemoglobin <7%. Forty-four patients (22%) had evidence of macrovascular complications. Retinopathy, neuropathy, and nephropathy were found in 42.5%, 32.5%, and 12%, respectively. Longer diabetes duration was significantly associated with poor glycemic control (OR = 1.006, P < .005). The age of the patients was independently associated with macrovascular complications (OR = 1.050, P = .029). Hyperlipidemia was significantly associated with neuropathy (OR = 0.229, P = .043) and retinopathy (OR = 12.887, P = .003). Although physical activity was lower in patients with suboptimal glycemic levels (P = .024), cardiovascular disease (P = .030), neuropathy (P < .001), retinopathy (P < .001), and nephropathy (P = .019), multivariate analysis showed that it was only independently associated with neuropathy (OR = 0.614, P = .001). The prevalence of suboptimal glycemic control is high in the studied population. Effective health measures are urgently needed to stop diabetes complications, especially retinopathy and neuropathy. Elderly people with long durations of diabetes, and lower physical activity should be the focus of the interventions. Tailored exercise programs are particularly needed for better diabetes control and for the prevention of complications in patients with T2DM.
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Affiliation(s)
- Mohammed Ewid
- Internal Medicine Department, College of Medicine, Sulaiman Al Rajhi University, Bukairyah, AL-Qassim, Saudi Arabia
- Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | - Elzaki M. Elzaki
- KFSH-B Diabetes and Endocrinology Center, Al-Qassim, Saudi Arabia
| | | | | | | | | | | | - Mervat Naguib
- Diabetes and Endocrinology Unit, Faculty of Medicine Kasr Al-Ainy Hospital, Cairo University, Cairo, Egypt
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Ata F, Khan AA, Khamees I, Mohammed BZM, Barjas HH, Muthanna B, Bashir M, Kartha A. Differential evolution of diabetic ketoacidosis in adults with pre-existent versus newly diagnosed type 1 and type 2 diabetes mellitus. BMC Endocr Disord 2023; 23:193. [PMID: 37700308 PMCID: PMC10496170 DOI: 10.1186/s12902-023-01446-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Diabetic ketoacidosis (DKA) was once known to be specific to type-1 diabetes-mellitus (T1D); however, many cases are now seen in patients with type-2 diabetes-mellitus (T2D). Little is known about how this etiology shift affects DKA's outcomes. METHODS We studied consecutive index DKA admissions from January 2015 to March 2021. Descriptive analyses were performed based on pre-existing T1D and T2D (PT1D and PT2D, respectively) and newly diagnosed T1D and T2D (NT1D and NT2D, respectively). RESULTS Of the 922 patients, 480 (52%) had T1D, of which 69% had PT1D and 31% NT1D, whereas 442 (48%) had T2D, of which 60% had PT2D and 40% NT2D. The mean age was highest in PT2D (47.6 ± 13.1 years) and lowest in PT1D (27.3 ± 0.5 years) (P < 0.001). Patients in all groups were predominantly male except in the PT1D group (55% females) (P < 0.001). Most patients were Arabic (76% in PT1D, 51.4% in NT1D, 46.6% in PT2D) except for NT2D, which mainly comprised Asians (53%) (P < 0.001). Patients with NT2D had the longest hospital length of stay (LOS) (6.8 ± 11.3 days) (P < 0.001), longest DKA duration (26.6 ± 21.1 h) (P < 0.001), and more intensive-care unit (ICU) admissions (31.2%) (P < 0.001). Patients with PT1D had the shortest LOS (2.5 ± 3.5 days) (P < 0.001), DKA duration (18.9 ± 4.2 h) (P < 0.001), and lowest ICU admissions (16.6%) (P < 0.001). CONCLUSIONS/INTERPRETATION We presented the largest regional data on differences in DKA based on the type and duration of diabetes- mellitus (DM), showing that T2D is becoming an increasing cause of DKA, with worse clinical outcomes (especially newly diagnosed T2D) compared to T1D.
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Affiliation(s)
- Fateen Ata
- Department of Endocrinology, Hamad General Hospital, Hamad Medical Corporation, 3050, Doha, Qatar.
| | - Adeel Ahmad Khan
- Department of Endocrinology, Hamad General Hospital, Hamad Medical Corporation, 3050, Doha, Qatar
| | - Ibrahim Khamees
- Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
| | | | | | - Bassam Muthanna
- Department of Geriatrics, University of Illinois College of Medicine, Chicago, USA
| | - Mohammed Bashir
- Department of Endocrinology, Hamad General Hospital, Hamad Medical Corporation, 3050, Doha, Qatar
- Qatar Metabolic Institute, Doha, Qatar
| | - Anand Kartha
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
- Weill Cornel Medicine, Doha, Qatar
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Iheanacho CO, Akhumi TF, Eze UIH, Ojieabu WA. Prevalence and predictors of type 2 diabetes complications: a single centre observation. Afr Health Sci 2023; 23:308-317. [PMID: 38357114 PMCID: PMC10862620 DOI: 10.4314/ahs.v23i3.37] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024] Open
Abstract
Background Diabetes complications are a major burden on persons living with diabetes and the health care systems. Objectives The study assessed the glycemic control, prevalence and predictors of type 2 diabetes complications among patients in a healthcare centre. Methods Two hundred adults who had type 2 diabetes in a general hospital were recruited for the study. Cross-sectional and retrospective surveys were used to determine prevalence, number and types of complications in the patients. SPSS version 21 was used for descriptive analysis and Chi-square (p<0.05). Results A total of 200 (100%) respondents participated in the study and 97 (48.5%) had poor glycemic control. Mean number of complications per patient was 2.48 ± 1.22. Number of complications per person and type of complications were significantly associated with Age (p = 0.000 and p = 0.000, respectively), Gender (p = 0.008 and p = 0.031, respectively) and Occupation (p=0.000 and p=0.006, respectively). Marital status (p = 0.032) and years of diagnosis (p=0.021) were also associated with type of complications. The majority of patients 64 (32.0%) were admitted in the previous year for diabetes-related complications. Majority 159 (79.5%) had ≥ 2 number of complications from the observed 497 complications. Conclusions Poor glycemic control and high prevalence of complications were observed. Also, socio-demographic characteristics were likely predictors of number and type of complications. These findings are essential for improved planning and prioritizing of diabetes care.
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Affiliation(s)
- Chinonyerem O Iheanacho
- Department of Clinical Pharmacy and Public Health, Faculty of Pharmacy, University of Calabar, Calabar, Nigeria
| | - Tolulope Folashade Akhumi
- Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Nigeria
| | - Uchenna I H Eze
- Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Nigeria
| | - Winifred A Ojieabu
- Department of Clinical Pharmacy and Biopharmacy, Faculty of Pharmacy, Olabisi Onabanjo University, Sagamu, Nigeria
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Welday Kahssay S, Demeke NF. Pharmacotherapy problems and associated factors among type 2 adult diabetic patients on follow up at Mizan-Tepi University Teaching Hospital, Southwest Ethiopia. PLoS One 2023; 18:e0288093. [PMID: 37540642 PMCID: PMC10403119 DOI: 10.1371/journal.pone.0288093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/19/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Over the past few decades, drug therapy problems (DTPs) have become a significant public health concern worldwide. DTPs in patients with diabetes are responsible for uncontrolled glycemia, disease worsening, early development of complications, high healthcare expenses, prolonged and recurrent hospitalizations, and mortality. OBJECTIVES This study aimed to identify the prevalence of drug therapy problems and determine the associated factors among patients with type II Diabetes Mellitus at a University Teaching Hospital in Southwest Ethiopia. METHODOLOGY Hospital-based cross-sectional study was conducted between September and October 2022. Data were collected through medical record reviews and interviewer-administered structured questionnaires, which were then analyzed using SPSS version 26. Cipolle's method was adapted for classification of DTPs. Bivariate followed by multivariate logistic regression analysis was used to assess the association between predictor variables and the outcome variable. P-value ≤ 0.05 was employed as a cut-off point to determine statistical significance. RESULT Among 117 participants, 172 drug therapy problems (DTPs) were identified, with an average of 1.47 DTPs per patient, and83 (70.9%) participants had at least one type of drug therapy problem. Of the seven DTPs identified, need additional drug therapy was the most common, 50 (42.7%), followed by non-compliance with medication, 45 (38.5%) and ineffective drug therapy, 25 (21.4%). Occupational status and comorbidity were factors that associated with the occurrence of DTPs. Farmers were approximately four times more likely to develop DTPs than housewives were (adjusted odds ratio (AOR) = 3.56, 95% CI: 1.12-11.38, P = 0.03). The odds of drug therapy problems were twice as high in those with four comorbid conditions than in those without comorbidities (AOR = 1.95, 95% CI: 0.90-3.76, p = 0.02). CONCLUSION In the current study, the proportion of type 2 diabetes patients with drug therapy problems was high. This potentially lead to uncontrolled glycemia and early development of comorbid conditions, increasing morbidity and mortality rates. This could be attributed to the failure to effectively integrate clinical pharmacy services in different hospital wards, which is the case in virtually all hospitals in Ethiopia.
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Affiliation(s)
- Semere Welday Kahssay
- Department of Pharmaceutical Chemistry and Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
| | - Nebeyi Fisseha Demeke
- Department of Pharmaceutical Chemistry and Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, Mizan-Tepi University, Mizan-Aman, Ethiopia
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Swaray SM, Tetteh J, Djonor SK, Ekem-Ferguson G, Clottey RY, Yacoba A, Yawson AE. Changes in trends and patterns of glycaemic control at Ghana's National Diabetes Management and Research Centre during the era of the COVID-19 pandemic. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002024. [PMID: 37315063 DOI: 10.1371/journal.pgph.0002024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 05/12/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Maintaining optimal glycaemic control (GC) delays the onset and progression of diabetes-related complications, especially microvascular complications. We aimed to establish the trend and pattern of GC, and its associated factors in persons living with diabetes (PLWD), and to examine the influence of COVID-19 on GC. METHODS A retrospective study involving secondary data from 2,593 patients' physical records from the National Diabetes Management and Research Centre (NDMRC) in Accra, extracted from 2015-2021. Growth rate of GC was assessed, and ordinal logistic and Poisson models weighted with Mahalanobis distance matching within propensity caliper were adopted to assess the impact of COVID-19 pandemic on GC. Stata 16.1 was utilized and the significant value set as p≤0.05. RESULTS GC pattern indicated a steady deterioration ranging from 38.6% (95%CI = 34.5-42.9) in 2015 to 69.2% (95%CI = 63.5-74.4) in 2021. The overall growth from 2015-2021 was 8.7%. Being a woman and increasing diastolic pressure significantly increase the likelihood of poor glycaemic control (PGC) by 22% and 25%, respectively compared with their respective counterparts [aOR(95%CI = 1.01-1.46 and 1.25(1.10-1.41), respectively]; whilst lower age increased the risk of PGC throughout the years. We found that risk of PGC during the era of COVID-19 was approximately 1.57(95%CI = 1.08-2.30) times significant, whilst the adjusted prevalence ratio (aPR) of PGC during the era of COVID-19 was approximately 64% significantly higher than the era without COVID-19 (aPR = 1.64, 95%CI = 1.10-2.43). CONCLUSION GC worsened from 2015-2021, especially during the COVID era. Younger age, uncontrolled blood pressure and/or being a woman were associated with PGC. The NDMRC and other centres that provide specialist healthcare in resource-limited settings, must determine the factors that militate against optimal service delivery in the era of the COVID-19 pandemic, and implement measures that would improve resilience in provision of essential care in the face of shocks.
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Affiliation(s)
| | - John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
| | | | - George Ekem-Ferguson
- National Cardiothoracic Centre, Korle Bu Teaching Hospital, Accra, Ghana
- Department of Psychiatry, Korle Bu Teaching Hospital, Accra, Ghana
| | - Ruth Yawa Clottey
- National Diabetes Management and Research Centre, Korle-Bu Teaching Hospital, Accra, Ghana
| | - Atiase Yacoba
- National Diabetes Management and Research Centre, Korle-Bu Teaching Hospital, Accra, Ghana
- Department of Medicine & Therapeutics, University of Ghana Medical School, Accra, Ghana
| | - Alfred Edwin Yawson
- Department of Community Health, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra, Ghana
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Sarraf DP, Gupta PP. A hospital-based assessment of glycemic control and medication adherence in type 2 diabetes mellitus in Eastern Nepal. J Family Med Prim Care 2023; 12:1190-1196. [PMID: 37636174 PMCID: PMC10451609 DOI: 10.4103/jfmpc.jfmpc_90_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: 01/11/2023] [Revised: 02/04/2023] [Accepted: 03/02/2023] [Indexed: 08/29/2023] Open
Abstract
Background Poor glycemic control in type 2 diabetes mellitus (T2DM) causes damage to various organs and leads to the development of disabling and life-threatening complications. Objectives To find out the prevalence of glycemic control and medication adherence (MA) and the factors affecting them. Methods A cross-sectional study was conducted among patients with T2DM. The patients were categorized as good glycemic control (HbA1c <7.0%) and poor glycemic control (HbA1c ≥7.0%). MA was categorized as low (score <6), medium (score 6 or 7), and high (score 8). The Statistical Package for Social Science (version 11.5) was used for statistical analysis at a P value less than 0.05. Results Of 129 patients, 65 (50.39%) were females. The mean age was 48.33 ± 12.86 years. The combination of metformin and glimepiride was prescribed to 37 (28.68%) patients. Diabetic knowledge was poor in 84 (65.12%) patients. Glycemic control was good in 108 (83.72%) patients. MA was medium in 72 (55.81%) patients. Patients taking regular fruit, having shorter duration of drug therapy, and having good diabetic knowledge had good glycemic control and were statistically significant (P value < 0.05). Patients having family support, nonalcoholic, taking regular fruit, being involved in daily jogging, having shorter duration of drug therapy, and having good diabetic knowledge had high MA and were statistically significant (P value < 0.05). Conclusion The majority of the diabetic patients had good glycemic control and medium MA. Patients taking regular fruit, being involved in daily jogging, having a shorter duration of drug therapy, and having good diabetic knowledge were identified as factors that affect both glycemic control and MA.
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Affiliation(s)
- Deependra Prasad Sarraf
- Department of Clinical Pharmacology and Therapeutics, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Pramendra Prasad Gupta
- Department of General Practice and Emergency Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Radić J, Kolak E, Vučković M, Gelemanović A, Đogaš H, Bučan Nenadić D, Radić M. Assessment of Hydration, Nutritional Status and Arterial Stiffness in Hypertensive Chronic Kidney Disease Patients. Nutrients 2023; 15:2045. [PMID: 37432203 DOI: 10.3390/nu15092045] [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: 03/31/2023] [Revised: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 07/12/2023] Open
Abstract
The aim of this cross-sectional study was to determine the body fluid volume in patients diagnosed with both chronic kidney disease (CKD) and arterial hypertension (AH), and to investigate the relationship between fluid overload (FO), nutritional status and arterial stiffness in this specific patient population. A total of 169 participants with CKD and AH were enrolled in the study, and data on general parameters, comorbidities, medication use, and laboratory parameters were collected. Body composition was assessed with a Tanita MC 780 device, and data on the central and peripheral systolic and diastolic blood pressure, as well as pulse wave velocity (PWV) and the augmentation index (AIx) were collected with an IEM Mobil-O-Graph 24 h ambulatory blood pressure monitor, which was based on oscillometry. The Mediterranean Diet Serving Score (MDSS) questionnaire was used to determine the adherence to the Mediterranean diet (MeDi). Our results showed that the significant positive predictors of hydration status were the use of diuretics and oral hypoglycemic agents, whereas the negative predictors were female sex, higher body mass index level and use of two or more antihypertensives in the form of a single-pill combination. We also found differences in blood pressure and arterial stiffness parameters in relation to volume status, along with differences based on the presence of diabetes mellitus (DM). In conclusion, these results call for a higher awareness of volume status in the care of CKD patients with AH, especially in those with diabetes mellitus.
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Affiliation(s)
- Josipa Radić
- Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital Centre Split, 21000 Split, Croatia
- Department of Internal Medicine, School of Medicine, University of Split, 21000 Split, Croatia
| | - Ela Kolak
- Nutrition and Dietetics Department, University Hospital Centre Split, 21000 Split, Croatia
| | - Marijana Vučković
- Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital Centre Split, 21000 Split, Croatia
| | - Andrea Gelemanović
- Mediterranean Institute for Life Sciences (MedILS), 21000 Split, Croatia
| | - Hana Đogaš
- Internal Medicine Department, Nephrology and Haemodialysis Division, University Hospital Centre Split, 21000 Split, Croatia
| | - Dora Bučan Nenadić
- Nutrition and Dietetics Department, University Hospital Centre Split, 21000 Split, Croatia
| | - Mislav Radić
- Department of Internal Medicine, School of Medicine, University of Split, 21000 Split, Croatia
- Internal Medicine Department, Rheumatology, Allergology and Clinical Immunology Division, Center of Excellence for Systemic Sclerosis in Croatia, University Hospital Centre Split, 21000 Split, Croatia
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Tegegne KD, Gebeyehu NA, Kassaw MW. Depression and determinants among diabetes mellitus patients in Ethiopia, a systematic review and meta-analysis. BMC Psychiatry 2023; 23:209. [PMID: 36991387 PMCID: PMC10052826 DOI: 10.1186/s12888-023-04655-6] [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: 09/20/2022] [Accepted: 03/06/2023] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION Primary studies have estimated the prevalence of depression and its determinants among diabetes patients. However, studies synthesizing this primary evidence are limited. Hence, this systematic review aimed to determine the prevalence of depression and identify determinants of depression among diabetes in Ethiopia. METHODS This systematic review and meta-analysis included a search of PubMed, Google Scholar, Scopus, Science Direct, PsycINFO, and Cochrane library. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Data were pooled using a random-effects model. Forest plots, and Egger's regression test were all used to check for publication bias. Heterogeneity (I)2 was computed. Subgroup analysis was done by region, publication year, and depression screening instrument. In addition, the pooled odds ratio for determinants was calculated. RESULTS Sixteen studies, including 5808 participants were analyzed. The prevalence of depression in diabetes was estimated to be 34.61% (95% CI: 27.31-41.91). According to subgroup analysis by study region, publication year, and screening instrument, the highest prevalence was observed in Addis Ababa (41.98%), studies published before 2020 (37.91%), and studies that used Hospital Anxiety and Depression Scale (HADS-D) (42.42%,) respectively. Older age > 50 years (AOR = 2.96; 95% CI: 1.71-5.11), being women (AOR = 2.31; 95% CI: 1.57, 3.4), longer duration with diabetes (above 5 years) (AOR = 1.98; 95% CI: 1.03-3.8), and limited social support (AOR = 2.37; 95% CI: 1.68-3.34), were the determinants of depression in diabetic patients. CONCLUSION The results of this study suggest that the prevalence of depression in diabetes is substantial. This result underscores the importance of paying particular attention to prevent depression among diabetes. Being older, not attending formal education, longer duration with diabetes, having comorbidity, and low adherence to diabetes management were all associated. These variables may help clinicians identify patients at high risk of depression. Future studies focusing on the causal association between depression and diabetes are highly recommended.
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Affiliation(s)
- Kirubel Dagnaw Tegegne
- Department of Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolita Sodo, Ethiopia
| | - Mesfin Wudu Kassaw
- School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
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Abate MD, Semachew A, Emishaw S, Meseret F, Azmeraw M, Algaw D, Temesgen D, Feleke SF, Nuru A, Abate M, Bantie B, Andualem A. Incidence and predictors of hyperglycemic emergencies among adult diabetic patients in Bahir Dar city public hospitals, Northwest Ethiopia, 2021: A multicenter retrospective follow-up study. Front Public Health 2023; 11:1116713. [PMID: 37006547 PMCID: PMC10063795 DOI: 10.3389/fpubh.2023.1116713] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/21/2023] [Indexed: 03/19/2023] Open
Abstract
Background Diabetic ketoacidosis and hyperglycemic hyperosmolar syndrome are the two commonly known life-threatening hyperglycemic emergencies of diabetes mellitus. Despite the growing hyperglycemic emergency impact among adult patients with diabetes, its incidence and predictors have not been well studied in Ethiopia. Thus, this study aimed to assess the incidence and predictors of hyperglycemic emergencies among adult patients with diabetes. Method A retrospective follow-up study design was conducted among a randomly selected sample of 453 adult patients with diabetes. Data were entered into EPI data version 4.6 and analyzed using STATA version 14.0. A Cox-proportional hazard regression model was fitted to identify the independent predictors of hyperglycemic emergencies, and variables having a p < 0.05 in the multivariable model were considered statistically significant. Result Among the total adult patients with diabetes included in the study, 147 (32.45%) developed hyperglycemic emergencies. Hence, the overall incidence of hyperglycemic emergencies was 14.6 per 100 person-years observation. The incidence of diabetic ketoacidosis was 12.5 per 100 person-years (35.6 and 6.3 among T1DM and T2DM, respectively). The incidence of the hyperglycemic hyperosmolar syndrome was 2.1 per 100 person-years (0.9 and 2.4 among T1DM and T2DM, respectively). The overall median free survival time was 53.85 months. Type 1 diabetes mellitus [AHR = 2.75, 95% CI (1.68, 4.51)], diabetes duration of ≥ 3 years [AHR = 0.33, 95% CI (0.21, 0.50)], recent acute illness [AHR = 2.99, 95% CI (2.03, 4.43)], presence of comorbidity [AHR = 2.36, 95% CI (1.53, 3.63)], poor glycemic control [AHR = 3.47, 95% CI (2.17, 5.56)], history of medication non-compliance [AHR = 1.85,95% CI (1.24, 2.76)], follow-up frequency of 2-3 months [AHR = 1.79,95% CI (1.06, 3.01)], and without community health insurance [AHR = 1.63, 95% CI (1.14, 2.35)] were significant predictors of hyperglycemic emergencies. Conclusion The incidence of hyperglycemic emergencies was high. Therefore, giving greater attention to patients with identified predictors could decrease the occurrence of hyperglycemic emergencies and related public health and economic impacts.
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Affiliation(s)
- Melsew Dagne Abate
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Ayele Semachew
- Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Solomon Emishaw
- Department of Emergency and Critical Care Nursing, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Fentahun Meseret
- Department of Pediatrics and Child Health Nursing, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Molla Azmeraw
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Dawit Algaw
- Department of Nursing, Bahirdar Health Sciences College, Bahir Dar, Ethiopia
| | - Dessie Temesgen
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Sefineh Fenta Feleke
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Ahmed Nuru
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia
| | - Makda Abate
- Department of Nursing, College of Medicine and Health Sciences, Debre Berhan University, Debre Berhan, Ethiopia
| | - Berihun Bantie
- Department of Comprehensive Nursing, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Atsedemariam Andualem
- Department of Nursing, School of Nursing and Midwifery, Injibara University, Injibara, Ethiopia
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Dawite F, Girma M, Shibiru T, Kefelew E, Hailu T, Temesgen R, Abebe G. Factors associated with poor glycemic control among adult patients with type 2 diabetes mellitus in Gamo and Gofa zone public hospitals, Southern Ethiopia: A case-control study. PLoS One 2023; 18:e0276678. [PMID: 36897872 PMCID: PMC10004482 DOI: 10.1371/journal.pone.0276678] [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: 11/22/2021] [Accepted: 10/12/2022] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Diabetes mellitus is a serious global public health problem that affects the whole life of people in terms of their biological, psychological, and social effects. Complications and death from diabetes occur from poorly controlled blood glucose levels. Thus, dealing with glycemic control is essential for controlling the development of devastating acute and chronic complications related to diabetes. Therefore, this study aims to assess factors associated with poor glycemic control among type2 diabetes patients in public hospitals of Gamo and Gofa zone southern, Ethiopia, 2021. METHODS An institution-based unmatched case-control study was employed among 312 randomly selected participants using a pre-tested, interviewer-administered, and structured questionnaire. Bivariate and multivariable logistic regression analysis was conducted to identify factors associated with poor glycemic control using IBM SPSS version 25. The strength of association was assessed by using an Adjusted odds ratio (AOR) with a 95% confidence interval (CI). RESULT Factors associated with poor glycemic control based on multivariable analysis were, having comorbidity (AOR = 2.35, 95% CI (1.39-3.95)), adhering to dietary recommendations (AOR = 0.31, 95% CI (089-0.51)), poor social support (AOR = 3.31, 95% CI (1.59-6.85)), physical exercise (AOR = 1.86 95% CI (1.11-3.12)), and having poly-pharmacy (AOR = 2.83, 95% CI (1.39-5.74)). CONCLUSION AND RECOMMENDATION This study indicated a significant association of comorbidity, physical exercise, poly-pharmacy, low social support, and adherence to dietary recommendations with poor glycemic control. We suggest that the health care providers and concerned bodies encourage patients to have regular check-ups and work on providing necessary social support.
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Affiliation(s)
- Firehiwot Dawite
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Meseret Girma
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Tamiru Shibiru
- School of Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Etenesh Kefelew
- School of Public Health, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Tadiwos Hailu
- School of Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Rodas Temesgen
- School of Medicine, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Getachew Abebe
- Department of Anatomy, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
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Abegaz TM, Ali AA. Health-Related Quality of Life and Healthcare Events in Patients with Monotherapy of Anti-Diabetes Medications. Healthcare (Basel) 2023; 11:healthcare11040541. [PMID: 36833075 PMCID: PMC9957473 DOI: 10.3390/healthcare11040541] [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: 12/31/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023] Open
Abstract
This study aimed to examine the difference in health-related quality of life (HRQOL) and diabetes-related healthcare events (HCEs) among adults with diabetes who were on metformin, sulfonylurea, insulin, or thiazolidinedione (TZD) monotherapy. The data were sourced from the Medical Expenditure Panel Survey (MEPS). Diabetes patients ≥18 years old who had a complete record of physical component score and mental component scores in round 2 and round 4 of the survey were included. The primary outcome was HRQOL of diabetes patients as measured by the Medical Outcome Study short-form (SF-12v2TM). Multinomial logistic regression and negative binomial regression were conducted to determine associated factors of HRQOL and HCE, respectively. Overall, 5387 patients were included for analysis. Nearly 60% of patients had unchanged HRQOL after the follow-up, whereas almost 15% to 20% of patients showed improvement in HRQOL. The relative risk of declined mental HRQOL was 1.5 times higher relative to unchanged mental HRQOL in patients who were on sulfonylurea 1.55 [1.1-2.17, p = 0.01] than metformin users. The rate of HCE decreased by a factor of 0.79, [95% CI: 0.63-0.99] in patients with no history of hypertension. Patients on sulfonylurea 1.53 [1.20-1.95, <0.01], insulin 2.00 [1.55-2.70, <0.01], and TZD 1.78 [1.23-2.58, <0.01] had increased risk of HCE compared to patients who were on metformin. In general, antidiabetic medications modestly improved HRQOL in patients with diabetes during the follow-up period. Metformin had a lower rate of HCE as compared to other medications. The selection of anti-diabetes medications should focus on HRQOL in addition to controlling glucose level.
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AlHaqwi AI, Amin MM, AlTulaihi BA, Abolfotouh MA. Impact of Patient-Centered and Self-Care Education on Diabetes Control in a Family Practice Setting in Saudi Arabia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1109. [PMID: 36673862 PMCID: PMC9859274 DOI: 10.3390/ijerph20021109] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
Background: Diabetes mellitus is a chronic and complex medical disease that leads to significant morbidity and mortality. Patient-centered diabetes education that emphasizes active patient involvement, self, and shared care constitutes a substantial and essential component of the comprehensive diabetes management approach. Objectives: To assess the impact of patient-centered diabetes education sessions on the prescribed treatment plan in controlling diabetes and other related cardiovascular risk factors. Methods: In a pre-experimental pretest-posttest one group study design, all referred patients with type 2 diabetes (T2DM) to the diabetes educator clinic (n = 130 patients) during the period of 6 months from January to July 2021 were subjected to multiple and consecutive patient-centered diabetes education sessions, based on the framework published by the Association of Diabetes Care and Education Specialties (ADCES), in addition to their usual treatment plan. Demographic, social, and biological data were obtained at the baseline, three months, and six months after the intervention. Nonparametric Friedman and Cochran’s Q tests for related samples were applied to examine the impact of this educational intervention on glycosylated hemoglobin (HbA1c) and other associated cardiovascular risks. The results of 130 patients with T2DM showed a significant reduction of mean systolic blood pressure “SBP” (p = 0.015), glycosylated hemoglobin (HbA1c) (p < 0.001), fasting blood sugar “FBS” (p < 0.001), total cholesterol (p < 0.001), low-density lipoprotein (p < 0.001), and triglyceride (p < 0.001), and significant rise of mean high-density lipoprotein (p = 0.011). At three and six months after the intervention, 43% and 58% of patients showed improved HbA1c levels. The mean HbA1c was reduced from 10.2% at the beginning of the study to 8.7% (p < 0.001) after six months. Moreover, a significant reduction in the prevalence of obesity (p = 0.018), high FBS (p = 0.011), and high SBP (p = 0.022) was detected. Conclusions: This study showed a considerable positive impact of diabetes education and patient-centered care on optimizing glycemic and other cardiovascular risk control. The needs of certain patients with T2DM should be addressed individually to achieve the best possible outcomes. Further research is needed to explore the long-term benefits of this intervention.
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Affiliation(s)
- Ali I. AlHaqwi
- Department of Family and Community Medicine, King Abdul-Aziz Medical City, King Saud Ben Abdu Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 22490, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), King Saud Ben Abdul Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 11481, Saudi Arabia
| | - Marwa M. Amin
- Department of Family and Community Medicine, King Abdul-Aziz Medical City, King Saud Ben Abdu Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 22490, Saudi Arabia
| | - Bader A. AlTulaihi
- Department of Family and Community Medicine, King Abdul-Aziz Medical City, King Saud Ben Abdu Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 22490, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), King Saud Ben Abdul Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 11481, Saudi Arabia
| | - Mostafa A. Abolfotouh
- King Abdullah International Medical Research Center (KAIMRC), King Saud Ben Abdul Aziz University for Health Sciences (KSAU-HS), Ministry of National Guard-Health Affairs, Riyadh 11481, Saudi Arabia
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Sabaghan M, Ataee S, Ataee M, Tebyanian M, Afrashteh S, Daneshi N. Diabetic peripheral neuropathy screening and the related risk factors to its prevalence in people with type 2 diabetes. Int J Diabetes Dev Ctries 2023. [DOI: 10.1007/s13410-022-01165-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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Legese GL, Asres G, Alemu S, Yesuf T, Tesfaye YA, Amare T. Determinants of poor glycemic control among type 2 diabetes mellitus patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: Unmatched case-control study. Front Endocrinol (Lausanne) 2023; 14:1087437. [PMID: 36843610 PMCID: PMC9947343 DOI: 10.3389/fendo.2023.1087437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023] Open
Abstract
BACKGROUND Poor glycemic control is one of the most determinant factors for type 2 diabetes-related morbidity and mortality. The proportion of type 2 diabetes mellitus patients with poor glycemic control remains high. Yet evidence on factors contributing to poor glycemic control remains scarce. The aim of this study is to identify determinants of poor glycemic control among type 2 diabetes mellitus patients at a diabetes mellitus clinic in University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia Determinants of Poor Glycemic Control among Type 2 Diabetes mellitus Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: Unmatched Case-Control Study. METHODS A hospital-based case-control study was conducted from June to September 2020. Using convenience sampling techniques, a total of 90 cases and 90 controls with type 2 diabetes were recruited. The data were entered into Epidata version 4.6.0.2 and analyzed by Stata version 14. A multivariable logistic regression analysis was performed to assess the association between independent variables and glycemic control. Both 95% CI and p-value<0.05 were used to determine the level and significance, respectively. RESULTS The mean age ( ± standard deviations) for the cases and controls were 57.55± 10.42 and 61.03± 8.93% respectively. The determinants of poor glycemic control were age (Adjusted odd ratio (AOR)= 0.08; 95% CI= 0.02-0.33), inadequate physical exercise (AOR = 5.05; 95% CI = 1.99-11.98), presence of comorbidities (AOR = 5.50; 95% CI = 2.06-14.66), non-adherence to anti-diabetes medications (AOR= 2.76; 95% CI= 1.19-6.40), persistent proteinuria (AOR=4.95; 95% CI=1.83-13.36) and high-density lipoprotein less than 40 mg/dl (AOR=3.08; 95% CI= 1.30-7.31). CONCLUSIONS Age less than 65 years, inadequate physical exercise, presence of comorbidities, non-adherence to anti-diabetes medications, persistent proteinuria, and high-density lipoprotein less than 40 mg/dl were the determinants of poor glycemic control. Therefore, targeted educational and behavioral modification programs on adequate exercise and medication adherence should be routinely practiced. Furthermore, early guideline-based screening and treatment of comorbidities and complications is required to effectively manage diabetes mellitus.
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Affiliation(s)
- Gebrehiwot Lema Legese
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- *Correspondence: Gebrehiwot Lema Legese,
| | - Getahun Asres
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Shitaye Alemu
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tesfaye Yesuf
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yeabsira Aklilu Tesfaye
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tsegaw Amare
- Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Bitew ZW, Alemu A, Jember DA, Tadesse E, Getaneh FB, Seid A, Weldeyonnes M. Prevalence of Glycemic Control and Factors Associated With Poor Glycemic Control: A Systematic Review and Meta-analysis. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2023; 60:469580231155716. [PMID: 36852627 PMCID: PMC10071101 DOI: 10.1177/00469580231155716] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/09/2023] [Accepted: 01/20/2023] [Indexed: 03/01/2023]
Abstract
The primary method for preventing health and health-related problems in diabetic people is glycemic control. Numerous studies have documented the importance of glycemic control and the factors that influence it. However, the results are dispersed. This study sought to identify the prevalence of poor glycemic control and associated factors in Ethiopia. Findings will be crucial to reduce the burden of poor glycemic control. Comprehensive search was performed from databases: PubMed, Global Health, CINAHL, IRIS, and FSTA. Gray literature sources were also explored. This document was prepared based on the PRISMA flowchart. The protocol is registered in PROSPERO (ID: CRD42022296583). STATA software was used for data analyses and I2 test with Cochrane Q statistics, and forest plot were used to verify heterogeneity. When the I2 value was higher than 50% and the p-value was 0.05, heterogeneity was deemed significant. To confirm publication bias, a funnel plot with an Egger's regression test was performed. The factors related to poor glycemic control were reported using pooled odds ratios (POR) and a 95% confidence interval. In this study, 46 papers totaling 15 457 people were used to calculate the pooled estimates. It was determined that 32.6% (95% CI: 28.3, 36.9) and 61.92% (95% CI: 57.92, 65.92) of the subjects, respectively, had good and poor glycemic control. Being male protected against poor glycemic control, while poor diet adherence, lack of exercise, poor adherence to anti-diabetic medications, and smoking increased the likelihood of poor glycemic control. Lack of formal education, no family history of diabetes, lack of glucometer for blood glucose monitoring, comorbidity, being overweight and prolonged length of stay with diabetes all contributed to poor glycemic control. Ethiopia had a fairly high rate of poor glycemic control. The main determinants are lifestyle factors. Therefore, it is important to focus on behavioral interventions.
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Affiliation(s)
- Zebenay Workneh Bitew
- St. Paul’s Hospital Millennium Medical
College, Addis Ababa, Ethiopia
- Addis Ababa University, Addis Ababa,
Ethiopia
| | | | | | - Erkihun Tadesse
- St. Paul’s Hospital Millennium Medical
College, Addis Ababa, Ethiopia
| | | | - Awole Seid
- Addis Ababa University, Addis Ababa,
Ethiopia
- Bahir Dar University, Bahir Dar,
Ethiopia
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Al-Mutairi AM, Alshabeeb MA, Abohelaika S, Alomar FA, Bidasee KR. Impact of telemedicine on glycemic control in type 2 diabetes mellitus during the COVID-19 lockdown period. Front Endocrinol (Lausanne) 2023; 14:1068018. [PMID: 36817609 PMCID: PMC9936328 DOI: 10.3389/fendo.2023.1068018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 01/18/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The lockdown at the start of coronavirus disease 2019 (COVID-19) pandemic in Saudi Arabia (March 2020 to June 2020) shifted routine in-person care for patients with type 2 diabetes mellitus (T2DM) to telemedicine. The aim of this study was to investigate the impact telemedicine had during this period on glycemic control (HbA1c) in patients with T2DM. METHODS 4,266 patients with T2DM were screened from five Ministry of National Guard Health Affairs hospitals in the Kingdom of Saudi Arabia. Age, gender, body mass index (BMI), HbA1c (before and after the COVID-19 lockdown), duration of T2DM, comorbidities and antidiabetic medications data were obtained. Mean and standard deviation of differences in HbA1c were calculated to assess the impact of telemedicine intervention. Correlations between clinically significant variances (when change in the level is ≥0.5%) in HbA1c with demographics and clinical characteristic data were determined using chi square test. RESULTS Most of the participants were Saudis (97.7%) with 59.7% female and 56.4% ≥60 years of age. Obesity was 63.8%, dyslipidemia 91%, and hypertension 70%. Mean HbA1c of all patients slightly rose from 8.52% ± 1.5% before lockdown to 8.68% ± 1.6% after lockdown. There were n=1,064 patients (24.9%) whose HbA1c decreased by ≥0.5%, n =1,574 patients whose HbA1c increased by ≥0.5% (36.9%), and n =1,628 patients whose HbA1c changed by <0.5% in either direction (38.2%). More males had significant improvements in glycemia compared to females (28.1% vs 22.8%, p<0.0001), as were individuals below the age of 60 years (28.1% vs 22.5%, p<0.0001). Hypertensive individuals were less likely than non-hypertensive to have glycemic improvement (23.7% vs 27.9%, p=0.015). More patients on sulfonylureas had improvements in HbA1c (42.3% vs 37.9%, p=0.032), whereas patients on insulin had higher HbA1c (62.7% vs 56.2%, p=0.001). HbA1c changes were independent of BMI, duration of disease, hyperlipidemia, heart and kidney diseases. CONCLUSION Telemedicine was helpful in delivering care to T2DM patients during COVID-19 lockdown, with 63.1% of patients maintaining HbA1c and improving glycemia. More males than females showed improvements. However, the HbA1c levels in this cohort of patients pre- and post-lockdown were unsatisfactorily high, and may be due to in part lifestyle, age, education, and hypertension.
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Affiliation(s)
- Abrar M. Al-Mutairi
- Research Unit, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia
- *Correspondence: Abrar M. Al-Mutairi, ; Keshore R. Bidasee,
| | - Mohammad A. Alshabeeb
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia
- Ministry of National Guard Health Affairs (MNG-HA), Riyadh, Saudi Arabia
- King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia
| | - Salah Abohelaika
- Department of Clinical Pharmacology, Qatif Central Hospital, Qatif, Saudi Arabia
| | - Fadhel A. Alomar
- Department of Pharmacology and Toxicology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Keshore R. Bidasee
- Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States
- Department of Environment and Occupational Health, University of Nebraska Medical Center, Omaha, NE, United States
- Nebraska Redox Biology Center, Lincoln, NE, United States
- *Correspondence: Abrar M. Al-Mutairi, ; Keshore R. Bidasee,
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López-Gómez SA, González-López BS, Scougall-Vilchis RJ, Márquez-Corona MDL, Minaya-Sánchez M, Navarrete-Hernández JDJ, de la Rosa-Santillana R, Acuña-González GR, Pontigo-Loyola AP, Villalobos-Rodelo JJ, Medina-Solís CE, Maupomé G. Factors Associated with Self-Report of Type 2 Diabetes Mellitus in Adults Seeking Dental Care in a Developing Country. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:218. [PMID: 36612540 PMCID: PMC9819279 DOI: 10.3390/ijerph20010218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/07/2022] [Accepted: 12/21/2022] [Indexed: 06/17/2023]
Abstract
The aims of the present study were to identify the prevalence and risk indicators of type 2 diabetes mellitus (T2DM) in urban-based Mexican adults seeking care in a university-based triage/intake dental clinic, and to develop a predictive model. A cross-sectional study was conducted on 3354 medical/dental records of adults who sought care at the triage/intake dental clinics of a public university. The dependent variable was self-report of a previous diagnosis of T2DM made by a physician. Several socio-demographic and socioeconomic covariates were included, as well as others related to oral and general health. A multivariate binary logistic regression model was generated. We subsequently calculated well-known statistical measures employed to evaluate discrimination (classification) using an (adjusted) multivariate logistic regression model (goodness-of-fit test). The average age of patients was 42.5 ± 16.1 years old and the majority were female (64.1%). The prevalence of T2DM was 10.7% (95%CI = 9.7−11.8). In the final multivariate model, the variables associated (p < 0.05) with the presence of T2DM were older age (40 to 59 years old, OR = 2.00; 60 to 95 years old, OR = 2.78), having any type of health insurance (OR = 2.33), having high blood pressure (OR = 1.70), being obese (OR = 1.41), and having a functional dentition (OR = 0.68). Although the global fit of the model and the calibration tests were adequate, the sensitivity (0.0%) and positive predictive (0.0%) values were not. The specificity (100%) and negative predictive (89.3%) values, as well as the correctly classified (89.3%) value, were adequate. The area under the ROC curve, close to 0.70, was modest. In conclusion, a prevalence of T2DM of 10.7% in this sample of Mexican adults seeking dental care was similar to national figures. Clinical (blood pressure, BMI and functional dentition), demographic (age), and socioeconomic (health insurance) variables were found to be associated with T2DM. The dental setting could be appropriate for implementing preventive actions focused on identifying and helping to reduce the burden of T2DM in the population.
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Affiliation(s)
- Sandra Aremy López-Gómez
- School of Behavioral Sciences, Autonomous University of the State of Mexico, Toluca 50130, Mexico
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico
| | - Blanca Silvia González-López
- Advanced Studies and Research Center in Dentistry “Dr. Keisaburo Miyata”, Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca 50130, Mexico
| | - Rogelio José Scougall-Vilchis
- Advanced Studies and Research Center in Dentistry “Dr. Keisaburo Miyata”, Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca 50130, Mexico
| | | | | | | | - Rubén de la Rosa-Santillana
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico
| | | | | | | | - Carlo Eduardo Medina-Solís
- Academic Area of Dentistry of Health Sciences Institute, Autonomous University of Hidalgo State, Pachuca 42160, Mexico
- Advanced Studies and Research Center in Dentistry “Dr. Keisaburo Miyata”, Faculty of Dentistry, Autonomous University of the State of Mexico, Toluca 50130, Mexico
| | - Gerardo Maupomé
- Richard M. Fairbanks School of Public Health, Indiana University/Purdue University, Indianapolis, IN 46202, USA
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Asfaw MS, Dagne WK. Physical activity can improve diabetes patients' glucose control; A systematic review and meta-analysis. Heliyon 2022; 8:e12267. [PMID: 36578408 PMCID: PMC9791347 DOI: 10.1016/j.heliyon.2022.e12267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 10/30/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
Background Glycemic control is vital to patient care, and it is still the most important treatment goal for reducing organ damage and other complications associated with diabetes. Physical activity is one of the factors that affects glycemic management. Therefore, the aim of this systematic review and meta-analysis was to find, evaluate, and synthesize the best available information on the link between physical exercise and glycemic control in Ethiopian diabetes patients. Methods Pubmed, Science Direct, Google Scholar and African Journals Online were the databases searched. In addition, gray literature were explored. All papers chosen for inclusion in the review underwent a thorough critical appraisal utilizing the Joanna Briggs Institute's standardized critical appraisal instruments (JBI critical appraisal checklist-2017). For statistical analysis and descriptive synthesis, quantitative articles were combined. The Odds ratio and their 95% confidence intervals were generated. Papers that were of excellent quality but lacked the main outcome (physical activity) for meta-analysis were subjected to descriptive synthesis. Results The finding of this meta-analysis showed diabetes patients who were physically active had controlled their blood glucose levels by 2.4 times compared to their counter (Odds ratio = 2.40, 95% Confidence Interval = 1.57,3.69). The duration of disease was found to be the most commonly reported predictor for poor glycemic control followed by dietary habits, patients' sex and age. Conclusion Physical activity, which is a simple and inexpensive therapy for diabetes patients, can help them control their blood glucose levels. Patients with diabetes who have had it for a long time should be aware of the need of regular physical activity in maintaining blood glucose control.
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Affiliation(s)
- Mulu Shiferaw Asfaw
- Biomedical Unit, School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia
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Waist-to-hip circumference and waist-to-height ratio could strongly predict glycemic control than body mass index among adult patients with diabetes in Ethiopia: ROC analysis. PLoS One 2022; 17:e0273786. [DOI: 10.1371/journal.pone.0273786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/15/2022] [Indexed: 11/11/2022] Open
Abstract
Background
Poorly controlled blood glucose is prevalent and contributes to the huge burden of diabetes related morbidity, and central obesity has a great role in the pathogenesis of diabetes and its adverse complications, which could predict such risks, yet evidence is lacking. Hence, this paper is to evaluate the predictive performance of central obesity indices for glycemic control among adult patients with diabetes in eastern Ethiopia.
Methods
A survey of 432 randomly chosen patients with diabetes was conducted using a pretested questionnaire supplemented by chart review, anthropometrics, and biomarkers by trained data collectors. The poor glycemic control was assessed using a fasting blood glucose (FBS) level of above 130 and/or an HgA1c level above 7%. Weight, height, waist circumference (WC), and hip circumference (HC) were measured under standard procedures and we calculated waist-to-hip circumference ratio (WHR) and waist-to-height ratio (WHtR). The receiver operating characteristics curve was used to assess the predictive performance of obesity indices for glycemic control using area under the curve (AUC) and corresponding validity measures.
Results
A total of 432 (92%) patients with diabetes were enrolled with a mean age of 49.6 (±12.4) years. The mean fasting blood glucose level was 189 (±72) mg dl-1 where 330 (76.4%) (95% CI: 74.4–78.4%) and 93.3% of them had poor glycemic control based on FBS and HgA1c, respectively. WC (AUC = 0.90; 95% CI: 0.85–0.95), WHR (AUC = 0.64; 95% CI: 0.43–0.84), and WHtR (AUC = 0.87; 95% CI: 0.83–0.94) have a higher predictive performance for poor glycemic control at cut-off points above 100 cm, 0.95, and 0.62, respectively. However, obesity indices showed a lower predictive performance for poor glycemic control based on FBS. Body mass index (BMI) had a poor predictive performance for poor glycemic control (AUC = 0.26; 95% CI: 0.13–0.40).
Conclusions
Poor glycemic control is a public health concern and obesity indicators, typically WC, WHR, and WHtR, have a better predictive performance for poor glycemic control than BMI.
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Lankrew Ayalew T, Gelaw Wale B, Tefera Zewudie B. Hypoglycemia prevention practice and associated factors among diabetes mellitus patients in Ethiopia: Systematic review and meta-analyssis. PLoS One 2022; 17:e0275786. [PMID: 36318542 PMCID: PMC9624414 DOI: 10.1371/journal.pone.0275786] [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: 01/05/2022] [Accepted: 09/22/2022] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Hypoglycemia is an urgent, life-threatening condition that requires prompt recognition and treatment for diabetes mellitus patients to prevent organ and brain damage. Hypoglycemia is one of the most important complications of diabetes mellitus patients around the globe. Hypoglycemia may increase vascular events and even death, in addition to other possible detrimental effects. In spite of the absence of other risk factors, patients receiving intensive insulin therapy are more likely to experience hypoglycemia. To reduce the risk of hypoglycemia and calculate the combined prevalence of hypoglycemia prevention practices among diabetes mellitus patients, recognition of hypoglycemia is critical. OBJECTIVE The main aim of this review was to evaluate the available data on Ethiopian diabetes mellitus patients' practices for preventing hypoglycemia and related factors. METHODS AND MATERIALS This review was searched using PubMed, the Cochrane Library, Google, Google Scholar, and the Web of Sciences. Microsoft Excel was used to extract the data. All statistical analyses were done using STATA Version 14 software with a random-effects model. The funnel plot and heterogeneity of the studies were checked. Subgroup analysis was done with the study area and authors' names. RESULTS In this systematic review, 12 studies totaling 3,639 participants were included. The estimated overall practice for preventing hypoglycemia among diabetic patients in Ethiopia were 48.33% (95% CI (28.21%, 68.46%, I2 = 99.7%, p ≤ 0.001). According to the subgroup analysis based on region, the highest estimated prevalence of the prevention practice of hypoglycemia among diabetes patients in Addis Ababa was 90%, followed by SNNRP at 76.18% and in the Amhara region at 68.31% respectively. The least prevalent was observed in the Oromia region 6.10%. In this meta-analysis, diagnoses with type II diabetes (AOR = 2.53, 95%CI: 1.05, 4.04), duration (AOR = 5.49, 95%CI:3.27,7.70), taking insulin for a long time(AOR = 4.31,95%CI:2.60,6.02), having good prevention knowledge (AOR = 2.89, 95%CI: 1.15,4.23), and occupation (AOR = 4.17, 95%CI: 2.20, 6.15) were significantly associated with hypoglycemia prevention practice. CONCLUSIONS This systematic review revealed that diabetic patients in Ethiopia had poor hypoglycemia prevention practices. Being an employee, taking insulin for a long time, having a good prevention practice, and having a type of diabetes mellitus were strongly correlated with practicing hypoglycemia prevention. This review implied the subsequent need for educational interventions for an individualized patient.
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Affiliation(s)
- Tadele Lankrew Ayalew
- Department of Nursing, School of Nursing, College of Health Science and Medicine Wolaita Sodo University, Sodo, Ethiopia
- * E-mail:
| | - Belete Gelaw Wale
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Health Science and Medicine Wolaita Sodo University, Sodo, Ethiopia
| | - Bitew Tefera Zewudie
- Department of Nursing, College of Health Science and Medicine, Wolkite University, Wolkite, Ethiopia
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Prasopthum A, Insawek T, Pouyfung P. Herbal medicine use in Thai patients with type 2 diabetes mellitus and its association with glycemic control: A cross-sectional evaluation. Heliyon 2022; 8:e10790. [PMID: 36212012 PMCID: PMC9535297 DOI: 10.1016/j.heliyon.2022.e10790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/02/2022] [Accepted: 09/21/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Herbal medicine has been integrated into Thai culture for many centuries. However, studies on using herbal medicine in combination with antidiabetic agents for glycemic control in managing diabetes are limited. Herein, we aimed to assess the use of herbal medicines with different dosages of antidiabetic agents and their association with glycemic control in Thai patients with type 2 diabetes mellitus (T2DM). Methods This hospital-based study included 739 patients with T2DM who consecutively visited four district hospitals in Thailand. An interviewer-administered questionnaire was used to collect patient-specific information, including hemoglobin A1c (HbA1c) levels. Chi-square and logistic regression analyses were used to assess associations and predictors, respectively. Results The prevalence of herbal medicine use was 37.5% (n = 264); 70.5% of the patients received information about herbal medicine usage for glycemic control from their relatives and friends, and 21 herbal plants were consumed in combination with their prescribed antidiabetic drugs. The use of herbal medicine was associated with the patients’ educational level (p = 0.001), income (p < 0.001), and duration of diabetes (p < 0.001). Good glycemic control (HbA1c < 7.0%) was associated with the use of bitter gourd in combination with 500 mg/day of the antidiabetic drug metformin (adjusted odds ratio = 8.33, 95% confidence interval = 1.04–66.49, p = 0.046). These patients were 2.92 times more likely to have good glycemic control than those who relied solely on 500 mg/day of metformin (adjusted OR = 2.921, 95% CI = 1.227–6.952, p = 0.015). Conclusions The prevalence of herbal plant use was associated with different variables, including age, BMI, T2DM duration, and metformin dosage. Among the 21 herbal plants, the consumption of bitter gourd with 500 mg/day of metformin was associated with good glycemic control.
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Applying the Reasoned Action Approach and Planning to Understand Diabetes Self-Management Behaviors. Behav Sci (Basel) 2022; 12:bs12100375. [PMID: 36285944 PMCID: PMC9598101 DOI: 10.3390/bs12100375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 09/23/2022] [Accepted: 09/27/2022] [Indexed: 11/09/2022] Open
Abstract
Individuals managing diabetes are required to adhere to self-management behaviors to ensure the optimal regulation of their blood glucose levels. This study examined the psychological determinants underlying three important diabetes self-management behaviors (e.g., physical activity, diet, and blood glucose monitoring) using the reasoned action approach (RAA) and planning. A cross-sectional design was used, with participants (N = 273) completing measures of RAA constructs (e.g., experiential and instrumental attitude, descriptive and injunctive norm, and capacity and autonomy) and planning (e.g., action and control planning) at time 1 and participation in the behaviors one week later at time 2. Regressions showed that RAA constructs accounted for good variance in intention and behavior in all behaviors. Intention towards diet and blood glucose monitoring was significantly predicted by instrumental attitude, injunctive norm, and capacity. Intention towards physical activity was significantly predicted by instrumental attitude, experiential attitude, injunctive norm, capacity, and autonomy. All behaviors were significantly predicted by intention, action planning, and coping planning. Additionally, capacity significantly predicted physical activity and autonomy significantly predicted diet and blood glucose monitoring. Successfully intervening in the influential psychological constructs identified in the study could ensure optimal blood glucose regulation in those managing diabetes.
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Fina Lubaki JP, Omole OB, Francis JM. Glycaemic control among type 2 diabetes patients in sub-Saharan Africa from 2012 to 2022: a systematic review and meta-analysis. Diabetol Metab Syndr 2022; 14:134. [PMID: 36127712 PMCID: PMC9487067 DOI: 10.1186/s13098-022-00902-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/05/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is an increased burden of diabetes globally including in sub-Saharan Africa. The literature shows that glycaemic control among type 2 diabetes patients is poor in most countries in sub-Saharan Africa. Understanding the factors influencing glycaemic control in this region is therefore important to develop interventions to optimize glycaemic control. We carried out a systematic review to determine the prevalence and factors associated with glycaemic control in sub-Saharan Africa to inform the development of a glycaemic control framework in the Democratic Republic of the Congo. METHODS We searched five databases (African Index Medicus, Africa-Wide Information, Global Health, PubMed, and Web of Science) using the following search terms: type-2 diabetes, glycaemic control, and sub-Saharan Africa. Only peer-reviewed articles from January 2012 to May 2022 were eligible for this review. Two reviewers, independently, selected articles, assessed their methodological quality using Joanna Briggs checklists, and extracted data. A meta-analysis was performed to estimate the prevalence of glycaemic control. Factors associated with glycaemic control were presented as a narrative synthesis due to heterogeneity as assessed by the I2. RESULTS A total of 74 studies, involving 21,133 participants were included in the review. The pooled prevalence of good glycaemic control was 30% (95% CI:27.6-32.9). The glycaemic control prevalence ranged from 10-60%. Younger and older age, gender, lower income, absence of health insurance, low level of education, place of residence, family history of diabetes, longer duration of diabetes, pill burden, treatment regimen, side effects, use of statins or antihypertensives, alcohol consumption, smoking, presence of comorbidities/complications, and poor management were associated with poor glycaemic control. On the other hand, positive perceived family support, adequate coping strategies, high diabetes health literacy, dietary adherence, exercise practice, attendance to follow-up, and medication adherence were associated with good glycaemic control. CONCLUSION Suboptimal glycaemic control is pervasive among patients with type-2 diabetes in sub-Saharan Africa and poses a significant public health challenge. While urgent interventions are required to optimize glycaemic control in this region, these should consider sociodemographic, lifestyle, clinical, and treatment-related factors. This systematic review and meta-analysis protocol is registered in PROSPERO under CRD 42021237941.
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Affiliation(s)
- Jean-Pierre Fina Lubaki
- Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa.
- Department of Family Medicine and Primary Care, Protestant University of Congo, Kinshasa, Democratic Republic of the Congo.
| | - Olufemi Babatunde Omole
- Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
| | - Joel Msafiri Francis
- Department of Family Medicine and Primary Care, University of the Witwatersrand, Johannesburg, South Africa
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Kidie AA, Ayal BG, Ayele T, Fentie EA, Lakew AM. Poor glycemic control and associated factors among pediatric diabetes mellitus patients in northwest Ethiopia, 2020: facility-based cross sectional retrospective study design. Sci Rep 2022; 12:15664. [PMID: 36123389 PMCID: PMC9485249 DOI: 10.1038/s41598-022-19909-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 09/06/2022] [Indexed: 11/13/2022] Open
Abstract
Diabetes mellitus is a global public health problem. Glycemic control is a major public health problem. Diabetes results from elevated levels of glycaemia such as increased glucose and glycated hemoglobin, and controlling glycaemia is an integral component of the management of diabetes. Glycemic control in children is particularly difficult to achieve. Identifying determinants of poor glycemic control is important for early modification of diabetic related end organ damages. This study was aimed to assess the status of glycemic control and associated factors among pediatric diabetes mellitus patients in northwest Ethiopia. Facility-based cross sectional retrospective cohort study design was used and this study was conducted from September, 2015 to February, 2018. Simple random sampling was used to select 389 samples. Data were collected using an extraction checklist. Data were entered into Epi-data − 4.6, and analyzed using Stata-16. Finally, multivariable binary logistic regression was done. Poor glycemic control was more common among pediatric patients 39.3% (95% CI 34.6, 44.3). Treatment discontinuation (AOR 2.42, 95% CI 1.25, 4.69), age (AOR 1.15, 95% CI 1.03, 1.28) and treatment dose (AOR 0.96, 95 CI 0.92, 0.99) were significantly associated with poor glycemic control. Prevalence of poor glycemic control was high. Patient’s age, history of treatment discontinuation and dose of treatment were the significant contributing factors to poor glycemic control. These need to be addressed to attain the objective of adequate glycemic control.
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Affiliation(s)
- Atitegeb Abera Kidie
- School of Public Health, College of Health Science, Woldia University, Woldia, Ethiopia.
| | | | - Tiruneh Ayele
- Department of Public Health, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Elsa Awoke Fentie
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Ayenew Molla Lakew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Puangpet T, Pongkunakorn T, Chulkarat N, Bunlangjit C, Surawit A, Pinsawas B, Mongkolsucharitkul P, Mayurasakorn K. Control and complications of diabetes in urban primary care units in Thailand: a cross-sectional study. BMC PRIMARY CARE 2022; 23:212. [PMID: 35996081 PMCID: PMC9396826 DOI: 10.1186/s12875-022-01823-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Primary health care system plays a central role in caring for persons with diabetes. Thai National Health Examination Survey (NHES) reports that only 40% of patients with type 2 diabetes mellitus (T2DM) achieve optimal glycemic control. We sought to evaluate the quality of diabetic care (QOC), prevalence of microvascular complications, and associated risk factors among T2DM patients treated at primary care units in urban areas in Thailand.
Methods
A population-based, cross-sectional study of 488 T2DM patients aged over 35 years from 25 primary care units in Samutsakhon, Thailand was conducted during February 2018 to March 2019. Clinical targets of care (TOC) and processes of care (POC) were measured to evaluate QOC. Multivariate logistic regression models were applied to explore the association between risk factors and glycemic control.
Results
41.2% of women and 44.4% of men achieved hemoglobin A1C (A1C) < 53 mmol/mol, while 31.3% of women and 29.7% of men had poor glycemic control (A1C > 63 mmol/mol). 39 participants (8%) achieved all TOC and 318 participants (65.2%) achieved all POC. Significant risk factors for poor glycemic control included diabetes duration > 6 years (AOR = 1.83, 95% CI = 1.20–2.79), being overweight (AOR = 2.54, 95% CI = 1.58–4.08), obesity (AOR = 1.71, 95% CI = 1.05–2.89), triglycerides > 1.7 mmol/l (AOR = 1.81, 95% CI = 1.25–2.78), low density lipoprotein-cholesterol (LDL-C) ≥ 2.6 mmol/l (AOR = 1.55, 95% CI = 1.04–2.28). On the other hand, participants aged > 65 years (AOR = 0.25, 95% CI = 0.14–0.55) or achieved TOC indicators (AOR = 0.69, 95% CI = 0.43–0.89) were significantly associated with glycemic control. Diabetic retinopathy was significantly related to obesity (AOR = 2.21, 95% CI = 1.00–4.86), over waist circumference (AOR = 2.23, 95% CI = 0.77–2.31), and diastolic blood pressure > 90 mmHg (AOR = 1.81, 95% CI = 1.48–1.96).
Conclusion
Access to essential diabetic screening in primary care units is crucial to determine status of disease control and guide disease management. Duration of T2DM, high body mass index, triglyceride and LDL-C were independently associated with poor glycemic control. Obesity was highly associated with diabetes retinopathy. Effort should be taken seriously toward monitoring these factors and providing effective care.
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Letta S, Aga F, Yadeta TA, Geda B, Dessie Y. Correlates of Glycemic Control Among Patients With Type 2 Diabetes in Eastern Ethiopia: A Hospital-Based Cross-Sectional Study. Front Endocrinol (Lausanne) 2022; 13:939804. [PMID: 35942179 PMCID: PMC9356126 DOI: 10.3389/fendo.2022.939804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/14/2022] [Indexed: 01/18/2023] Open
Abstract
Introduction Even though optimal blood glucose control reduces the risk of diabetes-related complications, many patients with type 2 diabetes (T2D) fail to achieve it for a variety of reasons. In the study area, there was a paucity of evidence regarding correlates of glycemic control. Therefore, this study aimed to find out the correlates of glycemic control among patients with T2D in Eastern Ethiopia. Methods A cross-sectional study was conducted among 879 adult patients with T2D on follow-up at two public hospitals in Harar. Data were collected through interviews, physical measurements, and record reviews. The level of glycemic control was determined from three consecutive fasting plasma glucose (FPG) measurements. A mean value of FPG measurements falling in the normal range (80-130 mg/dl) was considered as optimal glycemic control; otherwise, a mean FPG level that is below or above the normal range (<80 mg/dl or >130 mg/dl) was defined as suboptimal glycemic control. Descriptive statistics were used to summarize the data, while a linear regression model was used to find out the correlates of glycemic control. A beta coefficient and a 95% CI reported associations. The statistical significance was declared at a p-value ≤0.05. Results The mean age of the patients with T2D was 52.7 ( ± 13.3) years. The mean FPG level was 172 ± 56 mg/dl. Suboptimal glycemic control was found in 76% (95% CI: 73.41, 79.04) of patients with T2D. In a multivariable linear regression, khat chewing (β = 6.12; 95% CI: 1.55, 8.69), triglycerides (β = 0.56; 95% CI: 0.41.48, 0.65), comorbidity (β = 5.29; 95% CI: 1.39, 9.13), and poor level of self-care practices (β = 5.43; 95% CI: 1.41, 6.46) showed a significant correlation with glycemic control. Conclusions This study found that about three-fourths of patients with T2D had suboptimal glycemic control. Khat chewing, comorbidity, and poor level of self-care practices were independently correlated with glycemic control. Thus, suppressing glycemic levels through appropriate treatment and strict diabetes self-care practices including avoidance of Khat chewing is a useful approach to attaining glycemic target that subsequently reduces cardiovascular risks.
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Affiliation(s)
- Shiferaw Letta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Fekadu Aga
- School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- Department of Nursing, College of Health Sciences, Madda Walabu University, Shashamene, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Sebők J, Édel Z, Dembrovszky F, Farkas N, Török Z, Balogh G, Péter M, Papp I, Balogi Z, Nusser N, Péter I, Hooper P, Geiger P, Erőss B, Wittmann I, Váncsa S, Vigh L, Hegyi P. Effect of HEAT therapy in patiEnts with type 2 Diabetes mellitus (HEATED): protocol for a randomised controlled trial. BMJ Open 2022; 12:e062122. [PMID: 35820741 PMCID: PMC9277369 DOI: 10.1136/bmjopen-2022-062122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The burden of type 2 diabetes mellitus (T2DM) is increasing worldwide. Heat therapy has been found effective in improving glycaemic control. However, to date, there is a lack of randomised controlled studies investigating the efficacy of heat therapy in T2DM. Therefore, we aim to investigate whether heat therapy with natural thermal mineral water can improve glycaemic control in patients with T2DM. METHODS AND ANALYSIS The HEAT therapy in patiEnts with type 2 Diabetes mellitus (HEATED) Study is a single-centre, two-arm randomised controlled trial being conducted at Harkány Thermal Rehabilitation Centre in Hungary. Patients with T2DM will be randomly assigned to group A (bath sessions in 38°C natural thermal mineral water) and group B (baths in thermoneutral water (30°C-32°C)). Both groups will complete a maximum of 5 weekly visits, averaging 50-60 visits over the 12-week study. Each session will last 30 min, with a physical check-up before the bath. At baseline, patients' T2DM status will be investigated thoroughly. Possible microvascular and macrovascular complications of T2DM will be assessed with physical and laboratory examinations. The short form-36 questionnaire will assess the quality of life. Patients will also be evaluated at weeks 4, 8 and 12. The primary endpoint will be the change of glycated haemoglobin from baseline to week 12. An estimated 65 patients will be enrolled per group, with a sample size re-estimation at the enrolment of 50% of the calculated sample size. ETHICS AND DISSEMINATION The study has been approved by the Scientific and Research Ethics Committee of the Hungarian Medical Research Council (818-2/2022/EÜIG). Written informed consent is required from all participants. We will disseminate our results to the medical community and will publish our results in peer-reviewed journals. TRIAL REGISTRATION NUMBER ClinicalTrials.gov, NCT05237219.
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Affiliation(s)
- Judit Sebők
- 2nd Department of Internal Medicine, University of Pecs Medical School, Pécs, Hungary
| | - Zsófia Édel
- 2nd Department of Internal Medicine, University of Pecs Medical School, Pécs, Hungary
| | - Fanni Dembrovszky
- Institute for Translational Medicine, Szentágothai Research Centre, University of Pecs Medical School, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Nelli Farkas
- Institute for Translational Medicine, Szentágothai Research Centre, University of Pecs Medical School, Pécs, Hungary
- Institute of Bioanalysis, University of Pecs Medical School, Pécs, Hungary
| | | | | | | | | | - Zsolt Balogi
- Institute of Biochemistry and Medical Chemistry, University of Pecs Medical School, Pécs, Hungary
| | - Nóra Nusser
- Harkány Thermal Rehabilitation Centre, Harkány, Hungary
| | - Iván Péter
- Harkány Thermal Rehabilitation Centre, Harkány, Hungary
| | - Philip Hooper
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Paige Geiger
- Department of Molecular and Integrative Physiology, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Bálint Erőss
- Institute for Translational Medicine, Szentágothai Research Centre, University of Pecs Medical School, Pécs, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - István Wittmann
- 2nd Department of Internal Medicine, University of Pecs Medical School, Pécs, Hungary
| | - Szilárd Váncsa
- Institute for Translational Medicine, Szentágothai Research Centre, University of Pecs Medical School, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | | | - Péter Hegyi
- Institute for Translational Medicine, Szentágothai Research Centre, University of Pecs Medical School, Pécs, Hungary
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
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Diabetic health literacy and associated factors among diabetes mellitus patients on follow up at public hospitals, Bale Zone, South East Ethiopia, 2021. PLoS One 2022; 17:e0270161. [PMID: 35797276 PMCID: PMC9262198 DOI: 10.1371/journal.pone.0270161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/05/2022] [Indexed: 11/19/2022] Open
Abstract
Objective This study was aimed to assess diabetic health literacy and associated factors among adult diabetic patients in public hospitals, Bale Zone, Southeast Ethiopia. Methods A hospital-based cross-sectional study was conducted among 402 diabetic patients in three public hospitals and the samples were selected using simple random sampling technique. The comprehensive functional, communicative, and critical health literacy questionnaire was used to measure diabetic health literacy. Descriptive statistics and Ordinary logistic regression analyses were conducted, and a P-value of < 0.05 was considered to declare a result as statistically significant. Result A total of 402 diabetic patients were involved in the study. Of all respondents, 41.8%, 27.9%, and 30.3% had low, moderate, and high diabetic health literacy respectively. Educational status; can’t read and write (AOR = 0.085;95% CI: 0.03,0.26), can read and write (AOR = 0.10; 95% CI: 0.04,0.30), primary school (AOR = 0.25; 95% CI: 0.09,0.67), secondary school (AOR = 0.37; 95% CI: 0.14,0.99), duration of onset ≤5 years (AOR = 2.05; 95% CI:1.09,4.19), being not member of DM association (AOR = 0.43; 95% CI: 0.26,0.73), having ≤ 3 diabetes mellitus information sources (AOR = 0.15; 95% CI: 0.03,0.77), social support; poor (AOR = 0.40;95% CI: 0.21,0.79), and moderate (AOR = 0.50; 95% CI: 0.28,0.92) were significantly associated with diabetic health literacy. Conclusion A substantial number of diabetic patients had low diabetic health literacy. Educational status, Sources of diabetic information, Member of DM association, and social support were significantly and positively associated with diabetic health literacy. But, duration of diabetes onset was negatively associated with diabetic health literacy of respondents. So, we recommend providing readable and picturized printed materials, and diabetic patient education to be considered.
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Lailaturrahmi L, Araswati F, Armenia A, Yosmar R. Effect of Drug Information Service on Clinical Outcome of Patients with Type 2 Diabetes Mellitus in Padang, Indonesia. BORNEO JOURNAL OF PHARMACY 2022. [DOI: 10.33084/bjop.v5i2.3301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) has been a health burden worldwide, including Indonesia. However, T2DM therapy needs a long and complex process, which patients often do not favor, thus making them does not take medications as instructed and negatively affecting clinical outcomes. This study aimed to understand the effect of Drug Information Service provision on the clinical outcome of T2DM patients. This quasi-experimental study was conducted using one group pre-post-test design. As the clinical outcome, the fasting blood glucose levels were measured before and after the intervention. A drug information service was provided through direct explanation to the patients. Sociodemographic data were analyzed descriptively. The difference in fasting blood glucose before and after the intervention was assessed using Wilcoxon signed-rank test. Forty patients participated in this study. Most participants are female (N=34; 85%) and receive two-drugs combination therapy of metformin and sulfonylureas (N=32; 77.5%). Although there is a decrease in mean fasting blood glucose level after intervention (174.92±59.561 vs. 184.20±49.768), there is no significant difference between fasting blood glucose levels pre-intervention and post-intervention (p>0.05). It is concluded that despite the noticeable decline of blood glucose level after drug information service, its effect on blood glucose control is not significant.
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Al-Ma'aitah OH, Demant D, Jakimowicz S, Perry L. Glycaemic control and its associated factors in patients with type 2 diabetes in the Middle East and North Africa: An updated systematic review and meta-analysis. J Adv Nurs 2022; 78:2257-2276. [PMID: 35621355 PMCID: PMC9541219 DOI: 10.1111/jan.15255] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 02/05/2022] [Accepted: 03/23/2022] [Indexed: 12/01/2022]
Abstract
Aims To examine the patient‐related factors that have been linked to glycaemic control in people living with type 2 diabetes mellitus in Middle Eastern countries. Design A systematic review and meta‐analysis. Data Sources A computerized search was conducted using the databases MEDLINE (via PubMed and Ovid), EMBASE, Scopus and CINAHL to identify peer‐reviewed articles published in English between 1 January 2010 and 21 May 2020. On 28 June 2021, the search was updated with the same keywords and databases; however, no further relevant studies were identified. Review Methods Extracted data were analysed using Review Manager 5.4. Results The final sample consisted of 54 articles with a total of 41,079 participants. Pooled data showed an increased risk of inadequate glycaemic control in smokers [OR = 1.26, 95% confidence interval (CI): 1.05, 1.52; p = .010], obese patients (OR = 1.30, 95% CI: 1.10, 1.54; p = .002), patients with elevated waist to hip ratio (OR = 1.62, 95% CI: 1.16, 2.26; p = .004) and longer disease duration (OR = 2.01, 95% CI: 1.64, 2.48; p < .001). A lower risk of inadequate control was associated with physical activity (OR = 0.40, 95% CI: 0.24, 0.67; p < .001) and self‐management (OR = 0.49, 95% CI: 0.29, 0.82; p = .006). Conclusion These findings highlight the opportunity to address factors to improve glycaemic control. Further longitudinal studies are required to better understand these variations, to assess all predictors of glycaemic control in participants with type 2 diabetes, and to provide a strong basis for future measures to optimize glycaemic control.
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Affiliation(s)
- Odai Hamed Al-Ma'aitah
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Daniel Demant
- School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.,School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Samantha Jakimowicz
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Lin Perry
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia.,Prince of Wales Hospital, South Eastern Sydney Local Health District, Sydney, Australia
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Ngetich E, Pateekhum C, Hashmi A, Nadal IP, Pinyopornpanish K, English M, Quansri O, Wichit N, Kinra S, Angkurawaranon C. Illness perceptions, self-care practices, and glycemic control among type 2 diabetes patients in Chiang Mai, Thailand. Arch Public Health 2022; 80:134. [PMID: 35524335 PMCID: PMC9078014 DOI: 10.1186/s13690-022-00888-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 05/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetes Self-Management Education (DSME) is a fundamental aspect of diabetes care, but no standard program exists in Thailand. Understanding current patterns of illness perceptions (concerns) and self-management practices among patients with diabetes in Thailand is vital to develop culturally tailored DSME programs. This study sought to explore the association between reported self-management practices and diabetes perceptions on glycemic control among patients with type 2 diabetes in Chiang Mai Province, Thailand. Specifically, the study examined whether the association between illness perceptions and diabetes control was mediated by self-management. METHODS This was a cross-sectional study conducted among type 2 diabetes patients on outpatient care and follow-up in four districts hospitals in Chiang Mai, Thailand. Illness perceptions was measured by the Brief Illness Perceptions Questionnaire (BIPQ). Self-management practices were measured by Summary Diabetes Self-Care activities (SDSCA). For illness perceptions and self-management practices, patients were classified into two groups, high level and low level based on the median values. Univariate and multivariable analyses were done to determine the association between the determinant factors: self-care practices and illness perceptions and the outcome of interest- good glycemic control (HbA1c < 7%). RESULTS Of the 200 participants recruited into the study, 180 completed the questionnaire. Only 35% of participants had good glycemic control (HBA1c < 7.0). Both illness perceptions and self-management practices were independently linked to glycemic control. Among illness perceptions, a sense of personal control was strongly associated with good glycemic control (p = 0.01). For self-management, appropriate diet (p = 0.03) and medication adherence (p = 0.05) were associated with good glycemic control. After adjustments for key baseline characteristics, patients with high levels of illness perceptions were less likely to achieve glycemic control (OR 0.55, 95% CI 0.29 to 1.14, p = 0.11) and those with high level of self-management were more likely to achieve glycemic control (OR 2.11, 95% CI 1.04 to 4.30, p = 0.04). The effect size for illness perception attenuated when further adjusted for levels of self-management (OR 0.88, 95% CI 0.39 to 1.96, p = 0.75) while the effect size for self-management and glycemic control did not materially change (OR 2.30, 95% CI 1.06 to 5.02, p = 0.04). CONCLUSION Illness perceptions and self-management practices are associated with glycemic control. Future culturally tailored interventions in Thailand aimed at improving glycemic should focus on personal control, improving diet and treatment adherence as these are more likely to help improve diabetes control as demonstrated in this study.
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Affiliation(s)
- Elisha Ngetich
- Nuffield Department of Surgical Sciences, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Chanapat Pateekhum
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Ahmar Hashmi
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Iliatha Papachristou Nadal
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Mike English
- Nuffield Department of Medicine, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Orawan Quansri
- ASEAN Institute for Health Development, Mahidol University, Salaya, Nakorn Pathom, Thailand
| | | | - Sanjay Kinra
- Department of Non-Communicable Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
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Abera RG, Demesse ES, Boko WD. Evaluation of glycemic control and related factors among outpatients with type 2 diabetes at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study. BMC Endocr Disord 2022; 22:54. [PMID: 35249547 PMCID: PMC8898656 DOI: 10.1186/s12902-022-00974-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/25/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The goals of glycemic management for patients with diabetes are to prevent or delay complications and optimize quality of life. However, in clinical practice, the recommended glycemic control target is difficult to achieve. Therefore, it is important to identify factors that influence the outcomes of glycemia to improve the quality of diabetic management. The study aimed to evaluate the level and factors associated with glycemic control among type 2 diabetic outpatients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. METHODS A hospital-based cross-sectional study was conducted among systematically selected 325 patients with type 2 diabetes who attended diabetic clinics at Tikur Anbessa Specialized Hospital. Pretested, structured, and interviewer-administered questionnaires were used to collect sociodemographic and diabetes-related information from March 1 to May 30, 2021. HbA1c was used to assess glycemic control according to the HbA1c target of < 7% ('good' control) as recommended by the American Diabetes Association for non-pregnant adults. The HbA1c level in the range of 7-8% was defined as 'inadequate' control and 'poor' at levels > 8%. Data entry and analysis were performed using SPSS v26. Multivariate logistic regression analysis was used to identify determinants of glycemic control. RESULTS The median level of HbA1c of the participants was 8.4% (IQR 6.8-10.1). And approximately three-quarters (73.8%) of the patients had inadequate and poor glycemic control (HbA1c ≥ 7%). Older age (AOR: 2.46, 95% CI: 1.28-6.01), DM duration of > 10 years (AOR: 3.15, 95% CI: 2.22-6.54), insulin therapy (AOR: 3.07, 95% CI: 2.10-6.12), poor diet compliance (AOR: 1.97, 95% CI: 1.28-3.52) and failure to set goals for glycemic control (AOR: 3.42, 95% CI: 2.17-5.97) were factors associated with inadequate and poor glycemic control. CONCLUSIONS The study revealed that a significant number of diabetic patients had inadequate and poor glycemic control levels. And this was associated with older age, longer duration of DM, insulin therapy, poor diet compliance, and failure to set control goals. This requires a focus on the associated factors identified and tailored management mechanisms to maintain good glycemic control.
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Affiliation(s)
- Rodas Getachew Abera
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
- Tikur Anbessa Specialized Hospital, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Eyouel Shimeles Demesse
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wako Dedecha Boko
- Department of Medical Laboratory Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
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Theivasigamani K, Palaniappan S. Drug Utilization Evaluation of Antidiabetic Agents in Primary Care Clinics of a South Indian Rural Province. INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH AND ALLIED SCIENCES 2022. [DOI: 10.51847/7rujh8q1hg] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Koo BK, Moon S, Moon MK. Muscle strength, an independent determinant of glycemic control in older adults with long-standing type 2 diabetes: a prospective cohort study. BMC Geriatr 2021; 21:684. [PMID: 34876063 PMCID: PMC8650318 DOI: 10.1186/s12877-021-02629-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/09/2021] [Indexed: 12/25/2022] Open
Abstract
Background Although the proportion of older patients with type 2 diabetes mellitus (T2DM) has increased, few studies have reported the factors affecting glucose levels in older patients with long-standing T2DM. This study assessed the determinants of glycemic control in older adults with T2DM of a duration of ≥10 years, including muscle mass, muscle quality, and β-cell function. Methods This was a prospective study of older patients aged ≥60 years with a T2DM duration of ≥10 years. The Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index, handgrip strength (HGS), and body composition through bioelectrical impedance analysis were assessed. The primary outcome was a composite of: (i) increment of glycated hemoglobin (HbA1c) from the baseline ≥0.6% and (ii) HbA1c ≥ 9% at any time point during the follow-up period. To find the predicting determinants of the outcome, we performed the Cox proportional hazard analysis. Results Among 100 patients (mean age, 64.0 ± 8.6 years; median duration of diabetes, 20 [interquartile range (IQR), 17–23] years; median HbA1c at baseline, 7.1 [IQR, 6.7–7.4] %), the primary outcome was observed in 40 (40.0%) patients during 4.0 (IQR 2.3–5.0) years of follow-up. A Cox proportional hazards model adjusted for age, sex, baseline HbA1c, obesity, duration of DM and anti-diabetic medication at baseline showed that low HGS and insulin resistance at the baseline were independent determinants of the primary outcome (hazard ratio [HR] = 2.23 [95% confidence interval (CI), 1.06–4.72] and 2.39 [95% CI, 1.18–4.83], respectively). Sex stratification confirmed that HGS and muscle mass were independent determinants of the primary outcome only in women (HR per quartile, 0.58 [95% CI, 0.37–0.93] and 0.46 [95% CI, 0.25–0.85], respectively). `. Conclusions Low HGS and insulin resistance were independent risk factors for aggravated glycemic control among older patients with long standing T2DM. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02629-5.
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Affiliation(s)
- Bo Kyung Koo
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.,Division of Endocrinology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Seoil Moon
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Kyong Moon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea. .,Division of Endocrinology, Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
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Verma D, Bahurupi Y, Kant R, Singh M, Aggarwal P, Saxena V. Effect of mHealth Interventions on Glycemic Control and HbA1c Improvement among Type II Diabetes Patients in Asian Population: A Systematic Review and Meta-Analysis. Indian J Endocrinol Metab 2021; 25:484-492. [PMID: 35355920 PMCID: PMC8959192 DOI: 10.4103/ijem.ijem_387_21] [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: 09/03/2021] [Revised: 12/04/2021] [Accepted: 12/10/2021] [Indexed: 11/04/2022] Open
Abstract
Introduction Due to the high prevalence of diabetes mellitus, it is pertinent to educate and inform diabetes patients about their self-management. It can be done effectively using innovative methods like mobile health (mHealth), which includes mobile applications, phone calls, and text messages. Thus, this meta-analysis was conducted to summarize the effectiveness of mHealth interventions for the management of diabetes compared with usual care in the Asian population. Materials and Methods Searches were performed in electronic databases, namely PubMed, Scopus, Embase, and Cochrane Library, in August and September 2020. Search terms used were "Diabetes Mellitus," "mHealth," "glycemic control", "HbA1c levels," and "Blood glucose levels." The primary outcome was glycated hemoglobin and blood glucose levels. Trials were pooled, and heterogeneity was quantified using the I2 statistic. Results The search yielded 3980 abstracts, of which 18 trials met the inclusion criteria. Lowering of Hba1c levels was reported in the majority of trials, which aided in Glycemic control. For post prandial blood glucose (PPBG) levels, a statistically significant reduction of value -20.13 (95%CI -35.16 to -5.10, P = 0.009, I2 = 59%) was seen in the mean in the intervention group, whereas for HbA1c levels the mean reduction in the intervention group was -0.44 (95%CI, -0.79 to 0.10, P = 0.01, I2 = 87%). Although these interventions proved beneficial for these outcomes, there was a difference in the amount of effects caused by different mHealth interventions. Conclusion This study acknowledged the effects of different mHealth interventions as per their accessibility and availability in recent years. There is a need to include more studies in future reviews to generate a larger body of evidence for the reported outcomes. The researchers should give the utmost priority to the transparency while reporting the interventions for effective interpretation of the retrieved data.
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Affiliation(s)
- Divya Verma
- School of Public Health, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Yogesh Bahurupi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Department of Internal Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Mahendra Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Pradeep Aggarwal
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Vartika Saxena
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Lim PC, Rajah R, Lee CY, Wong TY, Tan SSA, Karim SA. Systematic Review and Meta-Analysis of Diabetes Knowledge among Type 2 Diabetes Patients in Southeast Asia. Rev Diabet Stud 2021; 17:82-89. [PMID: 34852899 PMCID: PMC9380083 DOI: 10.1900/rds.2021.17.82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE Recognition of patient baseline knowledge is important in educating patients with type 2 diabetes mellitus (T2D) to manage their disease effectively. The purpose of this study is to review current evidence on the level of diabetes knowledge among T2D patients and determine factors affecting their knowledge. METHODS A systematic search of English language articles published between 1990 and June 2019 was conducted using six electronic databases. Only quantitative studies that assessed knowledge of T2D patients in Southeast Asian countries were included. Data were extracted and a meta-analysis was conducted. RESULTS A total of 6210 articles were retrieved; seven articles met the inclusion criteria, comprising 1,749 T2D patients. The calculated mean knowledge score was 55.6% (95% CI: 7.6 to 103.6). Five types of assessment tools were identified ranging from five to 41 questions that focused on disease specifics, treatment, and nutrition. Age, education level, and glycemic control were the most common factors impacting knowledge. CONCLUSIONS The level of knowledge among T2D patients in Southeast Asia was unsatisfactory, especially in older patients with low education levels and poor glycemic control. Hence, an appropriate educational plan should be prioritized to these groups.
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Affiliation(s)
| | | | - Chong Yew Lee
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Ducraux P, Waeber G, Marques-Vidal P. Do Weight trajectories influence diabetes control? A prospective study in Switzerland (CoLaus study). Prev Med Rep 2021; 23:101473. [PMID: 34258179 PMCID: PMC8259406 DOI: 10.1016/j.pmedr.2021.101473] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 04/13/2021] [Accepted: 06/23/2021] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Identify anthropometric trajectories among subjects with type 2 diabetes mellitus (T2DM), and associate them with glycaemic control. METHODS Prospective study including 268 community-dwelling participants with T2DM (34% women, mean age 68.7 ± 8.9 years) followed for 10.7 years (range: 8.8-13.6 years). T2DM control was considered for 1) fasting plasma glucose (FPG) < 7.0 mmol/L, or 2) HbA1c < 7.0% (53 nmol/mol). Changes in weight or waist and weight variability were considered. RESULTS One half (FPG) and one third (HbA1c) of participants presented with uncontrolled T2DM. Half of the participants presented with obesity and 75% with abdominal obesity. During follow-up, half of the participants maintained their weight, 25% gained > 5 kg, and 25% lost < 5 kg; almost half increased their waist by > 5 cm. Using FPG as criterion, participants who lost > 5 cm waist were more likely to be controlled: multivariable-adjusted odds ratio (OR) and 95% confidence interval (CI): 3.10 (1.23-7.78). Participants with controlled T2DM also presented with a higher weight variability: multivariable adjusted mean ± standard error 4.8 ± 0.3 vs. 3.9 ± 0.3 kg, p = 0.028. Using HbA1c as criterion, participants who lost > 5 kg were less likely to be controlled: OR and (95% CI): 0.35 (0.18-0.66). Similar findings were obtained when restricting the analysis to participants who were diabetic throughout the whole study period. CONCLUSION In a Swiss community-based sample of participants with T2DM, T2DM control rates could be implemented. Neither weight nor waist variability was significantly and consistently associated with T2DM control.
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Affiliation(s)
- Pauline Ducraux
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland
| | - Gérard Waeber
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland
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