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Khan WJ, Arsalan M, Javed Khan W. Diabetes Self-Care Activities and Their Relationship With Glycemic Control in Patients Visiting Hayatabad Medical Complex, Peshawar. Cureus 2023; 15:e42741. [PMID: 37654937 PMCID: PMC10467515 DOI: 10.7759/cureus.42741] [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: 07/31/2023] [Indexed: 09/02/2023] Open
Abstract
Background A significant portion of the Pakistani population is affected by diabetes, which has emerged as a global healthcare concern. Objective This study aimed to assess the correlation between glycemic control in diabetes patients and their engagement in diabetes self-care activities (DSCA). Methodology Cross-sectional research was conducted at Hayatabad Medical Complex in Peshawar between June 2019 and May 2020. A total of 280 carefully selected patients with type 2 diabetes mellitus (T2DM) were included. Data collection involved an interviewer-administered questionnaire encompassing sociodemographic information, diabetes-related data, and the summary of the Diabetes Self-Care Activities (SDSCA) scale. Descriptive statistics and Pearson's chi-square test were employed for data analysis. Results The study observed that the majority of participants (40.36%) were females, and the age range of the participants was between 42 and 53 years (68.22%). According to the study, 55.00% of participants had a normal body mass index (BMI), and 71.08% of participants had diabetes in their family. Regarding glycemic control, 55.71% of individuals exhibited good control based on fasting blood sugar (FBS) levels while 74.64% showed poor control according to hemoglobin A1C (HbA1c) values. HbA1c was substantially linked with a general diet (healthy eating plan), physical activities, and adherence to medication ((odds ratios (OR): 3.12), (95% confidence interval (CI): 1.02 - 8.78), (P value: 0.031)); ((OR: 2.19, 95%), (CI:1.18 - 3.79), (P value: 0.003)); ((OR: 2.85), (95% CI: 1.22 - 6.59), P value: 0.021)). Conclusion The findings indicated that health professionals need to create health education programs on DSCA in order to increase DSCA adherence in people with T2DM while maintaining glycemic control.
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Affiliation(s)
- Wagmah Javed Khan
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Muhammad Arsalan
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Wardah Javed Khan
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
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Gomes DL, da Silva ECB, Reis AL, Carvalhal MMDL, Kikuchi JLD, Uliana GC, Berino TN. Adherence to Online Nutritional Monitoring Was Associated with Better Food Habits in People with T1DM during the COVID-19 Pandemic in Brazil. Nutrients 2023; 15:2121. [PMID: 37432251 DOI: 10.3390/nu15092121] [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: 03/02/2023] [Revised: 03/27/2023] [Accepted: 03/31/2023] [Indexed: 07/12/2023] Open
Abstract
Until this moment, no research has been found that has assessed adherence to online nutritional monitoring by adults with Diabetes Mellitus Type 1 (T1DM) during the pandemic. This article aims to analyze the association between eating habits and adherence to nutritional online care by adults with T1DM during social distancing because of the COVID-19 pandemic in Brazil. A cross-sectional study was carried out in July 2020. An online form was used to collect sociodemographic data, financial status, eating habits, carrying out online nutritional monitoring, and adherence to social distancing. Pearson's chi-squared test was performed with adjusted residual analysis and binomial logistic regression analysis (p < 0.05). Out of the 472 adults, only 8.9% had consulted with a nutritionist. Doing nutritional monitoring online during social distancing was associated with a reduction in the consumption of ultra-processed foods (p = 0.021), eating more servings of fruit (p = 0.036), and doing carbohydrate counting (CC) more frequently (p = 0.000). Doing nutritional monitoring online increased adherence to carbohydrate counting by 2.57 times and increased the consumption of fruits by 0.423 times. Therefore, nutritional monitoring, even if performed remotely, can influence the acquisition and maintenance of healthier eating habits, in addition to assisting adherence to the practice of CC.
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Affiliation(s)
- Daniela Lopes Gomes
- Postgraduate Program in Neuroscience and Behavior, Behavior Theory and Research Nucleus, Federal University of Pará, Belém 66075-110, Brazil
- Faculty of Nutrition, Federal University of Pará, Belém 66075-110, Brazil
| | | | - Aline Leão Reis
- Postgraduate Program in Neuroscience and Behavior, Behavior Theory and Research Nucleus, Federal University of Pará, Belém 66075-110, Brazil
- Faculty of Nutrition, Federal University of Pará, Belém 66075-110, Brazil
| | | | - Jeane Lorena Dias Kikuchi
- Postgraduate Program in Neuroscience and Behavior, Behavior Theory and Research Nucleus, Federal University of Pará, Belém 66075-110, Brazil
| | - Gabriela Correia Uliana
- Postgraduate Program in Neuroscience and Behavior, Behavior Theory and Research Nucleus, Federal University of Pará, Belém 66075-110, Brazil
| | - Talita Nogueira Berino
- Postgraduate Program in Neuroscience and Behavior, Behavior Theory and Research Nucleus, Federal University of Pará, Belém 66075-110, Brazil
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Pitayarangsarit S, Bhagaman N, Yodmai K, Thangsirikul N, Tipayamongkholgul M. The resiliency of noncommunicable diseases services during the public health crisis: a lesson from Bangkok, Thailand. BMC Health Serv Res 2023; 23:409. [PMID: 37101168 PMCID: PMC10132400 DOI: 10.1186/s12913-023-09400-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 04/13/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND The healthcare services for non-communicable diseases (NCD) are commonly affected by public health crises like the COVID-19 pandemic. During the pandemic, all healthcare facilities in Bangkok had been overwhelmed by the extreme caseload of COVID-19. Health service resiliency is crucial for the continued service of healthcare facilities post pandemic. This study aims to explore the impacts of COVID-19 on NCD service disruption and addressed the resilience of healthcare services at the operational level. METHODS Healthcare facility-based surveys and in-depth interviews were conducted among representatives of the facilities in Bangkok from April 2021 to July 2021. The web-based, self-administered questionnaire, was sent to directors or authorities of all healthcare facilities in Bangkok Thailand (n = 169). Two healthcare facilities from three levels of health services were purposively selected. The directors or medical doctors and nurses who are in charge of the NCD service, and working at the six selected health facilities, were invited to participate in the in-depth interviews. Descriptive statistics were used to analyze the survey data, and thematic analysis was used to analyze the data from the in-depth interviews. RESULTS The impact of COVID-19 on NCD service disruption in the second wave (2021) was more severe than in the first wave (2020). The main reasons for NCD service disruptions are insufficient staff, and the closure of some services offered by the healthcare facilities. Surprisingly, both the budget and medical supply for healthcare facilities in Bangkok are less affected by the COVID-19 pandemic. Our study revealed resilience capability i.e. absorptive, adaptive, and transformative capabilityamong the healthcare facilities that provide a continuum of care by increasing availability and accessibility to healthcare services for chronic illness as DM. The service disruption in Bangkok may alter from other provinces because of variations in COVID-19 incidence and health services contexts. CONCLUSION During the public health crisis, using affordable and common digital technologies to ensure DM patients can access a continuum of care and providing alternative services such as mobile medical laboratories, medication delivery, and medical refill at drug stores can increase consistent monitoring of glycemic levels and use of prescribed medication.
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Affiliation(s)
- Siriwan Pitayarangsarit
- Division of Non-communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
- International Health Policy Program, Ministry of Public Health, Nonthaburi, Thailand
| | - Nanapas Bhagaman
- Department of Epidemiology, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Korravarn Yodmai
- Department of Family Health, Faculty of Public Health, Korravarn Yodmai, Mahidol University, 420/1 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand
| | - Nattaya Thangsirikul
- Division of Non-communicable Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Mathuros Tipayamongkholgul
- Department of Epidemiology, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road, Ratchathewi, Bangkok, 10400, Thailand.
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Olesen K, Joensen LE, Madsen KP, Willaing I. How has the COVID-19 Pandemic Affected Diabetes Self-Management in People With Diabetes? - A One-Year Follow-Up Study. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:867025. [PMID: 36992738 PMCID: PMC10012120 DOI: 10.3389/fcdhc.2022.867025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 06/10/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND AND AIM In Denmark, the COVID-19 pandemic resulted in two lockdowns, one from March to May 2020 and another from December 2020 to April 2021, which had severe impact on everyday life. The aim of this study was to explore changes in diabetes self-management behaviors during the pandemic and to examine how specific population characteristics were associated with changes in diabetes management. METHODS AND PARTICIPANTS In a cohort study from March 2020 to April 2021, two online questionnaires were collected from a total of 760 people with diabetes. Descriptive statistics were used to assess the proportion of participants experiencing improvements, deterioration, and status quo in diabetes self-management during the pandemic. Using logistic regressions, baseline characteristics were explored as potential predictors of change. RESULTS Approximately half of the participants reported that they experienced lower physical activity in April 2021 compared to before the pandemic, approximately one fifth reported diabetes self-management to be more difficult than prior to the pandemic, and one fifth reported eating more unhealthily than before the pandemic. Some participants reported higher frequency of high blood glucose levels (28%), low blood glucose levels (13%) and more frequent blood glucose variability (33%) compared to before. Easier diabetes self-management was reported by relatively few participants, however, 15% reported eating more healthily, and 20% reported being more physically active. We were largely unable to identify predictors of change in exercise activities. The few baseline characteristics identified as predictors of difficulties in diabetes self-management and adverse blood glucose levels due to the pandemic were sub-optimal psychological health, including high diabetes distress levels. CONCLUSION Findings indicate that many people with diabetes changed diabetes self-management behaviors during the pandemic, mostly in a negative direction. Particularly high diabetes distress levels in the beginning of the pandemic was a predictor of both positive and negative change in diabetes self-management, indicating that people with high diabetes distress levels could potentially benefit from increased support in diabetes care during a period of crisis.
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Affiliation(s)
- Kasper Olesen
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Lene Eide Joensen
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Kristoffer Panduro Madsen
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Ingrid Willaing
- Health Promotion Research, Copenhagen University Hospital – Steno Diabetes Center Copenhagen, Herlev, Denmark
- Section of Health Services Research, Department of Public Health, Copenhagen University, Copenhagen, Denmark
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Nouhjah S, Shahbazian H, Ghodrati N. Changes in self-care behaviors of Iranian patients with type 2 diabetes using insulin pens during COVID-19 pandemic. OBESITY MEDICINE 2022; 33:100418. [PMID: 35664969 PMCID: PMC9142209 DOI: 10.1016/j.obmed.2022.100418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 04/10/2022] [Accepted: 04/26/2022] [Indexed: 11/29/2022]
Abstract
Aims The COVID-19 pandemic as a serious public health concern has been accompanied with changes and restrictions in everyday life. This can affect directly or indirectly health behaviors and disease management, particularly in developing countries with low resources. This study aimed to compare self-care behaviors of patients with type 2 diabetes using insulin pens before and after the COVID-19 pandemic. Methods This was a prospective cohort study involving 300 patients with type 2 diabetes who had been referred to a referral tertiary care diabetes clinic during 2018–2019. The Summary of Diabetes Self-Care Activities Assessment (SDSCA) questionnaire was used for the evaluation of 5 self-care activities. Results The mean total self-care score before and one year after the onset of the COVID-19 crisis was 37.63 (SD, 10.89) and 26.14 (SD, 10.99), respectively. Before the COVID-19 crisis, 27%, 54.3%, and 18.7% of patients had poor, moderate, and good self-care, respectively. One year after the onset of the epidemic, however, these rates were 66.3%, 29%, and 4.7%, respectively. There was a significant difference between the mean score of 5 indices of self-care behaviors before and after the COVID-19 crisis (p < 0.01). Conclusion Our findings suggest the deterioration of self-care behaviors amidst the COVID-19 pandemic in an Iranian population. Continuous follow-up of patients with diabetes and the design of effective educational programs for these patient can prevent or delay the long-term consequences of diabetes, especially in the context of the COVID-19 crisis.
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Cummings C, Seng K, Tweet R, Wagner J. Lifestyles Under Lockdown: A Scoping Review of International Studies on Type 2 Diabetes Self-Management Behaviors During COVID-19. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2022; 3:830353. [PMID: 36992763 PMCID: PMC10012117 DOI: 10.3389/fcdhc.2022.830353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022]
Abstract
BackgroundThe effect of the COVID-19 pandemic on diabetes self-management behaviors is unclear.ObjectivesThis paper is a scoping review of studies examining health behaviors among people with type 2 diabetes during the COVID-19 pandemic.Eligibility CriteriaWe searched articles available in English using the Search terms “COVID” and “diabetes”, and, separately, each of the following terms: “lifestyle”, “health behavior”, “self-care”, “self-management”, “adherence”, “compliance”, “eating”, “diet”, “physical activity”, “exercise”, “sleep”, “self-monitoring of blood glucose”, or “continuous glucose monitoring”.Sources of EvidenceWe searched PubMed, PsychInfo, and Google Scholar databases from December 2019 through August 2021.Charting MethodsData were extracted by 4 calibrated reviewers and study elements were charted.ResultsThe search identified 1,710 articles. After screening for relevance and eligibility, 24 articles were included in this review. Findings show the strongest evidence for reduced physical activity and stable glucose monitoring and substance use. There was equivocal evidence for deleterious changes in sleep, diet, and medication intake. With one minor exception, there was no evidence for favorable changes in health behaviors. Limitations of the literature include small samples, predominantly cross-sectional study designs, reliance on retrospective self-reports, sampling through social media, and few standardized measures.ConclusionsEarly studies of health behaviors among people with type 2 diabetes during the COVID-19 pandemic suggest a need for novel interventions to support diabetes self-management, especially targeting physical activity. Future studies should go beyond documenting changes in health behaviors and examine predictors of change over time.
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Affiliation(s)
- Caroline Cummings
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, United States
| | - Kagnica Seng
- Department of Psychological Sciences, Central Connecticut State University, New Britain, CT, United States
| | - Ryan Tweet
- Division of Endocrinology, Diabetes and Clinical Nutrition, Oregon Health & Science University, School of Medicine, Portland, OR, United States
| | - Julie Wagner
- Division of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine and Department of Psychiatry, School of Medicine, Farmington, CT, United States
- *Correspondence: Julie Wagner,
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