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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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Joshi J, Patel P, Gandhi S, Patel N, Chaudhari A. Factors influencing adherence to self-care practices among patients of type 2 diabetes mellitus from Saurashtra region of Gujarat: A conclusive research. J Family Med Prim Care 2022; 11:6395-6401. [PMID: 36618213 PMCID: PMC9810919 DOI: 10.4103/jfmpc.jfmpc_473_22] [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: 02/26/2022] [Revised: 06/15/2022] [Accepted: 06/17/2022] [Indexed: 11/11/2022] Open
Abstract
Background It is commonly understood that diabetes self-care practice is critical in the management of the disease. However, the magnitude and determinants of self-care practices are not well evaluated at the community level. Methods A community based cross-sectional study was conducted among 178 type 2 DM patients. Self-care practices were evaluated for the last seven days and each item was scored from 0 (none of the days in a week) to 7 (all 7 days were followed). Results Adherence to medication (89.3%) and blood glucose monitoring (65.2%) were relatively higher than other domains. Factors associated with dietary adherence were secondary level education and above (OR = 22.1, 95% CI = 6.85 to 71.3), physician or endocrinologist treating doctors (OR = 3.36, 95% CI = 1.24 to 11.32), joint and three-generation family (OR = 3.32, 95% CI = 1.23 to 8.92) and upper and middle socioeconomic class (OR = 2.5, 95% CI = 1.1 to 6.2). Good glycemic control was significantly associated with dietary adherence (OR = 6.81, 95% CI = (2.71 to 17.16), medication adherence (OR = 4.59, 95% CI = 1.3 to 16.24) and regular exercise (OR = 3.65, 95% CI = 1.62 to 8.19). Conclusion There is need to develop structured diabetes self-care education programs with involvement of private practitioners as a majority of the patients consult private practitioners for treatment. Health educators might have to place emphasis on self-care education to patients as well as caregivers belonging to low socioeconomic class and having lower education.
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Affiliation(s)
- Jwalant Joshi
- Department of Community Medicine, Banas Medical College and Research Institute, Palanpur, Gujarat, India
| | - Punit Patel
- Department of Community Medicine, Banas Medical College and Research Institute, Palanpur, Gujarat, India
| | - Shreyashkumar Gandhi
- Department of Community Medicine, Dr. Kiran C Patel Medical College and Research Institute, Bharuch, Gujarat, India
| | - Nitesh Patel
- Department of Community Medicine, Banas Medical College and Research Institute, Palanpur, Gujarat, India
| | - Ashishkumar Chaudhari
- Department of Community Medicine, GMERS Medical College Dharpur, Patan, Gujarat, India
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Emire MS, Zewudie BT, Tarekegn TT, GebreEyesus FA, Amlak BT, Mengist ST, Terefe TF, Mewahegn AA. Self-care practice and its associated factors among diabetic patients attending public hospitals in Gurage zone southwest, Ethiopia. PLoS One 2022; 17:e0271680. [PMID: 36155496 PMCID: PMC9512188 DOI: 10.1371/journal.pone.0271680] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 07/05/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Diabetes is a chronic disease that requires lifelong medical treatment and lifestyle modifications. Even though patients often neglect their own needs, self-care is an important factor in preventing and delaying complications related to diabetes. There are limited studies about self-care practice, and most of the studies conducted in Ethiopia focused on some parts of the recommended self-care practice. Therefore, this study aimed to assess the self-care practice and associated factors among diabetic patients in Gurage zone, south Ethiopia.
Methods
An institution-based cross-sectional study was conducted from February 6 to March 29, 2021. A systematic sampling method was employed to select 420 study participants. The data were collected using a pretested interviewer-administered questionnaire. All variables with P < 0.25 in the bi-variable logistic regression analysis were entered into multivariable logistic regression analysis. The statistical significance was declared at a p-value < 0.05.
Results
A total of 384 diabetes patients participated with a response rate of 91.4%. This study showed that more than half (60.4%) of the study participants had poor self-care practices. Being female (AOR: 2.40; 95% CI:1.31–4.40), rural residence (AOR:7.16;95% CI: 3.31–15.46), duration of diabetes treatment 5–10 years (AOR: 0.03; 95% CI: 0.1–0.11), duration of diabetes treatment ≥ 10 years (AOR:0.8; 95% CI: 0.03–0.21), haven’t social support (AOR: 0.10; 95% CI: 0.05–0.23), haven’t got health education (AOR: 0.17,95%CI 0.09–0.32) were factors significantly associated with self-care practice.
Conclusions
Despite, the importance of diabetes self-care practice for the management of diabetes and preventing its complications, a high number of diabetes patients had poor self-care practices. Female, rural residence, duration of diabetes mellitus, lack of social support, and not get of health education were significantly associated with poor self-care practice. Therefore, health care providers should give attention to diabetic patients with the aforementioned factors that affect diabetic patients’ self-care practices.
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Affiliation(s)
- Mamo Solomon Emire
- Department of Nursing, Wolkite University College of Medicine and Health Science, Wolkite, Ethiopia
- * E-mail:
| | - Bitew Tefera Zewudie
- Department of Nursing, Wolkite University College of Medicine and Health Science, Wolkite, Ethiopia
| | - Tadesse Tsehay Tarekegn
- Department of Nursing, Wolkite University College of Medicine and Health Science, Wolkite, Ethiopia
| | - Fisha Alebel GebreEyesus
- Department of Nursing, Wolkite University College of Medicine and Health Science, Wolkite, Ethiopia
| | - Baye Tsegaye Amlak
- Department of Nursing, Wolkite University College of Medicine and Health Science, Wolkite, Ethiopia
| | - Shegaw Tesfa Mengist
- Department of Nursing, Wolkite University College of Medicine and Health Science, Wolkite, Ethiopia
| | - Tamene Fetene Terefe
- Department of Nursing, Wolkite University College of Medicine and Health Science, Wolkite, Ethiopia
| | - Agerie Aynalem Mewahegn
- Department of Nursing, Wolkite University College of Medicine and Health Science, Wolkite, Ethiopia
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Letta S, Aga F, Assebe Yadeta T, Geda B, Dessie Y. Self-care practices and correlates among patients with type 2 diabetes in Eastern Ethiopia: A hospital-based cross-sectional study. SAGE Open Med 2022; 10:20503121221107337. [PMID: 35784669 PMCID: PMC9244934 DOI: 10.1177/20503121221107337] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/25/2022] [Indexed: 11/15/2022] Open
Abstract
Objective: This study investigated the level and correlates of self-care practices among patients with type 2 diabetes on follow-up in two public hospitals in Harar, Eastern Ethiopia. Methods: We conducted a hospital-based cross-sectional study on adult patients with type 2 diabetes, surveying diabetes self-care practices using a 15-item Summary of Diabetes Self-Care Activities. Responses ranged from 0 to 7 days, and a composite score was computed representing the mean days of diabetes self-care practices. A generalized Poisson regression model with robust variance was used. The association between the diabetes self-care practices and correlates was examined using the incidence rate ratio with a 95% confidence level. The statistical significance was set at a p value of ⩽0.05. Results: This study included 879 patients with type 2 diabetes. The overall mean (standard deviation) diabetes self-care practices were 3.7 ± 1.1 days out of the recommended 7 days, indicating low self-care practices. After controlling for other variables, tertiary educational level (incidence rate ratio = 1.06; 95% confidence interval: 1.01, 1.12), adequate diabetes knowledge (incidence rate ratio = 1.04; 95% confidence interval: 1.00, 1.08), moderate (incidence rate ratio = 1.07; 95% confidence interval: 1.02, 1.11) and high perceived self-efficacy (incidence rate ratio = 1.14; 95% confidence interval: 1.09, 1.13) (incidence rate ratio = 1.07; 95% confidence interval: 1.02, 1.11), high to marginal food security (incidence rate ratio = 1.13; 95% confidence interval: 1.03, 1.24), and receiving dietary advice (incidence rate ratio = 1.11; 95% confidence interval: 0.06, 1.15) were positively correlated with diabetes self-care practices. A history of hospitalization, on the other hand, was found to be inversely correlated with diabetes self-care practices (incidence rate ratio = 0.94; 95% confidence interval: 0.88, 0.99). Conclusion: The study indicated that adherence of patients with type 2 diabetes to the recommended self-care practices was considerably low. Therefore, tailored diabetes self-management education to enhance self-efficacy and diabetes self-care practices must be in place. This can be achieved through the system or individual-based integrated intervention efforts.
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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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Momot SL, Agustarika B, Mustamu AC, Sari NK. HbA1c as Early Warning Complications of Kidney Failure in Type 2 Diabetes Mellitus. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Chronic kidney disease is closely related to diabetes. Basic information about the treatment and physical condition of diabetic patients should be analyzed to provide further evidence of prevention. Based on the high prevalence of diabetes mellitus (DM) among patients with renal failure, there is a great need to learn more about its prevention and management including laboratory diagnostic tests because HbA1c levels are directly proportional to blood glucose levels.
AIM: The purpose of this study was to determine the effect of HbA1c levels on creatinine levels in patients with Type 2 DM.
METHODS: This type of research is a quantitative study with a cross-sectional approach. The sample in this study was 38 DM patients who had their diagnosis confirmed using consecutive sampling techniques. According to the healthcare centre’s data, the respondent’s blood sample was taken at the respondent’s house, and the HbA1c and creatinine levels were tested in the laboratory. Data analysis using the Chi-square test.
RESULTS: The results of this study indicate that there is no relationship between HbA1c levels and the incidence of kidney failure with p = 0.588, OR 0.658.
CONCLUSION: This research showed that there was no relationship between HbA1c levels with the incidence of kidney failure.
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Macedo JCL, Soares DA, de Carvalho VCHDS, Cortes TBA, Mistro S, Kochergin CN, Rumel D, Oliveira MG. Self-Care in Patients with Non-Optimal Diabetes Management in Brazilian Rural Areas: A Mixed-Methods Study. Patient Prefer Adherence 2022; 16:1831-1842. [PMID: 35923656 PMCID: PMC9342662 DOI: 10.2147/ppa.s373302] [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: 05/04/2022] [Accepted: 07/21/2022] [Indexed: 12/03/2022] Open
Abstract
PURPOSE This study aims to assess self-care in patients with non-optimal diabetes management (HbA1c >7.0% for adults and >8.0 for those aged 60 or over) and the positive and negative experiences associated with it in the rural communities of a Brazilian municipality. PATIENT AND METHODS This is a cross-sectional mixed-methods study. The data were collected from participants with high HbA1c through focus group discussions, subsequently performing thematic analysis, and through structured questionnaires (socioeconomic characteristics and the Summary of Diabetes Self-Care Activities (SDSCA)). RESULTS The mean HbA1c of the 156 study participants was 9.94% (95% confidence interval: 9.70-10.19%) and most participants (86.54%) had negative self-care behaviors, with an overall SDSCA mean score of 3.55. This mean was not positive for any of the socioeconomic characteristics. The self-care activities with the most satisfactory performance concerned non-smoking and the use of prescribed medications, and the poorest results were observed for the practice of specific physical activities. The qualitative data indicated that the study participants face many difficulties regarding self-care practices, especially those related to an adequate diet. CONCLUSION The self-care assessment revealed unsatisfactory self-care behaviors as well as high HbA1c levels among the study participants and highlighted the various difficulties they encounter. This indicates the need for more attentive health teams to monitor patients, especially regarding actions focused on the non-pharmacological elements of self-care, such as lifestyle changes, which were found to be the dimensions with the most unsatisfactory results.
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Affiliation(s)
- Jessica Caline Lemos Macedo
- Master’s Program in Collective Health, Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil
| | - Daniela Arruda Soares
- Master’s Program in Collective Health, Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil
| | | | - Taciana Borges Andrade Cortes
- Master’s Program in Collective Health, Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil
| | - Sóstenes Mistro
- Master’s Program in Collective Health, Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil
| | | | - Davi Rumel
- Department of Community Health, School of Medicine of the Municipal University of São Caetano do Sul, São Caetano do Sul, São Paulo, Brazil
| | - Marcio Galvão Oliveira
- Master’s Program in Collective Health, Multidisciplinary Health Institute, Federal University of Bahia, Vitória da Conquista, Bahia, Brazil
- Correspondence: Marcio Galvão Oliveira, Multidisciplinary Health Institute, Federal University of Bahia, Rua Hormindo Barros, 58 - Candeias, Vitória da Conquista - BA, Vitória da Conquista, Bahia, 45029-094, Brazil, Tel +55 77 988280954, Email
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