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Wondm SA, Zeleke TK, Dagnew SB, Moges TA, Tarekegn GY, Belachew EA, Tamene FB. Association between self-care activities and glycemic control among patients with type 2 diabetes mellitus in Northwest Ethiopia general hospitals : a multicenter cross-sectional study. Sci Rep 2024; 14:23198. [PMID: 39369010 DOI: 10.1038/s41598-024-72981-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Accepted: 09/12/2024] [Indexed: 10/07/2024] Open
Abstract
Diabetes self-care activities are essential for achieving optimal glycemic control. However, little investigation has been conducted in Ethiopia to evaluate the relationship between the rate glycemic controland self-care activities among patients with type 2 diabetes mellitus (T2DM). Therefore, this study was conducted to assess self -care activities and their association with glycemic control among patients with T2DM in Northwest Ethiopia general hospitals. This multicenter cross-sectional study was conducted in Northwest Ethiopia general hospitals diabetic clinics. Diabetes self-care activities were measured using the Amharic version of the Summary of Diabetes Self-Care Activities (SDSCA-Amharic). Glycated hemoglobin (HbA1c) were used to assess the rate of glycemic control. A linear regression model was used to identify predictors of self-care activities and glycemic control. P-value of < 0.05 at 95% confidence interval (CI) was considerd as statistically significant. Of 413 participants included in the final analysis, two-thirds (66.3%) had poor glycemic control, with a mean HbA1c of 7.94% (SD = 1.75). Blood glucose testing was the most important self-care activity domain for predicting better glycemic control [β=-0.36, 95% CI (-0.48, -0.24); P = 0.0001] followed by diet [β=-0.29, 95% CI (-0.39, -0.083); P = 0.0001], foot-care [β=-0.28, 95% CI (-0.3, -0.061); P = 0.003], and physical activity [β=-0.27, 95% CI (-0.29, -0.056); P = 0.004], respectively. Moreover, unable to read and write [β = 0.72, 95% CI (0.57, 3.8); P = 0.037], overweight [β = 0.32, 95% CI (0.011, 0.62); P = 0.042], obesity [β = 0.67, 95% CI (0.39, 0.94); P = 0.0001], and low level of medication adherence [β = 0.7, 95% CI (0.39, 1.1); P = 0.0001] were significant predictors of poor glycemic control. Previous diabetes education [β=-0.88, 95% CI (-1.2, -0.57); P=0.0001] was a significant predictor of good glycemic control. The prevalence of poor glycemic control and poor self-care activities were high among patients with T2DM. Self-care activities were independent predictors of glycemic control among patients with T2DM. Therefore, management interventions for patients with T2DM should focus on improving self-care activities and other predictor variables.
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Affiliation(s)
- Samuel Agegnew Wondm
- Department of Pharmacy, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
| | - Tirsit Ketsela Zeleke
- Department of Pharmacy, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Samuel Berihun Dagnew
- Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tilaye Arega Moges
- Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | | | - Eyayaw Ashete Belachew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fasil Bayafers Tamene
- Department of Pharmacy, College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
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Mkumbi GG, Boaz M. Prevalence of poor glycemic control and the monitoring utility of glycated albumin among diabetic patients attending clinic in tertiary hospitals in Dodoma, Tanzania: A cross-sectional study protocol. PLoS One 2024; 19:e0289388. [PMID: 39231139 PMCID: PMC11373853 DOI: 10.1371/journal.pone.0289388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 06/16/2024] [Indexed: 09/06/2024] Open
Abstract
The burden of diabetes is rising in developing countries, and this is significantly linked to the increasing prevalence of poor glycemic control. The cost of glycated haemoglobin (HbA1c) testing is a barrier to timely glycemic assessments, but newer tests such as glycated albumin may be cheaper and tempting alternatives. Additional research must ascertain if glycated albumin (GA) can act as a viable supplement or alternative to conventional HbA1c measurements for glycemic control in diabetic individuals. GA as a biomarker is an emerging area of interest, particularly for those who display unreliable HbA1c levels or cannot afford the test. This study aims to investigate the prevalence of poor glycemic control in outpatient diabetic patients and the utility of glycated albumin in this population's monitoring of glycemic control. Method. A cross-sectional study of 203 diabetic patients will be conducted at the Dodoma Regional Referral Hospital and Benjamin Mkapa Hospital from August 1st, 2023, to August 31st, 2024. Patients diagnosed with diabetes mellitus for over six months will be screened for eligibility. Informed consent, history, clinical examination, and voluntary blood sample collection will be obtained from all eligible patients. Glycated Albumin levels will be obtained from the same blood samples collected. The glycemic status of all patients will be defined as per HbA1c, and a level of greater than 7% will considered as a poor control. The analysis will be computed with SPSS version 28.0, and a predictor variable, P<0.05, will be regarded as statistically significant, with the utility of GA determined by plotting the area under the ROC curve and the confusion matrix.
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Affiliation(s)
- George Gabriel Mkumbi
- Department of Internal Medicine, School of Medicine and Dentistry, The University of Dodoma, Dodoma, Tanzania
- Department of Internal Medicine, Benjamin Mkapa Hospital, Dodoma, Tanzania
| | - Matobogolo Boaz
- Department of Internal Medicine, School of Medicine and Dentistry, The University of Dodoma, Dodoma, Tanzania
- Department of Internal Medicine, Benjamin Mkapa Hospital, Dodoma, Tanzania
- Department of Internal Medicine, University of Dodoma Hospital, Dodoma, Tanzania
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Muchunguzi AH, Kimaro E, Konje ET, Kidenya BR, Mori AT, Kaale E. Factors associated with glycaemic control and diabetes complications in patients at Bugando Medical Centre, Mwanza, Tanzania: A cross-sectional study design. PLoS One 2024; 19:e0308659. [PMID: 39213431 PMCID: PMC11364410 DOI: 10.1371/journal.pone.0308659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Accepted: 07/28/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Glycaemic control is essential for improving the quality of life in patients with Diabetes Mellitus (DM). Untreated hyperglycaemia can result in numerous severe and life-threatening complications, such as damage to the eyes, kidneys, nerves, heart, and peripheral vascular system. Appropriate glycaemic control and management is fundamental to prevent and delay diabetes complications. Therefore, this study aims to assess the prevalence of poor glycaemic control, its associated factors, and the prevalence of diabetes-related complications among DM patients. METHODS A cross-sectional study was conducted among 340 DM patients treated at Bugando Medical Center from 4th - 30th April 2023 to determine the prevalence of poor glycaemic control and its predictors. Secondary data from 7952 DM patients treated between April 2022 and 30th May 2023 were used to determine DM-related complications. STATA 15 version …was used for analysis. RESULTS Out of 340 patients, 66.4% had poor glycaemic control with HbA1c or Random Blood Glucose greater than 7% or 7mmol/L, respectively. Older age, duration of DM of more than 10 years, insulin therapy, and those unaware of glycaemic target goals were factors associated with poor glycaemic control. (AOR: 2.46, 95% CI: 1.28-6.01, P = 0.03), (AOR: 3.15, 95% CI: 2.22-6.55, P = 0.016), (AOR: 3.07, 95% CI: 2.10-6.12, P = 0.022) and (AOR: 3.42, 95% CI: 2.17-5.97, P = 0.001), respectively. Of the 7952 patient records reviewed indicated that 44.5% had complications, of which 25.8% had neurological complications and 55.3% had multiple complications. CONCLUSION Two-third of DM patients failed to achieve good glycaemic control and about half of the patient's records reviewed indicated they developed diabetic complications. Thus appropriate interventions are necessary to improve glycaemic control and prevent or control complications among DM patients.
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Affiliation(s)
- Aneth H. Muchunguzi
- Department of Pharmaceutics, School of Pharmacy, Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania
| | - Emmanuel Kimaro
- Department of Pharmaceutics, School of Pharmacy, Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania
| | - Eveline T. Konje
- Department of Biostatistics and Epidemiology, School of Public Health, Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania
| | - Benson R. Kidenya
- Department of Biochemistry, School of Medicine, Catholic University of Health and Allied Sciences (CUHAS), Mwanza, Tanzania
| | - Amani T. Mori
- Department of Global Public Health and Primary Care, Section for Ethics and Health Economics, University of Bergen, Bergen, Norway
| | - Eliangiringa Kaale
- Pharm R&D Laboratory, School of Pharmacy, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
- Department of Medicinal Chemistry, Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
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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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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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Mengstie MA, Abebe EC, Dejenie TA, Seid MA, Teshome AA. Frequency and correlates of poor glycemic control in patients with type 2 diabetes at Jimma Medical Centre, Ethiopia: a cross-sectional study. Pan Afr Med J 2024; 47:7. [PMID: 38371649 PMCID: PMC10870164 DOI: 10.11604/pamj.2024.47.7.37452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/01/2022] [Indexed: 02/20/2024] Open
Abstract
Introduction the majority of studies in Ethiopia determine the prevalence of glycemic control employed by fasting blood sugar (FBS), which is impacted by a variety of factors. Hence, the purpose of this study was to assess the status of glycemic control using HbA1c and its correlates in patients with type 2 diabetes in Southwest Ethiopia. Methods a cross-sectional study was employed among 124 T2 diabetes mellitus (DM) patients at Jimma Medical Center (JMC), Southwest Ethiopia. HbA1c and FBS were estimated using the Cobas 6000 analyzer. The body mass index (BMI) and waist-to-hip ratio were calculated as the standard formula. Data were analyzed by SPSS version 25. Logistic regression analysis was employed to identify independent risk factors associated with poor glycemic control of DM patients. Results males comprised 63.7% (n=79) of the total respondents. The mean age of aOR: 2.21, 95% CI 1.13, 4.34; p = 0.01f participants was 51.84 ± 11.6 years; 60.5% (n=75) of T2 DM patients were in poor glycemic control (HbA1c ≥ 7%). In multivariate logistic regression analysis, BMI of ≥ 30, (aOR: 2.21, 95% CI 1.13, 4.34) increased waist-to-hip ratio (aOR: 1.63, 95% CI 0.82, 2.18), high systolic blood pressure (aOR: 1.52, 95% CI 1.11, 6.23), high FBS (aOR: 1.61, 95% CI 1.00, 4.12), and longer duration of DM (aOR: 1.23, 95% CI 0.87, 1.88) were associated with poor glycemic control. Conclusion the level of poor glycemic control in the study population is high. Obesity and/or overweight, central obesity, systolic hypertension, and fasting blood sugar levels were all associated with poor glycemic control in T2 DM patients.
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Affiliation(s)
- Misganaw Asmamaw Mengstie
- Department of Biochemistry, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Endeshaw Chekol Abebe
- Department of Biochemistry, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tadesse Asmamaw Dejenie
- Department of Biochemistry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Abdu Seid
- Department of Physiology, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Assefa Agegnehu Teshome
- Department of Anatomy, College of Medicine and Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Adebabay AA, Worede AG, Sume BW, Mihiret GT, Shimelash RA, Goshu BT. Prevalence and associated factors of foot deformity among adult diabetic patients on follow-up at Debre Markos comprehensive specialized hospital, Northwest Ethiopia, 2022, cross-sectional study. BMC Endocr Disord 2023; 23:265. [PMID: 38037014 PMCID: PMC10687907 DOI: 10.1186/s12902-023-01519-8] [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: 03/15/2023] [Accepted: 11/22/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Diabetes foot deformity is among the major causes of diabetic foot ulceration, resulting in lower limb amputation. However, the study on the distribution of foot deformity and its risk factor among diabetic patients in Ethiopia is limited. This study determined the overall prevalence and associated factors of foot deformity among adult diabetic patients on follow-up at Debre Markos Comprehensive Specialized Hospital, Northwest Ethiopia. METHODS Hospital-based cross-sectional study was conducted among 392 diabetic patients using a systematic random sampling technique at Debre Markos Comprehensive Specialized Hospital. Data were collected by pre-tested, semi-structured questionnaires and diabetic foot assessment format. Multivariable binary logistic regression was used to determine the association between dependent and independent variables. Adjusted odds ratios (AOR) with their 95% confidence interval (CI) were used to determine the strength of the association, and a variable with a p-value < 0.05 was statistically significant factors of diabetes foot deformity. RESULT The overall prevalence of foot deformity was 33.4% [95% CI: 28.9-38.3]. In the final logistic regression analysis, rural residency [AOR = 2.64, 95% CI: 1.31, 5.31], poor glycemic control [AOR = 2.41; 95% CI: 1.34, 4.33], diabetes duration ≥ 10 years [AOR = 2.74; 95% CI: 1.50, 5.02], inadequate footwear [AOR = 2.11; 95% CI: 1.17, 3.82] and presence of peripheral neuropathy [AOR = 8.21; 95% CI: 4.54, 14.84] were statistically significant associated factors with diabetes foot deformity. CONCLUSION The prevalence of foot deformity among adult diabetic patients was high. It is recommended to incorporate foot deformity screening in routine diabetic patient follow-ups especially for those with poor glycaemic control, rural residency, long diabetes duration, inadequate footwear, and diabetic peripheral neuropathy.
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Affiliation(s)
- Aderajew Agmass Adebabay
- Department of Biomedical science, School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
| | - Amanuel Girma Worede
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Bickes Wube Sume
- Department of Biomedical science, School of Medicine, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Getachew Tilaye Mihiret
- Department of Midwifery, Medicine and College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Rahel Asres Shimelash
- Department of pediatric Nursing, Medicine and College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Bahiru Tenaw Goshu
- Department of Human Anatomy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Yeheyis T, Hoyiso D, Ekubazgi KW, Chura GK, Alemayehu Y. The Pattern of Initial Presentation of Diabetes, Treatment Outcome and Its Predictors Among Diabetic Pediatrics Attended Service at Selected Public Hospitals of Southern Ethiopia: A Multi-Center Study. Risk Manag Healthc Policy 2023; 16:2485-2495. [PMID: 38024493 PMCID: PMC10676097 DOI: 10.2147/rmhp.s437361] [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: 09/20/2023] [Accepted: 11/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background Diabetes mellitus is the most common metabolic disorder in the pediatric population. Globally the incidence of diabetes increased from 11.3 million (95% UI 10.6-12.1) in 1990 to 22.9 million (21.1-25.4) in 2017, with a 102.9% increase and there was a 3% increase in diabetes mortality rates by age between 2000 and 2019. Objective This study aims to assess the pattern of initial presentation of pediatric diabetes mellitus, treatment outcome, and its predictors among pediatrics who attended service at selected public hospitals in southern Ethiopia from 2015 to 2019. Methods A cross-sectional study was conducted among 422 randomly selected pediatrics from October 1st, 2021 to December 30, 2021, and participants were selected randomly from 8 randomly selected public hospitals in southern Ethiopia after proportional to client flow allocation of samples. Data was extracted from clients' charts using a data extraction checklist. Statistical Package for Social Sciences (SPSS) version 24, and logistic regression analysis were applied to determine the presence of an association between dependent and independent variables, and significance was declared at p-value <0.05. Results In this study, most (74.6%) of the pediatrics initially presented with Diabetic ketoacidosis (DKA). This study found that Two-thirds (67.1%) of the respondents in the study had a good treatment outcome. In this study residence, presenting signs and symptoms; poly symptoms and weight loss, history of hospitalization, and comorbidity were predictors of treatment outcome of pediatric diabetes mellitus. Conclusion Diabetes mellitus with Diabetic ketoacidosis is the predominant pattern of initial presentation in the study. The magnitude of poor treatment outcomes of diabetes mellitus among pediatrics in this study is high and unacceptable Residence, signs, and symptoms at initial presentation, history of hospitalization, and comorbidity were found to be significant independent predictors of treatment outcome of pediatric diabetes mellitus.
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Affiliation(s)
- Tomas Yeheyis
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Dawit Hoyiso
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Kinfe Woldu Ekubazgi
- School of medicine, College of Medicine and health sciences, Hawassa University, Hawassa, Ethiopia
| | - Gemechu Kediro Chura
- Department of Nursing, College of medicine and health sciences, Meda Welabu University, Shashemene, Ethiopia
| | - Yonas Alemayehu
- School of Nursing, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
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Liu Z, Zhang X, Wang J, Shen L, Tang E. Evaluation of coupling coordination development between digital economy and green finance: Evidence from 30 provinces in China. PLoS One 2023; 18:e0291936. [PMID: 37831729 PMCID: PMC10575532 DOI: 10.1371/journal.pone.0291936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 09/10/2023] [Indexed: 10/15/2023] Open
Abstract
The convergence of China's digital economy and green finance holds great significance for fostering a sustainable and high-quality developmental path. However, existing studies have not explored the coupling coordination development between these two crucial subsystems. To bridge this gap, this paper employs a modified coupling coordination degree (CCD) model to assess and affirm the coupling coordination degree between the digital economy and green finance across 30 provinces in China from 2015-2021. Based on degree results, provinces are classified into three clusters by using K-means and hierarchical clustering algorithm. Our findings unveil that the current level of coupling coordination development in China is at a primary coordination stage. Although regional disparities significantly exist, the overall level of coordination remains steadily increasing, with the eastern region outperforming the western region. Additionally, we determine that the COVID-19 pandemic's disruption on the coupling coordination development of these systems has been limited. This research sheds light on the evolution of coupling systems and offers practical recommendations for strengthening the coordinated development of the digital economy and green finance.
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Affiliation(s)
- Zebin Liu
- School of Finance and Mathematics, Huainan Normal University, Huainan, Anhui Province, China
| | - Xiaoheng Zhang
- School of Economics and Management, Anhui University of Science & Technology, Huainan, Anhui Province, China
| | - Jingjing Wang
- School of Finance and Mathematics, Huainan Normal University, Huainan, Anhui Province, China
| | - Lei Shen
- School of Finance and Mathematics, Huainan Normal University, Huainan, Anhui Province, China
| | - Enlin Tang
- School of Finance and Mathematics, Huainan Normal University, Huainan, Anhui Province, China
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Solomon M, Shiferaw BZ, Tarekegn TT, GebreEyesus FA, Mengist ST, Mammo M, Mewahegn AA, Mengiste BT, Terefe TF. Prevalence and Associated Factors of Hypertension Among Adults in Gurage Zone, Southwest Ethiopia, 2022. SAGE Open Nurs 2023; 9:23779608231153473. [PMID: 36761364 PMCID: PMC9903024 DOI: 10.1177/23779608231153473] [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: 07/30/2022] [Revised: 12/05/2022] [Accepted: 01/08/2023] [Indexed: 02/08/2023] Open
Abstract
Introduction Hypertension affects over a billion people worldwide, making it a major public health problem. The problem is significant in both developed and developing countries. However, studies are scarce in developing countries such as Ethiopia. Objectives This study aimed to assess the prevalence of hypertension and its associated factors at the community level, in South Ethiopia. Methods A cross-sectional study design was employed on a sample of 680 participants in the study from April 1 to June 30, 2022. An interview administer was conducted using a standardized and pretested questionnaire was employed. The Epi data 3.1 versions were used to enter data and then exported into SPSS version 23 for analysis. All variables in the multivariable logistic analysis were a candidate with a bi-variable at p < .25. The multivariable logistic regressions were performed to determine the predictors of hypertension, and the significance level was established with p < .05. Results There were a total of 635 participants and the response rate was 93.4%. The prevalence of hypertension was found to be 22.0% [95% CI; 19.1-25.4]. The mean age of the participants was 40.8 ± 12.88 years. Being older age (AOR: 1.95; 95%CI; 1.13-3.36), family history [AOR: 2.65, 95%; CI (1.29-5.45)], eating animal fat [AOR: 0.21, 95%; CI (0.08-0.52)], smoking cigarettes [AOR: 4.06, 95%; CI (2.24-7.36)] and had poor knowledge about hypertension [AOR: 2.69, 95%; CI (1.61-4.49)] were significantly associated with raised blood pressure. Conclusions Hypertension was prevalent in one out of every five study participants. Older age, family history of hypertension, animal fat intake, cigarette smoking, and lack of knowledge were found to be significant factors for hypertension. To address the burden of hypertension, health care practitioners should provide broad health education, routine screening, and promotion of recommended lifestyle measures.
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Affiliation(s)
- Mamo Solomon
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia,Mamo Solomon, Department of Nursing, College of Medicine and Health Sciences, Wolkite University, P O Box 07, Wolkite, Ethiopia.
| | - Bisrat Zeleke Shiferaw
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia
| | - Tadesse Tsehay Tarekegn
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia
| | - Fisha Alebel GebreEyesus
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia
| | - Shegaw Tesfa Mengist
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia
| | - Mitiku Mammo
- Department of Biomedical Science, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia
| | - Agerie Aynalem Mewahegn
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia
| | | | - Tamene Fetene Terefe
- Department of Nursing, College of Medicine and Health Sciences, Wolkite University, Welkite, Ethiopia
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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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Iregbu S, Spiers J, Duggleby W, Salami B, Schick-Makaroff K. Nigerian Health Care Providers and Diabetes Self-Management Support: Their Perspectives and Practices. QUALITATIVE HEALTH RESEARCH 2023; 33:92-105. [PMID: 36519805 PMCID: PMC9827480 DOI: 10.1177/10497323221143889] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Nigeria struggles to reframe its traditional acute-care disease approach to health care to accommodate rising needs for chronic disease care. This interpretive descriptive study explored Nigerian healthcare providers' (HCPs) perspectives, experiences, and practices related to self-management support (SMS). Observational and experiential data were gathered from 19 HCPs at two urban hospitals in Southeastern Nigeria (seven physicians, four nurses, five dietitians/nutritionists, and three health educators). There were four themes: (a) compliance-oriented medical model, (b) SMS as advice, informal counseling, and education, (c) navigating the sociocultural terrain, and (d) workarounds. Nigerian HCPs perspectives and SMS practices were characterized by attempts to foster compliance with healthcare instructions within a traditional biomedical model. Participants enhanced patient support using specific strategies to bypass structural system obstacles. These findings demonstrate the need to reevaluate the current understanding of SMS in Nigeria and its practice.
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Affiliation(s)
- Sandra Iregbu
- Faculty of Nursing,
University
of Alberta, Ave Edmonton, AB,
Canada
| | - Jude Spiers
- Faculty of Nursing,
University
of Alberta, Ave Edmonton, AB,
Canada
| | - Wendy Duggleby
- Faculty of Nursing,
University
of Alberta, Ave Edmonton, AB,
Canada
| | - Bukola Salami
- Faculty of Nursing,
University
of Alberta, Ave Edmonton, AB,
Canada
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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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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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15
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Awang H, Muda R, Rusli N, Abd Rahman MA, Embong K. Epidemiology of Poor Glycaemic Control among Patients with Type 2 Diabetes Mellitus in Terengganu State of Malaysia. EUROPEAN JOURNAL OF MEDICAL AND HEALTH SCIENCES 2022; 4:89-94. [DOI: 10.24018/ejmed.2022.4.5.1499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
Background: Type 2 diabetes mellitus (T2DM) is among the most common non-communicable diseases worldwide and Malaysia. Poor glycaemic control among T2DM patients lead to serious life-long complications. Therefore, it is imperative to study the prevalence of poor glycaemic control and its risk factors to facilitate public health physicians and clinicians in developing the best strategies to optimize glycaemic control among T2DM patients.
Materials and Methods: A comparative cross-sectional study between groups of good glycaemic control and poor glycaemic control was conducted among type 2 diabetes mellitus (T2DM) patients who fulfilled study criteria in Terengganu state of Malaysia. Eligible samples in the National Diabetes Registry registered from 1st January 2021 until 31st December 2021 were included into the study. Descriptive statistics, simple and multiple logistic regressions were employed for data analysis.
Result: A total of 17,165 samples were recruited in the descriptive part of the study. The prevalence of patients with poor glycaemic control in Terengganu state was 65.3% (95% CI: 0.62, 0.67). In the inferential part of the study, a total 3,700 samples were randomly selected. Multivariable analysis using multiple logistic regression revealed age, duration of diabetes, body mass index, cigarette smoking, presence of retinopathy and presence of hypertension were the significant factors associated with poor glycaemic control among T2DM patients in Terengganu state with an adjusted odds ratio (AOR) of 0.95 (95%CI:0.94, 0.96); p<0.001), AOR 1.15 (95%CI:1.13, 1.17; p<0.001), AOR 1.03 (95%CI:1.01, 1.04; p<0.001), AOR 1.45 (95%CI:1.01, 2.10; p=0.047), AOR 1.32 (95%CI:1.01, 1.73; p=0.043) and AOR 1.39 (95%CI:1.16, 1.67; p<0.001) respectively.
Conclusion: Strategies focusing on the identified risk factors may improve diabetes mellitus management and avert life-long diabetic complications.
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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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Sendekie AK, Belachew EA, Dagnew EM, Netere AK. Rate of glycaemic control and associated factors in patients with type 2 diabetes mellitus treated with insulin-based therapy at selected hospitals in Northwest Ethiopia: a multicentre cross-sectional study. BMJ Open 2022; 12:e065250. [PMID: 36691186 PMCID: PMC9454077 DOI: 10.1136/bmjopen-2022-065250] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 08/16/2022] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVES This study was aimed to determine the level of glycaemic control and associated factors in patients with type 2 diabetes mellitus (T2DM) treated with insulin-based therapy. DESIGNS Institutional-based multicentre cross-sectional study design was employed to conduct this study. SETTINGS The diabetes follow-up clinics of selected hospitals in Northwest Ethiopia. PARTICIPANTS Adult patients with T2DM treated with insulin-based therapy at the selected hospitals who met the eligibility criteria were the study participants. MAIN OUTCOME MEASURES Good glycaemic control; when fasting blood glucose (FBG) level ranged from 70 to 130 mg/dL, and FBG <70 and >130 mg/dL was considered poor glycaemic control. A logistic regression model was used to identify determinants of poor glycaemic control. A p<0.05 at 95% CI was statistically significant. RESULTS Of 403 study participants, 54.8% were males with a mean age of 55.03±10.8 years. Though patients with T2DM were treated with insulin-based therapy, most of the participants (72.5%) could not achieve the target FBG. The overall mean FBG was 177.1±54.3, and far from the target glucose level. Patients who could not practise self-monitoring of blood glucose were found more likely to have poor glycaemic control compared with those who practised self-monitoring (p<0.001). Whereas patients who had a normal body mass index (p=0.011) and who were treated with premixed insulin-based therapy (p=0.04) were found less likely to have poor glycaemic control compared with patients with obesity and who received NPH insulin based-regimens, respectively. CONCLUSION This study demonstrated that a significant proportion of the study samples could not achieve glycaemic targets and the average blood glucose was far higher than the recommended glycaemic target level. Insulin initiation and titration, considering the determinants of glycaemic control, could be recommended to achieve target glycaemic levels.
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Affiliation(s)
- Ashenafi Kibret Sendekie
- Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Eyayaw Ashete Belachew
- Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Ephrem Mebratu Dagnew
- Clinical Pharmacy, Debre Markos University College of Health Science, Debre Markos, Amhara, Ethiopia
| | - Adeladlew Kassie Netere
- Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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Letta S, Aga F, Yadeta TA, Geda B, Dessie Y. Poor Self-Care Practices and Being Urban Resident Strongly Predict Chronic Complications Among Patients with Type 2 Diabetes in Eastern Ethiopia: A Hospital-Based Cross-Sectional Study. Diabetes Metab Syndr Obes 2022; 15:2095-2106. [PMID: 35898445 PMCID: PMC9309320 DOI: 10.2147/dmso.s368165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/12/2022] [Indexed: 11/23/2022] Open
Abstract
Background Diabetes, together with its complications, has a considerable negative influence on people's quality of life and healthcare delivery and raises diabetic mortality. However, there is limited information about the diabetes-associated chronic complications in the study setting. Therefore, this study aimed to determine the burden and factors related to the chronic complications among patients with type 2 diabetes (T2D) in Eastern Ethiopia. Methods A hospital-based cross-sectional study was conducted among 879 patients with T2D at two public hospitals in Harar. The data were collected through interviews using a structured questionnaire. Data related to the diagnosis of chronic complications and biochemical tests were extracted from medical records. The outcome variable was the number of chronic complications that happened to the patients. A generalized Poisson regression model with robust variance estimation was used to investigate the association of independent variables with chronic complications. An adjusted prevalence ratio with a 95% CI was reported to show an association using a p-value ≤0.05. Results One or more chronic complications were presented in 43% of T2D (95% CI: 39.65, 46.19). Macrovascular and microvascular complications were found in 27.6% and 23.5% of patients, respectively. Urban residence (APR = 2.64; 95% CI: 1.54, 4.54), low wealth status (APR = 1.80; 95% CI: 1.17, 2.76), diabetes duration ≥5 years (APR = 1.46; 95% CI: 1.05, 2.01), hypertriglyceridemia (APR = 1.48; 95% CI: 1.07, 2.09) and poor self-care practices (APR = 1.62; 95% CI: 1.18, 2.23) were factors significantly associated with the chronic complications. Conclusion The burden of chronic complications was high, with nearly half of T2D patients experiencing one or more chronic complications. Almost one in ten patients suffered from multiple chronic complications. The complications were mainly influenced by being urban resident, low wealth status, and poor self-care practices. Therefore, health care providers need to educate patients and promote self-care practices and healthy lifestyles to achieve treatment goals and lower the risk of chronic complications.
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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 Campus, Shashamene, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Abdissa D, Hirpa D. Poor glycemic control and its associated factors among diabetes patients attending public hospitals in West Shewa Zone, Oromia, Ethiopia: An Institutional based cross-sectional study. Metabol Open 2022; 13:100154. [PMID: 34977524 PMCID: PMC8683587 DOI: 10.1016/j.metop.2021.100154] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 12/03/2021] [Accepted: 12/05/2021] [Indexed: 01/01/2023] Open
Abstract
Purpose Diabetes mellitus (DM) is increasing at an alarming rate throughout the world and its complications of has become a major public health concern in all countries. Glycemic control is the most important predictor for DM related complications and deaths. However information on glycemic control remains scarce in Ethiopia including our study area. Hence, the aim of this study was to assess the magnitude and factors associated with poor glycemic control among diabetic outpatients at West Shewa public Hospitals, Ethiopia. Methods A facility-based cross-sectional study was conducted from June 01 to September 30, 2020. Poor glycemic control was assessed by glycated hemoglobin level and a systematic random sampling method was employed to select participants. An interviewer-administered structured questionnaire was used and the data entered into Epi data version 3.1 and exported into SPSS version 22 for analysis. Logistic regression was conducted to identify predictors of poor glycemic control. A p-value of <0.05 was considered statistically significant. Results A total of 390 participants were involved in the study with mean age of 46.45 (±15.6) years. The study finding showed that the prevalence of poor glycemic control was found to be 63.8%. Age of ≥50 years (AOR = 2.77; 95% CI: 0.15,0.85), being single (AOR = 2.55; 95% CI: 0.179,.857), having high low-density lipoprotein cholesterol (AOR = 3.44; 95% CI: 1.65, 7.12), being female gender (AOR = 2.4; 95%CI: 0.31,0.816), alcohol intake (AOR = 1.88; 95% CI: 1.135, 3.1) and presence of diabetic peripheral neuropathy (AOR = 1.24; 1.1,1.39) were associated with poor glycemic control. Conclusion About two-thirds of participants had poor blood glucose control. Increased age, high low-density lipoprotein cholesterol, family history of diabetes, being single, being female, diabetic peripheral neuropathy and alcohol intake were associated with poor glycemic control. Hence, effort should be made towards reducing these factors among DM patients by the concerned body.
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Affiliation(s)
- Daba Abdissa
- Department of Biomedical Sciences, College of Medical Sciences, Institute of Health Sciences, Jimma University, Oromia, Ethiopia
| | - Delessa Hirpa
- Department of Public Health, College of Health Science and Medicine, Ambo University, Oromia, Ethiopia
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Joy T, Najeeb S, Sreedevi A, Vijayakumar K. Glycemic control and its determinants among people with type 2 diabetes mellitus in Ernakulam district, Kerala. Indian J Public Health 2022; 66:S80-S86. [DOI: 10.4103/ijph.ijph_1104_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Almomani MH, AL-Tawalbeh S. Glycemic Control and Its Relationship with Diabetes Self-Care Behaviors Among Patients with Type 2 Diabetes in Northern Jordan: A Cross-Sectional Study. Patient Prefer Adherence 2022; 16:449-465. [PMID: 35221675 PMCID: PMC8865859 DOI: 10.2147/ppa.s343214] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 01/15/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a chronic progressive disease that significantly impacts morbidity and mortality worldwide. Glycemic control is central in diabetes management, yet complex and challenging to achieve; it can be affected by various factors. Diabetes self-care behaviors are vital strategies for effective T2DM management. PURPOSE To evaluate the levels of glycemic control and diabetes self-care behaviors, and the significance of each behavior on glycemic control among patients with T2DM in Jordan. PATIENTS AND METHODS This cross-sectional study was conducted in medical and endocrinology outpatient clinics of three hospitals in northern Jordan. A convenience sample of 520 patients with T2DM participated in the study. Diabetes self-care behaviors, including diet, exercise, blood glucose testing, taking medication, and foot care behaviors, were measured using the Arabic version of the Summary of Diabetes Self-Care Activities (SDSCA-Arabic) questionnaire. Psychological distress was measured using the Arabic version of the 4-items Patient Health Questionnaire (PHQ-4). Glycated hemoglobin (HbA1c) levels were used to assess glycemic control. RESULTS Out of 520 participants, 92.7% (n= 482) had poor glycemic control (HbA1c ≥7%), with a mean of 9.29% (SD=2.06) for HbA1c. The SDSCA overall mean score was 3.25 days (SD=0.88), indicating an unsatisfactory level, with 79.2% of participants having performed self-care activities 4-days/week. Greater adherence to diabetes self-care behaviors was associated with better glycemic control. Exercise was the most important predictor of HbA1c (p<0.001), followed by general diet (p<0.001), specific diet (p<0.001), and blood sugar testing (p<0.001). Moreover, the Body Mass Index (p<0.001), treatment type (p<0.001), and income (p=0.03) were significant predictors. CONCLUSION The proportions of poor glycemic control and unsatisfactory self-care behaviors were high among T2DM patients. To enhance patients' self-care behaviors and lifestyles changes, the patients need tailored diabetes self-care management educational and supportive programs, conducted by qualified diabetes educators using culturally sensitive strategies.
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Affiliation(s)
- Maysa H Almomani
- Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
- Correspondence: Maysa H Almomani, Tel +962 2 7201000 Ext 26176, Fax +962 2 7201065, Email
| | - Shahinaz AL-Tawalbeh
- Department of Community and Mental Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Iregbu SC, Duggleby W, Spiers J, Salami B. An Interpretive Description of Sociocultural Influences on Diabetes Self-Management Support in Nigeria. Glob Qual Nurs Res 2022; 9:23333936221121337. [PMID: 36105718 PMCID: PMC9465563 DOI: 10.1177/23333936221121337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study is to explore how Nigeria’s social and cultural
environment influences professional diabetes self-management support
practices. This interpretive descriptive study is based on two
diabetes clinics in southeastern Nigeria. Nineteen healthcare
providers, including nurses, were purposely selected and engaged in
participant observation and interviews. Concurrent data generation and
analysis facilitated iterative constant comparative analysis. Findings
show significant factors influencing diabetes self-management support
include belief in the supernatural origin of diabetes,
individual–family interdependence, myths and limited understanding of
diabetes, lack of health insurance, poverty, and the rigidity of a
hierarchical acute care model of diabetes services. Thus, there is an
urgent need to adapt diabetes self-management support strategies to
fit people’s contexts. By doing so, specific challenges in the
healthcare system can directly be addressed while capitalizing on
identified strengths and adapting select strategies that
constructively foster person-centered and culturally appropriate
care.
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Affiliation(s)
- Sandra Chinwe Iregbu
- University of Alberta Edmonton, Canada.,Pennsylvania State University, Schuylkill, USA
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Farooqi MH, Abdelmannan DK, Al buflasa MM, Abbas Hamed MA, Xavier M, Santos Cadiz TJ, Nawaz FA. The Impact of Telemonitoring on Improving Glycemic and Metabolic Control in Previously Lost-to-Follow-Up Patients with Type 2 Diabetes Mellitus: A Single-Center Interventional Study in the United Arab Emirates. Int J Clin Pract 2022; 2022:6286574. [PMID: 35685530 PMCID: PMC9159213 DOI: 10.1155/2022/6286574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 01/28/2022] [Accepted: 03/24/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Telemonitoring (TM), mobile-phone technology for health, and bluetooth-enabled self-monitoring devices represent innovative solutions for proper glycemic control, compliance and monitoring, and access to providers. OBJECTIVE In this study, we evaluated the impact of TM devices on glycemic control and the compliance of 38 previously lost-to-follow-up (LTFU) patients with type 2 diabetes mellitus (T2DM). METHODS This was an interventional single-center study that randomly recruited LTFU patients from the Dubai Diabetes Center (DDC), UAE. After contact and recruitment by phone, patients had an initial visit at which they were provided with home-based TM devices. A follow-up visit was conducted three months later. RESULTS The mean HbA1c decreased significantly from 10.3 ± 1.9% at baseline to 7.4 ± 1.5% at the end of follow-up, with a mean difference (MD) of -2.9% [95% CI: -3.6 to -2.2]. The percentage of patients with HbA1c <7% was 50% after three months. Home-based blood sugar monitor devices showed a significant reduction in fasting blood glucose (FBG) after three months (MD = -40.1 mg/dL, 95% CI: -70.8 to -9.3). A significant reduction was observed in terms of body weight after three months (MD = -1.3 kg, 95% CI: -2.5 to -0.08). The mean number of days the participants used a device was the highest for portable pill dispensers (86.5 ± 22.8 days), followed by a OneTouch® blood glucose monitor (72.9 ± 23.5 days). CONCLUSIONS TM led to significant improvements in overall diabetes outcomes, including glycemic control and body weight, indicating its effectiveness in a challenging population of T2DM patients who had previously been lost to follow-up.
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Affiliation(s)
| | | | | | | | - Maxon Xavier
- Dubai Diabetes Center, Dubai Health Authority, Dubai, UAE
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Nigussie S, Birhan N, Amare F, Mengistu G, Adem F, Abegaz TM. Rate of glycemic control and associated factors among type two diabetes mellitus patients in Ethiopia: A cross sectional study. PLoS One 2021; 16:e0251506. [PMID: 33974654 PMCID: PMC8112661 DOI: 10.1371/journal.pone.0251506] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/28/2021] [Indexed: 01/21/2023] Open
Abstract
Objective To assess the rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia. Methods A cross-sectional study was conducted from 13 May to 16 August 2019. Type 2 diabetic patients on follow up at Dilchora Referral Hospital who fulfilled the inclusion criteria of the study were included. Systematic random sampling was used to select study participants. Data was collected by a face-to-face interview and review of medical records. The primary outcome was the level of blood glucose during three consecutive visits. Poor glycemic control was defined as a blood sugar level of more than 154 mg/dL based on the average of measurements from three consecutive visits. Multivariate logistic regression analysis was used to identify determinants of glycemic control. Result A total of 394 participants responded to the interview and were included in the final analysis. The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6%-50.0%). Patients who were on oral anti-diabetic drug plus insulin had more than two times greater chance of poor glycemic control than patients on oral anti-diabetic drug alone: 2.177(95%CI:1.10–4.29). The odds of poor glycemic control in patients who did not understand the pharmacist’s instructions was two times higher than patients with good understanding of instructions 1.86(95%CI: 1.10–3.13). Patients who had poor level of practice were found to have poor glycemic control: 1.69(95% CI: 1.13–2.55). Conclusion The overall prevalence of poor glycemic control was high among type 2 diabetes patients. Oral anti-diabetic drugs in combination with insulin, lack of understanding of pharmacist’s advice, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacists should reassure the understanding of patients before discharge during counseling. Optimization of the dose of antidiabetic medications and combination of oral hypoglycemic agents should be considered.
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Affiliation(s)
- Shambel Nigussie
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
- * E-mail:
| | - Nigussie Birhan
- Department of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Firehiwot Amare
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Getnet Mengistu
- Pharmacology and Toxicology Unit, Pharmacy Department, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia
| | - Fuad Adem
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Science, Haramaya University, Harar, Ethiopia
| | - Tadesse Melaku Abegaz
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
- Clinical and Health Science, University of South Australia, Adelaide, Australia
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Azeez T. Diabesity lipid index: A potential novel marker of 10-year cardiovascular risk. VASCULAR INVESTIGATION AND THERAPY 2021. [DOI: 10.4103/2589-9686.321923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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