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Shang C, Yuan M, Wang Y, Wang Y, Bao W, Zeng S, Zhang D, Liu P, Sun L. Association Between Visceral Obesity and Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Retrospective Study. Diabetes Metab Syndr Obes 2024; 17:2869-2880. [PMID: 39100969 PMCID: PMC11298209 DOI: 10.2147/dmso.s470836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 07/23/2024] [Indexed: 08/06/2024] Open
Abstract
Purpose To investigate the association between visceral obesity and glycemic control in patients with type 2 diabetes mellitus. Patients and Methods A retrospective analysis involved 714 patients diagnosed with type 2 diabetes mellitus from the National Metabolic Management Center from November 2021 to February 2024. Medical data included sociodemographic data, lifestyle behaviors, and anthropometric and biochemical measurements. Multivariate logistic regression analysis was used to analyze their associations. Results Among the patients, 251 (35.2%) achieved good glycemic control (HbA1c < 7.0%). On univariate analysis, higher diastolic blood pressure, longer duration of type 2 diabetes mellitus, tobacco smoking, alcohol drinking, insulin treatment, higher levels of fasting plasma glucose, homeostasis model assessment of insulin resistance, triglyceride, total cholesterol, and low-density lipoprotein cholesterol, visceral obesity (visceral fat area ≥ 100cm2) and diabetic peripheral neuropathy were all positively correlated with poor glycemic control; female, older age, higher levels of C peptide and serum uric acid were inversely associated with poor glycemic control (all P < 0.05). On multivariate logistic regression analysis, the results suggested that higher diastolic blood pressure [OR: 1.021, 95% CI (1.002, 1.040), P = 0.030], insulin treatment [currently used: OR = 2.156, 95% CI (1.249, 3.724), P = 0.006], higher level of fasting plasma glucose [OR: 1.819, 95% CI (1.598, 2.069), P < 0.001], and visceral obesity [OR: 1.876, 95% CI (1.158, 3.038), P = 0.011] were risk factors for poor glycemic control. Conclusion This study indicated that visceral obesity (visceral fat area ≥ 100cm2) is positively associated with poor glycemic control, and serves as an independent risk factor for poor glycemic control (HbA1c ≥ 7.0%) in patients with type 2 diabetes mellitus. Screening for visceral obesity should be emphasized, and targeted interventions should be taken to improve glycemic control in patients with type 2 diabetes mellitus.
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Affiliation(s)
- Chang Shang
- Department of Nephropathy and Endocrine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Mengfei Yuan
- Department of Nephropathy and Endocrine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Yue Wang
- Department of Nephropathy and Endocrine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Yahui Wang
- Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Wujisiguleng Bao
- Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Shuanghui Zeng
- Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Dandan Zhang
- Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Ping Liu
- Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Integrated Chinese and Western Medicine Metabolic Disease Research Center, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Luying Sun
- Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Integrated Chinese and Western Medicine Metabolic Disease Research Center, Fangshan Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
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Kiptoo J, Mekuriya Yadesa T, Ajayi CO, Kushemererwa O, Kantengwa A, Muyingo A. Effectiveness of Jena DM® Herbal Formulation as Complementary Therapy to Conventional Oral Hypoglycemic Agents in Type-2 Diabetes Mellitus: A Quasi-experimental Study. Cureus 2024; 16:e62649. [PMID: 39036260 PMCID: PMC11258422 DOI: 10.7759/cureus.62649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND There is vast preclinical evidence that indicates that extracts from several Artemisia plant species have significant antidiabetic benefits. However, clinical evidence is limited to this effect. OBJECTIVE We sought to evaluate the effectiveness of Jena DM® (an Artemisia annua-based poly-herbal formulation) on glycemic control (Hb A1C) and insulin metabolism (HOMA), when administered as a complementary therapy in type-2 diabetes mellitus (T2DM). This study was supported by a research grant (JRD005) from Jena Herbals (U) Ltd, which is a local herbal medicines manufacturing facility in Uganda. METHODS We conducted a 12-week quasi-experimental study, involving 118 patients under routine follow-up at a diabetes and endocrinology clinic. Random assignment to either conventional or experimental study groups was done using a random number generator (Microsoft Excel version 16.0). Participant sociodemographic and clinical data as well as whole blood samples (3-5 mL) were obtained at scheduled clinic visits. Medication adherence was assessed using the Hill-Bone Scale, and adverse drug events (ADEs) using the Naranjo causality and the National Institute of Allergy and Infectious Diseases, Division of AIDS (DAIDS) scales. Group differences in glycemic control (HbA1C), fasting serum insulin (FSI) indices (% HOMA2-B, HOMA-IR), and other cardiometabolic parameters were assessed using independent samples t-test, and Pearson chi-square statistical tests were used. A p-value <0.05 was considered statistically significant. Ethical approvals were obtained before the study commencement. RESULTS 12-week daily complementary therapy with Jena DM® showed no significant effect on Hb A1C reduction (0.1 (95% CI: -0.56, 0.80) %; p=0.798); however, we observed a significant reduction in total body weight (2.0 (95% CI: 0.73, 3.28) kg; p=0.002). The overall frequency of self-reported ADEs including dizziness was significantly higher among patients that used Jena DM® (p=0.001). Epigastric pain was the most severe ADE necessitating clinical management. There was no significant difference in the homeostatic model assessment for insulin resistance (HOMA2-IR) between study groups. CONCLUSION In contrast to a few studies that previously showed significant hypoglycemic effects of Artemisia-based extracts, this study did not show a statistically significant reduction on HbA1C during a 12-week complementary use of Jena DM® in patients with T2DM. Based on the findings of this study, future research should evaluate the long-term effects of Jena DM® on body weight, overall insulin metabolism, and the subsequent effect on glycemic control in T2DM.
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Affiliation(s)
- Joshua Kiptoo
- Pharmacy, Mbarara University of Science and Technology, Mbarara, UGA
| | | | | | | | - Adellah Kantengwa
- Diabetes & Endocrinology, Mbarara Regional Referral Hospital, Mbarara, UGA
| | - Anthony Muyingo
- Internal Medicine, Mbarara University of Science and Technology, Mbarara, UGA
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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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Ruangchaisiwawet A, Bankhum N, Tanasombatkul K, Phinyo P, Yingchankul N. Prevalence and the association between clinical factors and Diabetes-Related Distress (DRD) with poor glycemic control in patients with type 2 diabetes: A Northern Thai cross-sectional study. PLoS One 2023; 18:e0294810. [PMID: 38011152 PMCID: PMC10681199 DOI: 10.1371/journal.pone.0294810] [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: 03/21/2023] [Accepted: 11/09/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Glycemic control is important to prevent diabetic complications. However, evidence linking factors such as diabetes-related distress (DRD) to poor glycemic outcomes is lacking in Thailand. Therefore, this study aimed to investigate the prevalence and associated factors of poor glycemic control type 2 diabetes. METHODS A cross-sectional study was conducted on 127 type 2 diabetic patients between December 2021 and March 2022 at Maharaj Nakorn Chiang Mai Hospital, Thailand. Data collection included demographic data, clinical data (duration of being type 2 diabetes, diabetic treatment modalities, weight, height, blood pressure, FBS, and HbA1c), behavioral data (self-care behavior, physical activity, dietary assessment, smoking, alcohol consumption, and sleep quality), and psycho-social data (depression and DRD). Poor glycemic control was defined as not achieving the target HbA1c based on the 2021 American Diabetes Association (ADA) Guideline. Multivariable logistic regression was used to explore the associations between potential factors including DRD, and poor glycemic control. RESULTS The prevalence of poor glycemic control in patients with type 2 diabetes was 29.1%. Our analysis revealed that age under 65 years old (OR 6.40, 95% CI 2.07-19.77, p = 0.001), obesity (BMI ≥ 25 kg/m2) (OR 2.96, 95% CI 1.05-8.39, p = 0.041), and DRD (OR 14.20, 95% CI 3.76-53.64, p<0.001) were significantly associated with poor glycemic control. Three dimensions of DRD were associated with poor glycemic control, including emotional distress (OR 4.23, 95% CI 1.51-11.85, p = 0.006), regimen-related distress (OR 6.00, 95% CI 1.88-19.18, p = 0.003), and interpersonal distress (OR 5.25, 95% CI 1.39-20.02, p = 0.015). CONCLUSION AND RECOMMENDATION Age, obesity, and DRD are associated with poor glycemic control. A holistic approach that includes addressing DRD is crucial for improving glycemic outcomes in patients with type 2 diabetes. Further studies in broader populations using a cohort design are recommended.
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Affiliation(s)
| | - Narumit Bankhum
- Nutrition and Dietary service section, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Krittai Tanasombatkul
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Phichayut Phinyo
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Center for Clinical Epidemiology and Clinical Statistics, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
- Musculoskeletal Science and Translational Research (MSTR), Chiang Mai University, Chiang Mai, Thailand
| | - Nalinee Yingchankul
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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Dubale M, Gizaw K, Dessalegn D. Magnitude and predictors of poor glycemic control in patients with diabetes at Jimma Medical Center, Ethiopia. Sci Rep 2023; 13:15952. [PMID: 37743416 PMCID: PMC10518326 DOI: 10.1038/s41598-023-42774-y] [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: 04/26/2023] [Accepted: 09/14/2023] [Indexed: 09/26/2023] Open
Abstract
Despite the development of new medications over the past decade to aid in the control of blood glucose, most diabetic patients often do not reach recommended glycemic targets of glycated hemoglobin (HbA1C) < 7% in daily clinical practice because of many contributing factors. This study was designed to assess the magnitude and predictors of poor glycemic control among adult diabetic patients on ambulatory chronic care follow-up at Jimma Medical Center. A cross sectional study was conducted on 307 adult diabetic patients between January 2 and April 30, 2022. Representative samples were selected using a systematic random sampling technique. Predictors of poor glycemic control were assessed using a binary and multi variable logistic regression. Data analysis was performed using Statistical Package for Social Science version 25 and R in the R studio environment. A total of 307 adult diabetic patients were included in the study making a response rate of 93%. Out of 307 adult diabetic patients, majority (62.5%) were males. Mean age of the patients was 48.91 ± 15.68 years. The majority, 221 (72%), of patients had poor glycemic control. Non-adherence of patients to medications (AOR = 3.36, 95% CI 1.16-9.72, p = 0.04), no formal education (AOR = 3.84, 95% CI (1.06-13.93, p = 0.04), therapeutic inertia (AOR = 3.16, 95% CI 1.61-6.20, p = 0.001) and poor diabetic knowledge (AOR = 4.79, 95% CI 1.56-14.68, p = 0.006) were found to be independent predictors of poor glycemic control. Nearly three fourth of diabetic patients in the present study had poor glycemic control and were at higher risk of developing diabetic complications or already developed it. These results highlight the need for appropriate management of patients focusing on adherence to medications, education, therapeutic inertia and diabetic knowledge to maintain good glycemic control and improve adverse outcomes of the disease in this study setting.
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Affiliation(s)
- Mariam Dubale
- Department of Clinical Pharmacy, School of Pharmacy, Jimma University, Jimma, Oromia, Ethiopia.
| | - Kaleab Gizaw
- Department of Pharmacology, School of Pharmacy, Jimma University, Jimma, Oromia, Ethiopia
- Department of Quantitative Pharmacology, Merck KGaA, Darmstadt, Hessen, Germany
| | - Dula Dessalegn
- Department of Clinical Pharmacy, School of Pharmacy, Jimma University, Jimma, Oromia, Ethiopia
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Kiryowa HM, Munabi IG, Buwembo W, Rwenyonyi CM, Mwaka ES, Kaddumukasa M. Periodontitis is associated with insulin resistance in adults living with diabetes mellitus in Uganda: a cross- sectional study. BMC Res Notes 2023; 16:217. [PMID: 37710310 PMCID: PMC10503142 DOI: 10.1186/s13104-023-06473-1] [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: 04/08/2023] [Accepted: 08/23/2023] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION Evidence suggests that majority of patients with diabetes mellitus in Uganda have poor glycaemic control as well as periodontal disease. This study set out to determine the association between periodontitis and insulin resistance in adult patients with diabetes mellitus in Uganda using the triglyceride glucose index. METHODS Two hundred and twenty-three adult study participants with confirmed diabetes mellitus were enrolled in a cross-sectional study. Oral examination was carried with the aid of a periodontal probe to determine the periodontal status and findings recorded using the WHO Oral Health Assessment Tool for Adults, 2013. We recorded clinical details for body mass index (BMI in kg/m2) and laboratory parameters including fasting blood sugar (mmol/L), glycated hemoglobin levels (HbA1c, %) and serum triglycerides (mmol/L) using a study questionnaire. Data were analyzed using R version 4.10. The glucose triglyceride index was used as a measure of insulin resistance. Logistic regression analysis carried out to determine the factors associated insulin resistance. RESULTS The majority of the study participants was female (70%) with an average age of 48.5 years (SD+/- 11.1). The mean body mass index was 29.6 kg/m2 (SD+/- 5.82). The mean serum triglyceride index was 9.48 (SD+/- 0.675). Eighty-six-point 1% of the participants had periodontal disease. Bivariate analysis revealed high odds for male sex (OR = 1.31, 95% C.I = 0.44-4.84, p = 0.65) and periodontitis (OR = 3.65, 95% C.I = 0.79-26.15, p = 0.13) but low odds for a high BMI (OR = 0.45. 95% C.I = 0.07-1.67, p = 0.30). Multivariate regression revealed a significant association between insulin resistance and periodontitis. (AOR = 3.52, 95% C.I = 1.19-1.83, p = 0.03). CONCLUSION Insulin resistance is highly prevalent in patients with diabetes mellitus in Uganda and is associated with periodontitis and low body weight.
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Affiliation(s)
- Haruna Muhmood Kiryowa
- Department of Anatomy, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
| | - Ian Guyton Munabi
- Department of Anatomy, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - William Buwembo
- Department of Anatomy, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | | | - Erisa Sabakaki Mwaka
- Department of Anatomy, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Mark Kaddumukasa
- Department of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
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Yahaya JJ, Doya IF, Morgan ED, Ngaiza AI, Bintabara D. Poor glycemic control and associated factors among patients with type 2 diabetes mellitus: a cross-sectional study. Sci Rep 2023; 13:9673. [PMID: 37316565 DOI: 10.1038/s41598-023-36675-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 06/07/2023] [Indexed: 06/16/2023] Open
Abstract
Glycemic control is of paramount importance in care and management for patients with type 2 diabetes mellitus (T2DM). Poor glycemic control is a major health problem that greatly contributes to the development of diabetes related complications. This study aims to assess the prevalence of poor glycemic control and associated factors among outpatients with T2DM attending diabetes clinic at Amana Regional Referral Hospital in Dar-es-salaam, Tanzania from December 2021 to September 2022. A face to face interviewer semi-structured questionnaire was administered during data collection. Binary logistic regression under multivariable analysis was used to determine the independent predictors of poor glycemic control. A total of 248 patients with T2DM were included in the analysis with mean age of 59.8 ± 12.1 years. The mean fasting blood glucose was 166.9 ± 60.8 mg/dL. The prevalence of poor glycemic control was 66.1% (fasting blood glucose > 130 mg/dL or < 70 mg/dL). Failure to adhere to regular follow-up (AOR = 7.53, 95% CI = 2.34-19.73, p < 0.001) and alcoholism (AOR = 4.71, 95% CI = 1.08-20.59, p = 0.040) were the independent predictors of poor glycemic control. The prevalence of poor glycemic control observed in this study was significantly high. Emphasis should be placed on ensuring that patients have regular follow-up for their diabetes clinics and they should also continue modifying some of lifestyle behaviors including refraining from alcoholism, this can help them to have good glycemic control.
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Affiliation(s)
- James J Yahaya
- Department of Pathology, School of Health Sciences, Soroti University, P. O. Box 211, Soroti, Uganda.
| | - Irene F Doya
- Department of Community Medicine, School of Medicine and Dentistry, University of Dodoma, Dodoma, Tanzania
| | - Emmanuel D Morgan
- Department of Pathology, School of Health Sciences, Soroti University, P. O. Box 211, Soroti, Uganda
| | - Advera I Ngaiza
- Deparment of Pathology, Muhimbili National Hospital, Dar-es-Salaam, Tanzania
- Department of Pathology, Muhimbili University of Health and Allied Sciences, Dar-es-Salaam, Tanzania
| | - Deogratius Bintabara
- Department of Community Medicine, School of Medicine and Dentistry, University of Dodoma, Dodoma, Tanzania
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Onyango JT, Namatovu JF, Besigye IK, Kaddumukasa M, Mbalinda SN. Social support from family, associated factors and relationship with glycemic control among diabetic patients in Uganda: a cross-sectional study. Pan Afr Med J 2023; 45:72. [PMID: 37663636 PMCID: PMC10474808 DOI: 10.11604/pamj.2023.45.72.38256] [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: 11/15/2022] [Accepted: 04/10/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction social support from family members in diabetes management is a predictor of optimal glucose control. There is limited evidence of the relationship in Uganda. The objective was to determine association of social support from family and glycemic control, and association of social demographic and clinical characteristics with family support among diabetic patients in eastern Uganda. Methods this was a cross-sectional study involving 405 adult patients attending diabetic clinics between May 2021 and June 2021. Socio-demographics, clinical characteristics, social support from family, and glycemic control data were collected. Descriptive statistics were done and associations were determined using Pearson chi-square and Fisher´s exact tests. Generalized linear model was used to determine independent association with social support from family. Results the mean age was 52 years, (60%) were female, majority (49.4%) were 45-64 years old. Perceived social support from family (PSS-fa) and good glucose control were found in; (95.3%) and (20.99%) respectively. PSS-fa was associated with good glucose control. Financial contribution from family members to cost of care, cohesion among family members in support of care, being (married/cohabiting) and monthly income ≥28 USD were associated with PSS-fa. Factors independently associated with PSS-fa were; female gender, financial contribution to cost of care and cohesion among family in support of care. Conclusion social support from family was associated with good glycemic control. Factors associated with PSS-fa were; female gender, financial contribution from family to cost of care and cohesion among family in support of care.
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Affiliation(s)
- Jude Tadeo Onyango
- Department of Family Medicine, Makerere University, P.O. Box 7062, Kampala, Uganda
| | | | | | - Mark Kaddumukasa
- Department of Medicine, Makerere University, P.O. Box 7062, Kampala, Uganda
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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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Sagastume D, Mertens E, Sibongwere DK, Dimbelolo JC, Kabundi JCK, de Man J, Van Olmen J, Peñalvo JL. A retrospective database study of the demographic features and glycemic control of patients with type 2 diabetes in Kinshasa, Democratic Republic of the Congo. BMC Med 2022; 20:258. [PMID: 35982436 PMCID: PMC9389797 DOI: 10.1186/s12916-022-02458-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The Kin-Antwerp project aimed at improving the quality of care provided to patients with diabetes in Kinshasa, the Democratic Republic of the Congo in Central Africa, including the digitalisation of routine clinical data to improve patients' follow-up. We aim to analyse the data of a study population of Kin-Antwerp to characterise their demographic features, assess their achievement of glycemic target over time, and identify groups requiring prioritised attention. METHODS We performed a secondary database analysis of routinely collected information from primary care patients with type 2 diabetes followed from 1991 to 2019. Data included demographics (age, sex), anthropometrics (weight, height), clinical parameters (blood pressure, plasma glucose), and anti-diabetic treatments. Achievement of glycemic target, defined as fasting plasma glucose < 126 mg/dL, over time was assessed using a multilevel mixed-effects logistic regression model. RESULTS Our study population of patients with type 2 diabetes (N = 8976) comprised a higher proportion of women (67%) and patients between 40 and 65 years old (70.4%). At the first follow-up, most patients were on treatment with insulin (56.5%) and had glycemic levels under the target (79.9%). Women presented more often with obesity (27.4%) and high systolic blood pressure (41.8%) than men (8.6% and 37.0%, respectively). Patients had a median follow-up of 1.8 (interquartile range: 0.5-3.4) years. Overall, the odds of achieving glycemic target increased by 18.4% (odds ratio: 1.184, 95% CI: 1.130 to 1.239; p < 0.001) per year of follow-up. Stratified analyses suggested that the odds of achieving glycemic control over time increased among older patients (> 40 years), but not among younger patients (< 40 years). CONCLUSION In our study population, an overall poor glycemic control was observed albeit with a modest improvement in the achievement of glycemic target throughout patients' follow-up. Younger patients may benefit from prioritised attention to achieve glycemic targets. Based on the information provided by the database, continue monitoring and improvement of the project Kin-Antwerp is recommended. Introducing further efforts to improve type 2 diabetes management should include robust glycemia-monitoring tools and haemoglobin A1c, as well as further outlining self-management strategies.
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Affiliation(s)
- Diana Sagastume
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium.
| | - Elly Mertens
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Deogratias Katsuva Sibongwere
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
| | - Jean-Claude Dimbelolo
- Centre d'Éducation Diabète & Santé Boulevard Lumumba n° 1 Musoso district, Municipality of Limete, Kinshasa, Democratic Republic of the Congo
| | - Jean Clovis Kalobu Kabundi
- Memisa, 19 Square de Meeûs, 1050 Brussels, Belgium and Memisa representation in Kinshasa, 47 Kisangani, commune de la Gombe, Kinshasa, Democratic Republic of the Congo
| | - Jeroen de Man
- Department of Family Medicine and Population Health, University of Antwerp, Doornstraat 331, 2610, Wilrijk, Belgium
| | - Josefien Van Olmen
- Department of Family Medicine and Population Health, University of Antwerp, Doornstraat 331, 2610, Wilrijk, Belgium
| | - José L Peñalvo
- Unit of Non-Communicable Diseases, Department of Public Health, Institute of Tropical Medicine, Nationalestraat 155, 2000, Antwerp, Belgium
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Self-care practice and glycemic Control among type 2 diabetes patients on follow up in a developing country: a prospective observational study. J Diabetes Metab Disord 2022; 21:455-461. [PMID: 35673465 PMCID: PMC9167384 DOI: 10.1007/s40200-022-00995-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 01/11/2022] [Accepted: 01/30/2022] [Indexed: 12/20/2022]
Abstract
Purpose The main goal of managing diabetes is to achieve glycemic control. However, the glycemic level of most diabetic patients is shown to be poorly controlled mainly due to poor adherence to self-care practices. This study aims to assess the level of self-care practice and glycemic control among type 2 diabetes patients on follow up in a resource limited country. Methods A four-month prospective observational study was conducted among type 2 diabetes patients from February 1 to May 30, 2021. Data was collected using a data abstraction checklist and structured questionnaire. The data was entered into Epidata version 4.4.6 and analyzed with SPSS version 26. Glycemic control and its predictors were determined using binary logistic regression. P-value less than 0.05 was considered as statistically significant. Results A total of 138 patients were included in the study. Nearly three-fourths (74.6%) of patients had poor glycemic control and the majority of patients had poor self-care practice. 78.3%, 98.6%, 96.4%, and 55.8% of patients had poor adherence to diet, exercise, self-monitoring of blood glucose, and medications respectively. Importantly, 85(79%), 102(75%), 99(74.4%), and 65(84.4%) patients with poor adherence to diet, physical activity, self-monitoring of blood glucose, and antidiabetic medications had poor glycemic control. On multivariate logistic regression, BMI (AOR 4.1, CI:1.20-14.11, p = 0.024) and drug adherence (AOR 3.08, CI:1.22-7.08, p = 0.017) were factors associated with poor glycemic control. Conclusions A higher proportion of patients had low-level of self-care practice and poor glycemic control. This highlights the need to improve patients' awareness about the importance of self-care practice to maintain good glycemic control and prevent adverse outcomes associated with the disease. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-022-00995-4.
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12
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Kiryowa HM, Munabi IG, Buwembo W, Rwenyonyi CM, Kaddumukasa M, Sabakaki EM. Prevalence and factors associated with periodontal disease in patients with diabetes mellitus attending Kiruddu National Referral Hospital, Uganda. Pan Afr Med J 2022; 43:202. [PMID: 36942143 PMCID: PMC10024556 DOI: 10.11604/pamj.2022.43.202.35971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/04/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction patients with diabetes mellitus present with high rates of periodontal disease. Severity and extent of periodontal disease may be directly associated with poor glycemic control. The burden of periodontal disease in patients with diabetes mellitus in Uganda is not documented. This study set out to determine the prevalence and factors associated with periodontal disease in patients with diabetes mellitus attending a national referral hospital in Uganda. Methods this was a cross-sectional study involving 264 patients with diabetes mellitus. Data were collected using a pretested questionnaire to assess factors associated with periodontal disease. This was followed by an oral examination to determine the community periodontal index (CPI) and clinical attachment loss (CAL). Laboratory tests included glycated hemoglobin and fasting blood sugar. Factors associated with periodontal diseases were evaluated using logistic regression analysis. Results of the 264 participants, 68.9% were females. The average age was 48.9 (SD = 11.0) years. Majority of the participants (32.6%) had diabetes mellitus for 2 to 5 years with oral hypoglycemic drugs being the most commonly (55.7%) used medication. The overall prevalence of periodontal disease was 85%. Univariate analysis revealed that prevalence of periodontal disease was associated with male sex, lower level of education, smoking, oral hygiene practices, poor glycemic control and combined diabetic medication. However, based on multivariate model, this prevalence was only significantly associated with lower level of education: aOR: 10.77 95% CI 1.04-226.38, p=0.05. Conclusion periodontal disease is highly prevalent in patients with diabetes mellitus in Uganda, especially those with a lower level of education. All diabetic patients should be screened and managed for periodontal disease. Oral health interventions should also be packaged and presented in a simple language to allow easy comprehension by even the less educated population.
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Affiliation(s)
- Haruna Muhmood Kiryowa
- School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
- Corresponding author: Haruna Muhmood Kiryowa, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda.
| | - Ian Guyton Munabi
- School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | - William Buwembo
- School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
| | | | - Mark Kaddumukasa
- School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda
| | - Erisa Mwaka Sabakaki
- School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda
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Jia SY, Zhang YL, Sun XY, Yuan C, Zheng SG. Impact of the Glycemic Level on the Salivary Proteome of Middle-Aged and Elderly People With Type 2 Diabetes Mellitus: An Observational Study. Front Mol Biosci 2021; 8:790091. [PMID: 34957219 PMCID: PMC8703016 DOI: 10.3389/fmolb.2021.790091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is an increasing global public health concern, but its impact on the salivary proteome is still unclear. To evaluate the effect of glycemic levels in middle-aged and elderly individuals with T2DM on salivary proteomics, we compared the differences by liquid chromatography tandem mass spectrometry (LC–MS/MS). Unstimulated whole saliva samples from 8 T2DM patients with good glycemic control (G group, HbA1c <6.5%) and 16 patients with poor control (P group, HbA1c ≥6.5%) were analyzed by LC–MS/MS in the data-independent acquisition mode (Clinical register number: ChiCTR1900023582.). After functional annotation, cluster analysis and receiver operating characteristic (ROC) curve analysis were carried out to screen and evaluate candidate proteins. A total of 5,721 proteins were quantified, while 40 proteins differed significantly. In the P group, proteins involved in oxidative stress-related processes were upregulated, whereas proteins related to salivary secretion were downregulated. The combination of thioredoxin domain-containing protein 17, zymogen granule protein 16B, and FAM3 metabolism regulating signaling molecule D yielded an area under the curve of 0.917 which showed a robust ability to distinguish the P and G groups. In conclusion, poorly controlled hyperglycemia may affect salivary proteins through various pathways, including oxidative stress and glandular secretion. Furthermore, the differentially expressed proteins, especially the three proteins with the best differentiation, might serve as an anchor point for the further study of hyperglycemia and oral diseases.
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Affiliation(s)
- Shu Yuan Jia
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Yan Ling Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Xiang Yu Sun
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Chao Yuan
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Shu Guo Zheng
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
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