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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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Dinavari MF, Sanaie S, Rasouli K, Faramarzi E, Molani-Gol R. Glycemic control and associated factors among type 2 diabetes mellitus patients: a cross-sectional study of Azar cohort population. BMC Endocr Disord 2023; 23:273. [PMID: 38087260 PMCID: PMC10714613 DOI: 10.1186/s12902-023-01515-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Despite the growing prevalence of diabetes and its complications, there is a dearth of data regarding factors associated with glycemic control. Therefore, in this cross-sectional study, we aimed to identify factors influencing glycemic control in patients with type 2 diabetes mellitus (T2DM) in the Iranian population. METHODS This cross-sectional study was conducted among the Azar cohort population and the glycemic control status of patients with T2DM was investigated. Possible risk factors including age, sex, marital status, educational level, smoking status, sleep duration, family history of diabetes and hypertension, socioeconomic status, physical activity level, and co-existence of other chronic diseases and their relationship with glycemic control status were also assessed. Multivariate logistic regression analysis was used to identify determinants of glycemic control. RESULTS Among 1,710 T2DM patients (60.2% female), the overall prevalence of poor glycemic control was 56.8%. In the unadjusted logistic regression analysis model, a low wealth score index significantly increased the risk of poor glycemic control (OR: 1.49;1.10-2.02). Variables significantly associated with poor glycemic control even after adjusting for confounding factors were first-degree family history of diabetes (OR: 1.34; 1.08-1.65), and sleep duration (OR: 1.29 ;1.02-1.62 for 6.6-8 h/d; OR:1.42;1.10-1.88 for > 8 h/d). Interestingly, we found that the co-existence of ≥ 3 chronic diseases with diabetes decreased the risk of poor glycemic control. CONCLUSIONS In the current study, most of the patients with T2DM had uncontrolled glycemic control. Due to the individual and social costs of diabetes complications, it is necessary to suggest tailored and effective interventions for controlling blood glucose levels in people with diabetes.
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Affiliation(s)
- Masoud Faghieh Dinavari
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sarvin Sanaie
- Research Center for Integrative Medicine in Aging, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kimia Rasouli
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elnaz Faramarzi
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Roghayeh Molani-Gol
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran.
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
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Adhikari P, Sriyuktasuth A, Phligbua W. Social determinants of health and glycemic control in persons with type 2 diabetes mellitus attending a tertiary hospital in Nepal: A cross-sectional study. BELITUNG NURSING JOURNAL 2023; 9:489-497. [PMID: 37901380 PMCID: PMC10600700 DOI: 10.33546/bnj.2753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/03/2023] [Accepted: 09/05/2023] [Indexed: 10/31/2023] Open
Abstract
Background Diabetes mellitus (DM) is an emerging global public health challenge worldwide, including Nepal. Social determinants of health (SDOH) play a major role in glycemic control among persons with type 2 DM (T2DM). However, little is known about the association between SDOH and glycemic control among individuals with T2DM in Nepal. Objective This study aimed to identify the level of glycemic control and SDOH associated with glycemic control among Nepalese with T2DM. Methods This cross-sectional study was conducted at a tertiary hospital in Kathmandu, Nepal, among 135 Nepalese diagnosed with T2DM who attended follow-up appointments. Convenience sampling and inclusion criteria were utilized for participant selection. Data were collected from April to June 2021 using validated scales. Descriptive statistics, Chi-square test, and binary logistic regression were employed to analyze the data. Results The mean age of the participants in this study was 53.84 (SD = 11.78) years, and the average monthly household income was 567.64 (SD = 362.30) USD. The majority of the participants (77.8%) were literate and had no health insurance coverage (73.3%). Approximately 64.4% of the participants showed suboptimal glycemic control indicated by glycated hemoglobin (HbA1c) ≥7%. The significant determinants of good glycemic control included monthly household income of >850 USD (odds ratio [OR] = 12.20, 95% confident interval [CI] = 1.76-84.61, p = 0.011) and 341-600 USD (OR = 7.64, 95% CI 1.35-42.98, p = 0.021), being literate (OR = 6.37, 95% CI = 1.65-24.49, p = 0.007), having health insurance (OR = 5.82, 95% CI = 1.49-22.65, p = 0.011), sufficient health literacy (OR = 3.46, 95% CI = 1.10-10.83, p = 0.03), and high (OR = 16.17, 95% CI = 2.36-110.67, p = 0.005) and moderate (OR = 7.02, 95% CI = 1.26-39.07, p = 0.026) food availability, respectively. Conclusion The study revealed suboptimal glycemic control in Nepalese with T2DM. This study presents essential social determinants of glycemic control in this population. Therefore, healthcare providers, particularly nurses, should pay more attention to assessing social determinants and provide targeted interventions to patients with T2DM who have low income, are illiterate, have no health insurance coverage, have insufficient health literacy, and have low resources for food availability.
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Affiliation(s)
- Prava Adhikari
- Faculty of Nursing, Mahidol University, Bangkok, Thailand
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Oliveira Hashiguchi L, Cox SE, Edwards T, Castro MC, Khan M, Liverani M. How can tuberculosis services better support patients with a diabetes co-morbidity? A mixed methods study in the Philippines. BMC Health Serv Res 2023; 23:1027. [PMID: 37749519 PMCID: PMC10519082 DOI: 10.1186/s12913-023-10015-7] [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: 03/06/2023] [Accepted: 09/08/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND People with diabetes mellitus (DM) have an estimated two- to three-times greater risk of adverse tuberculosis (TB) treatment outcomes compared to those without DM. Blood glucose control is a primary aim of managing DM during TB treatment, yet TB programmes are not generally adapted to provide DM services. The purpose of this study was to understand perceptions and the lived experiences of diabetic patients in TB treatment in the Philippines, with a view to informing the development of disease co-management strategies. METHODS This mixed methods study was conducted within a prospective cohort of adults newly-starting treatment for drug-sensitive and drug-resistant TB at 13 public TB clinics in three regions of the Philippines. Within the subset of 189 diabetic persons who self-reported a prior DM diagnosis, or were diagnosed by screenings conducted through the TB clinic, longitudinal blood glucose data were used to ascertain individuals' glycaemic control (controlled or uncontrolled). Univariable logistic regression analyses exploring associations between uncontrolled glycaemia and demographic and clinical factors informed purposive sampling of 31 people to participate in semi-structured interviews. All audio-recorded data were transcribed and thematic analysis performed. RESULTS Participants - both with controlled and uncontrolled blood glucose - were knowledgeable about diabetes and its management. However, a minority of participants were aware of the impact of DM on TB treatment and outcomes. Many participants newly-diagnosed with DM at enrolment in TB treatment had not perceived any diabetic symptoms prior and would have likely not sought clinical consult otherwise. Access to free glucose-lowering medications through TB clinics was a key enabling resource. However, participants expressed fear of side effects and interrupted access to glucose-lowering medications, and a preference for phytotherapy. Many participants felt that physical and financial impacts of TB and its treatment were challenges to DM management. CONCLUSIONS AND RECOMMENDATIONS Results of this study indicate that public TB clinics can provide diabetic patients with additional health care resources and education to address co-morbidity. TB programmes might consider identifying patients with complicated DM, and offering diabetic monitoring and management, as DM and diabetic complications may compound the burden of TB and its treatment.
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Affiliation(s)
- Lauren Oliveira Hashiguchi
- National Institute of Nursing Research, National Institutes of Health, 31 Center Drive, Bethesda, MD, 20892-2178, USA.
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK.
- School of Tropical Medicine & Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
| | - Sharon E Cox
- School of Tropical Medicine & Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- Faculty of Epidemiology & Population Health, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK
- United Kingdom Health Security Agency, 61 Colindale Avenue London NW9 5EQ, Collindale, UK
| | - Tansy Edwards
- School of Tropical Medicine & Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki, 852-8523, Japan
- MRC International Statistics and Epidemiology Group, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Mary C Castro
- Nutrition Center Philippines, Muntinlupa City, Manila, Philippines
| | - Mishal Khan
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK
- Aga Khan University, National Stadium Road, Karachi, 74800, Pakistan
| | - Marco Liverani
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, Keppel St, London, WC1E 7HT, UK
- School of Tropical Medicine & Global Health, Nagasaki University, 1 Chome-12-4 Sakamoto, Nagasaki, 852-8523, Japan
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Integrated Diabetes Self-Management (IDSM) mobile application to improve self-management and glycemic control among patients with Type 2 Diabetes Mellitus (T2DM) in Indonesia: A mixed methods study protocol. PLoS One 2022; 17:e0277127. [PMID: 36441733 PMCID: PMC9704669 DOI: 10.1371/journal.pone.0277127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 10/21/2022] [Indexed: 11/29/2022] Open
Abstract
The number of patients with diabetes in Indonesia reach 19,47 million in 2021, mostly is caused by the adoption of sedentary and unhealthy lifestyles. Continuous self-management is important in diabetes care. It requires optimal coordination and communication between patients, families, and health care provider. The use of communication technology could be solution to the problem. This study aims to initiate an android-based mobile apps technology as a tool for patient, family, and healthcare provider to optimize patient with T2DM treatment. This study will be conducted in Public Health Centers (PHCs) in Yogyakarta using an exploratory sequential mixed-methods design which is divided into three phases. The first phase will use qualitative descriptive methods. Patients with T2DM, families, nurses, physicians and Health Social Security Agency officers in Indonesia will be involved in a focus group discussion (FGD) and in-depth interviews to understand their needs in optimizing the treatment. The second phase will be the development of an android-based application on the first phase results. The apps will be usability tested by involving experts (heuristic evaluation) and users (think aloud method) to ensure that the apps really meet targeted user's need. In the third phase, we will collect feedback from user after using this apps for three months. The effectiveness of the apps will be measured by self-management improvement and glycemic control of patients with T2DM. The non-equivalent control group design will be applied using a pre-repeated post-test control group. The result of this study will be an Android-based Application which will be called Integrated Diabetes Self-Management (IDSM) app to optimize the implementation of diabetes self-management which can improve glycemic control of patients with T2DM as one of the indicators of the Indonesian Chronic Disease Management Program at PHCs.
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Khan YH, Alzarea AI, Alotaibi NH, Alatawi AD, Khokhar A, Alanazi AS, Butt MH, Alshehri AA, Alshehri S, Alatawi Y, Mallhi TH. Evaluation of Impact of a Pharmacist-Led Educational Campaign on Disease Knowledge, Practices and Medication Adherence for Type-2 Diabetic Patients: A Prospective Pre- and Post-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610060. [PMID: 36011692 PMCID: PMC9408490 DOI: 10.3390/ijerph191610060] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/28/2022] [Accepted: 08/08/2022] [Indexed: 06/01/2023]
Abstract
Type 2 Diabetes mellitus is a major public health concern with an alarming global growth rate. According to the World Health Organization (WHO), Saudi Arabia ranks seventh in the world and second in the Middle East for the largest estimated burden of diabetic cases. Evidence shows that pharmacist-led care programs can be beneficial for the effective treatment of diabetes mellitus. Current study was aimed to evaluate the impact of Pharmacist-Based Diabetic Intervention (PDIM) for Type 2 Diabetes patients on knowledge of the disease, adherence to medications and self-care practices during the first wave of COVID-19. A multi-arm pre-post study was conducted among type 2 diabetic patients from April to October 2021 in Sakaka, Saudi Arabia. Patients were randomly divided into an intervention and a control group. The intervention group received the PDIM, whereas the control group only received the usual care. The pharmacist-based diabetes intervention model consisted of a diabetic educational module and medication improvement strategies. Furthermore, the intervention group also received specific telepharmacy services (calls, messages or emails) to address their medication-related problems, inquire about medication adherence and follow-up. At the end of six months, disease knowledge, self-care practices, and medication adherence score were analyzed. Furthermore, HbA1c and lipid profile were also compared. A total of 109 patients were included in the study. A significant difference was observed in the knowledge score between the intervention and control group (16.89 ± 2.01 versus 15.24 ± 2.03, p-value < 0.001). Similarly, self-care practices also improved in the intervention group as compared to the control group (4.39 ± 1.10 versus 3.16 ± 0.97, p-value < 0.001). Furthermore, the medication adherence and HbA1c significantly improved during between the group analysis (p < 0.05). Our study demonstrates that pharmacist-based diabetes intervention model is effective in improving patients’ knowledge of diabetes, self-care practices, medication adherence and glycemic control.
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Affiliation(s)
- Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
- Health Sciences Research Unit, Jouf University, Sakaka 72388, Saudi Arabia
| | | | - Nasser Hadal Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Ahmed D. Alatawi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
| | - Aisha Khokhar
- Institute of Pharmacy, Lahore College for Women University, Lahore 54000, Pakistan
| | - Abdullah Salah Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
- Health Sciences Research Unit, Jouf University, Sakaka 72388, Saudi Arabia
| | | | - Asrar A. Alshehri
- Infection Control Department, Alameen Hospital, Taif 26511, Saudi Arabia
| | - Sameer Alshehri
- Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Taif University, Taif 21944, Saudi Arabia
| | - Yasser Alatawi
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia
| | - Tauqeer Hussain Mallhi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Sakaka 72388, Saudi Arabia
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Implication of Salivary Biochemical Parameters for Diagnosis and Prognosis of Type 2 Diabetes Mellitus. Int J Anal Chem 2022; 2022:1781613. [PMID: 35992561 PMCID: PMC9385334 DOI: 10.1155/2022/1781613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/02/2022] [Accepted: 07/15/2022] [Indexed: 11/18/2022] Open
Abstract
Background. Clinical laboratory diagnosis and prognosis for diabetes mellitus is performed using blood as a major specimen; however, saliva may represent as an alternative noninvasive specimen of choice. This study aims to evaluate salivary biochemical parameters in diabetic and healthy individuals to substantiate saliva’s role in the diagnosis and prognosis of type 2 diabetes mellitus (T2DM). Methods. This case-control study included 150 T2DM patients and 150 apparently healthy individuals. Socio-demographic data and anthropometric measurements were recorded using a standard questionnaire. Correlation between salivary and blood levels for each parameter was determined using Pearson correlation. Linear regression was performed to estimate the blood levels of the parameters from their salivary levels. Receiver operating characteristics (ROC) analysis was done to determine the diagnostic ability of salivary glucose and establish a sensitivity, specificity, and cut-off value. Results. Salivary glucose, TC, LDL-C, urea, and creatinine were significantly higher in people with diabetes than in the control population (
). A significant positive correlation was found between salivary and blood parameters including glucose, TC, TG, LDL-C, urea, and creatinine except for HDL-C in both case and control groups. The linear relationship for each parameter, except glucose in case population and HDL-C in case, control, and the total population was observed between blood and saliva. ROC analysis gave a cut-off value of 1.9 mg/dl for salivary glucose with 71.4% sensitivity and 72.3% specificity. Conclusion. Salivary estimation significantly reflects the blood parameters in this study, indicating that saliva can be a noninvasive specimen for the diagnosis and prognosis of T2DM.
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Paudel G, Vandelanotte C, Dahal PK, Biswas T, Yadav UN, Sugishita T, Rawal L. Self-care behaviours among people with type 2 diabetes mellitus in South Asia: A systematic review and meta-analysis. J Glob Health 2022; 12:04056. [PMID: 35916498 PMCID: PMC9346342 DOI: 10.7189/jogh.12.04056] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background The burden of Type 2 Diabetes Mellitus (T2DM) in South Asian countries is increasing rapidly. Self-care behaviour plays a vital role in managing T2DM and preventing complications. Research on self-care behaviours among people with T2DM has been widely conducted in South Asian countries, but there are no systematic reviews that assess self-care behaviour among people with T2DM in South Asia. This study systematically assessed the studies reporting self-care behaviours among people with T2DM in South-Asia. Methods Adhering to the PRISMA guidelines, we searched six bibliographic databases (Scopus, PubMed, CINAHL, Embase, Web of Science, and PsychInfo) to identify the relevant articles published between January 2000 through March 2022. Eligibility criteria included all observational and cross-sectional studies reporting on the prevalence of self-care behaviours (ie, diet, physical activity, medication adherence, blood glucose monitoring, and foot care) conducted in South Asian countries among people with T2DM. Results The database search returned 1567 articles. After deduplication (n = 758) and review of full-text articles (n = 192), 92 studies met inclusion criteria and were included. Forward and backward reference checks were performed on included studies, which resulted in an additional 18 articles. The pooled prevalence of adherence to blood glucose monitoring was 65% (95% CI = 49-80); 64% for medication adherence (95% CI = 53-74); 53% for physical activity (95% CI = 39-66); 48% for diet (95% CI = 38-58); 42% for foot care (95% CI = 30-54). About a quarter of people with T2DM consumed alcohol (25.2%, IQR = 13.8%-38.1%) and were using tobacco products (18.6%, IQR = 10.6%-23.8%). Conclusions Our findings suggest that the prevalence of self-care behaviours among people with T2DM in South Asia is low. This shows an urgent need to thoroughly investigate the barriers to the practising of self-care and design and implement interventions to improve diabetes self-care behaviour among people with T2DM in South Asia.
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Affiliation(s)
- Grish Paudel
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia
| | - Corneel Vandelanotte
- Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia
| | - Padam K Dahal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia
| | - Tuhin Biswas
- The Australian Research Council Centre of Excellence for Children and Families over the Life Course, The University of Queensland, Brisbane, Queensland, Australia
| | - Uday N Yadav
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.,Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
| | - Tomohiko Sugishita
- Section of Global Health, Division of Public Health, Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Lal Rawal
- School of Health, Medical and Applied Sciences, Central Queensland University, Sydney, Australia.,Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Australia.,Translational Health Research Institute (THRI), Western Sydney University, Sydney Australia
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Shrestha N, Karki K, Poudyal A, Aryal KK, Mahato NK, Gautam N, Kc D, Gyanwali P, Dhimal M, Jha AK. Prevalence of diabetes mellitus and associated risk factors in Nepal: findings from a nationwide population-based survey. BMJ Open 2022; 12:e060750. [PMID: 35193925 PMCID: PMC8867329 DOI: 10.1136/bmjopen-2022-060750] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The burden of diabetes mellitus (DM) has increased globally, particularly in low-income and middle-income countries, including Nepal. Population-based nationally representative data on the prevalence of DM is limited. This paper presents the prevalence of DM and its associated risk factors in Nepal. RESEARCH DESIGNS AND METHODS This population-based study sampled 13 200 participants aged 20 years and above in 400 clusters of 72 districts of Nepal. The study used a standardised questionnaire adapted from the WHO STEPwise approach to non-communicable disease risk factor surveillance instrument and digitalised in Android-compatible mobile phones. Fasting and 2 hours postprandial blood samples were taken to test various biochemical parameters. Descriptive followed by multivariate analyses were done to assess the association between explanatory variables and the outcome variable. PRIMARY OUTCOME MEASURES Prevalence of DM. RESULTS The prevalence of DM was found to be 8.5% (95% CI 7.8% to 9.3%). The odds of DM occurrence were higher in the upper age groups (40-59 years at adjusted OR (AOR) 3.1 (95% CI2.3 to 4.2) and 60+ years at AOR 4.7 (95% CI 3.3 to 6.6)), compared with the group aged 20-39 years. Men were found to have higher odds of DM (AOR 1.3, 95% CI 1.1 to 1.6) compared with women. Urban residents had almost twice higher odds of DM (AOR 1.7, 95% CI 1.4 to 2.2) compared with rural residents. Participants with raised blood pressure (BP) (AOR 2.2, 95% CI 1.8 to 2.7), those who were overweight and obese (AOR 2.0, 95% CI 1.6 to 2.4) and those who had high triglycride level (≥150 mg/dL) (AOR 2.1, 95% CI 1.8 to 2.6) also had twice higher odds of DM compared with those with normal BP, an average body mass index and normal triglyceride level, respectively. CONCLUSIONS Targeted interventions to higher risk groups as well as prevention and control of other associated biological risk factors might help to reduce the prevalence of DM in Nepal.
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Affiliation(s)
- Namuna Shrestha
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Khem Karki
- Department of Community Medicine, Maharajgunj Medical Campus, Kathmandu, Nepal
| | - Anil Poudyal
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - K K Aryal
- Public Health Promotion and Development Organization, Kathmandu, Nepal
| | | | - Nitisha Gautam
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Dirghayu Kc
- Public Health Promotion and Development Organization, Kathmandu, Nepal
| | - Pradip Gyanwali
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Meghnath Dhimal
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
| | - Anjani Kumar Jha
- Research Section, Nepal Health Research Council, Kathmandu, Nepal
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Associated patient demographic characteristics and disease-related self-care behaviors with diabetes: a mediation model. J Diabetes Metab Disord 2021; 20:1301-1308. [PMID: 34900781 DOI: 10.1007/s40200-021-00856-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
Objective The burden of diabetes is increasing rapidly in Turkey; however, there is insufficient information regarding the interrelated factors of diabetes. This study aims to fill this gap by investigating associated characteristics and self-care behaviors of patients with diabetes. Methods Path analysis was used to test interrelated factors of diabetes. Data were obtained from a cross-sectional, population-based study (Turkey Health Survey) from 2014. The determined sample size was 9,740 households, and 26,075 individuals were interviewed. There were 19,129 persons who reported having diabetes. Age and gender characteristics and disease-related self-care behaviors of individuals were collected through a self-reported questionnaire. Goodness-of-fit indices were used to assess model fit. Results The results demonstrated that patient characteristics, self-care behaviors, and diabetes are causally interrelated (p < 0.0001). Blood glucose monitoring mediated the interrelationships between patient demographic characteristics and diabetes. The model fit indices indicated a good fit of the path model to the data (goodness-of-fit index = 0.96; comparative fit index = 0.89; incremental fit index = 0.89; normed fit index = 0.89). The fight against the increasing prevalence of diabetes mandates enhancing self-care behaviors of individuals with diabetes, including regular blood glucose monitoring and the inculcation of healthy dietary habits. Conclusions The results can guide health policy makers to promote patient-centered management of diabetes in the age of the escalating burden of this disease.
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Xu Y, Gallagher PJ, Tan CWY, Tsou KYK, Tan DHY, Ramaya H, Lee JY. Impact of team‐based pharmaceutical care on the humanistic outcomes among patients with long‐standing diabetes: An interim analysis of a randomized, controlled, multicenter study. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Yingqi Xu
- Department of Pharmacy, Faculty of Science National University of Singapore Singapore Singapore
| | - Paul J. Gallagher
- Department of Pharmacy, Faculty of Science National University of Singapore Singapore Singapore
| | | | | | | | - Henry Ramaya
- National University Polyclinics Singapore Singapore
| | - Joyce Y.‐C. Lee
- Department of Clinical Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences University of California Irvine California USA
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Hazrati-Meimaneh Z, Amini-Tehrani M, Pourabbasi A, Gharlipour Z, Rahimi F, Ranjbar-Shams P, Nasli-Esfahani E, Zamanian H. The impact of personality traits on medication adherence and self-care in patients with type 2 diabetes mellitus: The moderating role of gender and age. J Psychosom Res 2020; 136:110178. [PMID: 32623192 DOI: 10.1016/j.jpsychores.2020.110178] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 06/16/2020] [Accepted: 06/19/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVES This study aimed to investigate the role of the five-factor model of personality (FFM) and the moderating role of gender and age in predicting medication adherence (MA) and self-care behaviors (SCB) among Iranian patients with type 2 diabetes mellitus (T2DM). METHODS This study was conducted on 495 patients with T2DM (73.5% female; n = 364) from two major cities of Iran (Tehran and Qom) in 2019. Pearson's correlation coefficient, multiple regression analysis, and conditional process analysis were performed. P < .05 and P < .10 were considered significant for the relationships and moderation analysis, respectively. RESULTS Neuroticism indicated a negative association with MA and SCB. Positive associations were found between MA and personality traits, including extraversion, agreeableness, and conscientiousness, whereas extraversion showed a weak correlation with SCB. According to the covariate-adjusted regression model, neuroticism had a negative effect on MA and SCB. Agreeableness had a positive effect on MA and a negative effect on SCB. However, extraversion exerted a negative effect on MA and a positive effect on SCB. Also, the negative effect of neuroticism on MA was highlighted in women, indicating marginally significant moderation effect. The positive effects of extraversion and conscientiousness on MA were moderated by age. The effect of conscientiousness on SCB was positive in young patients and negative in old patients. No interaction effect was observed between age and gender. CONCLUSION This study indicated that neuroticism, extraversion, and agreeableness significantly contributed to MA, but not to SCB. However, the effects were conditioned by age for extraversion and conscientiousness to some extent.
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Affiliation(s)
- Zahra Hazrati-Meimaneh
- Department of Health Education and Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran; South Tehran Heath Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohammadali Amini-Tehrani
- Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran; Health Psychology and Behavior Medicine Research Group, Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Ata Pourabbasi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Zabihollah Gharlipour
- Department of Health Education and Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran.
| | - Fatemeh Rahimi
- South Tehran Heath Center, Tehran University of Medical Sciences, Tehran, Iran; Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran..
| | | | - Ensieh Nasli-Esfahani
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran..
| | - Hadi Zamanian
- Department of Health Education and Promotion, School of Health, Qom University of Medical Sciences, Qom, Iran; Health Psychology and Behavior Medicine Research Group, Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Babaniamansour S, Aliniagerdroudbari E, Niroomand M. Glycemic control and associated factors among Iranian population with type 2 diabetes mellitus: a cross-sectional study. J Diabetes Metab Disord 2020; 19:933-940. [PMID: 33520813 DOI: 10.1007/s40200-020-00583-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/01/2020] [Indexed: 11/26/2022]
Abstract
Purpose Detection and modification of various factors such as life style, smoking and so on can significantly improve the glycemic control status. This study aimed to investigate glycemic control status and its relevant factors among patients with Type 2 DM. Methods In this cross-sectional study, the glycemic control status of patients with type 2 DM was investigated. In addition, relevant risk factors including demographic, clinical characteristics, self-care management behavior, medication adherence and laboratory data and their relationship with glycemic control status were assessed. Glycemic control status was defined as very good (HbA1c < 7%), good (HbA1c = 7-7.9%), poor (HbA1c = 8-9.9%) or extremely bad (HbA1c ≥ 10%). Results The present study included 562 patients (64.4% female). Most of the patients (37%) had poor glycemic control status. Microvascular complications especially diabetic neuropathy were the most common complications in our study. Glycemic control had significant relationship with level of education (p < .01) and occupation (p = .04). Among laboratory parameters, fasting plasma glucose (FPG) and total cholesterol levels were significantly lower in patients with desirable glycemic control (p < .05). The linear regression test showed that HbA1c had significant relationship with FPG (p < .01) and increasing one standard deviation in FPG can increase the level of HbA1c 0.014. Conclusion Glycemic control status in our study was very low and FPG was the strongest predictor of glycemic control status. Some other factors were also associated such as education level, occupation, type of treatment, diastolic blood pressure, the lipid profile and aspartate transaminase.
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Affiliation(s)
- Sepideh Babaniamansour
- Department of Internal Medicine, School of Medicine, Islamic Azad University Tehran Faculty of Medicine, Tehran, Iran
| | - Ehsan Aliniagerdroudbari
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahtab Niroomand
- Division of Endocrinology, Department of Internal Medicine, Clinical Research Development Unit of Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Arabi Ave, Daneshjoo Blvd, Velenjak, 7th Floor, Bldg. No. 2, Tehran, Iran
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Maleki Chollou K, Gaffari-fam S, Babazadeh T, Daemi A, Bahadori A, Heidari S. The Association of Health Literacy Level with Self-Care Behaviors and Glycemic Control in a Low Education Population with Type 2 Diabetes Mellitus: A Cross-Sectional Study in Iran. Diabetes Metab Syndr Obes 2020; 13:1685-1693. [PMID: 32547130 PMCID: PMC7245439 DOI: 10.2147/dmso.s253607] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 04/24/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION Promoting Health Literacy (HL) can be a priority in strategic healthcare planning of the countries. Low HL is prevalent in some societies which make barriers to successful self-care of diseases. The aim of this study was to examine the association of HL with self-care behaviors and glycemic control in a low education population with type 2 diabetes mellitus. METHODS This cross-sectional study was conducted in Sarab city, Iran. The 192 participants were patients diagnosed as type 2 diabetes and with low level of education. Convenient sampling method was applied and the participants were chosen by their medical records in health-care centers. To collect data a valid and reliable tool was used based on HL dimensions and self-care behaviors. Using hierarchical logistic regression, the possible association of variables with self-care behaviors and glycemic control was assessed. RESULTS The mean age of study participants was 58.12 (±11.83) years. A 28.8% of the variation in the self-care behaviors is explained by the HL and the demographic variables (R= 0.288%; p-value<0.05). Furthermore, decision-making was the strongest predictor of self-care behaviors (β= 0.451). Approximately 80% of the variation in the HbA1c is explained by the HL, self-care behaviors, and the demographic variables (R= 0.804%; p-value<0.05). CONCLUSION This study revealed that the HL dimensions predicted approximately one-fourth of self-care behaviors and the self-care behaviors and HL dimensions about eight-tenths of HbA1c in this population. These findings call for the need for interventional programs on HL to improve the self-care behaviors and HbA1c control.
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Affiliation(s)
| | - Saber Gaffari-fam
- School of Nursing of Miandoab City, Urmia University of Medical Sciences, Urmia, Iran
| | - Towhid Babazadeh
- Department of Public Health, Sarab Faculty of Medical Sciences, Sarab, Iran
- Correspondence: Towhid Babazadeh Department of Public Health, Sarab Faculty of Medical Sciences, Sarab, IranTel +98 41 4322 4586Fax +98 41 4323 7412 Email
| | - Amin Daemi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Bahadori
- Food and Drug Safety Research Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Sohrab Heidari
- School of Nursing of Miandoab City, Urmia University of Medical Sciences, Urmia, Iran
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