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Fernandes CM, Bernardo GL, Fernandes AC, Geraldo APG, Hauschild DB, Venske DKR, Medeiros FL, Proença RPDC, Uggioni PL. Impact of a Cooking Intervention on the Cooking Skills of Adult Individuals with Type 2 Diabetes Mellitus: A Pilot Study. Nutrients 2024; 16:1657. [PMID: 38892590 PMCID: PMC11175113 DOI: 10.3390/nu16111657] [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: 04/23/2024] [Revised: 05/21/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVE To investigate the impact of the Nutrition and Culinary in the Kitchen (NCK) Program on the cooking skills of Brazilian individuals with type 2 diabetes mellitus (T2DM). METHODS A randomized controlled intervention study was performed, with intervention and control groups. The intervention group participated in weekly sessions of the NCK Program for six weeks (including two in-person practical cooking and three online cooking workshops). The cooking recipes were adapted by replacing high glycemic index ingredients with low and medium glycemic index alternatives. Of note, the recipes did not contain added sugars or sweeteners, were based on the use of fresh or minimally processed foods, herbs, and spices, and were sensorially tested by individuals with T2DM before use in the intervention. The study outcomes were participant score changes on the seven scales. A validated online instrument was administered to the control and intervention groups at baseline (T1) and post-intervention (T2). Parametric and non-parametric tests were used to assess the differences between the T1 and T2 parameters. RESULTS Of the 60 individuals enrolled, 44 answered the questionnaire at both times. The findings revealed a 45.37% ± 93.57% increase in Knowledge of Cooking Terms in the intervention group, whereas the control group showed a 3.82% ± 16.17% reduction (p = 0.008). There was an increase in all the other cooking skills and healthy eating scales from T1 to T2 in the intervention group, but the differences were not significant. CONCLUSIONS The development of cooking skills can contribute to increasing culinary knowledge and the availability of time to cook at home. The results contribute to the planning of health actions aimed at individuals with DM2 through culinary interventions and public food and nutrition policies.
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Affiliation(s)
- Clarice Mariano Fernandes
- Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil; (C.M.F.); (G.L.B.); (A.C.F.); (A.P.G.G.); (D.B.H.); (D.K.R.V.); (F.L.M.)
- Nutrition Post-Graduate Program, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
| | - Greyce Luci Bernardo
- Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil; (C.M.F.); (G.L.B.); (A.C.F.); (A.P.G.G.); (D.B.H.); (D.K.R.V.); (F.L.M.)
- Nutrition Post-Graduate Program, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
- Nutrition Departament, Federal University of Santa Catarina, Campus Universitário, s/n, Trindade, Florianópolis 88040-900, SC, Brazil
| | - Ana Carolina Fernandes
- Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil; (C.M.F.); (G.L.B.); (A.C.F.); (A.P.G.G.); (D.B.H.); (D.K.R.V.); (F.L.M.)
- Nutrition Post-Graduate Program, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
- Nutrition Departament, Federal University of Santa Catarina, Campus Universitário, s/n, Trindade, Florianópolis 88040-900, SC, Brazil
| | - Ana Paula Gines Geraldo
- Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil; (C.M.F.); (G.L.B.); (A.C.F.); (A.P.G.G.); (D.B.H.); (D.K.R.V.); (F.L.M.)
- Nutrition Departament, Federal University of Santa Catarina, Campus Universitário, s/n, Trindade, Florianópolis 88040-900, SC, Brazil
| | - Daniela Barbieri Hauschild
- Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil; (C.M.F.); (G.L.B.); (A.C.F.); (A.P.G.G.); (D.B.H.); (D.K.R.V.); (F.L.M.)
- Nutrition Post-Graduate Program, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
| | - Débora Kurrle Rieger Venske
- Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil; (C.M.F.); (G.L.B.); (A.C.F.); (A.P.G.G.); (D.B.H.); (D.K.R.V.); (F.L.M.)
- Nutrition Post-Graduate Program, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
- Nutrition Departament, Federal University of Santa Catarina, Campus Universitário, s/n, Trindade, Florianópolis 88040-900, SC, Brazil
| | - Fharlley Lohann Medeiros
- Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil; (C.M.F.); (G.L.B.); (A.C.F.); (A.P.G.G.); (D.B.H.); (D.K.R.V.); (F.L.M.)
- Nutrition Post-Graduate Program, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
| | - Rossana Pacheco da Costa Proença
- Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil; (C.M.F.); (G.L.B.); (A.C.F.); (A.P.G.G.); (D.B.H.); (D.K.R.V.); (F.L.M.)
- Nutrition Post-Graduate Program, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
- Nutrition Departament, Federal University of Santa Catarina, Campus Universitário, s/n, Trindade, Florianópolis 88040-900, SC, Brazil
| | - Paula Lazzarin Uggioni
- Nutrition in Foodservice Research Centre, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil; (C.M.F.); (G.L.B.); (A.C.F.); (A.P.G.G.); (D.B.H.); (D.K.R.V.); (F.L.M.)
- Nutrition Post-Graduate Program, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
- Nutrition Departament, Federal University of Santa Catarina, Campus Universitário, s/n, Trindade, Florianópolis 88040-900, SC, Brazil
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Nakitto B, Opedo M, Nansubuga F, Omondi E, Musinguzi E, Otile EC, Ekak S, Nannungi C, Apiyo P, Pebolo PF, Bongomin F. Willingness to start insulin therapy among insulin-naïve persons with type 2 diabetes mellitus at Gulu Regional Referral Hospital, Gulu City, Uganda. Ther Adv Chronic Dis 2024; 15:20406223241247650. [PMID: 38665975 PMCID: PMC11044801 DOI: 10.1177/20406223241247650] [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: 11/23/2023] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Background Most patients with type 2 diabetes mellitus (DM2) will require insulin for glycemic control during their disease. Objectives We evaluated the willingness to start insulin therapy among insulin-naïve persons with DM2 in urban Northern Uganda. Design A facility-based, quantitative, cross-sectional study was conducted between June and August 2023 recruiting insulin-naïve type 2 diabetes mellitus patients attending routine health care at Gulu Regional Referral Hospital, Gulu, Uganda. Methods We gauged participants' willingness to use insulin by asking, 'If your doctor prescribed insulin for you, would you accept to use it?' with responses categorized as either 'Yes' or 'No'. Poisson regression analysis was performed to assess the factors associated with willingness to start insulin therapy. p < 0.05 were considered statistically significant. Results We enrolled 190 participants, with a mean age of 55 ± 12.72 years. Most participants were female (63.7%, n = 121), attained a primary level of education (70.0%, n = 133), and were unemployed (84.2%, n = 160). Overall, 73.4% (n = 138) of the participants were willing to receive insulin therapy if indicated. Participants recently advised on insulin showed a 34% higher willingness [adjusted prevalence ratio (aPR): 1.34, 95% confidence interval (CI): 1.06-1.72, p = 0.007], whereas those with a disease duration of 6 years or more were 43% less willing (aPR: 0.57, 95% CI: 0.39-0.81, p = 0.002) and those concerns about coping with insulin therapy were 55% less willing to commence insulin therapy (aPR: 0.57, 95% CI: 0.39-0.81, p = 0.002). Conclusion About three in every four participants with DM were willing to receive insulin if indicated. However, healthcare providers should consider personalized counseling strategies to alleviate concerns and enhance informed decision-making regarding insulin initiation. Future interventions should focus on addressing specific barriers associated with prolonged disease duration and apprehensions related to insulin therapy to optimize glycemic control in this population.
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Affiliation(s)
| | - Moses Opedo
- Faculty of Medicine, Gulu University, Gulu, Uganda
| | | | | | | | | | - Steven Ekak
- Faculty of Medicine, Gulu University, Gulu, Uganda
| | | | - Paska Apiyo
- Department of Internal Medicine, Gulu Regional Referral Hospital, Gulu, Uganda
| | | | - Felix Bongomin
- Faculty of Medicine, Gulu University, P.O. Box 166, Gulu, UgandaDepartment of Internal Medicine, Gulu Regional Referral Hospital, P.O. Box 160, Gulu, Uganda
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Zhu L, Pan Z, Shen F, Shen Y, Zhang W. Effects of family support system on the self-management behaviour of patients with T2DM: a multi-centre cross-sectional study in community settings. Fam Pract 2024; 41:114-122. [PMID: 38412362 DOI: 10.1093/fampra/cmae010] [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] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND The burden of type 2 diabetes mellitus (T2DM) in China continues to escalate. OBJECTIVE To investigate the impact of family support system on the self-management behaviour of patients with T2DM. METHODS In this cross-sectional study, 1,042 participants were sampled using a multistage stratified probability-proportionate-to-size method. On-site interviews were conducted using a structured questionnaire administered by 122 family doctors from 13 community health service centres in 8 administrative districts. A structural equation model was established to investigate the impact of individual factors and family support system on the self-management behaviour of T2DM patients. Statistical analysis was performed using the SPSS 25.0 software. RESULTS The self-management behaviour pass rate among individuals with T2DM was 40.9%. In terms of individual factors, those with a high school education level or above demonstrated higher self-management behaviour scores than those with a junior high school education level or lower. The structural equation model revealed a path of interactions among individual factors, family support system-related factors, and the self-management behaviour of patients with T2DM: Family function → Family support → Patients' self-management behaviour → Quality of life. The coefficient of the direct path from family function to family support was 0.74 (P < 0.001), while the coefficient of the direct path from family support to self-management behaviour was 0.68 (P = 0.001). CONCLUSION There is significant room for improvement in the self-management behaviour of T2DM patients in China. Family function can enhance the self-management behaviour of T2DM patients by promoting family support.
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Affiliation(s)
- Lan Zhu
- Department of General Practice, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
- Xietu Street Community Health Service Center, Xuhui District, Shanghai, China
| | - Zhigang Pan
- Department of General Practice, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Fulai Shen
- Research Center of Strengthening Foundation of Health, Institute of Healthy Yangtze River Delta, Shanghai Jiao Tong University, Shanghai, China
| | - Yi Shen
- New Exploration Project Team, Diabetes Management Community, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Wei Zhang
- School of Public Health, Fudan University, Shanghai, China
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Fattahi Ardakani M, Salahshouri A, Sotoudeh A, Fard MR, Dashti S, Ahmadi Chenari H, Baumann SL. A Study of the Use of Medicinal Plants by Persons With Type 2 Diabetes in Iran. Nurs Sci Q 2024; 37:168-172. [PMID: 38491885 DOI: 10.1177/08943184231224454] [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] [Indexed: 03/18/2024]
Abstract
Medicinal plants are used by many people with Type 2 diabetes in Iran. The aim of this study was to explore why this is so, from their perspective. Sixteen persons with Type 2 diabetes in Yazd City, Iran, were interviewed in April and May 2020 for this study. A thematic analysis of the transcripts of those interviews was done using MAXQDA 10 software. Six themes were identified: beliefs about medicinal plants, psychological factors, accessibility and economic barriers, patients' knowledge and awareness, social pressure, and the role of family culture. The recommendation of the study is that health counselors and specialists should provide needed information and skills for the proper use of medicinal plants, and the pharmaceutical infrastructures need to be expanded to provide enough drugs to facilitate better access to needed medication and reduce reliance on medicinal plants for persons with Type 2 diabetes.
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Affiliation(s)
| | - Arash Salahshouri
- Department of Health Education and Promotion, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Sotoudeh
- Department of Public Health, School of Public Health, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mohammad Rafati Fard
- Research, Health Science/Physiology, Clinical Research Development Unit, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Saeed Dashti
- Department of Public Health, Ferdows School of Allied Medicine and Public Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Hadi Ahmadi Chenari
- Department of Nursing, Ferdows School of Allied Medicine and Public Health, Birjand University of Medical Sciences, Birjand, Iran
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Obeagu EI. Red blood cells as biomarkers and mediators in complications of diabetes mellitus: A review. Medicine (Baltimore) 2024; 103:e37265. [PMID: 38394525 DOI: 10.1097/md.0000000000037265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
Red blood cells (RBCs), traditionally recognized for their oxygen transport role, have garnered increasing attention for their significance as crucial contributors to the pathophysiology of diabetes mellitus. In this comprehensive review, we elucidate the multifaceted roles of RBCs as both biomarkers and mediators in diabetes mellitus. Amidst the intricate interplay of altered metabolic pathways and the diabetic milieu, RBCs manifest distinct alterations in their structure, function, and lifespan. The chronic exposure to hyperglycemia induces oxidative stress, leading to modifications in RBC physiology and membrane integrity. These modifications, including glycation of hemoglobin (HbA1c), establish RBCs as invaluable biomarkers for assessing glycemic control over extended periods. Moreover, RBCs serve as mediators in the progression of diabetic complications. Their involvement in vascular dysfunction, hemorheological changes, and inflammatory pathways contributes significantly to diabetic microangiopathy and associated complications. Exploring the therapeutic implications, this review addresses potential interventions targeting RBC abnormalities to ameliorate diabetic complications. In conclusion, comprehending the nuanced roles of RBCs as biomarkers and mediators in diabetes mellitus offers promising avenues for enhanced diagnostic precision, therapeutic interventions, and improved patient outcomes. This review consolidates the current understanding and emphasizes the imperative need for further research to harness the full potential of RBC-related insights in the realm of diabetes mellitus.
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Tuobenyiere J, Mensah GP, Korsah KA. Patient perspective on barriers in type 2 diabetes self-management: A qualitative study. Nurs Open 2023; 10:7003-7013. [PMID: 37488987 PMCID: PMC10495717 DOI: 10.1002/nop2.1956] [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: 01/04/2023] [Revised: 05/21/2023] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
AIM To explore the perceived barriers in Type 2 Diabetes care among patients with diabetes. Design The study adopted a qualitative exploratory-descriptive design. METHODS A semi-structured interview guide was used to collect data from fifteen (15) purposively sampled patients with Type 2 Diabetes at a primary level health facility in the Bono East region. Participants' ages ranged between 42-72 years. The interviews were audio-recorded, transcribed verbatim and analysed using thematic content analysis. RESULTS Patients with Type 2 Diabetes encountered a range of barriers in diabetes care. These barriers included lack of knowledge of diabetes dietary management strategies, financial constraints, non-compliance to treatment, lack of glucometers, lack of social support, and increased waiting time at health care facilities. The findings indicate that more education on diabetes and dietary management is required as well as social support from peers, family, and non-governmental organizations. PATIENT OR PUBLIC CONTRIBUTION Diabetes self-management barriers as revealed by the patients who were participants of this study requires nurses and midwives to ensure that self-management education is well understood by patients and their relatives. This would empower the patients and bring clarity to their confusion about self-care practices.
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Affiliation(s)
- Justin Tuobenyiere
- General Nursing Department, Holy Family Nursing and Midwifery Training CollegeTechimanGhana
| | | | - Kwadwo Ameyaw Korsah
- Department of Adult Health, School of Nursing and MidwiferyUniversity of GhanaAccraGhana
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Islam MA, El-Dahiyat F, Nouri A, Alefan Q, Naqvi AA. Validation of the Arabic version of the general medication adherence scale in patients with type 2 diabetes mellitus in Jordan. Front Pharmacol 2023; 14:1194672. [PMID: 37799962 PMCID: PMC10547870 DOI: 10.3389/fphar.2023.1194672] [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] [Received: 03/27/2023] [Accepted: 09/04/2023] [Indexed: 10/07/2023] Open
Abstract
Background: Medication adherence is a major challenge for patients with diabetes. Adherence rates are often low, and this can lead to poor glycaemic control and increased risk of complications. There are a number of tools available to measure medication adherence, but few have been validated in Arabic-speaking populations. Aim: This study aimed to validate the Arabic version of the General Medication Adherence Scale in patients with type 2 diabetes in Jordan. Methods: A cross-sectional study was conducted for 3 months among patients attending diabetes mellitus outpatient clinic in Irbid, Jordan. The validation procedure included confirmatory factor analysis (CFA) and equation modelling (SEM). Fit indices, namely, goodness of fit index (GFI), Tucker Lewis index (TLI), comparative fit index (CFI), and root mean square error of approximation (RMSEA) were observed. Corrected item-total correlation (ITC) was reported. Reliability was assessed using Cronbach's alpha (α) and α value based on item deletion was also carried out. Intraclass correlation coefficient (ICC) was reported. Data were analyzed using IBM SPSS v23 and IBM AMOS v25. Results: Data from 119 participants were gathered. The mean adherence score was 27.5 (±6) ranging from 6 to 33. More than half of the patients were adherent to their therapy (n = 79, 66.4%). The reliability of the scale (n = 11) was 0.907, and ICC ranged from 0.880-0.930: 95% CI. The following values were observed in CFA; χ2 = 62.158, df = 41, χ2/df = 1.516, GFI = 0.913, AGFI = 0.860, TLI = 0.960, CFI = 0.971 and RMSEA = 0.066. A total of 10 out of 11 items had corrected ITC >0.5. The α remained between 0.89-0.92 during item deletion. Conclusion: The results obtained in this study suggest that the scale is valid and reliable in measuring adherence to medications in the studied sample of patients with diabetes. This scale can be used by clinicians in Jordan to assess adherence and may further aide in evaluating interventions to improve adherence rates in persons with type 2 diabetes.
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Affiliation(s)
- Md. Ashraful Islam
- Department of Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Faris El-Dahiyat
- Clinical Pharmacy Program, College of Pharmacy, Al Ain University, Al Ain, United Arab Emirates
| | - Ahmed Nouri
- Medical Faculty, Institute of Anatomy II, University Hospital Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany
| | - Qais Alefan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Atta Abbas Naqvi
- Department of Pharmacy Practice, School of Pharmacy, University of Reading, Whiteknights Campus, Reading, United Kingdom
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Nield L, Bhanbhro S, Steers H, Young A, Fowler Davis S. Impact of Voluntary, Community and Social Enterprise (VCSE) Organisations Working with Underserved Communities with Type 2 Diabetes Mellitus in England. Healthcare (Basel) 2023; 11:2499. [PMID: 37761696 PMCID: PMC10530582 DOI: 10.3390/healthcare11182499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 07/31/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
The Voluntary, Community and Social Enterprise (VCSE) sector offers services and leadership within the health and care system in England and has a specialist role in working with underserved, deprived communities. This evaluation aims to identify best practices in self-management support for those living with type 2 diabetes mellitus (T2DM) and to develop a theory of change (TofC) through understanding the impact of VCSE organisations on diabetes management. An appreciative inquiry (AI) was carried out and co-delivered using qualitative interviews and an embedded analysis with VCSE partners. A voluntary service coordinated seven VCSE organisations who assisted with recruiting their service users and undertook interviews to identify the impact of existing activities and programmes. People living with T2DM were interviewed about services. Themes were as follows: (a) individual and group activities; (b) trusted services and relationships across the community; (c) long-term engagement; (d) sociocultural context of diet and nutritional choices; (e) experience of adaptation; and (f) culturally appropriate advice and independent VCSE organisations. The structured educational approach (DESMOND) for T2DM was accessed variably, despite these services being recommended by NICE guidelines as a standard intervention. The VCSE offered continuity and culturally appropriate services to more marginalised groups. This evaluation highlights the importance of targeted engagement with underserved communities, particularly where primary care services are more limited. The TofC is a unique insight into the impact of VCSE services, offering bespoke support to manage T2DM, suggesting areas for improvements in capacity and offering the capability to sustain the VCSE sector as an essential element of the T2DM care pathway in England.
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Affiliation(s)
- Lucie Nield
- Advanced Wellbeing Research Centre, Sheffield Hallam University, Sheffield S10 2BP, UK
| | - Sadiq Bhanbhro
- Department of Nursing and Midwifery, Sheffield Hallam University, Sheffield S1 1WB, UK;
| | - Helen Steers
- Voluntary Action Sheffield, Sheffield S1 4FW, UK;
| | - Anna Young
- Sheffield Hallam University Health Centre, Sheffield S1 1WB, UK;
| | - Sally Fowler Davis
- School of Allied Health, Anglia Ruskin University, Cambridge CB1 1PT, UK;
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Deshmane AR, Muley AS. Adherence and Barriers to Medical Nutrition Therapy and the Effect on Glycemic Control Among Individuals With Type 2 Diabetes in India. CURRENT RESEARCH IN NUTRITION AND FOOD SCIENCE JOURNAL 2022. [DOI: 10.12944/crnfsj.10.3.18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Medical Nutrition Therapy (MNT) has a remarkable effect on glycemic control among individuals with Type 2 Diabetes. However, the extent of adherence to MNT isn't hundred percent. Therefore, we aim to determine the adherence level towards the MNT advised by a Registered Dietitian (RD); to identify the barriers and associated contributing factors and strategies to improve the compliance towards the MNT among people with Type 2 Diabetes. A cross-sectional study was conducted among people with Type 2 Diabetes visiting the out-patient diabetes clinic from Kolhapur city, India. A structured questionnaire was used to capture the adherence and non-adherence, reasons and barriers to adhering the MNT. Out of 293 participants, 41.6% were adhering to the MNT. There was a significant association between the non working group (p = 0.01), presence of co-morbidities (p = 0.03) and diabetes duration < 10 years (p = 0.05) with the increased adherence level. Similarly, there was a significant reduction of 26.7%, 38.1%, and 30.9% in the fasting, postprandial blood glucose and HbA1c values respectively in adhering group post MNT advice. More than 50% of the participants in the adhering group gave ‘To Improve overall health’ and ‘To control sugar’ as reasons to adhere. ‘Habitual to what they eat’ (64.3%), ‘Does not satisfy hunger’ (42.1%) and ‘Lack of willpower’ (42.1%), were the common barriers identified in our study. Our study shows that the MNT advised by an RD is effective in reducing the socio-cultural barriers to adherence and improves glycemic control. Strategies like making the workplace more diabetes-friendly and adopting behavior changing techniques should be implemented to increase adherence.
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Affiliation(s)
- Aditi Rajesh Deshmane
- 2Clinical Nutrition and Dietetics, Indian Institute of Food Science and Technology, Aurangabad, India
| | - Arti S Muley
- 1Nutrition and Dietetics Program, Symbiosis Institute of Health Sciences, Symbiosis International (Deemed University), Pune, India
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Abujbara M, Khreisat EA, Khader Y, Ajlouni KM. Effect of Insulin Injection Techniques on Glycemic Control Among Patients with Diabetes. Int J Gen Med 2022; 15:8593-8602. [PMID: 36545247 PMCID: PMC9762765 DOI: 10.2147/ijgm.s393597] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Objective Previous studies have shown that healthcare professionals rarely instruct patients about proper insulin injection techniques. This study aimed to assess the practices of insulin injection techniques among patients with diabetes treated and assess the effect of these practices on glycemic control. Patients and Methods This cross-sectional study was conducted between November 2020 and February 2021. A random systematic sampling technique was used to recruit study subjects at specialist outpatient clinics. Subjects with type 1 or 2 diabetes mellitus who had been using insulin injections for at least a year were included in this study. Results A total of 298 subjects with type 1 diabetes and 553 with type 2 diabetes participated in this study. The mean age of patients with type 1 diabetes was 20.1 ± 10.4 years. The mean age of patients with type 2 diabetes was 58.6 ± 9.5 years. The median type 1 diabetes duration was 6.0 years, and median type 2 diabetes duration was 15.0 years. About 66.8% of patients with type 1 diabetes and 69.4% of patients with type 2 diabetes were rotating insulin injection sites. Almost 36.6% of patients with type 1 diabetes and 50.5% of patients with type 2 diabetes reported using the same insulin needle more than three times. The prevalence of lipohypertrophy was 57.0% among patients with type 1 diabetes and 55.5% among patients with type 2 diabetes. The absence of lipohypertrophy, rotation of insulin injection site, and total daily insulin dose ≤50 units were all independently significantly associated with better glycemic control. Conclusion Insulin injection techniques were suboptimal among significant proportion of patients with diabetes in Jordan. Improper insulin injection technique, especially the rotation of injection sites and lipohypertrophy formation, was associated with uncontrolled blood glucose levels. Educational interventions that focus on insulin injection techniques among Jordanian patients with diabetes are strongly recommended.
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Affiliation(s)
- Mousa Abujbara
- Department of Diabetes and Endocrinology, the National Centre (Institute) for Diabetes, Endocrinology and Genetics/The University of Jordan, Amman, Jordan
| | - Eiman A Khreisat
- Department of Nursing, the National Centre (Institute) for Diabetes, Endocrinology and Genetics/The University of Jordan, Amman, Jordan
| | - Yousef Khader
- Department of Community Medicine, Jordan University of Science and Technology (JUST), Irbid, Jordan
| | - Kamel M Ajlouni
- Department of Endocrinology and Diabetes, the National Centre (Institute) for Diabetes, Endocrinology and Genetics/The University of Jordan, Amman, Jordan,Correspondence: Kamel M Ajlouni, Department of Endocrinology and Diabetes, the National Centre (Institute) for Diabetes, Endocrinology and Genetics/The University of Jordan, Amman, Jordan, Email
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ABDOLLAHI FARIBA, BIKDELI HAMED, ZEABADI SAKINEHMOGHADDAM, SEPASI RANAREZAI, KALHOR ROGHAYE, MOTALEBI SEYEDEHAMENEH. Predicting role of illness perception in treatment self-regulation among patients with type 2 diabetes. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2022; 63:E604-E610. [PMID: 36890999 PMCID: PMC9986977 DOI: 10.15167/2421-4248/jpmh2022.63.4.2727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/12/2022] [Indexed: 03/10/2023]
Abstract
Background and Objective Impaired self-regulation negatively impacts self-efficacy, self-management, blood sugar control, and quality of life among patients with diabetes. Hence, identifying the predictors of self-regulation is a necessity for healthcare providers. The current study aimed to determine the predictive role of illness perception in treatment self-regulation in patients with type 2 diabetes. Methods The current study is a descriptive cross-sectional study. A total of 200 patients with type 2 diabetes, who were referred to the only specialized clinic for endocrinology and diabetes affiliated with Qazvin University of Medical Sciences in 2019-2020, were recruited through a convenience sampling method. For data collection, the brief Illness Perception Questionnaire and the Treatment Self-Regulation Questionnaire were used. Collected data were analyzed by SPSS v21 using a multivariable regression model. Results Mean and standard deviation scores of self-regulation and illness perception were 69.11 ± 17.61 and 36.21 ± 7.05, respectively. Results of the multivariate regression model revealed the significant correlations of self-regulation with illness perception, age, cardiovascular complications, diabetic retinopathy, and diabetic foot ulcers. Conclusions In this study, participants presented a moderate level of self-regulation. The results also revealed that illness perception could be a predictor of improving patients' self-regulation. Therefore, providing infrastructure programs such as continuous education and appropriate care programs for diabetic patients to improve their illness perception can effectively improve their self-regulation behaviors.
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Affiliation(s)
- FARIBA ABDOLLAHI
- Department of Medical Sciences, Qazvin Branch, Islamic Azad University, Qazvin, Iran
| | - HAMED BIKDELI
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - SAKINEH MOGHADDAM ZEABADI
- Department of Medical Emergencies, School of Paramedical Sciences, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - RANA REZAI SEPASI
- Department of Medical Sciences, Qazvin Branch, Islamic Azad University, Qazvin, Iran
| | - ROGHAYE KALHOR
- Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran
| | - SEYEDEH AMENEH MOTALEBI
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
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Sińska BI, Dłużniak-Gołaska K, Jaworski M, Panczyk M, Duda-Zalewska A, Traczyk I, Religioni U, Kucharska A. Undertaking Healthy Nutrition Behaviors by Patients with Type 1 Diabetes as an Important Element of Self-Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13173. [PMID: 36293753 PMCID: PMC9602576 DOI: 10.3390/ijerph192013173] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/29/2022] [Accepted: 10/03/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Self-control/self-care means the active participation of a diabetic patient in therapy. It involves making numerous decisions and undertaking actions independently. The primary activities under the patient's control include adherence to medication regimens and maintenance of a health-promoting lifestyle, especially a healthy diet. However, the sense of responsibility for one's own health, i.e., high sense of responsibility (HSR), is an important element in the treatment of diabetes and in undertaking pro-health behaviors. The study aimed at analyzing adherence to dietary recommendations in the context of HSR in patients with type 1 diabetes. METHODS The cross-sectional study was conducted on a group of 394 adults. The assessment of adherence to dietary recommendations was performed with the present authors' Diabetes Dietary Guidelines Adherence Index (DDGA Index). The measurement of HSR was performed with the standardized Sense of Responsibility for Health Scale (HSRS). The assessment of the multifactorial influence of independent variables on the DDGA Index, including the "responsibility for health" variable, was conducted with the use of a linear regression model. RESULTS The mean DDGA value was 18.68 (SD = 3.97). The patients significantly more often avoided unhealthy products than included recommended products into the diet at a required frequency. A positive correlation was demonstrated between HSR and adherence to dietary recommendations (βstd. = 0.43, p < 0.001). CONCLUSIONS The sense of responsibility for one's health plays a main role in adherence to dietary recommendations in diabetes. Our study showed that a higher sense of responsibility for health was associated with a higher level of adherence to dietary recommendations. Patients with a high sense of responsibility for one's health will be more involved in the therapeutic process, including adherence to dietary recommendations. Therefore, all education actions should comprise not only dietary knowledge transfer and shaping appropriate skills, but they should also strengthen the sense of responsibility for one's health.
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Affiliation(s)
- Beata Irena Sińska
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, 27 Erazma Ciołka Street, 01-445 Warsaw, Poland
| | - Karolina Dłużniak-Gołaska
- Pediatric Clinical Hospital—University Clinical Center, Medical University of Warsaw, 63A Żwirki I Wigury Street, 02-091 Warsaw, Poland
| | - Mariusz Jaworski
- Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska Street, 00-575 Warsaw, Poland
| | - Mariusz Panczyk
- Department of Education and Research in Health Sciences, Faculty of Health Sciences, Medical University of Warsaw, 14/16 Litewska Street, 00-575 Warsaw, Poland
| | - Aneta Duda-Zalewska
- Department of Public Health, Faculty of Health Sciences, Medical University of Warsaw, Jana Nielubowicza Street 5, Blok F, 02-097 Warsaw, Poland
| | - Iwona Traczyk
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, 27 Erazma Ciołka Street, 01-445 Warsaw, Poland
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, Kleczewska 61/63, 01-826 Warsaw, Poland
| | - Alicja Kucharska
- Department of Human Nutrition, Faculty of Health Sciences, Medical University of Warsaw, 27 Erazma Ciołka Street, 01-445 Warsaw, Poland
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13
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Zhao D. Goals of cure: Perspectives on the concept of cure in type 2 diabetes. J Eval Clin Pract 2022; 28:445-453. [PMID: 35150460 PMCID: PMC9303532 DOI: 10.1111/jep.13666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/24/2022] [Accepted: 02/01/2022] [Indexed: 11/29/2022]
Abstract
UNLABELLED RATIONALE, AIMS AND OBJECTIVES: Type 2 diabetes (T2D) is an archetypical chronic condition of significant prevalence. Yet the concept of cure in the context of T2D reveals an interplay between the medical imagination and clinical realities that can shift the course of a patient's care. There are two domains in which cure is sociologically constructed: the professional domain occupied by clinicians treating people with T2D, and the lay domain occupied by T2D patients. Lay epistemologies of cure tend to be focused on modifying the experience of having T2D, while professional epistemologies tend to focus on modifying the disease through medical treatment. The objective of this study is to explore the role of the concept of cure in the context of type 2 diabetes, a model for chronic disease. METHODS Through surveys and interviews of T2D patients, providers and researchers at an urban academic medical centre, I explore the perspectives and attitudes each group have towards the concept of cure in T2D. Semi-structured interviews of T2D professionals and patient surveys consisting of free response questions and Likert scale items were thematically analysed for perspectives on cure in T2D. RESULTS Sixteen T2D patients met inclusion criteria and consented to the survey and ten T2D professionals were interviewed. Cure is conceived of heterogeneously both within and between epistemologies. Patients carry hopes of cure predicated on eliminating the unpleasant experiences of T2D and its treatments, while T2D professionals tend to avoid invoking the concept of cure, at least to patients, on grounds of clinical uncertainty. However, the concept of cure is a significant motivator of treatment in both lay and professional epistemologies. CONCLUSION Different viewpoints on cure in T2D present an opportunity for shared meaning and decision making between patients and their providers that can frame the best possible outcome for patient care.
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Affiliation(s)
- David Zhao
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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14
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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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Obesity Measures as Predictors of Type 2 Diabetes and Cardiovascular Diseases among the Jordanian Population: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212187. [PMID: 34831943 PMCID: PMC8618033 DOI: 10.3390/ijerph182212187] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 12/23/2022]
Abstract
Obesity is strongly associated with cardiovascular diseases (CVD) and type 2 diabetes (T2D). This study aimed to use obesity measures, body mass index (BMI) and waist circumference (WC) to predict the CVD and T2D risk and to determine the best predictor of these diseases among Jordanian adults. A cross-sectional study was conducted at the governmental and military hospitals across Jordan. The study participants were healthy or previously diagnosed with CVD or T2D. The continuous variables were compared using ANOVA, and the categorical variables were compared using the X2 test. The multivariate logistic regression was used to predict CVD and T2D risk through their association with BMI and WC. The final sample consisted of 6000 Jordanian adults with a mean age of 41.5 ± 14.7 years, 73.6% females. The BMI (OR = 1.7, CI: 1.30–2.30, p < 0.001) was associated with a higher risk of T2D compared to WC (OR = 1.3, CI: 1.04–1.52, p = 0.016). However, our results showed that BMI was not associated with CVD risk, while the WC was significantly and positively associated with CVD risk (OR = 1.9, CI: 1.47–2.47, p < 0.001). In conclusion, an elevated BMI predicts a higher risk of T2D, while WC is more efficient in predicting CVD risk. Our results can be used to construct a population-specific intervention to reduce the risk of CVD and T2D among adults in Jordan and other countries with similar backgrounds.
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Bonikowska I, Szwamel K, Uchmanowicz I. Analysis of the Impact of Disease Acceptance, Demographic, and Clinical Variables on Adherence to Treatment Recommendations in Elderly Type 2 Diabetes Mellitus Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8658. [PMID: 34444407 PMCID: PMC8391118 DOI: 10.3390/ijerph18168658] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 01/13/2023]
Abstract
This project aimed to analyze the impact of disease acceptance and selected demographic and clinical factors on the adherence to treatment recommendations in elderly type 2 diabetes mellitus patients. The observational study was performed using standardized research questionnaires: the Acceptance of Illness Scale (AIS), the Self-Care of Diabetes Inventory (SCODI), and the Adherence in Chronic Diseases Scale (ACDS). Two hundred patients with T2DM were studied (age M = 70.21 years, SD = 6.63 years). The median degree of disease acceptance was 29 (min-max = 8-40) and the median level of adherence was 24 (min-max = 13-28). Disease acceptance was a significant (p = 0.002) independent predictor of the odds of qualifying for non-adherence OR = 0.903, 95% CI = 0.846-0.963. The respondents gave the lowest scores for glycemic control (Mdn = 38.99, min-max = 8.33-150), and health control (Mdn = 55.88, min-max = 11.76-100). A one-way ANOVA showed that the non-adhering patients were significantly older compared to the adherence group and were taking significantly more diabetes pills per day. The level of disease acceptance was average, but it turned out to be an independent predictor of adherence. Therefore, it is justified to use psychological and behavioral interventions that are aimed at increasing the level of diabetes acceptance in elderly people with T2DM. It is important to have a holistic approach to the patient and to take actions that consider the patient's deficits in the entire biopsychosocial sphere. The obtained result confirmed the legitimacy of interventions aimed at increasing the level of disease acceptance in this group of patients.
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Affiliation(s)
- Iwona Bonikowska
- Institute of Health Sciences, Department Nursing, University of Zielona Góra, 2 Energetyków Street, 65-00 Zielona Góra, Poland
| | - Katarzyna Szwamel
- Institute of Health Sciences, University of Opole, Katowicka Street 68, 45-060 Opole, Poland;
| | - Izabella Uchmanowicz
- Faculty of Health Sciences, Wrocław Medical University, K. Bartla 5, 51-618 Wroclaw, Poland;
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17
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Alexandre K, Campbell J, Bugnon M, Henry C, Schaub C, Serex M, Elmers J, Desrichard O, Peytremann-Bridevaux I. Factors influencing diabetes self-management in adults: an umbrella review of systematic reviews. JBI Evid Synth 2021; 19:1003-1118. [PMID: 33741836 DOI: 10.11124/jbies-20-00020] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The objective of this review was to identify and describe the factors influencing diabetes self-management in adults by summarizing the available evidence concerning their types, categories, and relative importance. INTRODUCTION A wide range of factors, acting simultaneously, influence diabetes self-management and interfere with its actual application by patients. There is a variety of systematic reviews of these factors; however, a more thorough examination of their influences was lacking. INCLUSION CRITERIA Systematic reviews of qualitative or quantitative literature focusing on factors influencing adult diabetes self-management in general or on individual behaviors (ie, management of oral antidiabetic medication and insulin injections, self-monitoring of blood glucose, foot care, healthy eating, regular exercise, and smoking cessation) will be included. METHODS We performed an extensive search of 11 bibliographic databases, including gray literature, up to June 2019. Quantitative and qualitative findings were summarized separately and labeled according to their types (eg, facilitator/barrier, strength and direction of association), categories (eg, demographic, social), and frequency of occurrence. RESULTS We identified 51 types of factors within 114 systematic reviews, which mostly addressed medication-taking behavior. Thirty-two (62.7%) factors were reported in both qualitative and quantitative literature. The predominant influences were psychological factors and behavioral attributes/skills factors. The most frequently reported facilitators of diabetes self-management were motivation to diabetes self-management, a favorable attitude to diabetes self-management, knowledge about the disease, medication and behaviors associated with diabetes self-management, skills, and self-efficacy/perceived behavioral control. The predominant barriers were the presence of depression, and polypharmacy or drug regimen complexity. The demographic factor of female sex was frequently reported for its negative influence on diabetes self-management, whereas older age was a positive factor. The social/cultural and physical environment were the least-studied categories. Other factors such as social support from family, friends, or networks; interventions led by health professionals; and a strong community environment with good social services favoring diabetes self-management were reported as major facilitators of diabetes self-management. CONCLUSIONS Essential components of interventions to promote effective diabetes self-management should aim to help adults manage the effects of specific factors related to their psychological and practical self-management experience. Screening for depression, in particular, should become an integral part of the support for adult diabetes self-management, as depression is a particular obstacle to the effectiveness of diabetes self-management. Future studies should more deeply examine the influence of factors identified in the sociocultural and physical environment categories. Research should properly consider and invest efforts in strengthening social support and innovative community care approaches, including pharmacist- and nurse-led care models for encouraging and improving adult diabetes self-management. Finally, researchers should examine non-modifiable factors - age, sex, or socioeconomic status - in the light of factors from other categories in order to deepen understanding of their real-world patterns of action on adult diabetes self-management. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42018084665.
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Affiliation(s)
- Ketia Alexandre
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland.,Bureau d'Echange des Savoirs pour des praTique exemplaires de soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
| | - Joan Campbell
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland.,Bureau d'Echange des Savoirs pour des praTique exemplaires de soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
| | - Marie Bugnon
- Faculté de Psychologie et des Sciences de l'Education, University of Geneva, Geneva, Switzerland
| | - Cristina Henry
- Association Vaudoise d'Aide et de Soins À Domicile (AVASAD), Lausanne, Switzerland
| | - Corinne Schaub
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland.,Bureau d'Echange des Savoirs pour des praTique exemplaires de soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
| | - Magali Serex
- School of Health Sciences (HESAV), University of Applied Sciences and Arts Western Switzerland (HES-SO), Lausanne, Switzerland.,Bureau d'Echange des Savoirs pour des praTique exemplaires de soins (BEST): A JBI Centre of Excellence, Lausanne, Switzerland
| | - Jolanda Elmers
- Centre Hospitalier Universitaire Vaudois (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Olivier Desrichard
- Faculté de Psychologie et des Sciences de l'Education, University of Geneva, Geneva, Switzerland
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Hadisuyatmana S, Efendi F, Has EMM, Wahyuni SD, Bauer M, Boyd JH, Reisenhofer S. The Experience of Indonesian Men Living with Type-2 Diabetes Mellitus and Erectile Dysfunction: A Semi-structured Interview Study. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-021-09687-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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De Groot J, Wu D, Flynn D, Robertson D, Grant G, Sun J. Efficacy of telemedicine on glycaemic control in patients with type 2 diabetes: A meta-analysis. World J Diabetes 2021; 12:170-197. [PMID: 33594336 PMCID: PMC7839169 DOI: 10.4239/wjd.v12.i2.170] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/07/2020] [Accepted: 12/29/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Telemedicine is defined as the delivery of health services via remote communication and technology. It is a convenient and cost-effective method of intervention, which has shown to be successful in improving glyceamic control for type 2 diabetes patients. The utility of a successful diabetes intervention is vital to reduce disease complications, hospital admissions and associated economic costs.
AIM To evaluate the effects of telemedicine interventions on hemoglobin A1c (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), post-prandial glucose (PPG), fasting plasma glucose (FPG), weight, cholesterol, mental and physical quality of life (QoL) in patients with type 2 diabetes. The secondary aim of this study is to determine the effect of the following subgroups on HbA1c post-telemedicine intervention; telemedicine characteristics, patient characteristics and self-care outcomes.
METHODS PubMed Central, Cochrane Library, Embase and Scopus databases were searched from inception until 18th of June 2020. The quality of the 43 included studies were assessed using the PEDro scale, and the random effects model was used to estimate outcomes and I2 for heterogeneity testing. The mean difference and standard deviation data were extracted for analysis.
RESULTS We found a significant reduction in HbA1c [-0.486%; 95% confidence interval (CI) -0.561 to -0.410, P < 0.001], DBP (-0.875 mmHg; 95%CI -1.429 to -0.321, P < 0.01), PPG (-1.458 mmol/L; 95%CI -2.648 to -0.268, P < 0.01), FPG (-0.577 mmol/L; 95%CI -0.710 to -0.443, P < 0.001), weight (-0.243 kg; 95%CI -0.442 to -0.045, P < 0.05), BMI (-0.304; 95%CI -0.563 to -0.045, P < 0.05), mental QoL (2.210; 95%CI 0.053 to 4.367, P < 0.05) and physical QoL (-1.312; 95%CI 0.545 to 2.080, P < 0.001) for patients following telemedicine interventions in comparison to control groups. The results of the meta-analysis did not show any significant reductions in SBP and cholesterol in the telemedicine interventions compared to the control groups. The telemedicine characteristic subgroup analysis revealed that clinical treatment models of intervention, as well as those involving telemonitoring, and those provided via modes of videoconference or interactive telephone had the greatest effect on HbA1c reduction. In addition, interventions delivered at a less than weekly frequency, as well as those given for a duration of 6 mo, and those lead by allied health resulted in better HbA1c outcomes. Furthermore, interventions with a focus on biomedical parameters, as well as those with an engagement level > 70% and those with a drop-out rate of 10%-19.9% showed greatest HbA1c reduction. The patient characteristics investigation reported that Hispanic patients with T2DM had a greater HbA1c reduction post telemedicine intervention. For self-care outcomes, telemedicine interventions that resulted in higher post-intervention glucose monitoring and self-efficacy were shown to have better HbA1c reduction.
CONCLUSION The findings indicate that telemedicine is effective for improving HbA1c and thus, glycemic control in patients with type 2 diabetes. In addition, telemedicine interventions were also found to significantly improved other health outcomes as well as QoL scores. The results of the subgroup analysis emphasized that interventions in the form of telemonitoring, via a clinical treatment model and with a focus on biomedical parameters, delivered at a less than weekly frequency and 6 mo duration would have the largest effect on HbA1c reduction. This is in addition to being led by allied health, through modes such as video conference and interactive telephone, with an intervention engagement level > 70% and a drop-out rate between 10%-19.9%. Due to the high heterogeneity of included studies and limitations, further studies with a larger sample size is needed to confirm our findings.
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Affiliation(s)
- Julia De Groot
- School of Medicine, Griffith University, Gold Coast 4222, Queensland, Australia
| | - Dongjun Wu
- School of Medicine, Griffith University, Gold Coast 4222, Queensland, Australia
| | - Declan Flynn
- School of Medicine, Griffith University, Gold Coast 4222, Queensland, Australia
| | - Dylan Robertson
- School of Medicine, Griffith University, Gold Coast 4222, Queensland, Australia
| | - Gary Grant
- School of Pharmacy and Pharmacology, Griffith University, Gold Coast 4222, Queensland, Australia
| | - Jing Sun
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Brisbane 4222, Queensland, Australia
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Haghravan S, Mohammadi-Nasrabadi F, Rafraf M. A critical review of national diabetes prevention and control programs in 12 countries in Middle East. Diabetes Metab Syndr 2021; 15:439-445. [PMID: 33592370 DOI: 10.1016/j.dsx.2021.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Diabetes mellitus has been known as one of the most significant systemic diseases with severe consequences and challenges to human health. AIM The primary aim of the current paper was to review the diabetes prevention programs in the Middle East countries, and secondary compare their goals and success rate and conclude possible upcoming strategies. METHODS All reports and documents regarding to diabetes prevention and control programs in the region were collected by searching Web of Science, PubMed, MEDLINE, Google Scholar, Scopus and EMBASE for articles up to 2020. The health policy triangle framework was used to analyze diabetes policies and programs. In the Middle East, a shift from rural to urban life, socioeconomic development, sedentary lifestyles, and high fat and sugary foods consumption led to increasing in obesity and diabetes rate, which have become a real challenge. RESULTS To decrease the burden of diabetes, preventive strategies with proper local socio-cultural context are needed. Evaluation of current policies and identifying stakeholders' views can help to improve the current strategies for the prevalence of diabetes and its complications. CONCLUSIONS It can provide local and global insight to evidence-informed decision-making for future policy reforms to enhance effectiveness of the program.
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Affiliation(s)
- Simin Haghravan
- Students Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Mohammadi-Nasrabadi
- Research Department of Food and Nutrition Policy and Planning, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Rafraf
- Nutrition Research Center, Faculty of Nutrition & Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
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Khdour MR, Awadallah HB, Alnadi MA, Al-Hamed DH. Beliefs About Medicine and Glycemic Control Among Type 2 Diabetes Patients: A Cross-Sectional Study in West Bank, Palestine. J Prim Care Community Health 2020; 11:2150132720971919. [PMID: 33287616 PMCID: PMC7727042 DOI: 10.1177/2150132720971919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION To examine the mean differences between patient beliefs about medicine with reference to adherence and glycemic control. METHODS This study utilized a cross-sectional questionnaire-based approach. Adherence to medication was measured with the Morisky Green Levine Medication Adherence Scale (MGLS); glycemic control as the last HbA1c test value; and beliefs about medicine with the Beliefs about Medicines Questionnaire (BMQ). RESULTS According to MGLS scale, 220 (57.9%) of the diabetic patients were classified as high adherent to their medications and 160 (42.1%) were classified as low adherent. Patients had strong believes in their medication, the mean necessity score was significantly outweighed the mean concerns score (17.7 vs 14.4; P < .001). Low adherent patients had significantly more concerns about long term effect of medications (14.4 vs 13.8; P < .008). No significant mean differences were found between glycemic controlled and uncontrolled group regarding necessity or concern domains. CONCLUSION Assessing beliefs about medicine is crucial for recognizing patients at risk of low adherence, which offers a way to help patients with diabetes to achieve a better glycemic control.
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Impact of Diabetes Perceptions on Medication Adherence in Japan. PHARMACY 2019; 7:pharmacy7040144. [PMID: 31671762 PMCID: PMC6958369 DOI: 10.3390/pharmacy7040144] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 10/21/2019] [Accepted: 10/27/2019] [Indexed: 12/26/2022] Open
Abstract
Background: Patients’ perception of diabetes mellitus is one of the psychosocial factors influencing diabetic behavior. This patients’ perception of the disease is a mental image formed from the experience of patients with type 2 diabetes mellitus and reportedly reflects the aspect of recuperation. We investigated the relationship between changes in the patients’ perception of the disease and medication adherence, as influenced by the active involvement of community pharmacists. Methods: A prospective cohort study that used patient registry based in community pharmacies was conducted in patients with type 2 diabetes using oral antidiabetic agents at a pharmacy in Ishikawa Prefecture in Japan. Patients responded to the questionnaire at the time of enrollment and at the end of the one-year intervention period. The pharmacist confirmed the patient's medication status and treatment problems via telephone calls at least once every two weeks for one year. Main outcome measures: Type 2 diabetes patients’ perception of the disease related to medication adherence. Results: The study enrolled 113 patients. Among the seven diabetes image factors, “Living an orderly life” and “Feeling of fear” were significantly associated with medication adherence. “Feeling of neglect of health” was significantly associated at the subscale level. Conclusion: All the three factors related to medication adherence indicated self-care ability. To enhance the self-care ability of the patient, pharmacists should assist in self-care interventions for the patients.
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Pokhrel S, Shrestha S, Timilsina A, Sapkota M, Bhatt MP, Pardhe BD. Self-Care Adherence And Barriers To Good Glycaemic Control In Nepalese Type 2 Diabetes Mellitus Patients: A Hospital-Based Cross-Sectional Study. J Multidiscip Healthc 2019; 12:817-826. [PMID: 31632050 PMCID: PMC6791337 DOI: 10.2147/jmdh.s216842] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 09/13/2019] [Indexed: 12/14/2022] Open
Abstract
Purpose The patient believes in adherence to medication rather than to self-care adherence and lifestyle changes for the management of diabetes. This study was carried out to establish the association of self-care adherence and their barriers in poor glycemic control in our diabetic population. Patients and methods This cross-sectional study was conducted among 480 already diagnosed diabetes outpatients attended in our two hospitals. Glycaemic control was defined by levels of HbA1c. Socio-demographic data, lifestyle variables and anthropometric measurements were recorded using a standard questionnaire. Fasting blood glucose, HbA1c and lipid profiles were estimated using the manufacturer’s guideline. Student’s t-test and one-way ANOVA were used for comparison between different groups and the correlation was established by Spearman correlation. Risk factors associated with poor glycaemic control were verified by logistic regression analysis. Results The mean HbA1c of the study population was 7.4±1.3% and 65.4% had poor glycaemic control with mean 8.0±1.1%. Higher HbA1c levels were significantly associated with duration of diabetes, a number of drugs used, patient–physician relationship and knowledge about diabetes. The poor glycaemic control was significantly associated with low adherence of following the meal plan, regular medication and regular exercising (p<0.001). Among all the barriers, a too busy schedule for following the meal plan, taking medications and exercising regularly was significantly correlated with HbA1c levels. Multivariable logistic regression analysis showed irregular meal plan (OR=5.27), irregular exercise (OR=2.25), number of medication used (OR= 0.19) and lesser extent patient–physician relationship (OR=2.68) were independent risk factors for poor glycaemic control. Conclusion The poor glycaemic control was associated with poor adherence to self-care adherence and their barriers in our diabetic population. Integrated knowledge on diabetes management should be targeted to improve glycaemic control in our communities.
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Affiliation(s)
- Sushant Pokhrel
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Sneha Shrestha
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Alaska Timilsina
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Manisha Sapkota
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Mahendra Prasad Bhatt
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Bashu Dev Pardhe
- Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
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