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Amon S, Aikins M, Haghparast-Bidgoli H, Kretchy IA, Arhinful DK, Baatiema L, Awuah RB, Asah-Ayeh V, Sanuade OA, Kushitor SB, Mensah SK, Kushitor MK, Grijalva-Eternod C, Blandford A, Jennings H, Koram K, Antwi P, Gray E, Fottrell E. Household economic burden of type-2 diabetes and hypertension comorbidity care in urban-poor Ghana: a mixed methods study. BMC Health Serv Res 2024; 24:1028. [PMID: 39232716 PMCID: PMC11375836 DOI: 10.1186/s12913-024-11516-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 08/30/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Non-communicable diseases (NCDs) predispose households to exorbitant healthcare expenditures in health systems where there is no access to effective financial protection for healthcare. This study assessed the economic burden associated with the rising burden of type-2 diabetes (T2D) and hypertension comorbidity management, and its implications for healthcare seeking in urban Accra. METHODS A convergent parallel mixed-methods study design was used. Quantitative sociodemographic and cost data were collected through survey from a random community-based sample of 120 adults aged 25 years and older and living with comorbid T2D and hypertension in Ga Mashie, Accra, Ghana in November and December 2022. The monthly economic cost of T2D and hypertension comorbidity care was estimated using a descriptive cost-of-illness analysis technique from the perspective of patients. Thirteen focus group discussions (FGDs) were conducted among community members with and without comorbid T2D and hypertension. The FGDs were analysed using deductive and inductive thematic approaches. Findings from the survey and qualitative study were integrated in the discussion. RESULTS Out of a total of 120 respondents who self-reported comorbid T2D and hypertension, 23 (19.2%) provided complete healthcare cost data. The direct cost of managing T2D and hypertension comorbidity constituted almost 94% of the monthly economic cost of care, and the median direct cost of care was US$19.30 (IQR:10.55-118.88). Almost a quarter of the respondents pay for their healthcare through co-payment and insurance jointly, and 42.9% pay out-of-pocket (OOP). Patients with lower socioeconomic status incurred a higher direct cost burden compared to those in the higher socioeconomic bracket. The implications of the high economic burden resulting from self-funding of healthcare were found from the qualitative study to be: 1) poor access to quality healthcare; (2) poor medication adherence; (3) aggravated direct non-medical and indirect cost; and (4) psychosocial support to help cope with the cost burden. CONCLUSION The economic burden associated with healthcare in instances of comorbid T2D and hypertension can significantly impact household budget and cause financial difficulty or impoverishment. Policies targeted at effectively managing NCDs should focus on strengthening a comprehensive and reliable National Health Insurance Scheme coverage for care of chronic conditions.
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Affiliation(s)
- Samuel Amon
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana.
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana.
| | - Moses Aikins
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana
| | | | - Irene Akwo Kretchy
- Department of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Accra, Ghana
| | - Daniel Kojo Arhinful
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Leonard Baatiema
- Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, P.O. Box LG 13, Legon, Accra, Ghana
- Center for Tropical Medicine and Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Vida Asah-Ayeh
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Olutobi Adekunle Sanuade
- Department of Population Health Sciences, Division of Health System Innovation and Research, Spencer Fox Eccles School of Medicineat the , University of Utah, Salt Lake City, USA
| | - Sandra Boatemaa Kushitor
- Department of Community Health, Ensign Global College, Kpong, Ghana
- Department of Food Science and Centre for Sustainability Studies, Stellenbosch University, Stellenbosch, South Africa
| | - Sedzro Kojo Mensah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Mawuli Komla Kushitor
- Institute for Global Health, University College London, London, UK
- Department of Health Policy, Planning and Management (HPPM), Fred N. Binka School of Public Health (HPPM), University of Health and Allied Sciences (UHAS), Ho, Volta Region, Ghana
- London School of Hygiene and Tropical Medicine, London, UK
| | - Carlos Grijalva-Eternod
- Institute for Global Health, University College London, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
| | - Ann Blandford
- UCL Interaction Centre (UCLIC), University College London, London, UK
| | - Hannah Jennings
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, University of York, York, UK
| | - Kwadwo Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Publa Antwi
- Department of Health Sciences, University of York, York, UK
| | - Ethan Gray
- Institute for Global Health, University College London, London, UK
- UCL Interaction Centre (UCLIC), University College London, London, UK
| | - Edward Fottrell
- Institute for Global Health, University College London, London, UK
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Adu FA, Poku CA, Adu AP, Owusu LB. The role of social support and self-management on glycemic control of type 2 diabetes mellitus with complications in Ghana: A cross-sectional study. Health Sci Rep 2024; 7:e2054. [PMID: 38650722 PMCID: PMC11033339 DOI: 10.1002/hsr2.2054] [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: 05/05/2023] [Revised: 02/08/2024] [Accepted: 04/02/2024] [Indexed: 04/25/2024] Open
Abstract
Background and Aims Diabetes mellitus (DM) can result in detrimental complications which are connected with long-term impairments and disabilities. Chronic complications are well-known consequences of type 2 diabetes mellitus (T2DM) progression, which reduce patient quality of life, place a burden on the healthcare system, and increase mortality. Measures to promote health outcomes for people with DM are scanty; the study therefore aimed at determining the effects of self-management and social support on glycemic control of T2DM with complications in Ghana. Methods A cross-sectional design using convenience sampling was conducted on 400 T2DM patients using Hensarling's Diabetes Family Support Scale and Summary of Diabetes Self‑Care Activities scale. Data analysis was conducted using descriptive, Pearson Moment Product Correlation and Binary Logistic Regression on self-management, social support, and glycemic control in T2DM patients. Results Social support among participants was high and there was a positive correlation or relationship between social support and T2DM self-management. There was a correlation between social support and self-management (r = 0.149, p < 0.05) and diet control (r = 0.221, p < 0.05). The results also showed a significant correlation between medication adherence and glycemic management (r = 0.116, p < 0.05) while female T2DM participants, individuals with at least primary education were less likely to have low self-management relative to T2DM. Conclusion Though the level of T2DM self-management was high it does not translate to good glycemic control. Focused health education programs should be incorporated into patients' care plans which will be particularly relevant for patients with T2DM and will contribute to positive physiological and psychological outcomes. Furthermore, a more robust monitoring and follow-up scheme should be scaled up or instituted for patients with T2DM.
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Affiliation(s)
- Frank Amankwah Adu
- Medical Technology in the Xiangya School of NursingCentral South UniversityChangshaChina
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Collins Atta Poku
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Amanda Parko Adu
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
| | - Lydia Boampong Owusu
- Department of NursingKwame Nkrumah University of Science and TechnologyKumasiGhana
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Obeng FY, Amponsah SK, Ofori EK, Afriyie DK. Medication errors at a diabetes management center in a resource-poor setting. INTERNATIONAL JOURNAL OF RISK & SAFETY IN MEDICINE 2024; 35:259-270. [PMID: 38788093 DOI: 10.3233/jrs-230062] [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: 05/26/2024]
Abstract
BACKGROUND Medication errors are known to cause adverse drug reactions, hospital admissions and mortality. In most resource-poor settings, medication errors occur but are undocumented. OBJECTIVE This study sought to investigate medication errors in a diabetic clinic at Komfo Anokye Teaching Hospital (KATH), Ghana. METHODS The research combined both qualitative and quantitative data collection methods. The quantitative aspect involved retrospectively reviewing patient folders over two years (1st January 2019 to 31st December 2021). Patients' folders were reviewed to identify possible medication errors. The qualitative arm explored underlying factors and experiences related to medication errors through interviews with healthcare workers. Ten healthcare professionals at KATH were interviewed using an interview guide. RESULTS A total of 264 patients' folders were retrieved. The majority (23.11%) of the patients were between 18 and 25 y.o., and there were more females (52.27%) than males. About 60% of the patients had diabetes and hypertension comorbidity. The overall prevalence of medication errors was 18.18%. The most prevalent type of medication error identified was wrong drug formulation (n = 19, 39.58%). About 47.92% of the medication errors resulted in adverse events and this was predominantly caused by antidiabetic drugs (47.83%) and anti-hypertensive drugs (34.78%). Patients in the age category of 26-35 y.o. [aOR: 0.31, CI: 0.11-0.90] had reduced odds of medication errors whilst patients with comorbidity of diabetes and hypertension [aOR: 5.95, CI: 2.43-14.60] had an increased odds of medication errors. Large patient population, low staff numbers and inadequate knowledge of drugs by healthcare workers were factors that contributed to medication errors. CONCLUSION Medication errors was moderately high in this diabetic clinic, and the errors led to a number of adverse events. Age, diabetes and hypertension comorbidity, large patient population, low staff numbers, and inadequate knowledge about drugs were identified as factors that influenced medication errors.
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Affiliation(s)
- Frank Yaw Obeng
- Department of Internal Medicine, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Seth Kwabena Amponsah
- Department of Medical Pharmacology, University of Ghana Medical School, Accra, Ghana
| | - Emmanuel Kwaku Ofori
- Department of Chemical Pathology, University of Ghana Medical School, Accra, Ghana
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Shita NG, Isayu AS. Predictors of blood glucose change and microvascular complications of type 2 diabetes mellitus patients in Felege Hiwot and Debre Markos referral hospital, North West Ethiopia. BMC Endocr Disord 2022; 22:136. [PMID: 35606785 PMCID: PMC9128238 DOI: 10.1186/s12902-022-01047-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Microvascular complications lead to disability, dependency, and accelerated morbidity and mortality. This study aimed to identify predictors of blood glucose change and time to microvascular complications among patients with type 2 diabetes. METHODS A retrospective cohort study was conducted among type 2 diabetes mellitus patients enrolled between December 2014 and December 2015 at Felege Hiwot and Debre Markos Referral Hospital. A total of 318 T2DM patients were included in the study. Joint modelling of longitudinal and survival analysis was employed to identify predictors of Blood Glucose Change and Microvascular Complications in Type 2 Diabetes Mellitus Patients. RESULTS The prevalence of microvascular complications in Type 2 diabetes patients was 26.3%, 95%confidence interval(CI):(21.5, 31.1). Of which, half of the patients developed a microvascular complication after 30 months from the onset of the follow-up. The significant predictors of developing microvascular complication were positive proteinurea (adjusted hazard ratio (AHR) = 1.418, 95%CI: 1.080, 1.861), Serum creatinine (AHR = 3.704, 95%CI: 1.992, 6.887), Weight (AHR = 1.058, 95%CI: 1.023, 1.094), and log fasting blood glucose(log(FBS))(AHR = 1.013, 95%CI: 1.010, 1.015). The predictors of fasting blood glucose progression were higher baseline FBS(est(estimate) = 0.002,95%CI:0.0018, 0.0022), Systolic blood pressure (SBP) (est = 0.003, 95%CI: 0.002, 0.004), diastolic blood pressure (DBP) (est = 0.002, 95%CI: 0.0002, 0.004), and age (est = 0.003, 95%CI: 0.001, 0.004). CONCLUSION The progression of the fasting blood glucose level for rural patients was faster than for urban patients. Patients having higher baseline FBS, previous hypertension history, higher SBP, higher DBP, older age, and fewer visits to the hospital have a relatively more progressive change in blood sugar levels. Patients having higher triglyceride levels, positive proteinuria, higher fasting blood sugar, higher weight, and a lesser number of hospital visits have a higher risk of developing a complication. In response to this finding, an aggressive intervention that targets to prevent microvascular complications is required.
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Understanding the information culture for self-management support of people living with diabetes in Ghana. DIGITAL LIBRARY PERSPECTIVES 2022. [DOI: 10.1108/dlp-11-2021-0098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study is to explore the information culture of people living with Diabetes Mellitus (DM) and how that impacts their self-management practices in Ghana. The study focuses on the information experiences and information cultural patterns and creates awareness of the need for people to be aware of effective information management for sustainable self-management support.
Design/methodology/approach
An interpretive qualitative approach was used. A total of 12 interviewees involving 10 diabetes patients and 2 health professionals provided data for the study. Allowing the participants to freely talk about their attitude and behaviour, defining their experiences around information for their self-management was the best approach to achieve an in-depth understanding this study seeks.
Findings
The specific elements defining the information of people living with DM in Ghana can be identified. People living with the condition are willing to share information about their condition not only with those within their diabetic community but also with anyone interested. They prefer to use information from sources they find reliable and trust, and they have good information-related competencies that are consistent with diabetic patients in other countries’ contexts to help them identify, access, use and share relevant information. Only a few of the interviewees have difficulty in evaluating the accuracy and currency of some of the information. But they receive a lot of support from experienced people from their community. People also prefer to have information about the condition in their ethnic language. It is important for people living with the condition in Ghana to get involved in the diabetic groups, clubs and community, as members appear to receive the most benefit and support from the community to self-manage the condition alone.
Research limitations/implications
The study is limited by the number of participants and the distances between the researchers and the research context. Also, even though two groups of participants were interviewed (diabetic patients and health professionals), the analysis did not separate the responses of the different groups of study participants. This paper provides a useful insight and understanding of the culture of people living with diabetes in Ghana in terms of how they access, use and share the information they need to support their self-management. It will create awareness of the importance of being mindful of information culture patterns in people in other groups in Ghana and beyond. The research processes and procedures described in the paper can be replicated by other researchers in other contexts.
Originality/value
Although there have been a lot of studies about diabetes and people living with the condition in Ghana, to the best of the authors’ knowledge, this is the first study looking at how people define their need for information, how they identify the source of the information and how they access and use the information, including their general behavioural patterns that influence these information experiences.
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Abd-Alsalam A, Zainal IG, Taqa GA. Estimation of protein oxidation parameters in patients with diabetic nephropathy. 1ST SAMARRA INTERNATIONAL CONFERENCE FOR PURE AND APPLIED SCIENCES (SICPS2021): SICPS2021 2022. [DOI: 10.1063/5.0121525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Seid MA, Akalu Y, Gela YY, Belsti Y, Diress M, Fekadu SA, Dagnew B, Getnet M. Microvascular complications and its predictors among type 2 diabetes mellitus patients at Dessie town hospitals, Ethiopia. Diabetol Metab Syndr 2021; 13:86. [PMID: 34404465 PMCID: PMC8369723 DOI: 10.1186/s13098-021-00704-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/02/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Diabetes mellitus is a serious metabolic disorder which becomes common in middle and low incomes countries since few decades. Microvascular complications include retinopathy, neuropathy and nephropathy all of which can lead to disability, dependency, accelerate their morbidity, and mortality. In Ethiopia, there is paucity data regarding this topic. Hence, this study aimed to assess prevalence of microvascular complications and its predictors among type 2 diabetes mellitus patients. METHODS Cross-sectional study was conducted from February to March 2020 at Dessie town hospitals. We used simple random sampling to recruit study participants and pre-tested interviewer administered questionnaire to collect the data. Data was entered into Epi-Data 3.1 and exported to SPSS-23 for analysis. Binary logistic regression was done to select potential variables to be adjusted at p ≤ 0.25. After running multivariable regression, variables with a p-value ≤ 0.05 were declared as statistically significant. RESULTS Three hundred and thirty-five type 2 DM patients participated in the study, of which 54.6% were males. One hundred and twenty-seven [37.9% (95% CI 32.5%-43.3%)] of diabetes mellitus had at least one microvascular complications. These were retinopathy 24.8%, nephropathy 16.1%, and neuropathy 8.1%. Age 60-87 years (AOR = 2.76, 95% CI 1.02-7.46), duration of diabetes > 5 years (AOR = 4.09, 95% CI 2.40-6.96), mellitus and co-morbid hypertension (AOR = 3.52, 95% CI 2.09-5.95), were statistically significant. CONCLUSIONS In this study, diabetic microvascular complications are prevalent. Increasing the age of participants, longer duration of diabetes mellitus and co-morbid hypertension were independent predictors. Health workers should give emphasis for diabetes mellitus through early screening and health education, abrupt medication for aged patients with long duration of diabetes mellitus, and hypertension, and also early detection and management of microvascular complication.
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Affiliation(s)
- Mohammed Abdu Seid
- Unit of Human Physiology, Department of Biomedical Science, College of Health Sciences, Debre Tabor University, P. O. Box: 272, Debre Tabor, Ethiopia.
| | - Yonas Akalu
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yibeltal Yismaw Gela
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yitayeh Belsti
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mengistie Diress
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sofonias Addis Fekadu
- Department of Optometry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mihret Getnet
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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He XY, Ou CL. Clinical significance of serum miR-129-5p in patients with diabetes mellitus presenting macrovascular complications. World J Diabetes 2021; 12:1282-1291. [PMID: 34512893 PMCID: PMC8394230 DOI: 10.4239/wjd.v12.i8.1282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/24/2021] [Accepted: 07/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Diabetic macrovascular complications (DMCs) are the most common complications encountered during the course of diabetes mellitus (DM) with extremely high mortality rates. Therefore, there is an urgent need to identify specific and sensitive biomarkers for the early diagnosis of DMCs.
AIM To investigate the expression and significance of serum miR-129-5p in patients with DM and macrovascular complications.
METHODS Serum samples were collected from 36 healthy controls, 58 patients with DM presenting no macrovascular complications, and 62 patients with DMCs. The expression of miR-129-5p was detected using quantitative real-time polymerase chain reaction. Pearson’s correlation assay was performed to analyze the correlation between serum miR-129-5p levels and clinical indicators. Receiver operator characteristic (ROC) analysis was conducted to analyze the diagnostic value of serum miR-129-5p in patients with DM or DMCs.
RESULTS There was a 4.378-fold and 7.369-fold increase in serum miR-129-5p expression in the DM (5.346 ± 0.405) and DMCs (8.998 ± 0.631) groups, respectively (P < 0.001), compared with the control group (1.221±0.090). In addition, the expression of serum miR-129-5p in patients with DMCs was higher than that in patients with DM, revealing a 1.683-fold increase (P < 0.001). Additionally, serum miR-129-5p expression significantly correlated with smoking history, disease duration, and glycated hemoglobin (HbA1c) in patients with DMCs (P < 0.001). The area under the ROC curve (AUC) of miR-129-5p as a serum marker was 0.964 (95% confidence interval [CI]: 0.930-0.997, P < 0.001) in distinguishing between patients with DM and healthy controls, whereas the AUC of miR-129-5p as a serum marker was 0.979 (95%CI: 0.959-0.999, P < 0.001) in distinguishing between patients with DMCs and healthy controls.
CONCLUSION Elevated serum miR-129-5p expression levels correlate with the development of DMCs and can be utilized as a novel early diagnostic biomarker for DM combined with macrovascular complications.
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Affiliation(s)
- Xiao-Yun He
- Department of Pathology, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
- Department of Endocrinology, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China
| | - Chun-Lin Ou
- Department of Pathology, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China
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Shiferaw WS, Akalu TY, Petrucka PM, Areri HA, Aynalem YA. Risk factors of erectile dysfunction among diabetes patients in Africa: A systematic review and meta-analysis. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2020; 21:100232. [PMID: 32685380 PMCID: PMC7358381 DOI: 10.1016/j.jcte.2020.100232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/18/2020] [Accepted: 06/27/2020] [Indexed: 12/21/2022]
Abstract
Background Erectile dysfunction in men is a common underestimated complication of diabetes mellitus, which is becoming a significant public health problem both in developing and developed countries. Erectile dysfunction threatens the well-being of clients, hence determining its risk factors and controlling it at an early stage is vital to preventing serious consequences and the burden of the disease. Therefore, this study aimed to systematically evaluate erectile dysfunction risk factors in patients with diabetes mellitus in Africa. Methods PubMed, Web of Science, Scopus, African Journals Online, Wiley Online Library and Google Scholar were searched and complemented by manual searches. Egger's regression test was used to determine publication bias. The I2 statistic was used to check heterogeneity between the studies. DerSimonian and Laird random-effects model was applied to estimate pooled effect size, odds ratios, and 95% confidence interval across studies. STATA version 14 statistical software was used for the meta-analysis. Result Overall, 17 studies with 6002 study participants were included to identify risk factors of erectile dysfunction among diabetic patients. Duration of diabetes mellitus >10 years (AOR = 2.63; 95% CI 1.27, 5.43), age >40 years (AOR = 1.24; 95% CI: 1.03, 1.51), peripheral neuropathy (AOR = 2.34; 95% CI: 1.51, 10.72), no physical exercise (AOR = 1.63; 95% CI: 1.49, 1.78), testosterone level <8 nmol/l (AOR = 2.83; 95% CI: 1.06, 12.86), and peripheral vascular disease (AOR = 2.85, 95% CI: 1.54–5.27) were significantly associated with erectile dysfunction among diabetic patients. Conclusions This study found that long duration of diabetes mellitus, age >40 years, testosterone deficiency, peripheral neuropathy, not involved in physical exercise, peripheral vascular disease, were significantly associated with increased risk of erectile dysfunction among diabetic patients Therefore, situation-based interventions and country context-specific preventive strategies should be developed to decrease the risk factors of erectile dysfunction among patients with diabetes mellitus.
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Affiliation(s)
- Wondimeneh Shibabaw Shiferaw
- Department of Nursing, College of Health Science, Debre Berhan University, Ethiopia
- Corresponding author at: P.O. Box 445, Debre Berhan, Ethiopia.
| | - Tadesse Yirga Akalu
- Department of Nursing, College of Health Science, Debre Markos University, Ethiopia
| | | | - Habtamu Abera Areri
- School of Nursing and Midwifery, College of Health Science, Addis Ababa University, Ethiopia
| | - Yared Asmare Aynalem
- Department of Nursing, College of Health Science, Debre Berhan University, Ethiopia
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Asefa A, Nigussie T, Henok A, Mamo Y. Prevalence of sexual dysfunction and related factors among diabetes mellitus patients in Southwest Ethiopia. BMC Endocr Disord 2019; 19:141. [PMID: 31852461 PMCID: PMC6921479 DOI: 10.1186/s12902-019-0473-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 12/10/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Diabetes mellitus causes multiple medical, psychological and sexual problems in both men and women. Sexual dysfunction is one of those problems that lead to a strong social and psychological problem which adversely affect marital relation and treatment outcome. The issue has not been well studied in Ethiopia; therefore, this study aimed to evaluate the prevalence and factors related to sexual dysfunction in adult patients with diabetes mellitus. METHODS Facility-based cross-sectional study was conducted among adults with diabetes mellitus on follow-up at diabetic clinics of Mizan-Tepi University Teaching Hospital and Tepi General Hospital. A consecutive sampling technique was employed to select 423 study participants, and data were collected through interviewer-administered questionnaire and patients' medical chart review. Changes in Sexual Functioning Questionnaire-fourteen items (CSFQ-14) was used to measure sexual dysfunction. Descriptive statistics and binary logistic regression analyses were performed. Two tail tests at α of less 0.05 were used as a level of significance. RESULTS A total of 398 diabetic patients were interviewed, with a 94% response rate. The prevalence of sexual dysfunction was 53.3%. Age of above 41 years (AOR: 3.98, 95% CI 2.32-6.85), lack of formal education (AOR: 3.20, 95% CI 1.60-6.39), divorced or widowed (AOR: 5.28, 95% CI 2.35-11.86), type 2 DM (AOR: 4.52, 95% CI 2.17-9.42), depression (AOR: 4.05, 95% CI 2.32-7.10), complications or co-morbidity (AOR: 2.05, 95% CI 1.18-3.58), and not doing physical activity (AOR: 1.62, 95% CI; 1.47-1.77) were significantly associated with sexual dysfunction among diabetes patients. CONCLUSIONS The prevalence of sexual dysfunction was as high as reports from other studies. Therefore, health care providers should include the issue of sexual health in their routine discussions with adult diabetes mellitus patients. Presence of depression, not doing physical activity and having complications or co-morbidity are modifiable factors associated with sexual dysfunction; therefore, they should be attended during care addressing sexual dysfunction.
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Affiliation(s)
- Adane Asefa
- Department of Public Health, College of Health Science, Mizan- Tepi University, Mizan-Aman, Ethiopia
| | - Tadesse Nigussie
- Department of Public Health, College of Health Science, Mizan- Tepi University, Mizan-Aman, Ethiopia
| | - Andualem Henok
- Department of Public Health, College of Health Science, Mizan- Tepi University, Mizan-Aman, Ethiopia
| | - Yitagesu Mamo
- Department of Pharmacy, College of Health Science, Mizan- Tepi University, Mizan-Aman, Ethiopia
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Addai-Mensah O, Annani-Akollor ME, Nsafoah FO, Fondjo LA, Owiredu EW, Danquah KO, Duneeh RV, Amponsah FA. Effect of poor glycaemic control on plasma levels and activity of protein C, protein S, and antithrombin III in type 2 diabetes mellitus. PLoS One 2019; 14:e0223171. [PMID: 31560710 PMCID: PMC6764655 DOI: 10.1371/journal.pone.0223171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 08/23/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) patients are predisposed to several diabetes-related complications. Dysregulation of the haemostatic mechanisms have been implicated. There are however no current studies assessing the levels and activity of protein C (PC), protein S (PS), and antithrombin III (AT III), which are essential in haemostatic regulation, in a single cohort of T2DM patients. This study evaluated the effect of poorly-managed T2DM on the levels and activity of PC, PS, and AT III. METHODS This cross-sectional study was conducted at the Diabetes Clinic, Cocoa Clinic in Kumasi, Ghana. A total of 242 T2DM patients, comprising 152 patients with poorly-managed diabetes and 90 well-managed diabetes patients, were recruited for the study. Fasting blood glucose, liver function tests and lipid profile were performed for each respondent. Glycated haemoglobin (HbA1c) was estimated by turbidimetric inhibition immunoassay. The levels and activity of PC, PS and AT III were measured by solid phase sandwich ELISA method. RESULTS There was a negative correlation between HbA1c and the levels and activity of PC, PS and AT III. The levels and activity of PC [(5.78 vs 4.64 μg/ml, p<0.0001) and (42.22 vs 36.21 U/ml, p = 0.01) respectively], PS [(22.55 vs 20.29 μg/ml, p = 0.010) and (235.94 vs 211.67 U/ml, p<0.0001) respectively] and AT III [(16.28 vs 14.41μg/ml, p<0.0001) and (176.01 vs 160.09 U/ml, p = 0.03) respectively] were significantly increased in patients with well-managed T2DM compared to the poorly-managed diabetes patients. Likewise, the levels and activity of PC, PS, and AT III was higher among T2DM patients using statins than patients who were statin-naïve. Among patients with well-managed T2DM, those who were on statins had significantly higher levels and activities of PC, PS, and AT III compared to well-managed T2DM patients not on statins. However, there no statistically significant differences between the level and activity of PC, PS, and AT III among poorly-managed T2DM patients with respect to statin status. CONCLUSION Poorly-managed type 2 diabetes mellitus is associated with reduced levels and activity of PC, PS and AT III compared to well-managed T2DM. Though use of statins may improve the levels and activity of the PC, PS and AT III in T2DM, their effect is limited in the presence of poorly-controlled T2DM. Proper management of diabetes is essential to reduce the likelihood of thrombotic events among T2DM patients.
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Affiliation(s)
- Otchere Addai-Mensah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
- * E-mail: ,
| | - Max Efui Annani-Akollor
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Frederick Obeng Nsafoah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Linda Ahenkorah Fondjo
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Eddie-Williams Owiredu
- Department of Molecular Medicine, School of Medical Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwabena Owusu Danquah
- Department of Medical Diagnostics, Faculty of Allied Health Sciences, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Dobrică EC, Găman MA, Cozma MA, Bratu OG, Pantea Stoian A, Diaconu CC. Polypharmacy in Type 2 Diabetes Mellitus: Insights from an Internal Medicine Department. ACTA ACUST UNITED AC 2019; 55:medicina55080436. [PMID: 31382651 PMCID: PMC6723949 DOI: 10.3390/medicina55080436] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 07/20/2019] [Accepted: 07/31/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Polypharmacy heavily impacts the quality of life of patients worldwide. It is a necessary evil in many disorders, and especially in type 2 diabetes mellitus, as patients require treatment both for this condition and its related or unrelated comorbidities. Thus, we aimed to evaluate the use of polypharmacy in type 2 diabetes mellitus vs. non-diabetes patients. MATERIALS AND METHODS A cross-sectional retrospective observational study was conducted. We collected the medical records of patients hospitalized in the Internal Medicine Clinic of the Clinical Emergency Hospital of Bucharest, Romania, for a period of two months (01/01/2018-28/02/2018). Patients diagnosed with type 2 diabetes mellitus were included in the study group, whereas patients who were not diabetic were used as controls. RESULTS The study group consisted of 63 patients with type 2 diabetes mellitus (mean age 69.19 ± 9.67 years, range 46-89 years; 52.38% males). The control group included 63 non-diabetes patients (mean age 67.05 ± 14.40 years, range 42-93 years, 39.68% males). Diabetic patients had more comorbidities (10.35 ± 3.09 vs. 7.48 ± 3.59, p = 0.0001) and received more drugs (7.81 ± 2.23 vs. 5.33 ± 2.63, p = 0.0001) vs. non-diabetic counterparts. The mean number of drug-drug and food-drug interactions was higher in type 2 diabetes mellitus patients vs. controls: 8.86 ± 5.76 vs. 4.98 ± 5.04, p = 0.0003 (minor: 1.22 ± 1.42 vs. 1.27 ± 1.89; moderate: 7.08 ± 4.08 vs. 3.54 ± 3.77; major: 0.56 ± 0.74 vs. 0.37 ± 0.77) and 2.63 ± 1.08 vs. 2.19 ± 1.42 (p = 0.0457), respectively. CONCLUSIONS Polypharmacy should be an area of serious concern also in type 2 diabetes mellitus, especially in the elderly. In our study, type 2 diabetes mellitus patients received more drugs than their non-diabetes counterparts and were exposed to more drug-drug and food-drug interactions.
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Affiliation(s)
- Elena-Codruța Dobrică
- "Carol Davila" University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, Bucharest 050474, Romania
| | - Mihnea-Alexandru Găman
- "Carol Davila" University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, Bucharest 050474, Romania.
| | - Matei-Alexandru Cozma
- "Carol Davila" University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, Bucharest 050474, Romania
| | - Ovidiu Gabriel Bratu
- "Carol Davila" University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, Bucharest 050474, Romania
- Emergency University Central Military Hospital, 88 Mircea Vulcanescu Street, Bucharest 010825, Romania
- Academy of Romanian Scientists, 54 Splaiul Independentei Street, Bucharest 030167, Romania
| | - Anca Pantea Stoian
- "Carol Davila" University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, Bucharest 050474, Romania
| | - Camelia Cristina Diaconu
- "Carol Davila" University of Medicine and Pharmacy, 8 Eroii Sanitari Boulevard, Bucharest 050474, Romania
- Internal Medicine Clinic, Clinical Emergency Hospital of Bucharest, 8 Calea Floreasca Street, Bucharest 014461, Romania
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