Current Issue : July - September Volume : 2017 Issue Number : 3 Articles : 7 Articles
Background: Previous research has failed to examine more than one self-care behaviour in type 2 diabetes patients in\nGhana. The purpose of this study is to investigate adult Ghanaian type 2 diabetes patients� adherence to four self-care\nactivities: diet (general and specific), exercise, self-monitoring of blood glucose (SMBG) and foot care.\nMethods: Consenting type 2 diabetes patients attending diabetes outpatient clinic appointments at three hospitals in\nthe Tamale Metropolis of Ghana completed a cross-sectional survey comprising the Summary of Diabetes Self-Care\nActivities Measure, and questions about demographic characteristics and diabetes history. Height and weight were also\nmeasured. Multiple linear regression analyses were conducted to identify the factors associated with adherence to\neach of the four self-care behaviours.\nResults: In the last 7 days, participants exercised for a mean (SD) of 4.78 (2.09) days and followed diet, foot care and\nSMBG for a mean (SD) of 4.40 (1.52), 2.86 (2.16) and 2.15 (0.65) days, respectively. More education was associated with a\nhigher frequency of reported participation in exercise (r = 0.168, p = 0.022), following a healthy diet (r = 0.223, p = 0.002)\nand foot care (r = 0.153, p = 0.037) in the last 7 days. Males reported performing SMBG (r = 0.198, p = 0.007) more\nfrequently than their female counterparts.\nConclusion: Adherence to diet, SMBG and checking of feet were relatively low. People with low education and\nwomen may need additional support to improve adherence to self-care behaviours in this type 2 diabetes population...
Diabetes mellitus (DM) is considered a major public health problem because\nof its high prevalence and progressive increase of incidence. DM chronic\ncomplications are major causes of morbidity and mortality, among which diabetic\nneuropathy (DN) stands out, affecting 30% - 50% of DM patients. An\nappropriate medical approach, involving anamnesis and thorough clinical\nexamination, is extremely important for the early diagnosis of DN and, therefore,\nto the prevention of its complications, including the amputation of\nlimbs. Despite of the importance of DN prevention and treatment, in order to\nprovide improved quality of life and longevity to DM patients, current therapeutic\noptions are very limited with respect to both symptom control and as\neffective disease therapies. Intensive glucose control is extremely important in\norder to prevent and avoid the progression of DN, as demonstrated in two\nlarge multicenter studies involving patients with type 1 DM, the DCCT (Diabetes\nControl and Complications Trial) and the EDIC (Epidemiology of Diabetes\nInterventions and Complications)....
Objective: To apply an intensive and multidisciplinary education protocol in\norder to decrease, improve, delay or cancel the beginning of neuropathy and\nthe manifestation of lesions in diabetic patients. Methodology: This is a\ncross-sectional descriptive study carried out at the Diabetes Mellitus Outpatient\nClinic and Ward of Santa Marcelina Hospital in Porto Velho. This research\nwas based on cases of patients with Diabetes and Diabetics with Leprosy.\nThe criteria used to include the patients were: being treated with insulin\ntherapy, not to be amputated, being on high medication of the leprosy at\nthe moment of the evaluation and to present nutritional risk classification by\nthe screening. The population was divided into two groups of fifteen patients:\neight diabetic patients, four male and four female. Seven diabetics associated\nwith leprosy were 4 males and 3 females. The monofilament test (Semmes-\nWeinstein 10 g) was used as the classification basis. Results and Discussion:\nGroup A, called the intensive care group, began diabetes education work with\nmedical, nutritional and rehabilitation guidelines by a multidisciplinary team\nfor an average period of 15 days in the ward and after discharged with biweekly\nmonitoring. Group B, called conventional care, received the same\nguidelines in outpatient care and the monitoring followed the quarterly protocol.\nBoth groups were evaluated and reassessed for a period of 180 days in\nthe outpatient clinic. Group A consisted of 8 (100%) patients, 4 (50%) diabetics\nand 4 (50%) diabetics and leprosy patients. Conclusion: Intensive education\nin diabetes showed an improvement in the sensitivity, healing and nutritional\nstatus of the patients, leading to an improvement in quality of life and\ndisability level, reducing or delaying the beginning of neurological complications.\nThe protocol intensive method demonstrated a 100% improvement in patients in group A....
Diabetes mellitus (DM) represents one of the most serious current health problems\nnowadays, considering the number of people affected, its complications\nand morbidities. A broad analysis was performed among diabetic patients attended\nin the Family Health Center from the district of Ba�º, in Cuiab�¡, Mato\nGrosso State (Center-east Brazil), to examine the patterns of occurrence of\noverweight or obesity, values of glycated hemoglobin and the diagnostic of\nmetabolic syndrome. The results show ahead a wide work that is necessary to\nprevent and early diagnose concerning DM, since only an intensive control will\nmake it possible to alter the reality of the unfavorable prognosis documented....
Background: The prevalence of erectile dysfunction among diabetic men varies between 35ââ?¬â??90%. Although\nerectile dysfunction is widespread among men with diabetes, the condition often remains undiagnosed and\ndemands appropriate assessment and prompt treatment. Erectile dysfunction can affect all aspects of a patientââ?¬â?¢s\nlife including physical, emotional, social, sexual, and relationships. The main aim of this study is to determine the\nprevalence and determinants of erectile dysfunction among diabetic patients attending hospitals in the Central\nand Northwest zone of Tigray, Ethiopia.\nMethods: A hospital based cross-sectional study was conducted on 249 male diabetic patients attending five\nhospitals in the Central and Northwestern Zone of Tigray, Ethiopia using systematic random sampling. The data was\ncollected from January 1 ââ?¬â?? February 30, 2016 and was entered and analyzed using SPSS version 20. Correlation and\nmultivariate logistic regression was employed to test associations between independent and outcome variables.\nResults: The mean age of study participants was 43.39 years and the mean duration of diabetes diagnosis was 6.\n22 years. The overall prevalence of erectile dysfunction was 69.9%, with 32.9% suffering from mild, 31.7% moderate,\nand 5.2% severe erectile dysfunction. Multivariate logistic regression revealed that erective dysfunction was\nsignificantly predicted by old age (Adjusted Odds Ratio [AOR] =15.013, CI:3.212ââ?¬â??70.166), longer duration of diabetes\n(AOR = 3.77, CI:1.291ââ?¬â??11.051), and lower monthly income (AOR = 0.285, CI:0.132ââ?¬â??0.615). No association was found\nwith body mass index, co-morbidity, glycemic control, and alcohol consumption.\nConclusion: The prevalence of erective dysfunction in this study population was very high. Age, income, and\nduration of diabetes were the independent predictors of erectile dysfunction. Nearly all of the patients in the\nsample (97%) had not been screened or treated for erectile dysfunction. Assessment and management of erectile\ndysfunction in the diabetic clinic should be part of routine medical care during follow-up visits with diabetic\npatients. Healthcare providers should put an emphasis on screening and treating older patients and those who had\na diabetes diagnosis for a longer duration....
Background: Sleep disorders are common and associated with multiple metabolic and psychological\nderangements. Obstructive sleep apnoea (OSA) is among the most common sleep disorders and an interrelationship\nbetween OSA, insulin resistance, obesity, type 2 diabetes (T2DM) and cardiovascular diseases\nhas been established. Prevalence of sleep disorders in Kenyans, particularly in individuals with T2DM is\nunknown. We thus aimed to determine prevalence of poor quality of sleep (QOS) and high risk for OSA,\namong persons with T2DM and determine their associations with socio-demographic and anthropometric\nvariables.\nMethods: Utilising a Cross- Sectional Descriptive design, QOS and risk for OSA were determined in a\nrandomly selected sample of patients with T2DM (cases) and an age and sex matched comparison group.\nThe validated Pittsburgh Sleep Quality Index (PSQI) and Berlin Questionnaire (BQ) were used to measure\nQOS and risk for OSA respectively. Associations between poor QOS, high risk for OSA, and socio-demographic and\nanthropometric variables in cases were evaluated.\nResults: From 245 randomly selected persons with T2DM attending outpatient clinics, aged over 18 years, 22 were\nexcluded due to ineligibility thus 223 were included in the analysis; 53.8% were females, mean age was 56.8 (SD 12.2)\nyears and mean BMI was 28.8 kg/m2 (SD 4.4). Among them, 119 (53%, CI 95% 46.5ââ?¬â??60.2) had poor QOS and 99 (44%\nCI 95% 37.8ââ?¬â??50.9) were at high risk for OSA. Among 112 individuals in comparison group, 33 (29.5%, CI 95% 20.9ââ?¬â??38.3)\nhad poor QOS and 9 (8%, CI 95% 3.3ââ?¬â??13.4) had high risk for OSA. Cases had a significantly higher probability for poor\nQOS [OR 2.76 (95% CI 1.7ââ?¬â??4.4))] and high risk for OSA [OR 9.1 (95% CI 4.4ââ?¬â??19.0)].\nHigher waist circumference was independently associated with a high risk for OSA in cases.\nConclusions: We demonstrate a high burden of sleep disturbances in patients with T2DM. Our findings may have\nimplications for clinicians to screen for sleep disorders when assessing patients with T2DM and warranting further\nattention by practitioners and researches in this field....
Background: The benefit of Self-monitoring of Blood Glucose (SMBG) in people with non-insulin treated type 2\ndiabetes remains unclear with inconsistent evidence from randomised controlled trials fuelling the continued\ndebate. Lack of a consistent finding has been attributed to variations in study population and design, including the\nSMBG intervention. There is a growing consensus that structured SMBG, whereby the person with diabetes and\nhealth care provider are educated to detect patterns of glycaemic abnormality and take appropriate action\naccording to the blood glucose profiles, can prove beneficial in terms of lowering HbA1c and improving overall\nwell-being. Despite this, many national health agencies continue to issue guidelines restricting the use of SMBG in\nnon-insulin treated type 2 diabetes.\nMethods: The SMBG Study is a 12 month, multi-centre, randomised controlled trial in people with type 2 diabetes\nnot on insulin therapy who have poor glycaemic control (HbA1c �58 mmol/mol / 7.5%). The participants will be\nrandomised into three comparative groups: Group 1 will act as a control group and receive their usual diabetes care;\nGroup 2 will undertake structured SMBG with clinical review every 3 months; Group 3 will undertake structured SMBG\nwith additional monthly telecare support from a trained study nurse. A total of 450 participants will be recruited from\n16 primary and secondary care sites across Wales and England. The primary outcome measure will be HbA1c at\n12 months with secondary measures to include weight, BMI, total cholesterol and HbA1c levels at 3, 6, 9 and\n12 months. Participant well-being and attitude towards SMBG will be monitored throughout the course of the study.\nRecruitment began in December 2012 with the last participant visit due in September 2016.\nDiscussion: This study will attempt to answer the question of whether structured SMBG provides any benefits to\npeople with poorly controlled type 2 diabetes who are not being treated with insulin. The data will also clarify whether\nthe telecare support provides additional value. The overall acceptability of SMBG as a tool for self-management will be\nassessed....
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