scholarly journals The association of the level of self-care on adherence to treatment in patients diagnosed with type 2 diabetes

Author(s):  
Sylwia Krzemińska ◽  
Katarzyna Lomper ◽  
Anna Chudiak ◽  
Davide Ausili ◽  
Izabella Uchmanowicz

Abstract Aims The study aimed to assess the impact of self-care on adherence to treatment in patients diagnosed with type 2 diabetes and effect of complex interaction of social, lifestyle, economic, environmental and behavioural. Methods The study was carried out between June 2018 and May 2019 on 324 patients (162 females, 162 males) with type 2 diabetes. To measure the levels of self-care, the Self-Care of Diabetes Index (SCODI) questionnaire was used. Adherence to treatment was assessed with the Adherence in Chronic Diseases Scale (ACDS). Results The highest scores of health behaviour were on the subscale of adherence with the mean value of 68.37, and the lowest results on the subscale of blood sugar self-monitoring, with the mean of 56.05. We found that low adherence to treatment was present in 52.47% of respondents, the moderate level in 39.20%, while only 8.33% of patients showed the high level. There were significant positive correlations between the ACDS and SCODI subscales (p < 0.05): self-care maintenance (0.436), self-care management (0.413), self-care monitoring (0.384), and self-care confidence (0.453). Conclusions Self-care affects on adherence in patients with type 2 diabetes. The higher self-efficacy in each of the areas of functioning, the higher the level of adherence to treatment. We found that demographic variables such as female sex, education and employment status can influence self-care in managing chronic illnesses such as type 2 diabetes.

Author(s):  
Larisa Dmitrievna Popovich ◽  
Svetlana Valentinovna Svetlichnaya ◽  
Aleksandr Alekseevich Moiseev

Diabetes – a disease in which the effect of the treatment substantially depends on the patient. Known a study showed that the use of glucometers with the technology of three-color display of test results facilitates self-monitoring of blood sugar and leads to a decrease in glycated hemoglobin (HbAlc). Purpose of the study: to modeling the impact of using of a glucometer with a color-coded display on the clinical outcomes of diabetes mellitus and calculating, the potential economic benefits of reducing the hospitalization rate of patients with diabetes. Material and methods. Based on data from two studies (O. Schnell et al. and M. Baxter et al.) simulation of the reduction in the number of complications with the use of a glucometer with a color indication. In a study by O. Schnell et al. a decrease of HbA1c by 0.69 percent is shown when using the considered type of glucometers, which was the basis of the model. Results. In the model, the use of a glucometer with a color-coded display for type 1 diabetes led to a decrease in the total number of complications by 9.2 thousand over 5 years per a cohort of 40 thousand patients with different initial levels of HbA1c. In a cohort of 40 thousand patients with type 2 diabetes, the simulated number of prevented complications was 1.7 thousand over 5 years. When extrapolating these data to all patients with diabetes included in the federal register of diabetes mellitus (FRD), the number of prevented complications was 55.4 thousand cases for type 1 diabetes and 67.1 thousand cases for type 2 diabetes. The possible economic effect from the use of the device by all patients with a diagnosis of diabetes, which are included in the FRD, estimated at 1.5 billion rubles for a cohort of patients with type 1 diabetes and 5.3 billion rubles for patients with type 2 diabetes. Conclusion. Improving the effectiveness of self-monitoring, which is the result of the use of glucometers with color indicators, can potentially significantly reduce the incidence of complications in diabetes and thereby provide significant economic benefits to society.


2019 ◽  
Vol 16 (2) ◽  
pp. 225-229
Author(s):  
M. V. Pshenichnov ◽  
O. V. Kolenko ◽  
E. L. Sorokin ◽  
Ya. E. Pashentcev

Purpose. Revealing of the ocular risk factors in the formation of diabetic macular edema (ME) in type 2 diabetes mellitus (DM2).Patients and methods. A 3.5-year research of 80 patients (160 eyes) with DM2 without signs of ME at the beginning of the research was performed. The main group consisted of 46 patients with ME symptoms on one or both eyes during the research period, the comparison group included 34 patients without ME symptoms to the end of the research. The initial ocular characteristics were retrospect compared in groups.Results. The mean value of the axial lengths (AL) in the eyes of the main group was 23.12 ± 0.75 mm compared to 23.82 ± 0.62 mm in the comparison group (significant difference, p < 0.01). AL was less than 23.5 mm in 66 % of the eyes in the main group and only in 22 % of the eyes in the comparison group (p < 0.01). The mean value of the initial macular retina volume in the main group was significantly higher than in the comparison group — 7.51 ± 0.22 mm3 and 7.21 ± 0.12 mm3, respectively (p < 0.01). Initial background diabetic retinopathy (DR) was noted in 73 % of the eyes in the main group, which significantly differed from the comparison group, where this index was noted only in 13 % of the eyes (p < 0.01).Conclusion. Significant ocular risk factors for the formation of ME in patients with DM2 are: the initial macular retina volume more than 7.3 mm3, the value of the AL less than 23.5 mm; the initial background DR. The use of the detected morphometric parameters of eye and retina in combination with an adequate assessment of the risk factors in human organism makes it possible to assume with high degree of probability a high risk of the primary formation of diabetic ME in patients with DM2. 


2012 ◽  
Vol 39 (3) ◽  
pp. 397-405 ◽  
Author(s):  
Lisa M. McAndrew ◽  
Melissa A. Napolitano ◽  
Leonard M. Pogach ◽  
Karen S. Quigley ◽  
Kerri Leh Shantz ◽  
...  

2021 ◽  
Author(s):  
Lucija Gosak ◽  
Majda Pajnkihar ◽  
Gregor Štiglic

BACKGROUND Chronic diseases are an important public health issue worldwide and affect an individual's quality of life. Due to the alarming rise in type 2 diabetes, healthcare, which was previously largely focused primarily on diagnosis and treatment of the disease, is increasingly focused on prevention and self-care. Patients who adhere to a constant and strict treatment regimen (physical activity, diet, medication) and regularly monitor their health, maintain self-care and health, prevent exacerbation of the disease and prevent complications of diabetes (retinopathy, diabetic feet). Many innovative devices that have become increasingly present in patient health care in recent years, such as mobile applications, are available to patients to maintain consistency in monitoring their health status. Mobile applications make it easier for individuals to monitor their self-care, monitor illness, and make it easier to follow instructions regarding disease control. OBJECTIVE The study aim is to determine the impact of mobile application use on self-care in patients with type 2 diabetes. The aim of the study is also to evaluate and test the usefulness of the forDiabetes application as a tool to improve the self-care of individuals with type 2 diabetes. METHODS We will perform a double-blind randomized controlled trial. The study will include individuals over the age of 18 who have been diagnosed and have regulated type 2 diabetes, who have already received oral treatment and are being treated in family medicine practice. Also, individuals included in the study should not have any acute complications due to the consequences of type 2 diabetes. During the study, they should be able to use an Android or iOS mobile phone and a blood glucose meter. With the help of simple randomization, individuals will be divided into an intervention and a control group. Individuals in the intervention group will use the forDiabetes mobile app to monitor their self-care for type 2 diabetes. Individuals in the control group will not receive a special intervention. Data will be collected using the “Self-care of Diabetes Inventory” questionnaire and a “Brief Illness Perception Questionnaire”. Blood sugar, blood pressure, HbA1c, and weight measurements will be monitored using the calibrated instruments during the study by the nurses employed in family medicine practice. Data will be collected at the beginning of the study and after the patient visit to the family medicine practice. RESULTS The expected results as a result of using the mobile application forDiabetes are the impact on the level of self-care, the impact on the perception of the disease, blood sugar levels, blood pressure, HbA1c, and the measured body weight of the patient. CONCLUSIONS The research contributes to greater visibility and usability of mobile applications for self-care of patients with type 2 diabetes and makes aware of the possible use of innovative methods. CLINICALTRIAL NCT04999189


2020 ◽  
Vol 8 (1) ◽  
pp. e001115 ◽  
Author(s):  
Eri Wada ◽  
Takeshi Onoue ◽  
Tomoko Kobayashi ◽  
Tomoko Handa ◽  
Ayaka Hayase ◽  
...  

IntroductionThe present study aimed to evaluate the effects of flash glucose monitoring (FGM) and conventional self-monitoring of blood glucose (SMBG) on glycemic control in patients with non-insulin-treated type 2 diabetes.Research design and methodsIn this 24-week, multicenter, open-label, randomized (1:1), parallel-group study, patients with non-insulin-treated type 2 diabetes at five hospitals in Japan were randomly assigned to the FGM (n=49) or SMBG (n=51) groups and were provided each device for 12 weeks. The primary outcome was change in glycated hemoglobin (HbA1c) level, and was compared using analysis of covariance model that included baseline values and group as covariates.ResultsForty-eight participants in the FGM group and 45 in the SMBG group completed the study. The mean HbA1c levels were 7.83% (62.1 mmol/mol) in the FGM group and 7.84% (62.2 mmol/mol) in the SMBG group at baseline, and the values were reduced in both FGM (−0.43% (−4.7 mmol/mol), p<0.001) and SMBG groups (−0.30% (−3.3 mmol/mol), p=0.001) at 12 weeks. On the other hand, HbA1c was significantly decreased from baseline values in the FGM group, but not in the SMBG group at 24 weeks (FGM: −0.46% (−5.0 mmol/mol), p<0.001; SMBG: −0.17% (−1.8 mmol/mol), p=0.124); a significant between-group difference was also observed (difference −0.29% (−3.2 mmol/mol), p=0.022). Diabetes Treatment Satisfaction Questionnaire score was significantly improved, and the mean glucose levels, SD of glucose, mean amplitude of glycemic excursions and time in hyperglycemia were significantly decreased in the FGM group compared with the SMBG group.ConclusionsGlycemic control was better with FGM than with SMBG after cessation of glucose monitoring in patients with non-insulin-treated type 2 diabetes.Trial registration numberUMIN000026452, jRCTs041180082.


2015 ◽  
Vol 23 (2) ◽  
pp. 200-207 ◽  
Author(s):  
Maria Fernanda Manoel Imazu ◽  
Barbara Nascimento Faria ◽  
Guilherme Oliveira de Arruda ◽  
Catarina Aparecida Sales ◽  
Sonia Silva Marcon

OBJECTIVE: to compare the effectiveness of two educational interventions used by a healthcare provider in the monitoring of individuals with type 2 diabetes mellitus (T2DM), regarding knowledge of the disease, impact on quality of life and adoption of self-care actions. METHODS: comparative, longitudinal, prospective study performed with 150 subjects with type 2 diabetes, analyzed according to the type of participation in the program (individual and/or group). Participants of the individual intervention (II) received nursing consultations every six months and those of the group intervention (GI) took part in weekly meetings for three months. Data were collected through four questionnaires: Identification questionnaire, Problem Areas in Diabetes Questionnaire (PAID), Summary of Diabetes Self-Care Activities Questionnaire (SDSCA) and the Diabetes Knowledge Scale (DKN-A). Data were analyzed using the Friedman and Mann Whitney tests, considering a statistical significance of p ≤ 0.05. RESULTS: there was an increase in knowledge about the disease in the II (p<0.003) and GI (p<0.007), with reduction of the impact on the quality of life in the II (p<0.007) and improvement in self-care actions in the GI (p<0.001). CONCLUSION: in both intervention models improvements were observed in the indicators, over the six month monitoring period.


2021 ◽  
Vol Volume 14 ◽  
pp. 193-203
Author(s):  
Natalia Świątoniowska-Lonc ◽  
Jacek Polański ◽  
Wojciech Tański ◽  
Beata Jankowska-Polańska

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
José Adrián Geraldo Murillo ◽  

Abstract Background In Mexico, 10.3% of the adult population has type 2 diabetes. Low socioeconomic status (SES) has been considered as a risk factor for developing this disease. The aim of this study was to determine whether SES is associated with blood glucose control, treatment adherence, and diabetic complications. Methods A retrospective cross-sectional observational study was conducted in Ensenada, Baja California, México, with a random sample of 103 hospitalized patients between November 2019 and February 2020. The information was collected by face-to-face interview with structured questionnaires and the medical records review. The analysis was performed using the SPSS statistics software. Results Of the patients who do not know how to perform self-monitoring of blood glucose (SMBG) in more than half of them were not educated (P = 0.002). Not performing SMBG at home was associated with increased risk of microvascular complications. [OR 2.88 CI 95% 1.20-6.89]. Those who were left without medications due to lack of money had a higher risk of hyperglycemia at home without going to the hospital [OR 3.89 95% CI 1.16-13.05]. Hypoglycemia prevailed in patients who did not perform GA due to lack of money to buy a glucometer. (P = 0.012). Conclusions Low socioeconomic status was associated with poor adherence to treatment and lack of self-monitoring of capillary glucose at home. Key messages Socioeconomic status, Type 2 diabetes, adherence to treatment, self-monitoring.


2021 ◽  
Author(s):  
Abhijeet Prasad Sinha ◽  
Manmohan Singhal ◽  
Mansi Gupta ◽  
Ashish Joshi

BACKGROUND Diabetes represents an important public health challenge in India and Globally. It affects quality of life and is one of the leading causes of death and disability. The burden on global health is huge and about 463 million adults are currently living with diabetes. 77 million people in India in the age group of 20-79 years are affected by this pandemic and total cost to health expenditure is 8 billion US dollars, therefore huge burden, and great economic cost on Public health. The self-management of diabetes, the research priorities include exploring the concept of diabetes self-management and major research questions would comprise of asking what affects self-management in persons with diabetes and how do m-health application and interventions can impact on the self-management behaviors in development, utility of the m-health app in self-management of person with diabetes. Therefore, this project research is of great significance and would bring an integrative approach on self-care management OBJECTIVE To design, develop and evaluate the impact of m-health enabled nutrition informatics intervention for home based self-management of type 2 diabetes in an Indian setting. METHODS A mixed research study will be conducted between January 2022 and January 2023. A sample of approximately 250 individuals will be recruited and enrolled using a nonprobability complete enumeration sampling method from selected urban settings of Delhi inclusion and exclusion criteria with age20-79 years male and female with Type 2 diabetes and have access to Smart phone Data will be collected using which questionnaires. The collected data will be used to assess use and utility of mobile health application developed. The knowledge, attitudes, practices, and beliefs regarding Diabetes self-care management. Lastly, the study questionnaire system usability survey(SUS) will be used to assess the usability of mobile applications on selfcare management of Diabetes RESULTS A pilot of 250 individuals has been conducted to pretest the DBMS questionnaire. The data collection will be initiated from January 2022, and the initial results are planned for publication by October 2022.Descriptive analysis of the gathered data will be performed using SPSS V11, and reporting of the results will be done at 95% CIs and P=.0.05. CONCLUSIONS The findings of the study would inform the elements essential for the development of m-health intervention to improve self-care management of diabetes at home settings. The usefulness and acceptance of the proposed intervention will be conducted. CLINICALTRIAL DITU/UREC/2021/07/10


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