Do adult patients with diabetes mellitus living in rural part of Ethiopia and having poor social support have disproportionately poor self-care practice? A systematic review and meta-analysis

Author(s):  
Fikadu Ambaw Yehualashet ◽  
Eleni Tesfaye Tegegne ◽  
Amare Demsie Ayele ◽  
Wubet Worku Takele
2019 ◽  
Author(s):  
Fikadu Ambaw Yehualashet ◽  
Wuber Worku Takele ◽  
Eleni Tesfaye Tegegne ◽  
Amare Demsie Ayele

Abstract Background Appropriate diabetic self-care is indispensable to prevent and limit diabetic associated short and long term complications including death. Despite the well-recorded devastating complications of diabetes mellitus, a pooled percentage of diabetic patients applying self-care and its determinants at the national level have remained unknown. Therefore, this comprehensive systematic review and meta-analysis is aimed at determining the pooled national percentage of diabetic self-care practice and its determinants among adult diabetic patients in Ethiopian. Methods: Different electronic databases including PubMed/Medline and search engines such as Google scholar were used to retrieve published studies. The Joanna Briggs Institute quality appraisal checklists were used to appraise the quality of studies. Data were extracted using excel spreadsheets and analyses were done by STATA 14. Heterogeneity among studies was diagnosed using the I2 test. The DerSimonian and Laird random-effects model was employed for substantial heterogeneity (I2>50%). The pooled estimate of diabetic self-care and odds ratio was reported based on the 95% CI. Results: A total of 3861 studies were identified, of which only 19 studies have reached the final qualitative synthesis and quantitative analysis. Well over half of the Ethiopian diabetic patients have good self-care 54.04% (47.07-61.01, I2 =97.3, P<0.001). Subgroup analysis showed that the highest pooled estimate was in Southern Nations Nationalities and Peoples 81.96(71.85-92.04), I2=89.1, P<0.002) while the lowest was from the Hareri region 44.53(32.16-56.89) I2=94%%, P<0.001). Being knowledgeable about diabetes mellitus 2.69 (1.62, 4.46; I2 =99%, P<0.001), having good social support 2.25(1.49-3.39; I2=99%, P=0.00), owning private glucometer 3.04(1.64, 5.65; I2=97.4, P<0.001), and being urban residents 3.26(2.24, 4.74; I2=96.3%, P<0.001) have promoted diabetic victims to apply self-care practice. Conclusions: Despite the life-threatening complications of diabetes mellitus, the percentage of patients applying self-care has remained low in Ethiopia, depicting the high proportion of diabetic patients are prone to develop long and short term complications of diabetes mellitus. Therefore, improving the client’s awareness about the disease and counseling clients about the significance of social support are believed to be possible strategies to improve self-care practice and policymakers are strongly recommended to combat complications to attain sustainable development goal 3.4 aims to reduce premature death.


2019 ◽  
Author(s):  
Fikadu Ambaw Yehualashet ◽  
Wuber Worku Takele ◽  
Eleni Tesfaye Tegegne ◽  
Amare Demsie Ayele

Abstract Background: Appropriate diabetic self-care is indispensable to prevent and limit diabetic associated short and long term complications including death. Therefore, this comprehensive systematic review and meta-analysis were aimed at exploring and determining the pooled national percentage of diabetic self-care and its determinants among adult diabetic patients in Ethiopian. Methods: Different electronic databases including PubMed/Medline and search engines such as Google scholar were used to retrieve published studies. The Joanna Briggs Institute (JBI) quality appraisal checklists were used to appraise the quality of studies. Data were extracted using excel spreadsheets and analyses were done by STATA 14. Heterogeneity among studies was diagnosed using the I2. The DerSimonian and Laird random-effects model was employed for substantial heterogeneity (I2>50%). Sensitivity and subgroup analyses were carried out. The funnel plot and Egger’s regression test was used to identify publication bias. Moreover, the nonparametric trim and fill analysis was done for findings with significant Egger’s test (p<0.05) and asymmetric distribution of studies in the funnel plot. The pooled estimate of diabetic self-care and odds ratio was reported based on the 95% CI. Results: Well over half of the Ethiopian diabetic patients have good self-care 54.04% (47.07-61.01, I2 =97.3, P<0.001). Subgroup analysis showed that the highest and the lowest pooled estimate of self-care was detected in Southern Nations Nationalities and Peoples and Hareri region with 81.96% and 44.53% respectively. Being knowledgeable about diabetes mellitus 2.69%, having good social support 2.25%, owning private glucometer 3.04%, and being urban residents 3.26% have promoted diabetic victims to apply self-care practice. Conclusions: Despite the life-threatening complications of diabetes mellitus, the percentage of patients applying self-care has remained low in Ethiopia, depicting the high proportion of diabetic patients are prone to develop long and short term life-threatening consequences of diabetes mellitus. Therefore, improving the client’s awareness about the disease and counseling clients about the significance of social support are believed to be possible strategies to improve self-care practice and policymakers are strongly recommended to combat diabetic associated complications to attain sustainable development goal 3.4 aims to reduce premature death.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tadesse Tolossa ◽  
Belayneh Mengist ◽  
Diriba Mulisa ◽  
Getahun Fetensa ◽  
Ebisa Turi ◽  
...  

Abstract Background Diabetes and its complications including foot ulcer constitute a global public health challenge attributing to a significant cause of morbidity and mortality. Foot ulcer is one of the long-term complication of diabetes mellitus which lead to infection and amputation of lower extremities. In Ethiopia, findings from few studies were inconsistent and there is a need to systematically pool existing data to determine the magnitude of foot ulcer in diabetics and factors contributing to it. Methods We identified articles through electronic databases such as Medline, Hinari, Pub Med, Cochrane library, the Web of Science and Google Scholar. Accordingly, we identified 95 published and one unpublished article. Finally, eleven studies which fullfilled eligibility criteria were included in final systematic review and meta-analysis. Data were extracted using a standardized data extraction checklist and the analyses were conducted using STATA version 14. The Cochrane Q test statistic and I2 tests were used to assess heterogeneity. Results The overall magnitude of foot ulcer was 12.98% (95%CI: 7.81–18.15) in diabetic patients in Ethiopia. Sub-group analyses revealed highest prevalence in Addis Ababa (19.31% (95%CI: 2.7. 41.37)). Foot ulcer was significantly associated with rural residence (OR = 2.72, 95%, CI: 1.84–4.01)), presence of callus on the feet ((OR = 12.67, 95%, CI: 6.47–24.79)), a body mass index of ≥24.5 ((OR = 2.68, 95%, CI: 1.58–4.56)), poor self- care practice ((OR = 1.47, 95%CI: 1.25–1.73)), type I diabetes mellitus ((OR = 0.42, 95%, CI: 0.22–0.79)), staying with DM for < 10 years ((OR = 0.23, 95%, CI: 0.11–0.50)), and age < 45 years ((OR = 0.44, 95%, CI: 0.21–0.92)). Conclusion The prevalence of diabetic foot ulcers in Ethiopia is relatively low, although its trend is increasing from time to time. Socio-demographic factors, body weight, and healthcare practice contribute to the development of diabetic foot ulcers. Appropriate interventions towards patient self-care practice, lifestyle modification and follow-up are wanted to prevent diabetic foot ulcers.


2017 ◽  
Vol 43 (4) ◽  
pp. 396-412 ◽  
Author(s):  
Youngshin Song ◽  
Soohyun Nam ◽  
Seyeon Park ◽  
In-soo Shin ◽  
Bon Jeong Ku

Purpose This meta-analysis examined relationships between social support and self-care in type 1 (T1DM) and 2 diabetes mellitus (T2DM). Methods We searched for published and unpublished studies using the following databases: PubMed, Embase, PsycINFO, the Cochrane Library, and Medline. MeSH search terms included “diabetes mellitus,” “social support,” “caregiver,” “self-care,” “self-management,” “self-care skills,” and “coping behavior.” Studies reporting correlations between social support and self-care were included. Results Initially, 2 095 studies were extracted. After eliminating duplicate and irrelevant studies, 28 studies involving 5 242 patients with diabetes were included. Of these, 22 studies examined T2DM subjects. Social support was significantly associated with self-care ( k = 28, r = .28, 95% CI: .21-.34, P < .001). Among the diabetes self-care types, the strongest effect was found for glucose monitoring ( k = 6, r = .21, 95% CI: .08-.33). The relationship between social support and self-care was stronger in T2DM ( k = 22, r = .30, 95% CI: .22-.37), relative to T1DM, samples ( k = 5, r = .22, 95% CI: .02-.38). Conclusion It was concluded that the overall effect size for social support on self-care was moderate, and its strength differed by ethnic majority within the sample, type of social support measures, and publication status.


2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Baye Dagnew ◽  
Getu Debalkie Demissie ◽  
Dessie Abebaw Angaw

Background. Self-care practice is the mainstay of management for good glycemic control. Despite the presence of a few pocket studies, no comprehensive study was conducted in Ethiopia to demonstrate the overall good self-care practice among diabetic patients in Ethiopia. Therefore, we intended to conduct this systematic review and meta-analysis to estimate the overall good self-care practice among people living with type 2 diabetes mellitus (T2DM) in Ethiopia. Methods. We systematically searched PubMed, Scopus, Science Direct, Cochrane library, Google scholar, and direct Google to retrieve relevant studies. Forest plot was used to present the pooled estimate of good self-care practice using DerSimonian and Laird’s random-effects model. We checked publication bias using Egger’s test and funnel plot. Potential heterogeneity was tested using the I-squared statistic. Moreover, subgroup and sensitivity analyses were performed. Results. In this review, 12 primary studies (with a total sample size of 4030) were included. Because of the presence of heterogeneity, we employed a random-effects model. After running the random-effects model, the pooled estimate of overall good self-care practice was 51.12% (95% CI: 41.90–60.34). Furthermore, the pooled estimate of good dietary practice was 50.18% (95% CI: 32.75–67.60), good physical exercise practice was 48.29% (95% CI: 34.14–62.43), the good footcare practice was 63.61% (95% CI: 45.56–81.66), and appropriate self-monitoring of the blood glucose level was 31.89% (95% CI: −4.62–68.41). In this meta-analysis, there was serious interstudy variation, but there was no publication bias. Conclusions. The overall good self-care practice among people living with T2DM was low which necessitates the need for designing strategies to increase the self-care practice. The health sector has to bolster awareness creation to allow better plasma glucose control and preventing diabetes-related complications. This trial is registered with CRD42019147694.


2020 ◽  
Vol 16 (6) ◽  
pp. 598-607 ◽  
Author(s):  
Rebeca Barbosa da Rocha ◽  
Cristiano Sales Silva ◽  
Vinícius Saura Cardoso

Background: Self-care is essential for the prevention of complications in patients with diabetes, but several authors report that even with health education programs, the incidence of complications in patients with diabetes continues to increase. Objective: We aimed to examine adherence to self-care strategies and the repercussions of adherence on the clinical profiles of individuals with type 2 diabetes. Methods: We performed a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We searched for related studies in 4 databases: PubMed, Web of Science, Scopus, and Latin American and Caribbean Health Science Literature (LILACS). We included observational studies in English and Portuguese that evaluated the effects of selfcare in individuals with type 2 diabetes. Results: The search resulted in the identification of 615 articles, of which 34 met all the inclusion criteria. General self-care was considered unsatisfactory. Physical exercise was classified as the self-care activity that was performed less frequently by individuals with type 2 diabetes mellitus; adherence to medication was the most frequent behavior among volunteers. Conclusion: The studies indicated poor adherence of the population to good self-care practices, reflected by the increase in complications related to DM.


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