Factors Affecting Cognitive Dysfunction Screening for Latinx Adults With Type 2 Diabetes

Abstract Before development of overt type 2 diabetes (T2DM), changes in brain structure and activation patterns are found in insulin resistance, indicating many with T2DM may already have alterations in cognitive function. How best practices are met for screening for cognitive dysfunction, specifically Latinx adults with T2DM who are at higher risk, remains unclear. The purpose of this study was to examine aspects influencing screening Latinx adults with T2DM for cognitive problems by identifying patient-, clinician- and clinic- level factors. This was a mixed methods study which used semi-structured interviews with Latinx adults with T2DM (n=30; mean age: 68; 57% Mexican American); surveys and interviews with health care providers (n = 15); and inventories of four outpatient clinics to identify factors (e.g. time, clinic policies) influencing screening. Data were analyzed via thematic analysis (interviews) and descriptive statistics (surveys and inventories). For patients, screening was important, but inability to work related to a possible diagnosis of dementia was a concern. Providers and patients agreed other health issues (e.g. hyperglycemia) took precedence to screening. Providers (96.7%) were expected to screen but did not have support/time from clinics and relied on patients for initial prompts. Only one clinic reported staff education on cognitive screening with an emphasis on potential cultural differences in test results and adequate resources related to dementia for Latinx adults. Clinics serving Latinx adults have a responsibility to deliver appropriate care. Leadership should consider innovative practices such creation, with patients, of educational materials for screening -a need highlighted by most participants.

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Understanding Gestational Diabetes, Future Diabetes Risk, and Diabetes Prevention: A Qualitative Study of Patient, Provider and Staff Perspectives

10.2337/figshare.15031746 ◽

2021 ◽

Author(s):

Hannah R. Lucas ◽

Roxann C. Williams ◽

Laura N. Hollar ◽

Bethany Johnson-Javois ◽

Heidi B. Miller ◽

...

Keyword(s):

Type 2 Diabetes ◽

Gestational Diabetes ◽

Health Care Providers ◽

Diabetes Prevention ◽

Diabetes Risk ◽

Care Providers ◽

Diabetes Screening ◽

Structured Interviews ◽

Future Diabetes

Gestational diabetes mellitus (GDM) increases type 2 diabetes risk; however, postpartum diabetes screening rates are low. Using semi-structured interviews and focus groups, this study investigates the understanding of GDM and its relationship to future diabetes risk and diabetes prevention among patients with public or no insurance (n = 36), health care providers (n = 21), and clinic staff (n = 9) from Federally Qualified Health Centers. Five main themes emerged: 1) general understanding of GDM diagnosis with focus on neonatal complications; 2) variable recall of diet, exercise, and weight recommendations; 3) overwhelming medication and self-monitoring routines; 4) short-term focus of type 2 diabetes risk and screening; and 5) limited understanding of all options for diabetes prevention. The results may inform diabetes screening and prevention interventions in primary care settings.

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Barriers to and facilitators of diabetes self-management practices in Rupandehi, Nepal- multiple stakeholders’ perspective

BMC Public Health ◽

10.1186/s12889-021-11308-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Mandira Adhikari ◽

Hridaya Raj Devkota ◽

Tomris Cesuroglu

Keyword(s):

Type 2 Diabetes ◽

Health Care Providers ◽

Low Income ◽

Management Practices ◽

Self Management ◽

Care Providers ◽

Structured Interviews ◽

Multiple Stakeholders ◽

Adherence To Medication

Abstract Background Self-management of diabetes is associated with glycaemic control and adherence to medication and healthy lifestyle practices. There is lack of information on the barriers to and facilitators of diabetes self-management practices in low income country, Nepal. This study aimed to explore the barriers to and facilitators of Type 2 diabetes self-management practices taking multiple stakeholders’ perspectives in Nepal. Methods Four focus group discussions and 16 semi-structured interviews with people with Type 2 diabetes, caregivers, health care providers and health managers were conducted from April to May 2018 in Rupandehi district of Western Nepal. They were audio-recorded, transcribed, and analysed using a thematic approach. Results Five main themes emerged that influenced diabetes self-management practices: individual factors, socio-cultural and economic factors, health system and policy factors, availability and accessibility of resources, and environmental factors. The important barriers were: lack of knowledge about diabetes self-management practices, cultural practices, insufficient counselling, lack of guidelines and protocols for counselling, and financial problems. The major facilitators were: motivation; support from family, peers, and doctors; and availability of resources in the community. Conclusion Based on our findings, a multilevel approach is needed to address these barriers and facilitators. These findings will help guide strategies to develop programs that impart knowledge and skills to improve the diabetes self-management practices of people with Type 2 diabetes.

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Understanding Gestational Diabetes, Future Diabetes Risk, and Diabetes Prevention: A Qualitative Study of Patient, Provider and Staff Perspectives

10.2337/figshare.15031746.v1 ◽

2021 ◽

Author(s):

Hannah R. Lucas ◽

Roxann C. Williams ◽

Laura N. Hollar ◽

Bethany Johnson-Javois ◽

Heidi B. Miller ◽

...

Keyword(s):

Type 2 Diabetes ◽

Gestational Diabetes ◽

Health Care Providers ◽

Diabetes Prevention ◽

Diabetes Risk ◽

Care Providers ◽

Diabetes Screening ◽

Structured Interviews ◽

Future Diabetes

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Sociocultural Influences on African Americans’ Representations of Type 2 Diabetes: A Qualitative Study

Ethnicity & Disease ◽

10.18865/ed.28.1.25 ◽

2018 ◽

Vol 28 (1) ◽

pp. 25 ◽

Cited By ~ 6

Author(s):

Olayinka O. Shiyanbola ◽

Earlise Ward ◽

Carolyn Brown

Keyword(s):

Type 2 Diabetes ◽

African Americans ◽

Racial Discrimination ◽

Health Care Providers ◽

Eating Habits ◽

Cultural Beliefs ◽

Sociocultural Factors ◽

Diabetes Diagnosis ◽

Care Providers

Objective: Illness representations, known as patients’ beliefs and expectations about an illness, may be influenced by cultural beliefs and personal experiences. This study explored African Americans’ perceptions of the sociocultural factors that influence their representations of diabetes.Design: Six semi-structured focus groups.Setting: Private space at a convenient site.Participants: Forty African Americans, aged 45-60 years with type 2 diabetes for at least one year prior.Results: Participants perceived that there was a race-mediated effect of how they developed diabetes because of poverty due to past slavery, racial discrimination by health care providers, and the stigma associated with diabetes within the African American community. Participants perceived that poverty influenced African Americans’ unhealthy eating habits, which led to diabetes diagnosis among their ancestors and their development of the disease since it was hereditary. Participants also perceived that there was provider ill intention, ie, providers were purposefully making people sick, and their lack of education on diabetes from providers was done on purpose, as information on diabetes was withheld and not shared due to racial discrimination. Perceived stigma by the community led to African Americans’ avoidance and denial of the disease, and subsequently the development of diabetes.Conclusions: To enhance disease management for African Americans with diabetes, it is important to focus on the sociocultural context of how African Americans view their world that may be influenced by their knowledge of negative historical circumstances and their current provider relationship, which, in turn, may be reflected in their perceptions of diabetes.Ethn Dis. 2018;28(1):25-32; doi:10.18865/ed.28.1.25.

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Health Care Providers’ Perceptions of Responsibilities and Resources to Reduce Type 2 Diabetes Risk After Gestational Diabetes Mellitus

Clinical Diabetes ◽

10.2337/cd17-0063 ◽

2018 ◽

Vol 36 (2) ◽

pp. 160-167

Author(s):

Sumali S. Hewage ◽

Shweta R. Singh ◽

Claudia Chi ◽

Jerry K.Y. Chan ◽

Tong Wei Yew ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Health Care ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Health Care Providers ◽

Diabetes Risk ◽

Care Providers

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A socioecological perspective : the "ups and downs" of living with type 2 diabetes among working adults in the rural south

10.32469/10355/79563 ◽

2019 ◽

Author(s):

◽

Lynn E. Glenn

Keyword(s):

Type 2 Diabetes ◽

Health Services ◽

Health Care Providers ◽

Preventive Health Services ◽

Patient Activation ◽

Preventive Health ◽

Self Management ◽

Care Providers ◽

Working Adults

Persons with higher patient activation levels are more likely to engage in preventive health behaviors. This qualitative study addressed a population that may be particularly vulnerable to poor diabetes outcomes: rural, working adults with type 2 diabetes (T2 DM) with low levels of patient activation. This study sought to gain a better understanding of the individual, interpersonal, health system, and community spheres of influence on engagement in diabetes self-management and recommended preventive health services among rural, working adults. A socioecological approach, based on Fisher's (2005) Resources and Supports for Self-Management Model, guided the study. The Patient Activation Measure (PAM-10) was used to identify individuals with low patient activation. Participants (N = 20) had PAM-10 scores less than 75 (M = 59.4) and were predominately African American (n = 12) and female (n = 14), earning incomes less than $50,000 (n = 13). The overarching theme, "ups and downs" of living with diabetes, emerged from the data. Four other major themes emerged: "the struggle", "you don't talk about it", "diabetes is not the priority", and "we're lucky to have what we have". Most participants had social support, employer health benefits, and a trusting, satisfactory relationship with health care providers. However, a lack of equitable workplace and community resources may have contributed to lack of engagement in diabetes self-management and preventive health services.

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Case Report: Type 2 Diabetes Mellitus

Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer) ◽

10.22146/rpcpe.33890 ◽

2018 ◽

Vol 1 (2) ◽

pp. 45

Author(s):

Shofi Hesfianto

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Health Care ◽

Chronic Disease ◽

Health Care Providers ◽

The Other ◽

Shared Understanding ◽

Care Providers ◽

Patient’S Expectation

.......A patient who was first diagnosed with a chronic disease often does not fully understand the meaning or significanceof the chronic disease with which his/ her body suffers, against the risk of future complications if the disease is not well-controlled. On the other hand, in this reported case, the patient’s expectation was that her chronic disease, the T2DM, can be cured. Therefore, a shared understanding between health care providers and patient is likely the key to commencing the course of managing any chronic disease in a patient effectively.......

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Faktor Pemicu Diabetes Tipe 2 Ditinjau dari Mata Pencaharian

10.31227/osf.io/hm7t3 ◽

2019 ◽

Author(s):

Felicia Acramin

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Health Care Providers ◽

Healthy Lifestyle ◽

Care Providers ◽

Diet Pattern ◽

Unhealthy Diet ◽

Genetic And Environmental Factors ◽

P Type

Type 2 diabetes or diabetes mellitus is the most common type of diabetes in which it's prevalence has been increasing globally, especially in Indonesia. Diabetes mellitus is a multifactorial disease, triggered by both genetic and environmental factors (such as sedentary lifestyle, obesity, and unhealthy diet) that are responsible for dysregulation of glucose metabolism in type 2 diabetes. Complications of diabetes have led to the decreasing quality of life in people with DM. The objective of this study was to observe livelihood factor (including lifestyle and diet factors) as factors contributing to type 2 diabetes risk in persons with DM. The method of this study was descriptive design with qualitative approach. The data were gathered by conducting in-depth interview with five DM sufferers that had five different jobs. The result of the interview showed that DM sufferers with various type of jobs had different patterns in lifestyle and diet leading to hyperglycemia and increased insulin resistance. As a result, those pathophysiological features developed into type 2 diabetes in DM sufferers. This study has major implication for the prevention of type 2 diabetes. It is recommended that health care providers should improve the patients and their family understanding about type 2 diabetes and improve the management of healthy lifestyle and diet pattern.

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Needs and resources of people with type 2 diabetes in peri-urban Cochabamba, Bolivia: A people-centred perspective.

10.21203/rs.3.rs-97221/v2 ◽

2021 ◽

Author(s):

Christine Leyns ◽

Niek Couvreur ◽

Sara Willems ◽

Ann Van Hecke

Keyword(s):

Type 2 Diabetes ◽

Health Care ◽

Health System ◽

Health Care Providers ◽

Treatment Plan ◽

Public Healthcare ◽

Care Providers ◽

Low Literacy ◽

Traditional Use

Abstract Background: The rising prevalence of type 2 diabetes results in a worldwide public healthcare crisis, especially in low- and middle-income countries (LMICs) with unprepared and overburdened health systems mainly focused on infectious diseases and maternal and child health. Studies regarding type 2 diabetes in LMICs describe specific interventions ignoring a comprehensive analysis of the local factors people see influential to their health. This study aims to meet this research gap by exploring what people with type 2 diabetes in Bolivia need to maintain or improve their health, how important they perceive those identified needs and to what extent these needs are met.Methods: From March until May 2019, 33 persons with type 2 diabetes from three periurban municipalities of the department of Cochabamba participated in this study. The concept mapping methodology by Trochim, a highly structured qualitative brainstorming method, was used to generate and structure a broad range of perspectives on what the participants considered instrumental for their health.Results: The brainstorming resulted in 156 original statements condensed into 72 conceptually different needs and resources, structured under nine conceptual clusters and four action domains. These domains illustrated with vital needs were: (1) self-management with use of plants and the possibility to measure sugar levels periodically; (2) healthcare providers with the need to trust and receive a uniform diagnosis and treatment plan; (3) health system with opportune access to care and (4) community with community participation in health and safety, including removal of stray dogs.Conclusions: This study identifies mostly contextual factors like low literacy levels, linguistic problems in care, the need to articulate people's worldview including traditional use of natural remedies with the Bolivian health system and the lack of expertise on type 2 diabetes by primary health care providers. Understanding the needs and structuring them in different areas wherein action is required serves as a foundation for the planning and evaluation of an integrated people centred care program for people with type 2 diabetes. This participative method serves as a tool to implement the often theoretical concept of integrated people centred health care in health policy and program development.

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Carbohydrate Knowledge and Expectations of Nutritional Support among Five Ethnic Groups Living in New Zealand with Pre- and Type 2 Diabetes: A Qualitative Study

Nutrients ◽

10.3390/nu10091225 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1225 ◽

Cited By ~ 1

Author(s):

Zhuoshi Zhang ◽

John Monro ◽

Bernard Venn

Keyword(s):

Type 2 Diabetes ◽

New Zealand ◽

Nutrition Education ◽

Ethnic Groups ◽

Health Care Providers ◽

Active Role ◽

Care Providers ◽

Nutritional Knowledge ◽

Plain Language

Despite availability of diabetes and nutrition information for people with pre- and type 2 diabetes, the uptake and understanding of these resources may differ among ethnic groups. Our objective was to explore dietary knowledge and diabetes experiences amongst Māori, European, Pacific Island, Indian and East Asian people living in New Zealand with a focus on carbohydrate-containing foods. A registered diabetes dietitian led ethnic-specific discussions in groups involving 29 people with pre- or type 2 diabetes. Discussions were audio-recorded, fully transcribed and coded independently by two investigators. Themes were developed using deductive and inductive techniques. Five themes emerged: knowledge, concerns, achievements, simplicity and self-determination. Nutritional knowledge was lacking and a greater awareness of trustworthy dietary resources was needed. There were concerns about diabetes complications and appropriate carbohydrate-containing foods and portions. Contrary to this, people felt proud when achieving dietary goals and grateful for support from health care providers and family. Participants were willing to engage in self-care if advice from health professionals was given in plain language, and in a culturally appropriate manner. Given the desire to take an active role in diabetes self-management and willingness to use electronic devices, an ethnic-specific nutrition education resource could be a valuable tool.

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