scholarly journals Oral antidiabetic medication adherence and glycaemic control among patients with type 2 diabetes mellitus: a cross-sectional retrospective study in a tertiary hospital in Saudi Arabia

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029280 ◽  
Author(s):  
Bander Balkhi ◽  
Monira Alwhaibi ◽  
Nasser Alqahtani ◽  
Tariq Alhawassi ◽  
Thamir M Alshammari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Saudi Arabia ◽  
Glycaemic Control ◽  
Tertiary Hospital ◽  
Good Adherence ◽  
Cross Sectional ◽  
Oral Antidiabetic

ObjectivesThe purpose of this study is to measure the adherence rates of oral antidiabetic drugs (OADs) in patients with type 2 diabetes mellitus (T2DM) and assess the relationship of glycaemic control and adherence to OADs after controlling for other associated factors.DesignCross-sectional retrospective study.SettingLarge tertiary hospital in the central region of Saudi Arabia.Participants5457patients aged 18 years and older diagnosed with T2DM during the period from 1 January 2016 to 31 December 2016.Primary and secondary outcome measuresThe modified medication possession ratio (mMPR) was calculated as a proxy measure for adherence of OADs. The factors associated with OADs non-adherence and medication oversupply were assessed using multinomial logistic regression models. The secondary outcomes were to measure the association between OADs adherence and glycaemic control.ResultsMajority of patients with T2DM were females (n=3400, 62.3%). The average glycated haemoglobin was 8.2±1.67. Among the study population, 48.6% had good adherence (mMPR >0.8) and 8.6% had a medication oversupply (mMPR >1.2). Good adherence was highest among those using repaglinide (71.0%) followed by pioglitazone (65.0%) and sitagliptin (59.0%). In the multivariate analysis, women with T2DM were more likely to have poor adherence (adjusted OR (AOR)=0.76, 95% CI=0.67, 0.86) compared with men. Also, medication oversupply was more likely among patients with hyperpolypharmacy (AOR=1.88, 95% CI=1.36, 2.63), comorbid osteoarthritis (AOR=1.72, 95% CI=1.20, 02.45) and non-Saudi patients (AOR=1.53, 95% CI=1.16, 2.01). However, no association was found between glycaemic control and adherence to OADs.ConclusionThe study findings support the growing concern of non-adherence to OADs among patients with T2DM in Saudi Arabia. Decision makers have to invest in behavioural interventions that will boost medication adherence rates. This is particularly important in patients with polypharmacy and high burden of comorbid conditions.

Prevalence, morbidity and mortality of deep neck abscess in a tertiary hospital from Northwestern Mexico

2021 ◽  
Vol 11 (41) ◽  
pp. 41-46
Author(s):  
Alejandra Pineda-Alvarado ◽  
Juan Antonio Lugo-Machado ◽  
Edwin Canché-Martin ◽  
Jaime Zuleyka Quintero ◽  
Irene Arellano-Ridriguez ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Hospital ◽  
Cervical Region ◽  
Cross Sectional ◽  
Neck Abscess ◽  
Deep Neck Abscess ◽  
Clinical Records

AbstractBACKGROUND. Neck abscesses are defined as processes of infectious origin, which form a collection of purulent material through the deep planes of the neck, formed by fasciae. It may involve one or more spaces of the cervical region. In addition, they can be localized or disseminated and generate extremely serious and life-threatening complications.OBJECTIVE. To identify the prevalence of deep neck abscess in our tertiary hospital center.MATERIAL AND METHODS. A retrospective, analytical, observational, and cross-sectional study was carried out from January 2015 to May 2019. The data observed during the care of the patients with a diagnosis of deep neck abscess were collected from the clinical records. Descriptive statistics were performed, and the odd ratio was used for the risk probability analysis.RESULTS. A prevalence of 42 cases was found in 5 years, with 8.4 annual cases, average age of 45.2 years, male gender predominance in 53% of the cases. Descending mediastinitis was the most common complication and a mortality of 8.33% was presented. Type 2 diabetes mellitus and the involvement of 3 or more spaces represented a higher risk for complications compared to healthy patients who presented involvement of ≤2 spaces.CONCLUSION. In the Northwestern region of Mexico of IMSS beneficiaries, we have a prevalence of 42 cases in 5 years, 8.4 per year. The average age of our series is 45.2 years and there is no difference regarding the affection by gender. The involvement of two or more than three spaces represents the majority of cases. More than half of our cases underwent surgical drainage. Type 2 diabetes mellitus alone or accompanied with other comorbidities was the most common associated pathology; this same entity and the involvement of 3 or more spaces presented a higher risk of complications

scholarly journals Assessing oral medication adherence among patients with type 2 diabetes mellitus treated with polytherapy in a developed Asian community: a cross-sectional study

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e016317 ◽  
Author(s):  
Cia Sin Lee ◽  
Jane Hwee Mian Tan ◽  
Usha Sankari ◽  
Yi Ling Eileen Koh ◽  
Ngiap Chuan Tan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Medication Adherence ◽  
Glycaemic Control ◽  
Univariate Analysis ◽  
Vascular Complications ◽  
Cross Sectional ◽  
Chinese Ethnicity

ObjectivesThe disease burden of type 2 diabetes mellitus (T2DM) is rising due to suboptimal glycaemic control leading to vascular complications. Medication adherence (MA) directly influences glycaemic control and clinical consequences. This study aimed to assess the MA of patients with T2DM and identify associated factors.DesignAnalysis of data from a cross-sectional survey and electronic medical records.SettingPrimary care outpatient clinic in Singapore.ParticipantsAdult patients with T2DM.Main outcome measuresMA to each prescribed oral hypoglycaemic agent (OHA) was measured using the five-question Medication Adherence Report Scale (MARS-5). Low MA is defined as a MARS-R score of <25. Demographic data, clinical characteristics and investigation results were collected to identify factors that are associated with low MA.ResultsThe study population comprised 382 patients with a slight female predominance (53.4%) and a mean±SD age of 62.0±10.4 years. 57.1% of the patients had low MA to at least one OHA. Univariate analysis showed that patients who were younger, of Chinese ethnicity, married or widowed, self-administering their medications or taking fewer (four or less) daily medications tended to have low MA to OHA. Logistic regression revealed that younger age (OR 0.97; 95% CI 0.95 to0.99), Chinese ethnicity (OR 2.80; 95% CI 1.53 to5.15) and poorer glycaemic control (HbA1c level) (OR 1.27; 95% CI 1.06 to1.51) were associated with low MA to OHA.ConclusionsYounger patients with T2DM and of Chinese ethnicity were susceptible to low MA to OHA, which was associated with poorer glycaemic control. Polytherapy was not associated with low MA.

scholarly journals Insulin Prescription Pattern among Type 2 DM patients visiting Outpatient Department at a Tertiary Hospital in Kathmandu, Nepal

2018 ◽  
Vol 1 (1) ◽  
pp. 3-7
Author(s):  
Hari Kumar Shrestha ◽  
R. Tamrakar ◽  
Ashish Shrestha ◽  
S.R. Amatya
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Insulin Dose ◽  
Tertiary Hospital ◽  
Premixed Insulin ◽  
Cross Sectional ◽  
Prescription Pattern ◽  
Study Participants

Background: Management of Type 2 Diabetes Mellitus includes nonpharmacological and pharmacological interventions of which insulin remains one of the most effective methods for achieving glycemic control, either alone or in combination with oral anti-diabetic medications. Effective usage of insulin in the management of glycaemia remains a challenge in developing countries like Nepal. To best of our knowledge, there is not any study regarding insulin prescription pattern on Type 2 Diabetes Mellitus patients using insulin from Nepal, so we studied the prescription pattern of insulin on insulin using Type 2 Diabetes Mellitus patients.Methods: Patients aged 30 years or above who present in Dhulikhel Hospital outpatient clinic during the period from January 2015 to June 2015 with diagnosis of Type 2 Diabetes Mellitus diagnosed at least for 6 months and were taking injection insulin at least since last 3 months were enrolled in this cross sectional, observational study.Results: Forty-five study participants had a mean age of 56.6 ±10.95 year, body mass index of 23.97 4.72 kg/m2, Diabetic duration of 10.33 6.41 years and HbA1c of 8.53 ±1.53%. Fifty-three percent were female and almost all study participants (96%) were taking Oral Antidiabetic Drugs along with Insulin. Sixty-three percent of participants were using Premix insulin whereas 33% were using basal insulin alone. Mean Insulin dose was 28.96 11.75 units per day. Among them, 80% were “self” injecting insulin and 53% were using Glucometer.Conclusion: Our data showed that premixed insulin being most commonly used insulin. All patients used Insulin Pen as delivery device and larger proportions of them were self injecting insulin. All patients felt mild hypoglycemia which can be improved by increased utilization of glucometer.Jour of Diab and Endo Assoc of Nepal 2017; 1(1): 3-7

scholarly journals Prevalence and Clinical Characteristics of Nonalcoholic Liver Disease in Type 2 Diabetes Mellitus Patients: A Cross-sectional Study

2021 ◽  
Author(s):  
Lakshmi Ravansamudram Hariharan ◽  
Jayanty Venakata Balasubra Maniyan
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Blood Glucose ◽  
Glycaemic Control ◽  
Clinical Characteristics ◽  
Cross Sectional ◽  
Duration Of Diabetes

Introduction: A refined diagnostic and classification strategy incorporating phenotypic characteristics of patients with Type 2 Diabetes Mellitus (T2DM) along with their blood glucose profile, lipid levels and evidence of Nonalcoholic Fatty Liver Disease (NAFLD) will help in identifying high risk population. Aim: To determine the prevalence and assess the clinical characteristics of NAFLD in T2DM patients from August 2016 to February 2017. Materials and Methods: This cross-sectional analysis was conducted on 100 T2DM patients with no history of alcohol intake, at the time of their screening. Physical examination and anthropometric measurements such as Body Mass Index (BMI) and Waist to Hip Ratio (WHR) were calculated. Fasting Blood Glucose (FBG), Post-Prandial Blood Glucose (PPBG), glycated haemoglobin (HbA1c), serum bilirubin, liver enzymes, lipid profile and ultrasound of the abdomen to diagnose NAFLD were done. Statistical analysis was carried out using student’s t-test and Statistical Package for the Social Sciences (SPSS) Version 19. Results: The prevalence of NAFLD in T2DM patients was 52%. The mean age was 52.27±1.82 years, with 40% males in the study cohort. There was a significant statistical correlation between the higher BMI (p<0.001), higher WHR (p=0.046), prevalence of upper body obesity (p<0.001) and the presence of NAFLD. The glycaemic control was poorer in patients with NAFLD with higher FBG (p=0.0027), PPBG (p=0.0027) and HbA1c p<0.001) than the non-NAFLD group. The serum cholesterol, triglycerides, Serum Glutamic Pyruvic Transaminase (SGPT), Serum Glutamic Oxaloacetic Transaminase (SGOT) were significantly higher in the NAFLD group. Duration of diabetes was not significantly different among the groups. Conclusion: The incidence of NAFLD is common in T2DM patients with poor glycaemic control, dyslipidaemia, and obesity being associated factors. Duration of diabetes is not a significant predictor of NAFLD.

scholarly journals Extent and Predictors of Poor Glycaemic Control among Elderly Pakistani Patients with Type 2 Diabetes Mellitus: A Multi-Centre Cross-Sectional Study

Medicina ◽  
2019 ◽  
Vol 55 (1) ◽  
pp. 21
Author(s):  
Muhammad Atif ◽  
Quratulain Saleem ◽  
Saima Asghar ◽  
Iram Malik ◽  
Nafees Ahmad
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycaemic Control ◽  
Self Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Poor Glycaemic Control

Objectives: This study aimed to explore the relationship between glycaemic control and factors that may influence this among elderly type 2 diabetes mellitus (T2DM) patients in Lahore, Pakistan. Methods: This descriptive, cross-sectional study was conducted at the Jinnah and Sir Ganga Ram Hospitals, Lahore using convenience sampling techniques between 1 December 2015 and 28 February 2016. The sample consisted of elderly (>65 years) T2DM patients. Glycaemic values and patient characteristics were obtained from medical charts. Consenting patients were interviewed to complete the Barthel Index, Lawton Instrumental Activities of Daily Living Scale, Clinical Frailty Scale, Iowa Pain Thermometer Scale, Geriatric Depression Scale, Montreal Cognitive Assessment tool, Mini Nutritional Assessment Scale—Short Form and Self Care Inventory—Revised Version. Multiple logistic regression analysis was carried out to determine the predictors of poor glycaemic control. Results: A total of 490 patients were approached and 400 agreed to participate. Overall, nearly one-third (32.2%, n = 129) of patients had glycated haemoglobin (HbA1c) at the target level. Fasting and random plasma glucose levels were within the target range to much the same extent; (36.8%, n = 147) and (27%, n = 108), respectively. HbA1c levels were also higher in patients with co-morbidities (67.4%, n = 229) with diabetes-related complications (73.5%, n = 227). Significant predictors of impaired glycaemic control (HbA1c) included poor diabetes self-care (adjusted odds ratio (AOR) 0.96; 95% confidence interval (CI) 0.95, 0.98), not being prescribed oral hypoglycaemic agents (OHA) (AOR 6.22; 95% CI 2.09, 18.46), regular hypoglycaemic attacks (AOR 2.53; 95% CI 1.34, 4.81) and falling tendency (AOR 0.19; 95% CI 0.10, 0.36). Conclusions: Poor glycaemic control prevailed among the majority of elderly Pakistani diabetic patients in this study. Triggering factors of poor glycaemic control should be taken into consideration by the healthcare professionals in targeting multifaceted interventions to achieve good glycaemic control.

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