scholarly journals Insulin Adherence in Type 2 Diabetes in Mexico: Behaviors and Barriers

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Janneth Bermeo-Cabrera ◽  
Paloma Almeda-Valdes ◽  
Josefa Riofrios-Palacios ◽  
Carlos A. Aguilar-Salinas ◽  
Roopa Mehta
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Low Socioeconomic Status ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Factors Associated ◽  
Fear Of Hypoglycemia ◽  
Insulin Omission

Objective. To investigate factors associated with insulin adherence in subjects with type 2 diabetes mellitus (T2D) attending a tertiary care centre in Mexico City. Material and Methods. Cross-sectional study, including 200 patients. Adherence to insulin therapy was measured with a medication adherence questionnaire. Sociodemographic data and factors related to insulin omission were collected and compared between the nonadherent and adherent groups. Results. We categorized 117 (58.5%) patients as nonadherent and 83 (41.5%) as adherent. Among the adherent, only 22 patients (11%) had excellent adherence to insulin therapy. The following factors were associated with nonadherence: lack of planning of daily activities (46.1%), fear of hypoglycemia (41%), economic factors (15.4%), and number of insulin applications (2.31 versus 1.76 applications per day). Conclusions. In this study, patients with type 2 diabetes attending a tertiary care referral centre showed inadequate adherence to insulin therapy. The principal factors associated with insulin omission were low socioeconomic status, fear of hypoglycemia, and a greater number of insulin applications per day.

scholarly journals Potentially Inappropriate Medication Use in Older Hospitalized Patients with Type 2 Diabetes: A Cross-Sectional Study

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 219
Author(s):  
Rishabh Sharma ◽  
Manik Chhabra ◽  
Kota Vidyasagar ◽  
Muhammed Rashid ◽  
Daniela Fialova ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Patients ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Beers Criteria ◽  
Sectional Study ◽  
Older Population ◽  
Cross Sectional ◽  
Factors Associated

Background: Older patients with type 2 diabetes mellitus (T2DM) are at greater risk of receiving potentially inappropriate medications (PIM) during hospitalization which may result in adverse outcomes. Aim: To evaluate the extent of PIM use in the older population with T2DM during hospitalization in a tertiary care hospital in India. Methods: A cross-sectional study was carried out from August 2019 to January 2020 in a tertiary care teaching hospital among the older population (aged ≥ 65 years) hospitalized with T2DM. Medications prescribed during hospitalization were reviewed following Beers Criteria 2019 to identify the extent of polypharmacy and PIM use. Binary logistic regression was applied to determine the factors associated with PIM use. Results: The mean age of the 150 patients hospitalized with T2DM was 68.85 ± 5.51 years, most of whom were men (54.7%). The participants had at least four comorbidities and were receiving an average of nine medications per day; the median length of hospital stay was 8 days (interquartile range (IQR): 4–19 days). Overall, three quarters (74%) of the participants had at least one PIM prescribed during their hospitalization as per Beers Criteria. Significant factors associated with the use of PIM during hospitalization are patients taking a higher number of medications (odds ratio (OR): 7.85, 95% CI 1.49–41.10), lower creatinine clearance values (OR: 12.90, 95% CI 2.81–59.28) and female patients (OR: 2.29; 95% CI: 1.05–4.97). Conclusions: PIM use is frequently observed in older T2DM patients during hospitalization. Polypharmacy, reduced renal function and female gender are associated with higher PIM use. Engaging clinical pharmacists in evaluating medication appropriateness can improve the outcomes of older patients.

scholarly journals Misconceptions about Insulin and Barriers to Insulin Initiation in Type 2 Diabetes among General Physicians in Southeast Nigeria

2020 ◽  
pp. 30-38
Author(s):  
Ejiofor Ugwu ◽  
Joseph Ojobi ◽  
Edmund Ndibuagu
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Rural Areas ◽  
Quantitative Research ◽  
Oral Glucose ◽  
Insulin Initiation ◽  
Cross Sectional ◽  
Fear Of Hypoglycemia ◽  
General Physicians

Aims: The aim of this study was to evaluate the perceptions of general physicians (GPs) regarding insulin and determine the barriers to its initiation in patients with type 2 diabetes mellitus (T2DM). Study Design: A cross-sectional, quantitative research. Place and Duration: Enugu metropolis, Southeast Nigeria, between March and November 2018. Methodology: We used structured self administered questionnaire to evaluate the perceptions of 64 GPs (45 males and 19 females) regarding insulin, and to elicit barriers to insulin initiation in subjects with T2DM. Results: The mean (SD) age of the participants was 45.5 (11.7) years and their duration of general practice ranged from 3 – 38 years. Majority were private practitioners predominantly in the rural areas. Only 15 (23.4%) respondents had ever initiated insulin for outpatient with T2DM. Fear of hypoglycemia, anticipated patients’ refusal of insulin, physician’s lack of confidence, and concerns about needle pains were among the commonly reported barriers to insulin initiation. Others were socio-economic factors including concerns about affordability of insulin and frequent glycemic monitoring, and availability of insulin storage facilities. There was a general consensus among the GPs on a number of misconceptions including that patients’ adherence to oral glucose lowering drugs eliminates the need for insulin; that insulin should be reserved as a last resort; and that once initiated, insulin therapy is lifelong. Conclusion: This study revealed that there are several physician-related barriers and misconceptions regarding insulin therapy for T2DM among GPs in Southeast Nigeria. Periodic training to improve GPs’ attitude to insulin and optimize insulin utilization in T2DM is required.

scholarly journals Factors Associated with Insulin Nonadherence in Type 1 Diabetes Mellitus Patients in Mexico

2019 ◽  
Vol 25 (3-4) ◽  
pp. 139-147
Author(s):  
Paloma Almeda-Valdes ◽  
Josefa Palacio Ríofrio ◽  
K. Walkiria Zamudio Coronado ◽  
David Rivera de la Parra ◽  
Janneth Bermeo Cabrera ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Insulin Therapy ◽  
Disordered Eating ◽  
Eating Behavior ◽  
Tertiary Care ◽  
Factors Associated ◽  
Fear Of Hypoglycemia ◽  
Disordered Eating Behavior ◽  
Insulin Omission

<b><i>Background:</i></b> Lack of adherence to insulin therapy is common among patients with type 1 diabetes. Factors associated with insulin omission in adult persons with type 1 diabetes in Latin America have not been studied in detail. <b><i>Objectives:</i></b> To investigate factors associated with insulin nonadherence including the presence of psychological disorders (disordered eating behaviors and depression) in adult patients with type 1 diabetes. <b><i>Methods:</i></b> Cross-sectional study including 104 consecutive adults (≥18 years old) attending a tertiary care center in Mexico City. Adherence to insulin therapy was measured with a specific item in a questionnaire. Sociodemographic data and factors related to insulin omission, including validated questionnaires to evaluate disordered eating behavior and depression, were collected and compared between the nonadherent and adherent groups with parametric or nonparametric statistical tests, as appropriate. <b><i>Results:</i></b> We classified 51 (49.1%) patients as nonadherent and 53 (50.9%) as adherent. Adherent subjects reported that they planned their activities around insulin application more often than the nonadherent subjects did (43.4 vs. 23.5%, <i>p</i> = 0.032). In a logistic regression model, fear of hypoglycemia (OR = 11.39) and economic reasons (OR = 6.02) were independently associated with insulin adherence. Presence of disordered eating behavior was identified in 14.4% of subjects, the majority belonging to the nonadherent group. <b><i>Conclusions:</i></b> Only 50% of the patients with type 1 diabetes were adherent. The principal factors associated with nonadherence were economic reasons and fear of hypoglycemia.

scholarly journals Dyslipidemic profile in Type 2 Diabetes Mellitus: A hospital-based study from Eastern Nepal

2020 ◽  
Vol 7 (2) ◽  
pp. 64-70
Author(s):  
Binod Kumar Lal Das ◽  
Netra Prassan ◽  
Mohammad Faiz Ansari ◽  
Kanishk Agrawal ◽  
Saloni Tripathi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Major Type ◽  
Tertiary Care Centre ◽  
Cross Sectional

Background: Dyslipidemia is highly prevalent in Type 2 Diabetes Mellitus (T2DM). It plays a major role in the pathogenesis for diabetic complications. This study intends to exemplify the pattern of dyslipidemia prevalent in T2DM patients attending tertiary care centre of Eastern Nepal. Material and methods: This is a hospital based cross-sectional study conducted in the T2DM patients visiting the routine biochemistry laboratory for their routine blood investigations. 226 patients were included who fulfilled the inclusion criteria. Biochemical parameters were analyzed in routine biochemistry laboratory in cobas c311 autoanalyzer. Results: Out of the 226 T2DM patients, 51% were female and 49% were male respectively. The mean age group was 54.15 ± 12.62 years. Mean value of, HbA1c level, total cholesterol, TG, HDL and LDL was 8.16 ± 2.59 %, 289.04 ± 47.83, 297.77 ± 119.64, 35.62 ± 12.64 140.88 ± 40.58 respectively. HbA1c was significantly correlated with the lipid profile in T2DM patients (p < 0.05). Conclusion: The findings from the present study depicts that the prevalence of dyslipidemia is higher in T2DM in our centre with hypertriglyceridemia being the major type of dyslipidemia in these patients. In addition, male exhibited higher rate of dyslipidemia compare to their female counterparts respectively.

scholarly journals Sex differences and correlates of poor glycaemic control in type 2 diabetes: a cross-sectional study in Brazil and Venezuela

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e023401 ◽  
Author(s):  
Fernanda G Duarte ◽  
Sandra da Silva Moreira ◽  
Maria da Conceição C Almeida ◽  
Carlos A de Souza Teles ◽  
Carine S Andrade ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Treatment Guidelines ◽  
Specific Treatment ◽  
Nationwide Survey ◽  
Haemoglobin A1c ◽  
Cross Sectional ◽  
Factors Associated ◽  
Adherence To Diet

ObjectiveExamine whether glycaemic control varies according to sex and whether the latter plays a role in modifying factors associated with inadequate glycaemic control in patients with type 2 diabetes (T2D) in Brazil and Venezuela.Design, setting and participantsThis was a cross-sectional, nationwide survey conducted in Brazil and Venezuela from February 2006 to June 2007 to obtain information about glycaemic control and its determinants in patients with diabetes mellitus attending outpatient clinics.Main outcome measuresHaemoglobin A1c (HbA1c) level was measured by liquid chromatography, and patients with HbA1c ≥7.0% (53 mmol/mol) were considered to have inadequate glycaemic control. The association of selected variables with glycaemic control was analysed by multivariate linear regression, using HbA1c as the dependent variable.ResultsA total of 9418 patients with T2D were enrolled in Brazil (n=5692) and in Venezuela (n=3726). They included 6214 (66%) women and 3204 (34%) men. On average, HbA1c levels in women were 0.13 (95% CI 0.03 to 0.24; p=0.015) higher than in men, after adjusting for age, marital status, education, race, country, body mass index, duration of disease, complications, type of healthcare, adherence to diet, adherence to treatment and previous measurement of HbA1c. Sex modified the effect of some factors associated with glycaemic control in patients with T2D in our study, but had no noteworthy effect in others.ConclusionsWomen with T2D had worse glycaemic control than men. Possible causes for poorer glycaemic control in women compared with men include differences in glucose homeostasis, treatment response and psychological factors. In addition, sex modified factors associated with glycaemic control, suggesting the need to develop specific treatment guidelines for men and women.

Awareness of Complications in Diabetic Patients - Study in a Tertiary Care Centre in Kerala

2021 ◽  
Vol 8 (37) ◽  
pp. 3334-3338
Author(s):  
Satish Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Type 2 Diabetic Patients ◽  
Complications Of Diabetes ◽  
Type 2 Diabetic

BACKGROUND Type 2 diabetes mellitus is common in the Indian population and awareness regarding the disease and its complications is low among the patients with diabetes. There is lack of studies regarding awareness of complications of diabetes among type 2 diabetic patients. The purpose of this study was to assess the awareness of diabetic complications among type 2 diabetic patients. METHODS This is an institutional based observational study. The sample comprised of 150 adult patients with type 2 diabetes mellitus who underwent treatment in the Department of Medicine, Medical College Kottayam and the patient’s age ranged from 18 - 77 years. RESULTS Majority of patients were in the age group 38 to 57 and the sample comprised of 56 % males and 44 % female patients. Out of 150 patients involved in the study, 120 patients (80 %) were aware of the complications of diabetes mellitus. Among the male patients, 70 (83.33 %) and among females, 50 (75.75 %) were aware of the complications in diabetes. In the study sample, 92 (61.33 %) were aware of the foot problems, 120 patients (80 %) were aware of renal complications, 91 patients were aware regarding eye problems of diabetes, 38 (25.33 %) regarding development of hypertension, 62 (41.33 %) regarding heart attack, 42 (28 %) patients were aware regarding development of stroke and 78 patients (52 %) had awareness regarding occurrence of recurrent infections. CONCLUSIONS Awareness regarding diabetes and its complications is fairly good among the diabetic patients in Kerala. Awareness regarding all complications of diabetes was higher among males than females. Providing awareness to type 2 diabetic patients by various educational programs may be of further help to prevent complications and to decrease the mortality and morbidity in type 2 diabetes patients. KEYWORDS Awareness, Diabetes

scholarly journals Factors Associated With Chronic Kidney Disease in Patients With Type 2 Diabetes in Bangladesh

2021 ◽  
Author(s):  
Sheikh Mohammed Shariful Islam ◽  
Masudus Salehin ◽  
Sojib Bin Zaman ◽  
Tania Tansi ◽  
Rajat Das Gupta ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Household Income ◽  
Multivariate Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Public Health Burden ◽  
Factors Associated

Diabetes and chronic kidney disease (CKD) are a major public health burden in low-and-middle-income countries. This study aimed to explore factors associated with CKD in patients with type 2 diabetes (T2D) in Bangladesh. A cross-sectional study was conducted among 315 adults with T2D presenting at the outpatient department of Bangladesh Institute of Health Sciences (BIHS) hospital between July 2013 to December 2013. CKD was diagnosed based on estimated Glomerular Filtration Rate using the &lsquo;Modification of Diet in Renal Disease&rsquo; equations and presence of albuminuria estimated by the albumin-to-creatinine ratio. Multivariate logistic regression analysis was used to determine the factors associated with CKD. The overall prevalence of CKD among patients with T2D was 21.3%. In the unadjusted model Factors associated with CKD were: aged 40-49 years (OR: 5.7, 95% CI: 1.3-25.4), age 50-59 years (7.0, 1.6-39), age &ge;60 years (7.6, 1.7-34); being female (2.2, 1.2-3.8), hypertensive (1.9, 1.1-3.5) and household income between 128.2-256.4 US$ (2.9, 1.0-8.2) compared with income &le;128.2$. However, after adjustment of other covariates, only duration of hypertension and household income (128.2-256.4 US$) remained statistically significant. There is a need to implement policies and programs for early detection and management of hypertension and CKD in T2D patients in Bangladesh.

scholarly journals Study of thyroid dysfunction in type 2 diabetes mellitus

2020 ◽  
Vol 7 (12) ◽  
pp. 1815
Author(s):  
Mausam Jain ◽  
Pramod R. Jha ◽  
Gaurang Patel
Keyword(s):  
Diabetes Mellitus ◽  
Glycaemic Control ◽  
Thyroid Dysfunction ◽  
Tertiary Care ◽  
Type Ii Diabetes Mellitus ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Long Duration

Background: Aim was to study prevalence of thyroid dysfunction in type II diabetes mellitus (T2DM) patients.Methods: The present study was a cross sectional observational study, which focused on cases of diabetes mellitus. Study was conducted in Departments of Medicine, SBKS MI & RC, a tertiary care centre for a period of 6 months. All the patients of T2DM were included. Total of 263 patients were enrolled which involved indoor, outpatient and diabetic clinic attending patients. A detailed history taking, clinical examination and relevant investigations (Hb%, Total count, platelet count, serum creatinine, FBS, PP2BS, HbA1C, S.TSH, F.T3 and F.T4). Appropriate statistical analytics were used and important correlations and conclusions were drawn.Results: A study of thyroid dysfunction (TD) in T2DM patients which included 263 diabetic patients, out of them 67 had thyroid dysfunction. Out of these 67 patients 43 were female and 24 were male. This suggests that female was more prone to thyroid dysfunction than males. Out of 67 TD patients, 42 were above the age of 50 year. So, as the age increases the prevalence of TD also increases thyroid dysfunction also depends on the glycaemic control of the patients. Out of 67 patients 22 patients had>8.0 HbA1C level. In our study we found that as the glycaemic control became poorer the prevalence of TD increase in hypothyroid but not in hyperthyroidism.Conclusions: Following conclusions were drawn from this study TD is more common in female than male, more after the age of 50 year, in T2DM patients. Hypothyroidism is more common with poor glycaemic control and long duration of T2DM patients. But for hyperthyroidism data which we evaluated was not significant and further conclusion bigger study is needed.

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