scholarly journals Prevalence and associated factors of diabetic foot ulcers among type 2 diabetic patients attending chronic follow-up clinics at governmental hospitals of Harari Region, Eastern Ethiopia: A 5-year (2013–2017) retrospective study

2021 ◽  
Vol 9 ◽  
pp. 205031212098738
Author(s):  
Assefa Tola ◽  
Lemma Demissie Regassa ◽  
Yohanes Ayele

Introduction: Diabetic foot disease is a growing major public health problem and the leading cause of prolonged hospital admission, health-related costs, and reduced quality of life for diabetes patients. This study aimed to determine the prevalence of diabetic foot ulcers (DFU) and its associated factors among type 2 diabetes patients in Harari Region, East Ethiopia. Methods: An institution-based retrospective study was conducted from 28 March to 30 April 2018, among type 2 diabetes patients diagnosed between 1 January 2013 and 31 December 2017, at three government hospitals of Harari Region. Data were collected using a standard checklist format. Data were entered into Epi Info Version 7 and analyzed using SPSS 24. Binary and multiple logistic regression models were used to determine the associated factors. Odds ratio with 95% confidence intervals was used to determine level of association. Result: A document of 502 type 2 diabetes patients was reviewed and included in the final analysis in this study. The prevalence of DFU among type 2 diabetes patients was 21.1%. Being currently married decreased the odds of DFU by 60% (adjusted odds ratio = 0.40; 95% confidence interval: 0.17–0.96). Factors associated with increased diabetes ulcers chance were physical inactivity 2.29 (adjusted odds ratio = 2.29; 95% confidence interval: 1.17–4.48), starting treatment with insulin 4.43 times (adjusted odds ratio = 4.43; 95% confidence interval: 1.84–10.67), obesity 27.76 (adjusted odds ratio = 27.76; 95% confidence interval: 13.96–55.23), delay to start follow-up 2.22 (adjusted odds ratio = 2.22; 95% confidence interval: 1.03–4.82), history of infection 3.50 (adjusted odds ratio= 3.50; 95% confidence interval: 1.83–6.69), and hypertension 3.99 (adjusted odds ratio = 3.99; 95% confidence interval: 2.08–7.65). Conclusion: The prevalence of DFU among type 2 diabetes is substantially high as more than one in five patients have this complication. Moreover, marital status, physical activity, baseline medication, obesity, delay for follow-up, infection history, and hypertension were significantly associated with the development of DFU.

2005 ◽  
Vol 153 (6) ◽  
pp. 837-844 ◽  
Author(s):  
Iacopo Chiodini ◽  
Massimo Torlontano ◽  
Alfredo Scillitani ◽  
Maura Arosio ◽  
Simonetta Bacci ◽  
...  

Objective: Subclinical hypercortisolism (SH) may play a role in several metabolic disorders, including diabetes. No data are available on the relative prevalence of SH in type 2 diabetes (T2D). In order to compare the prevalence of SH in T2D and matched non-diabetic control individuals, we performed a case-controlled, multicenter, 12-month study, enrolling 294 consecutive T2D inpatients (1.7% dropped out the study) with no evidence of clinical hypercortisolism and 189 consecutive age- and body mass index-matched non-diabetic inpatients (none of whom dropped out). Design and methods: Ascertained SH (ASH) was diagnosed in individuals (i) with plasma cortisol after 1 mg overnight dexamethasone suppression >1.8 μg/dl (50 nmol/l), (ii) with more than one of the following: (a) urinary free cortisol >60.0 μg/24 h (165.6 nmol/24 h), (b) plasma ACTH <10.0 pg/ml (2.2 pmol/l) or (c) plasma cortisol >7.5 μg/dl (207 nmol/l) at 24:00 h or >1.4 μg/dl (38.6 nmol/l) after dexamethasone-CRH (serum cortisol after corticotrophin-releasing hormone stimulus during dexamethasone administration) test, and (iii) in whom the source of glucocorticoid excess was suggested by imaging and by additional biochemical tests (for ACTH-dependent ASH). Results: Prevalence of ASH was higher in diabetic individuals than in controls (9.4 versus 2.1%; adjusted odds ratio, 4.8; 95% confidence interval, 1.6–14.1; P = 0.004). In our population the proportion of T2D which is statistically attributable to ASH was approx. 7%. Among diabetic patients, the presence of severe diabetes (as defined by the coexistence of hypertension, dyslipidaemia and insulin treatment) was significantly associated with SH (adjusted odds ratio, 3.8; 95% confidence interval, 1.4–10.2; P = 0.017). Conclusions: In hospitalized patients, SH is associated with T2D.


2021 ◽  
Vol 9 ◽  
pp. 205031212110230
Author(s):  
Tadesse Alemu ◽  
Tirhas Tadesse ◽  
Getasew Amogne

Objective: The objective of the study was to explore the level of glycemic control and its determinants among patients with type 2 diabetes mellitus at Menelik II Referral Hospital, Addis Ababa, Ethiopia. Methods: Cross-sectional study design was employed. The sample size was determined using a single proportion formula and 245 patients with type 2 diabetes mellitus were involved in this study. Systematic sampling method was used to select the study subjects. Standard questionnaire was used to collect patient’s biographic data, economic data, self-care activities, and patient compliance to medications. Summary statistics of a given data were calculated. Logistic regression model was used to measure the relationship between the outcome and predictor variable. Direction and strength of association was expressed using odds ratio and 95% confidence interval. Result: More than three-fourth, 191 (80.3%) of diabetic patients had poor glycemic control. Poor glycemic control was found to be 7.03 times higher among diabetic patients with duration of 5–10 years (adjusted odds ratio = 7.03, 95% confidence interval = 2.7–18.6). Similarly, diabetic patients with a duration of above 10 years were poorly controlled their blood sugar level (adjusted odds ratio = 2.3, 95% confidence interval = 1.028–5.08) in comparison to diabetic patients with a duration of fewer than 5 years. It was also found that compliance with a specific diet was significantly associated with good control of blood sugar level (adjusted odds ratio = 3.7, 95% confidence interval = 1.24–11.13). Conclusion: The magnitude of patients with poor glycemic control was high. Duration of diabetes and non-compliance with diets high in fruits, vegetables, and diets low in fat and sugar were significantly related to uncontrolled blood glucose levels. Therefore, developing strategies targeted toward improving blood glucose control with special attention to diabetes mellitus (DM) patients with a duration of ⩾5 years and those who poorly comply with their diet was strongly recommended.


2022 ◽  
Vol 10 ◽  
pp. 205031212110687
Author(s):  
Dereje Bikila Yami ◽  
Techane Sisay Tuji ◽  
Bedasa W/Michael Gelete ◽  
Kassahun Beyene Workie

Objectives: This study aims to assess the disclosure status of HIV-positive children and its associated factors in selected hospitals in East Arsi zone, Oromia regional state, Ethiopia, 2020. Methods: Institutional-based cross-sectional study design was conducted on 410 sample size. Four hospitals were randomly selected among hospitals that currently gave service. Data were collected from caregivers/biological parents by interviewing from 30 July 2020 to 30 August 2020 using the systematic random sampling technique. In logistic regression analysis, the variables which had independent correlations with dependent variable were identified based on adjusted odds ratio and a p value <0.05 with 95% confidence interval was claimed as statistically significant. Results: Disclosure status of HIV-positive children was 59.8%, 95% confidence interval (54.9, 64.1). Children diagnosed at the age of <5 (adjusted odds ratio = 0.25, 95% confidence interval (0.126, 0.49)), antiretroviral therapy follow-up for 6–15 years (adjusted odds ratio = 2.08, 95% confidence interval (1.013, 4.29)), children diagnosed at the appropriate age of ⩾12 years (adjusted odds ratio = 1.95, 95% confidence interval (1.09, 3.49)), and children diagnosed at the age of <11 years (adjusted odds ratio = 4.5, 95% confidence interval (3.45, 8.38)) were positively associated factors to disclose status. Conclusion: The disclosure status of HIV-positive children was low in this study. Antiretroviral therapy follow-up for 6–15 years, children diagnosed at the appropriate age of ⩾12 years, children diagnosed at the age of <5 years, and children who aged below 11 years were positively associated with disclosure status. Thus, we recommended, health care providers and all stakeholders should give age-appropriate counseling regarding when and why to disclose their status.


Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 588-P
Author(s):  
ANI S. TODOROVA ◽  
RUMYANA DIMOVA ◽  
NEVENA CHAKAROVA ◽  
MINA SERDAROVA ◽  
GRETA GROZEVA-DAMYANOVA ◽  
...  

Author(s):  
Khalid Mohamed ◽  
Rami Alharbi ◽  
Yazeed Aljoahni ◽  
Abdulmajeed Alamri ◽  
Mohammed Saeed ◽  
...  

Author(s):  
Qiao Qin ◽  
Fangfang Fan ◽  
Jia Jia ◽  
Yan Zhang ◽  
Bo Zheng

Abstract Purpose An increase in arterial stiffness is associated with rapid renal function decline (RFD) in patients with chronic kidney disease (CKD). The aim of this study was to investigate whether the radial augmentation index (rAI), a surrogate marker of arterial stiffness, affects RFD in individuals without CKD. Methods A total of 3165 Chinese participants from an atherosclerosis cohort with estimated glomerular filtration rates (eGFR) of ≥ 60 mL/min/1.73 m2 were included in this study. The baseline rAI normalized to a heart rate of 75 beats/min (rAIp75) was obtained using an arterial applanation tonometry probe. The eGFRs at both baseline and follow-up were calculated using the equation derived from the Chronic Kidney Disease Epidemiology Collaboration. The association of the rAIp75 with RFD (defined as a drop in the eGFR category accompanied by a ≥ 25% drop in eGFR from baseline or a sustained decline in eGFR of > 5 mL/min/1.73 m2/year) was evaluated using the multivariate regression model. Results During the 2.35-year follow-up, the incidence of RFD was 7.30%. The rAIp75 had no statistically independent association with RFD after adjustment for possible confounders (adjusted odds ratio = 1.12, 95% confidence interval: 0.99–1.27, p = 0.074). When stratified according to sex, the rAIp75 was significantly associated with RFD in women, but not in men (adjusted odds ratio and 95% confidence interval: 1.23[1.06–1.43], p = 0.007 for women, 0.94[0.76–1.16], p = 0.542 for men; p for interaction = 0.038). Conclusion The rAI might help screen for those at high risk of early rapid RFD in women without CKD.


Author(s):  
Ani S. Todorova ◽  
Edward B. Jude ◽  
Rumyana B. Dimova ◽  
Nevena Y. Chakarova ◽  
Mina S. Serdarova ◽  
...  

The aim of this study was to assess vitamin D status in patients with type 2 diabetes and diabetic foot ulcers (DFU). A total of 242 participants with type 2 diabetes, mean age 59.1 ± 10 years, mean body mass index 31.4 ± 6.3 kg/m2, and estimated glomerular filtration rate ≥45 mL/min/1.73m2, were divided into 2 groups: 73 with DFU (35 with and 38 without active infection) and 169 without DFU (106 with diabetic peripheral neuropathy, 63 without complications). Neuropathy was assessed by 10 g monofilament, Rydel-Seiffer 128 Hz tuning fork, and temperature discrimination. Serum 25(OH)D (25-hydroxy vitamin D) was assessed by ECLIA (electro-chemiluminescence immunoassay) method. Median 25(OH)D level was 12.6 ng/mL (IQR [interquartile range] 9.3-17.6 ng/mL) in the studied cohort. The DFU group presented with lower 25(OH)D level as compared with diabetic patients without foot ulcers (non-DFU group): 11.6 ng/mL (IQR 8.5-15.8 ng/mL) versus 13.5 ng/mL (IQR 9.6-18.6 ng/mL), P = .001; the diabetic peripheral neuropathy subgroup demonstrated lower 25(OH)D level in comparison with participants without complications: 12.5 ng/mL (IQR 9-17.2 ng/mL) versus 15.9 ng/mL (IQR 10.4-20.8 ng/mL), P = .031. This remained significantly different even after correction for age and duration of diabetes. There was no difference in 25(OH)D level between the subgroups according to the presence of active infection. In conclusion, vitamin D deficiency may play a role in the development of diabetes complications.


2017 ◽  
Vol 52 (2) ◽  
pp. 181-191 ◽  
Author(s):  
Jordana K Bayer ◽  
Ruth Beatson ◽  
Lesley Bretherton ◽  
Harriet Hiscock ◽  
Melissa Wake ◽  
...  

Objective: To determine whether a population-delivered parenting programme assists in preventing internalising problems at school entry for preschool children at-risk with temperamental inhibition. Methods: Design: a randomised controlled trial was used. Setting: the setting was 307 preschool services across eight socioeconomically diverse government areas in Melbourne, Australia. Participants: a total of 545 parents of inhibited 4-year-old children: 498 retained at 1-year follow up. Early intervention: Cool Little Kids parenting group programme was implemented. Primary outcomes: the primary outcomes were child DSM-IV anxiety disorders (assessor blind) and internalising problems. Secondary outcomes: the secondary outcomes were parenting practices and parent mental health. Results: At 1-year follow up (mean (standard deviation) age = 5.8 (0.4) years), there was little difference in anxiety disorders between the intervention and control arms (44.2% vs 50.2%; adjusted odds ratio = 0.86, 95% confidence interval = [0.60, 1.25], p = 0.427). Internalising problems were reduced in the intervention arm (Strengths and Difficulties Questionnaire: abnormal – 24.2% vs 33.0%; adjusted odds ratio = 0.56, 95% confidence interval = [0.35, 0.89], p = 0.014; symptoms – mean (standard deviation) = 2.5 (2.0) vs 2.9 (2.2); adjusted mean difference = –0.47, 95% confidence interval = [–0.81, –0.13], p = 0.006). Parents’ participation in the intervention was modest (29.4% attended most groups, 20.5% used skills most of the time during the year). A priori interaction tests suggested that for children with anxious parents, the intervention reduced anxiety disorders and internalising symptoms after 1 year. Conclusion: Offering Cool Little Kids across the population for inhibited preschoolers does not impact population outcomes after 1 year. Effects may be emerging for inhibited children at highest risk with parent anxiety. Trial outcomes will continue into mid-childhood.


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