Screening tuberculosis patients for diabetes mellitus in a routine program setting in Kampala, Uganda: a cross-sectional study

Background: Uganda is located in East Africa and is among the countries with the lowest income globally. The ten health centres in this project serve populations in the under-privileged communities of Kampala. The objective of the study was to implement diabetes mellitus (DM) screening among tuberculosis (TB) patients in a routine program setting with limited resources and high human immunodeficiency virus (HIV) prevalence. Methods: A descriptive cross-sectional observational study was conducted in ten health centres in Kampala, Uganda. As part of a project to implement DM screening in a routine setting, TB patients were screened for DM by trained health workers. A fasting blood glucose (FBG) value ≥7.0mmol/l was considered to indicate DM. For this study, aggregate data was collected and analysed using SPSS for Windows, version 13.0. Results: Among 4,590 TB patients registered, 4,016 (88.0%) were screened with random blood glucose (RBG). Of those with RBG ≥6.1mmol/l, 1,093 (83.3%) were screened with FBG. In total, 92 (2.3%) patients were diagnosed with DM and 66 (71.8%) of them were newly diagnosed. The proportion of TB patients screened with FBG in the health centres varied from 58.2% to 100%. The proportion of patients screened with FBG and the prevalence of DM were significantly higher in private health centres compared with public health centres. The health centres in peri-urban areas screened more patients with RBG than those in urban areas. Health centres without DM services screened a larger number of patients with RBG and FBG than those with DM services. Conclusions: It appears feasible to implement screening TB patients for DM in routine program settings with limited resources and high HIV prevalence. Its introduction requires close collaboration between TB and DM services. The challenges identified need government attention and certain institutional and service-related factors need to be better managed at times.

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Screening tuberculosis patients for diabetes mellitus in a routine program setting in Kampala, Uganda: a cross-sectional study

F1000Research ◽

10.12688/f1000research.19279.2 ◽

2019 ◽

Vol 8 ◽

pp. 872

Author(s):

Joseph Nsonga ◽

John Paul Dongo ◽

Frank Mugabe ◽

Gerald Mutungi ◽

Richard Walyomo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Urban Areas ◽

Health Workers ◽

Fasting Blood Glucose ◽

Hiv Prevalence ◽

Limited Resources ◽

Cross Sectional ◽

Number Of Patients ◽

Health Centres

Background: Uganda is located in East Africa and is among the countries with the lowest income globally. The ten health centres in this project serve populations in the under-privileged communities of Kampala. The objective of the study was to implement diabetes mellitus (DM) screening among tuberculosis (TB) patients in a routine program setting with limited resources and high human immunodeficiency virus (HIV) prevalence. Methods: A descriptive cross-sectional observational study was conducted in ten health centres in Kampala, Uganda. As part of a project to implement DM screening in a routine setting, TB patients were screened for DM by trained health workers. A fasting blood glucose (FBG) value ≥7.0mmol/l was considered to indicate DM. For this study, aggregate data was collected and analysed using SPSS for Windows, version 13.0. Results: Among 4,590 TB patients registered, 4,016 (88.0%) were screened with random blood glucose (RBG). Of those with RBG ≥6.1mmol/l, 1,093 (83.3%) were screened with FBG. In total, 92 (2.3%) patients were diagnosed with DM and 66 (71.8%) of them were newly diagnosed. The proportion of TB patients screened with FBG in the health centres varied from 58.2% to 100%. The proportion of patients screened with FBG and the prevalence of DM were significantly higher in private health centres compared with public health centres. The health centres in peri-urban areas screened more patients with RBG than those in urban areas. These health centres without DM services screened a larger number of patients with RBG and FBG than those with DM services. Conclusions: It appears feasible to implement screening TB patients for DM in routine program settings with limited resources and high HIV prevalence. Its introduction requires close collaboration between TB and DM services. The challenges identified need government attention and certain institutional and service-related factors need to be better managed at times

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Differences in fasting blood glucose levels in acceptors Progestin Injections and Combination Injections

Jurnal Ners dan Kebidanan Indonesia ◽

10.21927/jnki.2020.8(3).247-252 ◽

2020 ◽

Vol 8 (3) ◽

pp. 247

Author(s):

Siti Cholifah ◽

Paramitha Amelia Kusumawardani ◽

Miftahul Muslih

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Health Workers ◽

Fasting Blood Glucose ◽

Hormonal Contraceptive ◽

Observational Research ◽

Cross Sectional ◽

Glucose Levels ◽

Blood Glucose Levels ◽

The Government

<em>Efforts to limit and regulate birth spacing as a goal to create quality families and healthy families, the government encourages people to use contraceptives as birth control. One of these contraceptives is injection contraception. Injecting contraception is the most widely used contraceptive tool by the people of Indonesia, is considered effective, practical, but has several side effects, the most worrying is that it affects blood glucose. Blood glucose levels in the human body that increase more than normal can be a symptom of diabetes mellitus. The purpose of this study is to determine differences in blood glucose levels in progestin injection and combined injection contraceptive acceptors. Observational research design using a cross sectional approach. The study population was all injectable acceptors. Samples were taken that met the inclusion criteria, namely respondents were willing to be examined, there was no history of diabetes mellitus (DM), less than 40 years of age, acceptors of at least 6-8 hours fasting. Sampling was carried out using consecutive sampling techniques totaling 50 acceptors (25 progestin injection acceptors, 25 combined injection acceptors). Data were analyzed by Witney mann test using α = 0.05. The results showed the mean fasting blood glucose for progestin injection acceptors was higher than for combination injections, the test results P = 0.008 <α = 0.05. The conclusions of the study show that there are significant differences in blood glucose levels in progestin-injecting acceptors and this combination means that progestin-injecting contraceptives have a higher impact on increasing fasting blood sugar levels compared with combined injection contraception. Suggestions for health workers to control blood glucose injector acceptors at acceptors who experience high glucose levels are recommended to replace non-hormonal contraceptive methods.</em>

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Alterations in Serum Electrolyte Homeostasis in Type-2 Diabetes Mellitus Patients - A Cross-Sectional Study in VIMSAR, Burla

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/641 ◽

2020 ◽

Vol 7 (52) ◽

pp. 3148-3152

Author(s):

Labanyabati Pattanaik ◽

Madhusmita Acharya ◽

Manoj Kumar Yadav ◽

Prafulla Kumar Mishra ◽

Madhab Nayak

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Blood Glucose ◽

Fasting Blood Glucose ◽

Cross Sectional Study ◽

Cross Sectional ◽

Electrolyte Disturbances ◽

Uncontrolled Diabetes ◽

Diabetes Patients

BACKGROUND Type 2 diabetes mellitus is a widely prevalent lifestyle disease associated with high morbidity and mortality due to dead end complications like acute coronary syndrome, chronic kidney failure and acute stroke. Diabetes mellitus patients frequently develop problems of dyselectrolytemia which is common among hospitalised patients with decompensated diabetes. But there is little information on the prevalence of electrolyte disturbances among diabetes patients. Our aim is to find out the pattern of dyselectrolytemia among type 2 diabetes patients and to know if there is any association of blood glucose level with dyselectrolytemia. METHODS An analytical cross-sectional study was done among type 2 diabetes patients admitted in the department of medicine. Fasting blood glucose (FBG), glycosylated haemoglobin level (HbA1c), blood sodium (Na+), potassium (K+) and calcium (Ca2+) were analysed. Occurrence of dyselectrolytemia was compared between patients of very much controlled versus uncontrolled blood glucose levels. RESULTS Out of 199 patients included in the study, 112 (56 %) had uncontrolled diabetes mellitus (DM) with HbA1c level > / = 7.0 %. Occurrence of hyponatremia, hypokalaemia, hyperkalaemia, hypocalcaemia and hypercalcemia were 35 %, 13 %, 7 %, 16 % and 2 % respectively. In diabetes patients, hyponatremia was seen more commonly in patients with uncontrolled DM than those with very much controlled blood glucose (52.67 % versus 12.64 %, p < 0.001). The extent of patients with hypokalaemia or hyperkalaemia didn't vary between the two groups. Patients on insulin treatment were more likely to have hyponatremia than noninsulin patients (p < 0.001). CONCLUSIONS Type 2 DM patients specifically those who have uncontrolled diabetes mellitus have an increased chance to develop dyselectrolytemia. The most well-known electrolyte disturbances seen were hyponatremia followed by hypocalcaemia in our study and they were generally predominant among patients with uncontrolled DM. KEYWORDS Type 2 Diabetes, Dyselectrolytemia, Hyperglycaemia, Fasting Blood Glucose, Hyponatremia

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Diabetes mellitus among patients attending TB clinics in Dar es Salaam: a descriptive cross-sectional study

BMC Infectious Diseases ◽

10.1186/s12879-019-4539-5 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Patricia J. Munseri ◽

Henrika Kimambo ◽

Kisali Pallangyo

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Fasting Blood Glucose ◽

Cross Sectional Study ◽

Dar Es Salaam ◽

Sub Saharan Africa ◽

Cross Sectional ◽

Family History Of Diabetes ◽

History Of ◽

Sub Saharan

Abstract Background A bi-directional interaction between diabetes mellitus and tuberculosis is well established and has been likened to that between HIV and TB. Whereas HIV screening is standard of care test in sub Saharan Africa TB programs, the same is not true for diabetes mellitus (DM). Sub Saharan Africa, a region with high TB infection rates, is going through an epidemiological transition with rapidly rising prevalence of diabetes. We aimed at characterizing TB patients with DM in order to identify factors associated with TB-DM dual disease among patients attending TB clinics in Dar es Salaam. Methods A cross-sectional study was conducted between September 2016 and January 2017 among patients attending TB clinics in Dar es Salaam. We collected socio-demographic characteristics, anthropometric measurements and screened for diabetes by measuring fasting blood glucose that was followed by a 2 h postprandial glucose for participants with impaired fasting blood glucose. We examined for socio-demographic and clinical factors associated with diabetes using logistic regression analysis. Results Of the 660 enrolled participants with TB, 25 (3.8%) were on treatment for diabetes while 39 (6.1%) and 147 (23%) of the remaining 635 participants were ultimately diagnosed with DM and impaired fasting blood glucose respectively. The overall prevalence of DM was 9.7% (64/660). Independent risk factors for diabetes included: age > 44 years {OR 4.52, 95% CI: [1.28–15.89]}; family history of diabetes {OR 3.42, 95% [CI 1.88–6.21]}. HIV sero-positive TB patients were less likely to have DM compared to those who were HIV sero-negative {OR 0.35, 95% CI [0.17–0.73]}. Conclusions Screening for diabetes should be advocated for TB patients aged above 44 years and/or with a family history of diabetes. HIV sero-negative TB patients were more likely to have DM compared to those who were HIV sero-positive. Further studies are needed to confirm this observation and the underlying factors.

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“PREVALENCE OF TB IN PATIENTS WITH DM UNDER REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME”

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i7.423 ◽

2019 ◽

Vol 3 (7) ◽

Author(s):

Dr. Mohammed Hidayath Hussain ◽

Mir Ahsan Ali Quadri ◽

Dr. Chelluri Eshwara Prasad

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Urban Areas ◽

Strong Association ◽

Fasting Blood Glucose ◽

Substantial Contribution ◽

P Value ◽

Tuberculosis Control ◽

Medical Sciences ◽

Significant Difference

Background: DM has been shown to be an independent risk factor for TB, and there is evidence showing high DM prevalence in TB patients in studies mainly from the southern part of India. This strong association between DM and TB raises the question as to whether TB patients should be routinely screened for DM. Many studies have been conducted to establish the relation between TB and DM using fasting blood glucose as the parameter. Objective: The primary objective of this study was to detect the prevalence of Diabetes Mellitus in the newly diagnosed TB patients by HbA1C and Fasting Blood Glucose. Design: This was a Cross Sectional study. Duration: The present study was conducted from January 2015 to June 2016. Setting: Shadan Institute of Medical Sciences, Hyderabad. Participants: 280 patients diagnosed with tuberculosis at the chest clinic of Shadan Institute Of Medical Sciences, Hyderabad. Methods: 140 out of the 280 patients who were diagnosed as TB underwent blood tests for Fasting Blood Glucose and HbA1C along with the routine investigations like CBP, ESR, Chest X ray, ECG, Sputum examination. The data of patients with TB and DM and patients with only TB was compared. The data of pulmonary and extra pulmonary TB groups was compared. The data of sputum positive and sputum negative groups was compared. Student’s t test was performed for normally distributed continuous variables and a p value was derived. Results: 38(27%) out of 140 patients had abnormal HbA1c i.e. > 6.5% having a strong association with male gender and age more than 45 years. The majority of the patients who had diabetes in this study, also had sputum positive TB(57%). This study showed a significant difference in mean age between the two groups of TB with diabetes(44.88 ± 5.721) and TB without DM(34.598 ± 10.56). Conclusion: There was a high prevalence of DM amongst the TB patients registered under RNTCP. Diabetes makes a substantial contribution to the burden of incident tuberculosis in India, and the association is particularly strong for the infectious form of tuberculosis. The current diabetes epidemic may lead to a resurgence of tuberculosis in endemic regions, especially in urban areas. This potentially carries a risk of global spread with serious implications for tuberculosis control. Keywords: Tuberculosis, Diabetes Mellitus, Blood Glucose, Sputum.

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Hubungan Antara Tingkat Stres Dan Kadar Glukosa Darah Puasa Penderita Diabetes Melitus Tipe 2 Di Kecamatan Maos

Jurnal Ilmu Kesehatan MAKIA ◽

10.37413/jmakia.v8i1.45 ◽

2019 ◽

Vol 8 (1) ◽

Author(s):

Esti Oktaviani Purwasih

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Blood Glucose ◽

Stress Level ◽

Fasting Blood Glucose ◽

P Value ◽

Cross Sectional ◽

Diabetes Melitus

ABSTRAKDiabetes melitus (DM) tipe 2 yaitu penyakit gangguan metabolik ditandai kenaikan gula darah karena penurunan sekresi insulin oleh sel beta pankreas dan atau ganguan resistensi insulin.Penelitian ini bertujuan untuk mengidentifikasi hubungan antara kadar glukosa darah puasa dengan tingkat stres pada penderita diabetes melitus (DM) tipe 2. Jenis penelitian adalah deskriptif korelasi dengan pendekatan cross sectional. Variabel independen dalam penelitian ini yaitu tingkat stres. Sedangkan variabel dependen dalam penelitian ini yaitu kadar glukosa darah puasa. Penelitian dilakukan di Puskesmas Maos dan Klinik Graha Amanah Maos bulan Maret 2017. Sampel diambil dengan total sampling, berjumlah 60 responden yang menderita DM tipe 2 minimal 1 tahun, memiliki kadar GDP 130 mg/dl, dan tidak memiliki penyakit komplikasi seperti gagal ginjal kronis, dan kanker.Hasil analisis data menggunakan spearman rho didapatkan tidak terdapat hubungan antara kadar glukosa darah puasa dan tingkat stres (p value = 0,137). Kata Kunci: Diabetes Mellitus Tipe 2, Glukosa Darah Puasa, Tingkat Stres. ABSTRACTType 2 diabetes mellitus (DM ) is a metabolic disease that characterized by an increasing of blood glucose because of decreasing insulin secretion by pancreatic beta cells and or insulin resistance disorders.This research aimed to identify the relationship between fasting blood glucose (FBG) level and stress level in patients with type 2 diabetes mellitus (DM). The research design was descriptive correlation with cross sectional approach. The independent variable in this study was stress level. The dependent variable in this study was fasting blood glucose level. The study was at Maos Community Health Center and Graha Amanah Clinic in March 2017.The sample was total sampling. These were 60 respondents who diagnosed type 2 diabetes mellitus at least 1 year, had FBG level 130 mg / dl, and did not have complications such as chronic kidney failure , and cancer.The results of data analysis by using spearman rho found that there was no correlation between fasting blood glucose level and stress level (p value = 0.137). Keywords: Type 2 Diabetes Mellitus, Fasting Blood Glucose, Stress Level.

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Pengaruh Self-Care terhadap Kadar Glukosa Darah Puasa Pasien Diabetes Melitus Tipe-2

JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) ◽

10.22146/jmpf.44535 ◽

2019 ◽

Vol 9 (2) ◽

Author(s):

Syahrizal Ramadhani ◽

Arie Fidiawan ◽

Tri Murti Andayani ◽

Dwi Endarti

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Fasting Blood Glucose ◽

Self Care ◽

Chi Square ◽

Cross Sectional ◽

Control Blood Glucose ◽

Glucose Levels ◽

Chi Square Test ◽

Cross Sectional Design

Diabetes Mellitus (DM) is a chronic hyperglycemic condition which may affect all aspects of life of the sufferer, and it can be life threatening. This problem can be minimized by doing self-care. Self-care has an influence on glycemic control, prevention of complications due to uncontrolled blood glucose and improving the quality of life for people with diabetes mellitus. This study aimed to determine the effect of self-care on fasting blood glucose of type 2 diabetics. This type of research was observational with cross-sectional design. The inclusion criteria for the study were patients with a diagnosis of diabetes mellitus aged > 18-year-old, treatment at a health center >8 weeks, had records of the last blood glucose fasting ≤1 month before the interview, while the exclusion criteria were patients who refused to participate and patients who could not communicate. Self-care measurement uses the Diabetes Self-Care Management Question (DSMQ) instrument. The number of respondents from this study was 115 people where 79,1% of respondents had a good level of self-care and 47% of respondents with fasting glucose levels that had not been achieved. The data were analyzed using Chi-square test. From this study, it was found that self-care had an effect on fasting blood glucose (OR=3,349, P<0,05). The lowest value of self-care in this study is the domain of physical activity and health-care, therefore patient motivation needs to be improved by exercise and routine check-up because self-care is one of the important factors that could control blood glucose levels.

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Blood Glucose Level And Candida spp. Growth In Elderly Diabetes Melitus Patients

Medical Laboratory Technology Journal ◽

10.31964/mltj.v4i1.174 ◽

2018 ◽

Vol 4 (1) ◽

pp. 1

Author(s):

Rifqoh Rifqoh ◽

Syaidatul Aslamiah ◽

Jujuk Anton Cahyono ◽

Erpan Roebiakto

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Blood Glucose Level ◽

Glucose Level ◽

Fasting Blood Glucose ◽

Fasting Blood Glucose Level ◽

Candida Spp ◽

Cross Sectional ◽

Patients With Diabetes ◽

Medium Level

Diabetes mellitus is a presdisposing factor against infection, especially in orofacial area. Infectious diseases are more frequent serious in patients with diabetes mellitus, which potentially increases their morbimortality. The more frequent oral mucosa infection of DM patients is candidiasis which caused by Candida spp. This research is aimed to obtain the correlation between fasting blood glucose level and Candida spp. growth in elderly diabetes mellitus patients. This analytical survey research used cross-sectional design through GOD-PAP methode for fasting blood glucose level test and macroscopic method for total colony of Candida spp. growth. The result of fasting blood glucose level test average 186,06 mg/dl the highest level is 492,90 mg/dl and the lowest one is 72,08 mg/dl. Meanwhile, the result of Candida spp. is 131 at the average and the highest growth is 350 and the lowest one is 12 colonies. The result of the research indicates that there is a rising of Candida spp. to level of fasting blood glucose in elderly diabetes mellitus patients. Based on correlational test of spearman, it gains significant value 0,001 < α = 0,005 of that shows there is a correlation between fasting blood glucose level and Candida spp. growth in diabetes mellitus elderly patients with the strenght relation (r) = 0,572 which means in medium level. Further researches about the influence to the other presdisposing factors of Candida spp. growth are recommended

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Profil penggunaan obat antidiabetes pada pasien diabetes mellitus tipe 2 di instalasi rawat jalan RSUD Provinsi NTB tahun 2018

Sasambo Journal of Pharmacy ◽

10.29303/sjp.v2i1.74 ◽

2021 ◽

Vol 2 (1) ◽

pp. 37-41

Author(s):

Baiq Sofianti Annisa ◽

Candra Eka Puspitasari ◽

Siti Rahmatul Aini

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Fasting Blood Glucose ◽

Regular Insulin ◽

Cross Sectional ◽

Glucose Levels ◽

Blood Glucose Levels ◽

Type 2 Dm ◽

Aspart Insulin

Diabetes mellitus (DM) is a disorder of insulin secretion, insulin action or both, which are characterized by blood glucose levels 200 mg/dl and / or fasting blood glucose levels 126 mg/dl. In 2017 Indonesia was recorded as the sixth largest country with DM in the world. The most common classification of diabetes is type 2 DM with an incidence 90-95%. The study aimed to determine the profile of antidiabetic use in type 2 DM patients at the outpatient installation of RSUD Provinsi NTB in 2018. This study used cross sectional design retrospectively with purposive sampling method for the period January-December 2018. The results showed that in 112 patients, 195 antidiabetic agents were prescribed. The antidiabetic prescribed were metformin (33.85%), glimepirid (25.13%), aspart insulin (13.33%), insulin detemir (8.21%), pioglitazone (6.67%), insulin glargine (6.67%), glyclazide (1.54%), gliquidone (1.54%), acarbose (1.54), regular insulin (1.03%), and insulin lispro (0.51%). Overall, antidiabetic use was in accordance with the guideline recommendations. Further research is needed regarding the review of prescriptions and detailed indications in order to increase rationality of drug use, reduce morbidity and mortality and reduce medical costs.

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Assessment of information and health habits of patients with diabetes mellitus

PONS - medicinski casopis ◽

10.5937/pomc18-32297 ◽

2021 ◽

Vol 18 (1) ◽

pp. 14-19

Author(s):

Nikola Savić ◽

Igor Lukić ◽

Jelena Mitrović ◽

Zoran Jokić ◽

Dušan Ružičić ◽

...

Keyword(s):

Diabetes Mellitus ◽

Health Care ◽

Health Education ◽

Health Workers ◽

The Body ◽

Health Habits ◽

Cross Sectional ◽

Number Of Patients ◽

Patients With Diabetes ◽

Education Work

Objective. Diabetes mellitus is a chronic disease in which the body either does not produce or inadequately uses the hormone of the pancreas, insulin. Health education work with this population of patients is an important aspect of treatment and health care, it aims to change harmful health behavior and prevent complications. The aim of the research is to examine the information and health habits of patients with diabetes mellitus, to determine the presence of factors that can affect the worsening of the condition and lead to complications of the disease. Methods. The research was conducted according to the type of cross-sectional study. To collect data, a questionnaire for patients with diabetes mellitus was used, which the authors constructed for this research. The research was conducted in the population of patients with diabetes, in the period June-August 2018. at the General Hospital in Valjevo. The sample consisted of 110 respondents. Results. In the observed sample, almost 2/3 (63%) of the respondents are overweight, and almost 3/4 (74%) of the respondents regularly control their blood sugar values. More than 1/2 (56%) were educated for glycemic self-control, 70% were informed about signs of hyperglycemia, 87% were signs of hypoglycemia. More than 1/3 of respondents are exclusively on insulin therapy, 87% adhere to the therapeutic regimen, 87% of the subjects are trained for insulin self-application. 90% of respondents go to check-ups regularly, and 97% think that the information they receive from health workers is useful. Conclusion. Healthcare professionals of all profiles, primarily doctors and nurses, should continuously conduct health education work with people with diabetes. The largest number of patients in the observed sample were informed about their disease and hygienic dietary regime. In order to make the results even more encouraging, it is necessary to intensify health education work at all levels of health care.

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