Barriers to care in patients with diabetes and poor glycemic control—A cross-sectional survey

(1) Background: The latest recommendations for diabetes management adapt the objectives of glycemic control to the frailty profile in older patients. The purpose of this study was to evaluate the proportion of older patients with diabetes whose treatment deviates from the recommendations. (2) Methods: This cross-sectional observational study was conducted in older adults with known diabetes who underwent an outpatient frailty assessment in 2016. Glycated hemoglobin (HbA1c) target is between 6% and 7% for nonfrail patients and between 7% and 8% for frail patients. Frailty was evaluated using the Fried criteria. Prescriptions of glucose-lowering drugs were analyzed based on explicit and implicit criteria. (3) Results: Of 110 people with diabetes with an average age of 81.7 years, 67.3% were frail. They had a mean HbA1c of 7.11%. Of these patients, 60.9% had at least one drug therapy problem in their diabetes management and 40.9% were potentially overtreated. The HbA1c distribution in relation to the targets varied depending on frailty status (p < 0.002), with overly strict control in frail patients (p < 0.001). (4) Conclusions: Glycemic control does not seem to be routinely adjusted to the health of frail patients. Several factors can lead to overtreatment of these patients.

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Effect of Regular Khat Chewing on Serum Fasting Sugar Level in Diabetic patients versus Healthy Individuals; A comparative study

Nutrition and Metabolic Insights ◽

10.1177/11786388211035220 ◽

2021 ◽

Vol 14 ◽

pp. 117863882110352

Author(s):

Yordanos Mengistu ◽

Gobena Dedefo ◽

Mesay Arkew ◽

Gebeyehu Asefa ◽

Gutema Jebessa ◽

...

Keyword(s):

Risk Factors ◽

Blood Glucose ◽

Glycemic Control ◽

Glucose Oxidase ◽

Blood Sugar ◽

Poor Glycemic Control ◽

Fasting Blood Sugar ◽

Healthy Individuals ◽

Cross Sectional ◽

Khat Chewer

Background: Khat chewing is a long standing social-cultural habit in several countries. Even though many people chew khat simply for its pleasurable and stimulatory effect, evidence showed widely-held belief among khat chewers in Ethiopia and other part of the world that khat helps to lower blood glucose while some studies are contradicted on the effect of khat. There is limited data about khat’s effect on blood glucose especially in our setting, Harar estern Ethiopia. Objective: Primarily the present study aims to compare fasting blood sugar level among khat chewer diabetic and healthy individuals, and to asses risk factors associated with poor glycemic control in diabetic subjects. Method: A cross-sectional study included 200 confirmed diabetic and healthy subjects. Fasting blood sugar was determined by enzymatic method glucose oxidase and glucose hexokinase. Glycemic control was also determined for diabetic subjects based on the last 2-month diabetic clinic visits and current measurement. Result: (Median ± IQR [interquartile range]) fasting blood sugar difference among Khat chewer and non khat chewer were 159 ± 83 mg/dl and 202 ± 79 mg/dl respectively in diabetic subjects when tested by glucose oxidase. Similarly, in healthy non khat chewer and khat chewer, khat chewers has lower (Median ± IQR) fasting blood glucose level 82 ± 18 mg/dl than non khat chewers 94 ± 13 mg/dl when tested by glucose oxidase. Regarding risk factors associated with poor glycemic control in diabetic subjects, positive parental diabetes history, insulin medication, being overweight, obese were significantly associated with poor glycemic control. Conclusion: There was significant effect of khat on median FBS among khat chewers in diabetic and healthy individuals. And the proportion of glycemic control was high among diabetic subjects. Recommendation: Health care professional and patients should manage the risk factors to delay disease progression and restrain the damage. More studies should be conducted in randomized control trial manner to further elucidate khat effect on blood sugar level so that the actual effect of khat can be identified unlike in cross sectional where there may not be strong causal relationship.

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Glycemic Control in Chinese Patients with Type 2 Diabetes Mellitus Receiving Oral Antihyperglycemic Medication-Only or Insulin-Only Treatment: A Cross-Sectional Survey

Diabetes Therapy ◽

10.1007/s13300-015-0114-2 ◽

2015 ◽

Vol 6 (2) ◽

pp. 197-211 ◽

Cited By ~ 9

Author(s):

Yun Chen ◽

Li Liu ◽

Liqun Gu ◽

Steven Babineaux ◽

Hayley Colclough ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Chinese Patients ◽

Cross Sectional Survey ◽

Cross Sectional

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Depression among patients with diabetes mellitus in a Nigerian teaching hospital

South African Journal of Psychiatry ◽

10.4102/sajpsychiatry.v16i2.232 ◽

2010 ◽

Vol 16 (2) ◽

pp. 4 ◽

Cited By ~ 3

Author(s):

Bawo Onesirosan James ◽

Joyce Ohiole Omoaregba ◽

George Eze ◽

Olufemi Morakinyo

Keyword(s):

Diabetes Mellitus ◽

Control Group ◽

Depression Symptoms ◽

Depression Symptom ◽

Treatment Goals ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Prevalence Of Depression ◽

Patients With Diabetes ◽

Diabetes Patients

Objectives. Depression is associated with diabetes mellitus and affects treatment goals negatively. We aimed to determine the prevalence of depression and identify its socio-demographic or clinical correlates among patients with diabetes mellitus attending an out-patient clinic in Nigeria.Methods. Two hundred consecutively recruited diabetes patients (index group) were compared with a similar number of apparently healthy controls in a cross-sectional survey. In both groups, in addition to obtaining socio-demographic details, depression was diagnosed using the Schedule for the Clinical Assessment in Neuropsychiatry (SCAN), while the Beck Depression Inventory (BDI) was used to assess depression symptom severity. Results. Sixty (30%) diabetes patients met a SCAN diagnosis for clinical depression, compared with 19 (9.5%) in the control group. Having a smaller income and more children were significantly correlated with higher depression symptoms on the BDI.Conclusion. Depression is highly co-morbid with diabetes mellitus. The care of individuals with diabetes mellitus should include the screening and possible treatment for depression in order to achieve and sustain treatment goals.

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