Assessing Barriers to Insulin Therapy among Omani Diabetic Patients Attending Three Main Diabetes Clinics in Muscat, Oman

Objectives: This study aimed to identify the main barriers which prevent patients with diabetes mellitus from accepting insulin therapy. Methods: This cross-sectional study was conducted from May to December, 2019. Convenience sampling was used to recruit participants from three Diabetes Clinics in Muscat. Eligible participants were interviewed in person based on a pre-prepared questionnaire. The questionnaire, which was administered in Arabic, includes demographic data, and 19 specific items on barriers to insulin therapy. Results: A total of 201 participants (response rate 93 %) were enrolled in the study. The commonest barriers were as follows: concern of frequent blood glucose checking (36.3%), long- term injections (33.8%), side-effects of insulin (29.9%), and weight gain (29.4%). Needle phobia was considered as a barrier by only 9% of the participants. Overall, 125 (62.2%) of the participants were willing to initiate insulin therapy despite of the presence of these barriers and only 20 (10%) of the participants were influenced by these barriers to the degree that they would reject insulin therapy. Conclusion: The majority of our participants had no identifiable reasons which would stop them from accepting insulin therapy. Effective strategies should be developed to address each of the main barriers to improve acceptance and adherence to insulin therapy. Keywords: Diabetes; Insulin; Barrier; Needle phobia; Hypoglycemia; Weight gain.

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RELUCTANCE OF PATIENTS WITH DIABETES MELLITUS TO INSULIN THERAPY; PSYCHOLOGICAL INSULIN RESISTANCE

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i2.4137 ◽

2021 ◽

Vol 71 (2) ◽

pp. 602-05

Author(s):

Umair Ali ◽

Muhammad Wajid Munir ◽

Jahanzeb Maqsood ◽

Mahwash Jamil ◽

Syed Saif Ur Rehman ◽

...

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Insulin Therapy ◽

Demographic Data ◽

Tertiary Care ◽

Negative Attitude ◽

Cross Sectional Study ◽

Cross Sectional ◽

Validated Questionnaire ◽

Patients With Diabetes

Objective: To evaluate factors resulting in reluctance of initiation of insulin therapy in patients with type 2 diabetes mellitus. Study Design: Cross sectional study. Place and Duration of Study: Medical OPD of a private tertiary care multi-specialty hospital in Islamabad, from Apr to Jul 2019. Methodology: Patients with diabetes mellitus between age of 30-70 years, who had poor glycaemic control on two oral antidiabetic drugs having HbA1c>9% and were insulin naïve, were included in this study. A validated questionnaire was developed which had two sections; first including the demographic data of the study populations and second having closedended dichotomous questions which were asked from patients by the treating physicians Results: A total of 180 patients with diabetes mellitus eligible for insulin therapy were included in the study, among them 52 (28.9%) were agreed to initiate the insulin. Negative attitude and beliefs include painful way of administration 85 (66.4%), difficult insulin storage 98 (76.6%), risk of hypoglycemia 82 (64.1%).The mean negative perception Score was 7.35 (SD 0.98). Conclusion: Psychological insulin resistance is present in significant diabetic population, and it is a big obstacle in insulin therapy initiation and compliance.

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Awareness of Foot Care Among Patients with Diabetes Mellitus attending a Tertiary Care Hospital

International Journal of Multidisciplinary and Current Research ◽

10.14741/ijmcr/v.6.2.8 ◽

2018 ◽

Vol 6 (02) ◽

Author(s):

Dr.P. Ganesh Kumar MS. ◽

Dr.P. Venkateswaran MS ◽

Damini. T

Keyword(s):

Economic Status ◽

Tertiary Care ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Care Hospital ◽

Foot Care ◽

Cross Sectional ◽

Patients With Diabetes ◽

Good Score ◽

Convenience Sampling

Objective: To assess the awareness of diabetes foot and care for foot in known diabetic patients. Methods: A cross- sectional study was carried out using non probability convenience sampling wherein 150 diabetic respondents who fulfilled the inclusion criteria were included. A pre tested questionnaire was used to assess their knowledge and practices regarding foot care. 14 questions were asked and one point was allotted for each of 7 questions among them. A score of more than 70% (5-7) was considered good, score of 40% - 70% (3 – 5) was considered satisfactory and less than 40% (below 3) was considered poor. Results: The age of the respondents selected was above 50 years. About 48.7% of the respondents had good awareness, 38.6% had satisfactory awareness and 12.7% had poor awareness. Literacy status of the respondents seems to have a significant association with their awareness. Economic status is not a significant factor.

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Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.1.237 ◽

2018 ◽

Vol 35 (1) ◽

Author(s):

Iqra Arshad ◽

Sara Mohsin ◽

Sana Iftikhar ◽

Tahseen Kazmi ◽

Luqman F. Nagi

Keyword(s):

Insulin Therapy ◽

Tertiary Care ◽

Cross Sectional Study ◽

Early Initiation ◽

P Value ◽

Diabetic Patients ◽

Cross Sectional ◽

Creative Commons ◽

Oral Medications ◽

Tertiary Care Hospitals

Background and Objective: Initiation of Insulin therapy during earlier stages has proved to significantly improve health outcomes among diabetics in comparison to oral medications. Not only patients but physicians are also often resistant to early initiation of insulin therapy. The objective was to assess misconceptions and barriers to early initiation of insulin therapy among diabetic patients coming to a diabetic clinic. Methods: This cross sectional study was conducted on 300 patients selected by convenience sampling arriving in Diabetes Outdoor Clinics of Mayo and Services Hospitals, Lahore during August 2017 to May 2018. The data was entered and analyzed by using SPSS version 17. Results: Out of 300 patients included in study, 39% (n= 117) were males and 61% (n=183) were females. The mean age of the participants at presentation was 48.46±13.15 years with a range of 13 to 80 years. Study participants considered it embarrassing to inject insulin in public place (p-value 0.01). The fear associated with lifelong commitment to insulin therapy once it is started, was also found statistically significant (p-value 0.001)particularly in subjects who have long duration of DM (>5 years). Conclusion: Perceptions of diabetic patients about insulin therapy are still barriers to early initiation of therapy and tend to prevail in Pakistan and around the globe. How to cite this:Arshad I, Mohsin S, Iftikhar S, Kazmi T, Nagi LF. Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.237 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Psychiatric Disorders in Diabetic Patients in Rafsanjan

Psychological Disorders and Research ◽

10.31487/j.pdr.2021.01.02 ◽

2021 ◽

pp. 1-4

Author(s):

Reza Bidaki ◽

Parvin Agha Mohamad Hasani ◽

Maryam Alireza Zade ◽

Rezvan Sadr Mohammadi ◽

Reza Bidaki ◽

...

Keyword(s):

Psychiatric Disorders ◽

Common Mental Disorders ◽

Risk Groups ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Sectional Study ◽

Cross Sectional ◽

Demographic Questionnaire ◽

Patients With Diabetes ◽

Diabetes Center

Objective: To determine prevalence rates, associated features, and risk factors for psychiatric disorders subsequent to the diagnosis of IDDM. Methods: In this cross-sectional study were been selected 100 randomly who referred to Rafsanjan Diabetes Center. The data of this study is gathered demographic questionnaire and Minnesota Multi-phasic Personality Inventory (MMPI). Data was analysed with software SPSS-17. Results: 76% of the patients were female and 24% were men 45.4% of the illiterate population. The results showed hypochondriasis (22%) and schizophrenia (19%) and depression (11%) are three psychiatric disorders that patients with diabetes in high-risk groups have reported. Conclusion: The present study demonstrated that about 30-45% of patients with diabetes suffered from common mental disorders. The prevalence of some psychiatric disorders is considerable in diabetic patients in Rafsanjan.

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Adherence of Patients with Diabetes to a Lifestyle Advice and Management Plan in Basra, Southern Iraq

International Journal of Diabetes and Metabolism ◽

10.1159/000500915 ◽

2019 ◽

Vol 25 (3-4) ◽

pp. 100-105 ◽

Cited By ~ 3

Author(s):

Rawnaq Adil Aladhab ◽

Majid Hameed Alabbood

Keyword(s):

Management Plan ◽

Cross Sectional Study ◽

Complex Problem ◽

Common Reason ◽

Diabetic Patients ◽

Lifestyle Advice ◽

Cross Sectional ◽

Adherence To Medication ◽

Patients With Diabetes ◽

Southern Iraq

Background: Poor adherence to treatment regimens is a complex problem, especially for those with chronic illnesses. Noncompliance is believed to be the most common reason for treatment failure in diabetic patients, leading to the absence of metabolic control and accelerating disease-related complications. Data on the adherence of people with diabetes in Iraq are lacking. Objectives: The purpose of this study was to measure the rate of adherence among Iraqi patients with diabetes. Methods: This was a cross-sectional study conducted in the Specialized Endocrine and Diabetes Center in Basra, southern Iraq, during the period from June to August 2018. Data were collected by completing an interviewing questionnaire consisting of 13 questions. Results: A total of 231 patients were included in the study (54.5% were female). Mean age was 51.85 ± 13.55 years. 65.4% of the participants were taking their medications at the right times. The most common reason for not taking their medication (48.8%) was difficulty in remembering the dosage times. 40.7% of the participants were sedentary. Only one-third of the patients followed their doctors’ instructions regarding diet. Conclusions: The rate of adherence to medication regimens and lifestyle advice was unsatisfactory in this study group. The awareness of diabetic patients and their caring physicians about the importance of adherence to therapy, exercise, and diet should be emphasized.

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Factors associated with wound healing outcome among Diabetic Foot patients- A cross sectional Study

International Journal of AYUSH Case Reports ◽

10.52482/ijacare.v5i1.170 ◽

2021 ◽

Vol 5 (1) ◽

pp. 36-46

Author(s):

M Jayalakshmi ◽

P Thenmozhi

Keyword(s):

Diabetic Foot ◽

Foot Ulcer ◽

Diabetic Foot Ulcer ◽

Cross Sectional Study ◽

Wound Management ◽

Diabetic Patients ◽

Foot Care ◽

Cross Sectional ◽

Patients With Diabetes ◽

One Year

Diabetic foot ulcer (DFU) has been identified as the leading reason for hospitalization among patients with diabetes. Patients with diabetes are at greater risk of complications, the most important of them are diabetic neuropathy and peripheral vascular disorders leading to the development of foot ulcers. The problem is generally faced and as well is considered as one among the most common complications of diabetes that affect millions of people all over the world. The current study, aimed to document the clinical profile and healing outcome of diabetic foot ulcer management which may become guidance for further improvement in wound management among diabetic foot ulcer patients. Cross sectional descriptive study was conducted over one-year period of time. A total of 246 Diabetic patients with a foot ulcer of Grade 1 to 3 participated in the study. Patients with higher grade ulcers of Grade 4 and 5 were excluded from the study. Final data analysis of 160 patients was done using SPSS version 20. The prevalence of Grade 2 and 3 ulcers were observed 54.37% and 31.8 % while Grade 1 ulcer was observed 13.75%. No risk factors were found to be significantly associated with diabetic foot ulcer. Wound was healed well in 50 % and partially healed in 21 % of the participants. Wound remains unchanged in 3 % of study participants, while 8% of participants underwent toe amputation. Foot ulceration is a preventable in many diabetic patients with adequate education, routine foot care and attention to foot wear.

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A study to assess the correlation between HbA1c and microalbuminuria among diabetics

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20205454 ◽

2020 ◽

Vol 8 (1) ◽

pp. 16

Author(s):

Sruthi Kare ◽

Vishwanath N. Reddy ◽

Thejdeep Mahamkali

Keyword(s):

Diabetes Mellitus ◽

Diabetic Nephropathy ◽

Socioeconomic Development ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Cross Sectional ◽

Duration Of Diabetes ◽

Medical College ◽

Significant Linear Correlation ◽

Patients With Diabetes

Background: India is one of the epicentres of the global diabetes mellitus pandemic. Rapid socioeconomic development and demographic changes, along with increased susceptibility for Indian individuals, have led to the explosive increase in the prevalence of diabetes mellitus in India over the past four decades. Diabetic Nephropathy is a common consequence of long-standing diabetes mellitus. The development of diabetic nephropathy has a dramatic increase on the morbidity and mortality of patients with diabetes. Objective of this study was to evaluate the prevalence of microalbuminuria in patients with diabetes mellitus patients. Methods: This cross-sectional study was conducted on T 2 diabetes mellitus patients visiting medicine OPD of R L Jalappa hospital constituent hospital of Sri Deveraj Urs Medical College, Tamaka, Kolar from May 2016 to July 2016. A total of 60 type-2 diabetes patients were enrolled in the study.Results: Average duration of diabetes among study group was 8 years and most of the patients were between 6-10 years. In type 2DM patients, microalbuminuria and glycemic control have shown a significant linear correlation with duration of diabetes (p<0.05). Also, micro albuminuria has a significant correlation with increase in level of glycosylated haemoglobin. Conclusions: The prevalence of microalbuminuria in diabetic patients was found to be high and being a developing country; there is a dire need that microalbuminuria and HbA1c testing should be done in both, newly diagnosed as well as already diagnosed type 2DM patients as an early marker of renal risk factor.

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COVID-19 Severity and Comorbidities in Diabetic Patients

Disease and Diagnosis ◽

10.34172/ddj.2021.18 ◽

2021 ◽

Vol 10 (3) ◽

pp. 91-98

Author(s):

Hamid Reza Samimagham ◽

Mehdi Hassani Azad ◽

Mohsen Arabi ◽

Dariush Hooshyar ◽

Abbas Sheikhtaheri ◽

...

Keyword(s):

Disease Severity ◽

Demographic Factors ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Cross Sectional ◽

Severity Of Disease ◽

Significant Difference ◽

Laboratory Results ◽

Patients With Diabetes ◽

Severe Group

Background: This study aimed to investigate the demographic factors, comorbidities, and laboratory results of diabetic patients with coronavirus disease 2019 (COVID-19) severity. Materials and Methods: This cross-sectional study enrolled 171 diabetic patients with COVID-19 admitted based on chest CT scan findings to the COVID-19 ward of Shahid Mohammadi Hospital in Hormozgan, Iran from 1 March to 1 June, 2020. Reverse-transcriptase polymerase chain reaction (RT-PCR) test was performed, and the patients were divided into three groups (mild, moderate, and severe) based on the severity of disease. Then we investigated the demographic factors, comorbidities, and laboratory results of diabetic patients with severe COVID-19 severity. Results: Regarding comorbidities, there was no significant difference between the three groups. Moreover, there was a significantly lower lymphocyte count in the severe group compared to moderate and mild groups (P = 0.001). We showed the increase in blood urea nitrogen (BUN) and creatinine to be significantly associated with increased disease severity (P = 0.001 and P = 0.009, respectively). We also showed a significant difference in aspartate aminotransferase (AST) levels between different groups of patients (P = 0.002) with a higher level of AST in the severe group (P = 0.020). Lactate dehydrogenase (LDH) and troponin were also significantly associated with an increase in COVID-19 severity in patients with diabetes (P = 0.013 and P = 0.002, respectively). Conclusion: There was a significant association between disease severity and BUN, creatinine, AST, LDH, and troponin levels in diabetic patients with COVID-19. There was no significant association between different groups regarding severity of disease and comorbidities.

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Clinical course and outcome in diabetic patients with COVID-19

Immunopathologia Persa ◽

10.34172/ipp.2021.23 ◽

2020 ◽

Vol 7 (2) ◽

pp. e23-e23

Author(s):

Zahra Davoudi ◽

Ilad Alavi Darazam ◽

Farnaz Saberian ◽

Sina Homaee ◽

Shervin Shokouhi ◽

...

Keyword(s):

Glycated Hemoglobin ◽

Clinical Course ◽

Severe Disease ◽

Invasive Mechanical Ventilation ◽

Cross Sectional Study ◽

Diabetic Patients ◽

Cross Sectional ◽

Risk Of Death ◽

Patients With Diabetes ◽

The Mean

Introduction: As diabetes is highly prevalent worldwide, understanding particular dimensions of COVID-19 infection in diabetic patients is of significant importance. Objectives: The present research aimed to evaluate the outcome of diabetic patients with COVID-19 infection, and the clinical and biochemical characteristics in survived and non-survived patients. Patients and Methods: The present single-center, cross-sectional study examined laboratory and clinical features of 160 patients with diabetes who had moderate to severe criteria. The obtained data were categorized as survived or non-survived patients and then we compared the clinical characteristics in two groups. Results: In this study, 160 diabetic patients (75 men and 85 women) admitted with moderate to severe Covid-19 were evaluated. The mean age of studied patients was 51-90 years old, with diabetes duration of 5 to 15 years. One hundred thirty-one patients (81.9%) survived, but twenty-nine patients (18.1%) did not survive. Regarding the comparison of symptoms, only the loss of consciousness on admission was higher in non- survived patients; however, a majority of the non-survivors have been admitted to ICU, 23(79.3%) and 26 (89.6%) needed invasive mechanical ventilation; in comparison to survived patients also had a shorter duration of hospital stay (5.5±5.1 versus 8.4±6.1days). Non–survivors more probably suffer from high blood pressure [23 (79.3%) patients versus 80 (61%) patients] and chronic kidney disease [20 (69%) patients versus 9 (6.9%) patients; P<0.001]. Glycated hemoglobin (HbA1c) of more than 9%, and high fasting blood sugar, severe inflammatory response, hepatic, renal, and coagulation impairment was higher in non–survived than those who survived. Conclusion: Multifactorial parameters result in the poor prognosis in diabetic patients; therefore, it is critical for identifying the key clinical, as well as laboratory characteristics of COVID-19 cases that lead to severe disease and increase the risk of death.

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Cataract and its risk factor among adults residing in South Bihar, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20202905 ◽

2020 ◽

Vol 8 (7) ◽

pp. 2618

Author(s):

Shiwani Gupta ◽

Animesh Gupta ◽

M. Nehal ◽

Kalyani Pandey ◽

Ananta Kreesna ◽

...

Keyword(s):

Family History ◽

Urban Areas ◽

Dietary Habits ◽

Demographic Data ◽

Sun Exposure ◽

Cross Sectional Study ◽

Cross Sectional ◽

Age Related ◽

History Of

Background: Cataract is considered as one of the most common causes of visual impairment and the leading cause of blindness in the world. Age related cataract occurs in people above 50 years of age and the its pathogenesis is multifactorial. Therefore, the present study was aimed to assess the prevalence and risk factors for cataract.Methods: Community based cross sectional study was conducted among adults residing at urban areas of South Bihar. The data was collected by interview method, using pre-tested semi-structured questionnaire which contains socio-demographic data, dietary habits, history of diabetes or hypertension, family history of cataract and long-term sun exposure.Results: Among 240 participants, 94 (39.2%) were male and 146 (60.8%) were female. Maximum participants were aged more than 70 years. The prevalence of cataract was 52.1%.Conclusions: The prevalence of cataract was quite high and was significantly associated with age, long term sun exposure and family history of cataract.

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