Prevalence of diabetes among homeless and slum dwellers in Accra, Ghana: A survey study

Abstract Objective: This study aimed at determining diabetes status of homeless people in Nima and Agbogbloshie, Accra, Ghana and to evaluate the association between socio-demographic characteristics and diabetes prevalence. Results: A total of 130 homeless and slum dwellers took part in the study out of which 7 (5.4%) participants were diagnosed with diabetes while 13 (10 %) were considered as having prediabetes. This is slightly lower than what had been reported two decades ago but similar to overall estimates of diabetes prevalence in Africa (5.7%). Diagnosis of normoglycemia, prediabetes and diabetes was based on individual’s hemoglobin A1c (HbA1c) level: ≤5.9%, 6.4–6.0%, and ≥6.5%, respectively. There was no significant association between prevalence of diabetes or prediabetes and the socio-demographic characteristics of the participants. The slightly lower diabetes prevalence among the homeless and slum dwellers compared to the general population may be due to constant movement of these people in the streets, a practice that could serve as a form of exercise for them. Intensive social support aimed at preventing and managing diabetes is crucial if we are to further reduce the incidence of diabetes in homeless people. Keywords: Homeless, Diabetes mellitus, Hemoglobin A1c, Head porters

Download Full-text

Prevalence of diabetes among homeless and slum dwellers in Accra, Ghana: A survey study

10.21203/rs.2.12642/v1 ◽

2019 ◽

Author(s):

AHMED TIJANI BAWAH ◽

Albert Abaka Yawson ◽

Mohammed Mustapha Seini ◽

Francis Agyemang Yeboah ◽

Robert Amadu Ngala

Keyword(s):

Diabetes Mellitus ◽

Social Support ◽

Hba1c Level ◽

Hemoglobin A1c ◽

Homeless People ◽

Demographic Characteristics ◽

Diabetes Prevalence ◽

Survey Study ◽

Slum Dwellers ◽

Diabetes Status

Abstract Objective: This study aimed at determining diabetes status of homeless people in Nima and Agbogbloshie, Accra, Ghana and to evaluate the association between socio-demographic characteristics and diabetes prevalence. Results: A total of 130 homeless and slum dwellers took part in the study out of which 7 (5.4%) participants were diagnosed with diabetes while 13 (10 %) were considered as having prediabetes. This is slightly lower than what had been reported two decades ago but similar to overall estimates of diabetes prevalence in Africa (5.7%). Diagnosis of normoglycemia, prediabetes and diabetes was based on individual’s hemoglobin A1c (HbA1c) level: ≤5.9%, 6.4–6.0%, and ≥6.5%, respectively. There was no significant association between prevalence of diabetes or prediabetes and the socio-demographic characteristics of the participants. The slightly lower diabetes prevalence among the homeless and slum dwellers compared to the general population may be due to constant movement of these people in the streets, a practice that could serve as a form of exercise for them. Intensive social support aimed at preventing and managing diabetes is crucial if we are to further reduce the incidence of diabetes in homeless people. Keywords: Homeless, Diabetes mellitus, Hemoglobin A1c, Head porters

Download Full-text

Prevalence of diabetes among homeless and slum dwellers in Accra, Ghana: a survey study

BMC Research Notes ◽

10.1186/s13104-019-4613-5 ◽

2019 ◽

Vol 12 (1) ◽

Author(s):

Ahmed Tijani Bawah ◽

Albert Abaka-Yawson ◽

Mohammed Mustapha Seini ◽

Francis Agyemang Yeboah ◽

Robert Amadu Ngala

Keyword(s):

Social Support ◽

General Population ◽

Hba1c Level ◽

Hemoglobin A1c ◽

Homeless People ◽

Demographic Characteristics ◽

Diabetes Prevalence ◽

Survey Study ◽

Slum Dwellers ◽

Diabetes Status

Abstract Objective This study aimed at determining diabetes status of homeless people in Nima and Agbogbloshie, Accra, Ghana and to evaluate the association between socio-demographic characteristics and diabetes prevalence. Results A total of 130 homeless and slum dwellers took part in the study out of which 7 (5.4%) participants were diagnosed with diabetes while 13 (10%) were considered as having prediabetes. This is slightly lower than what had been reported two decades ago but similar to overall estimates of diabetes prevalence in Africa (5.7%). Diagnosis of normoglycemia, prediabetes and diabetes was based on individual’s hemoglobin A1c (HbA1c) level: ≤ 5.9%, 6.4–6.0%, and ≥ 6.5%, respectively. There was no significant association between prevalence of diabetes or prediabetes and the socio-demographic characteristics of the participants. The slightly lower diabetes prevalence among the homeless and slum dwellers compared to the general population may be due to constant movement of these people in the streets, a practice that could serve as a form of exercise for them. Intensive social support aimed at preventing and managing diabetes is crucial if we are to further reduce the incidence of diabetes in homeless people.

Download Full-text

Effect of eradication of HCV infection by direct-acting antivirals in diabetic HCV-infected patients as regards glycemic control

Egyptian Liver Journal ◽

10.1186/s43066-020-00061-9 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Mohamed Mohei El Badry ◽

Doaa Abdelhady Ali ◽

Noha Hamdy Eltaweel ◽

Marwa A. Abdel-Wahed

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Hba1c Level ◽

Hemoglobin A1c ◽

Fever Hospital ◽

Diabetic Patients ◽

Direct Acting Antivirals ◽

Direct Acting

Abstract Background A burden of data suggests that insulin signaling could be impaired with hepatitis C virus infection, and this boost the onset of type 2 diabetes mellitus beyond and in addition to the histological effect on the associated liver disease. We aimed to evaluate the hemoglobin A1c (HbA1c) levels before and after therapy with direct-acting antivirals (DAAs) in HCV-diabetic patients who achieved sustained virological response (SVR) at Aswan Fever Hospital. This prospective study was conducted at the Viral Hepatitis Treatment Center, Aswan Fever Hospital, Aswan, Egypt, between November 2017 and May 2018. A total of 85 randomly selected diabetic patients (type 2 diabetes mellitus) with chronic HCV infection were received sofosbuvir and daclatasvir as a dual therapy for 3 months, then followed up for week 12 after the end of DAA therapy, Changes in the levels of hemoglobin A1c (HbA1c) were measured at baseline then 12 weeks after the end of treatment with DAAs. Results Thirty-two patients (37.6%) showed a significant glycemic improvement after receiving DAAs therapy; in the form of > 1% reduction in HbA1c level (p value < 0.001). Their baseline mean HbA1c level was 7.98 ± 0.62% which was significantly improved 12 weeks after the end of therapy (SVR) to reach a level of 6.88 ± 0.81%. Meanwhile, 53 patients (62.4%) had a baseline mean HbA1c of 8.24 ± 0.64% and a post-treatment mean HbA1c level of 8.34 ± 0.61% (p value = 0.083). Conclusion DAAs-based eradication of HCV is associated with improved glycemic control in 37.6% of patients with diabetes as evidenced by a significant reduction of mean HbA1c.

Download Full-text

Evaluation of Hemoglobin A1c before and after initiation of continuous glucose monitoring in children with type 1 diabetes mellitus

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0587 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Shilpa Gurnurkar ◽

Lindsey Owens ◽

Sweta Chalise ◽

Neha Vyas

Keyword(s):

Diabetes Mellitus ◽

Type 1 Diabetes ◽

Type 1 Diabetes Mellitus ◽

Continuous Glucose Monitoring ◽

Hba1c Level ◽

Hemoglobin A1c ◽

Glucose Monitoring ◽

Retrospective Chart Review ◽

Dependent Samples

Abstract Objectives The development of continuous glucose monitoring (CGM) systems has allowed for identification of blood sugar variations and trends in real-time that is not feasible with conventional self-monitoring of blood glucose. However, there is inconsistent data to show that the use of CGM leads to better glycemic control as measured by Hemoglobin A1c (HbA1c) in pediatric patients with type 1 diabetes mellitus. Our study aimed to compare the average HbA1c level in the 1–2 years prior to starting a CGM to the average HbA1c level in the 1–2 years immediately following CGM initiation in a sample of 1–20 year olds with type 1 diabetes mellitus. Methods Participants were 90 youth (ages 1–20) followed for type 1 diabetes care at our institution who used a CGM for at least a 6 month time period. We performed a retrospective chart review to obtain up to four HbA1c values pre and post-CGM initiation each. We evaluated pre- and post-CGM initiation changes in mean HbA1c via dependent samples t-tests using IBM SPSS 24.0. Results The mean HbA1c was 8.7% pre-CGM and decreased to 8.27% 9–12 months after CGM initiation in the overall sample. A statistically significant decrease in HbA1c was seen in patients who used multiple daily injections (p=0.02), those with a pre-CGM HbA1c greater than 9% (p=0.01), and those with a diabetes duration of 5–10 years (p=0.02). Conclusion CGM use was associated with a decrease in HbA1c over time which was statistically significant in some subgroups.

Download Full-text

Chronic Kidney Diseases Among Homeless and Slum Dwellers in Accra: A Survey Study

10.21203/rs.3.rs-65462/v1 ◽

2020 ◽

Author(s):

Ahmed Tijani Bawah ◽

Foster Edufia ◽

Fatima Nasara Yussif ◽

Anastasia Adu ◽

Mohammed Mustapha Seini ◽

...

Keyword(s):

Kidney Disease ◽

Renal Insufficiency ◽

Kidney Diseases ◽

Homeless People ◽

Normal Serum ◽

Kidney Damage ◽

Survey Study ◽

Slum Dwellers ◽

Severe Renal Insufficiency ◽

Immunodeficiency Syndrome

Abstract Objective: This study aimed at determining the prevalence of chronic kidney disease (CKD) among homeless people in Nima and Agbogbloshie, Accra, Ghana and to evaluate the association between socio‑demographic characteristics and CKD. Results: Participants with normal serum creatinine (SCr), made up of 232 males and 280 females totaling 512 took part in the study. Those with normal glomerular filtration rate (GFR) were 86% and 84.6% by means of the C-G and MDRD equations respectively. According to the C-G formula, kidney damage and mild to severe renal insufficiency was found in 13.2% of the participants and 4 participants (0.8%) had renal failure. On the other hand, 15.4% of the participants were found to have some kidney damage and mild to severe renal insufficiency according to the MDRD formula with no participant suffering from kidney failure. The prevalence of renal dysfunction among the homeless Ghanaians was significant especially among those with hypertension, diabetes and human immunodeficiency syndrome virus (HIV) infection. . Intensive social support aimed at preventing and managing kidney disease is crucial if we are to reduce the incidence of kidney related illnesses in homeless people.

Download Full-text

The Association of Perioperative Glycemic Control with Postoperative Surgical Site Infection Following Elective Foot Surgery in Patients with Diabetes

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000005 ◽

2017 ◽

Vol 2 (2) ◽

pp. 2473011416S0000 ◽

Cited By ~ 1

Author(s):

Jourdan Cancienne ◽

Minton Cooper ◽

Brian Werner

Keyword(s):

Diabetes Mellitus ◽

Glycemic Control ◽

Surgical Site Infection ◽

Hba1c Level ◽

Roc Analysis ◽

Hemoglobin A1c ◽

Site Infection ◽

Foot Surgery ◽

Increased Risk ◽

Patients With Diabetes

Category: Midfoot/Forefoot Introduction/Purpose: Diabetes mellitus has been associated with an increased risk for postoperative surgical site infection (SSI) following foot and ankle surgery; however, among patients with diabetes, the level of perioperative glycemic control may affect the risk of postoperative SSI. There remains little evidence to support a perioperative hemoglobin A1c (HbA1c) level that could serve as a threshold for a significantly increased risk of postoperative SSI following foot surgery. The primary goal of the present study was to evaluate the association of perioperative glycemic control as demonstrated by hemoglobin a1c (HbA1c) in patients with diabetes with the incidence of postoperative SSI following elective foot surgery. Our secondary objective was to calculate a threshold level of HbA1c above which the risk of postoperative SSI after foot surgery increases significantly in patients with diabetes. Methods: A national administrative database was queried for patients who underwent common elective foot surgeries, including hallux valgus corrections, hallux rigidus correction and hammertoe corrections among others. Patients who underwent more complex procedures and patients with concomitant hindfoot procedures were excluded. Patients with diabetes mellitus who had a perioperative HbA1c level recorded within 3 months of surgery were identified; and were then stratified into thirteen mutually exclusive groups based on their hemoglobin a1c in 0.5 mg/dl increments from < 5.49 mg/dl to > 11.5 mg/dl. The incidence of SSI was determined by either a diagnosis or procedure for SSI within 1 year postoperatively using CPT and ICD-9 codes, and was calculated for each HbA1c patient group. A receiver operating characteristic (ROC) analysis was performed to determine an optimal threshold value of the HbA1c above which the risk of postoperative SSI was significantly increased. Results: 4,744 patients who underwent forefoot surgery with diabetes and a perioperative HbA1c recorded within 3 months of surgery in the database were included in the study. The rate of deep SSI requiring irrigation and debridement within one year postoperatively stratified by HbA1c is pictured in Figure 1, which ranged from a low of 2.5% to a high of 11.8% and was significantly correlated with increasing HbA1c levels (P < 0.0001). The results of ROC analysis determined that the inflection point of the ROC curve corresponded to an HbA1c level above 7.5 mg/dL (P < 0.0001, AUC = 0.622, spec. = 75%, sens. = 44%). Conclusion: The risk of postoperative SSI following elective foot surgery in patients with diabetes mellitus increases significantly as the perioperative HbA1c increases. ROC analysis determined that a perioperative HbA1c above 7.5 mg/dL could serve as a threshold for a significantly increased risk of postoperative SSI following elective foot surgery.

Download Full-text

Characteristics and needs of people living homeless in León (Nicaragua): Similarities and differences with other groups in severe social exclusion

International Social Work ◽

10.1177/0020872819896820 ◽

2020 ◽

pp. 002087281989682

Author(s):

José Juan Vázquez ◽

Alexia Suarez ◽

Alberto Berríos ◽

Sonia Panadero

Keyword(s):

Social Support ◽

Social Exclusion ◽

New Technologies ◽

Homeless People ◽

Demographic Characteristics ◽

Developmental Differences ◽

Economic Resources ◽

Similarities And Differences ◽

Social Difficulty ◽

Waste Pickers

The study examines various aspects (e.g. socio-demographic characteristics, access to economic resources, social support, chronicity and access to new technologies) in a sample of homeless people living in León (Nicaragua; n = 68). A questionnaire was used to collect the data. The results showed that people experiencing homelessness in León (Nicaragua) have enormous social difficulty, with high levels of chronification. Despite the major cultural and developmental differences between Spain and Nicaragua, there are considerable similarities between people living homeless in the two countries, while there are significant differences compared with waste pickers in León (Nicaragua) regarding the same aspects.

Download Full-text