scholarly journals Challenges and factors associated with poor glycemic control among type 2 diabetes mellitus patients at Nekemte referral hospital, western Ethiopia: cross-sectional study

2019 ◽  
Author(s):  
Ginenus Fekadu ◽  
Kejela Bula ◽  
Getu Bayisa

Abstract Background: Diabetes is increasing at an alarming rate throughout the world and about 80% of diabetics’ lives in developing countries. Similar to the rest of sub Saharan African countries, Ethiopia is experiencing significant burden of diabetes with increased prevalence, complications and mortality as well as life threatening disabilities. Reasons for poor glycemic control in type 2 diabetes are complex and multivariable. Hence, this study was aimed to identify challenges and factors associated with poor glycemic control among type 2 diabetes patients. Method: A hospital based cross sectional study was conducted on type 2 diabetic patients attending diabetic clinic of Nekemte Referral Hospital (NRH) from February 1 to April 30, 2018. Fasting blood glucose of last three clinic visits were obtained and the mean fasting blood glucose measurements was used to determine the level of glycemic control. Analysis included both descriptive and inferential statistics with SPSS version 20.0. Predictor variable with P< 0.05 was considered statistically significant. Result: Out of the total 228 included type 2 diabetes mellitus (DM) patients, 51.8% were males. The mean age of participants was 43±12.4 years and 154(67.5%) were found not following their general dietary program correctly. Nearly one third, 73(32%) of participants never attended diabetic education and 52(22.8%) of the patients had greater than 10 years’ duration on treatment. The majority, 148(64.9%) of patients had poor blood glucose control. Age range of 40-60 years (AOR=2.01, 95% CI 0.04-0.06, P=0.044), being illiterate (AOR = 3.12, 95 % CI 1.52-8.50, P=0.001), having informal education only (AOR=2.28, 95% CI 2.14-32.60, P=0.024), longer duration of diabetes treatment (>10 years) (AOR = 3.94, 95 % CI 1.51-27.83, P=0.012), inadequate physical exercise (AOR = 3.19, 95 % CI 1.05-19.84, P=0.019), smoking (AOR = 4.51, 95 % CI 0.00-0.50, p=0.022) were independent predictors of poor glycemic control up on a multivariable logistic regression analysis. Conclusion: Nearly two third of patients had poorly controlled diabetes. Age, exercise, level of education, duration of the treatment and smoking were significantly associated with poor glycemic control. Health facilities should provide continuous education as well as barriers of glycemic control should be explored with further research.

PLoS ONE ◽  
2021 ◽  
Vol 16 (5) ◽  
pp. e0251506
Author(s):  
Shambel Nigussie ◽  
Nigussie Birhan ◽  
Firehiwot Amare ◽  
Getnet Mengistu ◽  
Fuad Adem ◽  
...  

Objective To assess the rate of glycemic control and associated factors among type 2 diabetes mellitus patients at Dilchora Referral Hospital, Dire Dawa, Eastern Ethiopia. Methods A cross-sectional study was conducted from 13 May to 16 August 2019. Type 2 diabetic patients on follow up at Dilchora Referral Hospital who fulfilled the inclusion criteria of the study were included. Systematic random sampling was used to select study participants. Data was collected by a face-to-face interview and review of medical records. The primary outcome was the level of blood glucose during three consecutive visits. Poor glycemic control was defined as a blood sugar level of more than 154 mg/dL based on the average of measurements from three consecutive visits. Multivariate logistic regression analysis was used to identify determinants of glycemic control. Result A total of 394 participants responded to the interview and were included in the final analysis. The overall prevalence of poor glycemic control was 45.2% (95%CI: 40.6%-50.0%). Patients who were on oral anti-diabetic drug plus insulin had more than two times greater chance of poor glycemic control than patients on oral anti-diabetic drug alone: 2.177(95%CI:1.10–4.29). The odds of poor glycemic control in patients who did not understand the pharmacist’s instructions was two times higher than patients with good understanding of instructions 1.86(95%CI: 1.10–3.13). Patients who had poor level of practice were found to have poor glycemic control: 1.69(95% CI: 1.13–2.55). Conclusion The overall prevalence of poor glycemic control was high among type 2 diabetes patients. Oral anti-diabetic drugs in combination with insulin, lack of understanding of pharmacist’s advice, and poor practice of diabetic patients were significant factors of poor glycemic control. Pharmacists should reassure the understanding of patients before discharge during counseling. Optimization of the dose of antidiabetic medications and combination of oral hypoglycemic agents should be considered.


2020 ◽  
Vol 7 (52) ◽  
pp. 3148-3152
Author(s):  
Labanyabati Pattanaik ◽  
Madhusmita Acharya ◽  
Manoj Kumar Yadav ◽  
Prafulla Kumar Mishra ◽  
Madhab Nayak

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


2020 ◽  
Author(s):  
Marjan Mohammadi ◽  
Seyyed Abolghasem Djazayeri ◽  
Asal Ataie Jafari

Abstract Background Food insecurity can increase risks of health and nutritional problems, leading to difficulties in self-care and poor glycemic control in diabetic patients. This study assessed food insecurity and its association with diabetes control and self-care in type 2 diabetes patients. Methods In this cross sectional study, 148 adults with type 2 diabetes participated. Food insecurity and self-care were determined using the 18-item USDA household food security status questionnaire and self-care (SDSCA) questionnaire. Data were analyzed using logistic and linear regression tests (SPSS 20 software). Results Thirty-seven percent of the participants were food-insecure and significantly more likely than food-secure participants to have poor glycemic control (OR = 3.02; CI: 1.45–2.65). No significant association was found between food-insecurity and overall self-care score. Conclusion Food-insecurity was directly associated with poor glycemic control in type 2 diabetes patients. Since economic status was significantly better in the food-secure group, it can be postulated that financial problems will eventually lead to poor glycemic control. Policy strategies to increase access to diabetes-appropriate foods may reduce socioeconomic inequalities in glycemic control.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liang Gao ◽  
Yaju Zhang ◽  
Xingmin Wang ◽  
Hongli Dong

Abstract Background Apolipoprotein (Apo) may be associated with type 2 diabetes (T2D), however, little is known whether or not serum apolipoproteins are correlated with fasting blood glucose (FBG) and the prevalence of T2D in Chinese populations. In this study, we examined the association of serum ApoA1, ApoB, and the ratio of ApoB/ApoA1 (ApoB/A1 ratio) with T2D and FBG level, and compared apolipoprotein indicators in predicting T2D in Chinese adults. Methods A total of 1027 subjects were enrolled in this cross-sectional study. The association of ApoA1, ApoB, and ApoB/A1 ratio with T2D prevalence was determined using logistic regression models. Multivariate-analysis of covariance (ANCOVA) was performed for comparisons of the mean difference in FBG level. Results We found that ApoB and ApoB/A1 ratio were positively associated with T2D prevalence and FBG, while inverse association was noted between ApoA1 and T2D prevalence as well as FBG. Stratified analyses for sex, age, body mass index (BMI), smoking, and alcohol consumption showed no significant difference for the association of ApoA1, ApoB, and ApoB/A1 ratio with the prevalence of T2D among subgroups (all p-interactions> 0.05). Nonetheless, ApoA1 poorly performed in predicting T2D as it provided an AUC value of 0.310 that was significantly lower than those observed for ApoB (AUC value: 0.631) and ApoB/A1 ratio (AUC value: 0.685). Finally, path analyses indicated that the association between ApoB and T2D was mediated by BMI. Conclusions This study reveals the association of serum ApoA1, ApoB, and ApoB/A1 ratio with T2D and FBG in Chinese adults, suggesting that ApoB and ApoB/A1 ratio may be early indicators for predicting T2D. Prospective investigation in large cohort is needed.


Author(s):  
Kartika Yulianti ◽  
◽  
Aris Wibudi ◽  
Mila Citrawati ◽  
◽  
...  

ABSTRACT Background: Diabetes Mellitus (DM) is a group of symptoms that arise due to increased blood sugar levels. Diabetes Mellitus type 2 has a higher risk of developing thyroid dysfunction. Thyroid dysfunction can affect various body metabolism and result in insulin resistance, significantly affecting glycemic control in DM patients. This study aimed to determine the relation between thyroid status as assessed by the level of thyroid-stimulating hormone (TSH), free thyroxine (FT4), and glycemic control (HbA1c). Subjects and Method: A cross-sectional study. A sample of 38 DM patients was selected by purposive sampling. The dependent variable was glycemic control. The independent variables were TSH and FT4. Patients were classified into 4 quartiles (Q) based on their TSH and FT4 levels. Statistic test used was non parametric for category group of variables, which was Chi square test. Results: Mean of fasting blood glucose was 200,56 mg/dL (modus 137 mg/dL), mean of 2 hours post prandial blood glucose was 247 mg/dL (modus 305 mg/dL). Subjetcs with poor glycemic control dominated as much as 76%. Most subjects had TSH level at Q4 (36%), while most of the subjects had FT4 level at Q1 (34%). The results showed that 38 samples with poor glycemic control were 72% in the 4th quartile (Q4) (> 3.1750 mU / L) TSH, and 64.7% were in Q1 (≤ 11.8400) FT4. The analysis showed that there was a significant relation between TSH (p = 0.047) and FT4 (p = 0.041) with glycemic control in type 2 DM patients. Conclusion: FT4 and TSH levels relate to glycemic control in type 2 DM patients Keywords: TSH, FT4, HbA1c, Diabetes Mellitus Correspondence: Mila Citrawati. Department of Faal, Faculty of Medicine, UPN Veteran, Jakarta. Jl. RS Fatmawati, Pondok Labu, South Jakarta 12450, Telp. (021) 7656971. E-mail: [email protected]. Mobile: 081282990515 DOI: https://doi.org/10.26911/the7thicph.05.12


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Mohammed S. Ellulu ◽  
Hanen Samouda

Abstract Background Chronic inflammation has been associated with insulin resistance and related metabolic dysregulation, including type 2 diabetes mellitus (T2DM). Several non modifiable (i.e. genetic predisposition) and modifiable (i.e. sedentary lifestyle, energy-dense food) risk factors were suggested to explain the mechanisms involved in the development of inflammation, but are difficult to assess in clinical routine. The present study aimed to identify easy to asses clinical and biological risk factors associated with inflammation in patients with T2DM. Methods One hundred nine patients (51 men, 58 women), 28–60 years old, from seven primary healthcare centers in Gaza City, Palestine, took part to the cross-sectional study (November 2013–May 2014). Study participants had T2DM with no history of inflammatory diseases, cardiovascular diseases, medication and/or any health condition that might affect the inflammatory markers, interleukin 6 (IL-6) and C-reactive protein (CRP). Inflammation was defined for IL-6 ≥ 2 pg/mL and CRP ≥ 6 mg/L. Multivariable logistic regressions were used to identify the relationship between inflammation and clinical and biological risk factors. Results After adjustment for age and gender, inflammation seems to increase with increased body mass index (BMI) (OR: 1.427 [1.055–1.931]), increased fasting blood glucose (OR: 1.029 [1.007–1.052]) and decreased adiponectin values (OR: 0.571 [0.361–0.903]). There were also significant relationships between inflammation and BMI (OR: 1.432 [1.042–1.968]), fasting blood glucose (OR: 1.029 [1.006–1.052]) and adiponectin (OR: 0.569 [0.359–0.902]), after adjustment for smoking habits and physical activity. Conclusion Managing obesity and associated complications (i.e. hyperglycemia, high adiponectin levels) might help decreasing inflammation in individuals with T2DM.


2018 ◽  
Vol 6 (1) ◽  
pp. e000453 ◽  
Author(s):  
Zuila Albuquerque Taboza ◽  
Katia Linhares Costa ◽  
Virginia Régia Silveira ◽  
Flavia Aparecida Furlaneto ◽  
Renan Montenegro Jr ◽  
...  

ObjectivesTo compare the glycemic control in non-smoking patients with type 2 diabetes according to their periodontal and dental status.Research design and methodsThis cross-sectional study investigated patients previously diagnosed with type 2 diabetes and under antidiabetic medication. Clinical data and fasting blood glucose (FBG) levels were collected from medical and dental records. Patients were divided into three groups according to dental and periodontal diagnosis: no or mild periodontitis (NO/MILD, n=96), moderate or severe periodontitis (MOD/SEV, n=74) and edentulous (n=141). FBG levels were compared between groups. Logistic regression was also applied to estimate the OR of presenting hyperglycemia.ResultsEdentulous patients had significantly higher FBG levels of 155.7±70.9 (mean±SD mg/dL) than those in the MOD/SEV (136.6±33.8) and the NO/MILD (123.1±36.7) groups. Differences between the latter two groups were also significant. Edentulous patients had adjusted ORs of 4.53, 4.27 and 3.95 of having FBG≥126, ≥150 and ≥180 mg/dL, respectively, in comparison with NO/MILD group. The MOD/SEV group also presented significant odds of having FBG≥126 mg/dL (OR=2.66) and ≥150 mg/dL (OR=2.45) than the NO/MILD group.ConclusionsPatients in the MOD/SEV group had worse glycemic control than the ones in the NO/MILD group. However, edentulous patients presented higher glycemic levels than both dentate groups, and also presented with higher odds of having hyperglycemia.


Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 391
Author(s):  
Junhee Ahn ◽  
Youngran Yang

(1) Background: Glycemic control is an effective way to reduce the cardiovascular complications of diabetes. The purpose of this study was to identify the factors associated with poor glycemic control amongst rural residents with diabetes in Korea. (2) Methods: This cross-sectional analysis was conducted amongst a total of 522 participants who had completed baseline health examinations for the Korean Genome and Epidemiology Study (KoGES) Rural Cohort from 2005 to 2011. The subjects were divided into two groups: the good glycemic control group (GCG) (glycosylated hemoglobin (HbA1C) < 7%) and the poor GCG (HbA1C ≥ 7%). Logistic regression was used to examine the role of sociodemographics, health-related behavior, comorbidity and diabetes-related and clinical factors in poor glycemic control amongst rural residents with diabetes. (3) Results: In total, 48.1% of participants were in the poor GCG. Poor GCG was significantly associated with drinking (odds ratio (OR) = 0.42, 95% CI = 0.24–0.71), lack of regular physical activity (OR = 1.68, 95% CI = 1.03–2.76), fasting blood glucose (FBG) > 130 mg/dL (OR = 7.80, 95% CI = 4.35–13.98), diabetes for > 7 years (OR = 1.79, 95% CI = 1.08–2.98), cholesterol ≥ 200 mg/dL (OR = 1.73, 95% CI = 1.05–2.84) and positive urine glucose (OR = 6.24, 95% CI = 1.32–29.44). (4) Conclusion: Intensive glucose control interventions should target individuals amongst rural residents with diabetes who do not engage in regular physical activity, have been diagnosed with diabetes for more than seven years and who have high fasting-blood glucose, high cholesterol levels and glucose-positive urine.


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