scholarly journals Influencing Factors Associated with Delayed Initiation of Insulin Among Patients with Type 2 Diabetes Mellitus at The Diabetes Clinic of a Tertiary Hospital in Ethiopia

2022 ◽  
Author(s):  
Elham Reshid ◽  
Bruck Messele Habte ◽  
Tedla Kebede ◽  
Teferi Gedif Fenta
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Influencing Factors ◽  
Diabetes Management ◽  
Healthcare Providers ◽  
Diabetes Clinic ◽  
Factors Influencing ◽  
Delayed Initiation

Abstract Background Guidelines recommend the initiation of insulin in patients with type 2 diabetes mellitus who failed on maximum dose of oral medications. However, time to initiation is inconsistent due to different barriers resulting in delay and thus leads to failure to achieve glycemic control which in turn may lead to different complications. The aim of this study was to explore factors influencing the delayed initiation of insulin among patients with type 2 diabetes being managed at the Diabetes Clinic of Tikur Anbessa Specialized Hospital. Methods A qualitative descriptive study design was employed. Data was collected using in-depth interviews with 27 participants, including patients and healthcare providers. Audio-recorded data was transcribed and then thematically analyzed. Results Different factors influencing the delayed initiation of insulin in patients with type 2 diabetes mellitus were revealed. Patient factors included beliefs about the necessity of insulin and concerns related to starting insulin. Physician factors included perceived patient’s situation and lack of clinical competency. Health institution factors included inadequate laboratory set up and absence of contextual guidelines for diabetes management including insulin initiation. Conclusions The study findings indicated different influencing factors some of which were similar to those reported from other settings while there were others which somehow were unique to study setting. These are indicative of the need to implement interventions such as strengthening the patients’ diabetes health education program that is considerate of the religious, cultural, and social aspects of the society.

scholarly journals Factors influencing the quality of life perception in patients with type 2 diabetes mellitus

2016 ◽  
Vol Volume 10 ◽  
pp. 2471-2477 ◽  
Author(s):  
Romulus Timar ◽  
Puiu Iulian Velea ◽  
Bogdan Timar ◽  
Diana Lungeanu ◽  
Cristian Oancea ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Factors Influencing

scholarly journals Impact of an Advanced Practice Pharmacist Type 2 Diabetes Management Program: A Pilot Study

2019 ◽  
Vol 10 (4) ◽  
pp. 20
Author(s):  
Jelena Lewis ◽  
Tiffany Nguyen ◽  
Hana Althobaiti ◽  
Mona Alsheikh ◽  
Brad Borsari ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Management ◽  
Drug Dose ◽  
Advanced Practice ◽  
Dose Increase ◽  
Therapeutic Decisions ◽  
The Impact

Background: The purpose of this study was to describe the impact of an Advanced Practice Pharmacist (APh) on lowering hemoglobin A1c (HbA1c) in patients with type 2 diabetes within a patient centered medical home (PCMH) and to classify the types of therapeutic decisions made by the APh. Methods: This was a retrospective study using data from electronic health records. The study evaluated a partnership between Chapman University School of Pharmacy and Providence St. Joseph Heritage Healthcare that provided diabetes management by an Advanced Practice Pharmacist in a PCMH under a collaborative practice agreement. Change in the HbA1c was the primary endpoint assessed in this study. The type of therapeutic decisions made by the APh were also evaluated. Descriptive analysis and Wilcoxon signed rank test were used to analyze data. Results: The study included 35 patients with diagnosis of type 2 diabetes mellitus managed by an APh from May 2017 to December 2017. Most of the patients were 60-79 years old (68.5%), 45.7% were female, and 45.7% were of Hispanic/Latino ethnicity. The average HbA1c was 8.8%±1.4% (range=6.0%-12.4%) and 7.5%±1.4% (range=5.5%-12.4%) at the initial and final APh visit, respectively (p<0.0001). Therapeutic decisions made by the APh included drug dose increase (35.5% of visits), drug added (16.4%), drug dose decrease (6.4%), drug switch (5.5%), and drug discontinuation (1.8%). Conclusion: The Advanced Practice Pharmacist’s interventions had a significant positive impact on lowering HbA1c in patients with type 2 diabetes mellitus in a PCMH. The most common therapeutic decisions made by the APh included drug dose increase and adding a new drug.   Article Type: Pharmacy Practice

scholarly journals Safety and Mode of Action of Diabetes Medications in comparison with 5-Aminolevulinic Acid (5-ALA)

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Peter R. Rehani ◽  
Hanaa Iftikhar ◽  
Motowo Nakajima ◽  
Tohru Tanaka ◽  
Zaid Jabbar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Amino Acid ◽  
Diabetes Management ◽  
Aminolevulinic Acid ◽  
Mechanisms Of Action ◽  
Mitochondrial Functions ◽  
Porphyrin Synthesis

5-Aminolevulinic acid (5-ALA) is a delta amino acid naturally present in every living cell of the human body. 5-ALA is produced in the mitochondria as the first product of the porphyrin synthesis pathway and composes heme; exogenously supplemented 5-ALA helps in upregulating mitochondrial functions. Mitochondrial dysfunction has been associated with the pathophysiology of diabetes mellitus. Thus, in this review, we evaluate the mechanisms of action and adverse effects of common medications used to treat type 2 diabetes mellitus as well as 5-ALA including its mechanism and possible use in diabetes management.

Pharmacists’ Impact on Improving Outcomes in Patients With Type 2 Diabetes Mellitus

2012 ◽  
Vol 38 (3) ◽  
pp. 409-416 ◽  
Author(s):  
Matthew J. Pepper ◽  
Natohya Mallory ◽  
T. Nicole Coker ◽  
Amber Chaki ◽  
Karen R. Sando
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetes Management ◽  
Management Team ◽  
Outpatient Clinics ◽  
End Points ◽  
Number Of Patients

Purpose The purpose of this study was to evaluate a diabetes education program that includes a pharmacist as a member of the diabetes management team by assessing the change in hemoglobin A1c (A1C), cholesterol, and blood pressure for patients with type 2 diabetes in outpatient clinics. Methods This was a retrospective study in outpatient clinics at Shands Jacksonville Medical Center. The patients were assigned into either the pharmacist group or the nonpharmacist group, according to the presence or the absence of a pharmacist in the clinic. The primary end point was the absolute change in A1C versus baseline. Secondary end points included change in cholesterol and blood pressure and the number of patients to attain American Diabetes Association goals. End points were recorded to correlate within 3 months of the initial visit and final visit with a provider. Results Compared to the nonpharmacist group, patients in the pharmacist group had more advanced and uncontrolled diabetes at baseline. The pharmacist group showed a greater percent change in A1C and improvement between the initial and final clinic visits, after adjusting for baseline confounders. Despite the statistically significant improvement in A1C in the pharmacist group, there was no difference found between the 2 groups for the end points of cholesterol and blood pressure. Conclusion Including a pharmacist as a part of the diabetes management team may result in lower A1C in patients with more advanced and uncontrolled type 2 diabetes mellitus versus a health care team without a pharmacist.

scholarly journals A Mobile Computerized Decision Support System to Prevent Hypoglycemia in Hospitalized Patients With Type 2 Diabetes Mellitus

2016 ◽  
Vol 11 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Stephan Spat ◽  
Klaus Donsa ◽  
Peter Beck ◽  
Bernhard Höll ◽  
Julia K. Mader ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Decision Support ◽  
Feasibility Study ◽  
Health Care Professionals ◽  
Diabetes Management ◽  
Insulin Dose ◽  
User Acceptance

Background: Diabetes management requires complex and interdisciplinary cooperation of health care professionals (HCPs). To support this complex process, IT-support is recommended by clinical guidelines. The aim of this article is to report on results from a clinical feasibility study testing the prototype of a mobile, tablet-based client-server system for computerized decision and workflow support (GlucoTab®) and to discuss its impact on hypoglycemia prevention. Methods: The system was tested in a monocentric, open, noncontrolled intervention study in 30 patients with type 2 diabetes mellitus (T2DM). The system supports HCPs in performing a basal-bolus insulin therapy. Diabetes therapy, adverse events, software errors and user feedback were documented. Safety, efficacy and user acceptance of the system were investigated. Results: Only 1.3% of blood glucose (BG) measurements were <70 mg/dl and only 2.6% were >300 mg/dl. The availability of the system (97.3%) and the rate of treatment activities documented with the system (>93.5%) were high. Only few suggestions from the system were overruled by the users (>95.7% adherence). Evaluation of the 3 anonymous questionnaires showed that confidence in the system increased over time. The majority of users believed that treatment errors could be prevented by using this system. Conclusions: Data from our feasibility study show a significant reduction of hypoglycemia by implementing a computerized system for workflow and decision support for diabetes management, compared to a paper-based process. The system was well accepted by HCPs, which is shown in the user acceptance analysis and that users adhered to the insulin dose suggestions made by the system.

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