Prevalence of the Effects of Anxiety and Depression on People with Type 2 Diabetes Mellitus: An Analysis of Health Policy Studies in Improving the Quality of Life of Poor Families in the Urban Areas of West Lombok, Indonesia

Background: To explore the tendency of the effects of anxiety and depression that occur in type 2 diabetes patients, especially poor patients who live in the urban areas with poor economic conditions, who do not have health access from the government, and live away from the hospitals. Methods: It is a cross-sectional study which aimed to determine the number of patients who experienced anxiety and depression problems due to the declining health conditions caused by diabetes. A sample size of 98 diabetics experiencing anxiety and depression when the treatment was carried out was included. The study design included a qualitative study with in-depth interviews with respondents who were at risk of diabetes, as well as to determine the level of anxiety and depression that occurred when medical care was provided and the feelings experienced by the respondents after the completion of treatment. Results: Diabetic patients are generally unaware that their illness is a chronic disease that takes a long time to treat. When the patients are sick, most of them do not immediately go to the hospital or a specialist to get their health examination and treatment, because the hospital is far from the patients’ residence. Furthermore, some patients still use traditional medicine and non-medical treatment, so when the patients with critical conditions are taken to the hospital, they already have chronic diabetes. Conclusions: The lack of access to health for chronic patients with poor economic conditions who live far from the hospitals and the scarcity of medical staff to carry out treatment of chronic diseases such as diabetes for poor patients in urban areas certainly have an impact on increasing the number of patients with chronic diseases. Therefore, the government is expected to be able to provide easy health policies to remote rural communities in order to achieve optimal community welfare and health.

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Sleep Characteristics in Diabetic Patients Depending on the Occurrence of Neuropathic Pain and Related Factors

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17218125 ◽

2020 ◽

Vol 17 (21) ◽

pp. 8125

Author(s):

Cristina Naranjo ◽

María Dueñas ◽

Carlos Barrera ◽

Guillermo Moratalla ◽

Inmaculada Failde

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Neuropathic Pain ◽

Sleep Quality ◽

Depression Scale ◽

Anxiety And Depression ◽

Diabetic Patients ◽

The Relationship

This study aims to compare the sleep characteristics (structure and quality) in patients with type-2 diabetes mellitus with and without diabetic neuropathic pain (DNP), and to investigate the relationship of sensory phenotypes, anxiety, and depression with sleep quality in DNP patients. A cross-sectional study was performed in patients with type-2 diabetes mellitus and neuropathy. Patients were classified into two groups—with or without neuropathic pain—according to the “Douleur Neuropathique-4 (DN4)” scale. Sleep characteristics and quality (Medical Outcomes Study—MOS-sleep), pain phenotype (Neuropathic Pain Symptom Inventory—NPSI), mood status (Hospital Anxiety and Depression scale—HADS), pain intensity (Visual Analogue Scale—VAS), and quality of life (SF-12v2) were measured. The sample included 130 patients (65 with DNP). The mean scores in all the dimensions of the MOS-sleep scale were higher (more disturbances) in the DNP patients. Higher scores in anxiety or depression, greater intensity of pain or a higher score in the paroxysmal pain phenotype were associated with lower sleep quality in DNP patients. A shorter duration of the diabetes and lower levels of glycated hemoglobin were also associated with lower sleep quality. The results show the relationship between DNP and sleep quality, and the importance of assessing sensory phenotypes and mental comorbidities in these patients. Taking these factors into consideration, to adopt a multimodal approach is necessary to achieve better clinical results.

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Comparison of Effectiveness between DPP4 inhibitors combined with Versus Other Oral Hypoglycaemic Agent(s) in Diabetic patients

Bangladesh Journal of Medicine ◽

10.3329/bjmed.v30i2.41532 ◽

2019 ◽

Vol 30 (2) ◽

pp. 63-70

Author(s):

Md Shameem Haidar

Keyword(s):

Type 2 Diabetes ◽

Glycemic Control ◽

Combination Group ◽

Diabetic Patients ◽

Glycemic Status ◽

Good Glycemic Control ◽

Dpp4 Inhibitor ◽

Number Of Patients ◽

Inhibitor Combination

Background: Diabetes is global health burden of disease that requires life-long pharmacological and non-pharmacological management to prevent complications such as cardiovascular disease, retinopathy, nephropathy, and neuropathy. Treatment of type 2 diabetes is based on an interplay of patient characteristics, severity of hyperglycemia and available therapeutic options. Metformin, sulfonylureas (SU) and DPP IV inhibitor are the most studied of the oral medications used worldwide. They play a prominent initial role in the type 2 diabetes treatment algorithm recommended by the several guideline. The growing evidence on new technologies and therapeutic interventions is rapidly expanding our knowledge and ability to manage diabetes and its complications; at the same time, however, it is challenge for physicians to select appropriate medication in appropriate dose for optimal patients care. Objectives: To compare the safety and efficacy of the dipeptidylpeptidase-4 (DPP-4) inhibitors combination with other oral hypoglycaemic agent(s) in patients with type 2 diabetes and inadequate glycemic control. Materials & method: Study was conducted among 600 patients over a period of 24 months. All the patients were adult male and female type 2 diabetic patients who received regular oral anti-diabetic drug(s) and duration of T2DM for one year or more were enrolled for study. Total 150 cases were selected. Patients with Type 1 DM, pregnant women with DM and who was receiving injectable antidiabetic medications were excluded from this study. Detail demographic data were collected from the informant and recorded in structured case report form. Clinical examination and relevant investigations were done. Main outcome variable was Glycemic status (HbA1C, FBG, 2HABF). Effectiveness of drugs was evaluated by glycaemic status of the patients. Result: Maximum number of patients (38.5%) was between 31-40 years age group with mean age 37.8±9.5 years. Present study shows that, for good glycemic control, all three results (FBS, 2H ABF and HbA1c) were within targeted level in majority patients of DPP4 Inhibitor combination group. Although FBS was best result in metformin group. About 51.9% of SUs group achieved the glycemic control targets level. In case of metformin group it was in 59.8% of patients, and in combined therapy 67.1% patients shows good glycemic target. So DPP4 Inhibitor combination is better medication than other to maintain good glycemic status in type 2 DM patient, due to maximum number of patients reached all three components of result within target range. Conclusion: Diabetes is chronic illness. Good glycemic control with choosing appropriate anti-diabetic medication is pivotal for DM management. In this study it is observed that DPP4 Inhibitor combination group of drug is better than other anti-diabetic medication to maintain good glycemic status in type 2 DM patients. Bangladesh J Medicine July 2019; 30(2) : 63-70

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Anxiety, Depression, and Common Chronic Diseases, and Their Association With Social Determinants in Saudi Primary Care

Journal of Primary Care & Community Health ◽

10.1177/21501327211054987 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110549

Author(s):

Leena R. Baghdadi ◽

Mohammed Khalid Alhassan ◽

Fawaz Hindi Alotaibi ◽

Khalid Badr AlSelaim ◽

Abdulrahman Abdulkhaliq Alzahrani ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Type 2 Diabetes ◽

Primary Care ◽

Chronic Diseases ◽

Social Determinants ◽

Depression Scale ◽

Anxiety And Depression ◽

P Value ◽

Psychological Conditions

Introduction: Patients with chronic diseases can experience psychological conditions, including anxiety and depression. However, the association between chronic diseases and these psychological conditions remains unclear. This study aimed to identify the relationship between anxiety, depression, and common chronic diseases (hypertension, type 2 diabetes, dyslipidemia, and rheumatoid arthritis), and their association with social determinants at an outpatient primary care setting. Methods: The validated hospital anxiety and depression scale was administered electronically to eligible participants. For each condition (anxiety and depression), participants were categorized as normal, borderline abnormal, and abnormal, according to their score out of 21 (≤7 = normal, 8-10 = borderline abnormal, ≥11 = abnormal). The scores and numbers of participants in each category were analyzed and compared with their demographic characteristics and chronic diseases for associations and relationships. Results: We recruited 271 participants (mean age of 51.65 + 11.71 years) attending primary care clinics. Of these patients, 17.7% and 8.9% had borderline abnormal and abnormal depression, respectively, and 10.3% and 8.9% of patients had borderline abnormal anxiety and abnormal anxiety. Common social determinants and lifestyle factors were examined. Age, gender, and sugary drinks’ consumption significantly increased the odds of hypertension and type 2 diabetes; vigorous physical activity 3 times a week, decreased the odds of developing these chronic diseases. Adjusted regression models showed a statistically significant association between the hospital anxiety and depression scale score for borderline and abnormal anxiety and the presence of type 2 diabetes (OR 3.04 [95% CI 1.13, 8.19], P-value = .03 and OR 4.65 [95% CI 1.63,13.22], P-value <.03, respectively) and dyslipidemia (OR 5.93 [95% CI 1.54, 22.86], P-value = .01, and OR 4.70 [95% CI 0.78, 28.35], P-value = .09, respectively). The odds of developing depression were 4 times higher ( P-value .04) in patients with rheumatoid arthritis. Conclusion: Among patients attending primary care outpatient clinics, anxiety, and depression were significantly associated with type 2 diabetes and rheumatoid arthritis, respectively. Social determinants and lifestyle factors play a major role in the development of common chronic diseases in Saudi Arabia. Primary care physicians should consider the patients’ psychological status, sociodemographic status, and lifestyle risks during the management of chronic diseases.

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Medical care standards for diabetes in the hospital: evolution of views from glycemic control to metabolic surgery

Russian Medical Inquiry ◽

10.32364/2587-6821-2020-4-6-340-346 ◽

2020 ◽

Vol 4 (6) ◽

pp. 340-346

Author(s):

A.B. Fursov ◽

◽

R.A. Fursov ◽

O.B. Ospanov ◽

◽

...

Keyword(s):

Type 2 Diabetes ◽

Glycemic Control ◽

Medical Care ◽

Metabolic Surgery ◽

The Body ◽

Diabetic Patients ◽

Economic Costs ◽

Number Of Patients ◽

Surgical Methods

A large number of patients with type 2 diabetes (T2D) have a high incidence of complications and disease decompensation, which becomes the reason for therapy inefficacy. In recent years, endocrinologists and diabetologists are increasingly paying attention to surgical methods for treating T2D. The review attempts to study and systematize new trends in the treatment of T2D, as well as to determine the historical vector of changes in diabetologist views on the control, stabilization of the glycemic level in diabetic patients, and surgical methods.A retrospective study of scientific approaches to the treatment of diabetes confirmed the opinion of some researchers that the evolution of treatment methods commonly consisted of improving control and means of insulin delivery to the body. The analysis of scientific papers that confirm that detection of glycemic disorders among those admitted to the surgical hospital has a direct and immediate benefit both in a planned and urgent order. The growth of economic costs associated with insufficient glycemic control in diabetic patients was studied. Over the past decades, medical care standards for diabetes are analyzed in chronological order. Using the American Diabetes Association Guidelines, new trends in the treatment of T2D have been developed, and a stable vector in changing views on the efficacy of surgical bariatric and metabolic methods has been identified.KEYWORDS: medical care standards, type 2 diabetes, glycemia, evolution of diabetes mellitus treatment, economic costs, guidelines, metabolic surgery, endoscopic methods.FOR CITATION: Fursov A.B., Fursov R.A., Ospanov O.B. Medical care standards for diabetes in the hospital: evolution of views from glycemic control to metabolic surgery. Russian Medical Inquiry. 2020;4(6):340–346. DOI: 10.32364/2587-6821-2020-4-6-340-346.

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TYPE 2 DIABETES MELLITUS;

The Professional Medical Journal ◽

10.29309/tpmj/2014.21.06.2255 ◽

2014 ◽

Vol 21 (06) ◽

pp. 1174-1177

Author(s):

Mukhtiar Hussain Jaffery ◽

Nisar Ahmed Shah ◽

Muhammad Sajid Abbas Jaffri ◽

Athar Hussain Memon ◽

Syed Zulfiquar Ali Shah

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Urban Areas ◽

University Hospital ◽

Diabetic Patients ◽

C Reactive Protein ◽

Reactive Protein ◽

The Mean

Objective: To determine the frequency of raised C-reactive protein (CRP) in patients with type 2 diabetes mellitus. Patients and methods: This cross sectional descriptive study of six months study was conducted at Liaquat University Hospital Hyderabad from March 2013 to August 2013. All diabetic patients of ≥35 years age of either gender for >01 year duration visited at OPD were evaluated for C-reactive protein and their glycemic status by hemoglobin A1c. The data was analyzed in SPSS and the frequency and percentage was calculated. Results: During six month study period, total 100 diabetic patients were evaluated for C-reactive protein. Majority of patients were from urban areas 75/100 (75%). The mean ±SD for age of patients with diabetes mellitus was 51.63±7.82. The mean age ±SD of patient with raised CRP was 53±7.21. The mean ±SD for HbA1c in patients with raised CRP is 9.55±1.73. The mean random blood sugar level in patients with raised CRP was 247.42 ± 6.62. The majority of subjects from 50-69 years of age group with female predominance (p = 0.01) while the CRP was raised in 70(70%) patients in relation to age (p=0.02) and gender (p=0.01) respectively. Both HbA1c and CRP was raised in 64.9% (p = 0.04) in patients with type 2 diabetes mellitus. The mean ±SD of CRP was 5.8±1.21 while for male and female individuals with raised CRP was 3.52±1.22 and 5.7±1.63 respectively. Conclusions: The raised CRP was observed in patients with type 2 diabetes mellitus

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Prevalence and Impact of Anxiety and Depression on Type 2 Diabetes in Tunisian Patients over Sixty Years Old

Depression Research and Treatment ◽

10.1155/2013/341782 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 5

Author(s):

Jawaher Masmoudi ◽

Rahma Damak ◽

Hela Zouari ◽

Uta Ouali ◽

Anouar Mechri ◽

...

Keyword(s):

Type 2 Diabetes ◽

Depressive Disorders ◽

Depression Scale ◽

Anxiety And Depression ◽

Diabetic Patients ◽

Good Glycemic Control ◽

Tunisian Patients ◽

Control Versus ◽

The Impact

Objectives. To estimate the prevalence of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS) in a population aged over sixty years with type 2 diabetes and to study the impact of anxiety and depression on glycemic balance and disease outcome.Results. The prevalence of anxiety and depression in the 62 subjects included in the study was, respectively, 40.3% and 22.6%. We found a relationship between these disorders and complicated diabetes. The subjects having an imperfectly balanced diabetes had a higher average anxiety score than those having a good glycemic control ( versus ; ). No relationship was found between diabetes balance and depression.Conclusion. Association between anxiety and depressive disorders and diabetes is frequent and worsens patients’ outcome, in terms of diabetes imbalance as well as in terms of diabetic complications. Our study shows that there is need for physicians to detect, confirm, and treat anxiety and depressive disorders in elderly diabetic patients.

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Pharmacogenomics of Drug Response in Type 2 Diabetes: Toward the Definition of Tailored Therapies?

PPAR Research ◽

10.1155/2015/415149 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 8

Author(s):

Carla Pollastro ◽

Carmela Ziviello ◽

Valerio Costa ◽

Alfredo Ciccodicola

Keyword(s):

Type 2 Diabetes ◽

Drug Resistance ◽

Lifestyle Changes ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Allelic Variants ◽

A Genome ◽

Number Of Patients ◽

Drug Responsiveness

Type 2 diabetes is one of the major causes of mortality with rapidly increasing prevalence. Pharmacological treatment is the first recommended approach after failure in lifestyle changes. However, a significant number of patients shows—or develops along time and disease progression—drug resistance. In addition, not all type 2 diabetic patients have the same responsiveness to drug treatment. Despite the presence of nongenetic factors (hepatic, renal, and intestinal), most of such variability is due to genetic causes. Pharmacogenomics studies have described association between single nucleotide variations and drug resistance, even though there are still conflicting results. To date, the most reliable approach to investigate allelic variants is Next-Generation Sequencing that allows the simultaneous analysis, on a genome-wide scale, of nucleotide variants and gene expression. Here, we review the relationship between drug responsiveness and polymorphisms in genes involved in drug metabolism (CYP2C9) and insulin signaling (ABCC8,KCNJ11, andPPARG). We also highlight the advancements in sequencing technologies that to date enable researchers to perform comprehensive pharmacogenomics studies. The identification of allelic variants associated with drug resistance will constitute a solid basis to establish tailored therapeutic approaches in the treatment of type 2 diabetes.

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Type 2 diabetes mellitus and multiple chronic diseases

Diabetes Mellitus ◽

10.14341/dm9605 ◽

2019 ◽

Vol 21 (6) ◽

pp. 455-461 ◽

Cited By ~ 1

Author(s):

Nailya S. Asfandiyarova ◽

Olga V. Dashkevich ◽

Natalya V. Doroshina ◽

Ekaterina I. Suchkova

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Chronic Diseases ◽

Young Age ◽

Type 2 Dm ◽

Number Of Patients ◽

Male Patients ◽

Multiple Chronic Diseases

Background: Recently, there has been an increase in the number of patients with multiple chronic diseases (MCD), particularly due to obesity and ageing. The role of type 2 diabetes mellitus (T2DM) in the development of MCD, however, is still unclear. Aims: This study aimed to determine the incidence of T2DM in the structure of polymorbidity considering sex and age-related characteristics. Materials and methods: Patients with MCD (n = 2,254; 769 men/1,485 women; aged, 1899 years) were examined. The incidence of type 2 diabetes among patients with MCD considering age and sex was determined. Results: Type 2 DM was detected in 407 patients with MCD (18.1%; male:female, 1:2.53). The polymorbidity index in male patients with type 2 diabetes was 1.52.0 times higher than that in male patients without diabetes. The rate of polymorbidity index increase was similar in both groups; however, its high initial value in patients with diabetes at a young age determined the burden of the comorbidity at a later age. In type 2 diabetes, hypertension was the predominant comorbidity at 1859 years of age (p0.05), whereas other cardiovascular diseases and liver and kidney diseases were predominant at 4574 years of age (p0.001) and hemiplegia at 4589 years of age (p0.05). Between 60 and 74 years, oncological diseases were found to be more common in patients without diabetes (p0.001). Obesity, regardless of the presence of diabetes, was associated with a greater disease burden (p0.05). Sex-related difference considering MCD in patients with type 2 DM was only observed for the higher incidence of myocardial infarction (p0.001) and peptic ulcer disease in males (p0.01). Females were more likely to have obesity, liver steatosis at a young age, or osteoarthritis than males in the general group (p0.05); no differences were noted with respect to other diseases. Conclusions: In this study, type 2 diabetes was present in 18.1% of patients with MCD; moreover, a high initial polymorbidity index in patients with T2DM at young age was associated with a higher incidence of chronic diseases later in life than that in patients without diabetes. Based on these results, type 2 diabetes, along with ageing and obesity, can be considered as a risk factor in the development of MCD.

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Detection and treatment of type 2 diabetes mellitus - an interdisciplinary problem

Problems of Endocrinology ◽

10.14341/probl201359144-48 ◽

2013 ◽

Vol 59 (1) ◽

pp. 44-48

Author(s):

E N Ostroukhova

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

General Practitioners ◽

Research Centre ◽

Diabetic Patients ◽

Diabetes Registry ◽

Number Of Patients ◽

Before And After

Diabetes morbidity exceeds the predicted level. The Russian diabetes registry contains the data on more than 3 million patients suffering from type 2 diabetes mellitus (DM2), but their actual number in the country is supposed to be several times greater. The main causes behind this increase are ageing of the general population and widespread obesity. The number of patients with DM2 is now so large that endocrinologists are unable to render medical assistance to all of them; therefore therapists and general practitioners have to take care of such patients. In order to improve the quality of therapeutic and prophylactic aids for the diabetic patients, the Endocrinological Research Centre of the Russian Ministry of Health supported by Novo Nordisk has developed the "Medical Ambitions" project . In the framework of this project, the education program was elaborated and implemented designed to enhance the awareness among therapists and general practitioners about modern approaches to the management of type 2 diabetes mellitus. The present paper reports the results of analysis of the work of educational seminars carried out by the specialists of I.P. Pavlov Sank-Peterburg State Medical University. The work included lectures, interactive seminars, clinical case studies, and discussions. Special attention was given to the new groups of medications for the treatment of DM2. The effectiveness of these activities was estimated from questionnaires distributed among the participants before and after the seminars. The therapists showed great interest in the program, the level of their knowledge about up-to-date strategies of DM2 treatment appreciably increased.

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Dietary Practice among Type 2 Diabetic Ppatients in Southern Ethiopia

International Journal of Endocrinology ◽

10.1155/2021/1359792 ◽

2021 ◽

Vol 2021 ◽

pp. 1-9

Author(s):

Kidus Temesgen Worsa ◽

Beakal Zinab ◽

Melese Sinaga Teshome

Keyword(s):

Type 2 Diabetes ◽

Nutrition Education ◽

Primary Education ◽

Formal Education ◽

Significant Proportion ◽

Education Level ◽

Diabetic Patients ◽

Dietary Practice ◽

Number Of Patients

Background. Diabetic patients’ dietary practice is critical to improve glycemic, lipid, and blood pressure control. However, a significant number of patients had poor dietary practice. In Ethiopia, more than half of diabetic patients were not practicing a healthy dietary approach. Therefore, this study assessed variables that were hardly addressed in previous studies. The aim of this study was to assess dietary practice and associated factors among patients with type 2 diabetes. Methods. A facility-based cross-sectional study was performed among patients with type 2 diabetes in Arba Minch General Hospital from April 21 to May 20, 2020. A systematic sampling technique was used to select 352 patients. The data were entered into EpiData version 3.1 and exported to SPSS version 21 for cleaning and analysis. Descriptive statistics were performed. All variables in bivariate analysis with p -value <0.25 were entered into a multivariable logistic regression model, and statistical significance was declared at a p -value of less than 0.05. Results. The prevalence of poor dietary practice was found to be 40.6% (95%CI (35.7–46.0)). After adjusting for other variables in multivariable analysis, not attending formal education (AOR = 3.0; 95%CI (1.6–5.5)), being at primary education level (AOR = 2.2; 95%CI (1.1–4.4)), being moderately food insecure (AOR = 5.3; 95%CI (2.8–9.9)), having depression (AOR = 5.9; 95%CI (3.0–11.4)), and not having nutrition education (AOR = 2.2; 95% (1.1–4.6)) were factors associated with poor dietary practice. Conclusions. A significant proportion of patients had poor dietary practice. The poor dietary practice was significantly higher among those with no formal education, at the primary education level, from the moderately food-insecure household, having depression, and not having nutrition education. The results imply the need for strengthening health information dissemination concerning healthy dietary practice in the form of a package.

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