Type 2 Diabetes Mellitus with Early Dry Skin Disorder: A Comparison Study between Primary and Tertiary Care in Indonesia

2021 ◽  
Vol 17 ◽  
Author(s):  
Lili Legiawati ◽  
Kusmarinah Bramono ◽  
Wresti Indriatmi ◽  
Em Yunir ◽  
Aditya Indra Pratama
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Early Stage ◽  
Tertiary Care ◽  
Laboratory Data ◽  
Dry Skin ◽  
Cross Sectional

Background: The prevalence of type 2 diabetes mellitus (T2DM) in Indonesia has continued to increase over the years. Management of T2DM is challenging across clinical settings, including primary and tertiary care. Uncontrolled T2DM puts patients at risk of the development of T2DM complications, especially early-stage dry skin that is neglected by most of the patilents. This study aimed to investigate the comparison between the T2DM management profile and dry skin clinical profile of T2DM patients in primary care and tertiary care settings. Methods: The study was conducted as a cross-sectional epidemiological study by comparing T2DM patient profiles in primary and tertiary care. The data collected included sociodemographic, clinical, and laboratory data that were correlated with T2DM and early dry skin related-T2DM. This study included early dry skin within the SRRC score of 3-11 and excluded infection, ulcer, and severe erythema. Results: The patients in primary and tertiary care presented poorly controlled T2DM with median HbA1c levels of 7.8% and 7.6%. The patients in primary care also presented with high triglyceride, 179 mg/dl. Furthermore, several significant differences were found in the duration of T2DM, duration of dry skin, and DM treatment (OAD and insulin). Conclusions: Significant differences in the duration of T2DM, duration of dry skin, and DM treatment (OAD and insulin) might be affected by the parameter of T2DM glycemic control (Blood pressure (BP), body mass index (BMI), HbA1c, random blood glucose (RBG), and triglyceride).

scholarly journals Thickness of Intraretinal Layers in Patients with Type 2 Diabetes Mellitus Depending on a Concomitant Diabetic Neuropathy: Results of a Cross-Sectional Study Using Deviation Maps for OCT Data Analysis

Biomedicines ◽  
2020 ◽  
Vol 8 (7) ◽  
pp. 190
Author(s):  
Ruby Kala Prakasam ◽  
Aleksandra Matuszewska-Iwanicka ◽  
Dagmar-Christiane Fischer ◽  
Heidrun Schumann ◽  
Diethelm Tschöpe ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Retinal Thickness ◽  
Early Stage ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Retinal Layers

Optical coherence tomography (OCT) supports the detection of thickness changes in intraretinal layers at an early stage of diabetes mellitus. However, the analysis of OCT data in cross-sectional studies is complex and time-consuming. We introduce an enhanced deviation map-based analysis (MA) and demonstrate its effectiveness in detecting early changes in intraretinal layer thickness in adults with type 2 diabetes mellitus (T2DM) compared to common early treatment diabetic retinopathy study (ETDRS) grid-based analysis (GA). To this end, we obtained OCT scans of unilateral eyes from 33 T2DM patients without diabetic retinopathy and 40 healthy controls. The patients were categorized according to concomitant diabetic peripheral neuropathy (DN). The results of MA and GA demonstrated statistically significant differences in retinal thickness between patients and controls. Thinning was most pronounced in total retinal thickness and the thickness of the inner retinal layers in areas of the inner macular ring, selectively extending into areas of the outer macular ring and foveal center. Patients with clinically proven DN showed the strongest thinning of the inner retinal layers. MA showed additional areas of thinning whereas GA tended to underestimate thickness changes, especially in areas with localized thinning. We conclude that MA enables a precise analysis of retinal thickness data and contributes to the understanding of localized changes in intraretinal layers in adults with T2DM.

scholarly journals Assessment of quality of life of type-2 diabetes mellitus patients in tertiary care teaching hospital in North India

2019 ◽  
Vol 9 (1) ◽  
pp. 107
Author(s):  
Aditya Parashar ◽  
K. K. Jha ◽  
Arun Kumar ◽  
Sheetal Singh Tomer ◽  
Dharmendra Singh Yadav ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
North India ◽  
Cross Sectional ◽  
Physical Strength

Background: Quality of life (QoL) is a standard indicating a person’s life in better condition as compared to a diseased person or patient. Diabetes itself is not a dangerous disease if managed properly, but it becomes life-threatening after a certain time period because of the patient’s poor interest in disease management and treatment adherence. Diabetes mellitus is an endocrine system disorder that invokes lack of insulin secretion in the bloodstream. The study was conducted to assess the QoL of type-2 diabetes mellitus patients with QoL instrument.Methods: Questionnaire based cross-sectional, prospective study was conducted at Teerthanker Mahaveer Hospital, Moradabad, for a duration of 6 months from January - June 2019, on 196 patients of type-2 diabetes mellitus.Results: On an average 56.5% people have accepted that due to the diabetic condition their working proficiency is decreased. 80.3% of patients have accepted that they were facing problems due to diabetic symptoms. Similarly, 84% of patients have accepted that the ongoing treatment was quite expensive than their expectations. Finally, the last section of the patient’s emotional/mental satisfaction showed that 49.7% of patients were very satisfied with their family support while 13.7% of patients were not satisfied.Conclusions: QOL instrument for Indian diabetes patient’s instrument helped to evaluate the patient’s physical strength, psychological strength of the patient during disease condition, the response provided from the family members and relatives, the economical status of the patient and its effects on their living.

scholarly journals Prescribing pattern of oral anti-diabetic agents in type 2 diabetes mellitus patients in a tertiary care hospital

2018 ◽  
Vol 7 (5) ◽  
pp. 956
Author(s):  
Taruna Sharma ◽  
Rajit Sahai ◽  
Suman Bala ◽  
Dilip C. Dhasmana ◽  
Nidhi Kaeley
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Combination Therapy ◽  
Tertiary Care ◽  
Fixed Dose ◽  
Care Hospital ◽  
Prescribing Pattern ◽  
Cross Sectional

Background: Prescription pattern studies are a tool for assessing the prescribing, dispensing and distribution of medicines. The main aim of assessing prescribing pattern is to facilitate rational use of medicines. So the main aim of the study was to assess the prescribing pattern of oral anti-diabetic agents in type 2 diabetes mellitus, to assess the rationality of the prescribed drugs and also to assess the pattern of co-morbid conditions associated with type 2 diabetes mellitus in a tertiary care hospital.Methods: This cross sectional study was conducted in the Department of Pharmacology in collaboration with Department of General Medicine. Study was conducted from 1st June 2016 to 31st Aug 2016 (3 months). A total of 100 patients were enrolled after taking written informed consent. A structured case recording form was used to record demographic details and prescription details. The rationality of prescriptions was assessed using American Diabetes Association guidelines 2015.Results: Majority of the patients were prescribed combination therapy (54%) followed by monotherapy (46%). Oral anti-diabetic agents used as monotherapy other than metformin were inappropriate. Among the patients receiving combination therapy majority were receiving a fixed dose combination which were inappropriate.Conclusions: Majority of the patients were receiving fixed dose combinations without justifiable pharmacokinetic/pharmacodynamic benefits. Such kinds of studies are required to improve rationality of prescription of drugs, decreasing morbidity and mortality of patients and decreasing the cost of treatment.

scholarly journals Real-world Evaluation of glycemic control and hypoglycemic Events among type 2 Diabetes mellitus study (REEDS): a multicentre, cross-sectional study in Thailand

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e031612
Author(s):  
Bancha Satirapoj ◽  
Thongchai Pratipanawatr ◽  
Boonsong Ongphiphadhanakul ◽  
Sompongse Suwanwalaikorn ◽  
Yupin Benjasuratwong ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Weight Gain ◽  
Goal Attainment ◽  
Tertiary Care ◽  
Treatment Compliance ◽  
Cross Sectional ◽  
Tertiary Care Hospitals

ObjectivePatients with type 2 diabetes mellitus (T2DM) often experience hypoglycaemia and weight gain due to treatment side effects. Sulfonylureas (SU) and the combination of SU and metformin (SU+MET) were the most common monotherapy and combination therapies used in Thailand tertiary care hospitals. This study aimed to assess the glycaemic goal attainment rates, hypoglycaemic episodes, weight gain and treatment compliance among patients with T2DM receiving SU or SU+MET.Research design and methodsA multicentre cross-sectional survey and retrospective review was conducted in five tertiary care hospitals, Thailand. Patients with T2DM aged ≥30 years were included consecutively during a 12-month period. Glycaemic control, experiences of hypoglycaemia, weight gain and compliance were evaluated. Glycaemic goal attainment was defined by HbA1clevel less than 7%.ResultsOut of the 659 patients (mean age (±SD)), 65.5 (10.0) years and median duration of T2DM (IQR), 10 (5–15) years), 313 (47.5%) achieved the glycaemic goal. HbA1clevels in the patients with goal attainment was significantly lower compared with those without (6.3%±0.5% vs 8.1%±1.2%, p<0.001). Goal attainment was significantly lower among patients treated with SU+MET than those treated with SU alone (43.5% vs 63.0%; OR 0.45, 95% CI 0.31, 0.66, p<0.001). A third of patients reported experiencing hypoglycaemia (30.7%) and weight gain (35.4%). Weight gain in the SU+MET group was lower than those receiving SU alone (33.1% vs 44.6%, p=0.015), but there was no difference in hypoglycaemic events. Major events in the previous 12 months were experienced by 68 patients, most commonly congestive heart failure and ischaemic heart disease. Approximately half of the patients (52.2%) reported not always taking their medication as prescribed.ConclusionsAmong patients with T2DM receiving SU or SU+MET, only about half of the patients achieved glycaemic goal and compliance with the treatment. Hypoglycaemia and weight gain posed a significant burden with risk of weight gain higher in the SU group.

scholarly journals Cribado de la retinopatía diabética en el primer nivel de atención usando retinografía en la Ciudad de México

2018 ◽  
Vol 16 (2) ◽  
pp. 11-19
Author(s):  
Daniel Paniagua Herrera ◽  
Consuelo González Salinas
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Macular Edema ◽  
Diabetic Macular Edema ◽  
Vision Loss ◽  
Tertiary Care ◽  
Number Of Patients

Objective:To determine the prevalence of diabetic retinopathy and diabetic macular edema by means of retinography in patients diagnosed with Type 2 diabetes mellitus according to time of evolution and degree of vision loss with and without refractive correction.Method: A descriptive cross-sectional study of 150 patients with Type 2 diabetes mellitus assessed in optometry in various health centers from the Sanitary Jurisdiction of Tlalpan, Health Services of Mexico City.Results: 150 patients (70% women, 30% men) aged 60 (+/– 7.77) were diagnosed with Type 2 diabetes mellitus, 52% of them with an evolution of 12.09 years (+/– 3.48). Of the total number of patients, 72.33% had retinopathy and/or diabetic macular edema lesions. The average visual acuity improved from 0.62 (+/– 0.48) to 0.37 (+/– 0.38) with refractive correction, absolute disability decreased by –18.76% and null or slight disability increased by 31.31%. Of the total population, 75.5% remained under monitoring in primary care, and 24.5% were referred to tertiary care in ophthalmology.Conclusion: The strategic opportunity to combat vision loss due to retinopathy and diabetic macular edema is found in its timely detection by health personnel trained in scrutiny and control at the primary care level, which would represent a decreased hospital load in tertiary care, thereby reducing costs for the health systems, as well as cost-efficiency for the years of sight gained and optimization of the patient’s global vision.

scholarly journals Pharmacoeconomic evaluation in cost of illness in type 2 diabetes mellitus patients in a tertiary care hospital

2017 ◽  
Vol 6 (10) ◽  
pp. 2334
Author(s):  
Tushar R. Bagle ◽  
Vijay A. Vare ◽  
Alankar Nimgade ◽  
Rohankumar C. Hire ◽  
Yogesh Sharma ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Pharmacoeconomic Evaluation ◽  
Exclusion Criterion ◽  
Care Hospital ◽  
Cross Sectional

Background: India is expected to bear the burden of world’s greatest increase of diabetes population. This burden needs to be considered in terms of costs.Methods: Cross-sectional study was done in type 2 diabetes mellitus 100 patients that attended Medicine OPD. Prior to enrollment Institutional Ethics Committee permission was taken. Written Informed consent was taken. Demographic information related to Education, Occupation and Income was taken down. Also Information related to diagnostic tests and medications were documented. Inclusion criterion were 18-70 years of either gender diagnosed by Physicians in OPD as type 2 diabetes, willing to participate and have followed in OPD for at least one year. The Exclusion criterion was Critically ill or unconscious patients and Pregnant women. Direct and indirect costs were calculated.Results: The average age was 56.31±10.50 years. The average fasting blood glucose was 120.65±22.70mg/dl. The average cost per month for investigations was 159.74±128.06. Annual visit to OPD was 13.06±7.35. Time loss per visit was 5.62±1.29 hours and of accompanying person was 6.55±3.87 hours. There were 2 from Lower and 63 from Upper Lower socioeconomic class. There were 41 patients having diabetic complications. The indirect cost was around 5838.51 and direct cost was around 19925. Total cost per annum per patient was around 32361.27 INR.Conclusions: There is need for strategies to reduce the cost burden. There is also needed to design financial systems for diabetes related nationwide health programs.

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