Approaches and Awareness of Family Physicians on Diabetes Management during Ramadan

Aim: This study aimed to determine the approaches of family physicians in Turkey on the fasting of diabetic patients and whether they use international treatment guidelines when making recommendations. In addition, this study aimed to increase the awareness of family physicians on this issue before Ramadan, which is the fasting month. Material and Method: The study herein comprised cross-sectional observational research. Before Ramadan 2018, a structured questionnaire form, which was unique to this study, was prepared by considering the guidelines of the International Diabetes Federation (IDF) and the American Diabetes Association (ADA), through platforms where family physicians gathered via social media and mail groups, and sent to the family physicians in Turkey via a link created using an electronic questionnaire preparation and application program. Moreover, the total knowledge level, attitude, and approach score were calculated through the questions prepared from the relevant guidelines. Results: Participating in the survey were 262 family physicians. Only 22% of family physicians said that they were aware that there were international guidelines for Ramadan and diabetes management, and only 10% said that they had read the relevant guidelines. The mean knowledge level, attitude, and approach scores were found to be lower than expected, and a significant difference was found between their scores and their academic titles. Conclusion: The lack of knowledge of international guidelines on the subject and lack of knowledge and experience about diabetes mellitus patient management in the fasting month stood out as the biggest problems. This study revealed that the awareness and competence of family physicians in disease management should be increased in addition to fasting before, during, and after Ramadan in diabetic patients.

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Self-monitoring of Blood Glucose (SMBG): Cornerstone of Diabetes Management- Bangladesh Perspective: A Recommendation

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v32i4.26109 ◽

2015 ◽

Vol 32 (4) ◽

pp. 218-223

Author(s):

Zafar Ahmed Latif

Keyword(s):

Decision Making ◽

Clinical Decision Making ◽

Diabetes Management ◽

Clinical Decision ◽

Local Context ◽

Diabetic Patients ◽

Glycemic Status ◽

Self Monitoring ◽

International Guidelines ◽

Local Guideline

SMBG is a crucial factor in diabetes management. It offersa quick check of glycemic status, helps to identify hypoglycemia and hyperglycemia. In addition SMBG assists in clinical decision making and as such it complements HbA1c. But due to many reasons SMBG is not practiced properly and adequately. In recent years several international guidelines higllighted the importance of SMBG for diabetes management. Very few diabetic patients in Bangladesh actually perform SMBG regularly at home. The awareness of the benefits of SMBG is also low. There is no uniformity in SMBG practice among the patients as there is no local guideline to help the physicians in determining the optimum SMBG frequency for their patients. So a working guideline on SMBG is the call of the day. This article is an attempt in that direction. Exploring international guidelines and evaluating their applicability in local context a number of recommendations have been proposed.J Bangladesh Coll Phys Surg 2014; 32: 218-223

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CONTROLLING DIET EXPERIENCE OF DIABETIC PATIENTS IN BUKITTINGGI, INDONESIA

10.31219/osf.io/v674z ◽

2021 ◽

Author(s):

Liza Merianti ◽

Dona Amelia ◽

Ade Srywahyuni

Keyword(s):

Blood Sugar ◽

Diabetes Management ◽

International Diabetes Federation ◽

Sampling Technique ◽

Diabetic Patients ◽

Dietary Control ◽

Descriptive Phenomenology ◽

Normal Limits ◽

Number Of Patients ◽

And Control

Background: In 2015, the International Diabetes Federation reported that there were 415 million adultsaged 20 to 79 with diabetes. Indonesia is among the 10 countries with the high number of diabetic patientsand is ranked 7th in the world with the number of patients reaching 10.2 million. Diabetes management canbe done through controlling blood sugar through 4 pillars, namely education, diet, exercise, andmedication. However, the current phenomena show that many diabetics have poor dietary control so theyfail maintain their blood sugar within its normal limits and are at greater risk for diabetes complications.However, we can still find diabetic patients who are able to improve their diet and control their blood sugar.Therefore, getting information from them, especially related to their experience in controlling their diet, isexpected to provide hope and motivation for others. Hence, this study aims to find out and expolore theexperience of diabetics with controlled blood sugar and dietMethods: This study uses a qualitative research method with a descriptive phenomenology approach. Theselection of participants was carried out by using a purposive sampling technique. The number ofparticipants in this study were 5 and data were processed through Colaizzi method.Result:.There are four themes obtained in this study namely: Self-commitment to discipline and dietarycompliance, Fruit as an alternative appetite suppresant, Controlling hunger as a habit, and Channellinghunger to activities. Controlling diet for participants has been succesfully done by created a new habitthrough controlling their hunger, so that they could keep their commitment dan disclipline for dietarycompliance, choosing fruits as alternative suppresant and doing activity for channeling the hunger.Therefore it is important for the nurses to educate the diabetic patients about how to deal with diet issuesthrough controlling a hunger as a habit

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Controlling diet experience of diabetic patients in Bukittinggi, Indonesia

10.31219/osf.io/gh698 ◽

2021 ◽

Author(s):

Ade Srywahyuni ◽

Dona Amelia

Keyword(s):

Blood Sugar ◽

Diabetes Management ◽

International Diabetes Federation ◽

Sampling Technique ◽

Diabetic Patients ◽

Dietary Control ◽

Descriptive Phenomenology ◽

Normal Limits ◽

Number Of Patients ◽

And Control

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Comparison of Social determinants and Evaluation of Disease Management of diabetic patients attending Rahman Medical Institute and Nahaki Emergency Satellite Hospital, Peshawar

Pakistan Journal of Public Health ◽

10.32413/pjph.v11i1.635 ◽

2021 ◽

Vol 11 (1) ◽

pp. 30-34

Author(s):

Aisha Liaqat ◽

Sanan Arshad ◽

Saddiqa Gul ◽

Ulfat Sultana ◽

Fatima Liaqat ◽

...

Keyword(s):

Disease Management ◽

Social Determinants ◽

Diabetes Management ◽

Medical Institute ◽

Diabetic Patients ◽

Ischemic Necrosis ◽

Equal Distribution ◽

The Social ◽

Significant Difference ◽

And Control

Background: Diabetes mainly depends on social determinants of health. Addressing the social determinants, and attitude toward disease management is an important step toward the prognosis, and control of diabetes. The objective of the study was to determine the contributing role of social Determinants in diabetes development and evaluation of diabetes parameters affecting the prognosis and management among the diabetic patients of NESH and RMI. Methods: This was comparative hospital based case control study carried out from the duration of March to December 2016. A total 174 patients, 87 diabetics and 87 non diabetics were included in the study. After taking written consent, a predesigned questionnaire was filled from each patient. Data were collected and analyzed by using SPSS version 16. Results: A total 174 study subjects, 87 diabetic (Cases) and non-diabetic (control) each from two different hospitals with equal distribution were included in the study. Out of 174 study subjects 59 (34%) were male and 115 (66%) were female. A significant difference was observed in weight and BMI p<0.05 of these two groups case and control. There found no significant difference among diabetics and non-diabetes in reference to their social determinants like gender p=0.1683, education p=0.4358 and income p= 0.4672, however a significant difference between these two groups were observed in marital status p=0.0001. It was found that significant difference was observed in decrease of vision (p=<0.001) and Ischemic necrosis of toes and finger (p=0.007) among diabetics patients of both hospital. Conclusion: The social determinants (age, gender, area, profession etc), carbohydrate and fat intake were not significantly different between diabetics and non-diabetics group. The significantly higher proportion of diabetic’s patients of rural hospital were found with decrease of vision and ischemic necrosis of toes and fingers educational intervention regarding diabetes management is needed in rural areas of Khyber Pakhtunkhwa.

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Physician Awareness in Diabetes Management During Ramadan 2015—A Focus Group Discussion

US Endocrinology ◽

10.17925/use.2017.13.01.30 ◽

2017 ◽

Vol 13 (01) ◽

pp. 30

Author(s):

Fatima Younis Al Slail ◽

Haroon UR Rashid ◽

Sahar Mohamed Fadl ◽

Omer Osman Kheir ◽

◽

...

Keyword(s):

Focus Group ◽

Primary Healthcare ◽

Diabetes Management ◽

Healthcare Services ◽

Diabetic Patients ◽

Continuous Training ◽

Attitudes And Practices ◽

Healthcare Center ◽

Primary Healthcare Center ◽

Lack Of Knowledge

Background: Diabetic Muslims who wish to fast are recommended to undergo medical counseling prior to fasting to prevent complications. This study assesses knowledge, attitudes, and practices, and identifies issues related to building capacity for physicians treating diabetic patients. Methods: We conducted a qualitative study based on focus group discussions with primary healthcare center (PHCC) doctors who manage diabetic patients in the Riyadh region. Results: There is a lack of knowledge of the classification system for risk assessment of diabetic patients who fast during Ramadan. All the responses showed that there were misconceptions regarding nitroglycerin tablets placed under the tongue to nullify fasting. Other issues addressed by respondents include the following: how to adjust the dose and subsequently convince the patient to follow a new regimen, loss of patient follow-up due to referral to the hospital, the refusal of some laboratories to perform examinations for patients referred from other PHCCs, and lack of patient medication compliance. Conclusion: The study reported a lack of knowledge among respondents regarding therapeutic and lifestyle management of diabetic patients during Ramadan. Other issues addressed by participants include lack of healthcare services at primary healthcare center facilities and services not working effectively. To empower physicians and improve knowledge, attitude, and practices for managing diabetic patients during Ramadan, experience, continuous training, as well as fully equipped healthcare centers (including both laboratory and pharmaceutical medical supplies) play a crucial role.

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Impact on Diabetes Management of the Restrictions of Social Participation to Combat the COVID-19 Pandemic at a Single Facility in Japan: A Retrospective, Observational Study

10.21203/rs.3.rs-142900/v1 ◽

2021 ◽

Author(s):

Toshiki Kogai ◽

Kazutoshi Fujibayashi ◽

Naotake Yanagisawa ◽

Nobuyuki Fukui ◽

Akihiko Takahashi ◽

...

Keyword(s):

Repeated Measures ◽

Mixed Model ◽

Diabetes Management ◽

Diabetic Patients ◽

Improvement Rate ◽

Deterioration Rate ◽

Significant Difference ◽

Chi Squared ◽

The Impact ◽

Hba1c Levels

Abstract Background: The aim of this study was to clarify the impact of limitations of activity due to the COVID-19 pandemic on diabetes management.Methods: To clarify the impacts of the emergency declared on April 7 2020, 345 patients, 1109 patients, and 752 patients whose HbA1c levels were measured in both March and April, May, or June were selected. The patients to be compared were selected from the 2019 data under the same conditions. In 2019, 469 patients, 1315 patients, and 783 patients whose HbA1c levels were measured in both March and April, May, or June were selected. The impact of restricted activity on diabetes management due to the declared emergencies was assessed by comparing HbA1c levels in April, May, and June minus the HbA1c levels in March of both 2019 and 2020. Subjects with a difference in HbA1c levels greater than 0 were defined as “worsened”, and subjects with a difference in HbA1c levels less than or equal to 0 were defined as “improved”. The deterioration rate and the improvement rate of the HbA1c level in 2019 and 2020 were compared by the Chi-squared test. Second, the linear trends of HbA1c from April to June between 2019 and 2020 were calculated by mixed model repeated measures ANOVA.Results: There were more patients with worsening HbA1c levels from March to April in 2020 than in 2019: 122 (26.0%) vs. 137 (39.7%), p<0.01. There were more patients with improved HbA1c levels from March to June in 2020 than in 2019: 478 (61.0%) vs. 512 (68.1%), p<0.01. Patients with improved HbA1c levels between March and May showed no significant difference between 2020 and 2019: 814 (61.9%) vs. 713 (64.3%), p=0.23. Slopes of HbA1c levels from April to June in 2019 and 2020 were -0.0024 (-0.0039, -0.0009) and -0.0099 (-0.0117 -0.0081), respectively. There were significant differences in the slopes -0.0075 (-0.0097, -0.0053), p<0.01) between the years.Conclusions: HbA1c levels did not appear to show persistent deterioration during the observational period in 2020. Meanwhile, some diabetic patients may have shown both improved and worsened diabetes control during the COVID-19 pandemic.

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Left Ventricular Dysfunction and Blood Glycohemoglobin Levels in Young Diabetics

Nuklearmedizin ◽

10.1055/s-0038-1629573 ◽

1991 ◽

Vol 30 (05) ◽

pp. 183-188

Author(s):

A. Aydrner ◽

A. Oto ◽

E. Oram ◽

O. Gedik ◽

C. F. Bekdik ◽

...

Keyword(s):

Ejection Fraction ◽

Left Ventricular Function ◽

Ventricular Function ◽

Left Ventricular ◽

Diabetic Patients ◽

Filling Fraction ◽

Time To Peak ◽

Significant Difference ◽

The Mean ◽

Hba1c Levels

Left ventricular function including regional wall motion (RWM) was evaluated by 99mTc first-pass and equilibrium gated blood pool ventriculography and glycohemoglobin (HbA1c) blood levels determined by a quantitative column technique in 25 young patients with insulin-dependent diabetes mellitus without clinical evidence of heart disease, and in healthy controls matched for age and sex. Phase analysis revealed abnormal RWM in 19 of 21 diabetic patients. The mean left ventricular global ejection fraction, the mean regional ejection fraction and the mean 1/3 filling fraction were lower and the time to peak ejection, the time to peak filling and the time to peak ejection /cardiac cycle were longer in diabetics than in controls. We found high HbA1c levels in all diabetics. There was no significant difference between patients with and without retinopathy and with and without peripheral neuropathy in terms of left ventricular function and HbA1c levels.

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Long-term survival of the nasal NK/T cell lymphoma

Orvosi Hetilap ◽

10.1556/oh.2008.28330 ◽

2008 ◽

Vol 149 (17) ◽

pp. 801-805

Author(s):

Péter Rajnics ◽

László Krenács ◽

András Kenéz ◽

Zoltán Járay ◽

Enikő Bagdi ◽

...

Keyword(s):

T Cell ◽

Treatment Guidelines ◽

Cell Lymphoma ◽

Treatment Options ◽

Diagnostic Procedures ◽

T Cell Lymphoma ◽

Term Survival ◽

Barr Virus ◽

Significant Difference ◽

Nk T Cell

The nasal NK/T cell lymphoma is a rare, extranodal non-Hodgkin lymphoma in western civilizations, which has poor prognosis. The Epstein–Barr virus can be detected in tumor cells in nearly all cases. There are no definite treatment guidelines in our days. There is no significant difference in survival between radiotherapy and chemotherapy according to Asian studies. In this case study we show our diagnostic procedures, our treatment options and we present the summary of this illness based on the data found in the literature.

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New Insight into Diabetes Management: From Glycemic Index to Dietary Insulin Index

Current Diabetes Reviews ◽

10.2174/1573399815666190614122626 ◽

2020 ◽

Vol 16 (4) ◽

pp. 293-300 ◽

Cited By ~ 1

Author(s):

Zahra Yari ◽

Vahideh Behrouz ◽

Hamid Zand ◽

Katayoun Pourvali

Keyword(s):

Glycemic Index ◽

Diabetes Management ◽

Glycemic Load ◽

Insulin Response ◽

Diet Therapy ◽

Current Data ◽

Diabetic Patients ◽

Carbohydrate Counting ◽

Insulin Requirements ◽

Insight Into

Background: Despite efforts to control hyperglycemia, diabetes management is still challenging. This may be due to focusing on reducing hyperglycemia and neglecting the importance of hyperinsulinemia; while insulin resistance and resultant hyperinsulinemia preceded diabetes onset and may contribute to disease pathogenesis. Objective: The present narrative review attempts to provide a new insight into the management of diabetes by exploring different aspects of glycemic index and dietary insulin index. Results: The current data available on this topic is limited and heterogeneous. Conventional diet therapy for diabetes management is based on reducing postprandial glycemia through carbohydrate counting, choosing foods with low-glycemic index and low-glycemic load. Since these indicators are only reliant on the carbohydrate content of foods and do not consider the effects of protein and fat on the stimulation of insulin secretion, they cannot provide a comprehensive approach to determine the insulin requirements. Conclusion: Selecting foods based on carbohydrate counting, glycemic index or glycemic load are common guides to control glycemia in diabetic patients, but neglect the insulin response, thus leading to failure in diabetes management. Therefore, paying attention to insulinemic response along with glycemic response seems to be more effective in managing diabetes.

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Characteristics of monitored diabetic patients by glycated haemoglobin (HbA1c)

International Journal of Bioassays ◽

10.21746/ijbio.2016.05.006 ◽

2016 ◽

Vol 5 (05) ◽

pp. 4563

Author(s):

Tariq A. Zafar

Keyword(s):

Blood Glucose ◽

Glycemic Control ◽

Glycated Haemoglobin ◽

Poor Glycemic Control ◽

Diabetic Patients ◽

Age Group ◽

Hba1c Test ◽

Significant Difference ◽

Tract Infections ◽

The Impact

Glycated haemoglobin (HbA1c) test indicates the blood glucose levels for the previous two to three months. Using HbA1c test may overcome many of the practical issues and prevent infections such as urinary tract infections (UTIs). The study aimed to evaluate the impact of glycemic control using HbA1c test to understand patient characteristics and UTIs prevalence. Glycemic control was evaluated by measuring HbA1c for a total of 208 diabetes patients who were regularly attending diabetes center in Al-Noor specialist hospital in Makkah. The results showed that good and moderate glycemic controlled patients were 14.9% and 16.9% respectively while the poor glycemic patients were 68.3%. Among the good improved glycemic control, 83.9% were females, 48.4% were from age group (15-44y). Among the moderately improved glycemic control, 68.4% were females, 54.3% were from age group (45-64 y) with no significant difference. The total number of the patients with positive UTIs was 55 (26.4%) while the total number of patients with negative was UTIs 153 (73.6%). Among the positive UTIs, 76.3% were with poor glycemic control while only 12.3% and 11% were moderate and good improved glycemic control respectively. Among the negative UTIs, 65.3% were with poor glycemic control while only 19% and 15.7% were with moderate and good improved glycemic control respectively. Prevalence of UTIs among diabetic patients was not significant (p > 0.05). It was concluded that HbA1c was useful monitoring tool for diabetes mellitus and may lead to improved outcomes. Using a HbA1c test may overcome many of the practical issues that affect the blood glucose tests.

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