The Impact of Outpatient Diabetes Management on Serum Lipids in Urban African-Americans With Type 2 Diabetes

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

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Effect of nutrition education on dietary diversity score of type 2 diabetes patients

10.21203/rs.3.rs-51087/v1 ◽

2020 ◽

Author(s):

Robert Mutagwanya ◽

Christine Magala Nyago ◽

Fredrick Nelson Nakwagala

Keyword(s):

Type 2 Diabetes ◽

Nutrition Education ◽

Diabetes Management ◽

Dietary Diversity ◽

Control Group ◽

Mulago Hospital ◽

Diabetic Patients ◽

The Impact ◽

Diabetes Patients

Abstract Background: Consumption of a varied diet reduces the risk of developing a deficiency or excess of any one nutrient. One of the three corner stones of diabetes management is diet and therefore, dietary diversity is key among diabetes patients. Objective: The objective of this study was to establish the impact of nutrition education on the dietary diversity scores (DDS) among type 2 diabetes patients. Methods: Kant et al method was used for scoring dietary diversity. Data were analyzed using the statistical package for social sciences (SPSS version 21). Pair sample t-test was used to compare total DDS after and before nutrition education. P< 0.05 was considered as statistically significant.Subjects: One hundred type 2 diabetic patients were randomly selected and divided into two groups of intervention and control (50 patients in each group) to participate in the study. Data were collected using a pre-tested questionnaire before and after intervention every after one month for a period of four months of intervention.Results: The average age of patients who participated in the study was 48 (40–51) years. Most of the patients were females (65.39%), compared to males (34.01%). At the end of the study period of four months, DDS in the control group decreased from 40.08% to 38.49% (p=0.064) while in the intervention group, DDS increased from 35.30 % to 54.20% (p<0.001). Conclusion: Dietary diversity increased after nutrition education among type 2 diabetes patients.Trial registration: The study was registered and approved on 17th April 2013 by the Research and Ethics committee of Mulago Hospital and Institutional Review Board of Mulago hospital (Protocol MREC 113).

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Patient Centered Studies Focusing on Diabetes Self-Management: A Scoping Review

Current Diabetes Reviews ◽

10.2174/1573399816666191230112657 ◽

2020 ◽

Vol 16 (6) ◽

pp. 557-569

Author(s):

Monika Salkar ◽

Meagen Rosenthal ◽

Tanvee Thakur ◽

Austin Arnold

Keyword(s):

Type 2 Diabetes ◽

Scoping Review ◽

Diabetes Management ◽

Current Knowledge ◽

Future Research ◽

Patient Centered ◽

Pubmed Database ◽

Research Questions ◽

The Impact

Background: Type 2 diabetes continues to be a significant burden to patients and health systems globally. Addressing this condition from an alternative perspective, patients and various other stakeholders from three northern Mississippi communities co-created patient-centered research questions focused on type 2 diabetes management. Objective: The objective of this scoping review was to explore current literature focusing on nine patient- centered research questions to establish current knowledge and identify future research needs in the area of type 2 diabetes. Methods: A scoping review was conducted to obtain an overview of research related to the study purpose. The PubMed database was searched from March 2013 to March 2018 to identify patient-centered studies focused on type 2 diabetes and relevant to one of the nine research questions. Results: A total of 33 studies were identified and included. For five of the research questions, there was either no previous research literature or only “related” studies could be identified. These largely unexplored topics included how the understanding of guidelines by healthcare providers, specialty, and communication of medication side-effects impact patients’ understanding and outcomes, the impact of improving patients’ preparedness to communicate with providers, and whether younger patients require weight management programs that account for this populations’ needs. Conclusion: This lack of previous literature presents a unique opportunity to partner with patients to conduct this study and help improve the management of type 2 diabetes.

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'It's a Dance between Managing Both': A Qualitative Study Exploring Perspectives of Persons With Knee Osteoarthritis and Type 2 Diabetes Mellitus on the Impact of Osteoarthritis on Diabetes Management and Daily Life

SSRN Electronic Journal ◽

10.2139/ssrn.3991623 ◽

2021 ◽

Author(s):

Lauren K. King ◽

Esther J. Waugh ◽

Crystal Mackay ◽

Ian Stanaitis ◽

Jane Stretton ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Qualitative Study ◽

Knee Osteoarthritis ◽

Diabetes Management ◽

Daily Life ◽

The Impact

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The Role of Finding Out in Type 2 Diabetes Management among West-African Immigrants Living in the UK

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18116037 ◽

2021 ◽

Vol 18 (11) ◽

pp. 6037

Author(s):

Folashade Alloh ◽

Ann Hemingway ◽

Angela Turner-Wilson

Keyword(s):

Type 2 Diabetes ◽

West Africa ◽

Diabetes Management ◽

African Immigrants ◽

West African ◽

Theory Approach ◽

The Uk ◽

West African Immigrants ◽

The Impact

Type 2 diabetes (T2DM) prevalence is three times higher among West African Immigrants compared to the general population in the UK. The challenges of managing T2DM among this group have resulted in complications. Reports have highlighted the impact of migration on the health of the immigrant population, and this has contributed to the need to understand the influence of living in West Africa, and getting diagnosed with T2DM, in the management of their condition in the UK. Using a qualitative constructivist grounded theory approach, thirty-four West African immigrants living in the UK were recruited for this study. All participants were interviewed using Semi-structured interviews. After coding transcripts, concepts emerged including noticing symptoms, delayed diagnosis, affordability of health services, beliefs about health, feelings at diagnosis, and emotions experienced at diagnosis all contribute to finding out about diagnosis T2DM. These factors were linked to living in West Africa, among participants, and played significant roles in managing T2DM in the UK. These concepts were discussed under finding out as the overarching concept. Findings from this study highlight important aspects of T2DM diagnosis and how lived experiences, of living in West Africa and the UK, contribute to managing T2DM among West African immigrants. The findings of this study can be valuable for healthcare services supporting West African immigrants living in the UK.

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Type 2 Diabetes Management: the impact of urbanization

City Healthcare ◽

10.47619/2713-2617.zm.2020.v1i2;76-88 ◽

2021 ◽

Vol 1 (2) ◽

pp. 76-88

Author(s):

Liudmila L. Kamynina ◽

Natalya P. Chernus

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Diabetes Management ◽

Urban Traffic ◽

Therapeutic Education ◽

Metabolic Memory ◽

Sports Organization ◽

Impact Of Urbanization ◽

The Impact

Management for Type 2 Diabetes Mellitus (T2DM) is connected with urbanization because 2/3 of T2DM-patients live in towns, that is reflected in the term «urban diabetes». The T2DM-onset and T2DM-progression are depended not only on complex interaction of modified and non-modified risk factors, but also and sociodemographic determinants (and its modification at municipal level allowed to neutralize the unfavorable risk factors of T2DM&obesity. The urban non-rational food, disturbance of circadian rhythm, low T2DM-pths compliance stimulate onset of obesity, deterioration of glycemic control, high postprandial hyperglycemia, glucolipotoxicity, epigenetic changes and negative metabolic memory. Meanwhile the city politics may affect to the non-modified T2DM-risk factors at carrying the municipal policy directed to the rational catering, mass sports, organization of recreational zones, decrease of excessive urban traffic, improvement of ecology. The paper considers the features of migration to urban, religious fasting, COVID at the urban T2DM. The «urban diabetes» must be considered at therapeutic education and affected to form the active T2DM-pts-management.

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A secondary qualitative analysis exploring the emotional and physical challenges of living with type 2 diabetes

British Journal of Diabetes ◽

10.15277/bjd.2021.309 ◽

2021 ◽

Author(s):

Michelle Hadjiconstantinou ◽

Helen Eborall ◽

Jacqui Troughton ◽

Noelle Robertson ◽

Kamlesh Khunti ◽

...

Keyword(s):

Type 2 Diabetes ◽

Qualitative Analysis ◽

Diabetes Management ◽

Well Being ◽

Daily Routine ◽

Structured Interviews ◽

Biographical Disruption ◽

Emotional Challenges ◽

The Impact

Background: Many feel that their new identity as ‘someone living with diabetes’ does not fit with their biography. Some individuals may be able to re-assess life goals, adapt their identity and adjust to living with type 2 diabetes mellitus (T2DM). For others, the biographical disruption experienced with their condition may negatively affect their emotional well-being and identity. Aim: To conceptualise and explore the emotional challenges experienced living with T2DM, using biographical disruption as analytical references. Design and setting: Secondary qualitative analysis of data collected from 31 semi-structured interviews. Method: Semi-structured interviews were conducted with people with T2DM in England. Data analysis was informed by constant comparative techniques. Results: People with T2DM undergo a cognitive process when their biography suddenly becomes interrupted. Suboptimal T2DM can bring a feeling of loss of control over one’s future, and loss of independence. What used to be perceived as ‘normal’ is now perceived as something that requires regular management, negatively impacting their daily routine and ability to carry out activities that once used to be effortless. Conclusions: Living with T2DM that is socially stigmatised can lead to poor well-being and may disturb one’s life biography. Strategies must take place to bring awareness to healthcare professionals of the impact and disruption that T2DM can have on an individual’s biography, identity and diabetes management.

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GM Diabetes My Way: Digital interventions supporting self-care in people with type 2 diabetes across Greater Manchester. A study Protocol. (Preprint)

10.2196/preprints.26237 ◽

2020 ◽

Author(s):

Joanna Goldthorpe ◽

Thomas Allen ◽

Joanna Brooks ◽

Evangelos Kontopantelis ◽

Fiona Holland ◽

...

Keyword(s):

Type 2 Diabetes ◽

Clinical Decision Making ◽

Diabetes Management ◽

Personal Health Record ◽

Economic Benefits ◽

Self Management ◽

Test Bed ◽

Digital Interventions ◽

The Impact

BACKGROUND Digital diabetes management systems have the potential to deliver cost-effective self-management support. DiabetesMyWay (DMW) is a platform for an open access website that includes a variety of multimedia resources including offering patients access to their clinical data in the form of an electronic personal health record. DMW aims to improve both the outcomes and experience of people with T2D, and provide them with a single care record which can be shared with their clinicians to support consultations, clinical decision making, care planning and self-management advice. OBJECTIVE The objective of this study is to evaluate the effectiveness of DMW and to explore acceptability to patients and clinicians METHODS A consensus approach to recruitment will be taken; all adults registered with type 2 diabetes, registered with a GP in the study area will be eligible. We will take a mixed methods approach to data collection analysis. RESULTS The primary outcome for effectiveness will be HbA1c value post intervention in participants and controls receiving usual care; a qualitative exploration of acceptability and a cost effectiveness evaluation. CONCLUSIONS Digital interventions have potential to transform self-management of T2D and deliver major clinical, psychological and economic benefits. This test bed project aims to assess the impact of a range of digital interventions delivered through DiabetesMyWay in an ethnically and socially diverse group of people with type two diabetes in Greater Manchester.

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The Impact of Family Support on Medication Adherence and Glycemic Control of Type 2 Diabetes Outpatients in a Nigerian Tertiary Hospital

Journal of Pharmaceutics and Therapeutics ◽

10.18314/jpt.v5i1.1653 ◽

2019 ◽

pp. 295-300

Author(s):

Chigozie Gloria Anene-Okeke ◽

Maxwell Ogochukwu Adibe ◽

Chinwe Victoria Ukwe ◽

Cletus Nze Aguwa

Keyword(s):

Type 2 Diabetes ◽

Medication Adherence ◽

Glycemic Control ◽

Family Support ◽

Diabetes Management ◽

Statistical Significance ◽

Fasting Blood Glucose ◽

Self Care ◽

The Impact

Background: Diabetes management rarely target family support as a means of promoting diabetes self-care behaviour among adults. The potential influence of family member on individuals with Type 2 diabetes has not been fully explored. The study aims to examine the impact of family support on medication adherence and glycemic control of their Type 2 diabetes out-patients in a tertiary hospital.Methods: The study was a prospective cross-sectional survey conducted on Type 2 diabetes out-patients attending endocrinology clinic at the University of Nigeria Teaching Hospital (UNTH) between October 2013 and April 2014. The Diabetes Family Behavioral Checklist (DFBC-13) was used to assess family support while the MMAS-8 (Morisky medication Adherence Scale) was used to assess medication adherence. Fasting blood glucose readings were obtained from patients’ case files.Data were analysed using SPSS (Statistical package for social sciences) version 16 and level of statistical significance set at p<0.05. Result: A total number of 250 patients were assessed. The mean score for family support was 42 of 65 (range 13 to 65). Family support score (diet, glucose, exercise, diabetic self-care) associated with educational status (socio-demographic characteristics) r = 0.171** p = 0.007. Family support was inversely correlated to adherence and glycemic control (-0.161**, P = 0.011, r = -0.098, p = 0.147) respectively. Medication adherence was low as only 1.6% of the respondents adhered to their medication.Conclusion: Family support had little influence on medication adherence and glycemic control.

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