Correlations Between Health Care Facilities Availability and Acceptance on Quality of Life in Patients with Type 2 Diabetes Mellitus

Background: Diabetes is one of the most prevalent non-communicable diseases (NCDs) all over the world and leading cause of death, disability, and economic loss. Diabetes imposes a heavy economic burden on individuals, their families and society as a whole. The aim of this study is to estimate the economic burden of type 2 diabetes mellitus (T2DM) in Bangladesh and to find association between glycemic control and Health Related Quality of Life with cost-of-illness (COI). Methodology: This will be an analytical cross-sectional cost-of-illness study. Within a specific time period participants aged ≥18 years, registered with Bangladesh Diabetic Somiti and having type 2 diabetes for more than one year will be recruited from selected hospitals inside and outside Dhaka to cover all level of health care services. A pre-tested electronic questionnaire will be used for data collection. The questionnaire will include demographic, clinical, behavioral information of the participants and all cost related information related to diabetes management during last one year. Descriptive statistics will include mean (±SD) or median (percentile) or relative frequencies (percentage) depending on the data. Two samples independent t-test or Mann-Whitney U-test, ANOVA or Kruskal-Wallis test and chi-squared tests will be used for univariate analysis. The multivariable regression analysis and bootstrap method will also be employed to analyze the relationship between the total cost of care (dependent variable) and several potential explanatory variables (independent variables). Logistic regression analysis will be performed to assess the factors affecting glycemic control and health related quality of life (HRQoL). The calculated total cost-of-illness will be projected for T2DM in Bangladesh by a mathematical modelling. Result & discussion: The results of the study will be useful as background information to forecast the economic burden of type 2 diabetes mellitus in Bangladesh and will be beneficial to conceptualize health strategies at national level. Furthermore, recognizing the factors of cost-of-illness will help both patients and health care providers to improve the management plan and cost control and hence, to have better quality of life. Evidence about the magnitude of the burden of T2DM is important for public health policymakers who are involved in making health care priorities and allocating scarce resources to facilitate the greatest benefits for type 2 diabetic people in Bangladesh. Bangladesh Journal of Medical Science Vol.18(3) 2019 p.501-507

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Community-based models of care for management of type 2 diabetes mellitus among non-pregnant adults in sub-Saharan Africa: a scoping review protocol

F1000Research ◽

10.12688/f1000research.52114.1 ◽

2021 ◽

Vol 10 ◽

pp. 535

Author(s):

Emmanuel Firima ◽

Lucia Gonzalez ◽

Jacqueline Huber ◽

Jennifer M. Belus ◽

Fabian Raeber ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Health Care ◽

Type 2 Diabetes Mellitus ◽

Scoping Review ◽

Health Care Facilities ◽

Engagement In Care ◽

Community Based ◽

Care Facilities

Background: The burden of type 2 diabetes mellitus (T2DM) is increasing in low- and middle-income countries, including sub-Sahara Africa (SSA). However, awareness of and access to T2DM diagnosis and care remain low in SSA, leading to delayed treatment, early morbidity, and mortality. Particularly in rural settings with long distances to health care facilities, community-based care models may contribute to increased timely diagnosis and care. This scoping review aims to summarize and categorize existing models of community-based care for T2DM among non-pregnant adults in SSA, and to synthesize the evidence on acceptance, clinical outcomes, and engagement in care. Method and analysis: This review will follow the framework suggested by Arskey and O’Malley, which has been further refined by Levac et al. and the Joanna Briggs Institute. Electronic searches will be performed in Medline, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Scopus, supplemented with backward and forward citation searches. We will include cohort studies, randomized trials and case-control studies that report cases of non-pregnant individuals diagnosed with T2DM in SSA who receive a substantial part of care in the community. Our outcomes of interest will be model acceptability, blood sugar control, end organ damage, and patient engagement in care. A narrative analysis will be conducted, and comparisons made between community-based and facility-based models, where within-study comparison is reported. Conclusion: Care for T2DM has become a global health priority. Community-based care may be an important add-on approach especially in populations with poor access to health care facilities. This review will inform policy makers and program implementers on different community-based models for care of T2DM in SSA, and critically appraise their acceptability and clinical outcomes. It will further identify evidence gaps and future research priorities in community-based T2DM care.

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