scholarly journals Perception towards Insulin Therapy and Factors Related to Insulin Refusal among Insulin Naive Type 2 Diabetes Mellitus Patients in Primary Care Clinics PKD Lipis

2021 ◽  
Vol 1 (2) ◽  
pp. 70-78
Author(s):  
Noralina Zakaria ◽  
Narasimman Baskaran ◽  
Wan Lin Lim

Introduction: Insulin is one of the suggested treatments to prevent and reduce long-term diabetes complications. However, due to many factors such as socio-demographic factors, many Type 2 diabetes mellitus patients refuse this treatment. This study aimed to determine perception towards insulin among naive Type 2 diabetes mellitus patients, to calculate the prevalence of rejecting insulin therapy, and to find out factors related to the refusal. Materials and methods: This cross-sectional study involved 188 insulin naive Type 2 diabetes mellitus patients attending five primary health clinics in Lipis district, Pahang from October to November 2017. A five-point Likert Scale was used to determine perception towards insulin therapy and the Chi-square test was used to assess the proportion of acceptance of the therapy. Simple and multiple logistic regressions were utilised to study the associated factor(s). Results: Mean score of 60.5 ± 8.2 pointed towards a negative appraisal of insulin therapy. Embarrassment to inject in public (69.1%) and concern of frequent hypoglycaemia (52.7%) were the most common perception. Nearly half of the respondents (46.3%) refused insulin therapy upon suggestion. After adjusting the variables using multiple logistic regressions, only gender (Adjusted OR=0.20, 95% CI=0.10-0.40, p<0.001), educational level (Adjusted OR=0.17, 95% CI=0.06-0.50, p=0.001), age (Adjusted OR=1.04, 95% CI=1.01-1.08, p=0.012) and glycated haemoglobin level (Adjusted OR=1.33, 95% CI=1.07-1.67, p=0.013) remained significant. Conclusion: In conclusion, insulin refusal among insulin naive patients was common in Lipis with an overall negative perception towards therapy. By tailoring strategies according to the patient’s factors such as gender, educational level, age, and glycated haemoglobin level, the insulin refusal rate might decrease in the future.

2015 ◽  
Vol 20 (1) ◽  
pp. 2
Author(s):  
S. Thillainathan ◽  
N. Pratheep ◽  
I.U.K. Marasinghe ◽  
K. Karunayokiny ◽  
K.P. Gunasinghe ◽  
...  

Author(s):  
Mrunal S. Phatak ◽  
Tara G. Chawla ◽  
Pallavi S. Phatak

Background: In this modern era stress is a commonly seen phenomenon. Stress affects physiological equilibrium leading to many pathologic conditions including endocrine disorders like diabetes mellitus. Physiological responses to stress including increased glucose production, glucose mobilisation and insulin resistance could partially mediate this risk. Meditation is a behavioural phenomenon which can be used to cause autonomic nervous system alterations and help in reducing stress and its effects.Methods: In this cross-sectional study 60 patients of type 2 diabetes mellitus (T2DM) were divided into 2 groups, 30 patients who are practicing Raja yoga meditation for more than 5 years and their glycemic status was compared with the glycemic status of 30 patients of T2DM who did not practice any form of yogic meditation.Results: Blood glucose level and glycated haemoglobin levels were significantly lower in yoga practitioners. Lipid profile showed significant reduction in total cholesterol and serum triglycerides.Conclusions: Thus, a better glycaemic control is achieved with regular practice of Raja yoga meditation which helps in maintaining optimal level of autonomic equilibrium at rest as well as during exposure to stress.


2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Fenqin Chen ◽  
Shuai Xu ◽  
Yingfang Wang ◽  
Feng Chen ◽  
Lu Cao ◽  
...  

Aims. Sarcopenia is a common condition in older individuals, especially in the elderly with type 2 diabetes mellitus (T2DM). The aim of the present study was to examine the risk factors for sarcopenia in elderly individuals with T2DM and the effects of metformin. Methods. A total of 1732 elderly with T2DM were recruited to this cross-sectional observational study, and we analyzed the data using logistic regression analyses. Skeletal muscle mass, grip strength, and usual gait speed were measured to diagnose sarcopenia according to the criteria of the Asian Working Group for Sarcopenia, combined with expert consensus on sarcopenia in China. Results. The overall prevalence of sarcopenia was 10.37% of the participants. In the multivariate analysis, sex, age, educational level, and BMI were risk factors for sarcopenia, with women more likely to develop sarcopenia relative to men ( OR = 2.539 , 95% CI = 1.475 –4.371; P < 0.05 ). We observed that sarcopenia increased with age and decreased with increasing BMI and educational level ( P < 0.05 ). Participants who took metformin alone or combined with other drugs exhibited a lower risk for sarcopenia than those who took no medication ( OR = 0.510 , 95% CI = 0.288 –0.904 and OR = 0.398 , 95% CI = 0.225 –0.702, respectively; P < 0.05 ). Conclusions. We showed that being female and at an older age, lower educational level, and lower BMI were risk factors for sarcopenia in elderly T2DM and that metformin acted as a protective agent against sarcopenia in these patients.


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 112-LB ◽  
Author(s):  
RONAN ROUSSEL ◽  
SANTIAGO DURAN-GARCIA ◽  
YILONG ZHANG ◽  
SUNERI SHAH ◽  
CAROLYN DARMIENTO ◽  
...  

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 2393-PUB
Author(s):  
KENICHIRO TAKAHASHI ◽  
MINORI SHINODA ◽  
RIKA SAKAMOTO ◽  
JUN SUZUKI ◽  
TADASHI YAMAKAWA ◽  
...  

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 910-P
Author(s):  
YO KOHATA ◽  
MAKOTO OHARA ◽  
TOMOKI FUJIKAWA ◽  
HIROE NAGAIKE ◽  
HIDEKI KUSHIMA ◽  
...  

2017 ◽  
pp. 35-44
Author(s):  
Dinh Toan Nguyen

Background: Studies show that diabetes mellitus is the greatest lifestyle risk factor for dementia. Appropriate management and treatment of type 2 diabetes mellitus could prevent the onset and progression of mild cognitive impairment to dementia. MoCA test is high sensitivity with mild dementia but it have not been used and studied widespread in Vietnam. Aim: 1. Using MoCA and MMSE to diagnose dementia in patients with type 2 diabetes mellitus. 2. Assessment of the relationship between dementia and the risk factors. Methods: cross-sectional description in 102 patients with type 2 diabetes mellitus. The Mini-Mental State Examination(MMSE) and the Montreal Cognitive Assessment (MoCA) were used to assess cognitive function. The diagnosis of dementia was made according to Diagnostic and Statistical Manual of Mental Disorders. Results: The average value for MoCA in the group of patients with dementia (15.35 ± 2.69) compared with non-dementia group (20.72 ± 4.53). The sensitivity and specificity of MoCA were 84.8% and 78.3% in identifying individuals with dementia, and MMSE were 78.5% and 82.6%, respectively. Using DSMIV criteria as gold standard we found MoCA and MMSE were more similar for dementia cases (AUC 0.871 and 0.890). The concordance between MoCA and MMSE was moderate (kappa = 0.485). When considering the risk factors, the education,the age, HbA1c, dyslipidemia, Cholesterol total related with dementia in the type 2 diabetes. Conclusion: MoCA scale is a good screening test of dementia in patients with type 2 diabetes mellitus.When compared with the MMSE scale, MoCA scale is more sensitive in detecting dementia. Key words: MoCA, dementia, type 2 diabetes mellitus, risk factors


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