scholarly journals Self-monitoring of blood glucose in Black Caribbean and South Asian Canadians with non-insulin treated Type 2 diabetes mellitus: a qualitative study of patients’ perspectives

2021 ◽  
Author(s):  
Enza Gucciardi ◽  
Mariella Fortugno ◽  
Andrea Senchuk ◽  
Heather Beanlands ◽  
Elizabeth McCay ◽  
...  

Background: To examine the views and current practice of SMBG among Black Caribbean and South Asian individuals with non-insulin treated Type 2 diabetes mellitus. Methods: Twelve participants completed semi-structured interviews that were guided by the Health Belief Model and analyzed using thematic network analysis. Results: The frequency of monitoring among participants varied from several times a day to once per week. Most participants expressed similar experiences regarding their views and practices of SMBG. Minor differences across gender and culture were observed. All participants understood the benefits, but not all viewed SMBG as beneficial to their personal diabetes management. SMBG can facilitate a better understanding and maintenance of self-care behaviours. However, it can trigger both positive and negative emotional responses, such as a sense of disappointment when high readings are not anticipated, resulting in emotional distress. Health care professionals play a key role in the way SMBG is perceived and used by patients. Conclusion: While the majority of participants value SMBG as a self-management tool, barriers exist that impede its practice, particularly its cost. How individuals cope with these barriers is integral to understanding why some patients adopt SMBG more than others.

2021 ◽  
Author(s):  
Enza Gucciardi ◽  
Mariella Fortugno ◽  
Andrea Senchuk ◽  
Heather Beanlands ◽  
Elizabeth McCay ◽  
...  

Background: To examine the views and current practice of SMBG among Black Caribbean and South Asian individuals with non-insulin treated Type 2 diabetes mellitus. Methods: Twelve participants completed semi-structured interviews that were guided by the Health Belief Model and analyzed using thematic network analysis. Results: The frequency of monitoring among participants varied from several times a day to once per week. Most participants expressed similar experiences regarding their views and practices of SMBG. Minor differences across gender and culture were observed. All participants understood the benefits, but not all viewed SMBG as beneficial to their personal diabetes management. SMBG can facilitate a better understanding and maintenance of self-care behaviours. However, it can trigger both positive and negative emotional responses, such as a sense of disappointment when high readings are not anticipated, resulting in emotional distress. Health care professionals play a key role in the way SMBG is perceived and used by patients. Conclusion: While the majority of participants value SMBG as a self-management tool, barriers exist that impede its practice, particularly its cost. How individuals cope with these barriers is integral to understanding why some patients adopt SMBG more than others.


2016 ◽  
Vol 11 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Stephan Spat ◽  
Klaus Donsa ◽  
Peter Beck ◽  
Bernhard Höll ◽  
Julia K. Mader ◽  
...  

Background: Diabetes management requires complex and interdisciplinary cooperation of health care professionals (HCPs). To support this complex process, IT-support is recommended by clinical guidelines. The aim of this article is to report on results from a clinical feasibility study testing the prototype of a mobile, tablet-based client-server system for computerized decision and workflow support (GlucoTab®) and to discuss its impact on hypoglycemia prevention. Methods: The system was tested in a monocentric, open, noncontrolled intervention study in 30 patients with type 2 diabetes mellitus (T2DM). The system supports HCPs in performing a basal-bolus insulin therapy. Diabetes therapy, adverse events, software errors and user feedback were documented. Safety, efficacy and user acceptance of the system were investigated. Results: Only 1.3% of blood glucose (BG) measurements were <70 mg/dl and only 2.6% were >300 mg/dl. The availability of the system (97.3%) and the rate of treatment activities documented with the system (>93.5%) were high. Only few suggestions from the system were overruled by the users (>95.7% adherence). Evaluation of the 3 anonymous questionnaires showed that confidence in the system increased over time. The majority of users believed that treatment errors could be prevented by using this system. Conclusions: Data from our feasibility study show a significant reduction of hypoglycemia by implementing a computerized system for workflow and decision support for diabetes management, compared to a paper-based process. The system was well accepted by HCPs, which is shown in the user acceptance analysis and that users adhered to the insulin dose suggestions made by the system.


2021 ◽  
Vol 34 (2) ◽  
pp. 144-146
Author(s):  
Ulaş Serkan Topaloğlu ◽  
Esma Eren ◽  
Yasin Şimşek

Research on pharmacological therapies for the treatment and prevention of Coronavirus Disease 2019 (COVID-19) is limited in patients with Type 2 Diabetes Mellitus (T2DM). In this case, diabetes management of a 51-year-old male patient who was followed up and treated with COVID-19 diagnosis in the pandemic clinic is presented. While metformin (2000 mg/day) oral therapy was continued, insulin glargine U100 (IGlar100) was added to the treatment subcutaneously. In addition, enoxaparin, hydroxychloroquine, azithromycin were started to be administered to the patient. During follow-up, respiratory distress and tachypnea (26 breaths/min), high fever (38.3oC), increased CRP (42 mg/dL), and decreased oxygen saturation (91%) were detected. Favipiravir was added to the treatment, and metformin was stopped due to possible lactic acidosis risk. IGlar300 treatment with more potency effect and lower risk of hypoglycaemia was initiated while IGlar100 was discontinued. In the follow-ups, titration was provided with IGlar300 to keep fasting blood glucose between 100-140 mg/dL and postprandial one between 140-180 mg/dL. In the treatment for this purpose, a maximum of 34 units/day insulin was needed. Capillary blood sugar monitoring was revised every 12 hours and then once a day. As the infection was brought under control, the required dose of IGlar300 decreased to 14 units/day. After diabetes training with a video phonecall, he was discharged with metformin and IGlar300. IGlar300 may be effective against diabetes in the COVID-19 pandemic. In addition, a significant contribution can be made both to the treatment safety of the patient in a glycemic sense and to the safety of contamination by reduced contact of health care professionals.


2014 ◽  
Vol 22 (6) ◽  
pp. 980-987 ◽  
Author(s):  
Lucas Pereira de Melo ◽  
Edemilson Antunes de Campos

OBJECTIVE: to interpret the meanings patients with type 2 diabetes mellitus assign to health education groups.METHOD: ethnographic study conducted with Hyperdia groups of a healthcare unit with 26 informants, with type 2 diabetes mellitus, and having participated in the groups for at least three years. Participant observation, social characterization, discussion groups and semi-structured interviews were used to collect data. Data were analyzed through the thematic coding technique.RESULTS: four thematic categories emerged: ease of access to the service and healthcare workers; guidance on diabetes; participation in groups and the experience of diabetes; and sharing knowledge and experiences. The most relevant aspect of this study is the social use the informants in relation to the Hyperdia groups under study.CONCLUSION: the studied groups are agents producing senses and meanings concerning the process of becoming ill and the means of social navigation within the official health system. We expect this study to contribute to the actions of healthcare workers coordinating these groups given the observation of the cultural universe of these individuals seeking professional care in the various public health care services.


2019 ◽  
Vol 10 (4) ◽  
pp. 20
Author(s):  
Jelena Lewis ◽  
Tiffany Nguyen ◽  
Hana Althobaiti ◽  
Mona Alsheikh ◽  
Brad Borsari ◽  
...  

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


2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Peter R. Rehani ◽  
Hanaa Iftikhar ◽  
Motowo Nakajima ◽  
Tohru Tanaka ◽  
Zaid Jabbar ◽  
...  

5-Aminolevulinic acid (5-ALA) is a delta amino acid naturally present in every living cell of the human body. 5-ALA is produced in the mitochondria as the first product of the porphyrin synthesis pathway and composes heme; exogenously supplemented 5-ALA helps in upregulating mitochondrial functions. Mitochondrial dysfunction has been associated with the pathophysiology of diabetes mellitus. Thus, in this review, we evaluate the mechanisms of action and adverse effects of common medications used to treat type 2 diabetes mellitus as well as 5-ALA including its mechanism and possible use in diabetes management.


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