scholarly journals Rates and Factors Associated With Laxative Prescription Among Type 2 Diabetes Patients in Primary Care

2020 ◽  
Vol 43 (4) ◽  
pp. 20-27
Author(s):  
Kantapong Thamcharoensak ◽  
Narucha Komolsuradej ◽  
Napakkawat Buathong ◽  
Kittisak Choomalee
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Chronic Constipation ◽  
Filtration Rate ◽  
Diabetic Patients ◽  
Hospital Visit ◽  
Primary Care Unit ◽  
Factors Associated ◽  
Type 2 Dm

Background: Diabetes mellitus (DM) is a common noncommunicable disease. Several gastrointestinal symptoms such as diarrhea, chronic constipation, and fecal incontinence are often observed in DM patients; among these, chronic constipation is the most commonly reported. Given the growing prevalence of diabetes-associated chronic constipation, the problem of laxative prescribed without diagnosis of constipation among type 2 diabetes patients has been found in the primary care unit. Therefore, it should attend to investigate the rate and factors associated with laxative prescription in type 2 diabetes. Objective: To evaluate the rate and factors associated with laxative prescription in type 2 diabetic patients at the primary care unit and general practitioner outpatient clinic at Songklanagarind Hospital. Results: Overall, 386 patients diagnosed with type 2 diabetes were enrolled (55.7% female; mean age, 63.3 years; median duration of type 2 diabetes, 7 years; median visit in 5 years of each patient, 44 visits). Prevalence of laxative prescriptions was 16.6%. Rate of laxative prescriptions was 1.7% within 5 years. Patients with no diagnosis constipation according to ICD-10 about 81.2%. The statistically significant factors associated with laxative prescriptions in diabetic patients were age, number of hospital visit in 5 years, duration of type 2 DM disease, height, diastolic blood pressure, hemoglobin, hematocrit, serum uric acid, and glomerular filtration rate. Conclusions: Most laxative prescribed diabetic patients were without written diagnosis of constipation. Factors associated with laxative prescriptions were age, number of hospital visit, duration of type 2 DM disease, height, diastolic blood pressure, hemoglobin, hematocrit, serum uric acid, and glomerular filtration rate.  

scholarly journals Diabetes Self-Care Practice, and Associated Factors Among Type 2 Diabetic Patients in Public Hospitals of Tigray Region, Ethiopia

2020 ◽  
Author(s):  
Medina Abdulkadir Wehabrebi ◽  
Goitom Molalign Takele ◽  
Hiyab Teklemichael Kidane ◽  
Kahsu Gebrekirstos Gebrekidan ◽  
Birhan Gebresillassie Gebregiorgis
Keyword(s):  
Type 2 Diabetes ◽  
Self Care ◽  
Public Hospitals ◽  
Care Practice ◽  
Diabetic Patients ◽  
Care Providers ◽  
Factors Associated ◽  
Tigray Region ◽  
Care Practices

Abstract Background: The prevalence of Type 2 diabetes is increasing steadily at an alarming rate and Ethiopia is placed fourth among the top five countries of the Africa region according to the International diabetes federation. Regardless of its burden, the self-care behaviors are still unknown. This study is aimed to determine the level of diabetes self-care practice and factors associated with among Type 2 diabetes mellitus patients in public hospitals of Tigray region.Methods: Institution-based, cross-sectional study was conducted in six selected hospitals of Tigray region from January to February, 2020. Data was collected by trained nurses with a face to face interview method using Summary Diabetes Self-Care Activities (SDSCA). Bivariate and multivariate logistic regression was used to identify factors associated with self-care practices. Statistical significance was declared at P-value < 0.05.Results: A total of 570 patients with type 2 diabetes were included in this study. The mean age of the participant was 46 ± 14.6 years. Less than half (46.7%) of the participants has good diabetes self-care practices. Urban residency (AOR=2.79, 95% CI 1.858-4.205), age group above 64 years (AOR=2.384, 95% CI 1.258-4.518), not having formal education (AOR=2.616, 95% CI 1.337-4.518), having family or social support (AOR=1.878, 95% CI 1.243-2.837), duration DM above 10 years (AOR=2.325, 95% CI 1.224-4.418), having personal glucometer at home (AOR=5.9, 95% CI 2.790-12.764) were determinant factors of good diabetes self-care practice. Conclusion: the diabetes self-care practices in the region was found to be low. Health care providers might have to consider actions to act on the identified factors and improve self-care practices of the patients. Especially, focusing on caring and giving follow up services to younger adults and DM patients coming from a rural areas.

scholarly journals Relationship between homocysteine and non-dipper pattern in patients with type 2 diabetes mellitus

2012 ◽  
Vol 56 (5) ◽  
pp. 285-290 ◽  
Author(s):  
Serdal Korkmaz ◽  
Abdulkerim Yilmaz ◽  
Gürsel Yildiz ◽  
Fatih Kiliçli ◽  
Serhat Içağasioğlu
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Control Group ◽  
Diabetic Patients ◽  
Nocturnal Blood Pressure ◽  
Type 2 Dm ◽  
Significant Difference

OBJECTIVE: The rate of reduction of nocturnal blood pressure (NBP) is lesser than normal in patients with type 2 diabetes mellitus (type 2 DM). Hyperhomocysteinemia (HHC) disrupts vascular structure and function, no matter the underlying causes. The risk of development of vascular disease is greater in diabetic patients with hyperhomocysteinemia than in patients with normal homocystein levels. The aim of the study was to investigate whether there are differences of homocystein levels in dipper and non-dippers patients with type 2 DM. SUBJECTS AND METHODS: We compared 50 patients (33 females, 17 males) with type 2 DM and 35 healthy individuals (18 females, 17 males ) in a control group. Ambulatory blood pressure monitoring (ABPM) was performed and homocysteine levels were measured in all patients. RESULTS: We found that the percentage of non-dipper pattern was 72% in patients with type 2 DM and 57% in control group. In diabetic and control individuals, homocystein levels were higher in non-dipper (respectively 13.4 ± 8.1 µmol/L and 11.8 ± 5 µmol/L) than in dipper subjects (respectively, 11.8 ± 5.8 µmol/L and 10.1 ± 4.2 µmol/L), but there was no significant difference between the two groups (respectively, p = 0.545, p = 0.294). CONCLUSION: In both groups, homocystein levels were higher in non-dipper than in dipper participants, but there was no significant difference between the groups. High homocystein levels and the non-dipper pattern increases cardiovascular risk. Therefore, the relationship between nocturnal blood pressure changes and homocystein levels should be investigated in a larger study.

scholarly journals Cardiac Function in Uncomplicated Type 2 Diabetes Mellitus

2019 ◽  
Vol 18 (2) ◽  
pp. 211-215
Author(s):  
Bimal K Agrawal ◽  
Parul Jain ◽  
Saurabh Marwaha ◽  
Richa Goel ◽  
Himanshu D Kumar ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cardiac Function ◽  
Cardiac Dysfunction ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Coronary Arterial Disease ◽  
Type 2 Dm

Objective: Diabetic cardiomyopathy (DC) is a myocardial disease characterized by myocyte hypertrophy, interstitial fibrosis, protein glycosylation and intra-myocardial micro-angiopathy due to prolonged exposure of myocardial tissues to hyperglycemia in diabetes mellitus (DM) patients. Alteration in cardiac function can be non-invasively assessed via echocardiography. The early recognition of cardiac dysfunction can prevent the symptomatic heart failure in DM patients. The study aimed at evaluating cardiac function in uncomplicated type 2 diabetes mellitus. Materials And Methods: Sixty Type 2 DM patients without any feature of the coronary arterial disease (CAD), hypertension, nephropathy and respiratory illness were enrolled in the study and compared with the sixty age matched healthy controls. Echocardiographic assessment was done in all subjects to evaluate the cardiac function. Results: Diastolic dysfunction was more common in diabetic patients when compared with normal healthy population. Systolic dysfunction progresses with age of the diabetic patient. Conclusion: Echocardiography is a simple noninvasive cost effective test for detecting cardiac dysfunction in Type 2 DM patients and should be applied to detect early Left ventricular(LV) dysfunction so that corrective measures may be initiated early and cardiac functions may be preserved for long. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.211-215

scholarly journals 433 Independent impact of metabolic syndrome on left ventricular longitudinal dysfunction in type 2 diabetes mellitus

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
O Casciano ◽  
F Luciano ◽  
S Cocozza ◽  
R Sorrentino ◽  
M Lembo ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Diastolic Dysfunction ◽  
Filtration Rate ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Lv Mass ◽  
Lv Diastolic Dysfunction

Abstract Background The risk of cardiovascular (CV) disease in type 2 diabetes mellitus (T2DM) is highly heterogeneous and an adequate risk stratification is needed. CV risk mainly depends on concomitant risk factors, combined in the metabolic syndrome (MetS). Echocardiography is an useful tool for diagnosis of cardiac organ damage and CV risk stratification in T2DM. Purpose To investigate the effects of MetS on left ventricular (LV) structure and function in patients with T2DM with normal LV ejection fraction (LVEF) and without overt coronary artery disease (CAD) and heart failure symptoms/signs. Methods We prospectively recruited 384 consecutive, uncomplicated T2DM patients. All patients underwent clinical exam, blood sampling and complete echo-Doppler exam, including determination of 2D-echo derived global longitudinal strain (GLS). LV mass index ≥45 g/m^2.7 in women and ≥49 g/m^2.7 in men was used to characterize LV hypertrophy. LV longitudinal dysfunction was assumed for GLS &lt; 20% in absolute values. LV diastolic dysfunction was identified according to 2016 ASE/EACVI recommendations. MetS was defined according to NCEP-ATP III criteria. Significant CAD including previous myocardial infarction, LV systolic dysfunction (= LVEF &lt;50%), hemodinamically significant valvular heart disease, primary cardiomyopathies, permanent atrial fibrillation, glomerular filtration rate &lt;30 ml/min and inadequate echo images were exclusion criteria. The study population was divided according to presence of MetS. Results 66% of the patients (254/384) met the criteria for MetS diagnosis. They had comparable age and heart rate with controls. Diabetic patients with MetS had higher glycated haemoglobin (HbA1c) (7.2 ± 1.3 vs. 6.9 ± 1.0%, p = 0.023) and uric acid (5.5 ± 1.4 vs. 4.9 ± 1.3 mg/dl, p = 0.001) than those without, and lower glomerular filtration rate (69.5 ± 15.0 vs 74.0 ± 12,1 ml/min, p = 0.004). MetS patients showed a higher LV mass index (p &lt; 0.0001) and a greater prevalence of both LV hypertrophy (31.9 vs 12.5%, p &lt; 0.0001) and diastolic dysfunction (52.6 vs. 32.8%, p = 0.007) (Figure). T2DM patients with MetS also had lower GLS (20.6 ± 2.1 vs. 21.9 ± 2.2%, p = 0.001), with a greater prevalence of LV longitudinal dysfunction (38.2 vs. 24.7%, p = 0.049) (Figure). After adjusting for age, T2DM duration, sex, HbA1c, uric acid, LV mass index and LV diastolic dysfunction by a multiple regression analysis in the pooled population, GLS reduction was independently associated with MetS (β coefficient = -0.184, p &lt; 0.02) and LV mass index (β= -0.94, p = 0.04). Conclusion In patients with T2DM, the presence of MetS induces a greater prevalence not only of LV hypertrophy and diastolic dysfunction but also of LV longitudinal deformation impairment. GLS reduction in diabetic patients is associated with MetS independently of confounders including glycemic control and diabetic duration. Abstract 433 Figure. Rate of LV alterations according to MetS

scholarly journals Peripheral Arterial Stiffness Is Independently Associated with a Rapid Decline in Estimated Glomerular Filtration Rate in Patients with Type 2 Diabetes

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Yi-Jing Sheen ◽  
Jiann-Liang Lin ◽  
Tsai-Chung Li ◽  
Cho-Tsan Bau ◽  
Wayne Huey-Herng Sheu
Keyword(s):  
Type 2 Diabetes ◽  
Glomerular Filtration Rate ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Rapid Decline ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Peripheral Arterial ◽  
Type 2 Diabetic

Introduction. Diabetes and its vascular complications are main noncommunicable chronic diseases and major global health issues. Peripheral arterial disease (PAD) is highly prevalent in diabetes with nephropathy. We evaluated the associations of variables of arterial stiffness and the decline in estimated glomerular filtration rate (eGFR) in patients with type 2 diabetes.Materials and Methods. A total of 577 type 2 diabetic patients (mean±SD: age,63±11years) were enrolled. A rapid decline in eGFR was defined as progressively lower eGFR detected at both the 6- and 12-month follow-up visits, plus a reduction in eGFR more than 3 mL·min−1per 1.73 m2per year.Results. Higher glycated hemoglobin (HbA1c), systolic blood pressure (SBP), pulse pressure (PP), and brachial-ankle pulse wave velocity (ba-PWV) at baseline were independently associated with a rapid decline in eGFR. The adjusted odds ratios (95% confidence intervals) for a rapid decline in eGFR for ba-PWV, SBP, and PP were 1.072 (1.011–1.136), 1.014 (1.004–1.025), and 1.025 (1.008–1.041), respectively, after adjustment for gender, age, body mass index, smoking, HbA1c, and baseline eGFR in separated models.Conclusions. Ba-PWV may serve as a simple and noninvasive predictor of rapid renal function progression in type 2 diabetic patients.

scholarly journals Factors Associated with Self-Care Behavior of Elderly Patients with Type 2 Diabetes in Thailand

2021 ◽  
Vol 14 (1) ◽  
pp. 494-498
Author(s):  
Prapada Watcharanat ◽  
Kitsarawut Khuancheree ◽  
Brian Lee
Keyword(s):  
Social Support ◽  
Type 2 Diabetes ◽  
Elderly Patients ◽  
Statistical Significance ◽  
Self Care ◽  
Diabetic Patients ◽  
Factors Associated ◽  
Average Value ◽  
Care Behavior

Introduction: Diabetes belongs to the chronic disease group with an average high prevalence rate of 463 million worldwide. This research aims to investigate factors associated with self-care behavior among elderly patients with type 2 diabetes. Methods: The sample included 441 patients diagnosed with diabetes admitted to the Tambon Health Promoting Hospital in Nakhon Nayok Province. The sample size used in this study was calculated according to the sampling group of Yamane with a 95% confidence level. Data were analyzed by descriptive statistics, correlation coefficients, and multiple regression analysis at the statistical significance level of 0.05. Results: The results showed that the average value of knowledge was 9.17 (SD=2.38), and the average values of attitude and social support behavior towards diabetes were 2.72 (SD=0.64) and 1.83 (SD=0.27), respectively. The results indicated that knowledge, attitude, and social support towards diabetes showed an average of a medium level. Moreover, the average value of self-care behavior towards diabetes was 30.52 (SD= 7.19). The results indicated that the knowledge about diabetes, attitude towards diabetes, and social support towards diabetes positively affected self-care behavior towards diabetes with the statistical significance of 0.05. Conclusion: Health promotion programs for patients with diabetes should be organized to promote knowledge and awareness on proper health behavior. In order to take care of themselves, diabetic patients must first get awareness regarding diabetes and then build skills for self-care. The results obtained in the study can help diabetic patients stay healthier, reduce the manifestation of both acute and chronic complications, and improve the quality of life of the elderly with diabetes.

scholarly journals Prevalence and Genotype Distribution of Hepatitis C Virus Infection among Patients with Type 2 Diabetes Mellitus

2018 ◽  
Vol 27 (4) ◽  
pp. 308-316 ◽  
Author(s):  
Fatemeh Farshadpour ◽  
Reza Taherkhani ◽  
Mohammad Reza Ravanbod ◽  
Seyed Sajjad Eghbali
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hcv Infection ◽  
Diabetic Patients ◽  
Genotype Distribution ◽  
Type 2 Dm

Objective: This study was conducted to determine the prevalence and genotype distribution of hepatitis C virus (HCV) infection among patients with type 2 diabetes mellitus (DM). Subjects and Methods: We included 556 consecutive patients with confirmed type 2 DM attending the Diabetic Clinic of the Bushehr University of Medical Sciences and 733 nondiabetic subjects as controls. Serum levels of fasting blood sugar (FBS), alanine transaminase (ALT), aspartate transaminase (AST), total cholesterol (TCH), and triglycerides (TG) were measured by enzymatic colorimetric methods, and the presence of anti-HCV antibodies was determined by enzyme-linked immunosorbent assay. Semi-nested reverse transcriptase-polymerase chain reaction (RT-PCR) followed by sequencing was performed on all anti-HCV-seropositive samples. Data were analyzed using the Statistical Package for the Social Sciences 17, and descriptive statistics, χ2 test, Fisher exact test, and the Student t test were used for analysis. Results: The seroprevalence of HCV in the diabetic patients was 1.98% (11/556), which was higher than HCV prevalence among the nondiabetic controls (4/733, 0.54%) (p = 0.032). No significant differences in ALT, AST, FBS, TG, and TCH levels were found between the HCV-seropositive and HCV-seronegative diabetic patients, although HCV-seropositive diabetic patients tended to have higher ALT, AST, and TCH levels, but lower TG and FBS levels than HCV-seronegative patients. In logistic regression analysis, only AST levels were significantly associated with HCV seropositivity among diabetic patients. The AST level of 41–80 IU/L was the only significant predictive variable for HCV seropositivity in the diabetic patients (odds ratio, 4.89; 95% CI: 1.06–22.49; p = 0.041). Of the 11 HCV-seropositive diabetic patients, 10 (91%) had HCV viremia with genotype 3a. Conclusion: Patients with type 2 DM had a higher prevalence of HCV infection than controls, and HCV seropositivity was independent of biochemical parameters.

scholarly journals Prevalence of Hypoglycemia Among Patients With Type 2 Diabetes Mellitus in a Rural Health Center in South India

2019 ◽  
Vol 10 ◽  
pp. 215013271988063 ◽  
Author(s):  
V. Samya ◽  
Vanishree Shriraam ◽  
Aliya Jasmine ◽  
G. V. Akila ◽  
M. Anitha Rani ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Health Center ◽  
Primary Care Physicians ◽  
Diabetic Patients ◽  
High Prevalence

Introduction: One of the greatest threats to achieving tight glycemic control is hypoglycemia, which can lead to decreased drug compliance, cardiovascular events, and even mortality. There is lack of literature on this complication in the Indian setting. This study will aid the primary care physician to achieve better glycemic control of the diabetic patients and provide patient education to prevent hypoglycemia. Materials and Methods: It was a cross-sectional study in which 390 patients with type 2 diabetes mellitus getting treated in a primary health center were assessed for symptoms of hypoglycemia. Results: Prevalence of hypoglycemia was 57.44% (95% CI 52.48-62.25). Severe hypoglycemia was found in 10.7% of the patients. The first reported symptom of hypoglycemia was dizziness (72.3%). The most common etiological factor leading to hypoglycemia was missing a meal (89.3%). Females were at a significant higher risk of developing hypoglycemia (OR 1.2, 95% CI 1.04-1.3, P < .05). Conclusion: This study has established the high prevalence of self-reported hypoglycaemia in the rural settings where resources are limited to monitor the glucose levels. The high prevalence urges the need for the primary care physicians to enquire about the hypoglycemic symptoms to all diabetic patients at each visit. It is also important to educate these patients about the symptoms of hypoglycemia and the importance of reporting of such symptoms, which will help in adjusting dose and preventing future attacks.

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