scholarly journals Barriers to dietary modifications for people living with type 2 diabetes in a rural indigenous Guatemalan community

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Julia Wilson ◽  
James Svenson ◽  
Sean Duffy ◽  
Jessica Schmidt
Keyword(s):  
Type 2 Diabetes ◽  
Rural Communities ◽  
Formal Education ◽  
Fruits And Vegetables ◽  
Cultural Barriers ◽  
Convenience Sample ◽  
Local Access ◽  
Food Expenditure ◽  
Dietary Modifications

In Guatemala, the prevalence of diabetes continues to increase with a disproportionate burden falling on indigenous rural communities. In this study, we assessed barriers to making dietary modifications for people living with type 2 diabetes in a rural indigenous Guatemalan population. Structed interviews (n=32) were conducted with participants selected from a convenience sample of adults with type 2 diabetes living in villages in and around San Lucas Tolimán, Guatemala. Frequencies were calculated for closed-ended questions and content analysis was used to evaluate open-ended questions. Most participants (81%) were women with low-levels of formal education and average daily food expenditure of just over $1 USD. The majority of participants were able to identify foods important in a diabetic diet, however, with significant barriers to making dietary modifications. Commonly cited perceived barriers included high costs of food due to travel and storage, inadequate local access to fresh fruits and vegetables and incompatibility with traditional diet. Several structural and cultural barriers exist to prevent dietary modifications for people living with type 2 diabetes in this rural indigenous population.

Relationship between medication adherence and psychosocial adjustment in patients with type 2 diabetes: A cross-sectional study

2020 ◽  
Vol 40 (3) ◽  
pp. 116-122
Author(s):  
Duygu Kes ◽  
Feray Gökdoğan
Keyword(s):  
Type 2 Diabetes ◽  
Psychosocial Adjustment ◽  
Large City ◽  
Psychosocial Care ◽  
Self Report ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Adherence To Medication ◽  
The Relationship

Adherence to drug treatment is a multidimensional concept. It is affected by many factors, such as physiological, psychological, family, environmental and social conditions. However, relatively little is known about the relationship between adherence to medication and psychosocial adjustment. The aim was to explore the relationship between adherence to antidiabetic drugs and the psychosocial adjustment of patients with type 2 diabetes mellitus. This cross-sectional descriptive correlational study was conducted between March and June 2018. A convenience sample of participants was recruited from seven internal disease outpatient clinics at a public tertiary hospital, located in a large city that serves as a gateway to nearby rural and urban areas in the north-west region of Turkey. Data were collected using the Adherence to Refills and Medications Scale (ARMS-7), and the Psychosocial Adjustment to Illness Scale–Self Report (PAIS–SR). This study is reported in accordance with STROBE. Pearson’s correlation analysis found a significant weak positive correlation between all domains of the PAIS–SR and the total scores on the ARMS‐7. The participants’ scores on medication refill were found to be significantly and positively correlated with all of the PAIS–SR domain scores except the sexual relationships domain. Psychosocial care could play a crucial role in improving drug regimen adherence among patients with diabetes. Therefore, nurses should integrate psychosocial care into daily practice.

A Prospective, Non-randomized Feasibility and Preliminary Efficacy Study of a Telemedicine-Enabled Co-management Intervention for Adults With Type 2 Diabetes and Moderate Anxiety and/or Depression

2021 ◽  
Vol 47 (2) ◽  
pp. 144-152
Author(s):  
Michelle F. Magee ◽  
Stacey I. Kaltman ◽  
Mihriye Mete ◽  
Carine M. Nassar
Keyword(s):  
Mental Health ◽  
Type 2 Diabetes ◽  
Management Program ◽  
Post Intervention ◽  
Convenience Sample ◽  
Intervention Delivery ◽  
Management Intervention ◽  
Moderate Depression ◽  
Patient Health

Purpose The primary aim of this pilot study was to examine the feasibility of codelivering a mental health intervention with an evidence-based type 2 diabetes (T2DM) boot camp care management program. The preliminary impact of participation on symptom scores for depression and anxiety and A1C was also examined. Methods This was a 12-week, non-randomized pilot intervention conducted with a convenience sample of adults with uncontrolled T2DM and moderate depression and/or anxiety at an urban teaching hospital. Co-management intervention delivery was via in-person and telehealth visits. Participants were assessed at baseline and 90 days. Results Participants (n = 18) were African American, majority female (83%), and age 50.7 ± 13.4 years. Significant improvements in mental health outcomes were demonstrated, as measured by a reduction in Patient Health Questionnaire − 9 scores of 2.4 ± 2.9 ( P = .01) and in Generalized Anxiety Disorder − 7 scores of 2.3 ± 1.9 ( P = .001). The pre-post intervention mean A1C improved by 3.4 ± 2.1 units from 12% ± 1.4% to 8.5% ± 1.7% ( P < .001). Conclusion The data generated in this pilot support the feasibility of delivering a diabetes and mental health co-management intervention using a combination of in-person and telemedicine visits to engage adults with T2DM and coexisting moderate depression and/or anxiety. Further research is warranted.

scholarly journals Traditional food taboos and practices during pregnancy, postpartum recovery, and infant care of Zulu women in northern KwaZulu-Natal

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Mmbulaheni Ramulondi ◽  
Helene de Wet ◽  
Nontuthuko Rosemary Ntuli
Keyword(s):  
Rural Communities ◽  
Formal Education ◽  
Fruits And Vegetables ◽  
Infant Care ◽  
Leafy Vegetables ◽  
Traditional Food ◽  
Food Taboos ◽  
Pregnancy And Postpartum ◽  
Kwazulu Natal ◽  
Postpartum Recovery

Abstract Background Traditional practices and beliefs influence and support the behavior of women during pregnancy and childbirth in different parts of the world. Not much research has been conducted to examine whether and how cultural traditions continue to shape maternity experiences of Zulu women. The aim of this study is to establish the extent at which women in certain rural communities adhere to traditional food taboos and practices during pregnancy, postpartum recovery, and infants feeding, in comparison to what is recommended by health care workers. Methods A survey was conducted in the rural northern KwaZulu-Natal between 2017 and 2020. A total of 140 women between the ages of 18 and 90 years were interviewed and they were chosen purposively based on their experiences in pregnancy, postpartum recovery, infant care, and their willingness to share the knowledge. Data were analyzed using descriptive statistics. Results Most (64%) of the participants said that they adhered to these cultural food taboos and practices. The most common foods avoided were certain fruits [mango, naartjie, orange, papaya, and peach], butternut, eggs, sweets (sugar, commercial juice, sweet food, and honey), chili, ice, and alcohol. The most recommended foods during pregnancy were leafy vegetables, fruits (except the avoided ones), liver, and fish. For postpartum recovery, women mostly consumed soft porridge, all fruits and vegetables, beetroot, and tea. Food not allowed for children younger than 2 years included meat, sugar and sweets, and chewable foods. Conclusion Differences on food taboos and practices between participants who received formal education and those who did not received it were insignificant. The beliefs about the detrimental effects of some foods were not backed up by scientific research. Restriction of some orange/yellow colored fruits during pregnancy that are rich in vitamin A and/or C may affect daily requirements of these micronutrients, and the foods recommended during pregnancy and postpartum period would not provide all the essential nutrients required for successful pregnancy. However, some of the food taboos would protect women from unhealthy eating. Our findings provide a basis for developing culturally appropriate nutritional mediation programs for Zulu women with a view to provide effective nutritional counseling.

scholarly journals Gender Differences in Lay Knowledge of Type 2 Diabetes Symptoms Among Community-dwelling Caucasian, Latino, Filipino, and Korean Adults - DiLH Survey

2014 ◽  
Vol 40 (6) ◽  
pp. 778-785 ◽  
Author(s):  
Yoshimi Fukuoka ◽  
Melinda S. Bender ◽  
JiWon Choi ◽  
Prisila Gonzalez ◽  
Shoshana Arai
Keyword(s):  
Type 2 Diabetes ◽  
Gender Differences ◽  
Multiple Logistic Regression Analysis ◽  
Signs And Symptoms ◽  
Korean Americans ◽  
Community Dwelling ◽  
Confounding Factors ◽  
Convenience Sample ◽  
Lay Knowledge

Purpose The purpose of this study was to explore gender differences in lay knowledge of type 2 diabetes symptoms among community-dwelling Caucasian, Latino, Filipino, and Korean Americans. Design and Methods A cross-sectional survey was administered to a convenience sample of 904 adults (172 Caucasians, 248 Latinos, 234 Koreans, and 250 Filipinos) without diabetes at community events, community clinics, churches, and online in the San Francisco Bay Area and San Diego from August to December 2013. Participants were asked to describe in their own words signs and/or symptoms of diabetes. A multiple logistic regression analysis was performed to examine the association of lay symptom knowledge with gender after controlling for potential confounding factors. Results Overall, the average age of the sample populations was 44 (SD ±16.1) years, 36% were male, and 58% were married. Increased thirst/dry mouth following increased urinary frequency/color/odor and increased fatigue/lethargy/low energy were the most frequently reported signs and symptoms (19.8%, 15.4%, and 13.6%, respectively). After controlling for known confounding factors, women were 1.6 (95% confidence interval, 1.2-2.3, P = .004) times more likely than men to report at least 1 diabetes symptom. However, this gender difference in knowledge of diabetes signs and symptoms did not significantly differ across Caucasians, Latinos, Filipinos, and Korean Americans ( P = .87). Conclusion The findings underscore the importance of improving public knowledge and awareness of signs and symptoms of diabetes, particularly in men.

scholarly journals Translation and Validation of the Patient Activation Measure in Portuguese People with Type 2 Diabetes Mellitus

2018 ◽  
Vol 31 (7-8) ◽  
pp. 382 ◽  
Author(s):  
Liliana Laranjo ◽  
Vera Dias ◽  
Carla Nunes ◽  
Dagmara Paiva ◽  
Bill Mahoney
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Psychometric Properties ◽  
Rating Scale ◽  
Patient Activation ◽  
Future Research ◽  
Convenience Sample ◽  
European Portuguese ◽  
Patient Activation Measure

Introduction: Management of diabetes mellitus is largely dependent on patients’ active participation in care. The ‘Patient Activation Measure 13’ assesses patients’ knowledge, skills, and confidence in self-care. We aimed to translate, culturally adapt, and validate the ‘Patient Activation Measure 13’ to Portuguese, in people with type 2 diabetes.Material and Methods: The translation and cultural adaptation occurred in six phases. A convenience sample of people with type 2 diabetes was recruited from the waiting rooms of a diabetes outpatient centre in Lisbon, between March and April 2014. The questionnaire was self-administered; medical records were reviewed to obtain glycated haemoglobin levels. Main statistical analyses were based on the Rasch rating scale model.Results: The response rate for the final questionnaire was 76%. Rasch analysis was conducted on 193 respondents. Respondents had a mean age of 67.1 (SD 10.1) years, 42.7% were women, and the mean patient activation measure score (0 - 100) in the sample was 58.5 (SD 10.1). The sample was low to moderate in terms of activation: 40.4% were low in activation (levels 1 and 2), 49.7% were in level 3, and 9.8% were in level 4, the highest level of activation. All items had good fit and the response categories functioned well. Item reliability was 0.97 and person reliability was between 0.77 (real) and 0.83 (model). Discussion: The ‘Patient Activation Measure 13’ was translated and culturally adapted to European Portuguese and validated in people with diabetes, showing good psychometric properties. Future research should aim at evaluating test-retest reliability of the Portuguese ‘Patient Activation Measure 13’, and exploring its ability to measure changes in activation over time.Conclusion: The ‘Patient Activation Measure 13’ is now available in European Portuguese and has good psychometric properties. 

scholarly journals Profiles of Polyphenol Intake and Type 2 Diabetes Risk in 60,586 Women Followed for 20 Years: Results from the E3N Cohort Study

Nutrients ◽  
2020 ◽  
Vol 12 (7) ◽  
pp. 1934
Author(s):  
Nasser Laouali ◽  
Takiy Berrandou ◽  
Joseph A. Rothwell ◽  
Sanam Shah ◽  
Douae El Fatouhi ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cohort Study ◽  
Fruits And Vegetables ◽  
Cox Regression ◽  
Joint Effect ◽  
Varied Diet ◽  
Polyphenol Intake ◽  
The Individual ◽  
Daily Intakes

Most studies on dietary polyphenol intake and type 2 diabetes (T2D) risk have focused on total or specific subclasses of polyphenols. Since polyphenols are often consumed simultaneously, the joint effect of an intake of multiple subclasses should be explored. We aimed to identify profiles of the dietary polyphenol subclasses intake associated with T2D. A total of 60,586 women from the Etude Epidémiologique auprès de femmes de l’Education Nationale (E3N) cohort study were followed for 20 years between 1993 and 2014. T2D cases were identified and validated. The individual energy-adjusted daily intakes of 15 subclasses of polyphenols were estimated at baseline using a food frequency questionnaire and the PhenolExplorer database. We used Bayesian profile regression to perform the clustering of the covariates by identifying exposure profiles of polyphenol intakes and, simultaneously, link these to T2D risk by using multivariable Cox regression models. We validated 2740 incident T2D cases during follow-up, and identified 15 distinct clusters with different intake profiles and T2D risk. When compared to the largest cluster (n = 6298 women), higher risks of T2D were observed in three of those clusters, which were composed of women with low or medium intakes of anthocyanins, dihydroflavonols, catechins, flavonols, hydroxybenzoic acids, lignans, and stilbenes. One cluster (n = 4243), characterized by higher intakes of these polyphenol subclasses, exhibited lower T2D risk when compared to the reference cluster. These results highlight the importance of a varied diet of polyphenol-rich foods such as nuts, fruits, and vegetables to prevent T2D risk.

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