Direct Financial Cost of Diabetes Mellitus among Adult Sudanese Patients in Khartoum State 2016-2017

Author(s):  
Mahmoud Elnil ◽  
Zeinab Swaraldahab ◽  
Sulaf Ibrahim Abdelaziz

Background: Diabetes mellitus is a chronic disease with devastating short and long-term complications that affect productivity. The corner stone for diabetes care is tight glycemic control with regular follow up. To achieve this care, medications and other health care services must be available and affordable. Objective: To estimate the direct cost of diabetes mellitus care among adult patients in Khartoum state. Methods: Cross-sectional study using multi-stage sampling technique to select the facilities proportional to population size. Patients were interviewed using questionnaire. Results: The total annual cost of Diabetes was estimated to be 3820 Sudanese pound (SDG) per person. Hospitalizations fees accounted for the major portion of the cost. Forty-seven percent of the patients were admitted with diabetes related problems during the previous year. One in four of the diabetic patients had no sufficient supply of medications. Conclusion: The total annual cost was significantly lower among those with regular follow up visits than those with irregular visits (P < 0.03). Emphasis should be put on providing affordable and available health services and medication especially at PHC level.

2019 ◽  
Vol 7 ◽  
pp. 205031211986564 ◽  
Author(s):  
Behailu Hawulte Ayele ◽  
Melkamu Merid Mengesha ◽  
Tewodros Tesfa

Objectives: Diabetes mellitus is a metabolic disorder of major public health importance due to its prevalence and potential health complication. The success of long-term maintenance therapy of diabetes patients depends largely on their ability to adherence to self-care practices. Africa’s most populous country, Ethiopia, has the highest burden of diabetes mellitus. However, studies on self-care activities of diabetic patients are limited. Therefore, this study measures the level of self-care activities of diabetic patients in a follow-up clinic of public hospitals in Harar and Dire Dawa, Eastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted on 320 randomly selected diabetic patients in Harar and Dire Dawa. A standard diabetic self-care activity interview tool was used to collect the data. Data were entered into Epi-data v 3.1 and STATA v 14.2 was used for analysis. Our outcome variable, self-care activities, has three ordered categories and a robust Ordinal logistic regression was used to identify predictors. All statistical tests with p-value <0.05 were considered as statistically significant. Results: The self-care activities of study participants were rated good for 38.1% (95% confidence interval: 32.94, 43.60). Being rural residents (adjusted odds ratio = 0.38, 95% confidence interval: 0.17, 0.82), attended secondary education (adjusted odds ratio = 2.96, 95% confidence interval: 1.51, 5.78), uncontrolled blood glucose (adjusted odds ratio = 1.68, 95% confidence interval: 1.02, 2.79), and had diabetic complications (one, adjusted odds ratio = 1.91, 95% confidence interval: 1.08, 3.38; two or more, adjusted odds ratio = 4.71, 95% confidence interval: 1.81, 12.25) were significantly associated with the better diabetes mellitus self-care activities. Conclusion: Significant number of diabetes mellitus patients living in rural areas did not adhere to diabetic self-care activities. This is more evident among participants who have limited or no formal education and patients with controlled blood glucose level. Therefore, individualized diabetic lifestyle education programs in follow-up clinics should target these population groups to improve self-care.


2021 ◽  
Vol 29 (01) ◽  
pp. 6-9
Author(s):  
Javaid Hassan ◽  
Shafiq Ur Rehman ◽  
Inayat Shah ◽  
Henna Salman ◽  
Zain Ul Abideen ◽  
...  

Introduction: Prolactin is produced in man in several other tissues like brain, mammary gland, lymphocytes, spleen and thymus. The prolactin receptors are found mainly in the ovary and the mammary glands. Prolactin effects Erectile dysfunction in patients with and without Diabetes Mellitus type 2.   Objective To find out prolactin in erectile dysfunction patients with/without Diabetes Mellitus and compare the difference in prolactin levels of Erectile dysfunction patients across the two groups of diabetic and non-diabetic patients.   Methodology A comparative cross-sectional study was conducted on 100 diabetics and 100 non-diabetic patients to assess the effects of diabetes on erectile dysfunction. A convenience sampling technique was used to select patients from two hospitals. Calibrator measurements were also performed for prolactin. Independent sample t-test was performed for comparison between the two groups.   Results Majority of patients were 40-49 years old (44.5%). Erectile dysfunction (ED) was significantly more common in older age groups. Duration of ED was higher in diabetic patients compared to non-diabetics. Prolactin level was higher in diabetics. Most diabetic and non-diabetic patients (48%) had mild severity of ED, however diabetic patients had slightly more severe form of ED compared to non-diabetics.   Conclusions Erectile dysfunction is generally common in our setting. It may be associated with age and higher levels of prolactin. Moreover, Diabetic patients with erectile dysfunction have more significant deviation of these hormones as compared to their non-diabetic counterparts.  


Author(s):  
Mohammed I. M. Ahmed

Background: The level of awareness of diabetic retinopathy is considered an important factor for early diagnosis and management of diabetic retinopathy. This study aimed to assess the level of awareness of diabetic retinopathy among patients with diabetes mellitus in Khartoum, Sudan. Methods: This cross-sectional study was conducted among diabetic patients attending Zeenam and Abdullah Khalil Diabetic Centers between June and September 2018. A convenience sample of diabetic patients was used. Information on the sociodemographic characteristics of the patients, patients’ knowledge, compliance with available treatments, and routine eye examinations was collected using a semi-structured questionnaire. Patients were also asked about the barriers that may interfere with a regular eye examination. Results: A total of 200 patients were enrolled and 94 (47%) of them were female; 13% of the respondents were diagnosed with diabetic retinopathy, 31.5% were hypertensive, and 13.5% had hyperlipidemia. Additionally, 88.5% of the patients were aware that DM can affect their eyes and 87% had never been diagnosed with diabetic retinopathy. Although around 83% thought that diabetic retinopathy could lead to blindness, only 35.5% of them had undergone fundus examination by ophthalmologists. Moreover, 39% of the participants had irregular diabetes follow-up and 43% monthly follow-up. Only 31% went for regular eye check-up; however, their compliance with routine retinal assessment was poor, with a total of 72.5% of participants assuming that they have good vision and need not get their eyes checked up regularly. The chief factor that was related to increased awareness of diabetic retinopathy in the study was the level of education. Conclusion: Although a large proportion of diabetic patients in Khartoum are aware that diabetes mellitus can affect their eyes, regular retinal assessment of patients was poor, thus hindering early diagnosis and management.


2020 ◽  
Vol 2 (1) ◽  
pp. 14-18
Author(s):  
Adnan Khan ◽  
Tajamul Ahmad ◽  
Nadia Afridi ◽  
Madiha Anees ◽  
Bilal Khan

Introduction: A fall may be defined as a loss of balance, resulting in coming to rest on the ground or on another object below knee level. Fear of all or Basophobia is a condition of concern towards falls and natural fear of unable to stand or walk. Since the identification of the post-fall syndrome, fear of fall is considered the major health issue among elderly population. Therefore, this study was conducted to measure the level of fear of fall and factors which might contribute to it. Material & Methods: It was a cross sectional study conducted to measure the level of fear of fall among the diabetic patients of Hayatabad Medical Complex Peshawar. According to the inclusion criteria, participants who had age more than 40 years and diabetic history of more than 2 years were included in the study. We measured the fear of fall with age, gender and duration of diabetes mellitus. Convenient sampling technique was used for the recruitment of the participants. Data was collected by self-repored questionnaires and was analyzed by SPSS 20.0 version. Results: A total of 306 participants, 164 (53.59%) males and 142 (46.40%) female with a mean age 56.02 ± 9.68 years (mean ± sd) were recruited. The level of fear of all was high in diabetic patients in which 222 (72.5%) participants showed high, 48 (15.7%) moderate and 36 (11.8%) low concerns. Conclusion: Fear of fall is a common problem in both male and female population having diabetes mellitus. It is one of the major concerns among patients with diabetes. It has a positive relation with age, duration of DM, and insulin intake.


2019 ◽  
Vol 4 (1) ◽  
pp. 14
Author(s):  
Rika Meldy Agustina ◽  
Noor Diani ◽  
Agianto Agianto

Introduction: In patients with type 2 diabetes mellitus (DM), sufficient knowledge and behavior are important for adherence to the lifelong treatment. The aim of this study is to measure the correlation between knowledge and behavior about the treatment of DM in diabetic patients in Kelurahan Cempaka.Methods: This is a cross-sectional study using a simple random sampling technique, with a total of 60 participants. We used a questionnaire on patients’ knowledge and behavior pertaining the treatment of type 2 DM.Result: From this study, we found that there is a significant correlation between knowledge and behaviour regarding the treatment in patients with type 2 DM (p<0.001).Conclusion: Knowledge has an important role in tailoring people’s behavior to carry out appropriate treatment in order to optimize the health status.


Author(s):  
Singam Sivasankar Reddy ◽  
Syeda Rahath ◽  
Rakshitha H N ◽  
Godson K Lal ◽  
Swathy S ◽  
...  

The objective of the study was to evaluate the risk of diabetes mellitus in elderlywith age above 20 years in a hospital setting using Indian Diabetes risk score and to provide patient counselling regarding their life style modifications and health related quality of life among participants with high risk of developing diabetes.A total of 125 non diabetic patients were interviewed with a pre designed selfstructured questionnaire (IDRS). Participants were chosen voluntarily and a written consent was obtained before the administration of the questionnaire from individual patients. In our study we observed that out of 125 patients,males 26[59%]and 18[41%] females were at high risk, males 39[58.2%] and 28[41.8%] females were at moderate risk, males 5[35.7%] and 9[64.3%] females were at low risk of developing diabetes mellitus.


2020 ◽  
Vol 2020 ◽  
pp. 1-12 ◽  
Author(s):  
Oliver Okoth Achila ◽  
Millen Ghebretinsae ◽  
Abraham Kidane ◽  
Michael Simon ◽  
Shewit Makonen ◽  
...  

Objective. There is a dearth of relevant research on the rapidly evolving epidemic of diabetes mellitus (particularly Type 2 diabetes mellitus) in sub-Saharan Africa. To address some of these issues in the Eritrean context, we conducted a cross-sectional study on glycemic and lipid profiles and associated risk factors. Methods. A total of 309 patients with diabetes mellitus on regular follow-up at the Diabetic and Hypertensive Department at Halibet Regional Referral Hospital, Asmara, were enrolled for the study. Data on specific clinical chemistry and anthropomorphic parameters was collected. Chi-squared (χ2) test or Fischer’s exact test was used to evaluate the relationship between specific variables. Multivariate logistic regression (backward: conditional) was undertaken to identify the factors associated with increased odds of suboptimal values in glucose and specific lipid panel subfractions. Results. High proportions of patients (76.7%) had suboptimal levels of HbA1c with a mean±SD of 8.6%±1.36, respectively. In multivariate regression analysis, the likelihood of HbA1c≥7% was higher in patients with abnormal WHR (AOR=3.01, 95% CI, 3.01 (1.15–7.92=0.024)) and in patients without hypertension (AOR=1.97, 95% CI (1.06–3.56), p=0.021). A unit reduction in eGFR was also associated with HbA1c≥7% (AOR=0.99, 95% CI (0.98–1=0.031)). In a separate analysis, the data shows that 80.9% of the patients had dyslipidemia. In particular, 62.1% of the patients had TC≥200 mg/dL (risk factors: sex, hypertension, and HbA1c concentration), 81.6% had LDL‐C≥100 mg/dL (risk factors: sex and hypertension), 56.3% had TG≥150 (risk factors: sex, HbA1c, and waist circumference), 62.8% had abnormal HDL-C (risk factors: waist circumference), 78.3% had non‐HDL<130 mg/dL (risk factors: duration of disease, reduced estimated glomerular filtration rate, and HbA1c), and 45.3% had abnormal TG/HDL (risk factors: sex, age of patient, FPG, and waist circumference). Conclusions. The quality of care, as measured by glycemic and specific lipid targets, in this setting is suboptimal. Therefore, there is an urgent need for simultaneous improvements in both indicators. This will require evidence-based optimization of pharmacological and lifestyle interventions. Therefore, additional studies, preferably longitudinal studies with long follow-up, are required on multiple aspects of DM.


1969 ◽  
Vol 2 (2) ◽  
pp. 187-191
Author(s):  
Sahibzada Saeed Jan ◽  
Taj Muhammad Khan ◽  
Alamzeb ◽  
Izaz-urrahman ◽  
Amanullah ◽  
...  

Background: As hypertension is the most important risk factor for stroke, it is generally considered to beasymptomatic condition and require lifetime therapy which may include chemotherapy and lifestylechanges. Hypertension also clearly contributes to the risk of macrovascular disease in patients with type-IIdiabetes mellitus. Therefore, the present study was conducted to evaluate the prevalence of hypertension indiabetic and non-diabetic stroke patients in community hospital district Swat. Methodology: This was a cross-sectional study, comprised of 100 subjects, 50 were diabetic and 50 werenon-diabetic stroke patients of ages between 28 to 90 years. The blood sugar (random and fasting), bloodpressure (systolic and diastolic) of Diabetic stroke subjects were compared with Non-diabetic strokesubjects. Results: The prevalence of hypertension was significantly high in diabetic stroke subject as compared tonon-diabetic stroke subjects. Conclusion: Diabetic patients with persistently elevated blood pressure are more prone to develop stroke ascompared to non diabetic with hypertension KEYWORDS:Stroke, Diabetes mellitus, hypertension.


Author(s):  
Muhammad Zohaib Siddiq ◽  
Shahid Hussain Memon ◽  
Anwar Ali ◽  
Tabassum Almas ◽  
Atiya Razzaq ◽  
...  

Background: Previous studies have established the fact that diabetic patients are predominantly inclined towards silent myocardial infarction (SMI). The objective of the present study is to determine the incidence of SMI in diabetes mellitus (DM) patients. Methodology: In this cross-sectional study, patient data was gathered on a predesigned proforma regarding the detailed history of dyspnea, DM and its duration, chest pain either present or not. Those patients who had normal ECG labeled negative for SMI, while those who had either ST-segment elevation or ST-segment deviation on resting ECG were positive for SMI. Study was conducted at the National Institute of Cardiovascular Diseases (NICVD) Karachi- Pakistan. Results: The mean age of the enrolled patients was 54.21±8.65 (40-70) years. Out of 210, majority were female (51.90%).Overall, 94(44.76%) patients were obese, 122(58.09%) were hypertensive, 90(42.85%) had dyslipidemia and 98(46.66%) diabetic patients were smokers. There were 93 (44.3%) DM patients who had SMI. Moreover, 109(51.90%) patients had a family history of myocardial ischemia. Conclusion:  The SMI incidence among diabetic patients was found higher in local population. It is proposed that diabetic patients with demonstrated cardiovascular autonomic neuropathy must be screened for the manifestation of SMI.


2021 ◽  
Vol 11 (1) ◽  
pp. 124-132
Author(s):  
Sh Sugiharto ◽  
Wiwiek Natalya ◽  
Bambang Widjanarko Otok

Background: Evidence shows that most general practitioners have low knowledge related to diabetes self-management during Ramadan fasting. However, studies on healthcare providers’ competencies related to diabetes self-management during Ramadan fasting are still rare.Purpose: This study aimed to investigate healthcare providers’ knowledge, attitude, and perspective concerning diabetes self-management during Ramadan fasting.Methods: The study applied a cross-sectional design and was conducted in forty-one (41) community health centers in Pekalongan, Central Java, Indonesia. The study participants were medical doctors, nurses, nutritionists, pharmacists, and public health officers. The total sampling technique was used. There were 205 healthcare providers who met the inclusion criteria. Their knowledge, attitude, and perspective were assessed using a questionnaire developed by Zainudin and Hussain. The Wilcoxon test was used to analyze the data. Results: The healthcare providers’ knowledge of Ramadan fasting was very low (36.79±26.11). More than half of the respondents (53.17%) advised diabetic patients to manage diabetes in general, although specific counseling for diabetic patients related to fasting in Ramadan month was not provided (55.12%). The perspective of Ramadan fasting among healthcare providers was moderate (62.68%±30.40). The results also showed that general and safe practice knowledge significantly affected the healthcare providers’ perspective toward Ramadan fasting (Z=-12.49, p=0.000), (Z=-12.02, p=0.000), respectively. Conclusion: Healthcare providers’ knowledge and attitude concerning diabetes self-management during Ramadan fasting were low. Accordingly, this affected their perspective. It is strongly recommended that a formal Ramadan fasting management training program should be given regularly to provide appropriate consultations and services. 


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