scholarly journals Misconceptions about Insulin and Barriers to Insulin Initiation in Type 2 Diabetes among General Physicians in Southeast Nigeria

2020 ◽  
pp. 30-38
Author(s):  
Ejiofor Ugwu ◽  
Joseph Ojobi ◽  
Edmund Ndibuagu
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Rural Areas ◽  
Quantitative Research ◽  
Oral Glucose ◽  
Insulin Initiation ◽  
Cross Sectional ◽  
Fear Of Hypoglycemia ◽  
General Physicians

Aims: The aim of this study was to evaluate the perceptions of general physicians (GPs) regarding insulin and determine the barriers to its initiation in patients with type 2 diabetes mellitus (T2DM). Study Design: A cross-sectional, quantitative research. Place and Duration: Enugu metropolis, Southeast Nigeria, between March and November 2018. Methodology: We used structured self administered questionnaire to evaluate the perceptions of 64 GPs (45 males and 19 females) regarding insulin, and to elicit barriers to insulin initiation in subjects with T2DM. Results: The mean (SD) age of the participants was 45.5 (11.7) years and their duration of general practice ranged from 3 – 38 years. Majority were private practitioners predominantly in the rural areas. Only 15 (23.4%) respondents had ever initiated insulin for outpatient with T2DM. Fear of hypoglycemia, anticipated patients’ refusal of insulin, physician’s lack of confidence, and concerns about needle pains were among the commonly reported barriers to insulin initiation. Others were socio-economic factors including concerns about affordability of insulin and frequent glycemic monitoring, and availability of insulin storage facilities. There was a general consensus among the GPs on a number of misconceptions including that patients’ adherence to oral glucose lowering drugs eliminates the need for insulin; that insulin should be reserved as a last resort; and that once initiated, insulin therapy is lifelong. Conclusion: This study revealed that there are several physician-related barriers and misconceptions regarding insulin therapy for T2DM among GPs in Southeast Nigeria. Periodic training to improve GPs’ attitude to insulin and optimize insulin utilization in T2DM is required.

scholarly journals Insulin Adherence in Type 2 Diabetes in Mexico: Behaviors and Barriers

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Janneth Bermeo-Cabrera ◽  
Paloma Almeda-Valdes ◽  
Josefa Riofrios-Palacios ◽  
Carlos A. Aguilar-Salinas ◽  
Roopa Mehta
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Therapy ◽  
Low Socioeconomic Status ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Factors Associated ◽  
Fear Of Hypoglycemia ◽  
Insulin Omission

Objective. To investigate factors associated with insulin adherence in subjects with type 2 diabetes mellitus (T2D) attending a tertiary care centre in Mexico City. Material and Methods. Cross-sectional study, including 200 patients. Adherence to insulin therapy was measured with a medication adherence questionnaire. Sociodemographic data and factors related to insulin omission were collected and compared between the nonadherent and adherent groups. Results. We categorized 117 (58.5%) patients as nonadherent and 83 (41.5%) as adherent. Among the adherent, only 22 patients (11%) had excellent adherence to insulin therapy. The following factors were associated with nonadherence: lack of planning of daily activities (46.1%), fear of hypoglycemia (41%), economic factors (15.4%), and number of insulin applications (2.31 versus 1.76 applications per day). Conclusions. In this study, patients with type 2 diabetes attending a tertiary care referral centre showed inadequate adherence to insulin therapy. The principal factors associated with insulin omission were low socioeconomic status, fear of hypoglycemia, and a greater number of insulin applications per day.

scholarly journals Prevalence and risk factors of Type 2 diabetes in an urbanizing rural community of Bangladesh

1970 ◽  
Vol 33 (2) ◽  
pp. 48-54 ◽  
Author(s):  
Md. Mafuzar Rahman ◽  
Md. Abdur Rahim ◽  
Quamrun Nahar
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Rural Community ◽  
Rural Areas ◽  
Fasting Blood Glucose ◽  
Significant Risk ◽  
Oral Glucose ◽  
Total Prevalence

This cross-sectional study was carried out to estimate the prevalence of type 2 diabetes mellitus and its’ risk factors in an urbanizing rural community of Bangladesh. Two villages were randomly selected from the rural areas of Gazipur district and total 975 subjects (>20 years), were included following simple random procedure. Capillary blood glucose levels, fasting blood glucose (FBG) levels and 2-hour after 75 g oral glucose load (OGTT) were measured. Height, weight, waist and hip circumferences and blood pressure were measured. The study population was lean with mean body mass index (BMI) of 20.48. The total prevalence of type 2 diabetes was 8.5%, men showed higher prevalence (9.4%) compare to women (8.0%). Increasing age and higher BMI were found to be significant risk factors following both FBG and OGTT. The study has shown that prevalence of diabetes has increased in the populations who are in transitional stage of urbanization, and may indicate an epidemiological transition due to fast expanding urbanization. Keywords: Bangladesh; Diabetes; RuralDOI: 10.3329/bmrcb.v33i2.1204Bangladesh Med Res Counc Bull 2007; 33: 48-54

scholarly journals Glycaemic control in type 2 diabetes patients and its predictors: a retrospective database study at a tertiary care diabetes centre in Ningbo, China

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e019697 ◽  
Author(s):  
Jialin Li ◽  
Kaushik Chattopadhyay ◽  
Miao Xu ◽  
Yanshu Chen ◽  
Fangfang Hu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Rural Areas ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Information Management System ◽  
Cross Sectional ◽  
Poor Glycaemic Control

ObjectivesThe objectives of the study were to assess glycaemic control in patients with type 2 diabetes (T2DM) at a tertiary care diabetes centre in Ningbo, China and to determine factors that independently predict their glycaemic control.DesignRetrospective cross-sectional study using an existing database, the Diabetes Information Management System.SettingTertiary care diabetes centre in Ningbo, China.ParticipantsThe study included adult patients with T2DM, registered and received treatment at the diabetes centre for at least six consecutive months. The study inclusion criteria were satisfied by 1387 patients, from 1 July 2012 to 30 June 2017.Primary outcome measureGlycaemic control (poor was defined as glycated haemoglobin (HbA1c)>=7% or fasting blood glucose (FBG)>7.0 mmol/L).ResultsIn terms of HbA1c and FBG, the 5-year period prevalence of poor glycaemic control was 50.3% and 57.3%, respectively. In terms of HbA1c and FBG, the odds of poor glycaemic control increased with the duration of T2DM (>1 to 2 years: OR 1.84, 95% CI 1.06 to 3.19; >2 to 4 years: 3.32, 1.88 to 5.85 and >4 years: 5.98, 4.09 to 8.75 and >1 to 2 years: 2.10, 1.22 to 3.62; >2 to 4 years: 2.48, 1.42 to 4.34 and >4 years: 3.34, 2.32 to 4.80) and were higher in patients residing in rural areas (1.68, 1.24 to 2.28 and 1.42, 1.06 to 1.91), with hyperlipidaemia (1.57, 1.12 to 2.19 and 1.68, 1.21 to 2.33), on diet, physical activity and oral hypoglycaemic drug (OHD) as part of their T2DM therapeutic regimen (1.80, 1.01 to 3.23 and 2.40, 1.36 to 4.26) and on diet, physical activity, OHD and insulin (2.47, 1.38 to 4.41 and 2.78, 1.58 to 4.92), respectively.ConclusionsMore than half of patients with T2DM at the diabetes centre in Ningbo, China have poor glycaemic control, and the predictors of glycaemic control were identified. The study findings could be taken into consideration in future interventional studies aimed at improving glycaemic control in these patients.

scholarly journals Nutrient intakes and dysglycaemia in populations of West African origin

2011 ◽  
Vol 105 (2) ◽  
pp. 297-306 ◽  
Author(s):  
Simon G. Anderson ◽  
Novie Younger ◽  
Adrian H. Heald ◽  
Marshall K. Tulloch-Reid ◽  
Wiyumile P. Simukonda ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Dietary Intake ◽  
Tolerance Test ◽  
Cross Sectional Study ◽  
Dietary Factors ◽  
Oral Glucose ◽  
African Origin ◽  
Cross Sectional ◽  
The Relationship

Examining the relationship between glucose intolerance and dietary intake in genetically similar populations with different dietary patterns and rates of type 2 diabetes may provide important insights into the role of diet in the pathogenesis of this disease. The objective of the present study was to assess the relationship between dietary variables and dysglycaemia/type 2 diabetes among three populations of African origin. The study design consists of a cross-sectional study of men and women of African descent aged 24–74 years from Cameroon (n 1790), Jamaica (n 857) and Manchester, UK (n 258) who were not known to have diabetes. Each participant had anthropometric measurements and underwent a 2 h 75 g oral glucose tolerance test. Habitual dietary intake was estimated with quantitative FFQ, developed specifically for each country. The age-adjusted prevalence of undiagnosed type 2 diabetes in Cameroon was low (1·1 %), but it was higher in Jamaica (11·6 %) and the UK (12·6 %). Adjusted generalised linear and latent mixed models used to obtain OR indicated that each 1·0 % increment in energy from protein, total fat and saturated fats significantly increased the odds of type 2 diabetes by 9 (95 % CI 1·02, 1·16) %, 5 (95 % CI, 1·01, 1·08) % and 16 (95 % CI 1·08, 1·25) %, respectively. A 1 % increase in energy from carbohydrates and a 0·1 unit increment in the PUFA:SFA ratio were associated with significantly reduced odds of type 2 diabetes. The results show independent effects of dietary factors on hyperglycaemia in African origin populations. Whether modifying intake of specific macronutrients helps diabetes prevention needs testing in randomised trials.

scholarly journals Microbiota-related metabolites and the risk of type 2 diabetes

2020 ◽  
Author(s):  
Jagadish Vangipurapu ◽  
Lilian Fernandes Silva ◽  
Teemu Kuulasmaa ◽  
Ulf Smith ◽  
Markku Laakso
Keyword(s):  
Type 2 Diabetes ◽  
Insulin Secretion ◽  
Insulin Sensitivity ◽  
Oral Glucose ◽  
Microbial Metabolites ◽  
Cross Sectional ◽  
Metabolomics Data ◽  
Incident Type ◽  
Increased Risk

<b>OBJECTIVE: </b>Recent studies have highlighted the significance of microbiome in human health and disease. Changes in the metabolites produced by microbiota have been implicated in several diseases. Our objective was to identify microbiome metabolites that are associated with type 2 diabetes. <p> </p> <p><b>RESEARCH DESIGN AND METHODS: </b>5,181 participants from the cross-sectional METabolic Syndrome In Men (METSIM) study that included Finnish men (age 57 ± 7 years, body mass index 26.5 ± 3.5 kg/m<sup>2</sup>) having metabolomics data available were included in our study. Metabolomics analysis was performed based on fasting plasma samples. Based on an oral glucose tolerance test, Matsuda ISI and Disposition index were calculated as markers of insulin sensitivity and insulin secretion. A total of 4,851 participants had a 7.4-year follow-up visit and 522 participants developed type 2 diabetes.</p> <p><b> </b></p> <p><b>RESULTS: </b>Creatine, 1-palmitoleoylglycerol(16:1), urate, 2-hydroxybutyrate/2-hydroxyisobutyrate, xanthine, xanthurenate, kynurenate, 3-(4-hydroxyphenyl)lactate, 1-oleoylglycerol(18:1), 1-myristoylglycerol(14:0), dimethylglycine and 2-hydroxyhippurate(salicylurate) were significantly associated with an increased risk of type 2 diabetes. These metabolites were associated with decreased insulin secretion or insulin sensitivity or both. Among the metabolites that were associated with a decreased risk of type 2 diabetes, 1-linoleoyl-glycerophosphocholine (18:2) significantly reduced the risk of type 2 diabetes.</p> <p><b> </b></p> <p><b>CONCLUSIONS: </b>Several novel and previously reported microbial metabolites related to gut microbiota were associated with an increased risk of incident type 2 diabetes, and they were also associated with decreased insulin secretion and insulin sensitivity. Microbial metabolites are important biomarkers for the risk of type 2 diabetes. </p>

scholarly journals Prevalence of comorbidities and their associated factors in patients with type 2 diabetes at a tertiary care department in Ningbo, China: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e040532
Author(s):  
Xueyu Li ◽  
Kaushik Chattopadhyay ◽  
Shengnan Xu ◽  
Yanshu Chen ◽  
Miao Xu ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Rural Areas ◽  
Disease Duration ◽  
Communicable Disease ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Department

ObjectivesTo determine the prevalence of comorbidities in patients with type 2 diabetes mellitus (T2DM) and identify the factors independently associated with comorbidities in a tertiary care department in Ningbo, China.DesignA computerised medical records database was used to conduct a cross-sectional study.SettingThe study was conducted in a tertiary care department in Ningbo, China.ParticipantsThe study was conducted on adult patients with T2DM, and it included 8 years of data, from 1 January 2012 to 31 December 2019.The primary outcome measureComorbidity was defined as the coexistence of at least one other chronic condition, that is, either a physical non-communicable disease (duration ≥3 months), a mental health condition (duration ≥3 months) or an infectious disease (duration ≥3 months).ResultsIn total, 4777 patients with T2DM satisfied the eligibility criteria. Over 8 years, the prevalence of comorbidities was 93.7%. The odds of comorbidities increased with the age of patients (18 to 39 years: 1; 40 to 59 years: OR 2.80, 95% CI 1.98 to 3.96; 60 to 69 years: OR 4.43, 95% CI 3.04 to 6.44; and ≥70 years: OR 10.97, 95% CI 7.17 to 16.77). The odds were lower in female patients (OR 0.66, 95% CI 0.51 to 0.84), patients residing in rural areas (OR 0.75, 95% CI 0.59 to 0.95) and patients without health insurance (OR 0.62, 95% CI 0.46 to 0.83). The odds were higher in single/divorced/widowed patients compared with those in married patients (OR 1.95, 95% CI 1.21 to 3.12).ConclusionsA large percentage of patients with T2DM in the tertiary care department in Ningbo, China, had comorbidities, and the factors associated with comorbidities were identified. The findings could be used in developing, evaluating and implementing interventions aimed at improving outcomes in patients with T2DM with comorbidities.

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