Knowledge, Attitude, practice, and their associated factor towards Diabetes Mellitus among peoples live in Debre Markos Town, North West Ethiopia, Amhara Regional State, Ethiopia 2020 GC

Background: Diabetes mellitus is a group of metabolic disease in which there is high blood glucose level over a prolonged period of time, chronic multi system disease related to abnormal insulin production, impaired insulin utilization and both. Risk of diabetes are obesity, being young or old age, family history of diabetes, history gestational diabetes, impaired, glucose metabolism, physical inactivity and ethnicity/race respectively. In type one diabetes mellitus insulin injection is needed to control the blood glucose level where as in type two diabetes mellitus the first line treatment is life style modification like diet management, exercise, and weight reduction then if uncontrolled use oral hypoglycemic agent.Objective: The main aim of the study was to assess Knowledge, Attitude, practice and their associated factor towards diabetes mellitus in Debre Markos town, northwest , Amhara Regional state, Ethiopia 2020 GC.Methodology: a community based cross-sectional study was conduct from June to July for 403 respondents using systematic random sampling technique to select the household after select the first household by lottery method. Data collected through self administered questions, the collected data process and analysis manually using pen, pencil, tally sheet and present in tables, graphs and charts respectively.Result: based on our study 138 (34.6%) of the respondents were classified as having inadequate knowledge, whereas 261(65.4%) of the respondents were deemed to be knowledgeable. from the participant 186(46.6%) had unfavorable attitude while 213(53.4%) had favorable attitude towards diabetes mellitus. Overall practice of the participant was 37.8% good practice and 62.2% poor practice. Single individuals 5.133 times (AOR=5.133, CI=1.737, 15.051) more likely knowledgeable than those divorced. Family history of diabetes mellitus 5.019 times (AOR=5.02- CI=1.59-15.76) more likely had favorable attitude than those who had no family history of DM. secondary educational level were 2.34 times (AOR=2.34, CI=1.14- 0.78) more likely good practice than those with able to read and write and persons in primary educational level. DM patients 2.811 times (AOR=2.81-95%, CI=0.99- 7.97) more likely good practice than non-diabetic.Conclusion: majority of the participant’s relatively knowledgeable. The overall attitude of the participant was more than half was favorable attitude. Majority of the study participants were poor practice regarding to DM controlling and management. Knowledge of the participant highly significant association with marital status, income and practice, practice also strong association with level of education and attitude significantly associated with family history of DM

Quality of Life of Adult Patients with Type 2 Diabetes Mellitus in Kuwait

Objectives: This study aimed to evaluate the Quality of Life (QoL) on Kuwaiti adult patients with Type 2 Diabetes Mellitus (T2DM), aged ≥ 45 years of both genders, who attended primary healthcare centers and to identify factors associated with QoL. Methods: This is a cross-sectional study conducted on a random sample stratified by gender, consisting of 604 Kuwaiti adult patients with T2DM, aged ≥ 45 years, diagnosed by physicians as diabetics for ≥ 6 months. A validated demographic and WHOQOL-BREF questionnaires were used to assess the QoL. Results: The sample consisted of both genders with equal proportions, the age of 46% of patients was within 56-65 years’ class. Only 24% of the participants had secondary school, while 57% were retired, and the income of 54% exceeds 1000 KD/month. The majority of patients (76%) were married, and 99% were living with their families. Obesity was reported in 54% of patients, and 16% were smokers. Only oral antidiabetic drugs were used by 50% of patients, and 24% of the sample had complications, 11% of them developed retinopathy. A family history of diabetes was reported in 74% of patients, and 45% of them have a duration of diabetes >10 years. Regarding the QoL, the median score was 71, around 77% of the sample has a good QoL. Conclusion: There is more need for public health action to control the disease, thus improving their QoL; this can be achieved by improving the patients’ health status and maintaining their abilities.

Serum Leptin and Earlier Stages of Nephropathy among Type 2 Diabetic Subjects in a Bangladeshi population

Objective: To evaluate the relationship of Serum Leptin and Early Nephropathy among uncontrolled type 2 Diabetes Mellitus patients of Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrinology and Metabolism (BIRDEM), Dhaka and Endocrinology department of Sylhet MAG Osmani Medical College (SOMC) & Hospital Sylhet, Bangladesh. Methods: This study was carried out from January 2013 to December 2015 among 100 type 2 diabetic patients from the outpatient department (OPD) BIRDEM and SOMC hospital. Results: 16 out of 30 controls and 65 out of 100 people with diabetes have a family history of diabetes. Early retinopathy and neuropathy were observed in 45.5% and 36.5% diabetic subjects. Mean±SD of serum urea in control subjects was 28.65±6.27; in diabetic subjects was 30.21±7.67. Serum creatinine in controls was 1.12±0.24, in diabetic subjects was 1.13±0.25. Serum leptin levels in control subjects {1.65 (0.05-8.66)} was lower than diabetic counterpart {1.21 (0.11-13.3)}. Leptin levels in male controls {(1.29 (0.05-2.49)} was significantly (P 0.000) lower than the female controls {4.03 (0.05-8.66)}. Conclusion: It was evident that there was very little or no association between serum leptin level and the indices of renal function. No changes of circulating serum Leptin concentration in the earlier stages of Diabetic Nephropathy were found.

Incidence and risk factors for dysglycaemia in Asian-Indians: a 10-year population-based prospective cohort study

BackgroundDiabetes prevalence estimates suggest an increasing trend in South-East Asia region, but studies on its incidence are limited. The current study aims to estimate the incidence of type 2 diabetes and pre-diabetes in a population-based cohort from India.MethodsA subset of Chandigarh Urban Diabetes Study cohort (n=1878) with normoglycaemia or pre-diabetes at baseline was prospectively followed after a median of 11 (0.5–11) years. Diabetes and pre-diabetes were diagnosed as per WHO guidelines. The incidence with 95% CI was calculated in 1000 person-years and Cox proportional hazard model was used to find the association between the risk factors and progression to pre-diabetes and diabetes.ResultsThe incidence of diabetes, pre-diabetes and dysglycaemia (either pre-diabetes or diabetes) was 21.6 (17.8–26.1), 18.8 (14.8–23.4) and 31.7 (26.5–37.6) per 1000 person-years, respectively. Age (HR 1.02, 95% CI 1.01 to 1.04), family history of diabetes (HR 1.56, 95% CI 1.09 to 2.25) and sedentary lifestyle (HR 1.51, 95% CI 1.05 to 2.17) predicted conversion from normoglycaemia to dysglycaemia, while obesity (HR 2.43, 95% CI 1.21 to 4.89) predicted conversion from pre-diabetes to diabetes.ConclusionA high incidence of diabetes and pre-diabetes in Asian-Indians suggests a faster conversion rate to dysglycaemia, which is partly explained by sedentary lifestyle and consequent obesity in these individuals. The high incidence rates call for a pressing need for public health interventions targeting modifiable risk factors.

Prevalence and Influencing Factors of Metabolic Syndrome among Adults in China from 2015 to 2017

The prevalence and influencing factors of metabolic syndrome (MetS) in Chinese residents aged 20 or older were investigated. The data were collected from China Nutrition and Health Surveillance (2015–2017), which used a stratified, multistage, random sampling method. A total of 130,018 residents aged 20 years or older from 31 provinces were included in this study. The National Cholesterol Education Programme Adult Treatment Panel III (NCEP ATP III) criteria were used to define MetS. The standardised prevalence of high waist circumference, high blood pressure and low high-density lipoprotein cholesterol were 40.8%, 49.4% and 41.1%, respectively. The following factors were associated with a higher prevalence of MetS: female [odds ratio (OR) = 1.773, 95% CI = 1.709–1.840]; older age (OR = 1.037, 95% CI = 1.036–1.039); living in north China (OR = 1.087, 95% CI = 1.058–1.117); high body mass index (OR = 1.402, 95% CI = 1.395–1.408); higher income [OR (95% CI): 1.044 (1.007–1.083), 1.083 (1.044–1.124) and 1.123 (1.078–1.170) for moderate, high, and very high income, respectively]; family history of hypertension (OR = 1.237, 95% CI = 1.203–1.273); family history of diabetes (OR = 1.491, 95% CI = 1.426–1.558) and current smoking status (OR = 1.143, 95% CI = 1.098–1.191). Living in the countryside (OR = 0.960, 95% CI = 0.932–0.988), moderate alcohol consumption (OR = 0.917, 95% CI = 0.889–0.946) and being physically active (OR = 0.887, 95% CI = 0.862–0.913) were associated with a lower prevalence of MetS. The prevalence of MetS among residents aged 20 years or older in China is increasing, especially among women, people aged 45 years or older and urban residents. Preventive efforts, such as quitting smoking and engaging in physical activity, are recommended to reduce the risk of MetS.

Evaluation of Frequency of Diabetic Ketoacidosis and Presenting Symptoms in Patients of Diabetes Mellitus Presenting

Objective: To evaluate the frequency of diabetic ketoacidosis and presenting symptoms in patients of diabetes mellitus presenting at tertiary care hospital. Material and methods: In this cross sectional study total 145 patients of diabetes were selected from Department of Medicine from April 2020 to November 2020. Inclusion criteria was: un-controlled type II Diabetes Mellitus with HBA1c levels > 8, age between 30-70 years, male or female. Diabetic ketoacidosis was studied in selected patients. Results: Mean age of the patients 49.80 ± 9.38 years. Out of 145 patients, ketoacidosis was found in 30 (21%) patients. Vomiting was the most common (88/60.69%) presenting symptom followed nausea in 59 (40.68%) patients, polyuria 50 (34.48%), polydipsia 41 (28.27%), abdominal pain 32 (22.07%), weight loss 16 (11.03%) and Polyphagia in 8 (5.52%) patients. Ketoacidosis was found in 15 (23.44%) male diabetics and 15 (18.52%) female diabetics. Association of ketoacidosis with gender was not significant (P = 0.468). Conclusion: Findings of this study showed a higher rate of diabetic ketoacidosis. Vomiting was the most common presenting symptom. Most of the patients were between 30-50 years. No gender difference was found in development of diabetic ketoacidosis. Most of the patients of diabetic ketoacidosis had family history of diabetes. Keywords: Ketone, Ketoacidosis, fasting serum glucose, diabetes mellitus, random serum glucose

Undiagnosed diabetes mellitus and associated factors among adults in Ethiopia: a systematic review and meta-analysis

Diabetes has become a major public health problem, with 4.6 million deaths annually. The number of people living with undiagnosed diabetes is on the rise and has a diverse prevalence. Thus, this systematic review and meta-analysis was aimed to synthesize the pooled estimate prevalence of undiagnosed diabetes mellitus, impaired fasting glucose and its associated factors in Ethiopia. The databases Medline, Hinari, Google Scholar, and Google search were used to find potential studies published from January 2013 until January 2021. Extracted data were entered into the excel spreadsheet. The random effects model with Der Simonian-Laird weights was used to assess the pooled estimate of prevalence of undiagnosed diabetes, impaired fasting glucose, and its associated factors. The Cochrane Q-test and I2 statistics were used to screen for statistical heterogeneity. A funnel plot and Egger's statistical test were also used to search for any publication bias (small study effect). After extensive searching of articles on different databases, a total of nine studies were included for this systematic review and meta-analysis. In random effects model, the pooled prevalence of undiagnosed diabetes mellitus and impaired fasting glucose was 5.75%, 95% CI (3.90–7.59%), and 8.94%, 95% CI (2.60–15.28%), respectively. Regarding the associated factors, participants family history of diabetes was significantly associated with diabetes status. The pooled odds of developing diabetes mellitus among participants with a family history of diabetes mellitus were about 3.56 times higher than those without a family history of diabetes mellitus (OR = 3.56, 95% CI (2.23, 5.68)). In this review, the higher prevalence of undiagnosed diabetes mellitus and impaired fasting glucose was observed among adults in Ethiopia. Family history of diabetes was found to have an association with increased risk of diabetes mellitus. Our finding highlights the need of screening at the community level, with special focus on adults with family history of diabetes mellitus.

An early model to predict the risk of gestational diabetes mellitus in the absence of blood examination indexes: application in primary health care centres

Background Gestational diabetes mellitus (GDM) is one of the critical causes of adverse perinatal outcomes. A reliable estimate of GDM in early pregnancy would facilitate intervention plans for maternal and infant health care to prevent the risk of adverse perinatal outcomes. This study aims to build an early model to predict GDM in the first trimester for the primary health care centre. Methods Characteristics of pregnant women in the first trimester were collected from eastern China from 2017 to 2019. The univariate analysis was performed using SPSS 23.0 statistical software. Characteristics comparison was applied with Mann-Whitney U test for continuous variables and chi-square test for categorical variables. All analyses were two-sided with p < 0.05 indicating statistical significance. The train_test_split function in Python was used to split the data set into 70% for training and 30% for test. The Random Forest model and Logistic Regression model in Python were applied to model the training data set. The 10-fold cross-validation was used to assess the model’s performance by the areas under the ROC Curve, diagnostic accuracy, sensitivity, and specificity. Results A total of 1,139 pregnant women (186 with GDM) were included in the final data analysis. Significant differences were observed in age (Z=−2.693, p=0.007), pre-pregnancy BMI (Z=−5.502, p<0.001), abdomen circumference in the first trimester (Z=−6.069, p<0.001), gravidity (Z=−3.210, p=0.001), PCOS (χ2=101.024, p<0.001), irregular menstruation (χ2=6.578, p=0.010), and family history of diabetes (χ2=15.266, p<0.001) between participants with GDM or without GDM. The Random Forest model achieved a higher AUC than the Logistic Regression model (0.777±0.034 vs 0.755±0.032), and had a better discrimination ability of GDM from Non-GDMs (Sensitivity: 0.651±0.087 vs 0.683±0.084, Specificity: 0.813±0.075 vs 0.736±0.087). Conclusions This research developed a simple model to predict the risk of GDM using machine learning algorithm based on pre-pregnancy BMI, abdomen circumference in the first trimester, age, PCOS, gravidity, irregular menstruation, and family history of diabetes. The model was easy in operation, and all predictors were easily obtained in the first trimester in primary health care centres.