Poor Adherence to Common Recommendations and Associated Factors among Outpatients with Type 2 Diabetes Mellitus in a Police Hospital of Ethiopia

Introduction Poor adherence to medication and healthy lifestyle managements, such as diet and regular exercise, remains to be a challenge for patients with type 2 diabetes mellitus. The objective of this study was to assess the pattern of adherence to common recommendations, reasons, and factors associated with poor overall adherence among outpatients with type 2 diabetes mellitus in a police hospital of Ethiopia. Method A facility-based cross-sectional study was done between 15 October 2016 and 15 January 2017. Systematic random sampling method was applied to recruit participants. A semistructured interview guide with an observation checklist was used to collect data. SPSS v.20.0 was used in the analysis. Results Out of 361 participants, over half (56.5%) participants were male and 235 (65.1%) participants were military. Nearly half (49%) of the participants were on oral combination therapy. Only 194 (53.7%) of the patients showed good adherence for diet. Half (50.1%) of the respondents had poor adherence to all recommendations. Reasons for poor adherence included lack of adequate knowledge (68.9%) for diet, carelessness (37.8%) for exercise, and lack of adequate knowledge (34.8%) followed by carelessness (28.3%) and forgetfulness (19.6%) for medication. Intake of herbal medicines doubled the likelihood of good adherence. Conclusion Adherence of patients to diet was found to be suboptimal. Lack of adequate knowledge, carelessness, and forgetfulness were among the reasons mentioned. Only use of herbal medicine showed statistical significance with adherence. Patient education on dietary practice is required in the study setting.

Advantages of Screening for Glucose Tolerance in the Sequential Weeks of Gestation

Prelife exposure relates to development during the time preceding the first appearance of life, a time course from “conception to confinement.” From single cell zygote to finally formed fetus at confinement, a remarkable change occurs due to maternal fuels and hormonal influence on the fetal development. The crucial period in the fetal development is the first trimester. Early exposure to aberrant maternal metabolism in the embryonic developmental stage would result in congenital malformation and fetal wastage. Maintaining maternal glucose at the recommended level of fasting 80 to 90 mg and 2 hours postprandial plasma glucose 110 to 120 mg/dL during preconceptional period and throughout pregnancy is the assurance for the healthy offspring with ideal birth weight of 2.5 to 3.5 kg and prevention of noncommunicable diseases in the future.

Why and How Stories Matter in Treating Children with T1DM—Best Practice from CDiC

Type 1 diabetes mellitus (T1DM) is a lifelong disorder that mostly happens any time during childhood. It needs constant care and attention. Self-management becomes very essential as there are multiple factors that influence management of blood glucose levels and good outcomes. Diabetes education1 is essential for this and it involves the process of providing the person with the knowledge and skills needed to perform diabetes self-care, manage crises, and to make lifestyle changes to successfully manage their life. It begins with teaching of survival skills and continues with higher learning to fit diabetes into lives of people with diabetes rather than changing the lives to manage diabetes. Although parents are responsible for this initially, children must be part of this learning and journey as they are the one who must deal with diabetes in their life.Although knowledge transfer from scientific (truth and fact based) and narrative story (experience and meaning based) is fundamentally different but narrative or stories are better absorbed and retained. Storytelling and experience sharing are rapidly developing fields in medical education, but its potential has yet to be realized in medical education. The Changing Diabetes in Children program focused at reaching out to the economically underprivileged children with T1DM has implemented the use of stories to help the T1DM child learn to take insulin injections and understand the basic do’s and don’t’s for proper diabetes management and motivate them to become self-reliant and independent adults in long run.

The Risk Factors for Immune System Impairment and the Need for Lifestyle Changes

Healthy immune system helps in enhancing the quality of life and reduces the risk of infectious disease. Chronic disease increases the risk of immune system impairment. The article reviews the evidence on risk factors causing immune system imbalance and articulates the complex nature of the relationships between immune system risk factors, chronic disease, and infectious disease to highlight the importance of lifestyle choices. Finally, some evidence is presented on mind–body interventions and lifestyle choices for enhancing the immune system function.

The Multigenerational Legacy of Diabetes, Emotional Reactions, and Insulin Adherence

Purpose The purpose of this study was to estimate the effect of having a multigenerational legacy of diabetes on insulin adherence by measuring memories of family members’ experiences with insulin self-injection. Methods A cross-sectional correlational design was implemented by surveying hospitalized adults with type 2 diabetes who recently transitioned to using insulin. Surveys included items about the vividness, frequency, and controllability of memories of a family member self-injecting insulin and concordant emotional reaction, and one’s own emotional reaction to a diagnosis of diabetes and insulin regimen adherence. Results A diverse sample responded to the surveys. Significant associations were revealed between having a recollection of a family member fearing insulin injections and a negative emotional reaction toward one’s own diabetes diagnosis with suboptimal insulin adherence. Suboptimal insulin adherence may be an indication of avoidance-based coping. Inquiry into how a multigenerational legacy of diabetes influences individual coping styles for diabetes self-management will help clinicians identify patients at risk for suboptimal insulin adherence.

Managing Diabetes in the COVID-19 Era: Focus on COVID-19 Safe Clinics, Telemedicine, and Diabetes Self-Management

Novel coronavirus disease 2019 is a dreaded pandemic that is going to persist, and diabetic people with poor glycemic control are at high risk of complications and death from it. Social distancing being the only way to prevent infection spread, it is very difficult to continue usual clinic-based diabetes care. So, in this review, we focus to discuss safe clinic practice recommendations, scope of telemedicine in care of follow-up patients, and diabetes self-management that every individual with diabetes needs to follow. These issues will be of utmost important as we need to understand and implement personal and social hygiene in a better way even in post lockdown period.

Foot Self-Care Behavior in Patients with Diabetes

Objective Diabetic foot ulcers (DFUs) are complications of diabetes that can progress with high mortality and morbidity. It is a preventable problem with the determination of risk factors and patient education. Our aim is to examine the knowledge and behavior of diabetic patients in our region about foot care. Materials and Methods Diabetic individuals who applied to the Endocrine and Internal Medicine Clinic were included in this cross-sectional study. Demographic variables, physical examination, and laboratory findings were recorded. “Diabetic foot information form for diabetic foot care” was used to evaluate the patient’s level of knowledge about diabetic foot and care. The questionnaire consists of 16 questions with two options, right or wrong, according to the suggestions of the guides. A total of 16 points scoring system has been established, 1 point for each correct answer and 0 points for the wrong answer. Results “Total acknowledgment scores” (TAS) were significantly higher in patients with DFU, amputation, and DFU history (p < 0.001). TAS were significantly lower in patients receiving oral antidiabetic therapy than those receiving insulin therapy (p = 0.005). Total scores were significantly lower in untrained patients compared with primary school graduates (p = 0.005), and in high school graduates compared with university graduates (p < 0.001). Conclusion In this study, a serious lack of information or insufficiency was found in patients with diabetes. More comprehensive training programs are needed to reduce diabetic foot development and complications.

An Exploratory Study of Cognitive Functioning and Psychological Well-Being in Middle-Aged Adults with Diabetes Mellitus

Background Diabetes mellitus is a chronic metabolic disorder characterized by increased level of blood sugar for a prolonged period of time. Apart from its impact on the bodily functions, the disorder has its own psychological consequences, commonly in terms of stress reaction, anxiety, and depression. Diabetes is also known to affect cognitive functions, but it is less studied in the Indian population and relatively ignored in the management plan. Discerning the cognitive functions in middle-aged adults diagnosed with diabetes can give valuable insight into comprehensive management of the disorder. With this background, the study attempted to explore the cognitive functioning and psychological well-being of middle-aged adults with diabetes and compared with healthy individuals. Methods A total of 30 middle-aged adults of both sexes diagnosed with diabetes type 2 were undertaken for the study and compared with 30 healthy adults regarding measures of cognitive functioning and psychological well-being. The measures were also explored for relationship if any with illness duration. Results Middle-aged adults with diabetes differed significantly in terms of response inhibition and processing speed compared with healthy controls. The groups significantly differed on subjective Psychological well-being in terms of self-control, anxiety and depression, and vitality. Duration of illness was found to be related to anxiety symptoms. Conclusion Diabetes affects response inhibition and processing speed in middle-aged adults. Assessing and addressing impairment in cognitive functions is recommended for a comprehensive management of diabetes in middle-aged adults.