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Huang Y, Sun Y, Wang S, Dai J, Zhang Q, Liu Z, Bai J, Xiao C, Liu Y. The working experiences and perceptions of Chinese medical social workers in a children's hospital. SOCIAL WORK IN PUBLIC HEALTH 2025; 40:247-260. [PMID: 40126087 DOI: 10.1080/19371918.2025.2468813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/25/2025]
Abstract
This study aimed to investigate the working experiences and perceptions of hospital-based, pediatric medical social workers in China. Eight medical social workers were interviewed. There were three primary themes extracted through the analysis: (1) negative experience and perceived work challenges of medical social workers; (2) positive experiences and sense of professional benefit for medical social workers; and (3) development needs of medical social work profession. While Chinese pediatric medical social workers have encountered several difficulties and challenges, they have also benefited from the work. Furthermore, they provided constructive recommendations for professional development at the hospital, social and national levels. Hoping this study can enrich the knowledge system of pediatric medical social work in China, promote the sustainable development of the nascent profession in China, and pave the way for the integration of pediatric medical social work practice in different socio-cultural contexts.
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Affiliation(s)
- Yingjuan Huang
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, Wuhan, China
| | - Yu Sun
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, Wuhan, China
| | - Sha Wang
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, Wuhan, China
- Department of Gynecology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Jiamiao Dai
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, Wuhan, China
| | - Qianping Zhang
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, Wuhan, China
| | - Ziyi Liu
- The First Clinical College, Hubei University of Chinese Medicine, Wuhan, China
| | - Jinbing Bai
- Emory University Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Cuiping Xiao
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yanqun Liu
- Center for Women's and Children's Health, Wuhan University School of Nursing, Wuhan University, Wuhan, China
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García-Villarino M, Martínez-Camblor P, García AV, Villa-Fernández E, Pérez-Fernández S, Lambert C, Pujante P, Fernández-Suárez E, Chiara MD, Torre EM, Rodríguez-Lacín JMF, De la Hera J, Delgado E. Impact of general practitioner appointment frequency on disease management in type 2 diabetes mellitus patients. Prim Care Diabetes 2025; 19:165-172. [PMID: 39884948 DOI: 10.1016/j.pcd.2025.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2024] [Accepted: 01/26/2025] [Indexed: 02/01/2025]
Abstract
AIMS We investigated the association between the frequency of visits to general practitioners (GPs) and the degree of disease control in patients with T2DM. METHODS This study included patients diagnosed with T2DM who visited their GPs between 2014 and 2018. A total of 89,674 patients, accounting for 1,203,035 visits, were included. Different clinical features such as glycated hemoglobin (HbA1c%), blood pressure (BP), and c-LDL levels were analyzed. Multifactorial control of T2DM was defined as HbA1c ≤ 7 %, BP ≤ 140/90 mmHg, and LDL cholesterol ≤ 100 mg/dL. Generalized Estimating Equations models were implemented in order to deal with repeated measures for the same patient. RESULTS The median age of the patients is 70 years, with 52.8 % being male. An increase in the number of visits per year significantly improves the likelihood of achieving multifactorial diabetes control. Patients with more than 3-visits per year (55.6 %) have a Relative Risks (RR) of 1.258 (95 % Confidence Interval: 1.120-1.414). Frequent visits are associated with better multifactorial control and better c-LDL management. Patients visiting more than 3-times annually tend to achieve better outcomes in multifactorial and c-LDL control. CONCLUSION Increasing the frequency of primary care visits significantly enhances multifactorial and cholesterol control among T2DM patients.
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Affiliation(s)
- Miguel García-Villarino
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Medicine. University of Oviedo, Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Oviedo, Spain.
| | - Pablo Martínez-Camblor
- Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Faculty of Health Sciences, Universidad Autónoma de Chile, Chile
| | - Ana Victoria García
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Elsa Villa-Fernández
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Sonia Pérez-Fernández
- Departamento de Estadística, Investigación Operativa y Didáctica de la Matemática. University of Oviedo, Oviedo, USA
| | - Carmen Lambert
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Pedro Pujante
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, USA
| | - Elena Fernández-Suárez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Medicine. University of Oviedo, Oviedo, Spain; Centro de Salud de Pola de Siero. Servicio de Salud del Principado de Asturias (SESPA), USA
| | - María-Dolores Chiara
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Oviedo, Spain
| | - Edelmiro Menéndez Torre
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Medicine. University of Oviedo, Oviedo, Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, USA
| | - José María Fernández Rodríguez-Lacín
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Centro de Salud Natahoyo (Gijón). Servicio de Salud del Principado de Asturias (SESPA), Spain
| | - Jesús De la Hera
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Elías Delgado
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Medicine. University of Oviedo, Oviedo, Spain; Servicio de Endocrinología y Nutrición, Hospital Universitario Central de Asturias, Oviedo, USA
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Shi H, Liu C, Luo HY. Impact of community public health care on treatment effect, health cognition, and self-management in patients with type 2 diabetes. World J Clin Cases 2025; 13:95183. [PMID: 39959766 PMCID: PMC11606368 DOI: 10.12998/wjcc.v13.i5.95183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/27/2024] [Accepted: 06/18/2024] [Indexed: 11/18/2024] Open
Abstract
BACKGROUND At present, China has become the country with the largest number of individuals with diabetes mellitus (DM) in the world, with a total of approximately 140 million patients, the majority of whom have type 2 DM (T2DM). Based on conventional nursing methods, community home care has important clinical significance in controlling blood sugar and disease progression. AIM To explore the impact of community public health nursing on treatment effect, health cognition, and self-management in patients with T2DM. METHODS One hundred patients with T2DM were selected as the research subjects. The patients were divided into either a conventional nursing group or community nursing (CN) group using the random number table method. The conventional nursing group (50 cases) received routine care, while the CN group (50 cases) received community public health care in addition to routine care as that for the conventional nursing group. The rate of excellent and good blood glucose control, fasting blood glucose before and after care, 2-h postprandial blood glucose, health cognition, and self-management ability, and patient satisfaction were compared between the two groups. RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group (88% vs 70%, P < 0.05). Before care, there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients (P > 0.05). After nursing, fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups, and both blood glucose levels in the CN group were lower than those of the conventional nursing group (P < 0.05). Compared with the scores before care, the cognitive level score for diabetes and self-management ability score improved after care in both groups. The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group (P < 0.05). The overall satisfaction of the CN group was better than that of the conventional nursing group (98% vs 86%, P < 0.05). CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control, and improve patients' health cognitive level and self-management ability.
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Affiliation(s)
- Hong Shi
- Department of Infrastructure Operation, West China Hospital of Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Chun Liu
- Department of Public Health, Minzu Street Community Health Service Center, Wuhan 430000, Hubei Province, China
| | - Hong-Yan Luo
- Caotang Community Health Service Center, Chengdu 610031, Sichuan Province, China
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Cashmore BA, Cooper TE, Evangelidis NM, Green SC, Lopez-Vargas P, Tunnicliffe DJ. Education programmes for people with chronic kidney disease and diabetes. Cochrane Database Syst Rev 2024; 8:CD007374. [PMID: 39171639 PMCID: PMC11339929 DOI: 10.1002/14651858.cd007374.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
BACKGROUND Adherence to complex regimens for people with chronic kidney disease (CKD) and diabetes is often poor. Interventions to enhance adherence require intensive education and behavioural counselling. However, whether the existing evidence is scientifically rigorous and can support recommendations for routine use of educational programmes in people with CKD and diabetes is still unknown. This is an update of a review first published in 2011. OBJECTIVES To evaluate the benefits and harms of education programmes for people with CKD and diabetes. SEARCH METHODS We searched the Cochrane Kidney and Transplant Register of Studies up to 19 July 2024 using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Registry Platform (ICTRP) Search Portal, and ClinicalTrials.gov. SELECTION CRITERIA We included randomised controlled trials (RCTs) and quasi-RCTs investigating the benefits and harms of educational programmes (information and behavioural instructions and advice given by a healthcare provider, who could be a nurse, pharmacist, educator, health professional, medical practitioner, or healthcare provider, through verbal, written, audio-recording, or computer-aided modalities) for people 18 years and older with CKD and diabetes. DATA COLLECTION AND ANALYSIS Two authors independently screened the literature, determined study eligibility, assessed quality, and extracted and entered data. We expressed dichotomous outcomes as risk ratios (RR) with 95% confidence intervals (CI) and continuous data as mean difference (MD) with 95% CI. Data were pooled using the random-effects model. The certainty of the evidence was assessed using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. MAIN RESULTS Eight studies (13 reports, 840 randomised participants) were included. The overall risk of bias was low for objective outcomes and attrition bias, unclear for selection bias, reporting bias and other biases, and high for subjective outcomes. Education programmes compared to routine care alone probably decrease glycated haemoglobin (HbA1c) (4 studies, 467 participants: MD -0.42%, 95% CI -0.53 to -0.31; moderate certainty evidence; 13.5 months follow-up) and may decrease total cholesterol (179 participants: MD -0.35 mmol/L, 95% CI -0.63 to -00.07; low certainty evidence) and low-density lipoprotein (LDL) cholesterol (179 participants: MD -0.40 mmol/L, 95% CI -0.65 to -0.14; low certainty evidence) at 18 months of follow-up. One study (83 participants) reported education programmes for people receiving dialysis who have diabetes may improve the diabetes knowledge of diagnosis, monitoring, hypoglycaemia, hyperglycaemia, medication with insulin, oral medication, personal health habits, diet, exercise, chronic complications, and living with diabetes and coping with stress (all low certainty evidence). There may be an improvement in the general knowledge of diabetes at the end of the intervention and at the end of the three-month follow-up (one study, 97 participants; low certainty evidence) in people with diabetes and moderately increased albuminuria (A2). In participants with diabetes and moderately increased albuminuria (A2) (one study, 97 participants), education programmes may improve a participant's beliefs in treatment effectiveness and total self-efficacy at the end of five weeks compared to routine care (low certainty evidence). Self-efficacy for in-home blood glucose monitoring and beliefs in personal control may increase at the end of the three-month follow-up (low certainty evidence). There were no differences in other self-efficacy measures. One study (100 participants) reported an education programme may increase change in behaviour for general diet, specific diet and home blood glucose monitoring at the end of treatment (low certainty evidence); however, at the end of three months of follow-up, there may be no difference in any behaviour change outcomes (all low certainty evidence). There were uncertain effects on death, serious hypoglycaemia, and kidney failure due to very low certainty evidence. No data was available for changes in kidney function (creatinine clearance, serum creatinine, doubling of serum creatinine or proteinuria). For an education programme plus multidisciplinary, co-ordinated care compared to routine care, there may be little or no difference in HbA1c, kidney failure, estimated glomerular filtration rate (eGFR), systolic or diastolic blood pressure, hypoglycaemia, hyperglycaemia, and LDL and high-density lipoprotein (HDL) cholesterol (all low certainty evidence in participants with type-2 diabetes mellitus and documented advanced diabetic nephropathy). There were no data for death, patient-orientated measures, change in kidney function (other than eGFR and albuminuria), cardiovascular disease morbidity, quality of life, or adverse events. AUTHORS' CONCLUSIONS Education programmes may improve knowledge of some areas related to diabetes care and some self-management practices. Education programmes probably decrease HbA1c in people with CKD and diabetes, but the effect on other clinical outcomes is unclear. This review only included eight studies with small sample sizes. Therefore, more randomised studies are needed to examine the efficacy of education programmes on important clinical outcomes in people with CKD and diabetes.
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Affiliation(s)
- Brydee A Cashmore
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Tess E Cooper
- NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | | | - Suetonia C Green
- Department of Medicine, University of Otago, Christchurch, New Zealand
| | - Pamela Lopez-Vargas
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
| | - David J Tunnicliffe
- Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
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Ahmed YH, Elbadawi HS, Sultan I, Mohammed RA, Aljedaani H, Abozeid HE, Badawy M. Implementation and Outcomes of Multidisciplinary Diabetes Management Program Among Type 2 Diabetic Patients: A Comparative Study. Cureus 2024; 16:e60979. [PMID: 38910761 PMCID: PMC11193887 DOI: 10.7759/cureus.60979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2024] [Indexed: 06/25/2024] Open
Abstract
BACKGROUND Current guidelines recommend shifting physician-led care (PLC) for type 2 diabetes mellitus (T2DM) to more effective multidisciplinary health care (MHC). However, few researchers have studied its real-life implementation in Saudi Arabia. Therefore, we aimed to assess the implementation and compare the outcomes of an MDC diabetes management program (DMP) among T2DM patients to a PLC at a general hospital after one year of follow-up in a real-world practice setting. METHODS We conducted this comparative patient files review study by analyzing medical records of all T2DM patients at two private care centers. Both were compared for their effectiveness in achieving two outcomes: the glycated hemoglobin (HbA1c) <7% and low-density lipoprotein-cholesterol (LDL-c) <70 mg/dl at the end of the first year. Additionally, we assessed the implementation of the DMP. RESULTS Eight hundred thirty-four medical records were reviewed, 537 from DMP, and 279 from the PLC center. The personal health coordination was almost complete (97.8%) in the DMP, but the implementation was incomplete regarding nutrition (65.7%), dental exam (64.8%), and foot care (58.3%). Both care groups were matched for age (p = 0.056), gender (p = 0.085), duration of diabetes (p = 0.217), and basal glycemic control (p = 0.171). The DMP showed a significant net decrease in HbA1c (-0.5 [IQR 1.47%] vs -0.2 [IQR 3.05%], p = 0.0001) and LDL-c (-10 [IQR 50] vs -5 [IQR 60.5] mg/dl, p = 0.004) compared to PLC. A higher percentage of patients achieved glycemic control in the DMP than in the PLC (49.4% vs 38.7%, p = 0.038). However, both programs demonstrated similar outcomes in lipid control (28.7% vs. 30%, p = 0.695). CONCLUSION Despite some gaps in implementation, one year of DMP showed better glycemic control among T2DM patients compared to PLC. Both programs were comparable in terms of lipid control. Further studies identifying the gaps in care implementation could improve sustainability, future replication, and generalizability of similar programs to other healthcare systems in Saudi Arabia.
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Affiliation(s)
- Youssef H Ahmed
- Department of Health Sciences, Syreon Middle East LLC, Alexandria, EGY
| | | | - Intessar Sultan
- Department of Internal Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Rehab A Mohammed
- Department of Internal Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
- Department of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, EGY
| | - Huda Aljedaani
- Department of Obstetrics and Gynecology, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Hanaa E Abozeid
- Department of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, EGY
| | - Mayar Badawy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta, EGY
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Sia CH, Simon O, Loh PH, Poh KK. Atherosclerotic cardiovascular disease landscape in Singapore. Front Cardiovasc Med 2024; 11:1342698. [PMID: 38720921 PMCID: PMC11076755 DOI: 10.3389/fcvm.2024.1342698] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide, accounting for over one-third of all deaths in Singapore. An analysis of age-standardized mortality rates (ASMR) for CVD in Singapore revealed a deceleration in the initial rapid decline in ASMR. A decrease in smoking prevalence may have contributed to the initial rapid decline in ASMR. Furthermore, other major risk factors, such as diabetes mellitus, hypertension, elevated low-density lipoprotein levels, and obesity, are steadily rising. Singapore's CVD economic burden is estimated to be 8.1 billion USD (11.5 billion SGD). The burden of CVD can only be reduced using individual and population-based approaches. Prevention programs must also be developed based on an understanding of risk trends. Therefore, this article attempts to capture the burden of CVD, trends in risk factor control, preventive care, disparities, and current unmet needs, particularly in atherosclerotic cardiovascular disease management in Singapore.
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Affiliation(s)
- Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Oliver Simon
- Medical Affairs, Novartis (Singapore) Ltd Pte, Singapore, Singapore
| | - Poay-Huan Loh
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Cardiology, Department of Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Huang X, Lu J, Huang R, Lu Q, Luo Y, Huang X, An L, Chen Y. Effects of multidisciplinary team continuous care model on psychological behavior and quality of life in children with β-thalassemia major. Am J Transl Res 2024; 16:905-915. [PMID: 38586087 PMCID: PMC10994799 DOI: 10.62347/obwd7382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/11/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVE To explore the effects of a multidisciplinary team (MDT) continuous care model on psychological behavior and quality of life in children with β-thalassemia major (β-TM). METHODS A retrospective study was conducted on 90 children with β-TM who were hospitalized in the Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for Nationalities from October 2021 to May 2022. According to nursing methods, the children were divided into a routine group and an experimental group, with 45 cases in each group. The routine group was intervened with routine nursing approaches, and the experimental group was intervened with the MDT continuous nursing mode on the basis of the control group. The psychological behavior [Positive and Negative Affect Scale for Children (PANAS-C)], quality of life (QoL) [Pediatric Quality of Life Inventory TM (PedsQLTM)] and satisfaction were compared between the two groups before and 6 months after intervention. The hemoglobin level and ferritin level of children after 3 months and 6 months of intervention were measured. The occurrence of complications and nursing satisfaction were recorded. The prognostic factors were further analyzed. RESULTS After the intervention, the positive emotion score, QoL score, hemoglobin level, satisfaction score in the experimental group were all higher than those in the conventional group, and the negative emotion score and ferritin level in the experimental group were all lower than those in the conventional group (all P < 0.05). The results of Cox analysis showed that the use of iron-removing drugs and arrhythmia/heart rate failure were risk factors affecting the prognosis of children with β-TM, while the MDT continuous nursing mode was a protective factor (all P < 0.05). CONCLUSION The MDT continuous care model can effectively promote mental health in children with β-TM, improve their quality of life, medical satisfaction, ameliorate the degree of anemia in children, reduce the incidence of complications and improve the prognosis; thus, it is worthy of wide clinical application.
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Affiliation(s)
- Xiuping Huang
- Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Jian Lu
- Center for Reproductive Medicine, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Rongxian Huang
- Department of Pediatrics, Baise People’s HospitalBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Qingmei Lu
- School of Nursing, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yanni Luo
- Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Xiaoxiao Huang
- Pediatric Intensive Care Unit, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Liqiao An
- Pediatric Intensive Care Unit, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
| | - Yuke Chen
- Department of Pediatrics, Affiliated Hospital of Youjiang Medical University for NationalitiesBaise 533000, Guangxi Zhuang Autonomous Region, China
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Jiang T, Liu C, Jiang P, Cheng W, Sun X, Yuan J, Wang Q, Wang Y, Hong S, Shen H, Zhu D, Zhang Y, Dai F, Hang J, Li J, Hu H, Zhang Q. The Effect of Diabetes Management Shared Care Clinic on Glycated Hemoglobin A1c Compliance and Self-Management Abilities in Patients with Type 2 Diabetes Mellitus. Int J Clin Pract 2023; 2023:2493634. [PMID: 38187353 PMCID: PMC10771925 DOI: 10.1155/2023/2493634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 05/09/2023] [Accepted: 09/28/2023] [Indexed: 01/09/2024] Open
Abstract
Objective We aim to evaluate the impact of diabetes management shared care clinic (DMSCC) on glycated hemoglobin A1c (HbA1c) compliance and self-management abilities in patients with type 2 diabetes mellitus (T2DM). Methods This study was a prospective cohort study of patients with T2DM participating in the DMSCC. At baseline and after management, the HbA1c levels were measured, the HbA1c compliance rate were calculated, and the Summary of Diabetes Self-Care Activities-6 (SDSCA-6), Diabetes Empowerment Scale-DAWN Short Form (DES-DSF), and Problem Areas in Diabetes Scale-Five-item Short Form (PAID-5) were completed. These pre- and post-management data were compared. Results A total of 124 eligible patients were enrolled. After the diabetes management of DMSCC, the average HbA1c decreased and the HbA1c compliance rate increased significantly (P < 0.01). SDSCA-6 showed significant improvement in physical activity, glycemic monitoring, smoking (P < 0.01), and taking medication (P < 0.05). DES-DSF suggested a greater willingness to try to effectively treat diabetes (P < 0.05). PAID-5 indicated significant improvement in diabetes-related emotional distress. Conclusion DMSCC can help patients with T2DM reduce HbA1c, increase HbA1c compliance, improve diabetes self-management behaviors, empowerment, and diabetes-related emotional distress and serve as an effective exploration and practice of diabetes self-management education and support.
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Affiliation(s)
- Tian Jiang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Chao Liu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Ping Jiang
- Department of Outpatient Changjiang Road, The First Affiliated Hospital of Anhui Medical University, Hefei 230061, Anhui, China
| | - Wenjun Cheng
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Xiaohong Sun
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Jing Yuan
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Qiaoling Wang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Yanlei Wang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Shihui Hong
- Department of Outpatient Changjiang Road, The First Affiliated Hospital of Anhui Medical University, Hefei 230061, Anhui, China
| | - Haiyan Shen
- Department of Outpatient Changjiang Road, The First Affiliated Hospital of Anhui Medical University, Hefei 230061, Anhui, China
| | - Dongchun Zhu
- Department of Pharmacy, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Yi Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Fang Dai
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Jing Hang
- Beijing Health Technology Co., LTD, Beijing 100085, China
| | - Jiguo Li
- Beijing Health Technology Co., LTD, Beijing 100085, China
| | - Honglin Hu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
| | - Qiu Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China
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Allam MM, Younan M, Abdelhamid M, Khan M, Elshafee M, Nada AM. A 5-structured visits multidisciplinary clinical care approach to optimize the care of patients with type 2 diabetes: a pilot study. Cardiovasc Endocrinol Metab 2023; 12:e0295. [PMID: 37859940 PMCID: PMC10584289 DOI: 10.1097/xce.0000000000000295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 09/11/2023] [Indexed: 10/21/2023]
Abstract
Introduction Multidisciplinary coordinated care has been associated with improvement of diabetes care. Aim and methods This is a retrospective cohort analysis aimed to assess the effect of application of the five-structured visits Multi-disciplinary Clinical Care Approach (FMCA) on each of T2DM control, complications and comorbidities. The patients' records were assessed for one year of regular diabetes care followed with a year after implementation of FMCA for patients attending the diabetes clinic at Zulekha hospital. The patients were divided according to HbA1c (cutoff 7%) at the end of the FMCA year of follow-up into a group of controlled and another group of uncontrolled diabetes designated CDM and UCDM, respectively. Results 49% of patients were males and the mean age was 44.22 years. HbA1c levels, LDL and urinary albumin/creatinine ratio (UACR) showed a marked decrease among the patients after implementation of FMCA (P = 0.02, P = 0.04, P = 0.003, respectively). Compared with an increase in the atherosclerotic cardiovascular risk score (ASCVD) during the regular period, exposure to FMCA significantly decreased the cardiovascular risk score (0.17%, 11.41%, P = 0.001, P = 0.001, respectively). A self-management score was significantly higher in CDM patients. After a multivariate regression analysis of factors affecting DM control, we detected that baseline HbA1c, UACR, self-management score and hospital admission rate were the most important factors to predict diabetes control. Conclusion The implementation of FMCA has shown a significant improvement in clinical and humanistic aspects of individuals with T2DM with a better outcome, more control and less complications.
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Affiliation(s)
- Magdy Mohamed Allam
- Alexandria University, Alexandria, Egypt
- Zulekha Hospital, Dubai, United Arab Emirates
| | - Mariam Younan
- Cairo University teaching Hospital, Cairo, Egypt
- Zulekha Hospital
| | | | | | | | - Aml Mohamed Nada
- Diabetes and Metabolism, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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10
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Maneesing TU, Dawangpa A, Chaivanit P, Songsakul S, Prasertsri P, Yumi Noronha N, Watanabe LM, Nonino CB, Pratumvinit B, Sae-Lee C. Optimising blood glucose control with portioned meal box in type 2 diabetes mellitus patients: a randomised control trial. Front Nutr 2023; 10:1216753. [PMID: 37533574 PMCID: PMC10390788 DOI: 10.3389/fnut.2023.1216753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/04/2023] [Indexed: 08/04/2023] Open
Abstract
Background The impact of dietary factors on glycaemic control in type 2 diabetes mellitus (T2DM) is well established. However, the effectiveness of transforming portion control into a practical innovation for glycaemic control in T2DM has not yet been established for counselling in nutrition. The aim of this study was to compare the effect of general counselling in nutrition (GCN) and a portioned meal box (PMB) on fasting blood glucose, glycated haemoglobin (HbA1c) and body composition. Methods A randomised, parallel intervention trial was conducted over 12 weeks, with GCN: carbohydrate portion control concept by using food exchange lists (n = 25) and PMB: portioned meal box was set by energy requirements (n = 25). Results Both GCN and PMB demonstrated reductions in HbA1c levels at the 6th and 12th weeks compared to baseline. However, no significant difference in HbA1c was observed between GCN and PMB at either the 6th or 12th week. Using PMB at least four times a week significantly decreased HbA1c during the intervention period (p = 0.021 and p < 0.001 for weeks 6 and 12 when compared with baseline, respectively). Changes in body composition were observed: body weight decrease in PMB only, body fat decrease and constant muscle mass in both groups. Both methods tended to relieve hunger and increased satiety in both groups. The satisfaction evaluation showed that participants preferred to use PMB over GCN (p = 0.001). Additionally, participants consumed less energy, carbohydrate and fat in PMB (p = 0.001, p = 0.019, and p = 0.001, respectively) and less energy and fat in GCN (p = 0.006 and p = 0.001, respectively). Conclusion A better diet, either through GCN or PMB, can play an important role in improving dietary intake compliance and controlling blood glucose.
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Affiliation(s)
- Tanu-udom Maneesing
- Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
- Exercise and Nutrition Innovation and Sciences Research Unit, Burapha University, Chonburi, Thailand
| | - Atchara Dawangpa
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pechngam Chaivanit
- Department of Internal Medicine, Faculty of Medicine, Burapha University, Chonburi, Thailand
| | - Sudjai Songsakul
- Department of Internal Medicine, Faculty of Medicine, Burapha University, Chonburi, Thailand
| | - Piyapong Prasertsri
- Faculty of Allied Health Sciences, Burapha University, Chonburi, Thailand
- Exercise and Nutrition Innovation and Sciences Research Unit, Burapha University, Chonburi, Thailand
| | | | - Lígia Moriguchi Watanabe
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Carla Barbosa Nonino
- Department of Health Sciences, Ribeirão Preto Medical School, São Paulo, Brazil
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Busadee Pratumvinit
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Chanachai Sae-Lee
- Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Research Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Amritanand A, Arthur A, Horo S, Obed P, Ramamurthy P, Rebekah G, Abraham VJ, Paul P. Comparative evaluation of diabetic retinopathy screening programs in regular ophthalmology clinics versus integrated diabetic clinics within rural health-care services. Oman J Ophthalmol 2023; 16:237-243. [PMID: 37602185 PMCID: PMC10433048 DOI: 10.4103/ojo.ojo_195_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 03/25/2023] [Accepted: 05/24/2023] [Indexed: 08/22/2023] Open
Abstract
BACKGROUND Robust integration of diabetic retinopathy (DR) screening within health systems is essential to prevent DR-related blindness. This, however, remains a challenge in the developing world. The aim of this study was to evaluate two models of DR screening programs within rural general health-care services. MATERIALS AND METHODS This was a retrospective observational study from two rural health centers. Demographic and clinical data of patients completing DR screening were analyzed. Patients were screened in regular ophthalmology clinics (ROC) or integrated diabetic clinics (IDC). Referral and treatment completion data were retrieved from the clinical charts at the base hospital. RESULTS A total of 2535 DR screenings were conducted for 2296 patients. The total population prevalence for any DR was 14.2% (95% confidence interval [CI]: 12.8%-15.6%) and vision-threatening DR (VTDR) was 4.7% (95% CI: 3.8%-5.6%). In the ROC and IDC groups, respectively, the prevalence of any DR was 20.4% and 8.2%, VTDR, 7.8% and 1.7%, and blindness, 1.4% and 0.4% (all P < 0.001). Referral completion rates were higher in the ROC group (44.8% vs. 25.2%, P < 0.001), while treatment completion in both was similar (69.6% vs. 70.6%). Referral and treatment completion rates for referable DR were 61.2% and 48.2%, and for VTDR, 62% and 38.8%, respectively. Only 11.45% of patients completed the repeat screening follow-up. CONCLUSIONS Patients attending IDCs had a significantly lower prevalence of any DR, VTDR, and blindness demonstrating the advantages of integrated diabetic care in a rural setting. However, referral uptake and DR treatment completion need strengthening.
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Affiliation(s)
- Anika Amritanand
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Anupriya Arthur
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Saban Horo
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Prathibha Obed
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Prashanth Ramamurthy
- Department of Rural Unit for Health and Social Affairs, Christian Medical College, Vellore, Tamil Nadu, India
| | - Grace Rebekah
- Department of Biostatistics, Christian Medical College, Vellore, Tamil Nadu, India
| | - Vinod Joseph Abraham
- Department of Community Health and Development, Christian Medical College, Vellore, Tamil Nadu, India
| | - Padma Paul
- Department of Ophthalmology, Christian Medical College, Vellore, Tamil Nadu, India
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12
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Haoues M, Zedini C, Chadli-Chaieb M. [Predictive factors for the level of knowledge, attitudes and quality of life of Tunisian diabetics : 1007 cases]. Rev Epidemiol Sante Publique 2023; 71:101413. [PMID: 36357272 DOI: 10.1016/j.respe.2022.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 11/09/2022] Open
Abstract
AIM OF THE STUDY To study the predictors of knowledge level, attitudes and quality of life of type 1(T1D) and type 2 (T2D) Tunisian diabetics POPULATION AND METHODS: We undertook an analytical cross-sectional study. The questionnaire was administered in Arabic and contained a section collecting socio-demographic, clinical and diabetes-specific data. The following sections contained the Arabic-translated and validated versions of the "Simplified Diabetes Knowledge Scale", the "Diabetes Attitude Scale-3" and the "Diabetes Health Profile-18" to assess level of diabetes knowledge, attitudes towards the disease and diabetics' quality of life. RESULTS We collected 186 T1D (18.5%) and 821 T2D (81.5%) completed questionnaires. A good level of knowledge about diabetes was indicated in T1D patients by glycemic self-monitoring and by secondary and university education, urban housing, stable employment, insulin therapy and prior therapeutic education, while regular medical follow-up was of particular importance in T2DM patients. Smoking and diabetes complications were predictors of a negative attitude towards the disease in T1D and T2D respectively. Diabetics' Impaired quality of life was predicted by age < 40 years and a low level of knowledge about diabetes in T1D and by female sex, insulin therapy and a low level of knowledge about diabetes in T2D. CONCLUSION Predictors of the level of knowledge, attitudes and quality of life of diabetics may be a basis for establishing a therapeutic education program tailored to the different populations.
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Affiliation(s)
- M Haoues
- Faculté de médecine de Sousse, Université de Sousse, Tunisie.
| | - C Zedini
- Faculté de médecine de Sousse, Université de Sousse, Tunisie; Département de médecine communautaire, Université de Sousse, Tunisie
| | - M Chadli-Chaieb
- Faculté de médecine de Sousse, Université de Sousse, Tunisie; Service d'endocrinologie et des maladies métaboliques, CHU Farhad Hached, Sousse, Tunisie
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Khoiry QA, Alfian SD, Abdulah R. Sociodemographic and behavioural risk factors associated with low awareness of diabetes mellitus medication in Indonesia: Findings from the Indonesian Family Life Survey (IFLS-5). Front Public Health 2023; 11:1072085. [PMID: 36761130 PMCID: PMC9905635 DOI: 10.3389/fpubh.2023.1072085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 01/05/2023] [Indexed: 01/26/2023] Open
Abstract
Introduction Low awareness of the necessity of taking medication is common among patients with diabetes mellitus (DM) due to their lack of understanding of the disease. Therefore, it is essential to determine the underlying risks influencing low awareness to design effective intervention strategies. This study aims to evaluate the association of sociodemographic and behavioural factors with low awareness to take medication among patients with DM in Indonesia. Method Retrospective data were obtained from the Indonesian Family Life Survey (IFLS-5), a national cross-sectional population-based survey among respondents with DM aged ≥15 years. DM status was confirmed by HbA1c testing, while sociodemographic and other health-related information was obtained from self-reported data. Gender, age, educational level, marital status, economic status, comorbidity, religiosity, residence and health insurance status were considered sociodemographic, whereas blood glucose monitoring status, sleeping problems, depression status, having a general medical check-up, satisfaction with healthcare needs and happiness status were considered behavioural risk factors. Awareness of DM medication was determined by self-reported responses to the question asked by the surveyor. Logistic regression analysis was used to evaluate the association between sociodemographic and behavioural factors and low awareness of DM medication. Odds ratios (ORs) with 95% confidence intervals (CIs) were reported. Result Most of the 706 respondents were female (58.8%) and aged 55-65 years (28.8%). Most of them showed low awareness of diabetes medication (87.7%). Irregular blood glucose monitoring (OR: 23.61, 95% CI 11.46-48.65; p < 0.001), without any comorbidity (OR: 2.03, 95% CI 1.05-3.90; p = 0.034), never had any general medical check-up (OR: 2.52, 95% CI 1.12-5.36; p = 0.016), 26-35 years of age (OR: 4.96, 95% CI 1.06-23.19; p = 0.042), 36-45 years of age (OR: 5.04, 95% CI 1.17-21.69; p = 0.030) and having no health insurance coverage (OR: 2.08, 95% CI 1.12-3.87; p = 0.021) were significantly associated with low awareness of diabetes medication. Conclusion Healthcare professionals should regularly evaluate blood glucose level, perform routine medical check-ups, prioritise patient satisfaction by providing appropriate care, involve patients in decision-making by determining their needs and then tailor an intervention to meet the need for, and improve their awareness of, DM medication.
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Affiliation(s)
- Qisty A. Khoiry
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia
| | - Sofa D. Alfian
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia,Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia,*Correspondence: Sofa D. Alfian ✉
| | - Rizky Abdulah
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Universitas Padjadjaran, Sumedang, Indonesia,Center of Excellence for Pharmaceutical Care Innovation, Universitas Padjadjaran, Sumedang, Indonesia
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14
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Wantonoro W, Komarudin K, Imania DR, Harun S, Nguyen TV. The Influence of 6-Month Interdisciplinary Accompaniment on Family Caregivers’ Knowledge and Self-Efficacy Regarding Diabetic Wound Care. SAGE Open Nurs 2023; 9:23779608231167801. [PMID: 37050936 PMCID: PMC10084543 DOI: 10.1177/23779608231167801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/29/2023] [Accepted: 03/18/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction Diabetes mellitus (DM) is a global health issue. Diabetic wounds have become a severe health complication. Interdisciplinary education and the use of homecare have led to improvements in the health of patients with chronic disease. The family caregiver's knowledge and self-efficacy positively impact the DM patient's self-care in the physical and psychological dimensions. There is still a need for interdisciplinary education to enhance family caregivers’ knowledge and self-efficacy regarding diabetic wound care. Objective To determine the effect of 6 months of interdisciplinary education on family caregivers’ knowledge and self-efficacy regarding diabetic wound care. Methods A quantitative longitudinal study with a quasi-experimental, one-group, pretest–posttest design was conducted. Family caregivers received 6 months of interdisciplinary education regarding diabetic wound care. The Foot Care Confidence Scale (FCCS) was used to measure the family caregivers’ knowledge and self-efficacy regarding diabetic wound care. The dependent samples t test and the Wilcoxon signed-rank test were used for statistical analysis. Results Sixteen caregivers of patients with diabetic ulcer wounds in the homecare unit participated in this intervention with a 6-month follow-up. Six months of interdisciplinary education significantly increased the family caregivers’ knowledge ( p = 0.001) and self-efficacy ( p = 0.001). However, there was no significant correlation between self-efficacy and gender, age, education level, or duration of wound care ( p = 0.91; 0.93; 0.38; 0.40, respectively). Long-term interdisciplinary education improved caregiver performance across genders, ages, education levels, and wound care experience durations. Conclusion Long-term interdisciplinary education of family caregivers is recommended as one method to enhance the family support system with respect to diabetic ulcer care management. In addition, interprofessional collaboration could be performed to enhance the understanding of healthcare, especially diabetic ulcer care.
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Affiliation(s)
- Wantonoro Wantonoro
- Department of Nursing, Universitas ‘Aisyiyah Yogyakarta, Yogyakarta, Indonesia
| | - Komarudin Komarudin
- Department of Physiology, Universitas ‘Aisyiyah Yogyakarta, Yogyakarta, Indonesia
| | - Dika Rizki Imania
- Department of Physiotherapy, Universitas ‘Aisyiyah Yogyakarta, Yogyakarta, Indonesia
| | - Sigit Harun
- Department of Nursing, Universitas ‘Aisyiyah Yogyakarta, Yogyakarta, Indonesia
- Unit Homecare PKU Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| | - Tuan Van Nguyen
- Department of Nursing, Faculty of Nursing and Medical Technology, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
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Alshowair A, Altamimi S, Alshahrani S, Almubrick R, Ahmed S, Tolba A, Alkawai F, Alruhaimi F, Alsafwani E, AlSuwailem F, Abdalla H, Abdel-Azeem A. Effectiveness of Case Manager Led Multi-Disciplinary Team Approach on Glycemic Control Amongst T2DM Patients in Primary Care in Riyadh: A Retrospective Follow-Up Study. J Prim Care Community Health 2023; 14:21501319231204592. [PMID: 37902553 PMCID: PMC10617256 DOI: 10.1177/21501319231204592] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/16/2023] [Accepted: 09/13/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVES Our study aims to assess the effectiveness of implementing a case manager-led Multidisciplinary Team approach in the primary healthcare setting on improving glycemic control and reducing cardiovascular risks for T2DM patients over a 6-month period. METHODS This retrospective record-based follow-up study was carried out on 3060 uncontrolled T2DM patients in primary healthcare centers in Riyadh First Health Cluster over a period of 6 months. The patient records are investigated and analyzed, including demographic characteristics and measurements of Hemoglobin A1c (HbA1c), Low-Density Lipoprotein Cholesterol (LDL-C), total cholesterol, and BP levels at enrollment and after 6 months of Multi-Disciplinary Team follow-up. The changes in the study variables and their correlations to each other are tested using Statistical Package for the Social Sciences software. RESULTS At enrollment, our patients were characterized by poor glycemic control (HbAIC > 8%). Most of them have high body weight with a mean BMI of (31.2 ± 1.7), and nearly two-thirds are either hypertensive or have dyslipidemia (43.4% and 47.3% respectively). After 6 months of MDT follow-up, there is a significant improvement in glycemic control among 1971 patients (64.4%), with a reduction in the mean level of different outcomes relative to baseline HbA1c (-15%, P < .001), total cholesterol (-9.0%, P < .001), LDL-C (-11.0%, P < .001), systolic BP (-7.7%, P < .001), and diastolic BP (-10.5%, P < .001). The improved glycemic control showed a significant positive correlation with the number of MDT visits but negatively correlated with BMI and the number of comorbidities. In addition, the improvements in secondary outcomes were positively and significantly correlated with such improvements in glycemic control. CONCLUSION Case-manager-led MDT approach significantly improves glycemic control and significantly improves control over dyslipidemia and hypertension, reducing cardiovascular risks, and unfavorable events among such diabetic patients. We highly recommend developing more MDTs, training case managers, and rigorously evaluating the MDT approach.
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Affiliation(s)
| | - Saleh Altamimi
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Saad Alshahrani
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Rehab Almubrick
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Syed Ahmed
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Ali Tolba
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Fatimah Alkawai
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Faisal Alruhaimi
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Eman Alsafwani
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Fatima AlSuwailem
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Haiam Abdalla
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Amro Abdel-Azeem
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
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Ebrahimi H, Sadeghi M, Esmaeili SM, Janmohammadi F, Bahonar E. Effect of Empowerment Model-Based Program on Quality of Life in Patients with Type 2 Diabetes: A Randomized Controlled Trial. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2023; 28:99-104. [PMID: 37250944 PMCID: PMC10215552 DOI: 10.4103/ijnmr.ijnmr_155_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/10/2021] [Accepted: 10/25/2022] [Indexed: 01/26/2023]
Abstract
Background Type 2 diabetes (T2D) is a chronic disease with a high prevalence globally, which is in the second place of importance for the investigation of chronic diseases. According to previous studies, Quality of Life (QOL) is low in diabetic patients. Hence, this study was conducted with the aim to evaluate the effect of the empowerment model on the QOL of patients with T2D. Materials and Methods A randomized controlled trial was performed on 103 T2D patients over 18 years of age, with a definitive diagnosis of diabetes and medical records in a diabetic center. Patients were randomly assigned to either the intervention or the control groups. Routine education was presented to the control group, and the empowerment model was used for education in the experimental group for 8 weeks. The data collection tools used consisted of a demographic characteristics form and the diabetic clients QOL questionnaire. The one-way analysis of variance, Chi-square test, paired t-test, and independent t-test were used for data analysis. Results After the intervention, there were significant differences between the two groups in terms of the physical (p = 0.003), mental (p = 0.002), social (p = 0.013), economic (p = 0.042), and illness and treatment dimensions of QOL (p = 0.033), as well as the total QOL score (p = 0.011). Conclusions According to the results of this study, the training program based on empowerment significantly increased the QOL of patients with T2D. Therefore, using this method can be recommended in patients with T2D.
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Affiliation(s)
- Hossein Ebrahimi
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahdi Sadeghi
- Vice_Chancellery of Treatment, Shahroud University of Medical Sciences, Shahroud, Iran
- Department of Health in Disasters and Emergencies, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Mahdi Esmaeili
- Vice_Chancellery of Treatment, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Farahnaz Janmohammadi
- Vice_Chancellery of Treatment, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Elahe Bahonar
- Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran
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D’Orto B, Polizzi E, Nagni M, Tetè G, Capparè P. Full Arch Implant-Prosthetic Rehabilitation in Patients with Type I Diabetes Mellitus: Retrospective Clinical Study with 10 Year Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811735. [PMID: 36142007 PMCID: PMC9517153 DOI: 10.3390/ijerph191811735] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/05/2022] [Accepted: 09/11/2022] [Indexed: 05/08/2023]
Abstract
The aim of this retrospective clinical study was to evaluate and compare implant survival, marginal bone loss, and clinical and prosthetic complications in healthy patients and patients with type I diabetes undergoing full arch implant-prosthetic rehabilitation. A total of 47 patients needing total fixed rehabilitation of one or both arches were enrolled for this study. Based on the absence of any systemic diseases (Group A) or the presence of type I diabetes (Group B), the sample was divided into two groups. According to the grade of bone atrophy in the posterior region, patients received full arch rehabilitation (of one or both jaws) with 6 axial implants or, if the residual posterior bone height was insufficient, All-on-Four rehabilitation and a total 236 dental implants were placed. Follow-up visits were performed 1 week after surgery, at 3 and 6 months and then once a year for the next 10 years. No statistically significant differences between groups were recorded about implant survival rates, marginal bone loss, or clinical and prosthetic complications. However, concerning complications, post-surgical bleeding and wound infection were recorded in Group A more than in Group B. In cases of compensated diabetes compensation, implant placement could be considered a safe procedure.
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Affiliation(s)
- Bianca D’Orto
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Elisabetta Polizzi
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
- Center for Oral Hygiene and Prevention, Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Matteo Nagni
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Giulia Tetè
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
| | - Paolo Capparè
- Dental School, Vita-Salute San Raffaele University, 20132 Milan, Italy
- Department of Dentistry, IRCCS San Raffaele Hospital, 20132 Milan, Italy
- Correspondence:
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Yıldırım Ayaz E, Dincer B, Oğuz A. The Effect of Foot Care Education for Patients with Diabetes on Knowledge, Self-Efficacy and Behavior: Systematic Review and Meta-Analysis. INT J LOW EXTR WOUND 2022; 21:234-253. [PMID: 35711163 DOI: 10.1177/15347346221109047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This systematic review and meta-analysis aimed to synthesize randomized controlled trials on the impact of foot care education on knowledge, self-efficacy and behavior in patients with diabetes. A search was made using PubMed, Web of Science, Science Direct, Google Scholar, YOK National Thesis Center and Google Scholar electronic databases for studies published between March 2003-January 2022. The search medical subject headings (MeSH) terms were diabetic foot, knowledge, self-efficacy, and behavior. Studies suitable for the systematic review and the meta-analysis met the following criteria (PICOS): target participants would be diagnosed with diabetes (population), diabetic foot education (intervention), comparison of the group receiving diabetic foot care education and routine care education, and the control group receiving only routine care education (comparison), studies evaluating the levels of knowledge, self-efficacy and behavior (outcome), randomized controlled trials (study design). Twenty-six studies were included in systematic review. Three studies for knowledge, 5 studies for behavior, 8 studies for self-efficacy were included in the meta-analysis (total sample: 2534, experiment: 1464, control: 1071). All of the studies had low reporting bias. The mean duration of educations for knowledge was 5.2 months. This duration was 4.8 months for behavior and 4.5 months for self-efficacy. In the random effect (since the homogeneity test: P < .001, this model was used), there were significantly difference in terms of knowledge (standardized mean difference (SMD): 1.656, 95% [CI]: 1.014-2.299, P < .001), and behavior (SMD: 1.045, 95% CI: 0.849-1.242, P < .001). But no difference was observed in terms of self-efficacy (SMD: 0.557, 95%CI: -0.402-1.517, P > .05). The results of a systematic review of twenty-six studies and a meta-analysis of 9 studies showed that diabetic foot education improved the level of knowledge and behavior of patients with diabetes, while not affecting their self-efficacy. Educational interventions with long-term follow-up are needed to address the growing health care needs of patients with diabetes.
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Affiliation(s)
- Elif Yıldırım Ayaz
- University of Health Sciences, 506079Sultan Abdülhamid Han Training and Research Hospital, Internal Medicine Clinic, İstanbul, Turkey
| | - Berna Dincer
- Faculty of Health Sciences, Department of Medical Nursing, Istanbul 226842Medeniyet University, İstanbul, Turkey
| | - Aytekin Oğuz
- 64071Istanbul Medeniyet University Göztepe Prof. Dr Süleyman Yalçın City Hospital, Internal Medicine Clinic, İstanbul, Turkey
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19
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Kumar S, Wong R, Newberry C, Yeung M, Peña JM, Sharaiha RZ. Multidisciplinary Clinic Models: A Paradigm of Care for Management of NAFLD. Hepatology 2021; 74:3472-3478. [PMID: 34324727 DOI: 10.1002/hep.32081] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 06/16/2021] [Accepted: 07/15/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Sonal Kumar
- Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY
| | - Rochelle Wong
- Department of Medicine, NewYork Presbyterian-Weill Cornell Medical Center, New York, NY
| | - Carolyn Newberry
- Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY
| | - Michele Yeung
- Division of Endocrinology, Weill Cornell Medicine, New York, NY
| | - Jessica M Peña
- Department of Medicine, NewYork Presbyterian-Weill Cornell Medical Center, New York, NY.,Dalio Institute of Cardiovascular Imaging, Department of Radiology, Weill Cornell Medicine and New York Presbyterian Hospital, New York, NY
| | - Reem Z Sharaiha
- Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY
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The Effectiveness of Pay-for-Performance Program of Diabetes Care for Psychiatric Patients: A Regional Psychiatric Hospital Experience. Healthcare (Basel) 2021; 9:healthcare9111565. [PMID: 34828611 PMCID: PMC8624475 DOI: 10.3390/healthcare9111565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/13/2021] [Accepted: 11/15/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The Pay-for-performance (P4P) program of diabetes care has demonstrated successful outcomes in patients with type 2 diabetes. However, the effectiveness of this multidisciplinary care model for psychiatric patients has never been evaluated. The objective of this study is to examine the effectiveness of P4P program of diabetes for psychiatric patients with diabetes. METHODS This study utilized a retrospective cohort design to examine the effectiveness of P4P program of diabetes care for psychiatric patients with diabetes. The participants' HbA1c (hemoglobin A1c) data of the fourth quarter in 2018 were used as baseline value, while P4P program was not applied yet. HbA1c data of every quarter in 2019 were collected. Generalized estimating equations (GEE) was used to analyze the change of HbA1c level. RESULTS The HbA1c level increased slightly in the first quarter, and then decreased gradually since the second quarter. The HbA1c level was significantly lower in the fourth quarter after P4P program intervention (p < 0.05). CONCLUSION P4P program of diabetes care is also effective on psychiatric patients with diabetes, and this multidisciplinary care model could be encouraged and promoted for psychiatric patients with diabetes.
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21
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Teo LM, Lim WY, Ke Y, Sia IKL, Gui CH, Abdullah HR. A prospective observational prevalence study of elevated HbA1c among elective surgical patients. Sci Rep 2020; 10:19067. [PMID: 33149252 PMCID: PMC7642441 DOI: 10.1038/s41598-020-76105-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/23/2020] [Indexed: 01/14/2023] Open
Abstract
Type 2 Diabetes Mellitus (DM) is a chronic disease with high prevalence worldwide. Using glycated haemoglobin (HbA1c) as a surrogate for potential pre-DM and DM conditions, our primary objective was to determine the HbA1c epidemiology in non-cardiac elective surgical patients in Singapore. Our secondary aim was to identify risk factors associated with elevated HbA1c. We conducted a prospective, observational single-centre study in adult patients. HbA1c screening was performed. Patient demographics and comorbidities were recorded. Patients were divided into those with HbA1C ≤ 6.0% and HbA1C ≥ 6.1%. Regression analyses were performed to identify associated factors. Subgroup analysis was performed comparing patients with HbA1C ≥ 6.1% and HbA1C ≥ 8.0%. Of the 875 patients recruited, 182 (20.8%) had HbA1c ≥ 6.1%, of which 32 (3.7%) had HbA1c ≥ 8%. HbA1C ≥ 6.1% was associated with Indian ethnicity [1.07 (1.01-1.13), p = 0.023], BMI > 27.5 [1.07 (1.02-1.11), p = 0.002], higher preoperative random serum glucose [1.03 (1.02-1.04), p < 0.001], pre-existing diagnosis of DM [1.85 (1.75-1.96), p < 0.001] and prediabetes [1.44 (1.24-1.67), p < 0.001], and peripheral vascular disease [1.30 (1.10-1.54), p = 0.002]. HbA1c ≥ 8% had an additional association with age > 60 years [0.96 (0.93-0.99), p = 0.017]. The prevalence of elevated HbA1c is high among the surgical population. Targeted preoperative HbA1c screening for at-risk elective surgical patients reduces cost, allowing focused use of healthcare resources.
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Affiliation(s)
- L M Teo
- Division of Anaesthesiology and Perioperative Medicine, Sengkang General Hospital, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
- Duke-NUS (National University of Singapore) Medical School, 8 College Rd, Singapore, 169857, Singapore.
| | - W Y Lim
- Division of Anaesthesiology and Perioperative Medicine, Sengkang General Hospital, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - Y Ke
- Singhealth Anaesthesiology Residency Program, Division of Anaesthesiology and Perioperative Medicine, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore
| | - I K L Sia
- National University of Singapore, Yong Loo Lin School of Medicine, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - C H Gui
- National University of Singapore, Yong Loo Lin School of Medicine, 1E Kent Ridge Road, Singapore, 119228, Singapore
| | - H R Abdullah
- Division of Anaesthesiology and Perioperative Medicine, Sengkang General Hospital, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore.
- Duke-NUS (National University of Singapore) Medical School, 8 College Rd, Singapore, 169857, Singapore.
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Jiraporncharoen W, Pinyopornpanish K, Junjom K, Dejkriengkraikul N, Wisetborisut A, Papachristou I, Hashmi A, Angkurawaranon C. Exploring perceptions, attitudes and beliefs of Thai patients with type 2 diabetes mellitus as they relate to medication adherence at an out-patient primary care clinic in Chiang Mai, Thailand. BMC FAMILY PRACTICE 2020; 21:173. [PMID: 32825811 PMCID: PMC7442984 DOI: 10.1186/s12875-020-01233-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 07/29/2020] [Indexed: 12/11/2022]
Abstract
Background Within the sphere of diabetes self-management, much emphasis has been placed on medication adherence. There has been a shift in thinking about medication adherence, moving from “compliance” and historically paternalistic models of care, to seeking better ways of characterizing dynamic and complex relationships that determine medication adherence and diabetes control. This study sought to understand the relationship between patient’s attitudes and medication adherence for oral anti-diabetics in Thailand. Methods In-depth interviews of patients with type 2 diabetes mellitus, taking oral anti-diabetic drugs, at the out-patient clinic run by the Department of Family Medicine, Chiang Mai University between May and December 2016. Thematic analysis followed the WHO framework for medication adherence in chronic disease to explore patient’s attitudes and their influence on medication compliance. Results Of 24 patients, 9 were men. The mean age was 62 years (SD 8.9 years). 67% had high compliance. Four themes were identified as important factors related to medication adherence: attitudes toward disease, attitudes toward treatment, attitudes toward family support and attitudes toward health care team. Specifically, symptoms at diagnosis, understanding and acceptance in taking medication, the presence of family support and the perception of concern by the doctor relate to improved medication compliance. Conclusions Medication adherence in Thai patients with diabetes requires support from both the health care providers and the family. The patient’s perception of the doctor’s concern creates greater patient trust in the health care team. This trust, along with family support, helps deepen patients’ understanding of the disease, accept the chronic nature of their disease, and engenders a positive attitude towards taking medication that can improve medication adherence.
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Affiliation(s)
- Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Korsin Junjom
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Nisachol Dejkriengkraikul
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Anawat Wisetborisut
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Iliatha Papachristou
- Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Ahmar Hashmi
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Sriphum, Muang, Chiang Mai, 50200, Thailand.
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Kim GH, Park Y, Lim HS. The Association between Diabetes Education and Glucose Control in Diabetic Patients: Using the 2008 and 2013 Korea National Health and Nutrition Examination Survey. Clin Nutr Res 2020; 9:81-89. [PMID: 32395438 PMCID: PMC7192670 DOI: 10.7762/cnr.2020.9.2.81] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/09/2020] [Accepted: 04/11/2020] [Indexed: 11/29/2022] Open
Abstract
This study was conducted to investigate the status of diabetes education in Korean diabetics and to analyze the association between blood sugar control and diabetes education. A total of 1,904 diabetic patients was classified into two groups (well-controlled group and uncontrolled group) using the 2008-2013 Korean National Health and Nutrition Survey data, and various variables were compared. Of the 1,904 patients, 15.9% had received diabetes education. The uncontrolled group had a low economic level, a high rate of drinking and obesity, and a low rate of moderate exercise. And the rate of drug treatment in the uncontrolled group was high, and the rate of education and nutrition education, and the total number of educations for diabetes were significantly lower than those in the control group. Factors affecting blood glucose control were analyzed drinking (odds ratio [OR], 1.34; 95% confidence interval [CI], 1.06–1.7), moderate exercise (OR, 0.45; 95% CI, 0.34–0.6), overweight and obesity (OR, 1.44; 95% CI, 1.17–1.78), duration of diagnosis (OR, 1.07; 95% CI, 1.05–1.08), treatment method (OR, 2.0; 95% CI, 1.45–2.77), nutritional education (OR, 0.62; 95% CI, 0.46–0.85), and education institution (OR, 0.71; 95% CI, 0.54–0.93). The results of this study support that education on lifestyle management, such as a balanced diet, regular exercise, and normal weight maintenance, is essential for blood glucose control, and patients with long-term treatment need cyclic and continuous education.
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Affiliation(s)
- Ga Hyun Kim
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan 31151, Korea
| | - Yoonhyung Park
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan 31151, Korea
| | - Hee-Sook Lim
- Department of Preventive Medicine, Soonchunhyang University College of Medicine, Cheonan 31151, Korea.,Department of Food and Nutrition, Yeonsung University, Anyang 14011, Korea
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