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Background: Diabetes is a fast-growing public health emergency, projected to affect 643 million people by 2045. While primary caregiver social support can influence the self-management practices of Type 2 diabetes (T2D) clients, there's often limited capacity to provide it. The study determined the effectiveness of enhanced caregivers' social support capacity on self-management practices of T2D clients in Machakos. Methods: A six-month quasi-experimental study design that adopted quantitative and qualitative data collection and analysis approaches. Primary caregivers at the Matungulu intervention site were trained on T2D self-management and types of social support, with no intervention conducted at the Masinga control site. Results: Over 90% of the 227 primary caregivers were female, with a mean age of 43.28, supporting approximately three T2D clients each. Post-intervention, a 27.2% change in capacity to identify all T2D self-management practices was noted compared to a 7.6% change in the control group. The greatest contribution was in the primary caregivers' ability to provide tangible, followed by emotional and informational social support, resulting in a statistically significant improvement in the self-management practices in the intervention site, B=0.140 (95% CI: 0.072, 0.208), t=4.046, p<0.001. Consequently, the difference in blood glucose levels was statistically significant, crude OR=3.213 [95% CI: 2.039, 5.063], p<0.001. Conclusions: Enhanced capacity to provide social support positively correlates with the T2D clients' self-management practices. Further investigation of factors that hinder the full realization of primary caregiver social support capacity benefits in improving self-management capacities among T2D clients is recommended.
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Objective:To analyze the mediating effects of emotional changes in self-management interventions on the relationship between behavioral management and quality of life in elderly patients with type 2 diabetes and therefore to provide a reference for improving the emotional status of elderly diabetes patients and future community-based self-management interventions.Methods:From 2016 to 2020, a total of 69 self-management groups were formed in Hangzhou, each consisting of 10-15 patients with type 2 diabetes.Based on the construction of a medical consortium and family doctors signing up to provide services, intervention teams were established to conduct a series of group self-management activities for each group.Surveys via questionnaires were conducted before and after the intervention, as well as 6 months after the intervention, to collect patient data on demographics, disease status, emotions, quality of life, and self-management behaviors.The intervention effects were evaluated, and the correlations between emotional changes, self-management behaviors, and changes in quality of life were analyzed.Bootstrap analysis was used to test the mediating effects.Results:A total of 707 elderly diabetes patients were included.There were statistically significant differences in the scores of the Self-Rating Anxiety Scale(SAS), the Self-Rating Depression Scale(SDS), physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health, physical component summary, mental component summary, the dietary control dimension of the type 2 diabetes self-care scale(2-DSCS), regular exercise, medication adherence, blood glucose monitoring, foot care, the dimension of prevention and management of hyperglycemia and hypoglycemia, and the total score of 2-DSCS( P<0.05 for all).Compared with pre-intervention, changes in SAS, SDS, physical component summary and mental component summary scores were all correlated with each dimension of 2-DSCS right after intervention and 6 months after intervention( r=-0.336-0.333, P<0.05), with the exception of changes in the blood glucose monitoring dimension score and changes in the emotional status score.The direct effect of self-management behavior on the quality of life in elderly patients with type 2 diabetes was 0.159, and the indirect effect through emotions was 0.229, with the mediating effect accounting for 59.02% of the total effect. Conclusions:Community-based group self-management activities can effectively improve the emotions and management behaviors of elderly diabetes patients and enhance their quality of life, Emotional changes play a certain mediating role between self-management behaviors and improvement in quality of life.
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For diabetes patients, especially elderly diabetes patients, insulin is widely used as an important treatment to control hyperglycemia.However, since a high percentage of elderly diabetes patients use high doses of insulin, it is common to incur issues such as increased insulin resistance and inappropriate treatment.Exogenous insulin-induced autoantibody production is associated with severe insulin resistance and refractory hyperglycemia and hypoglycemia and is referred to as exogenous insulin antibody syndrome.With hypoglycemia, high insulin levels may be inconsistent with C-peptide levels.Increasing the dose of insulin to control blood glucose may be counterproductive.It is necessary to quickly and accurately make a diagnosis and make personalized adjustments to the glucose-lowering regimen to avoid serious consequences.
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Objective:To explore the effects of online character strengths intervention on the distress-related and self-management ability of young and middle-aged patients with type 2 diabetes. To provide reference for improving the physical and mental health of patients.Methods:Ninety-two young and middle-aged patients with type 2 diabetes admitted to the Second Affiliated Hospital of Xuzhou University of Medicine from July 2021 to July 2022 were selected and divided into intervention group and control group with 46 cases in each group by random number table method. The control group was given routine care, and the intervention group was given online character strengths intervention for 8 weeks. Diabetes-related distress Questionnaire (DDS) and Diabetes Self-Care Scale (DSCS) were used to evaluate the effects of the two groups of patients before intervention, immediately after intervention and 1 month after intervention.Results:The total DDS scores of the control group were (2.18 ± 0.70) and (2.01 ± 0.65) when the moment and 1 month after intervention, while the scores in the intervention group were (1.74 ± 0.47) and (1.18 ± 0.17), the differences were significant ( t = 3.13, 8.34, both P<0.05). The total DSCS scores of the control group were (72.25 ± 11.55) and (73.12 ± 10.72) when the moment and 1 month after intervention, while the scores in the intervention group were (85.95 ± 5.91) and (85.24 ± 5.21), the differences were significant ( t = 10.13, 2.10, both P<0.05). Conclusions:Online character strengths intervention can help alleviate the distress associated with young and middle-aged patients with type 2 diabetes and improve the level of self-management.
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Objective:To explore the application advantages of hospital-community linkage network blood glucose management model for elderly type 2 diabetes patients in community in order to supply reference for improve patients′ qualitye of life.Methods:This study was a randomized controlled study. A total of 84 elderly patients in Huangpu Community Hospital of Guangzhou from February to September 2022 were selected and divided into control group and intervention group by a table of random numbers. The control group adopted the hospital community linkage management model, and the intervention group followed the network management mode on the basis of the routine management. After 6 months of intervention, we compared the level of fasting blood glucose, blood glucose two hours after meal and glycosylated hemoglobin, and the scores of the Summary of Diabetes Self-Care Activities (SDSCA), Diabetes Specificity Quality of Life Scale(DSQL) between the two groups to illustrate the application advantages.Results:There were no significant differences in blood glucose two hours after meal, fasting blood glucose and glycosylated hemoglobin between the intervention and control groups (all P>0.05). After 6 months of intervention, the blood glucose two hours after meal, fasting blood glucose and glycosylated hemoglobin of the intervention group were (9.25 ± 2.87) mmol/L, (6.07 ± 0.69) mmol/L and (7.04 ± 1.59) %, respectively, which were lower than those of the control group (11.04 ± 3.75) mmol/L, (6.57 ± 0.95) mmol/L and (8.02 ± 2.25)%. The differences were statistically significant ( t = 2.45, 2.76, 2.30, all P<0.05). After 6 months of intervention, the scores of SDSCA scale and DSQL scale were (34.21 ± 10.43) and (135.64 ± 10.71) points, which were higher than (29.12 ± 7.36) and (145.85 ± 10.33) points in the control group, and the differences were statistically significant ( t = 2.58, 4.44, both P<0.05). Conclusions:The hospital-community linkage network management model can improve the blood glucose level of elderly patients with type 2 diabetes mellitus in the community and has a positive effect on improving self-management behavior ability and improving quality of life.
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RESUMEN Objetivo : Obtener la prevalencia de Porphyromonas gingivalis en pacientes con Diabetes Mellitus tipo 2. Material y método : Este estudio fue de tipo descriptivo transversal. El tipo de muestreo fue por conveniencia y la muestra estuvo conformada por 50 pacientes diagnosticados con Diabetes Mellitus tipo 2. Los grados de Periodontitis se clasificaron de acuerdo a los criterios de Papapanou et al., año 2018. Se obtuvo la prevalencia de Porphyromonas gingivalis por PCR de punto final. La muestra se tomó en dos sitios con mayor profundidad de bolsa. El control de la glucosa se evaluó midiendo el porcentaje de hemoglobina glicosilada. El análisis estadístico fue realizado mediante el Software InfoStat 2019, y se empleó la Prueba de Independencia mediante el estadístico Chi-Cuadrado con un 5% de significancia. Resultados : Se obtuvo una prevalencia del 30 % de P. gingivalis. Un 56% de la muestra presentó un grado 0 de periodontitis un, 24 % grado I, 8% presentó un grado II y un 12%, un grado III. No se encontró diferencia estadísticamente significativa entre la presencia de P. gingivalis y los grados de periodontitis. Conclusión: La prevalencia de P. gingivalis en la muestra de pacientes con diabetes tipo 2 es de un 30% y su distribución es independiente del grado de enfermedad periodontal.
ABSTRACT Objective : To obtain the prevalence of Porphyromonas gingivalis in patients with type 2 Diabetes Mellitus. Material and method : This study was descriptive and cross-sectional. The type of sampling was for convenience and the sample consisted of 50 patients diagnosed with Type 2 Diabetes Mellitus. The degrees of Periodontitis were classified according to the criteria of Papapanou et al., (2018). The prevalence of Porphyromonas gingivalis was obtained by end-point PCR. The sample was taken in two places with greater depth of pocket. Glucose control was evaluated by measuring the percentage of glycosylated hemoglobin. The statistical analysis was performed using the InfoStat 2019 Software and the Independence Test was used using the Chi-Square statistic with 5% significance. Results : A 30% prevalence of P. gingivalis was obtained. 56% of the sample had a grade 0 of periodontitis, 24% grade I, 8% had grade II and 12% had grade III. No statistically significant difference was found between the presence of P. gingivalis and the degrees of periodontitis. Conclusions: The prevalence of P. gingivalis in the sample of patients with type 2 diabetes is 30% and its distribution is independent of the degree of periodontal disease.
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Objective:To explore the effects of low-calorie diet intervention and aerobic exercise intervention on insulin levels and body composition in obese patients with type 2 diabetes.Methods:A total of 300 obese patients with early type 2 diabetes who were diagnosed and treated in the Department of Endocrinology, Xuanwu Hospital of Capital Medical University from July 2016 to July 2019 were selected as the research objects. According to the random sampling method, they were divided into a control group and an observation group with 150 cases each. Calorie diet intervention was given to control group, while the observation group was given low-calorie diet intervention and concentrated aerobic exercise intervention. Observation and evaluation of fasting blood glucose (FBG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR), body mass index (BMI), body fat percentage, body weight, triacylglycerol (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) were conducted.Results:After 4 weeks of intervention, FBG, FINS, HOMA-IR, BMI, body fat percentage, body mass, TG, TC, HDL-C, LDL-C indicators of the observation group were (6.15±0.92) mmol/L and (14.12±1.11) mU/L, 2.67±0.32, (25.01±1.75) kg/m 2, (27.45±1.92)%, (70.01±3.56) kg, (3.01±0.30) mmol/L, (5.25±0.88) mmol/L, (2.25 ±0.42) mmol/L, (3.15±0.41) mmol/L. The control group were (8.18±1.28) mmol/L, (16.78±1.85) mU/L, 3.78±0.78, (27.36±2.45) kg/m 2, (29.78±2.39)%, (72.98±5.62) kg, (3.49±0.52) mmol/L, (6.23±1.08) mmol/L, (1.88±0.30) mmol/L, (3.98±0.89)mmol/L. The difference between the two groups was statistically significant ( t values were 5.47-16.13, all P<0.05). After 8 weeks of intervention, FBG, FINS, HOMA-IR, BMI, body fat percentage, body mass, TG, TC, HDL-C, LDL-C indicators of the observation were (5.06±0.45) mmol/L, (12.78±0.69) mU/L, 2.01±0.12, (23.25±1.18) kg/m 2, (25.05±1.19)%, (66.02±2.45) kg, (2.21±0.12) mmol/L, (4.03±0.41) mmol/L, (3.08 ±0.72) mmol/L, (2.65±0.15) mmol/L,while in the control group were (6.07±0.88) mmol/L, (14.09±1.05) mU/L, 2.95±0.45, (26.98±2.08) kg/m2, (27.18±2.06)%, (70.98±4.02) kg, (2.98±0.28) mmol/L, (5.16±0.71) mmol/L, (2.41±0.51) mmol/L, (3.29±0.39) mmol/L. The difference between the two groups was statistically significant ( t values were 5.47-30.96, all P<0.05). Conclusions:Low-calorie diet intervention combined with concentrated aerobic exercise intervention is more conducive to improving patients′ blood sugar and blood lipid levels, as well as reducing body weight.
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Objective:To investigate the effect of nurse-led stress inoculation training on fear of self-injecting and self-testing and self-management behaviors in elderly type 2 diabetic patients and provide reference for diabetes nursing care.Methods:A total of 110 elderly type 2 diabetic patients of Department of Endocrinology of Hainan People′s Hospital from January 2018 to January 2020 were divided into experimental group and control group according to odd and even numbers, with 55 patients in each group. The control group received routine nursing care, while the experimental group implemented nurse-led stress inoculation training for 4 weeks. The intervention effect was assessed by Diabetes Fear of Injecting and Self-testing Ouestionnaire (D-FISQ) and Diabetes self-management behaviors among older (DSMB-O), respectively.Results:In the study, one patient in the experimental group fell off, and finally included 54 cases in the experimental group and 55 cases in the control group. After intervention, the fear of self-injecting scores, fear of self-testing scores, and total D-FISQ scores were 13.15 ± 3.02, 15.67 ± 3.59 and 28.81 ± 5.08 in the experimental group, significantly lower than those in the control group (15.25 ± 3.18, 17.56 ± 3.92 and 32.82 ± 4.89), the difference was statistically significant ( t=3.55, 2.63, 4.19, P<0.05). Active exercises, current medication, blood glucose monitoring, dealing with problem, active response, reducing risks scores and total DSMB-O scores were 2.39 ± 0.49, 2.39 ± 0.49, 2.20 ± 0.81, 4.41 ± 0.92, 4.70 ± 1.13, 5.06 ± 0.79 and 25.28 ± 2.57 in the experimental group, significantly higher than those in the control group (3.95 ± 0.85, 2.11 ± 0.85, 1.51 ± 0.50, 3.95 ± 0.78, 4.13 ± 1.43, 4.38 ± 1.16 and 22.09 ± 2.24), the difference was statistically significant ( t values were 2.10-6.90, P<0.05). Conclusions:Nurse-led stress inoculation training can effectively alleviate fear of self-injecting and self-testing and promote self-management behaviors of elderly patients with type 2 diabetes.
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Objective:To investigate the correlation between phase angle and muscle mass reduction in elderly diabetic patients.Methods:This paper retrospectively collected and analyzed the data of human composition and laboratory index in elderly patients with diabetes(n=106)and non-diabetic(n=153)patients in the Nutrition Department of Beijing Hospital, compared the differences between two groups, and explored the correlation between phase angle and muscle mass reduction in elderly diabetic patients.Phase angle was detected by bioelectrical impedance which was calculated as reactance/resistance× 180/π.Results:Phase angle was lower in elderly diabetic patients(5.17±0.65)°than in non-diabetic elderly patients(5.37±0.76)°( t=-2.075. P<0.05); age and fasting blood glucose were higher in elderly diabetic patients than in non-diabetic elderly patients(all P<0.05).There was no significant difference between the two groups in body mass index, fat, body fat percentage, visceral fat area, skeletal muscle index, body cell mass, total protein, albumin, and hemoglobin(all P>0.05).Correlation analysis results showed that in elderly diabetic patients, the phase angle was negatively correlated with body mass index( r=0.288, P<0.01), age( r=-0.680, P<0.01), was positively correlated with skeletal muscle( r=0.477, P<0.01), skeletal muscle index( r=0.505, P<0.01)and hemoglobin( r=0.382, P<0.01); and in the elderly non-diabetic group, phase angle was negatively correlated with age( r=-0.666, P<0.01)and positively correlated with body mass index( r=0.296, P<0.01), skeletal muscle( r=0.504, P<0.01), fat free mass( r=0.161, P<0.05), skeletal muscle index( r=0.441, P<0.01), body cell volume( r=0.496, P<0.01), and hemoglobin( r=0.420, P<0.01).The bioelectrical impedance apectroscopy detected skeletal muscle mass index<7.0 kg/m 2 for male and<5.7 kg/m 2 for female were used as the diagnosis standard for reduced muscle mass.The detection rate of muscle mass reduction was higher in elderly diabetic patients(17 cases, 16.04%)than in elderly non-diabetic patients(12 cases, 7.84%, χ2=4.229, P<0.05).The results of multiple regression analysis showed that the decrease of muscle mass in elderly diabetic patients was related to low phase angle( OR=0.413, 95% CI: 0.280-0.973, P<0.05)and aging( OR=2.174, 95% CI: 1.574-3.003, P<0.01). Conclusions:The phase angle is lower in diabetic elderly patients than in non-diabetic elderly patients, and the incidence of muscle mass reduction is higher in diabetic elderly patients than in non-diabetic elderly people.Decreased phase angle and increased age are related to the decrease of muscle mass in elderly diabetic patients.
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Objective:To investigate the status of hypoglycemia fear, diabetes distress, self-regulatory fatigue and self-management in type 2 diabetes patients. The chain mediating effects of self-regulated fatigue and psychological distress on hypoglycemic fear and self-management were investigated.Methods:The Hypoglycemia Fear Survey-Worry Subscale (CHFSII-WS), Diabetes Distress Scale (DDS), Self-Regulatory Fatigue Scale (SRF-S) and Summary of Diabetes Self-Care Activities (SDSCA) were used to investigate the type 2 diabetes patients from the department of Endocrinology of the First Affiliated Hospital in Jinzhou Medical University. And constructed the structural equation model.Results:The scores of fear of hypoglycemia in type 2 diabetes patients were positively correlated with psychological pain and self-regulating fatigue ( r=0.739, 0.625, P<0.05), but negatively correlated with self-management level ( r=-0.602, P<0.05). The psychological pain score was positively correlated with the self-regulating fatigue score ( r=0.669, P<0.05) and negatively correlated with the self-management level score ( r=-0.609, P<0.05). The score of self-regulation fatigue was negatively correlated with the score of self-management ( r=-0.596, P<0.05). Pathway analysis showed that hypoglycemia fear could directly affect self-management behavior, indirectly predict self-management level through self-regulation fatigue and psychological pain respectively, and negatively affect self-management behavior through chain mediation of self-regulation fatigue and psychological pain ( χ2/ df=3.079, GFI=0.920, CFI=0.961, NFI=0.943, IFI=0.961, RMSEA=0.078). Conclusions:The Self-regulated fatigue and psychological distress acts as the chain mediators of hypoglycemic fear and self-management in patients with type 2 diabetes.
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RESUMEN En México la interculturalidad en salud se plantea como una integración de dos sistemas de conocimiento, el conocimiento ancestral carente de bases científicas y que se transmite a través de las generaciones, y el modelo médico convencional. En múltiples estudios se describe que existe un gran porcentaje de médicos que han recibido pacientes que hacen uso de esta terapéutica. El objetivo fue identificar la prevalencia del uso de medicina tradicional herbolaria y el perfil de uso en pacientes con diabetes tipo 2 en una zona urbana. Se realizó un estudio observacional, transversal descriptivo en pacientes con diagnóstico de diabetes mellitus tipo 2, pertenecientes a un sistema de seguridad social de la ciudad de Querétaro, en un periodo mayor a 6 meses. El plan de análisis estadístico incluyó promedios, porcentajes, intervalos de confianza para promedios e intervalos de confianza para porcentajes. Se identificó que la prevalencia de uso de la medicina tradicional herbolaria era de 22.2%, con una edad promedio de 60.98 años, con predominio en el sexo femenino y una escolaridad secundaria o menos, la planta más utilizada fue moringa en un 45%, el uso más frecuente para el control glucémico en un 97% y su consumo era como agua de tiempo en la mayoría de las plantas. En este estudio se pudo describir la prevalencia de uso en una zona urbana, así como el perfil de las personas que hacen uso de esta terapéutica, con la finalidad de generar nuevas informaciones y promover el estudio de estas prácticas.
ABSTRACT In Mexico the interculturality in health is posed as an integration of the two systems of knowledge, the ancient knowledge lacking scientific bases which is transmitted through generations, and the conventional medical model. In multiple studies, the existence of a great percentage of medical doctors that have received patients using this therapy is described. The objective was to identify the prevalence of the use of herbal traditional medicine and the profile of use in patients with diabetes type 2 in an urban zone. This was an observational, transversal descriptive study performed in patients with diagnostic of diabetes mellitus type 2, belonging to a system of social security in Queretaro city, in a period greater than 6 months. The plan of statistical analysis included averages, percentages, confidence intervals for averages and percentages. The prevalence of use of the herbal traditional medicine was 22.2% with and average age of 60.98 years old, with predominance of the female sex and a scholarship of middle school or less, the plant mostly used was moringa in a 45%, the most frequent use was the glycemic control in 97% and the consumption was as natural water in most plants. In this study, it was described the prevalence of the use in an urban zone, as well as the profile of the people that use this therapy, with the purpose of generate new information and promote the study of these practices.
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Objective:To investigate the therapeutic effects of Metformin combined with a glucagon-like peptide-1(GLP-1)analogue on type 2 diabetes mellitus and immune cell function in elderly patients.Methods:A total of 180 elderly obese patients with type 2 diabetes mellitus treated in our hospital from November 2018 to November 2020 were included.They were divided into the control group(n=90, treated with Metformin)and the observation group(n=90, taking the GLP-1 analogue liraglutide in addition to Metformin). The two groups of patients were compared on body mass index(BMI), waist-to-hip ratio, glycosylated hemoglobin(HbA1c), fasting blood glucose(FBG), 2 hour postprandial blood glucose(2h-PBG), triglycerides(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C)and islet cell function(homeostatic model assessment of β-cell function, HOMA-β).Results:After treatment, BMI and waist-to-hip ratio decreased more significantly in the observation group than in the control group( P<0.05). HbA1c, FBG and 2H PBG levels were lower in the observation group than in the control group after treatment[(8.81±1.48)% vs.(10.6±1.94)%, (5.54±1.03)mmol/L vs.(6.91±1.10)mmol/L, (7.13±1.27)mmol/L vs.(8.86±1.74)mmol/L, all P<0.05]. After treatment, the observation group had more significantly decreased TG and TC levels and increased HDL-C levels than the control group( P<0.05). Changes in HOMAIR and HOMA-β in the observation group were more evident than in the control group after treatment( P<0.05). The incidence of adverse reactions during treatment was significantly lower in the observation group than in the control group(11.1% vs.31.1%, P<0.05). Conclusions:Metformin combined with a GLP-1 analogue has clearly favorable effects on T 2DM in elderly patients with obesity, helps achieve good blood glucose control and is very safe to use.The combination therapy can significantly restore the function of islet cells in patients with diabetes and delay the progression of diabetes.
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Resumen Objetivo Interpretar la percepción de pacientes indígenas chontales sobre su enfermedad y la calidad en el control de la diabetes tipo 2 en el estado mexicano de Tabasco. Materiales y métodos Se realizó investigación cualitativa en tres unidades médicas que dan atención a población indígena chontal. Participaron 44 personas con diabetes tipo 2 en cuatro grupos focales. Se emplearon guías de entrevista y dinámica de grupos. Para el análisis de los datos se empleó el software MAXQDA 2018. Se integraron los discursos más representativos, estos fueron documentados, organizados, categorizados y codificados. Resultados Los discursos de los indígenas chontales revelan que los problemas que perciben para lograr la calidad en el controlde su enfermedad son: su situación económica precaria, desigualdad y rezago para recibir atención médica, el escaso apoyo de la familia, la hegemonía del médico en la atención, la violencia doméstica en el caso de las mujeres, la necesidad de ser tratados como personasy no como una enfermedad, la manera como descifran su enfermedad, basada en mitos y creencias erróneas. Conclusiones Los resultados de este estudio muestran que la cosmovisión de las personas para comprender la diabetes que padecen ylograr su control metabólico, es clave para los servicios de salud en la mejora de la calidad.
Abstract Objective To interpret the perception of indigenous chontal patients about their disease and the quality in the control of type 2 diabetes in the Mexican state of Tabasco. Materials and methods Qualitative research was conducted in three medical units that provide attention to the indigenous Chontal population. 44 people with type 2 diabetes participated in four focus groups. Interview guides and group dynamics were used. For the analysis of the data, the MAXQDA 2018 software was used. The most representative speeches were integrated, these were documented, organized, categorized and codified. Results The speeches of the Chontal Indians reveal that the problems they perceive to achieve quality in the control of their disease are: their precarious economic situation, inequality and lag to receive medical care, poor family support, doctor's hegemony in care, domestic violence in the case of women, the need to be treated as people and not as a disease, the way they decipher their disease, based on myths and mistaken beliefs. Conclusions The results of this study show that the worldview of people to understand the diabetes they suffer and achieve their metabolic control, is key for health services in improving quality.
Resumo Objetivo Interpretar a percepção dos pacientes indígenas chontales sobre sua doença e a qualidade no controle da diabetes tipo 2 no estado mexicano de Tabasco. Materiais e métodos Pesquisa qualitativa realizada em três unidades médicas que atendem a população indígena Chontal. Participaram 44 pessoas com diabetes tipo 2 divididas em quatro grupos focais. Foram utilizados guias de entrevista e dinâmica de grupo. Para a análise dos dados foi utilizado o software MAXQDA 2018. Os discursos mais representativos foram integrados, sendo documentados, organizados, categorizados e codificados. Resultados Os discursos dos índios chontales revelam que os problemas que eles percebem para obter a qualidade no controle de sua doença são: situação econômica precária; desigualdade e atraso na atenção médica; apoio familiar insuficiente; hegemonia médica no cuidado; violência doméstica no caso das mulheres; a necessidade de serem tratados como pessoas e não como um doente; e a maneira como decifram sua doença com base em mitos e crenças equivocadas. Conclusões Os resultados deste estudo mostram que a visão de mundo das pessoas para entender a sua diabetes e alcançar seu controle metabólico é fundamental para os serviços de saúde na melhoria de sua qualidade.
Résumé Objectif Interpréter la perception de patients autochtones chontal de leur maladie et de la qualité du contrôle du diabète de type 2 dans l'État mexicain de Tabasco. Matériels et méthodes Une recherche qualitative a été menée dans trois unités médicales qui fournissent des soins à la population autochtone chontal. 44 personnes atteintes de diabète de type 2 ont participé à quatre groupes de discussion. Des guides d'entretien et des dynamiques de groupe ont été utilisés. L'analyse des données a été réalisée avec le logiciel MAXQDA 2018. Les discours les plus représentatifs ont été intégrés, documentés, organisés, catégorisés et codés. Résultats Les discours des autochtones chontal révèlent que les problèmes qu'ils perçoivent pour atteindre la qualité dans le contrôle de leur maladie sont les suivants : leur situation économique précaire, l'inégalité et le retard social dans l'accès aux services médicaux, le faible soutien de la famille, l'hégémonie du médecin, la violence domestique dans le cas des femmes, le besoin d'être traité comme des personne et non comme une maladie, leur façon d'interpréter leur maladie sur la base de mythes et de croyances erronées. Conclusions Les résultats de cette étude montrent que la cosmovision des personnes en relation à leur compréhension du diabète dont elles souffrent et à leur possibilité de parvenir à contrôler leur métabolisme est essentielle pour l'amélioration de la qualité des services de santé.
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Objective To examine the effects of Berberine(BBR)on inflammatory pathways related to endoplasmic reticulum stress(ERS) in the penumbra area following focal cerebral ischemia-reperfusion injury in type 2 diabetic rats.Methods A total of 72 healthy male Sprague-Dawley rats were fed a high-fat,high-sugar diet and injected with streptozotocin to establish a type 2 diabetes mellitus model.The diabetic rats were randomly divided by digital lottery method into a Sham operation group(Sham group),a diabetic rat + BBR treatment group(BBR group),a diabetic middle cerebral artery occlusion(MCAO)model group (MCAO group),and a diabetic rats MCAO + BBR treatment group (MCAO + BBR group).Six rats were included in each group.The two treatment groups received prespecified doses of BBR through gastric perfusion at 48 h,24 h before surgery,and 6h after surgery.The MCAO model was prepared by a suture occlusion method.The neurological deficit scores were performed,and the expression of tumor necrosis factor-α(TNF-a)and interleukin-1β(IL-1β) was detected by enzyme-linked immunosorbent assay(ELISA).The mRNA expression of ERS marker protein GRP78 was detected by quantitative real time polymerase chain reaction(RT-qPCR),and the expression of ERS-related inflammatory pathway proteins 678 Glucoseregulated protein(GRP78)、Pancreatic endoplasmic reticul um Rinase (PERK)、nuclear factor-κB (NF-κB)] was detected by Western blot.Results the cerebral ischemic penumbra area,after 2 h of ischemia and 24 h of reperfusion,the neurological deficit score in the MCAO group was higher than that in the MACO+BBR group [(2.83 ± 0.41) vs.(1.67± 0.52),P ＜0.05],and the expression levels of pro-inflammatory cytokines(TNF-α and IL-1β)and ERS-related inflammatory pathway proteins(GRP78,PERK and NF-κB p65)were also significantly increased(all P＜0.05).However,BBR treatment was able to alleviate the neurological dysfunction caused by cerebral ischemia-reperfusion in type 2 diabetic rats (P＜0.05).Similarly,BBR treatment also reduced the expression levels of pro-inflammatory factors(TNF-α and IL-1β)and ERS-related inflammatory pathway proteins(GRP78,PERK and NF-κB p65)in the cerebral ischemic penumbra area(all P＜0.05).Conclusions Through inhibiting ERS-related inflammatory pathways,BBR plays a neuroprotective role to alleviate cerebral ischemia-reperfusion injury in type 2 diabetic rats.
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Objective@#To examine the effects of Berberine(BBR)on inflammatory pathways related to endoplasmic reticulum stress(ERS)in the penumbra area following focal cerebral ischemia-reperfusion injury in type 2 diabetic rats.@*Methods@#A total of 72 healthy male Sprague-Dawley rats were fed a high-fat, high-sugar diet and injected with streptozotocin to establish a type 2 diabetes mellitus model.The diabetic rats were randomly divided by digital lottery method into a Sham operation group(Sham group), a diabetic rat + BBR treatment group(BBR group), a diabetic middle cerebral artery occlusion(MCAO)model group(MCAO group), and a diabetic rats MCAO + BBR treatment group(MCAO + BBR group). Six rats were included in each group.The two treatment groups received prespecified doses of BBR through gastric perfusion at 48 h, 24 h before surgery, and 6h after surgery.The MCAO model was prepared by a suture occlusion method.The neurological deficit scores were performed, and the expression of tumor necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)was detected by enzyme-linked immunosorbent assay(ELISA). The mRNA expression of ERS marker protein GRP78 was detected by quantitative real time polymerase chain reaction(RT-qPCR), and the expression of ERS-related inflammatory pathway proteins[78 Glucoseregulated protein(GRP78)、Pancreatic endoplasmic reticulum Rinase(PERK)、nuclear factor-κB(NF-κB)]was detected by Western blot.@*Results@#the cerebral ischemic penumbra area, after 2 h of ischemia and 24 h of reperfusion, the neurological deficit score in the MCAO group was higher than that in the MACO+ BBR group [(2.83±0.41)vs.(1.67±0.52), P<0.05], and the expression levels of pro-inflammatory cytokines(TNF-α and IL-1β)and ERS-related inflammatory pathway proteins(GRP78, PERK and NF-κB p65)were also significantly increased(all P<0.05). However, BBR treatment was able to alleviate the neurological dysfunction caused by cerebral ischemia-reperfusion in type 2 diabetic rats(P<0.05). Similarly, BBR treatment also reduced the expression levels of pro-inflammatory factors(TNF-α and IL-1β)and ERS-related inflammatory pathway proteins(GRP78, PERK and NF-κB p65)in the cerebral ischemic penumbra area(all P<0.05).@*Conclusions@#Through inhibiting ERS-related inflammatory pathways, BBR plays a neuroprotective role to alleviate cerebral ischemia-reperfusion injury in type 2 diabetic rats.
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Background: Obesity has major adverse effects on health. Obesity is associated with an increase in mortality, with a 50-100% increased risk of death from all causes compared to normal-weight individuals, mostly due to cardiovascular causes. The aim of this study was to correlate Body Mass Index (BMI) and glycaemic control (HbA1c) in type 2 Diabetic patients.Methods: In this study 100 patients of type 2 diabetic were subjected to detailed history, clinical examination, BMI, HbA1c and routine biochemical investigations.Results: Out of 100 diabetic patients included in this study 62 of them were male and 38 were female. Among 100 patients. Majority of patients were overweight (BMI 25-29.9) which is account to about 58 of total cases, 30 patients were normal BMI and 12 patients were obese. Statistical analysis a positive correlation found between BMI and poor glycaemic control (HbA1c), which is significant.Conclusions: From this study it was concluded that obesity (BMI) is associated with poor glycaemic control.
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Objective@#To investigate the association between fresh fruit consumption and status of glycemic control, among patients with type 2 diabetes mellitus (T2DM).@*Methods@#Using the stratified cluster sampling method, a cross-sectional study was conducted among 19 473 diabetic patients who were under the Disease Management Program related to the National Basic Public Health Service in Changshu county, Huai’an and Qinghe districts of Huai’an city from December 2013 to January 2014, under the combination of fasting plasma glucose (FPG) and haemoglobin A1c (HbA1c) methods, the glycemic control status in T2DM patients was assessed. Multiple logistic regression method was used to explore the relationship between fresh fruit consumption and status of glycemic control among T2DM patients.@*Results@#62.4% of the T2DM patients reported their amount of fruits intake in the past year. Both the levels of FPG and HbA1c decreased in T2DM patients, when the frequency and amount of fresh fruit consumption were increasing. Compared with patients who did not take fresh fruits, the risk of poor glycemic control in patients with fresh fruit consumption of 1-4 times/week and ≥5 times/week decreased 20% (OR=0.80, 95%CI: 0.73-0.87) and 30% (OR=0.70, 95%CI: 0.62-0.80), respectively. Patients with fruit consumption of 50-99 g/day and ≥100 g/day had lower risk of poor glycemic control, with ORs (95%CI) as 0.71 (95%CI: 0.62-0.83) and 0.68 (95%CI: 0.59-0.78), respectively.@*Conclusions@#The association of fresh fruit intake and glycemic control was statistically significant in patients with type 2 diabetes. With the increase of frequencies and amounts of fresh fruit consumption, the levels of FPG and HbA1c showed a decreasing trend. Our findings suggested that fresh fruit intake seemed helpful for glycemic control.
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Objective@#To understand the factors affecting the compliance of blood glucose monitoring in patients with type 2 diabetes in rural areas, and to provide evidence for improving the compliance of patients with blood glucose monitoring.@*Methods@#A method of phenomenological study in qualitative research was conducted to conduct deep semi-structured interviews on 43 patients with poor blood glucose compliance in type 2 diabetes in rural areas, and to analyze the collected data.@*Results@#Extracted five themes: bad experience affected compliance; lack of knowledge about blood glucose monitoring; economic and time was not sufficient; "long-term illness into a good doctor" overconfidence; social support uncertainty.@*Conclusions@#The status of blood glucose monitoring in rural type 2 diabetes patients is not optimistic. In order to improve the compliance of patients with blood glucose monitoring, nursing workers should pay attention to the mastery of blood glucose monitoring knowledge in rural type 2 diabetes patients, improve blood glucose monitoring methods and techniques, and give full play to the role of family doctors. Efforts to improve patient blood glucose monitoring compliance.
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One hundred and fifty diabetic patients,who received management by community family doctors and hospital consortium (1+1+1) team for at least 1 year,were enrolled from January 2017 to May 2017.After that they continued to receive the management for 1 more year by the team which were trained with TeamSTEPPS (team strategies and tools to enhance performance and patient safety).The management effect before and after TeamSTEPPS training was compared.After the TeamSTEPPS training,the team management ability was improved,so that the compliance of diabetic patients with medical advice,regular examination of blood glucose,regular follow-up assessment,health education,regular exercise and diet control were all better than before,and the differences were statistically significant (all P＜0.01).Fasting blood glucose,postprandial 2 h-blood glucose,glycosylated hemoglobin and LDL-C levels were all lower than before,and the achieved rate of the above indicators were also increased (P＜0.05).It is suggested that application of TeamSTEPPS in team training can effectively enhance the management ability for chronic disease of family doctors and improve compliance and clinical indicators of patients with diabetes under management.
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Objective To investigate the correlation between the level of microalbuminuria and severity of coronary artery disease in elderly coronary heart disease(CHD)patients combined with diabetes.Methods A total of 176 elderly CHD patients combined with diabetes were enrolled and prospectively studied.They were randomized into observation group(n=98)with microalbuminuria and the control group(n=78)with normoalbuminuria.The correlation between level of microalbuminuria and Gensini score was analyzed.Results The level of microalbuminuria and Gensini score were higher in observation group than in control group (P ＜ 0.05).There were statistically significant differences in level of microalbunminuria(F =9.87,P =0.013) and in Gensini score (F =9.07,P =0.015)among patients with single-,double-and triple-vessel disease.There was a positive correlation between levels of microalbuminuria and Gensini scores in CHD patients with type 2 diabetes(r =0.68,P＜0.01).Conclusions The level of microalbuminuria is positively correlated with the severity of coronary artery disease in elderly CHD patients with type 2 diabetes.The microalbuminuria level can reflect the severity of coronary artery disease in a certain degree.It has certain clinical significance for predicting patient's condition in elderly CHD patients with type 2 diabetes.