ABSTRACT
Background: Diabetes mellitus is a multisystem disorder associated with number of complications. If patients are to contribute to the effective control of diabetes, awareness and practices can assist in reducing the incidence of its complications.Methods: A cross-sectional study of 200 type II diabetic patients at JSS Hospital, Mysuru was conducted, assessment of health seeking behaviour using semi structured questionnaire was done. Quality of life was assessed using WHO QOL-BREF Questionnaire.Results: Among 200 study participants 53.5% belongs to age group 41-60, 57.5% were males, 44.5% were having family history of diabetes, 68.5% were on oral hypoglycemic agents. 163 (81.5%) were anxious when they were diagnosed as diabetics, 123 (61.5%) were influenced by themselves to go for investigations, 68 (34%)were influenced by Doctors, 131 (65.5%) had no money as the barrier to attend hospital for check-up, 186 (93%) visit hospital once in less than 3 months, 180 (90%) of them believed oral drugs are the treatment for diabetes, 188 (94%) prefer Allopathic medicine. Association between initial response on diagnosis and interval for regular monitoring with Quality of life of diabetic patients was statically significant (p?0.05).Conclusions: Health seeking behaviour is an important determinant of controlled glycaemic status and Quality of life of people living with diabetes.
ABSTRACT
Background: Diabetes distress is a condition distinct from depression that is related to diabetes outcomes. This study intends to identify the predicting risk factors of diabetes distress in Bangladeshi type 2 diabetes mellitus patients. Methods: A cross sectional study was conducted from January to June, 2012 in Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka. Data were collected through interview and reviewing documents. Results: Among 165 respondents, the proportion of diabetes distress was 48.5% (n=80) which include 22.4% (n=37) high distress and 26.1% (n=43) moderate distress. Glycemic status measured by HbA1c was the best predictor of diabetes distress [Adjusted odds ratio (AOR) 1.56; 95% Confidence Interval (CI) 1.16 to 2.10]. Insulin users were five times more likely to develop distress [Adjusted odds ratio (AOR) 5.05; 95% Confidence Interval (CI) 1.20 to 21.19] than users of oral anti-diabetic agents. Other predictors of diabetes distress were duration of DM [Adjusted odds ratio (AOR) 1.27; 95% Confidence Interval (CI) 1.06 to 1.52], Diabetic complications [Adjusted odds ratio (AOR) 3.92; 95% Confidence Interval (CI) 1.09 to 14.19], Average monthly family income [Adjusted odds ratio (AOR) 1.00; 95% Confidence Interval (CI) 1.00 to 1.00]. Conclusion: HbA1c, treatment modalities, duration of DM, diabetic complications and average monthly family income appeared to be significant predicting factors of diabetes distress among the type 2 diabetes mellitus patients. This should be taken into consideration for effective management of patient.
ABSTRACT
The aim of this observational study was to describe the profile of subjects with type 2 diabetes mellitus from Gujarat, India. The study was performed with newly-diagnosed 622 type 2 diabetic subjects who attended the Department of Diabetology, All India Institute of Diabetes and Research and Yash Diabetes Specialties Centre (Swasthya), Ahmedabad, during August 2006–January 2009. The subjects completed an interviewer- administered questionnaire. The questionnaire included variables, such as sociodemographic factors, presenting symptoms, risk profile (hypertension, obesity, dyslipidaemia, and glycaemic status), family history of diabetes, physical activity, and behavioural profile. Blood pressure, body mass index (BMI), glycosylated haemoglobin levels, and fasting lipid profile were measured. Descriptive and bivariate analyses were carried out using the SPSS software (version 11.5). In total, 622 type 2 diabetes mellitus (T2DM) cases with mean age of 47.7±10.9 years were studied. Of the 622 subjects, 384 (62%) were male. The majority (68%) of the T2DM subjects were obese, and 67% had a positive family history of diabetes. Renal dysfunctions and vision impairment were, respectively, found in 10% (n=62) and 9% (n=57) of the 622 T2DM subjects. The mean HbA1c level was 9.02±1.67%, and good glycaemic control (HbA1c level <7%) was achieved only in 7.4% of the T2DM subjects. Results of chi-square analysis showed that higher BMI (≥25 kg/m2) was significantly associated with hypertension among the T2DM subjects (p<0.01). There were significant differences (p<0.05) between male and female subjects with respect to mean age, BMI, waist- and hip-circumference, and mean low-density lipoprotein (LDL) level. The results revealed that many factors, such as obesity, family history of diabetes, dyslipidaemia, uncontrolled glycaemic status, sedentary lifestyles, and hypertension were prevalent among the T2DM subjects. The characterization of this risk profile will contribute to designing more effective and specific strategies for screening and controlling T2DM in Gujarat, India.
ABSTRACT
Various physiological parameters like blood pressure, temperature, blood sugar after onset of stroke have been proposed as possible marker of stroke prognosis to study the glycaemic status after acute stroke and assess the role of glycaemic status along with other clinical parameters in influencing stroke outcome. Forty-two confirmed stroke patients attending hospital within 6 hours of onset of stroke onset were included in the study. The time lag for hospitalization, blood pressure, blood sugar, HbA1c, stroke severity according to Toronto Scale, demographic factors, stroke onset type, type of stroke, past history of stroke, diabetes, and hypertension were recorded. The outcome was whether patient survived at the end of forth week. Twenty-one percent of patients who were not known diabetic found to be hyperglycemic though their HBA1C level was normal. Eighty-nine percent of such patients died. This rate was significantly higher than patients known to be diabetic with raised sugar and HBA1c level (26% patients, 12% mortality). There was strong and significant association between stroke severity and poor outcome. Strong and significant association was also found between stroke severity and blood sugar level. Modeling of stroke outcome using decision tree analysis (QUEST) found stroke severity as most important and significant predictor especially for severe stroke cases. In mild and moderately severe stroke, high sugar level was found to be a predictor, though not statistically significant.This study suggests that stroke severity is the most important predictor of stroke outcome, with high sugar level as a marker of stroke severity.