Health-related quality of life of people with type 2 diabetes and its associated factors at a tertiary care clinic in Ningbo, China: A cross-sectional study.

INTRODUCTION: The burden of type 2 diabetes (T2DM) in China is increasing, with potential impacts on the health-related quality of life (HRQoL) of those who develop the disease. Context-specific assessment of HRQoL and its associated factors informs the development of contextually appropriate interventions to improve HRQoL. This study aimed to determine the HRQoL and its associated factors in people with T2DM at a tertiary care clinic in Ningbo, China. METHODS: A cross-sectional survey was undertaken among 406 people with T2DM in 2020-21. The primary outcome was HRQoL measured using EQ VAS and EQ-5D index from the EQ-5D-3L questionnaire. Multivariable regression analysis was used to determine the factors associated with HRQoL scores. RESULTS: The mean (± standard deviation) EQ VAS score was 68.7 (13.8). Median (interquartile range) EQ-5D index was 1 (0.027). Prevalence of problems in HRQoL domains was as follows: pain/discomfort (15.7%), anxiety/depression (13.3%), mobility (5.4%), self-care (3.5%) and managing usual activities (5.2%). The ≥60 years age group had a mean EQ VAS score 8.7 points higher (95% CI 3.4, 13.9; p < .001) than the 18-39 years age group. Those with T2DM >10 years had a mean EQ VAS score 8.6 points lower than those with a duration <1 year (-12.8, -4.4; p = .001). A T2DM duration >10 years was associated with a reduction in the EQ-5D index of 0.029 (-0.041, -0.016; p < .001) compared with a duration <1 year. CONCLUSIONS: Depression/anxiety and pain/discomfort are important domains of reduced HRQoL for this population. A longer duration of T2DM is associated with reduced HRQoL scores, including both EQ VAS and EQ-5D index. Increasing age may be counterintuitively associated with an increase in EQ VAS score in this population, potentially reflecting a 'paradox of aging' process. Future work should focus on developing, evaluating and implementing interventions to improve HRQoL in T2DM, such as strategies to manage pain and mental health conditions.

Effectiveness and safety of self-management interventions among adult type 2 diabetes mellitus patients in sub-Saharan Africa: a systematic review protocol.

OBJECTIVE: The objective of this review is to evaluate and synthesize evidence on the effectiveness and safety of self-management interventions among adult type 2 diabetes mellitus patients in sub-Saharan Africa. INTRODUCTION: Type 2 diabetes mellitus is a large and growing problem in sub-Saharan Africa. Several randomized controlled trials have been conducted assessing a range of self-management interventions among adult patients in sub-Saharan African settings. A comprehensive systematic review on the effectiveness and safety of these self-management interventions is required to inform health policy. This will allow for wide implementation of evidence-based self-management interventions in adults with type 2 diabetes mellitus in sub-Saharan Africa. INCLUSION CRITERIA: This systematic review will include randomized controlled trials assessing the effectiveness and safety of self-management interventions among adult type 2 diabetes mellitus patients in sub-Saharan Africa. METHODS: The authors will undertake a systematic search for published and unpublished studies using the following sources: MEDLINE (Ovid), Embase (Ovid), CINAHL (EBSCO), PsycINFO (Ovid), Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Global Health (EBSCO), Directory of Open Access Journals, OpenGrey, EthOS, and ProQuest Dissertations and Theses. No language restrictions will be applied. The review will be conducted in accordance with the JBI methodology for systematic reviews of effectiveness. Narrative synthesis will be conducted, followed by meta-analysis, where feasible. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021237506.

What are the development priorities for management of type 2 diabetes by general practitioners in Ningbo, China: a qualitative study of patients' and practitioners' perspectives.

OBJECTIVES: To explore patients' and general practitioners' (GPs') perspectives on primary care management of patients with type 2 diabetes mellitus (T2DM) in Ningbo, China. We aimed to understand the current benefits and challenges and to identify development priorities. DESIGN: Exploratory qualitative descriptive study using face-to-face interviews and analysed by thematic, inductive analysis. SETTING: 11 primary care facilities spread across the city of Ningbo, China. PARTICIPANTS: 23 patients with T2DM and 20 GPs involved in caring for patients with T2DM. RESULTS: GPs were considered the first point of contact and providers of information. However, the care varied, and many GPs lacked confidence and felt overworked. The medication was a particularly weak area. The diagnostic screening commenced late, leading to crisis presentations. Patients were variably informed about their condition, contributing to poor adherence. CONCLUSIONS: Future developments of primary care for T2DM in Ningbo should centre around improving GP confidence and workload and patient education and adherence.