The influence of family characteristics on glycaemic control among adult patients with type 2 diabetes mellitus attending the general outpatient clinic, National Hospital, Abuja, Nigeria

Adherence to chemotherapy and associated factors among adult patients with cancer in the Amhara region, Ethiopia, 2022

BACKGROUND

Adherence to chemotherapy treatment requires collaboration and sincere agreement between healthcare providers and patients. Poor medication adherence is problematic as it can lead to reduced effectiveness of the treatment. Poor survival, a rise in relapses, treatment failure, and higher healthcare expenses will result from this. A measure of patient treatment adherence is crucial to attain ideal results, such as curative treatment or improving quality of life.

OBJECTIVE

To assess cancer patients' adherence to chemotherapy and related factors patients in the Amhara Region, Ethiopia, in 2022.

METHODS AND MATERIALS

Between May 28, 2022, and June 22, 2022, 460 cancer patients in the Amhara region participated in a cross-sectional study carried out by systematic randomized sampling. Data were gathered using an interview-based, previously approved questionnaire. For analysis, the data were first imported into Epi-Data version 4.6 and then exported to the Statistical Package for Social Science version 26. Variables with a p-value of 0.25 were evaluated in a bivariate logistic regression to select a candidate variable for multivariate logistic regression. Variables with a p-value less than 0.05 were deemed significantly associated factors in multivariable logistic regression, and the resulting AOR and 95% CI are displayed for those variables. The Hosmer Lemeshow test was used to confirm the model's appropriateness, and multi-collinearity was verified with a standard error.

RESULTS

The proportion of good adherence in the Amhara region is 42.3% (95%CI [37.6-47.6]). A history of comorbidity [AOR = 2.74, 95% CI (1.56, 4.81)], no serious side effects from chemotherapy [AOR = 3.50, 95% CI (1.55, 7.90)], having social support [AOR = 1.52, 95% CI (1.21, 1.95)], being a woman [AOR = 2.17, 95% CI (1.31, 3.60)], and having a family history of cancer [AOR = 3.58, 95% CI (2.22, 5.76)], were associated with good chemotherapy adherence.

CONCLUSION AND RECOMMENDATIONS

Compared to other studies, the proportion of poor adherence in the Amhara region was high. Health professionals, families, and government representatives should all work together to provide social support and other systems that will lessen the likelihood that cancer patients with comorbidities may have side effects from chemotherapy.

Association of Met420del Variant of Metformin Transporter Gene SLC22A1 with Metformin Treatment Response in Ethiopian Patients with Type 2 Diabetes

Objective

This study aimed to evaluate whether the M420del variants of SLC22A1 (rs72552763) is associated with metformin treatment response in Ethiopian patients with type 2 diabetes mellitus (T2DM).

Patients and Methods

A prospective observational cohort study was conducted on 86 patients with T2DM who had been receiving metformin monotherapy for <1 year. Patients showing ≥0.5% reduction in HbA1c levels from baseline within 3 months and remained low for at least another 3 months were defined as responders while those patients with <0.5% reduction in HbA1c levels and/or those whom started a new class of glucose-lowering drug(s) because of unsatisfactory reduction were defined as non-responders. In addition, good glycemic control was observed when HbA1c ≤7.0%, and the above values were regarded as poor. Genotyping of rs72552763 SNP was performed using TaqMan® Drug Metabolism Enzyme Genotyping Assay and its association with metformin response and glycemic control were assessed by measuring the change in HbA1c and fasting blood glucose levels using Chi-square, logistic regression and Mann-Whitney U-test. Statistical significance was set at p <0.05.

Results

The minor allele frequency of the rs72552763 SNP of SLC22A1 was 9.3%. Metformin response was significantly higher in deletion_GAT (del_G) genotypes as compared to the wild-type GAT_GAT (G_G) genotypes. Furthermore, a significantly lower median treatment HbA1 level was found in del_G genotypes as compared to G_G genotypes. However, the association of rs72552763 with metformin response was not replicated at the allele level. In contrast, the minor del_allele was significantly associated with good glycemic control compared to the G_allele, though not replicated at del_G genotypes level.

Conclusion

This study demonstrated that metformin response was significantly higher in study participants with a heterozygous carrier of M420del variants of SLC22A1 as compared to the wild-type G_G genotypes after 3 months of treatment.

Does family-centred education improve treatment adherence, glycosylated haemoglobin and blood glucose level in patients with type 1 diabetes? A randomized clinical trial

AIM

To investigate the effect of family-centred education on treatment adherence, glycosylated haemoglobin and blood glucose level in patients with Type 1 Diabetes Mellitus.

DESIGN

Randomized controlled trial.

METHODS

Sixty patients with Type 1 Diabetes Mellitus were randomly allocated into the intervention and control group. Data were collected using demographic and Modanloo Adherence to Treatment Questionnaires. The patients received 12 family-centred educational sessions in the intervention group.

RESULTS

A significant difference was found in the mean score of treatment adherence between the two groups after the intervention (p < 0.001). The mean score of treatment adherence significantly increased in the intervention group after family-centred education. The mean score of Fasting Blood Glucose and Glycosylated Haemoglobin A1C significantly decreased in the intervention group after the intervention (p < 0.001).

CONCLUSION

Relevant authorities need to consider family-centred education as one of the most important education methods in Type 1 Diabetes Mellitus patients.

TRIAL REGISTRATION

IRCT20131112015390N4; August 21, 2020.

Social networks, perceived social support, and HbA1c in individuals with type 2 diabetes mellitus in urban Ghana

OBJECTIVES

Although links between social relationships and health are well established, few studies have concurrently examined the effects of compositional, structural, and functional dimensions of social networks on glycemic (HbA1c) control in low- and middle-income countries such as Ghana. In these settings where informal social relationships are critical for access to resources, evaluating the links between social network characteristics, social support, and glycemic control may provide clarity about important relationships that facilitate the well-being of individuals with type 2 diabetes mellitus (T2DM).

DESIGN

In 2018, we conducted a hospital-based, cross-sectional survey of noninstitutionalized adults with T2DM in Ghana. Using data from 247 study participants, multivariable linear regression models were used to estimate associations between: 1) HbA1c and three social network characteristics (kin composition, household composition, and network density); 2) social support and the three social network characteristics; and 3) HbA1c and social support. We also examined gender differences in these associations and applied mediation techniques to determine if network characteristics operated through social support to affect HbA1c.

RESULTS

Findings indicated that higher kin composition and higher household composition were each significantly associated with increased social support. Neither social support nor social network characteristics were significantly related to HbA1c, and there were no gender differences in any of these associations.

CONCLUSION

Although family and household members were identified as important sources of social support for diabetes management, the ways in which they influence HbA1c control among Ghanaians require further investigation. Future studies can examine whether changes in social support over time, social support satisfaction, or other dimensions of social relationships improve T2DM outcomes in countries like Ghana.

Diabetes Mellitus Family Assessment Instruments: A Systematic Review of Measurement Properties

Although many instruments are used to assess the families of people with diabetes, their measurement properties have not been systematically reviewed. We aimed to identify and evaluate the psychometric properties of the instruments used to assess family functioning in adults with diabetes.

METHODS

A systematic literature review, according to the JBI systematic reviews of measurement properties, was conducted using different databases, including gray literature. PROSPERO registration number: CRD42021239733. Two independent reviewers searched, screened, and assessed the risk of bias among the articles according to the COSMIN methodology. The quality of each included instrument was assessed using the updated criteria for good measurement properties.

RESULTS

Eighty-one studies were included, and thirty-one eligible instruments were identified. The psychometric properties frequently assessed were structural validity, internal consistency, and construct validity.

CONCLUSIONS

Although 31 instruments were included, none of their psychometric properties were scored as "very good". From the instruments scored as adequate on development and content validity, five stood out for their quality appraisal.. The development of new instruments is not recommended. More studies should be conducted on the existing instruments to assess the less commonly evaluated psychometric properties. Using valid instruments to develop and evaluate interventions is essential to promote health literacy and the effectiveness of diabetes management.

Childhood obesity in urban Ghana: evidence from a cross-sectional survey of in-school children aged 5-16 years

BACKGROUND

Childhood obesity is a growing public health concern in many low-income urban settings; but its determinants are not clear. The purpose of this study is to assess the prevalence of childhood obesity and associated factors among in-school children aged 5-16 years in a Metropolitan district of Ghana.

METHODS

A cross-sectional quantitative survey was conducted among a sample of 285 in-school children aged 5-16 years. Pre-tested questionnaires and anthropometric data collection methods were used to collect data. Descriptive, bivariate, binary and multivariate logistic regression statistical techniques were used to analyse data.

RESULTS

Some 46.9% (42.2% for males and 51.7% for females) of the children were overweight. Of this, 21.2% were obese (BMI falls above 95th percentile). Childhood obesity was higher in private school (26.8%) than public school (21.4%), and among girls (27.2%) than boys (19%). Factors that increased obesity risks included being aged 11-16 as against 5-10 years (aOR = 6.07; 95%CI = 1.17-31.45; p = 0.025), having a father whose highest education is 'secondary' (aOR =2.97; 95% CI = 1.09-8.08; p = 0.032), or 'tertiary' (aOR = 3.46; 95% CI = 1.27-9.42; p = 0.015), and consumption of fizzy drinks most days of the week (aOR = 2.84; 95% CI = 1.24-6.52; p = 0.014). Factors that lowered obesity risks included engaging in sport at least 3times per week (aOR = 0.56; 95% CI = 0.33-0.96; p = 0.034), and sleeping for more than 8 h per day (aOR = 0.38; 95% CI = 0.19-0.79; p = 0.009).

CONCLUSION

Higher parental (father) educational attainment and frequent consumption of fizzy drinks per week may increase obesity risks among in-school children aged 5-16 years in the Metropolitan district of Ghana. However, regular exercise (playing sport at least 3 times per week) and having 8 or more hours of sleep per day could lower obesity risks in the same population. Age and sex-appropriate community and school-based interventions are needed to promote healthy diet selection and consumption, physical activity and healthy life styles among in-school children.

Diabetes management in Senegalese families: A dyadic-narrative illustration

Objectives In many Sub-Saharan African cultures, diabetes self-management behaviors such as dietary adherence do not occur in isolation but are carried out in the context of local culture, a significant factor in shaping those health behaviors. Methods Using a family-based narrative approach, we explore how Senegalese families manage diabetes. We interviewed twenty people living with diabetes and selected family caregivers from MBour, Senegal. Results We found that people living with diabetes experienced physical, emotional, and financial stressors as a result of managing their condition. In addition, family caregivers play an important role in managing their family member's diabetes. Discussion The act of caregiving affects caregiver diabetes prevention behaviors. In some cases, this caregiving role leads to an increase of healthy behaviors such as reducing dietary sugar; however, in some cases, caregivers do not see the need to engage in healthy behaviors. Diabetes prevention and management interventions that support both Senegalese people living with diabetes and their family caregivers are warranted.