Assessment of factors affecting diabetes management in the City Changing Diabetes (CCD) study in Tianjin

Family-Based, Culturally Responsive Intervention for Chinese Americans With Diabetes: Lessons Learned From a Literature Review to Inform Study Design and Implementation

BACKGROUND

The prevalence of diabetes in the United States is very high, and Chinese peoples with diabetes are estimated to comprise 50% of the total cases. Rates of diabetes continue to rise among Chinese and Chinese American people; however, research regarding effective diabetes interventions for this minority group is sparse.

OBJECTIVE

A literature review was conducted to determine a study design and interventions for future studies investigating the efficacy of a family-based intervention to improve diabetes care for Chinese Americans.

METHODS

The review was conducted from January 2023 to April 2023. The PubMed, CINAHL, ScienceDirect, ProQuest, Google Scholar, Scopus, and Cochrane Central Register of Controlled Trials databases were searched. The key search terms were "diabetes type 2," "Chinese patients," "minority patients," "interventions for diabetes," "diabetes and family," "culturally responsive interventions for diabetic patients," "family education for diabetes," and "diabetes in China."

RESULTS

The initial search retrieved 2335 articles, and 10 articles met the selection criteria to examine the efficacy of family-based interventions for Chinese American people. The review showed that providing multiple sessions of education and counseling for both patients and family members is promising for improving diabetes care. Recruitment of 20 to 60 dyads consisting of a patient and a family member can help assess family dynamics in the process of diabetes care, such as food shopping and preparation, and of diabetes management to further evaluate the efficacy of an intervention. Glycated hemoglobin (HbA1c) was the most often used primary outcome. Other secondary outcomes included knowledge and efficacy in diabetes management and self-care activities related to diabetes care.

CONCLUSIONS

A family-based intervention is essential for optimizing diabetes care for Chinese Americans. Thus, recruitment of a dyad consisting of a patient and a family member is important to investigate the efficacy of a family-based intervention for improving diabetes care in this population. Strategies for improving recruitment and retention of dyads were identified. In addition, technology can be used to promote the delivery of interventions to patients, which in turn increases efficacy. This review can help researchers investigate the efficacy of family-based interventions for promoting diabetes management by designing culturally appropriate study protocols and interventions.

Associations between Primary Healthcare Experiences and Glycemic Control Status in Patients with Diabetes: Results from the Greater Bay Area Study, China

Primary healthcare (PHC) plays an important role in diabetes management; community health centers (CHCs) serve as the main providers of PHC. However, few studies have discussed the association between the service quality of PHC and the effects of diabetes management. In this study, we explored the associations between experiences of PHC in CHCs and glycemic control status in patients with diabetes mellitus. This study was conducted in six CHCs in the Greater Bay Area of China. In total, 418 patients with diabetes mellitus (44% males and 56% females) were recruited between August and October 2019. We evaluated their PHC experiences using the Primary Care Assessment Tool (PCAT) developed by Johns Hopkins and assessed their glycemic control status by measuring their fasting plasma glucose levels. Binary logistic regression analyses were conducted to assess the associations between the patients’ PHC experiences and glycemic control status, adjusting for covariates. The patients with good glycemic control had significantly higher total and dimensional PCAT scores compared with those with poor glycemic control (p < 0.05). Higher PCAT scores were significantly associated with a greater adjusted odds ratios (aORs) of good glycemic control for total and dimensional PCAT scores. For example, compared to those with poor glycemic control, the aORs for those with good glycemic control was 8.82 (95% CI = 4.38−17.76) per total PCAT score increasing. Especially, the aORs for those with good glycemic control were 3.92 (95% CI = 2.38−6.44) and 4.73 (95% CI = 2.73−8.20) per dimensional PCAT score of family-centeredness and community orientation increasing, respectively. Better PHC experiences were associated with better diabetes management. In particular, family-centered and community-oriented CHCs may help improve diabetes management in China and other low- and middle-income countries.

Therapeutic itinerary of elderly people with diabetes mellitus: implications for nursing care

OBJECTIVE

to describe the therapeutic itinerary of elderly people with diabetes mellitus registered at Family Health Strategy units.

METHODS

qualitative and descriptive study carried out with 15 elderly people with diabetes mellitus between February and April 2019 by applying semi-structured interviews with the participants. Data were submitted to analysis of Minayo's operational proposal.

RESULTS

in the folk care subsystem, the use of medicinal herbs, healers, and faith was emphasized by the participants. In the professional care subsystem, Family Health Strategy units were the services with the strongest bond to elderly people, but these patients still had to resort to the private healthcare network. Family proved to be the main source of support in the popular care subsystem.

FINAL CONSIDERATIONS

nursing must acknowledge the different types of knowledge, coping strategies, beliefs, and the culture of elderly people with diabetes mellitus to guarantee the delivery of comprehensive care.

Trends in diabetes care with special emphasis to medicinal plants: Advancement and treatment

Diabetic mellitus (DM) is a common metabolic disorder prevailing throughout the world. It may affect a child to an older person depending upon the physiology and the factors influencing the internal metabolic system of the body. Several treatments are available in the market ranges from synthetic drugs, insulin therapy, herbal drugs, and transdermal patches. Interestingly, the development of technologies and digital health have proving very helpful in improving the lifestyle of diabetic patients. All treatment approaches have their own advantages and disadvantages in the form of effectiveness and side effects. Medicinal plants have a long history of traditional application in the treatment of diabetes and even the use of plants are growing day-by-day due to the significant results against diseases and fewer side effects as compared to other treatment therapies. The intention behind writing this review is to gather all information and discussed them exhaustively in an article. The novel Coronavirus 2019 (COVID-19) pandemic has affected my lives including diabetic patients. The antidiabetic treatment strategies during this period has also discussed. In this article, we highlighted the molecular mechanism and herbal phytoconstituents that are responsible for lowering blood glucose level. The factors responsible for the progression of metabolic disorders can be controlled with the use of phytoconstituents present in herbal plants to maintain β-cells performance and restore blood glucose level. It can be concluded that medicinal plants are effective and affordable with lesser side effects for treating DM.

Identifying Needs and Barriers to Diabetes Dietary Education in Chinese People with Type 2 Diabetes and Their Family Members in Guangzhou: A Qualitative Study

PURPOSE

The purpose of this exploratory qualitative study was to identify the needs and barriers to diabetes dietary education issues in a Chinese context among people with type 2 diabetes and also their family members.

PATIENTS AND METHODS

Nineteen patients with type 2 diabetes and 15 family members were randomly selected from a larger study in Guangzhou. Descriptive phenomenological qualitative inquiry guided this study.

RESULTS

Both patients and their family members claimed a variety of needs regarding diabetes dietary information and that it should be patient-centered. In addition, both groups identified the effectiveness and helpfulness of diabetes diet-related health education, but family members reported a lack of professional education. Patients reported that the barriers to diabetes diet-related health education were: 1) patients' different faculties of memory and acceptance, 2) educators' methods of explaining the information, 3) lack of advertising and intensity of publicity both inside and outside of the hospital. Family members identified that diabetes diet-related health education assisted them with taking care of patients with diabetes and it was also beneficial for themselves to gain more dietary knowledge and develop healthy dietary habits.

CONCLUSION

It is necessary to make some adjustment to traditional diabetes dietary education. It may be a good strategy to investigate the needs and faculties of memory and acceptance of people with diabetes before starting a diabetes education program. Hospitals should intensify their publicity of diabetes education and make it more attractive to patients with diabetes and their family members. Educators should add information specifically for family members while conducting diabetes education. Tertiary hospitals could provide standardized training regarding diabetes-related health education to community family physicians; in this way, diabetes education could gradually be transferred to them and both groups of clinicians could share in the education.