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Molla IB, Hagger V, Rothmann MJ, Rasmussen B. The Role of Community Organisation, Religion, Spirituality and Cultural Beliefs on Diabetes Social Support and Self-Management in Sub-Saharan Africa: Integrative Literature Review. JOURNAL OF RELIGION AND HEALTH 2025:10.1007/s10943-024-02233-y. [PMID: 39853664 DOI: 10.1007/s10943-024-02233-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/23/2024] [Indexed: 01/26/2025]
Abstract
To examine the evidence for the role of community organisations, religion, spirituality, cultural beliefs, and social support in diabetes self-management, we undertook an integrative literature review utilising MEDLINE, APA PsycINFO, CINAHL, and grey literature databases. The selected articles were appraised for quality, and the extracted data were analysed thematically. The search yielded 1586 articles, and after eliminating duplicates, 1434 titles and abstracts were screened, followed by a full-text review of 103 articles. Ultimately, 47 articles met the inclusion criteria for the review, utilising various study designs, including qualitative, quantitative, mixed-methods, and nonrandomised clinical trials. These findings indicate that spirituality and religiosity can positively affect diabetes self-management by providing motivation, coping skills, social support, and guidance for healthy behaviours. A strong social support system enhances diabetes self-management and glycaemic control for individuals with diabetes. However, some aspects of religion and culture, such as beliefs about medications, may also pose challenges or barriers to diabetes self-management. Adherence to medication, food choices, physical activity, and the use of complementary or alternative medicine can be influenced by sociocultural factors. Additionally, cultural beliefs and social norms influence understanding diabetes aetiology, management, and symptom reactions. The findings highlight that it is crucial to understand the cultural, religious, or spiritual influences that can either assist or impede self-management habits in individuals with diabetes and could inform interventions that support personalised and effective care.
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Affiliation(s)
- Israel Bekele Molla
- Institute of Health, School of Nursing, Jimma University, Jimma, Ethiopia.
- The Centre for Quality and Patient Safety, School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia.
| | - Virginia Hagger
- The Centre for Quality and Patient Safety, School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia
| | - Mette Juel Rothmann
- The Centre for Quality and Patient Safety, School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia
- Steno Diabetes Centre Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
| | - Bodil Rasmussen
- The Centre for Quality and Patient Safety, School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia
- Steno Diabetes Centre Odense, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Odense, Denmark
- Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
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Hayashino Y, Tsuboi S, Yamamoto Y, Ishii H. Burden of Current Insulin Therapy and Expectations for Future Insulin Therapy: Results from INBEING, a Web-Based Survey in Japan. Diabetes Ther 2024; 15:2537-2555. [PMID: 39485624 PMCID: PMC11561213 DOI: 10.1007/s13300-024-01664-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2024] [Accepted: 10/15/2024] [Indexed: 11/03/2024] Open
Abstract
INTRODUCTION This survey assessed the perspectives of physicians, people with diabetes (PWD), and caregivers in Japan regarding initiation barriers and treatment burden associated with insulin therapy, and expectations for new insulin therapies. METHODS An online survey, conducted May-June 2023, was completed by physicians (n = 411), PWD (type 1 diabetes, n = 108; type 2 diabetes [T2D]: insulin-naive, n = 114; insulin-treated, n = 108), and caregivers (family members, n = 107; nurses, n = 117; care workers, n = 104). Agreement with statements regarding initiation barriers, current feelings, and burden of insulin therapy was assessed. Physicians' views on ideal glycated hemoglobin (HbA1c) levels and actual levels in PWD at insulin initiation were captured. RESULTS Most PWD agreed with the statements "I don't want to be bothered with doing injections" (77.8-92.1%) and "I don't want to inject myself for the rest of my life" (78.7-91.2%). Physicians also considered these factors to be of high importance for PWD; however, physician and PWD (insulin-naive T2D) responses were significantly different for 11 statements. The greatest underestimation by physicians was for the statement "my family will be worried" (41.8% vs. 66.7%), whereas social factors (e.g., "my friendships may suffer," "if I take insulin I will be discriminated against") were overestimated by physicians (49.1% vs. 33.3% and 46.5% vs. 24.6%, respectively). Although > 70% of physicians considered HbA1c < 9.0% (< 75 mmol/mol) ideal for insulin initiation, only ~ 30% of PWD started insulin at HbA1c < 9.0% (< 75 mmol/mol). Nurses rated the burden of assisting with insulin injections significantly lower than family members or care workers. Respondents agreed the need for less frequent injections and improved glycemic control were important attributes expected from future insulin therapies. CONCLUSION Differences in perceptions between physicians and PWD in Japan regarding insulin therapy persist, but this gap may be narrowing. Both groups agreed that future insulin therapies should be simpler and provide better glycemic control.
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Affiliation(s)
| | | | | | - Hitoshi Ishii
- Department of Doctor-Patient Relationships, Nara Medical University, Kashihara, Japan
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Lorenzo C, Soumare H. [Developing cultural competence for better support]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2024; 69:42-44. [PMID: 39515912 DOI: 10.1016/j.soin.2024.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
Culture, in its broadest sense, can have an impact on diabetes management. Taking into account cultural particularities in the care of patients seems essential to offering them care that is equitable and meaningful to them. Developing nurses' cultural competence through reflection, training and experience could be a lever enabling them to achieve this objective of quality and relevance of care.
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Affiliation(s)
- Camille Lorenzo
- Service diabétologie pédiatrique, Hôpital Jean-Verdier, AP-HP, avenue du 14-Juillet, 93140 Bondy, France
| | - Hada Soumare
- Centre municipal de santé Le cygne, 6 rue du Cygne, 93200 Saint-Denis, France.
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Arueyingho O, Aprioku JS, Marshall P, O'Kane AA. Insights Into Sociodemographic Influences on Type 2 Diabetes Care and Opportunities for Digital Health Promotion in Port Harcourt, Nigeria: Quantitative Study. JMIR Diabetes 2024; 9:e56756. [PMID: 39167439 PMCID: PMC11375378 DOI: 10.2196/56756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 06/20/2024] [Accepted: 07/02/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND A significant percentage of the Nigerian population has type 2 diabetes (T2D), and a notable portion of these patients also live with comorbidities. Despite its increasing prevalence in Nigeria due to factors such as poor eating and exercise habits, there are insufficient reliable data on its incidence in major cities such as Port Harcourt, as well as on the influence of sociodemographic factors on current self-care and collaborative T2D care approaches using technology. This, coupled with a significant lack of context-specific digital health interventions for T2D care, is our major motivation for the study. OBJECTIVE This study aims to (1) explore the sociodemographic profile of people with T2D and understand how it directly influences their care; (2) generate an accurate understanding of collaborative care practices, with a focus on nuances in the contextual provision of T2D care; and (3) identify opportunities for improving the adoption of digital health technologies based on the current understanding of technology use and T2D care. METHODS We designed questionnaires aligned with the study's objectives to obtain quantitative data, using both WhatsApp (Meta Platforms, Inc) and in-person interactions. A social media campaign aimed at reaching a hard-to-reach audience facilitated questionnaire delivery via WhatsApp, also allowing us to explore its feasibility as a data collection tool. In parallel, we distributed surveys in person. We collected 110 responses in total: 83 (75.5%) from in-person distributions and 27 (24.5%) from the WhatsApp approach. Data analysis was conducted using descriptive and inferential statistical methods on SPSS Premium (version 29; IBM Corp) and JASP (version 0.16.4; University of Amsterdam) software. This dual approach ensured comprehensive data collection and analysis for our study. RESULTS Results were categorized into 3 groups to address our research objectives. We found that men with T2D were significantly older (mean 61 y), had higher household incomes, and generally held higher academic degrees compared to women (P=.03). No statistically significant relationship was found between gender and the frequency of hospital visits (P=.60) or pharmacy visits (P=.48), and cultural differences did not influence disease incidence. Regarding management approaches, 75.5% (83/110) relied on prescribed medications; 60% (66/110) on dietary modifications; and 35.5% (39/110) and 20% (22/110) on traditional medicines and spirituality, respectively. Most participants (82/110, 74.5%) were unfamiliar with diabetes care technologies, and 89.2% (98/110) of those using technology were only familiar with glucometers. Finally, participants preferred seeking health information in person (96/110, 87.3%) over digital means. CONCLUSIONS By identifying the influence of sociodemographic factors on diabetes care and health or information seeking behaviors, we were able to identify context-specific opportunities for enhancing the adoption of digital health technologies.
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Kharsati N, Kulkarni M. Living with diabetes in Northeast India: An exploration of psychosocial factors in management. DIALOGUES IN HEALTH 2024; 4:100180. [PMID: 38766602 PMCID: PMC11101859 DOI: 10.1016/j.dialog.2024.100180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 05/07/2024] [Accepted: 05/07/2024] [Indexed: 05/22/2024]
Abstract
Purpose India is the 'Diabetes Capital of the World' and accounts for one in seven adults living with diabetes worldwide. Psychosocial, economic, and cultural correlates of disease have important implications for disease management but are rarely explored in India. The purpose of this study is to address psychosocial and cultural factors in diabetes management in the northeastern region of India which has a high disease burden. Methods This study attempts to explore the psychosocial and lived experience of diabetes in the northeastern state of Meghalaya. The sample was selected from individuals attending an outpatient facility of a multi-speciality clinic. Semi-structured interviews were conducted with 25 individuals (13 women and 12 men), above the age of 40 years, who had been diagnosed with diabetes for at least 6 months. The narratives were analysed using thematic analysis. Results Using the social cognitive framework, themes were organized in terms of a thematic map linking knowledge of diabetes to the perception of diabetes as 'a silent killer', to coping, leading to self-efficacy. However high self-efficacy, over time, may lead to complacency, disrupting health behaviours and requiring re-establishment of those behaviours. Adequate knowledge along with cognitive adaptation and self-efficacy were important constructs that contributed to behaviour change and maintenance. Elements of the cultural context were observed in the spiritual aspects of adaptation, the socially isolating consequences of diabetes, as well as gender differences in social support and management. Conclusion Understanding the lived experiences of patients contributes to planning more effective interventions keeping the social and cultural context in mind for more effective management of diabetes. Additionally, acknowledging and supporting women's needs in diabetes management is called for.
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Affiliation(s)
- Naphisabet Kharsati
- Department of Humanities and Social Sciences, Indian Institute of Technology Bombay, Mumbai 400076, India
| | - Mrinmoyi Kulkarni
- Department of Humanities and Social Sciences, Indian Institute of Technology Bombay, Mumbai 400076, India
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Zeh P, Young A, Gholap N, Randeva H, Robbins T, Johal K, Patel S, O'Hare JP. Diabetes specialist intervention in general practices in areas of deprivation and ethnic diversity: A qualitative evaluation (QUAL-ECLIPSE). Prim Care Diabetes 2024; 18:37-43. [PMID: 37926590 DOI: 10.1016/j.pcd.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/21/2023] [Accepted: 10/29/2023] [Indexed: 11/07/2023]
Abstract
AIM To assess patients' and healthcare professionals' perspectives of a specialist-led Diabetes Risk-based Assessment Clinic (DIRAC) for people with diabetes at high risk of complications (PWDHRC) in areas of deprivation in Coventry, UK. METHODS A qualitative evaluation of a pilot trial, comprising a specialist team intervention (DIRAC), was undertaken in seven GP practices through observations of weekly virtual or occasional face-to-face patient consultations and monthly interventionists' meetings. Semi-structured interviews were carried out post-intervention, with PWDHRC, primary care clinicians and diabetes specialists (interventionists). Thematic analyses of observations and interviews were undertaken. KEY FINDINGS Over 12 months, 28 DIRAC clinics comprising 154 patient consultations and five interventionists' meetings, were observed. 19 interviews were undertaken, PWDHRC experienced 'culturally-sensitive care from a specialist-led clinic intervention encompassing integrated care. This model of care was recommended at GP practice level, all participants (PWDHRC, primary care clinicians and diabetes specialist interventionists) felt upskilled to deal with complex diabetes care. The EMIS and ECLIPSE technologies utilised during the intervention were perceived to positively contribute to diabetes management of PWDHRC despite reservations around cost and database. CONCLUSION The specialist-led DIRACs were largely appreciated by study participants. These qualitative data support the trial progressing to a full-service evaluation.
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Affiliation(s)
- Peter Zeh
- Centre for Healthcare Research, Faculty of Health & Life Sciences, Coventry University, Coventry CV1 5RW, UK; Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM) Centre, University Hospitals Coventry & Warwickshire NHS Trust, Coventry CV2 2DX, UK.
| | - Annie Young
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | - Nitin Gholap
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM) Centre, University Hospitals Coventry & Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Harpal Randeva
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM) Centre, University Hospitals Coventry & Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Timothy Robbins
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM) Centre, University Hospitals Coventry & Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - Kam Johal
- Henley Green Medical Centre, Coventry CV2 1AB, UK
| | - Shweta Patel
- University Hospitals of Leicester NHS Trust, LE5 4PW Leicester, UK
| | - J Paul O'Hare
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK; Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM) Centre, University Hospitals Coventry & Warwickshire NHS Trust, Coventry CV2 2DX, UK
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Altabtabaei R, Alhuwail D. Exploring the Challenges and Opportunities of Adopting and Using Telemedicine for Diabetes Care and Management: Qualitative Semistructured Interview Study Among Health Care Providers and Patients With Diabetes. JMIR Hum Factors 2023; 10:e46324. [PMID: 37676711 PMCID: PMC10514770 DOI: 10.2196/46324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 07/22/2023] [Accepted: 07/28/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND Around the world, over half of the global population experiences noncommunicable diseases, resulting in premature death. Health care providers (HCPs) can deliver medical treatment from a distance by using digital advancements such as telemedicine. However, there is a limited understanding of the difficulties and opportunities of implementing telemedicine solutions in different socioeconomic and cultural environments, including Kuwait. OBJECTIVE The purpose of this study is to (1) examine the obstacles and benefits of telemedicine in the context of diabetes treatment and management, as perceived by both HCPs and patients with diabetes; (2) investigate the nonfunctional requirements for telemedicine applications used in diabetes care and management; and (3) provide suggestions to enhance the integration and adoption of telemedicine in Kuwait's health care system for diabetes care and management. METHODS The research used a qualitative and exploratory design, with semistructured interviews as the main data collection method. Participants were recruited on the internet through social media platforms due to the COVID-19 pandemic. The results were analyzed using thematic analysis and the Framework Method. The "diffusion of innovation" model was used as a perspective to interpret the findings. RESULTS A total of 20 participants were included in this study-10 HCPs and 10 patients with diabetes-all of whom supported telemedicine. The HCPs reported that many diabetes cases could be managed through telemedicine, with only a few requiring in-person visits. Patients with diabetes noted the convenience and time-saving aspect of telemedicine. Both groups recommended the creation of a secure and user-friendly telemedicine system similar to popular social media platforms. Additionally, participants emphasized the importance of telemedicine during the pandemic as a way to prioritize patient safety. CONCLUSIONS The results of this study provide valuable insights into the needs and preferences of both HCPs and patients with diabetes in a resource-rich country like Kuwait to embrace telemedicine. The COVID-19 pandemic has changed the way medical care is provided and has pushed both groups to consider digital solutions for ongoing diabetes management and treatment.
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Affiliation(s)
- Rabab Altabtabaei
- Information Science Department, Kuwait University, Kuwait City, Kuwait
| | - Dari Alhuwail
- Information Science Department, Kuwait University, Kuwait City, Kuwait
- Health Informatics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
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Sparre T, Hammershøy L, Steensgaard DB, Sturis J, Vikkelsøe P, Azzarello A. Factors Affecting Performance of Insulin Pen Injector Technology: A Narrative Review. J Diabetes Sci Technol 2023; 17:290-301. [PMID: 36540004 PMCID: PMC10012375 DOI: 10.1177/19322968221145201] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Insulin treatment is an essential hormone replacement therapy for the survival of people with type 1 diabetes and is often used for treatment in type 2 diabetes, particularly as the disease progresses. Advances in insulin therapy have been made since its discovery, including production of human insulin and development of insulin analogs with improved efficacy and safety profiles. The different types of available insulin formulations allow health care professionals to personalize treatment to an individual's needs. Generally, insulin requires parenteral administration via subcutaneous injection owing to very low oral bioavailability. METHODS This article reviews the human, technological, economical, and regulatory factors affecting the performance of insulin pens and the relationship between them. Opportunities and challenges that insulin pen injections may encounter in the future are also considered. RESULTS Insulin delivery devices, together with other factors, influence dose accuracy, convenience, and quality of life, contributing to easier medication administration with high efficacy and safety. For patients, ease of use, fast and accurate drug delivery, and painless injection are the most valuable features of an insulin injection device. For manufacturers, technological feasibility and economic viability also need to be considered when developing injection devices. CONCLUSION Insulin pen injectors are generally preferred over vial and syringe, although access may be limited in some health care systems. Insulin pen injectors can adapt to different insulin regimens and formulations and have the potential to acquire dosing data in real time.
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Affiliation(s)
- Thomas Sparre
- Novo Nordisk A/S, Søborg, Denmark
- Thomas Sparre, MD, PhD, Novo Nordisk A/S,
Vandtårnsvej 112, Søborg 2860, Denmark.
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Gender and urban-rural residency based differences in the prevalence of type-2 diabetes mellitus and its determinants among adults in Naghadeh: Results of IraPEN survey. PLoS One 2023; 18:e0279872. [PMID: 36881587 PMCID: PMC9990936 DOI: 10.1371/journal.pone.0279872] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 12/16/2022] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is one of the most important risk factors for cardiovascular diseases, with a high economic burden on health care systems. Since gender and residency can affect people's lifestyle and health behaviors, this study was conducted to investigate the prevalence of T2DM and its determinants by gender and residency. METHODS A secondary analysis study was conducted on the survey data of the IraPEN (Iran's Package of Essential Non-Communicable Disease) pilot program conducted in 2017 in Naghadeh County, Iran. Data of 3,691 participants aged 30-70 years from rural and urban areas of the County were included into data analysis process. Sociodemographic factors, anthropometric measurements, and cardiovascular risk factors related to T2DM were assessed. RESULTS The overall prevalence of T2DM within the population was 13.8%, which was significantly higher among women (15.5%) than men (11.8%), and non-significantly higher in urban (14.5%) areas than rural (12.3%) areas. In both genders, age (male: OR 1.01, 95% CI: 1.00-1.03; P = 0.012; female: OR 1.03, 95% CI: 1.02-1.04; P<0.001), blood pressure (male: OR 1.77, 95% CI: 1.13-2.79; P = 0.013; female: OR 2.86, 95% CI: 2.12-3.85; P<0.001), and blood triglycerides (male: OR 1.46, 95% CI: 1.01-2.11; P = 0.04; female: OR 1.34, 95% CI: 1.02-1.77; P = 0.035) had a significant relationship with the chance of developing T2DM. Among women, a significant relationship was found between abdominal obesity (OR 1.68, 95% CI: 1.17-2.40; P = 0.004) and the chance of developing T2DM. Age (rural: OR 1.03, 95% CI: 1.01-1.04; P<0.001; urban: OR 1.02, 95% CI: 1.01-1.04; P<0.001), blood pressure (rural: OR 3.14, 95% CI: 2.0-4.93; P<0.001; urban: OR 2.23, 95% CI: 1.66-3; P<0.001), and abdominal obesity (rural: OR 2.34, 95% CI: 1.41-3.87; P = 0.001; urban: OR 1.46, 95% CI: 1.06-2.01; P = 0.019), in both rural and urban areas, blood cholesterol (OR 1.59, 95% CI: 1.07-2.37; P = 0.02) in rural areas, and blood triglycerides (OR 1.51, 95% CI: 1.16-1.98; P = 0.002) in urban areas were significant predictors of T2DM. CONCLUSION Given the higher prevalence of T2DM among females, risk reduction strategies at the community level should be more targeted at women. The higher prevalence of T2DM risk factors among the urban population is a wake-up call for policymakers to pay more attention to the consequences of unhealthy and sedentary lifestyles within urban communities. Future actions should be focused on appropriate timely action plans for the prevention and control of T2DM from early years of life.
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Boateng D, Ayellah BB, Adjei DN, Agyemang C. Contribution of diabetes to amputations in sub-Sahara Africa: A systematic review and meta-analysis. Prim Care Diabetes 2022; 16:341-349. [PMID: 35305899 DOI: 10.1016/j.pcd.2022.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 11/22/2022]
Abstract
Diabetes related amputations remain a major global problem, with devastating complications. We critically appraised relevant literature to quantify the prevalence of diabetes related amputations in sub-Saharan Africa (SSA). An electronic search was performed using the EMBASE and PubMed databases until 2020. Twenty-four out of 834 studies retrieved were included. The pooled prevalence of diabetic-related amputations was 36.9% (95%CI: 32.9%-40.8%). Complications of diabetes related amputations included infection, anaemia, foot deformity and mortality. The study revealed a substantial contribution of diabetes to the burden of amputations in SSA and suggests the need for further studies to assess how to reduce the incidence of diabetes, reduce the incidence of and or delay the progression of macro and microvascular complications of diabetes in SSA.
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Affiliation(s)
- Daniel Boateng
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands; Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | | | - David Nana Adjei
- Department of Medical Laboratory Sciences, School of Biomedical and Allied Health Sciences, College of Health Sciences, University of Ghana, Korle-Bu, Accra, Ghana
| | - Charles Agyemang
- Department of Public Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, Netherlands
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Sherwood ZS, Sandford J, Jacob S. Can collaborative working improve diabetic retinal screening rates in individuals also diagnosed with a severe mental illness? Future Healthc J 2022; 9:161-165. [DOI: 10.7861/fhj.2022-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Faal Siahkal S, Javadifar N, Najafian M, Iravani M, Zakerkish M, Heshmati R. The psychosocial challenges associated with gestational diabetes mellitus: A systematic review of qualitative studies. Prim Care Diabetes 2022; 16:11-26. [PMID: 34538572 DOI: 10.1016/j.pcd.2021.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/30/2021] [Accepted: 09/06/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Gestational diabetes is a disease with complex management that requires multidisciplinary collaboration. To achieve treatment goals, in addition to using medications and paying attention to exercise and diet, it is also important to take into account the mental health and psychosocial aspects of diabetes management. This study aimed to highlight these challenges associated with gestational diabetes. METHOD This qualitative systematic review involved a search of the following databases: CINAHL, EMBASE, MEDLINE, and PsycINFO. Title, abstract, and full-text screening was done using Covidence software, and quality assessment of the included papers was conducted using the Critical Appraisal Skills Programme Checklist. Enhancing transparency in reporting the synthesis of the qualitative research statement (ENTREQ) was used in the design of this paper. Data synthesis was done using meta-aggregation method. RESULTS Out of the 2440 articles searched, 24 were qualitatively analyzed. The CASP score of the included papers was optimal. The 514 findings extracted from the 24 studies were aggregated into five broad conceptual categories: psychological challenges, socio-cultural challenges, information-communication challenges, challenges associated with a lifestyle change, and challenges related to health care. CONCLUSION Recognizing the psychosocial challenges associated with gestational diabetes and developing support packages tailored to psychosocial needs can help improve the management of these patients.
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Affiliation(s)
- Shahla Faal Siahkal
- Midwifery Department, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Nahid Javadifar
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mahin Najafian
- Department of Obstetrics and Gynecology, School of Medicine, Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mina Iravani
- Reproductive Health Promotion Research Center, Midwifery and Reproductive Health Department, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mehrnoosh Zakerkish
- Department of Endocrinology and Metabolism, Faculty of Medicine, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Rasoul Heshmati
- Department of Psychology, Faculty of Education and Psychology, University of Tabriz, Tabriz, Iran.
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Pham Q, Gamble A, Hearn J, Cafazzo JA. The Need for Ethnoracial Equity in Artificial Intelligence for Diabetes Management: Review and Recommendations. J Med Internet Res 2021; 23:e22320. [PMID: 33565982 PMCID: PMC7904401 DOI: 10.2196/22320] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/02/2020] [Accepted: 01/16/2021] [Indexed: 12/13/2022] Open
Abstract
There is clear evidence to suggest that diabetes does not affect all populations equally. Among adults living with diabetes, those from ethnoracial minority communities—foreign-born, immigrant, refugee, and culturally marginalized—are at increased risk of poor health outcomes. Artificial intelligence (AI) is actively being researched as a means of improving diabetes management and care; however, several factors may predispose AI to ethnoracial bias. To better understand whether diabetes AI interventions are being designed in an ethnoracially equitable manner, we conducted a secondary analysis of 141 articles included in a 2018 review by Contreras and Vehi entitled “Artificial Intelligence for Diabetes Management and Decision Support: Literature Review.” Two members of our research team independently reviewed each article and selected those reporting ethnoracial data for further analysis. Only 10 articles (7.1%) were ultimately selected for secondary analysis in our case study. Of the 131 excluded articles, 118 (90.1%) failed to mention participants’ ethnic or racial backgrounds. The included articles reported ethnoracial data under various categories, including race (n=6), ethnicity (n=2), race/ethnicity (n=3), and percentage of Caucasian participants (n=1). Among articles specifically reporting race, the average distribution was 69.5% White, 17.1% Black, and 3.7% Asian. Only 2 articles reported inclusion of Native American participants. Given the clear ethnic and racial differences in diabetes biomarkers, prevalence, and outcomes, the inclusion of ethnoracial training data is likely to improve the accuracy of predictive models. Such considerations are imperative in AI-based tools, which are predisposed to negative biases due to their black-box nature and proneness to distributional shift. Based on our findings, we propose a short questionnaire to assess ethnoracial equity in research describing AI-based diabetes interventions. At this unprecedented time in history, AI can either mitigate or exacerbate disparities in health care. Future accounts of the infancy of diabetes AI must reflect our early and decisive action to confront ethnoracial inequities before they are coded into our systems and perpetuate the very biases we aim to eliminate. If we take deliberate and meaningful steps now toward training our algorithms to be ethnoracially inclusive, we can architect innovations in diabetes care that are bound by the diverse fabric of our society.
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Affiliation(s)
- Quynh Pham
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anissa Gamble
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada
| | - Jason Hearn
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.,Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Joseph A Cafazzo
- Centre for Global eHealth Innovation, Techna Institute, University Health Network, Toronto, ON, Canada.,Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, ON, Canada
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14
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Payton C, Kimball S, Ahrenholz NC, Wieland ML. Preventive Care and Management of Chronic Diseases in Immigrant Adults. Prim Care 2020; 48:83-97. [PMID: 33516426 DOI: 10.1016/j.pop.2020.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Immigrants may have variable access to chronic disease screening and treatment in their countries of origin and host country, often limited by their immigration status. Immigrants face barriers to chronic disease management and preventive care, including health insurance access, linguistic challenges, lack of culturally sensitive care, limited records, and acculturation. Health care providers should prioritize chronic disease screening and follow up regularly to encourage preventive care and self-management of chronic disease.
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Affiliation(s)
- Colleen Payton
- School of Nursing and Public Health, Moravian College, 1200 Main Street, Bethlehem, PA 18018, USA.
| | - Sarah Kimball
- Immigrant & Refugee Health Center, Boston Medical Center, 725 Albany Street, 43 Suite 5b, Boston, MA 02118, USA; Boston University School of Medicine, 72 E Concord St, Boston, MA 02118, USA
| | - Nicole Chow Ahrenholz
- International Medicine Clinic, Harborview Medicine Center, 325 9th Avenue Box 359895, Seattle, WA 98104, USA; University of Washington School of Medicine, 1959 NE Pacific St, Seattle, WA 98195, USA
| | - Mark L Wieland
- Community Internal Medicine, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA
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15
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Subrata SA. Implementation of spiritual care in patients with diabetic foot ulcers: a literature review. ACTA ACUST UNITED AC 2020; 29:S24-S32. [PMID: 32790549 DOI: 10.12968/bjon.2020.29.15.s24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Lower extremity amputation is a complication of diabetic foot ulcers that can cause spiritual crisis. Integrating spiritual care into nursing practice is important to overcome this. However, studies articulating the role of nurses in spiritual care when caring for patients with diabetic foot ulcers is limited. This article aims to describe the importance of providing spiritual care for this group of patients. The interpretation of spiritual care with respect to the relationship between the patient and the family, and the role of the nurse are discussed. The findings offer a theoretical perspective on spiritual care that can be used to develop spiritual interventions, as well as prevent spiritual crises in patients with diabetic foot ulcers.
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Affiliation(s)
- Sumarno Adi Subrata
- Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Thailand, Nursing Lecturer at the Department of Nursing and Wound Research Centre, Faculty of Health Sciences, Universitas Muhammadiyah Magelang, Indonesia
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16
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Yu JH, Kim HY, Kim SR, Ko E, Jin HY. Factors influencing psychological insulin resistance in type 2 diabetes patients. Int J Nurs Pract 2019; 25:e12733. [DOI: 10.1111/ijn.12733] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/05/2018] [Accepted: 03/01/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Ji Hyeon Yu
- Chonbuk National University Hospital Jeonju South Korea
| | - Hye Young Kim
- College of Nursing, Research Institute of Nursing ScienceChonbuk National University Jeonju South Korea
| | - Sung Reul Kim
- College of NursingKorea University Seoul South Korea
| | - Eun Ko
- Department of Nursing, College of Life Science and Natural ResourcesSunchon National University Suncheon South Korea
| | - Heung Yong Jin
- Department of Internal Medicine, Division of Endocrinology and MetabolismChonbuk National University, Medical School Jeonju South Korea
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17
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Bermeo-Cabrera J, Almeda-Valdes P, Riofrios-Palacios J, Aguilar-Salinas CA, Mehta R. Insulin Adherence in Type 2 Diabetes in Mexico: Behaviors and Barriers. J Diabetes Res 2018; 2018:3190849. [PMID: 30116737 PMCID: PMC6079463 DOI: 10.1155/2018/3190849] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 05/16/2018] [Accepted: 06/28/2018] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To investigate factors associated with insulin adherence in subjects with type 2 diabetes mellitus (T2D) attending a tertiary care centre in Mexico City. MATERIAL AND METHODS Cross-sectional study, including 200 patients. Adherence to insulin therapy was measured with a medication adherence questionnaire. Sociodemographic data and factors related to insulin omission were collected and compared between the nonadherent and adherent groups. RESULTS We categorized 117 (58.5%) patients as nonadherent and 83 (41.5%) as adherent. Among the adherent, only 22 patients (11%) had excellent adherence to insulin therapy. The following factors were associated with nonadherence: lack of planning of daily activities (46.1%), fear of hypoglycemia (41%), economic factors (15.4%), and number of insulin applications (2.31 versus 1.76 applications per day). CONCLUSIONS In this study, patients with type 2 diabetes attending a tertiary care referral centre showed inadequate adherence to insulin therapy. The principal factors associated with insulin omission were low socioeconomic status, fear of hypoglycemia, and a greater number of insulin applications per day.
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Affiliation(s)
- Janneth Bermeo-Cabrera
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Paloma Almeda-Valdes
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Josefa Riofrios-Palacios
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Carlos A. Aguilar-Salinas
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Roopa Mehta
- Departamento de Endocrinología y Metabolismo, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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