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Jeong M. Associations of Sleep Quality and Physical Activity with Diabetes Quality of Life in Korean Americans with Type 2 Diabetes: A Cross-Sectional Study. Healthcare (Basel) 2024; 12:756. [PMID: 38610178 PMCID: PMC11012051 DOI: 10.3390/healthcare12070756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/25/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024] Open
Abstract
The cross-sectional study aimed to examine the associations of sleep quality and physical activity with diabetes quality of life in Korean Americans with type 2 diabetes. A total of 119 Korean American adults with type 2 diabetes were recruited from Korean communities in Arizona, USA. The Pittsburgh Sleep Quality Index for sleep quality, the International Physical Activity Questionnaire for physical activity, and the Diabetes Quality of Life (DQOL) for quality of life were assessed. Descriptive statistics, bivariate correlations, and multiple linear regressions were conducted. The mean score of the total DQOL was 1.85 (SD = 0.28). Approximately 70% of those had poor sleep quality and a third showed low physical activity. The findings demonstrated that both sleep quality and low physical activity were independent predictors of overall DQOL scores, indicating that poor sleep quality and low physical activity are associated with reduced Diabetes Quality of Life in this demographic. Specifically, the satisfaction subscale of DQOL showed significant associations with low physical activity levels, suggesting that enhancing physical activity could potentially improve satisfaction within DQOL. Furthermore, the impact subscale was positively related to sleep quality, suggesting that better sleep quality might significantly lower the perceived negative impact of diabetes on daily life. No significant associations were found between sleep quality, physical activity, and the worry subscale of DQOL in the adjusted models. The study indicates that addressing sleep quality and promoting physical activity are essential components of diabetes management strategies aimed at improving the quality of life for Korean Americans with type 2 diabetes. This underlines the need for tailored interventions that consider cultural preferences and individual needs to enhance diabetes outcomes and quality of life in this population.
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Affiliation(s)
- Mihyun Jeong
- Department of Nursing, Gwangju University, Gwangju 61743, Republic of Korea
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Saha CK, Shubrook JH, Guyton Hornsby W, Yang Z, Pillay Y, Mather KJ, de Groot M. Program ACTIVE II: 6- and 12-month outcomes of a treatment approach for major depressive disorder in adults with type 2 diabetes. J Diabetes Complications 2024; 38:108666. [PMID: 38266570 PMCID: PMC10922820 DOI: 10.1016/j.jdiacomp.2023.108666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/12/2023] [Accepted: 12/17/2023] [Indexed: 01/26/2024]
Abstract
AIMS To evaluate the long-term effects of behavioral treatments on glycemic and psychological outcomes for patients with major depressive disorder (MDD) and type 2 diabetes (T2D). METHODS Program ACTIVE II was a multicenter randomized controlled comparative effectiveness trial of cognitive behavioral therapy (CBT), exercise (EXER), combination treatment (CBT + EXER) and usual care (UC) for adults with MDD and T2D. RESULTS Primary outcomes: change in A1c and depressive symptoms at 6- (N = 87) and 12-months (N = 75) from baseline. In those with a baseline A1c ≥7.0 %, CBT + EXER showed lasting A1c benefit at 6- (-1.2 %; SE: 0.6; p = 0.032) and 12-months (-1.4 %; SE: 0.6; p = 0.025) compared to UC. All groups had clinically significant improvements in depressive symptoms. At 6 months, CBT + EXER had significant improvements in diabetes-related distress regimen burden (p = 0.005); and social support (CIRS, p = 0.043) compared to UC. CONCLUSIONS The Program ACTIVE II CBT + EXER intervention demonstrated a sustained improvement in A1c for a subgroup of study participants with a baseline A1c ≥7.0 %. However, this finding should be considered preliminary because of small sample size. All 3 behavioral intervention groups demonstrated improvements in psychosocial outcomes one-year post-intervention. These findings point to the enduring benefits of community-based interventions to extend the availability of depression treatment for T2D patients.
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Affiliation(s)
- Chandan K Saha
- Indiana University School of Medicine, United States of America
| | | | - W Guyton Hornsby
- West Virginia University School of Medicine, United States of America
| | - Ziyi Yang
- Indiana University School of Medicine, United States of America
| | | | - Kieren J Mather
- Indiana University School of Medicine, United States of America
| | - Mary de Groot
- Indiana University School of Medicine, United States of America.
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Mendorf S, Heimrich KG, Mühlhammer HM, Prell T, Schönenberg A. Trajectories of quality of life in people with diabetes mellitus: results from the survey of health, ageing and retirement in Europe. Front Psychol 2024; 14:1301530. [PMID: 38274698 PMCID: PMC10808439 DOI: 10.3389/fpsyg.2023.1301530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/29/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Previous longitudinal studies identified various factors predicting changes in Quality of Life (QoL) in people with diabetes mellitus (PwDM). However, in these studies, the stability of QoL has not been assessed with respect to individual differences. Methods We studied the predictive influence of variables on the development of QoL in PwDM across three waves (2013-2017) from the cross-national panel dataset Survey of Health, Ageing, and Retirement in Europe (SHARE). To determine clinically meaningful changes in QoL, we identified minimal clinically important difference (MCID). Linear regressions and Linear Mixed Models (LMM) were conducted to determine factors associated with changes in QoL. Results On average, QoL remained stable across three waves in 2989 PwDM, with a marginal difference only present between the first and last wave. However, when looking at individual trajectories, 19 different longitudinal patterns of QoL were identified across the three time-points, with 38.8% of participants showing stable QoL. Linear regression linked lower QoL to female gender, less education, loneliness, reduced memory function, physical inactivity, reduced health, depression, and mobility limitations. LMM showed that the random effect of ID had the strongest impact on QoL across the three waves, suggesting highly individual QoL patterns. Conclusion This study enhances the understanding of the stability of QoL measures, which are often used as primary endpoints in clinical research. We demonstrated that using traditional averaging methods, QoL appears stable on group level. However, our analysis indicated that QoL should be measured on an individual level.
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Affiliation(s)
- Sarah Mendorf
- Department of Neurology, University Hospital Jena, Jena, Germany
| | - Konstantin G. Heimrich
- Department of Neurology, University Hospital Jena, Jena, Germany
- Department of Geriatrics, University Hospital Jena, Jena, Germany
| | - Hannah M. Mühlhammer
- Department of Neurology, University Hospital Jena, Jena, Germany
- Department of Geriatrics, University Hospital Halle, Halle, Germany
| | - Tino Prell
- Department of Neurology, University Hospital Jena, Jena, Germany
- Department of Geriatrics, University Hospital Halle, Halle, Germany
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Volčanšek Š, Lunder M, Janež A. Health-Related Quality of Life Assessment in Older Patients with Type 1 and Type 2 Diabetes. Healthcare (Basel) 2023; 11:2154. [PMID: 37570394 PMCID: PMC10418676 DOI: 10.3390/healthcare11152154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/20/2023] [Accepted: 07/25/2023] [Indexed: 08/13/2023] Open
Abstract
Type 1 (T1D) and type 2 diabetes (T2D) are determinants of health-related outcomes including health-related quality of life (HRQOL). We aimed to determine differences in HRQOL between older adults with T1D and T2D and specific factors influencing HRQOL in this age group. This study used a cross-sectional design with 56 age- and HbA1c-matched T1D and T2D patients (aged 68.9 ± 7.8 years; 55% had T2D). We employed several validated questionnaires (Short Form-36 (SF-36) and the EuroQol-5 Dimensions/Visual Analog Scale (VAS)) to investigate the relationships between HRQOL domains and diabetes type, glycemic control, complications, and comorbidities. T1D was associated with better self-reported general health (assessed with the SF-36 general health domain (p = 0.048) and the EuroQol-5 VAS (p = 0.002), whereas no significant differences in the other SF-36 domains, self-reported diabetes distress, anxiety, or depression were found. Most HRQOL domains were not associated with HbA1c or the presence of diabetes complications. The most significant reduction in HRQOL was experienced by patients with higher BMIs, irrespective of the diabetes type. The obtained HRQOL data could be used in clinical settings for evidence-based patient education focused on specific subgroups of patients, as well as in national healthcare policies, e.g., interventions designed to alleviate obesity.
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Affiliation(s)
- Špela Volčanšek
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Mojca Lunder
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
| | - Andrej Janež
- Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška 7, 1000 Ljubljana, Slovenia; (M.L.); (A.J.)
- Medical Faculty, University of Ljubljana, Vrazov trg 2, 1000 Ljubljana, Slovenia
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Alzahrani O, Fletcher JP, Hitos K. Quality of life and mental health measurements among patients with type 2 diabetes mellitus: a systematic review. Health Qual Life Outcomes 2023; 21:27. [PMID: 36949507 PMCID: PMC10031182 DOI: 10.1186/s12955-023-02111-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 03/14/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Over the past few decades the benefits of assessing Quality of Life (QoL) and mental health in patients with Type 2 Diabetes Mellitus (T2DM) have steadily increased with limited studies relating to the most useful method to assess these patients. This study aims to identify, review, summarise, and evaluate the methodological quality for the most validated commonly used health-related QoL and mental health assessment measurements in diabetic patients. METHODS All original articles published on PubMed, MedLine, OVID, The Cochrane Register, Web of Science Conference Proceedings and Scopus databases were systematically reviewed between 2011 and 2022. A search strategy was developed for each database using all possible combinations of the following keywords: "type 2 diabetes mellitus", "quality of life", mental health", and "questionnaires". Studies conducted on patients with T2DM of ≥ 18 years with or without other clinical illnesses were included. Articles designed as a literature or systematic review conducted on either children or adolescents, healthy adults and/or with a small sample size were excluded. RESULTS A total of 489 articles were identified in all of the electronic medical databases. Of these articles, 40 were shown to meet our eligibility criteria to be included in this systematic review. Approximately, 60% of these studies were cross-sectional, 22.5% were clinical trials, and 17.5% of cohort studies. The top commonly used QoL measurements are the SF-12 identified in 19 studies, the SF-36, included in 16 studies, and the EuroQoL EQ-5D, found in 8 studies. Fifteen (37.5%) studies used only one questionnaire, while the remaining reviewed (62.5%) used more than one questionnaire. Finally, the majority (90%) of studies reported using self-administered questionnaires and only 4 used interviewer mode of administration. CONCLUSION Our evidence highlights that the commonly used questionnaire to evaluate the QoL and mental health is the SF-12 followed by SF-36. Both of these questionnaires are validated, reliable and supported in different languages. Moreover, using single or combined questionnaires as well as the mode of administration depends on the clinical research question and aim of the study.
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Affiliation(s)
- Owiss Alzahrani
- Westmead Research Centre for Evaluation of Surgical Outcomes, Department of Surgery, Westmead Hospital, Sydney, Australia.
- The University of Sydney, Faculty of Medicine and Health, Westmead Clinical School, Sydney, Australia.
- Department of Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - John P Fletcher
- Westmead Research Centre for Evaluation of Surgical Outcomes, Department of Surgery, Westmead Hospital, Sydney, Australia
- The University of Sydney, Faculty of Medicine and Health, Westmead Clinical School, Sydney, Australia
| | - Kerry Hitos
- Westmead Research Centre for Evaluation of Surgical Outcomes, Department of Surgery, Westmead Hospital, Sydney, Australia
- The University of Sydney, Faculty of Medicine and Health, Westmead Clinical School, Sydney, Australia
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Diriba DC, Leung DYP, Suen LKP. Factors predicted quality of life of people with type 2 diabetes in western Ethiopia. PLoS One 2023; 18:e0281716. [PMID: 36791135 PMCID: PMC9931092 DOI: 10.1371/journal.pone.0281716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 01/31/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Multiple factors predict the quality of life of adults with diabetes. However, the relationships of demographics, self-management practice, and support status with the quality of life of people with diabetes are unknown. Therefore, the study aimed to assess factors related with the quality of life of adults with type 2 diabetes in western Ethiopia. METHODS A hospital-based cross-sectional study involving adults with type 2 diabetes was conducted in western Ethiopia from June 02, 2020, to August 31, 2020. Convenience sampling technique was used in selecting subjects. The translated and psychometrically tested summary of diabetes self-management activities (expanded), diabetes quality of life, and diabetes care profile support scales were used in measuring self-management practice, quality of life, and support status, respectively. Data were collected via face-to-face interviews. Factors related with quality of life were examined through bivariate analysis and multivariable linear regression. In all statistical tests, P value <0.05 and confidence level that excluded zero were considered statistically significant. RESULTS A total of 417 adults with type 2 diabetes participated in the study. In a multivariable linear regression, seven factors including age, male, homemakers, those separated/divorced, number of years since diabetes diagnosis, self-management practice and support needed were related with quality of life. Male patients (β = 2.786, 95% CI = 1.285 to 4.287, p < 0.001), homemakers (β = 0.366, 95% CI = 0.056; 0.677, p = 0.021), self-management practice (β = 4.528, 95% CI = 3.851 to 5.205, p < 0.001) and those who needed support from their families or peers (β = 1.623, 95% CI = 0.458; 2.788, p = 0.006) were related positively with quality of life whereas those who separated or divorced (β = -1.698, 95% CI = -3.371 to -0.025, p = 0.047), older age (β = -0.195, 95% CI = -0.269 to -0.121, p < 0.001) and those who lived with diabetes for a longer duration (β = -2.206, 95% CI = -4.151 to -0.261, p = 0.026) were related negatively with quality of life. CONCLUSION Quality of life of people with type 2 diabetes living in western Ethiopia was predicted positively by being male, homemakers, having self-management practice, and support needed, whereas negatively influenced by old age, separation or divorce, and long diabetes life. Thus, encouraging self-management practice, and continuous family or friend support are necessary to enhance quality of life of people with type 2 diabetes. Further study should employ random sampling techniques and involve participants from multiple study settings to increase representativeness of the samples.
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Affiliation(s)
- Dereje Chala Diriba
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Doris Y. P. Leung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
| | - Lorna K. P. Suen
- School of Nursing, Tung Wah College, Hong Kong, Hong Kong SAR, China
- * E-mail:
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Kataria P, Bhasin SK, Upadhyay MK, Madhu SV. Quality of life among type 2 diabetes patients aged 30–64 years attending diabetes clinic in a tertiary care hospital in East Delhi, India. Int J Diabetes Dev Ctries 2023. [DOI: 10.1007/s13410-022-01167-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Elezi B, Rumano M, Abazaj E, Topi S. Health-related quality-of-life measures used in hemodialysis patients in Albania. Egypt J Intern Med 2023. [DOI: 10.1186/s43162-022-00172-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Abstract
Background
Chronic kidney disease is a growing worldwide public health concern. On the other hand, patients’ perception of health is an important outcome measure in the assessment of the influence of chronic disease and received treatment. Interest in measuring health-related quality of life has increased together with an awareness that such humanistic outcomes require valid and reliable measures. The aimed study was to evaluate the health-related quality of life (QoL) and to investigate the relationship between selected demographic and clinical characteristics and Health-related Quality of Life (HRQoL) scores in hemodialysis patients.
Methods
This survey study was conducted on hemodialysis patients (209 patients) during the periods 2017–2018. The QoL includes 25 questions classified into five dimensions, which are mobility, personal care, common activities, discomfort and pain, anxiety, and depression. P value < .05 was considered statistically significant.
Results
Overall 209 hemodialysis patients, the mean of the five domains varies from a minimum value of 1.75 ± 1.06 for personal care to a maximum value of 2.65 ± 1.44 for anxiety and/or depression. In our study, among hemodialysis patients is seen a significant association scored between the quality of life and demographic variables like age groups (p = 0.034), and gender (p = 0.01) as in the previous studies. The presence of comorbidities was significantly associated with the QOL (p = 0.001). About the questionnaire, “How good or bad your health is today” the average score resulted to be 47.08 ± 4.5.
Conclusion
As we saw from the results of this study, a considerable number of the patients live with low income. Age, sex, and comorbidities are dependent factors of HRQoL. Therefore, we suggest that future studies include other factors that will evaluate hemodialysis efficiency and find the association between these and QoL.
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Langendoen-Gort M, Groeneveld L, Prinsen CAC, Beulens JW, Elders PJM, Halperin I, Mukerji G, Terwee CB, Rutters F. Patient-reported outcome measures for assessing health-related quality of life in people with type 2 diabetes: A systematic review. Rev Endocr Metab Disord 2022; 23:931-977. [PMID: 35779199 PMCID: PMC9515038 DOI: 10.1007/s11154-022-09734-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2022] [Indexed: 11/26/2022]
Abstract
Patient-Reported Outcome Measures (PROMs) are important tools to assess outcomes relevant to patients, with Health-Related Quality Of Life (HRQOL) as an important construct to be measured. Many different HRQOL PROMs are used in the type 2 diabetes field, however a complete overview of these PROMs is currently lacking. We therefore aimed to systematically describe and classify the content of all PROMs that have specifically been developed or validated to measure (aspects of) HRQOL in people with type 2 diabetes. A literature search was performed in PubMed and EMBASE until 31 December 2021. Studies on the development or validation of a PROM measuring HRQOL, or aspects of HRQOL, in people with type 2 diabetes were included. Title and abstract and full-text screening were conducted by two independent researchers and data extraction was performed independently by one of the researchers. Data were extracted on language in which the PROM was developed, target population, construct(s) being measured, names of (sub)scales and number of items per (sub)scale. In addition, all PROMs and subscales were classified according to specific aspects of HRQOL based on the Wilson & Cleary model (symptom status, functional status, general health perceptions) to aid researchers in PROM selection. In total 220 studies were identified that developed or validated PROMs that measure (aspects of) HRQOL in people with type 2 diabetes. Of the 116 unique HRQOL PROMs, 91 (of the subscales) measured symptom status, 60 measured functional status and 26 measured general health perceptions. In addition, 16 of the PROMs (subscales) measured global quality of life. 61 of the 116 PROMs (subscales) also include characteristics of the individual (e.g. aspects of personality, coping) or environment (e.g. social or financial support) and patient-reported experience measures (PREMs, e.g. measure of a patient's perception of their personal experience of the healthcare they have received, e.g. treatment satisfaction), which are not part of the HRQOL construct. Only 9 of the 116 PROMs measure all aspects of HRQOL based on the Wilson & Cleary model. Finally, 8 of the 116 PROMs stating to measure HRQOL, measured no HRQOL construct. In conclusion, a large number of PROMs are available for people with type 2 diabetes, which intend to measure (aspects of) HRQOL. These PROMs measure a large variety of (sub)constructs, which are not all HRQOL constructs, with a small amount of PROMs not measuring HRQOL at all. There is a need for consensus on which aspects of HRQOL should be measured in people with type 2 diabetes and which PROMs to use in research and daily practice. PROSPERO: CRD42017071012. COMET database: http://www.comet-initiative.org/studies/details/956 .
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Affiliation(s)
- Marlous Langendoen-Gort
- General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Lenka Groeneveld
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
| | - Cecilia A C Prinsen
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - Joline W Beulens
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Petra J M Elders
- General Practice, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands
| | - Ilana Halperin
- Department of Medicine, Temerty Faculty of Medicine, Sunnybrook Health Sciences Center, King's College Circle, University of Toronto, Toronto, ON, Canada
| | - Geetha Mukerji
- Department of Medicine, Temerty Faculty of Medicine, Sunnybrook Health Sciences Center, King's College Circle, University of Toronto, Toronto, ON, Canada
- Women's College Hospital Institute for Health System Solutions and Virtual Care, 76 Grenville Street, Toronto, ON, Canada
| | - Caroline B Terwee
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands
- Amsterdam Public Health, Methodology, Amsterdam, The Netherlands
| | - Femke Rutters
- Epidemiology and Data Science, Amsterdam UMC, Location Vrije Universiteit Amsterdam, de Boelelaan 1117, Amsterdam, Netherlands.
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands.
- Amsterdam Cardiovascular Sciences, Diabetes & Metabolism, Amsterdam, The Netherlands.
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Rakotoarisoa L, Wagner C, Munch M, Renaud Picard B, Grenet D, Olland A, Greget M, Enescu I, Bouilloud F, Bonnette P, Guth A, Bosco D, Mercier C, Rabilloud M, Berney T, Yves Benhamou P, Massard G, Camilo C, Colin C, Arnold C, Kessler R, Kessler L. Feasibility and efficacy of combined pancreatic islet-lung transplantation in cystic fibrosis-related diabetes-PIM study: A multicenter phase 1-2 trial. Am J Transplant 2022; 22:1861-1872. [PMID: 35403818 PMCID: PMC9540675 DOI: 10.1111/ajt.17058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 03/21/2022] [Accepted: 04/04/2022] [Indexed: 01/25/2023]
Abstract
Cystic fibrosis-related diabetes (CFRD) is a common complication of cystic fibrosis (CF), and restoring metabolic control in these patients may improve their management after lung transplantation. In this multicenter, prospective, phase 1-2 trial, we evaluate the feasibility and metabolic efficacy of combined pancreatic islet-lung transplantation from a single donor in patients with CFRD, terminal respiratory failure, and poorly controlled diabetes. Islets were infused via the portal vein under local anesthesia, 1 week after lung transplantation. At 1 year, the primary outcome was transplant success as evaluated by a composite score including four parameters (weight, fasting glycemia, HbA1c, and insulin requirements). Ten participants (age: 24 years [17-31], diabetes duration: 8 years [4-12]) received a combined islet-lung transplant with 2892 IEQ/kg [2293-6185]. Transplant success was achieved in 7 out of 10 participants at 1-year post transplant. Fasting plasma C-peptide increased from 0.91 μg/L [0.56-1.29] to 1.15 μg/L [0.77-2.2], HbA1c decreased from 7.8% [6.5-8.3] (62 mmol/mol [48-67]) to 6.7% [5.5-8.0] (50 mmol/mol [37-64]), with 38% decrease in daily insulin doses. No complications related to the islet injection procedure were reported. In this pilot study, combined pancreatic islet-lung transplantation restored satisfactory metabolic control and pulmonary function in patients with CF, without increasing the morbidity of lung transplantation.
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Affiliation(s)
- Luc Rakotoarisoa
- Department of Endocrinology, Diabetes and NutritionStrasbourg University HospitalFrance,Inserm UMR 1260Regenerative NanomedicineStrasbourgFrance
| | - Clothilde Wagner
- Department of Endocrinology, Diabetes and NutritionStrasbourg University HospitalFrance
| | - Marion Munch
- Department of Endocrinology, Diabetes and NutritionStrasbourg University HospitalFrance
| | - Benjamin Renaud Picard
- Inserm UMR 1260Regenerative NanomedicineStrasbourgFrance,Department of PneumologyCystic Fibrosis CenterStrasbourg UniversityStrasbourgFrance
| | - Dominique Grenet
- Department of PneumologyCystic Fibrosis CenterHôpital FochSuresnesFrance
| | - Anne Olland
- Inserm UMR 1260Regenerative NanomedicineStrasbourgFrance,Department of Thoracic SurgeryStrasbourg University HospitalStrasbourgFrance
| | - Michel Greget
- Department of RadiologyStrasbourg University HospitalStrasbourgFrance
| | - Iulian Enescu
- Department of RadiologyStrasbourg University HospitalStrasbourgFrance
| | | | | | - Axel Guth
- Department of RadiologyHôpital FochSuresnesFrance
| | - Domenico Bosco
- Department of Surgery, Islet Isolation, and TransplantationGeneva University HospitalsGenevaSwitzerland
| | - Catherine Mercier
- Pôle Santé PubliqueService de Biostatistique et BioinformatiqueHospices Civils de Lyon, LyonFrance,Université de LyonLyonFrance,Université Lyon 1VilleurbanneFrance,Laboratoire de Biométrie et Biologie ÉvolutiveÉquipe Biostatistique‐SantéCNRSUMR 5558VilleurbanneFrance
| | - Muriel Rabilloud
- Pôle Santé PubliqueService de Biostatistique et BioinformatiqueHospices Civils de Lyon, LyonFrance,Université de LyonLyonFrance,Université Lyon 1VilleurbanneFrance,Laboratoire de Biométrie et Biologie ÉvolutiveÉquipe Biostatistique‐SantéCNRSUMR 5558VilleurbanneFrance
| | - Thierry Berney
- Department of Surgery, Islet Isolation, and TransplantationGeneva University HospitalsGenevaSwitzerland
| | - Pierre Yves Benhamou
- Department of Endocrinology, Diabetes and NutritionGrenoble University HospitalGrenobleFrance
| | - Gilbert Massard
- Inserm UMR 1260Regenerative NanomedicineStrasbourgFrance,Department of Thoracic SurgeryStrasbourg University HospitalStrasbourgFrance
| | - Coralie Camilo
- Pôle Santé PubliqueService de Biostatistique et BioinformatiqueHospices Civils de Lyon, LyonFrance,Université de LyonLyonFrance,Université Lyon 1VilleurbanneFrance,Laboratoire de Biométrie et Biologie ÉvolutiveÉquipe Biostatistique‐SantéCNRSUMR 5558VilleurbanneFrance
| | - Cyrille Colin
- Pôle Santé PubliqueService de Biostatistique et BioinformatiqueHospices Civils de Lyon, LyonFrance,Université de LyonLyonFrance,Université Lyon 1VilleurbanneFrance,Laboratoire de Biométrie et Biologie ÉvolutiveÉquipe Biostatistique‐SantéCNRSUMR 5558VilleurbanneFrance
| | - Cécile Arnold
- Department of Clinical ResearchStrasbourg University HospitalStrasbourgFrance
| | - Romain Kessler
- Inserm UMR 1260Regenerative NanomedicineStrasbourgFrance,Department of PneumologyCystic Fibrosis CenterStrasbourg UniversityStrasbourgFrance
| | - Laurence Kessler
- Department of Endocrinology, Diabetes and NutritionStrasbourg University HospitalFrance,Inserm UMR 1260Regenerative NanomedicineStrasbourgFrance
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11
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Nasir NFM, Draman N, Zulkifli MM, Muhamad R, Draman S. Sleep Quality among Patients with Type 2 Diabetes: A Cross-Sectional Study in the East Coast Region of Peninsular Malaysia. Int J Environ Res Public Health 2022; 19:ijerph19095211. [PMID: 35564603 PMCID: PMC9105183 DOI: 10.3390/ijerph19095211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 02/04/2023]
Abstract
Poor sleep is related to type 2 diabetes and adversely influences a person’s quality of life. This study aimed to evaluate sleep quality in patients with type 2 diabetes (T2DM), its associated factors, and its relationship with quality of life. A cross-sectional study was conducted at a primary care clinic in a tertiary hospital on the east coast of Malaysia. This study included 350 participants (175 men and 175 women). Data were collected using the Malay version of the Pittsburgh Sleep Quality Index (PSQI-M) with a cut-off point of >5 as poor sleep, the Malay version of Diabetes Distress Scale (MDDS-17) and the revised Malay version of T2DM-related quality of life (Rv-DQOL). Statistical analysis was conducted using the SPSS software version 26.0. The respondents’ median (interquartile range (IQR)) age was 62.0 (11.0) years, and poor sleep was reported in 32% (95% confidence interval (CI) = 27.1, 36.9) of the participants. Multivariate logistic regression analysis revealed that poor sleep quality was significantly associated with nocturia (odds ratio (OR) = 2.04; 95% CI = 1.24, 3.35), restless legs syndrome (OR = 2.17; 95% CI = 1.32−3.56) and emotional burden (OR = 2.37; 95% CI = 1.41−3.98). However, no statistically significant association was observed between sleep quality and quality of life among our participants.
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Affiliation(s)
- Nor Fareshah Mohd Nasir
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (N.F.M.N.); (M.M.Z.); (R.M.)
| | - Nani Draman
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (N.F.M.N.); (M.M.Z.); (R.M.)
- Correspondence:
| | - Maryam Mohd Zulkifli
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (N.F.M.N.); (M.M.Z.); (R.M.)
| | - Rosediani Muhamad
- Department of Family Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia; (N.F.M.N.); (M.M.Z.); (R.M.)
| | - Samsul Draman
- Department of Family Medicine, Kulliyyah of Medicine, International Islamic University Malaysia, Jalan Sultan Ahmad Shah, Kuantan 25200, Malaysia;
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12
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Arnold SV, Khunti K, Tang F, Chen H, Nicolucci A, Gomes MB, Ji L, Shestakova MV, Watada H, Cooper A, Fenici P, Hammar N, Medina J, Kosiborod M. Impact of micro‐ and macrovascular complications of type 2 diabetes on quality of life: Insights from the DISCOVER prospective cohort study. Endocrinol Diabetes Metab 2022; 5:e00321. [PMID: 35029066 PMCID: PMC8917866 DOI: 10.1002/edm2.321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/14/2021] [Accepted: 12/20/2021] [Indexed: 11/25/2022] Open
Abstract
Background The key goals of management in patients with type 2 diabetes (T2D) are to prolong life and improve quality of life. Micro‐ and macrovascular complications of T2D not only increase the risk of morbidity and mortality, but cross‐sectional studies indicate they may also worsen quality of life. We prospectively examined the association of complications that developed during the follow‐up with concurrent changes in quality of life. Materials and methods DISCOVER is a multinational, prospective, observational cohort study of T2D patients enrolled at initiation of second‐line glucose‐lowering therapy. Quality of life was assessed with the SF‐36 Physical (PCS) and Mental Components Summary (MCS) scores at baseline, 6 months, and 1, 2 and 3 years. Hierarchical repeated measures regression models for PCS and MCS were constructed with complications included as time‐dependent covariates; first each complication was modelled alone and then second including all interval complications (to account for different complications occurring in the same patient). Results Among 7830 patients with T2D from 30 countries (mean age 56.6 years, 47.6% women, mean duration of T2D 5.6 years), baseline mean SF‐36 PCS was 48.0 ± 7.8 and SF‐36 MCS was 45.5 ± 10.4. At baseline, 1422 (18.2%) patients had a known microvascular complication, and 966 (12.3%) had a macrovascular complication. Over the 3 years of the study, 641 (12.0%) developed a new microvascular complication (most commonly neuropathy) and 372 (5.8%) developed a new macrovascular complication (most commonly coronary disease). New diagnoses of coronary disease, peripheral artery disease, heart failure and neuropathy were each associated with subsequent moderate reductions in SF‐36 PCS (range 0.7 to 1.6 points) and new cerebrovascular disease was associated with a reduction in SF‐36 MCS (2.6 points). Results were consistent when all interval complications were considered in the same model. Conclusion In a prospective, multinational study of patients with T2D, the development of macrovascular complications and neuropathy was associated with decreases in both physical and mental quality of life. Our results provide additional support for clinicians to focus on the prevention, detection and management of the complications of T2D.
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Affiliation(s)
- Suzanne V. Arnold
- Saint Luke’s Mid America Heart Institute Kansas City Missouri USA
- University of Missouri Kansas City Missouri USA
| | | | - Fengming Tang
- Saint Luke’s Mid America Heart Institute Kansas City Missouri USA
| | | | - Antonio Nicolucci
- Center for Outcomes Research and Clinical Epidemiology Pescara Italy
| | | | - Linong Ji
- Peking University People’s Hospital Beijing China
| | | | | | | | | | - Niklas Hammar
- AstraZeneca Gothenburg Mölndal Sweden
- Institute of Environmental Medicine Karolinska Institutet Stockholm Sweden
| | | | - Mikhail Kosiborod
- Saint Luke’s Mid America Heart Institute Kansas City Missouri USA
- University of Missouri Kansas City Missouri USA
- The George Institute for Global Health and University of New South Wales Sydney Australia
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13
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García Ulloa AC, Tron-Gómez MS, Díaz-Pineda M, Hernández-Juárez D, Landa-Anell MV, Melgarejo-Hernández MA, Hernández-Jiménez S. Maintenance of Self-Care Activities During COVID-19 Lockdown in Patients with Type 2 Diabetes That Received a Comprehensive Care Program Training. Diabetes Metab Syndr Obes 2022; 15:2857-2865. [PMID: 36160467 PMCID: PMC9504530 DOI: 10.2147/dmso.s379547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/07/2022] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION In 2020, several countries established a global emergency state. Lockdowns restricted people's lifestyles and daily activities to prevent coronavirus spread. These measures hindered diabetes mellitus control and lifestyle changes. This study aims to evaluate if attending a multidisciplinary program before the pandemic helped maintain a good metabolic state, lifestyle modifications, and mental health in patients with diabetes mellitus during the COVID-19 lockdown. METHODS Patients included in this study attended a multidisciplinary program, with <5 years of diagnosis of type 2 diabetes, without disabling complications, between 18-70 years old. The complete lockdown occurred from February 27, 2020, to May 31, 2020. The first patient (non-COVID) to return to the center for face-to-face consultation was in March 2021. Consultations in 2019 were face-to-face and changed to a virtual modality during 2020. We analyzed metabolic, lifestyle, mental health, and diabetes education parameters. RESULTS A total of 133 patients with type 2 diabetes mellitus were included with complete information in visits before and during the lockdown. Metabolic parameters and self-care measures (nutrition plan, foot evaluation, and self-glucose monitoring) evaluated on our patients had no change during the lockdown. We found a significant increase in the time patients spent sitting during the day (p<0.05). Barriers to exercise increased during lockdown, being joint pain (3.8% to 12.0%, p<0.01) and lack of time to exercise (4.5% to 7.5%, p=0.33) being the most common. There was no significant difference in symptoms of anxiety and depression, quality of life, and empowerment. CONCLUSION A multidisciplinary diabetes mellitus program, including diabetes education for self-care activities, positively impacts patients, maintaining good outcomes despite lockdown difficulties.
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Affiliation(s)
- Ana C García Ulloa
- Center of Comprehensive Care for the Patient with Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Maria S Tron-Gómez
- Faculty of Health Sciences, Universidad Anáhuac México Norte, Huixquilucan, Mexico
| | - Michelle Díaz-Pineda
- Center of Comprehensive Care for the Patient with Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Diana Hernández-Juárez
- Center of Comprehensive Care for the Patient with Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - María V Landa-Anell
- Center of Comprehensive Care for the Patient with Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Marco A Melgarejo-Hernández
- Center of Comprehensive Care for the Patient with Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Sergio Hernández-Jiménez
- Center of Comprehensive Care for the Patient with Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
- Correspondence: Sergio Hernández-Jiménez, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Centro de Atención Integral del Paciente con Diabetes, Vasco de Quiroga No. 15, Belisario Domínguez, Colonia Sección XVI, Tlalpan, Mexico City, 14080, Mexico, Tel +1 52 55 54870900 (5045); +1 52 55 55737378, Email
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14
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Nouripour F, Mazloom Z, Fararouei M, Zamani A. Effect of protein and carbohydrate distribution among meals on quality of life, sleep quality, inflammation, and oxidative stress in patients with type 2 diabetes: A single-blinded randomized controlled trial. Food Sci Nutr 2021; 9:6176-6185. [PMID: 34760248 PMCID: PMC8565242 DOI: 10.1002/fsn3.2570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/30/2021] [Accepted: 08/09/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND/OBJECTIVES Patients with diabetes mellitus have a lower quality of life and sleep compared with healthy individuals. Nutrition therapy has an important role in the management of diabetes and can improve inflammation and quality of life in patients with diabetes. The present study aimed to evaluate the effect of high-protein versus high-carbohydrate intake during evening meal on quality of life, sleep quality, inflammation, and oxidative stress in subjects with type 2 diabetes. SUBJECTS/METHODS This is a 10-week randomized controlled trial. 96 adult patients with type 2 diabetes were assigned into one of the following three groups: standard evening meal (ST), high-carbohydrate evening meal (HC), and high-protein evening meal (HP). The effect of these diets was examined on high-sensitivity C-reactive protein, malondialdehyde, quality of life, and sleep quality. RESULTS Sleep quality improved significantly in all groups (p < .05). The quality of life and high-sensitivity C-reactive protein improved in all groups except for the HP group (p < .05). Serum malondialdehyde level did not change significantly throughout the study (p > .05). CONCLUSIONS Small manipulation of protein and carbohydrate distribution among the meals might not affect sleep quality. A diet with an even distribution of macronutrients among the meals or with a higher percentage of carbohydrates in the evenings can improve the quality of life and reduce inflammation in patients with type 2 diabetes, while a diet with a higher percentage of protein in the evenings may not improve it.
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Affiliation(s)
- Fatemeh Nouripour
- Department of Clinical NutritionSchool of Nutrition and Food SciencesShiraz University of Medical SciencesShirazIran
| | - Zohreh Mazloom
- Department of Clinical NutritionSchool of Nutrition and Food SciencesShiraz University of Medical SciencesShirazIran
| | - Mohammad Fararouei
- Department of EpidemiologySchool of HealthShiraz University of Medical SciencesShirazIran
| | - Ali Zamani
- Department of Internal medicineSchool of Medicine, Endocrinology and Metabolism Research CenterShiraz University of Medical SciencesShirazIran
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15
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Oluchi SE, Manaf RA, Ismail S, Kadir Shahar H, Mahmud A, Udeani TK. Health Related Quality of Life Measurements for Diabetes: A Systematic Review. Int J Environ Res Public Health 2021; 18:ijerph18179245. [PMID: 34501838 PMCID: PMC8431362 DOI: 10.3390/ijerph18179245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/29/2022]
Abstract
Health-related quality of life (HRQOL) is an essential measure that is used to assess the effect of chronic disease management on the health status of an individual. Previous studies have identified various instruments used in the measuring of diabetes-specific health-related quality of life (HRQOL). The aim of this paper is to provide a systematic review of the various instruments used for the diabetes-specific measure of HRQOL, and place emphasis on its content and measurement properties. Methods Preferred Reporting Items for Systematic Reviews and Meta analyses (PRISMA) guidelines was used. A systematic search strategy was used to identify publications reporting diabetes HRQOL measures. The search terms used were: “diabetes quality of life”, “measurements”, and “instruments”. The database that was searched includes PubMed, Science Direct, CINAHL, and Medline. Articles written in the English language and published from January 1990 to December 2020 were included. Those articles that did not measure HRQOL for diabetic patients were excluded. Results: A total of seventeen instruments met the inclusion criteria and included in the review. The appraisal of diabetes scale (ADS), Audit of Diabetes-Dependent QOL measure (ADDQOL), Diabetes Health Profile (DHP), and Problem Areas in Diabetes (PAID) are more suitable for single-scale questionnaires when investigating one or more specific aspects of diabetes-specific quality of life (QOL). The ADDQOL, ADS, Diabetes Impact Measurement Scales (DIMS), Diabetes Quality of Life Clinical Trial Questionnaire (DQLCTQ-R), Malay Version of Diabetes Quality of Life (DQOL), Iranian Diabetes Quality of Life (IRDQOL), Brief Clinical Inventory, and PAID are relevant measures of HRQOL for insulin dependent diabetes mellitus (IDDM) and non-insulin dependent diabetes mellitus (NIDDM) patients. The Asian Diabetes Quality of Life AsianDQOL, The Chinese Short Version of DQOL, Elderly Diabetes Burden Scale (EDBS), Malay Version of Diabetes Quality of Life (DQOL), are relevant measures of HRQOL for NIDDM patients. Only two instruments assess for responsiveness, namely PAID and DQLCTQ-R. In PAID, the effect sizes ranged from 0.32 to 0.65 for interventions. The DQLCTQ-R four domains were responsive to clinical change in metabolic control. Based on this review ADDQOL, DSQOLS, and EDBS psychometric properties are sufficient. Conclusion: Most studies did not check for responsiveness, and future studies should prioritize responsiveness to change, which was not included in the psychometric finding of the reviewed instruments.
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Affiliation(s)
- Sampson Emilia Oluchi
- Department of Community Health, Faculty of Medicine and Health Sciences Universiti Putra Malaysia, Serdang 43400, Selangor Darul Ehsan, Malaysia; (S.E.O.); (S.I.); (H.K.S.); (A.M.)
| | - Rosliza Abdul Manaf
- Department of Community Health, Faculty of Medicine and Health Sciences Universiti Putra Malaysia, Serdang 43400, Selangor Darul Ehsan, Malaysia; (S.E.O.); (S.I.); (H.K.S.); (A.M.)
- Correspondence:
| | - Suriani Ismail
- Department of Community Health, Faculty of Medicine and Health Sciences Universiti Putra Malaysia, Serdang 43400, Selangor Darul Ehsan, Malaysia; (S.E.O.); (S.I.); (H.K.S.); (A.M.)
| | - Hayati Kadir Shahar
- Department of Community Health, Faculty of Medicine and Health Sciences Universiti Putra Malaysia, Serdang 43400, Selangor Darul Ehsan, Malaysia; (S.E.O.); (S.I.); (H.K.S.); (A.M.)
| | - Aidalina Mahmud
- Department of Community Health, Faculty of Medicine and Health Sciences Universiti Putra Malaysia, Serdang 43400, Selangor Darul Ehsan, Malaysia; (S.E.O.); (S.I.); (H.K.S.); (A.M.)
| | - Theophilus Kachidelu Udeani
- Department of Medical Laboratory Sciences, Faculty of Health Sciences & Technology College of Medicine, University of Nigeria Enugu Campus, Enugu 410001, Nigeria;
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16
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Diriba DC, Leung DYP, Suen LKP. Cultural Adaptation and Psychometric Properties of the Diabetes Quality of Life Scale in Afaan Oromoo among People Living with Type 2 Diabetes in Ethiopia. Int J Environ Res Public Health 2021; 18:7435. [PMID: 34299884 DOI: 10.3390/ijerph18147435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND The original 46-item diabetes quality of life (DQOL) scale has been translated into different languages, and the translated DQOL has shown good reliability and validity after deleting some items. The aim of this study was to translate the diabetes quality of life (DQOL) scale into Afaan Oromoo and to culturally adapt and evaluate the psychometric properties of the DQOL-Afaan Oromoo (DQOL-AO) among people living with T2D in Ethiopia. METHODS A cross-sectional study with a convenience sampling technique was conducted in 2020. The DQOL was translated and adapted to Afaan Oromoo. Item-total correlations and exploratory factor analysis (EFA) assessed factor structure; the Cronbach's alpha assessed internal consistency and relationships with gender, educational status, marital status, age, and employment status; and status of diabetes-related disease assessed the construct validity of the DQOL-AO. RESULTS 417 participants responded to all items of the DQOL. Item-total correlation analysis and EFA produced a 34-item DQOL-AO with four subscales, which demonstrated that the internal consistency of the overall DQOL-AO was 0.867, and scores were 0.827, 0.846, 0.654, and 0.727 for the impact, satisfaction, social/vocational worry, and diabetes-related worry subscales, respectively. Statistically significant differences between QOL were obtained in educational status (F = 7.164, p < 0.001) and employment status (F = 4.21, p = 0.002). Individuals who attended college and above and government employees had better QOL. CONCLUSION The 34-item DQOL-AO provided preliminary evidence as a reliable and valid tool to measure diabetic-related QOL before it can be widely used among adults living with T2D who speak Afaan Oromoo.
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17
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Markmann JF, Rickels MR, Eggerman TL, Bridges ND, Lafontant DE, Qidwai J, Foster E, Clarke WR, Kamoun M, Alejandro R, Bellin MD, Chaloner K, Czarniecki CW, Goldstein JS, Hering BJ, Hunsicker LG, Kaufman DB, Korsgren O, Larsen CP, Luo X, Naji A, Oberholzer J, Posselt AM, Ricordi C, Senior PA, Shapiro AMJ, Stock PG, Turgeon NA. Phase 3 trial of human islet-after-kidney transplantation in type 1 diabetes. Am J Transplant 2021; 21:1477-1492. [PMID: 32627352 PMCID: PMC9074710 DOI: 10.1111/ajt.16174] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/19/2020] [Accepted: 06/20/2020] [Indexed: 01/25/2023]
Abstract
Allogeneic islet transplant offers a minimally invasive option for β cell replacement in the treatment of type 1 diabetes (T1D). The CIT consortium trial of purified human pancreatic islets (PHPI) in patients with T1D after kidney transplant (CIT06), a National Institutes of Health-sponsored phase 3, prospective, open-label, single-arm pivotal trial of PHPI, was conducted in 24 patients with impaired awareness of hypoglycemia while receiving intensive insulin therapy. PHPI were manufactured using standardized processes. PHPI transplantation was effective with 62.5% of patients achieving the primary endpoint of freedom from severe hypoglycemic events and HbA1c ≤ 6.5% or reduced by ≥ 1 percentage point at 1 year posttransplant. Median HbA1c declined from 8.1% before to 6.0% at 1 year and 6.3% at 2 and 3 years following transplant (P < .001 for all vs baseline), with related improvements in hypoglycemia awareness and glucose variability. The improved metabolic control was associated with better health-related and diabetes-related quality of life. The procedure was safe and kidney allograft function remained stable after 3 years. These results add to evidence establishing allogeneic islet transplant as a safe and effective treatment for patients with T1D and unstable glucose control despite intensive insulin treatment, supporting the indication for PHPI in the post-renal transplant setting.
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Affiliation(s)
- James F. Markmann
- Division of Transplant Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Michael R. Rickels
- Division of Endocrinology, Diabetes & Metabolism, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Thomas L. Eggerman
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Nancy D. Bridges
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - David E. Lafontant
- Clinical Trials Statistical and Data Management Center, University of Iowa, Iowa City, Iowa
| | - Julie Qidwai
- Clinical Trials Statistical and Data Management Center, University of Iowa, Iowa City, Iowa
| | - Eric Foster
- Ferring Pharmaceuticals, Parsippany, New Jersey
| | - William R. Clarke
- Clinical Trials Statistical and Data Management Center, University of Iowa, Iowa City, Iowa
| | - Malek Kamoun
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Rodolfo Alejandro
- Diabetes Research Institute and Clinical Cell Transplant Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Melena D. Bellin
- Department of Endocrinology, University of Minnesota, Minneapolis, Minnesota
| | - Kathryn Chaloner
- Clinical Trials Statistical and Data Management Center, University of Iowa, Iowa City, Iowa
| | - Christine W. Czarniecki
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Julia S. Goldstein
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland
| | - Bernhard J. Hering
- Schulze Diabetes Institute and Department of Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Lawrence G. Hunsicker
- Clinical Trials Statistical and Data Management Center, University of Iowa, Iowa City, Iowa
| | - Dixon B. Kaufman
- Division of Transplantation, Department of Surgery, University of Wisconsin, Madison, Wisconsin
| | - Olle Korsgren
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | | | - Xunrong Luo
- Department of Medicine, Duke University, Durham, North Carolina
| | - Ali Naji
- Division of Transplantation, Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - José Oberholzer
- Department of Surgery, University of Illinois, Chicago, Illinois
| | - Andrew M. Posselt
- Department of Surgery, University of California, San Francisco, California
| | - Camillo Ricordi
- Diabetes Research Institute and Clinical Cell Transplant Program, University of Miami Miller School of Medicine, Miami, Florida
| | - Peter A. Senior
- Clinical Islet Transplant Program and Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - A. M. James Shapiro
- Clinical Islet Transplant Program and Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Peter G. Stock
- Department of Surgery, University of California, San Francisco, California
| | - Nicole A. Turgeon
- Department of Surgery, University of Texas Dell Medical School, Austin, Texas
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18
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Vela AM, Palmer B, Gil-Rivas V, Cachelin F. The Role of Disordered Eating in Type 2 Diabetes: A Pilot Study. Am J Lifestyle Med 2021; 17:131-139. [PMID: 36636384 PMCID: PMC9830250 DOI: 10.1177/15598276211002459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Rates of type 2 diabetes mellitus continue to rise around the world, largely due to lifestyle factors such as poor diet, overeating, and lack of physical activity. Diet and eating is often the most challenging aspect of management and, when disordered, has been associated with increased risk for diabetes-related complications. Thus, there is a clear need for accessible and evidence-based interventions that address the complex lifestyle behaviors that influence diabetes management. The current study sought to assess the efficacy and acceptability of a pilot lifestyle intervention for women with type 2 diabetes and disordered eating. The intervention followed a cognitive behavioral therapy guided-self-help (CBTgsh) model and included several pillars of lifestyle medicine, including: diet, exercise, stress, and relationships. Ten women completed the 12-week intervention that provided social support, encouraged physical activity, and addressed eating behaviors and cognitions. Results indicate the lifestyle intervention was a feasible treatment for disordered eating behaviors among women with type 2 diabetes and was also associated with improved diabetes-related quality of life. The intervention was also acceptable to participants who reported satisfaction with the program. The current CBTgsh lifestyle intervention is a promising treatment option to reduce disordered eating and improve diabetes management.
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Affiliation(s)
- Alyssa M. Vela
- Alyssa M. Vela, Department of Surgery,
Division of Cardiac Surgery, Northwestern Feinberg School of Medicine, 676 N St.
Clair, Suite 7-336, Chicago, IL 60611; e-mail:
| | - Brooke Palmer
- Department of Medicine, University of Minnesota
Medical School, Minneapolis, Minnesota
| | - Virginia Gil-Rivas
- Department of Psychology, The University of
North Carolina at Charlotte, Charlotte, North Carolina
| | - Fary Cachelin
- Wellbeing, Education, and Language Studies, The
Open University, Milton Keynes, Buckinghamshire, UK
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19
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Ramiro-Cortijo D, de la Calle M, Gila-Díaz A, Moreno-Jiménez B, Martin-Cabrejas MA, Arribas SM, Garrosa E. Maternal Resources, Pregnancy Concerns, and Biological Factors Associated to Birth Weight and Psychological Health. J Clin Med 2021; 10:jcm10040695. [PMID: 33578963 PMCID: PMC7916643 DOI: 10.3390/jcm10040695] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 12/25/2022] Open
Abstract
Cognitive maternal adaptation during pregnancy may influence biological variables, maternal psychological, and neonatal health. We hypothesized that pregnant women with numerous general resources and less negative emotions would have a better coping with a positive influence on neonatal birth weight and maternal psychological health. The study included 131 healthy pregnant women. A blood sample was obtained in the first trimester to assess biological variables (polyphenols, hematological and biochemical parameters). Psychological variables (negative affect, anxiety, optimism, resilience, family–work conflicts, pregnancy concerns, general resources, and life satisfaction) were evaluated at several time points along gestation, and birth weight was recorded. Hierarchical linear regression models were used to associate the above parameters with maternal psychological outcome at the end of gestation (depression, resilience, and optimism) and neonatal outcome (birth weight). Maternal depression was associated with leukocytes (β = 0.08 ± 0.03, p-value = 0.003), cholesterol (β = 0.01 ± 0.002, p-value = 0.026), and pregnancy concerns (β = 0.31 ± 0.09, p-value = 0.001). Maternal resilience was associated with leukocytes (β = −0.14 ± 0.09, p-value = 0.010) and life satisfaction (β = 0.82 ± 0.08, p-value = 0.001), and maternal optimism was associated with polyphenol levels (β = 0.002 ± 0.001, p-value = 0.018) and life satisfaction (β = 0.49 ± 0.04, p-value = 0.001). Birth weight was associated with maternal resilience (β = 370.2 ± 97.0, p-value = 0.001), red blood cells (β = 480.3 ± 144.4, p-value = 0.001), and life satisfaction (β = 423.3 ± 32.6, p-value = 0.001). We found associations between maternal psychological, blood variables, and birth weight and maternal depression. This study reveals the relevance of psychological health during pregnancy for maternal and neonatal outcome, and it emphasizes the need to consider it in preventive policies in the obstetric field.
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Affiliation(s)
- David Ramiro-Cortijo
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain; (D.R.-C.); (A.G.-D.)
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA
| | - María de la Calle
- Obstetrics and Gynecology Service, Hospital Universitario La Paz, Paseo de la Castellana 261, 28046 Madrid, Spain;
| | - Andrea Gila-Díaz
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain; (D.R.-C.); (A.G.-D.)
- Pharmacology and Physiology PhD Degree, Escuela de Doctorado, Universidad Autónoma de Madrid, Ciudad Universitaria de Cantoblanco, 28049 Madrid, Spain
| | - Bernardo Moreno-Jiménez
- Department of Biological & Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain;
| | - Maria A. Martin-Cabrejas
- Department of Agricultural and Food Chemistry, Faculty of Science, Universidad Autónoma de Madrid, C/Francisco Tomás y Valiente 7, 28049 Madrid, Spain;
| | - Silvia M. Arribas
- Department of Physiology, Faculty of Medicine, Universidad Autónoma de Madrid, C/Arzobispo Morcillo 2, 28029 Madrid, Spain; (D.R.-C.); (A.G.-D.)
- Correspondence: (S.M.A.); (E.G.)
| | - Eva Garrosa
- Department of Biological & Health Psychology, Faculty of Psychology, Universidad Autónoma de Madrid, C/Ivan Pavlov 6, 28049 Madrid, Spain;
- Correspondence: (S.M.A.); (E.G.)
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Barua L, Faruque M, Chowdhury HA, Banik PC, Ali L. Health-related quality of life and its predictors among the type 2 diabetes population of Bangladesh: A nation-wide cross-sectional study. J Diabetes Investig 2021; 12:277-285. [PMID: 32564501 PMCID: PMC7858106 DOI: 10.1111/jdi.13331] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 05/29/2020] [Accepted: 06/15/2020] [Indexed: 11/27/2022] Open
Abstract
AIMS/INTRODUCTION We aimed to assess the health-related quality of life (HRQoL) and identify its predictors among type 2 diabetes patients of Bangladesh. MATERIALS AND METHODS This nationwide cross-sectional study assessed HRQoL among 1,806 type 2 diabetes patients using the EuroQol-5 Dimensions Questionnaire (EQ-5D-5L), and the responses were further translated into a single summary crosswalk index score using the UK time trade-off value set. The predictors were determined using multinomial logistic regression analysis. RESULTS The mean EQ-5D-5L index score was 0.62 (standard deviation 0.25), and men scored better than women. More than half of the study participants (53.4%) were ranked as "average" HRQoL. Overall, 64% of respondents had a "problem" at least in one of the dimensions of the EQ-5D-5L, and the burden of reported "problems" was higher among women (70%). Among the five dimensions, the highest reported "problem" was 79.8% for anxiety/depression, 77.7% for pain/discomfort and 60.1% for mobility. However, younger participants (aged <30 years) showed a higher burden of anxiety/depression (95%) compared with the rest of the population. The specific predictors of average/good HRQoL (odds ratio >1) were being men, living in a rural area, married, literate, a monthly income >19,488 BDT, absence of comorbidity and had a duration of diabetes ≤5 years. CONCLUSIONS The majority of Bangladesh's type 2 diabetes patients had an "average" HRQoL based on the EQ-5D-5L index score. In broad terms, the identified predictors were sex, place of residence, marital status, literacy, monthly income, comorbidity and duration of diabetes.
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Affiliation(s)
- Lingkan Barua
- Department of Non‐communicable DiseasesBangladesh University of Health Sciences (BUHS)DhakaBangladesh
| | - Mithila Faruque
- Department of Non‐communicable DiseasesBangladesh University of Health Sciences (BUHS)DhakaBangladesh
| | | | - Palash Chandra Banik
- Department of Non‐communicable DiseasesBangladesh University of Health Sciences (BUHS)DhakaBangladesh
| | - Liaquat Ali
- Department of Biochemistry and Cell BiologyBangladesh University of Health Sciences (BUHS)DhakaBangladesh
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21
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Hernández-Jiménez S, García-Ulloa AC, Alcántara-Garcés MT, Urbina-Arronte LE, Lara-Sánchez C, Velázquez-Jurado HR. Feasibility and acceptance of a virtual multidisciplinary care programme for patients with type 2 diabetes during the COVID-19 pandemic. Ther Adv Endocrinol Metab 2021; 12:20420188211059882. [PMID: 34868545 PMCID: PMC8637687 DOI: 10.1177/20420188211059882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 10/25/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND AND AIMS Type 2 diabetes mellitus is one of the major public health concerns. The current lifestyle and advances in technology resulted in the development of a virtual mode of professional healthcare, which is an effective alternative method of management of patients. This study aimed to assess the feasibility of implementation of a virtual comprehensive care programme during the COVID-19 pandemic, patients' acceptance and the changes in self-care behaviours, metabolic parameters and emotional factors. METHODS The programme employed in this study included nine health interventions in 1 day. Due to the COVID-19 pandemic, the mode of interventions, including questionnaires, patient evaluations and a satisfaction survey, was modified to the virtual form in 2020. This study assessed the changes in self-care behaviours, metabolic parameters and emotional factors and compared the data pertaining to patients who received virtual healthcare in 2020 with those who received face-to-face modality of medical care in 2019. RESULTS During June to November 2020, 130 patients received healthcare by means of the virtual modality. The change in modality of healthcare was feasible and 75% of the patients displayed good acceptance of the same. The evaluation of self-care behaviours included self-monitoring blood glucose (SMBG) levels, foot care and regular exercise. The duration of exercise decreased from 120 to 0 min/week (p < 0.001). However, there was no change in metabolic parameters. Regarding the mental health parameters, we observed an increase in the proportion of patients with anxiety (21.5% versus 11.1%), depressive symptoms (10.8% versus 4.3%), diabetes distress (18.5% versus 11.1%) and prescription of psychotropic drugs (32.8% versus 18.2%) (p < 0.05) in virtual versus face-to-face, respectively. CONCLUSION The virtual comprehensive care programme for the management of patients with diabetes is a feasible approach that allows healthcare professionals to provide an adequate care during the COVID-19 pandemic.
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Affiliation(s)
- Sergio Hernández-Jiménez
- Centro de Atención Integral del Paciente con
Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición
Salvador Zubirán, Mexico City, Mexico
| | | | - María Teresa Alcántara-Garcés
- Centro de Atención Integral del Paciente con
Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición
Salvador Zubirán, Mexico City, Mexico
| | - Luz Elena Urbina-Arronte
- Centro de Atención Integral del Paciente con
Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición
Salvador Zubirán, Mexico City, Mexico
| | - Carolina Lara-Sánchez
- Centro de Atención Integral del Paciente con
Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición
Salvador Zubirán, Mexico City, Mexico
| | - Héctor Rafael Velázquez-Jurado
- Centro de Atención Integral del Paciente con
Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición
Salvador Zubirán, Mexico City, Mexico
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David OP, Edgar G, Catherwood D, Taiwo AO. Type of diabetes mellitus and health-related quality of life in Nigeria: Ethnic and sex differences. Journal of Psychology in Africa 2020. [DOI: 10.1080/14330237.2020.1842518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Graham Edgar
- School of Natural & Social Sciences, University of Gloucestershire, Cheltenham, UK
| | - Dianne Catherwood
- School of Natural & Social Sciences, University of Gloucestershire, Cheltenham, UK
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Bozdemir-Ozel C, Arikan H, Calik-Kutukcu E, Karadüz BN, Inal-Ince D, Kabakci G, Sumer E, Dagdelen S. Subclinical Inflammation Is Associated With Reductions in Muscle Oxygenation, Exercise Capacity and Quality of Life in Adults With Type 2 Diabetes. Can J Diabetes 2020; 44:422-427. [PMID: 32616275 DOI: 10.1016/j.jcjd.2020.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 02/13/2020] [Accepted: 02/28/2020] [Indexed: 01/08/2023]
Abstract
OBJECTIVES Exercise capacity is related to both morbidity and mortality in patients with type 2 diabetes (T2DM). The aim of this study was to investigate the relationship between subclinical inflammation level, exercise capacity, muscle oxygenation and quality of life in T2DM. METHODS This study includes 28 patients with T2DM (mean age, 51.5±5.0 years; male-to-female ratio, 6:22). Exercise capacity was evaluated using an incremental symptom-limited maximal exercise test on a bicycle ergometer. Muscle oxygenation was investigated using a wearable lactate-measuring device. Diabetes-specific quality of life was assessed using the Diabetes Quality of Life Questionnaire (DQOL). Subclinical inflammation was assessed using C-reactive protein (CRP) levels. RESULTS CRP level was negatively correlated with peak workload during the test (r=-0.588, p=0.002), muscle oxygenation (r=-0.465, p=0.019) and the psychological impact of treatment subscale of the DQOL (r=-0.540, p=0.017), and positively correlated with body mass index (r=0.519, p=0.008), waist circumference (r=0.426, p=0.038) and fat percentage (r=0.573, p=0.004). There was no correlation between CRP and fasting blood glucose or glycated hemoglobin level (p>0.05). Peak workload was inversely related to fat percentage (r=-0.467, p=0.016) and the DQOL worry about the future impact of diabetes subscale (r=-0.501, p=0.021). CONCLUSIONS In our study, subclinical inflammation negatively affected muscle oxygenation, exercise capacity and quality of life independently of glycemic indicators. Our findings suggest that the degree of glycemic control is insufficient to explain lower exercise capacity. Further studies are needed to investigate subclinical inflammation-reducing interventions in T2DM.
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Affiliation(s)
- Cemile Bozdemir-Ozel
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey.
| | - Hülya Arikan
- Faculty of Health Sciences, Department of Physiotherapy, Atılım University, Ankara, Turkey
| | - Ebru Calik-Kutukcu
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Beyza Nur Karadüz
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Deniz Inal-Ince
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Giray Kabakci
- Department of Cardiology, School of Medicine, Hacettepe University, Ankara, Turkey
| | - Erkan Sumer
- Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Selçuk Dagdelen
- Department of Endocrinology and Metabolism, School of Medicine, Hacettepe University, Ankara, Turkey
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Erickson ML, Mey JT, Axelrod CL, Paul D, Gordesky L, Russell K, Barkoukis H, O'Tierney-Ginn P, Fielding RA, Kirwan JP, Catalano PM. Rationale and study design for lifestyle intervention in preparation for pregnancy (LIPP): A randomized controlled trial. Contemp Clin Trials 2020; 94:106024. [PMID: 32389808 DOI: 10.1016/j.cct.2020.106024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 01/13/2023]
Abstract
INTRODUCTION Maternal obesity increases neonatal risk for obesity and metabolic syndrome later in life. Prior attempts to break this intergenerational obesity cycle by limiting excessive gestational weight gain have failed to reduce neonatal adiposity. Alternatively, pre-conception lifestyle interventions may improve the in utero metabolic milieu during early pregnancy leading to improved fetal outcomes. This randomized controlled trial (RCT) is evaluating whether a lifestyle intervention to reduce weight and improve maternal metabolism in preparation for pregnancy (LIPP) attenuates neonatal adiposity, compared to standard medical advice. MATERIAL AND METHODS Overweight/class 1 obese women after a previous pregnancy, ~12 weeks postpartum, preparing for a subsequent pregnancy, will be block randomized (1:1) to either LIPP or standard of care in a parallel design. Randomization is stratified by lactation status and overweight vs. class 1 obesity. The LIPP program consists of intensive short-term weight loss followed by weight maintenance until conception using supervised exercise and a low glycemic Mediterranean diet. PRIMARY OUTCOMES Group differences in neonatal adiposity at birth assessed by PEA POD and placental mitochondrial lipid metabolism. SECONDARY OUTCOMES Group differences in maternal pregravid and gestational body composition, insulin sensitivity, β-cell function, fasting metabolic and inflammatory biomarkers, and overall quality of life. Exploratory outcomes include umbilical cord blood insulin resistance, lipid profile and inflammation. DISCUSSION This RCT will determine the efficacy of maternal weight loss prior to pregnancy on reducing neonatal adiposity. Findings may change standard obstetrical care by providing Level 1 evidence on lifestyle interventions improving neonatal outcomes for women planning for pregnancy. CLINICAL TRIAL REGISTRATION NCT03146156.
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Affiliation(s)
- M L Erickson
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America
| | - J T Mey
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America
| | - C L Axelrod
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America; Department of Translational Services, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America
| | - D Paul
- Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America
| | - L Gordesky
- Department of Reproductive Biology, Center for Reproductive Health, MetroHealth Medical, 2500 MetroHealth Dr, Cleveland, OH 44109, United States of America
| | - K Russell
- Mother Infant Research Institute, Tufts Medical Center, 800 Washington St, Boston, MA 02111, United States of America
| | - H Barkoukis
- Department of Nutrition, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106, United States of America
| | - P O'Tierney-Ginn
- Department of Reproductive Biology, Center for Reproductive Health, MetroHealth Medical, 2500 MetroHealth Dr, Cleveland, OH 44109, United States of America; Mother Infant Research Institute, Tufts Medical Center, 800 Washington St, Boston, MA 02111, United States of America
| | - R A Fielding
- Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, 711 Washington St, Boston, MA 02111, United States of America
| | - J P Kirwan
- Integrative Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, LA 70808, United States of America; Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, United States of America.
| | - P M Catalano
- Department of Reproductive Biology, Center for Reproductive Health, MetroHealth Medical, 2500 MetroHealth Dr, Cleveland, OH 44109, United States of America; Mother Infant Research Institute, Tufts Medical Center, 800 Washington St, Boston, MA 02111, United States of America.
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Uchinuma H, Ichijo M, Harima N, Tsuchiya K. Dulaglutide improves glucocorticoid-induced hyperglycemia in inpatient care and reduces dose and injection frequency of insulin. BMC Endocr Disord 2020; 20:58. [PMID: 32381085 PMCID: PMC7203793 DOI: 10.1186/s12902-020-0542-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Accepted: 04/28/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Glucocorticoid (GC)-induced hyperglycemia is characterized by elevated postprandial blood glucose, which commonly requires multiple insulin injections. We investigated whether a long-acting glucagon-like peptide-1 receptor agonist, dulaglutide (Dula), safely improved GC-induced hyperglycemia in inpatients, to reduce insulin injection frequency. METHODS The data of hospitalized patients with GC-induced hyperglycemia treated with Dula (Dula group, n = 38) or without (non-Dula group, n = 38) were retrospectively evaluated. Baseline data were collected at the beginning of GC treatment. The primary outcome in this study was glycemic control, which was compared between the groups using the six-point blood glucose (before and 2 h after each meal) profiles at discharge. The daily injection frequency of injectable drugs at discharge were also compared between groups. RESULTS No specific trend of underlying diseases was observed between the non-Dula and Dula groups. The proportion of patients previously administered with GC pulse therapy was comparable between the two groups. No significant differences were observed between groups, in the starting maintenance GC dose, GC dose at pretreatment of Dula and discharge, and cumulative GC dose during the observation. Six-point blood glucose levels at pretreatment and discharge were comparable between the two groups. However, daily injection frequency of injectable drugs and insulin dose were significantly lower in the Dula group than that in the non-Dula group. No differences were observed in the number of hypoglycemic events, the elevation of serum pancreatic enzyme levels, or gastrointestinal adverse events. CONCLUSION These findings suggest that Dula could provide glycemic control while reducing the insulin dose and injection frequency in inpatients with GC-induced hyperglycemia. The occurrence of adverse events such as gastrointestinal symptoms and hypoglycemia did not increase in the Dula-treated patients compared to those not treated, suggesting its safety.
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Affiliation(s)
- Hiroyuki Uchinuma
- Department of Diabetes and Endocrinology, University of Yamanashi Hospital, 1110 Shimokato, Chuo, Yamanashi, 4093898, Japan
| | - Masashi Ichijo
- Department of Diabetes and Endocrinology, University of Yamanashi Hospital, 1110 Shimokato, Chuo, Yamanashi, 4093898, Japan
| | - Noriyuki Harima
- Department of Diabetes and Endocrinology, University of Yamanashi Hospital, 1110 Shimokato, Chuo, Yamanashi, 4093898, Japan
| | - Kyoichiro Tsuchiya
- Department of Diabetes and Endocrinology, University of Yamanashi Hospital, 1110 Shimokato, Chuo, Yamanashi, 4093898, Japan.
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Carlton J, Rowen D, Elliott J. Assessment of the psychometric properties and refinement of the Health and Self-Management in Diabetes Questionnaire (HASMID). Health Qual Life Outcomes 2020; 18:59. [PMID: 32138742 PMCID: PMC7059394 DOI: 10.1186/s12955-020-01305-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 02/21/2020] [Indexed: 11/25/2022] Open
Abstract
Background The Health And Self-Management In Diabetes (HASMIDv1) questionnaire consists of 8 attributes, 4 about quality of life, and 4 about self-management. The overall aim of this study was to rigorously examine the psychometric properties of the HASMIDv1 questionnaire. Methods The study comprised two phases. Phase 1 identified items of the HASMIDv1 questionnaire that potentially required rewording through consultation with a patient involvement panel and two focus groups of people with diabetes. Phase 2 involved a cross-sectional longitudinal survey where HASMID, EQ-5D-5L, health, treatment and sociodemographic questions were administered using both paper and online versions to people with diabetes. Participants were asked to complete the survey again approximately 3 months later. Psychometric analyses were undertaken to examine floor and ceiling effects, item distributions, known group differences and internal consistency. Rasch analysis was undertaken to assess differential item functioning and disordered thresholds. Results Phase 1 derived five alternative wordings to items: Irritable, Affects Mealtimes, Daily Routine, Social Activities and Problem. Phase 2 achieved 2835 responses at time point 1 (n = 1944 online, n = 891 paper version) and 1243 at time point 2 (n = 533 online, n = 710 paper version). Overall the HASMID items performed well, though two alternative worded items (Irritable and Social Activities) provided additional information not fully captured by the original HASMID items. Conclusion Psychometric evaluation and Rasch analysis were used in conjunction with expert opinion to determine the final questionnaire. The application of psychometric analyses or Rasch analysis alone to inform item selection would have resulted in different items being selected for the final instrument. The benefit of a combined approach has produced an instrument which has a broader evaluation of self-management. The final validated HASMID-10 is a short self-report PRO that can be used to evaluate the impact of self-management for people living with diabetes. HASMID-10 can be scored using total summative scores, with utility and monetary values also available for use in cost-utility and cost-benefit analyses.
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Affiliation(s)
- Jill Carlton
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Donna Rowen
- School of Health and Related Research (ScHARR), University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Jackie Elliott
- Department of Oncology and Metabolism, University of Sheffield, Medical School, Sheffield, S10 2JF, UK.,Sheffield Teaching Hospitals NHS Trust, Diabetes and Endocrine Centre, Northern General Hospital, Sheffield, S5 7AU, UK
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Pereira EV, Tonin FS, Carneiro J, Pontarolo R, Wiens A. Evaluation of the application of the Diabetes Quality of Life Questionnaire in patients with diabetes mellitus. Arch Endocrinol Metab 2020; 64:59-65. [PMID: 32187271 PMCID: PMC10522290 DOI: 10.20945/2359-3997000000196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 12/21/2018] [Indexed: 11/23/2022]
Abstract
Objective Diabetes mellitus (DM) is a chronic disease with great impact on patients' quality of life (QoL). This variable can be measured using reliable, standardized, and validated instruments. The purpose of this study was to evaluate the application and reporting of the Diabetes Quality of Life Measure (DQOL) or the Diabetes Quality of Life for Youths Measure (DQOLY), an adapted version for young patients with DM. Materials and methods A systematic review of interventional and observational studies using the DQOL or DQOLY was performed. Searches were conducted in the electronic databases Medline, Scopus, Web of Science, Lilacs, and SciELO. Results After conducting the searches, 111 studies met the inclusion criteria and were included in the qualitative analysis. Of these, 32 studies were classified as interventional and 79 as observational, with 27,481 patients. The DQOL was applied in 82 studies, the DQOLY in another 27, and two studies used both instruments. DM was classified as type 1 DM in 69 studies and type 2 DM in 35 studies. Six studies included both patients. Improvement in patients' QoL after an intervention was observed in 13 interventional studies. Most of the studies (90%) provide a detailed description of the instrument and 52% the previous validation. The interpretation of the scores obtained varies among the studies, probably due to the differences inherent in cultural validations, translations, and adaptations. Conclusion The application of the instruments in clinical practice must be rigorously standardized and requires an accurate understanding of psychometric and statistical concepts. Arch Endocrinol Metab. 2020;64(1):59-65.
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Affiliation(s)
- Edilene Vieira Pereira
- Departamento de FarmáciaUniversidade Federal do ParanáCuritibaPRBrasil Departamento de Farmácia , Universidade Federal do Paraná (UFPR), Curitiba , PR , Brasil
| | - Fernanda Stumpf Tonin
- Departamento de FarmáciaUniversidade Federal do ParanáCuritibaPRBrasil Departamento de Farmácia , Universidade Federal do Paraná (UFPR), Curitiba , PR , Brasil
| | - Jaqueline Carneiro
- Departamento de FarmáciaUniversidade Federal do ParanáCuritibaPRBrasil Departamento de Farmácia , Universidade Federal do Paraná (UFPR), Curitiba , PR , Brasil
| | - Roberto Pontarolo
- Departamento de FarmáciaUniversidade Federal do ParanáCuritibaPRBrasil Departamento de Farmácia , Universidade Federal do Paraná (UFPR), Curitiba , PR , Brasil
| | - Astrid Wiens
- Departamento de FarmáciaUniversidade Federal do ParanáCuritibaPRBrasil Departamento de Farmácia , Universidade Federal do Paraná (UFPR), Curitiba , PR , Brasil
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Kurtalic N, Kurtalic S, Salihbegovic EM. Skin Changes in Patients with Diabetes Melitus Type 2 and their Impact on Quality of Life. Mater Sociomed 2020; 32:283-286. [PMID: 33628131 PMCID: PMC7879440 DOI: 10.5455/msm.2020.32.283-286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction: Changes in the skin can occur as part of a diabetic, metabolic disorder or diabetic complications. Studies have shown that diabetes has an extremely strong negative impact on quality of life, especially diabetes with complications. Aim: Examine the impact of skin changes in patients with type 2 diabetes mellitus on quality of life. Methods: A prospective study analysed the quality of life in 200 respondents with type 2 diabetes mellitus which had diabetes-related skin changes. Subjects were divided into four groups according to the type of skin changes associated with diabetes mellitus. Group 1 consisted of patients which had skin changes with a greater or lesser association with diabetes mellitus, group 2 patients with infections, group 3 patients with cutaneous manifestations of diabetic complications and group 4 patients with allergic reactions to antidiabetic therapy. Quality of life assessment was performed using the Skindex-29 questionnaire, and the Nijsten categorization was used to assess the impact of skin changes in patients with type 2 diabetes mellitus on quality of life. Results: There were (51.95%) respondents in group 1, group 2 (24.02%), group 3 (22.22%) and group 4 (1.8%) respondents. In the scale of emotions in 84 respondents (43.0%) the impact on quality of life was serious, in the scale of symptoms in 96 (48%) was moderate, and in the scale of social and physical functioning 106 (55%) also had a moderate impact on quality of life, as well as in the total score of 94 respondents (47%). There was a statistically significant difference in the scale of social and physical functioning in the presence of skin changes in group 1 (x2 = 7.95; df = 3, p = 0.045) and group 3 (x2 = 12.48, df = 3; p = 0.006), and in the total score of Skindex-29 when it comes to changes in the skin of group 3 (x2 = 7.26, df = 3, p = 0.05). Conclusion: the quality of life in patients with type 2 diabetes mellitus which have skin changes is significantly reduced.
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Affiliation(s)
- Nermina Kurtalic
- Cantonal Hospital "Dr Irfan Ljubijankic" Bihac, Bosnia and Herzegovina
| | - Sadat Kurtalic
- Cantonal Hospital "Dr Irfan Ljubijankic" Bihac, Bosnia and Herzegovina
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Jayalakshmi MS, Thenmozhi P, Vijayaragavan R. Impact of chronic wound on quality of life among diabetic foot ulcer patients in a selected hospital of Guwahati, Assam, India. Ayu 2020; 41:19-23. [PMID: 34566380 PMCID: PMC8415236 DOI: 10.4103/ayu.ayu_33_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/31/2020] [Accepted: 02/02/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Diabetic foot ulcer (DFU) is an important mortality factor among diabetes mellitus (DM) patients and has a massive impact on the quality of life (QoL) of patients. The non-heal foot ulcer needs extra care and need special attention in maintaining wound hygiene. Dressing on wound is done in four stages such as cleanse the wound, debridement of wound, fashioning of edges and final dressing. The important stage of cleanse the wound was done with solution extracted from neem leaves which has medicinal value and anti-biotic properties and was used instead of normal saline or water solution, which do not carry medicinal value. Other medicinal solutions are of high cost as well as not easily available such as octanedione dihydrochloride or hypochlorous acid etc. AIMS This study was aimed to investigate the impact of DFU on QoL among patients suffering from chronic wounds. MATERIALS AND METHODS A cross-sectional, descriptive study was conducted at foot care clinic in a private hospital situated at Guwahati, Assam. Data were collected using a pro forma consisting of sociodemographic variables, Wagner ulcer classification and Cardiff wound impact questionnaire. Analysis of data was done using the descriptive and inferential statistical methods. RESULTS A total of 118 DFU patients of type 1 and 2 DM were studied. Out of which, 81.4% were male and 18.6% were female. About 66 participants (55.9%) were in grade 2 and 38 (32.2%) were in grade 3 of Wagner ulcer classification. Overall mean score for QoL was 6.27, whereas overall mean score for satisfaction on QoL was 7.01. Patients had the highest score in the well-being domain and lowest in the social life stress. Computation of correlation matrix and factor analysis showed a positive correlation between QoL and satisfaction and negative correlation between QoL and satisfaction with stressful experience of social life and physical symptoms experience (P < 0.05, 0.01). Multiple regression analysis reveals that satisfaction had a significant impact on QoL (P < 0.001) with r2 = 62.59%. Factor analysis of correlation matrix showed that physical symptoms and daily living experiences and social experiences as well as stress dominated factor 1 followed by satisfaction led QoL in factor 2 and social life stress was the leading force in factor 3. CONCLUSION QoL of patients with DFUs can be improved by educating the diabetic patients on the prevention and early detection of foot ulcers, other diabetic complications, and availing benefits of prevailing health-care facility in early stages.
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Affiliation(s)
| | - P Thenmozhi
- Department of Nursing, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - R. Vijayaragavan
- Department of Nursing, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
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Abstract
Background The prevalence of type 2 diabetes in the Saudi population is increasing at an alarming level. Diabetes is characterized by a considerable health and economic burden on the population and affected individuals. Objectives This study aims to assess the level of quality of life in type 2 diabetic patients and to investigate the determinant of quality of life in a primary health care setting. Methods The study used a cross-sectional design to investigate the quality of life among type 2 diabetic patients at the Al-Wazarat Health Care Center (WHC) in Riyadh, Saudi Arabia. The study used the Arabic version of the quality of life 36-items short-form questionnaire (SF-36). Results The study included 482 completed questionnaires out of the 525 distributed. The response rate is 91.8%. The average age of the patients is 56.3 ± 7.8 years. The self-reported average body mass index (BMI) is 31.6 ± 6.6 kg/m2. The duration of diabetes since diagnosis is 9.7± 3.1 years. The most common comorbidity was hypertension 75.9% (366/482). The multivariate regression analysis provided models that explained the role of certain variables in determining the quality of life in type 2 diabetic patients significantly. The most striking results are explaining the factors affecting physical functioning by 41% (R2=0.41) and mental health by 34% (R2=0.34). Conclusion This study can influence the practices of medical practice and promotion in WHC specifically and Riyadh city more generally. The improvement and preservation of HRQoL in diabetic patients required an understanding of the factors that can influence it. The gender disparity is an area that needs further investigation. Changes in the delivery of healthcare in diabetes clinics to account for these factors may provide better results.
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Affiliation(s)
| | - Saleh Albahlei
- Family Medicine, Al-Wazarat Health Care Center, Riyadh, SAU
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Kang GE, Zahiri M, Lepow B, Saleem N, Najafi B. The Effect of Daily Use of Plantar Mechanical Stimulation Through Micro-Mobile Foot Compression Device Installed in Shoe Insoles on Vibration Perception, Gait, and Balance in People With Diabetic Peripheral Neuropathy. J Diabetes Sci Technol 2019; 13:847-856. [PMID: 30943782 PMCID: PMC6955449 DOI: 10.1177/1932296819839703] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE People with diabetic peripheral neuropathy (DPN) have impaired gait and balance performance. The aim of this study is to investigate therapeutic effectiveness of mechanical stimulation through a wearable foot compression device equipped in a shoe insole on vibration perception, balance control and gait performance in people with DPN. METHODS Using a single-arm 4-week intervention study design, we examined effectiveness of daily use of shoes equipped with the foot compression device (Footbeat™, AVEX, Grand Junction, CO, USA) on improving vibration perception threshold (VPTmax), skin perfusion pressure (SPP), ankle brachial index (ABI), lower extremities edema (circumferences in the calf and ankle), and motor performance (postural sway with eyes open and closed conditions, and gait performance during normal, dual-task and fast walking). Thirty people with type 2 diabetes and symptoms of PN completed the experimental protocol. RESULTS Improvements in VPTmax (before = 27.4 V, after = 23.3 V, P = .007, d = 0.33, where d denotes effect size), center-of-mass sway in the mediolateral direction with both eyes open and closed conditions (before = 0.94 cm, after = 0.76 cm, P = .020, d = 0.47; before = 1.10 cm, after = 0.83 cm, P = .033, d = 0.66, respectively), and stride velocity for normal walking, dual-task walking and fast walking tasks (before = 0.87 m/s, after = 0.96 m/s, P = .017, d = 0.41; before = 0.75 m/s, after = 0.91 m/s, P = .001, d = 0.77; before = 1.10 m/s, after = 1.20 m/s, P = .043, d = 0.33, respectively) were found post treatment. There was no significant improvement in SPP, ABI, and circumferences in the calf and ankle. CONCLUSIONS Our findings suggest the wearable foot compression device may be effective for reducing neuropathic symptoms and enhancing motor performances in people with DPN.
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Affiliation(s)
- Gu Eon Kang
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Mohsen Zahiri
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Brian Lepow
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Nimrah Saleem
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
- Bijan Najafi, PhD, iCAMP, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, 7200 Cambridge St, Houston, TX 77030, USA.Emails: ;
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Beverly EA, Rennie RG, Guseman EH, Rodgers A, Healy AM. High Prevalence of Diabetes Distress in a University Population. J Osteopath Med 2019; 119:556-568. [DOI: 10.7556/jaoa.2019.099] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Abstract
Context
Diabetes distress is an affective condition that addresses an individual's frustrations, worries, and concerns about living with diabetes. It is associated with fewer self-care behaviors, suboptimal glycemic control, and lower quality of life (QOL). For these reasons, diabetes care guidelines recommend routine assessment of diabetes distress.
Objective
To assess diabetes distress in a university population.
Methods
This study was conducted using a descriptive, cross-sectional design. Researchers assessed diabetes distress and other psychosocial factors via an electronic anonymous survey among students, faculty, and staff at a large university in the Midwest.
Results
A total of 173 participants completed the survey (mean [SD] age, 35.1 [16.7] years), with 108 [62.4%] female and 142 [82.1%] white participants). Eighty-five participants had type 1 diabetes mellitus (T1DM), and 88 had type 2 diabetes mellitus (T2DM). Of the 85 T1DM participants, 23 (27.4%) reported high diabetes distress, and 27 (30.7%) T2DM participants reported high diabetes distress. Sixteen T1DM (18.8%) and 15 T2DM (17.0%) participants screened positive for severe depression. Severe depression was associated with high distress for both T1DM and T2DM participants (T1DM: χ2=28.845, P<.001; T2DM: χ2=20.679, P<.001). Participants with T1DM reported more frequent self-care behaviors (mean [SD], 62.3 [17.1] vs 52.2 [19.2]; P<.001), but lower diabetes QOL (63.3 [14.1] vs 68.5 [15.5]; P=.021) compared with T2DM participants. No differences were observed in depressive symptoms, diabetes self-efficacy, and coping styles. Linear regression models showed that high diabetes distress scores (standardized β=.323, P=.025; standardized β=.604, P<.001) were independently associated with higher hemoglobin A1C levels and lower diabetes QOL after controlling for depressive symptoms, age, and gender in T1DM participants. Similarly, high diabetes distress scores (standardized β=.434, P<.001) were associated with lower diabetes QOL in T2DM participants after controlling for the same variables.
Conclusion
High diabetes distress levels were associated with lower diabetes QOL for both T1DM and T2DM participants. These findings suggest that attending or working at a university may be associated with high diabetes distress scores and lower diabetes QOL. Additional research with a larger, more diverse sample from multiple universities is needed to confirm these findings.
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de Groot M, Shubrook JH, Hornsby WG, Pillay Y, Mather KJ, Fitzpatrick K, Yang Z, Saha C. Program ACTIVE II: Outcomes From a Randomized, Multistate Community-Based Depression Treatment for Rural and Urban Adults With Type 2 Diabetes. Diabetes Care 2019; 42:1185-1193. [PMID: 31221693 PMCID: PMC6609961 DOI: 10.2337/dc18-2400] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 04/18/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Depression (major depressive disorder [MDD]) in adults with type 2 diabetes mellitus (T2DM) is associated with worsened diabetes complications, increased health care costs, and early mortality. Program ACTIVE II was a randomized, controlled, multicenter treatment trial designed to test the comparative effectiveness of cognitive behavioral therapy (CBT) and/or community-based exercise (EXER) on diabetes and depression outcomes compared with usual care (UC). RESEARCH DESIGN AND METHODS Using a 2 × 2 factorial randomized controlled trial design, adults with T2DM for ≥1 year who met DSM-IV-TR criteria for MDD were randomized to CBT (10 sessions occurring over 12 weeks; N = 36), EXER (12 weeks of community-based exercise including six sessions with a personal trainer; N = 34), CBT+EXER (concurrent over a 12-week period; N = 34), and UC (N = 36). Primary outcomes were depression remission rate (assessed by psychiatric interviewers blind to assignment) and change in glycemic control (HbA1c). RESULTS The mean age was 56.0 years (SD 10.7). Participants were female (77%), white (71%), and married (52%). After controlling for education and antidepressant use, odds of achieving full MDD remission in the intervention groups were 5.0-6.8 times greater than UC (P < 0.0167). The CBT+EXER group demonstrated improved HbA1c compared with UC. For participants with a baseline HbA1c ≥7.0%, exploratory post hoc subgroup analysis showed that the CBT+EXER group had a 1.1% improvement in HbA1c (P < 0.0001) after controlling for covariates. CONCLUSIONS The Program ACTIVE behavioral treatment interventions demonstrated clinically meaningful improvements in depression outcomes in adults with T2DM and MDD. These community-based interventions are complementary to medical care and extend access to those in rural and urban areas.
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Affiliation(s)
- Mary de Groot
- Indiana University School of Medicine, Indianapolis, IN
| | - Jay H Shubrook
- Touro University California College of Osteopathic Medicine, Vallejo, CA.,Ohio University Heritage College of Osteopathic Medicine, Athens, OH
| | | | | | | | | | - Ziyi Yang
- Indiana University School of Medicine, Indianapolis, IN
| | - Chandan Saha
- Indiana University School of Medicine, Indianapolis, IN
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García-Ulloa AC, Landa-Anell V, Melgarejo-Hernández M, Villegas-Narvaez A, Urbina-Arronte LE, Hernández-Jiménez S. Assessment of a Multidisciplinary Intervention in Patients With BMI ≥35 kg/m2 and Recently Diagnosed Type 2 Diabetes. J Clin Endocrinol Metab 2019; 104:2994-3002. [PMID: 30912810 DOI: 10.1210/jc.2018-01148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 03/20/2019] [Indexed: 11/19/2022]
Abstract
CONTEXT Patients with a body mass index (BMI) ≥35 kg/m2 have lower benefits with intensive treatments and metabolic control goals are more difficult to reach. OBJECTIVE Evaluate the effect of a comprehensive care program in patients with a BMI ≥35 kg/m2. DESIGN Prospective cohort study. SETTING Comprehensive Care Center in a National Institute of Health. PATIENTS Patients with type 2 diabetes, ≤5 years of diagnosis, without disabling complications, nonsmokers, and a BMI <45 kg/m2. INTERVENTIONS Exercise and nutritional interventions are modified for patients with a higher BMI to achieve metabolic control. MAIN OUTCOME MEASURES Main outcome is achievement of treatment goals defined as HbA1c <7%, low-density lipoprotein cholesterol (LDL-c) <100 mg/dL, and blood pressure <130/80 mm Hg. Secondary measures were the percentage of patients achieving three metabolic goals. RESULTS A total of 587 patients with annual evaluation were included. Mean age was 55.3 ± 9.5 years, 56.6% women, time since diagnosis of 1 year (0 to 5). BMI <35 kg/m2 group included 521 patients and BMI ≥35 kg/m2 group included 66 patients. In the BMI ≥35 kg/m2 group, we observed a greater decrease in weight and fat mass at 3 months compared with <35 kg/m2 group, but the HbA1c, LDL-c, or blood pressure goals were similar at 3 months and 1 year between groups. CONCLUSIONS Comprehensive interventions are equally effective in patients with recently diagnosed type 2 diabetes with BMI ≥35 kg/m2 compared with patients with a lower BMI.
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Affiliation(s)
- Ana Cristina García-Ulloa
- Centro de Atención Integral del Paciente con Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Victoria Landa-Anell
- Centro de Atención Integral del Paciente con Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Marco Melgarejo-Hernández
- Centro de Atención Integral del Paciente con Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Andrea Villegas-Narvaez
- Centro de Atención Integral del Paciente con Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Luz Elena Urbina-Arronte
- Centro de Atención Integral del Paciente con Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Sergio Hernández-Jiménez
- Centro de Atención Integral del Paciente con Diabetes (CAIPaDi), Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Rwegerera GM, Moshomo T, Gaenamong M, Oyewo TA, Gollakota S, Rivera YP, Masaka A, Godman B, Shimwela M, Habte D. Health-related quality of life and associated factors among patients with diabetes mellitus in Botswana. Alexandria Journal of Medicine 2019. [DOI: 10.1016/j.ajme.2017.05.010] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Affiliation(s)
- Godfrey Mutashambara Rwegerera
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, BotswanaFaculty of Medicine, Department of Internal Medicine, University of Botswana, Botswana
- Department of Medicine, Princess Marina Hospital, Gaborone, BotswanaDepartment of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | - Thato Moshomo
- Scottish Livingstone Hospital, Molepolole, BotswanaScottish Livingstone Hospital, Molepolole, Botswana
| | - Marea Gaenamong
- Department of Accident and Emergency, Princess Marina Hospital, Gaborone, BotswanaDepartment of Accident and Emergency, Princess Marina Hospital, Gaborone, Botswana
| | - Taibat Aderonke Oyewo
- Department of Medicine, Princess Marina Hospital, Gaborone, BotswanaDepartment of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | - Sivasomnath Gollakota
- Department of Medicine, Princess Marina Hospital, Gaborone, BotswanaDepartment of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | - Yordanka Piña Rivera
- Faculty of Medicine, Department of Internal Medicine, University of Botswana, BotswanaFaculty of Medicine, Department of Internal Medicine, University of Botswana, Botswana
- Department of Medicine, Princess Marina Hospital, Gaborone, BotswanaDepartment of Medicine, Princess Marina Hospital, Gaborone, Botswana
| | - Anthony Masaka
- Botho University, Gaborone, BotswanaBotho University, Gaborone, Botswana
| | - Brian Godman
- Department of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, SwedenDepartment of Laboratory Medicine, Division of Clinical Pharmacology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United KingdomStrathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
| | - Meshack Shimwela
- Amana Municipal Hospital, Dar-es-Salaam, TanzaniaAmana Municipal Hospital, Dar-es-Salaam, Tanzania
| | - Dereje Habte
- Management Sciences for Health (MSH), Addis Ababa, EthiopiaManagement Sciences for Health (MSH), Addis Ababa, Ethiopia
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36
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Dehesh P, Dehesh T, Gozashti MH. Evaluating the Direct and Indirect Effects of SF-36 Domains Score on Two Main Factors in Diabetic Patients with Path Analysis: Health-Related Quality of Life Study. Romanian Journal of Diabetes Nutrition and Metabolic Diseases 2019; 26:21-30. [DOI: 10.2478/rjdnmd-2019-0003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Background and aims: Diabetes mellitus (DM) patients have a lower quality of life. This study aimed to examine the direct and indirect effect of eight domains score of the SF-36 questionnaire on two main factors, i.e., overall physical health (GH_M) and overall mental health (MH_M), in DM patients. To the best of our knowledge, this issue has been rarely studied so far.
Material and method: A total of 1037 DM patients filled out the Persian version of the SF-36 questionnaire. The path analysis was used in this study.
Results: In this research, only social functioning (SF) domain has significantly lower the men compared to women (P=0.06). Physical functioning (PF), bodily pain (BP), general health (GH) and vitality (VT) have a negative significant direct effect on the GH_M factor. GH domain also has a positive indirect and total effect on MH_M factor, and other domains have no significant total effect on MH_M factor.
Conclusion: It is better that physicians, focus on regulating physical activity and reducing body pain in diabetes patients, which have the most direct impact on HRQoL, to achieve a more effective outcome in improving quality of life in this patient.
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Hernández-Jiménez S, García-Ulloa AC, Bello-Chavolla OY, Aguilar-Salinas CA, Kershenobich-Stalnikowitz D. Long-term effectiveness of a type 2 diabetes comprehensive care program. The CAIPaDi model. Diabetes Res Clin Pract 2019; 151:128-137. [PMID: 30954513 DOI: 10.1016/j.diabres.2019.04.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 01/22/2019] [Accepted: 04/01/2019] [Indexed: 12/12/2022]
Abstract
AIMS To evaluate the effectiveness of a comprehensive care program to achieve and maintain goals in patients with type 2 diabetes. METHODS The CAIPaDi program includes 9 interventions delivered in 7 h. It seeks to achieve metabolic goals, identify and resolve barriers that would make implementation difficult, and provide self-efficacy and empowerment to patients by identifying personal profiles to establish individualized strategies. The program consists of a 4 intervention visits (1, 2, 3, and 4 months) and two follow up visits (12 and 24 months). Outcomes are compared between every visit. Main outcome was the attainment of the USA National Committee for Quality Assurance treatment goals. RESULTS 1104 patients completed the first 4 visits, 545 the 12 month evaluation, and 218 the 24 month evaluation. After the conclusion of the four monthly sessions, 80.6% had HbA1c <7%, 72.1% had BP <130/80 mmHg and 71.6% had LDL- cholesterol <100 mg/dl. After twelve months, the percentage of goals achieved were 65.9%, 67.7% and 43.3% respectively (p < 0.001). For the 2-year evaluation the percentages were 61.0%, 70.6%, and 40.8% respectively (p < 0.001). All patients had renal, eye, foot and dental evaluations. Empowerment and quality of life showed significant changes; anxiety and depression scores remained low at annual follow-ups. CONCLUSIONS The CAIPaDI program results in sustained improvement and maintenance of treatment goals.
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Affiliation(s)
- Sergio Hernández-Jiménez
- Center of Comprehensive Care for the Patient with Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
| | - Ana Cristina García-Ulloa
- Center of Comprehensive Care for the Patient with Diabetes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | - Omar Yaxmehen Bello-Chavolla
- Unit of Research in Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; PECEM Program, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | - Carlos A Aguilar-Salinas
- Unit of Research in Metabolic Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
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Holmes-Truscott E, Skovlund SE, Hendrieckx C, Pouwer F, Peyrot M, Speight J. Assessing the perceived impact of diabetes on quality of life: Psychometric validation of the DAWN2 Impact of Diabetes Profile in the second Diabetes MILES - Australia (MILES-2) survey. Diabetes Res Clin Pract 2019; 150:253-263. [PMID: 30880093 DOI: 10.1016/j.diabres.2019.03.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 01/25/2019] [Accepted: 03/07/2019] [Indexed: 12/14/2022]
Abstract
AIMS To investigate the validity and reliability of the 6-item DAWN2 Impact of Diabetes Profile (DIDP), and the modified 7-item DIDP, which includes assessment of dietary freedom. METHODS The online, cross-sectional, Australian MILES-2 survey included the DIDP and other validated measures, to examine convergent, discriminant and known-groups validity. The DIDP was completed by 2207 adults with diabetes (Type 1: n = 1012; Type 2 insulin: n = 504; non-insulin: n = 691). Data were subjected to exploratory factor analysis, internal consistency reliability and univariate statistics, conducted separately by diabetes type/treatment. RESULTS The DIDP was highly acceptable: 99% completion rate. One-factor solutions were supported for the 6-item and 7-item DIDP scales, in all diabetes type/treatment groups (variance explained range: 6-item: 59-67%, 7-item: 55-62%), with satisfactory internal consistency (α = 0.85-0.90). Known-groups validity was demonstrated, by diabetes type and complications presence/absence, as was satisfactory convergent and discriminant validity. CONCLUSIONS The DIDP meets the need for a brief, contemporary, valid and reliable measure of the perceived impact of diabetes on quality of life, suitable for adults with Type 1 or Type 2 diabetes mellitus. The 6-item and 7-item scales have psychometric equivalence. Use of the seventh item can be informed by research questions.
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Affiliation(s)
- Elizabeth Holmes-Truscott
- School of Psychology, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
| | - Soren E Skovlund
- Steno Diabetes Center North Jutland, Aalborg University Hospital and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
| | - Christel Hendrieckx
- School of Psychology, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia.
| | - Frans Pouwer
- School of Psychology, Deakin University, Geelong, VIC, Australia; Department of Psychology, University of Southern Denmark, Odense M, Denmark.
| | - Mark Peyrot
- Loyola University Maryland, Baltimore, MD, USA
| | - Jane Speight
- School of Psychology, Deakin University, Geelong, VIC, Australia; The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, VIC, Australia; Department of Psychology, University of Southern Denmark, Odense M, Denmark; AHP Research, Hornchurch, Essex, UK.
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Li H, Ji M, Scott P, Dunbar-Jacob JM. The Effect of Symptom Clusters on Quality of Life Among Patients With Type 2 Diabetes. Diabetes Educ 2019; 45:287-294. [DOI: 10.1177/0145721719837902] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Purpose The purpose of this study was to examine the collective effect of a symptom cluster (depression, anxiety, fatigue, and impaired sleep quality) at baseline on the quality of life (QOL) of patients with type 2 diabetes (T2DM) over time. Methods This was a secondary data analysis of 302 patients with T2DM who presented with both hypertension and hyperlipidemia. All of the participants were enrolled in a randomized controlled intervention study testing strategies to improve medication adherence. The psychological symptoms and QOL were assessed at baseline, 6 months, and 12 months. Cluster analysis was used to identify subgroups of patients based on the severity of symptoms at baseline. Results Hierarchical cluster analysis identified 4 patient subgroups: all low severity, mild, moderate, and all high severity. There were significant differences in patients’ QOL overall among the 4 subgroups. Compared with the all-low-severity subgroup, subgroups with higher severity of the 4 symptoms had poorer QOL across all 3 time points. QOL was most impacted by trait anxiety across the 3 time points. Conclusion QOL was significantly impacted by psychological symptom clusters among patients with T2DM. Healthcare providers should not neglect psychological symptoms that patients experience. It is important to assess and manage these symptoms to improve QOL among patients with diabetes.
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Affiliation(s)
- Hongjin Li
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, PA (Ms Li)
| | - Meihua Ji
- School of Nursing, Capital Medical University, Beijing, China (Dr Ji)
| | - Paul Scott
- Department of Health & Community Systems, Center for Research & Evaluation, School of Nursing, University of Pittsburgh, Pittsburgh, PA (Dr Scott)
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AlSadrah SA. Impaired quality of life and diabetic foot disease in Saudi patients with type 2 diabetes: A cross-sectional analysis. SAGE Open Med 2019; 7:2050312119832092. [PMID: 30815259 PMCID: PMC6385329 DOI: 10.1177/2050312119832092] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 01/29/2019] [Indexed: 12/31/2022] Open
Abstract
Objectives: This study aimed to assess the overall health-related quality of life in type 2 diabetes mellitus patients with diabetic foot disease compared to diabetic patients without diabetic foot and to identify the clinical utility of this assessment. Methods: A total of 250 consecutive patients with type 2 diabetes mellitus (100/150 with/without diabetic foot, respectively) were interviewed. The questionnaires of the 36-item short-form survey and region-specific foot and ankle ability measure were applied. Wagner–Meggitt wound classification was used for foot-ulcer evaluation. Follow-up of patients for 3–6 weeks was done to identify the potential clinical short outcomes of diabetic foot ulcers. Results: Type 2 diabetes mellitus patients with diabetic foot exhibited poor mental and physical health consequences. Females had more prevalence of forefoot lesions, larger ulcer size, advanced Wagner grade, and higher frequency of unhealed ulcers. Receiver operating characteristic curve analysis demonstrated high value of foot and ankle ability measure and 36-item short-form questionnaires to discriminate type 2 diabetes mellitus patients with and without diabetic foot at cutoff values of 66 and 49.6, respectively. Foot and ankle ability measure questionnaire also showed high performance for differentiating the clinical outcome of foot ulcer. Total foot and ankle ability measure subscale score above the cutoff value of 65.5 could discriminate patients with complete healing and unhealed ulcer lesions at a high sensitivity and specificity. Conclusion: The current findings confirm the impact of diabetic foot disease on type 2 diabetes mellitus overall health-related quality of life reflected in 36-item short-form questionnaire and foot and ankle ability measure questionnaire which showed high discriminative values for type 2 diabetes mellitus patient sub-grouping. Their application in routine clinical health assessment with continuous medical education programs is highly recommended to achieve a better health-related quality of life.
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Affiliation(s)
- Sana A AlSadrah
- Department of Preventive Medicine, Governmental Hospital Khobar, Health Centers in Khobar, Ministry of Health, Khobar, Saudi Arabia
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Jelsness-Jørgensen LP, Jensen Ø, Gibbs C, Bekkhus Moe R, Hofsø D, Bernklev T. Psychometric testing of the Norwegian Diabetes Health Profile (DHP-18) in patients with type 1 diabetes. BMJ Open Diabetes Res Care 2018; 6:e000541. [PMID: 30613400 PMCID: PMC6304096 DOI: 10.1136/bmjdrc-2018-000541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 09/14/2018] [Accepted: 11/08/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE The Diabetes Health Profile-18 (DHP-18) was developed to measure disease-specific health-related quality of life. It has been translated into Norwegian but remains invalidated. The purpose of this paper was to examine the psychometric properties of the Norwegian DHP-18. RESEARCH DESIGN AND METHODS Participants with type 1 diabetes were recruited from three outpatient clinics in Norway. Clinical and sociodemographic data were collected, and participants completed the DHP-18 and the Short-Form 36 (SF-36). Descriptive analysis, frequencies, t-tests and the chi-squared tests were used. Principal axis factoring (PAF) and confirmatory factor analysis (CFA) were used. Convergent validity was tested using Spearman's correlation between the DHP-18 and SF-36. Reliability was tested using Cronbach's alpha and intraclass correlation coefficient. RESULTS In total, 288 patients were included. No floor and ceiling effects were found. A forced PAF analysis revealed that three questions had an eigenvalue below 0.40. In the unforced PAF analysis, one question loaded below 0.40, while three questions loaded into a fourth factor. The correlation between the DHP-18 and SF-36 dimensions was low to moderate. Problematic internal consistency was observed for the disinhibited eating dimension in the forced PAF and in the suggested fourth dimension in the unforced PAF. CFA revealed poor fit. The test-retest reliability displayed good to excellent values, but responsiveness was limited. CONCLUSIONS Problematic issues were identified regarding factor structure, item loadings, internal consistency and responsiveness. Further evaluation of responsiveness is particularly recommended, and using a revised 14-item DHP version is suggested.
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Affiliation(s)
- Lars-Petter Jelsness-Jørgensen
- Department of Health and Welfare, Østfold University College, Halden, Norway
- Department of Internal Medicine, Østfold Hospital Trust, Grålum, Norway
| | - Øystein Jensen
- Department of Health and Welfare, Østfold University College, Halden, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Charlotte Gibbs
- Department of Endocrinology, Telemark Hospital Trust, Skien, Norway
| | | | - Dag Hofsø
- Morbid Obesity Centre and Section of Endocrinology, Vestfold Hospital Trust, Tønsberg, Norway
| | - Tomm Bernklev
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research and Development, Vestfold Hospital Trust, Tønsberg, Norway
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Jensen Ø, Bernklev T, Gibbs C, Moe RB, Hofsø D, Jelsness-Jørgensen LP. Fatigue in type 1 diabetes, prevalence, predictors and comparison with the background population. Diabetes Res Clin Pract 2018; 143:71-78. [PMID: 29969723 DOI: 10.1016/j.diabres.2018.06.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/29/2018] [Accepted: 06/13/2018] [Indexed: 11/15/2022]
Abstract
AIM Fatigue is scarcely studied in type 1 diabetes (T1D), and the aims were to investigate its prevalence compared to the background population, potential associations, and to validate the Fatigue Questionnaire (FQ) in type 1 diabetes. METHODS Persons with T1D were recruited from three outpatient clinics in Norway. Fatigue was measured using the FQ, and FQ data from the Norwegian background population were used for comparison. Socio-demographic and clinical variables were obtained by self-report, clinical investigation, medical records and laboratory tests. RESULTS Of 332 eligible patients, 288 (87%) were included. Mean age was 44.65/44.95 years (SD 13.34/13.38) for females/males, respectively. Total fatigue (TF) was 15.31 (SD 5.51) compared to 12.2 (SD 4.0) in the background population (p < 0.001). HADS ≥ 8, current menstruation, increased leukocytes and sleep problems were associated with increased TF. Chronic fatigue (CF) was reported in 26.4% compared to 11% in the background population (p < 0.001). HADS ≥ 8, increased time since diagnosis and decreased sleep quality were associated with CF. The validity, internal consistency and repeatability of the FQ was confirmed. CONCLUSIONS Fatigue was more common in T1D than in the background population, and associated with increased anxiety, depression and sleep problems. The FQ demonstrated satisfactory psychometric properties.
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Affiliation(s)
- Øystein Jensen
- Østfold University College, Dept of Health and Welfare, Pb 770, 1757 Halden, Norway; Institute of Clinical Medicine, University of Oslo, Klaus Torgårds vei 3, 0372 Oslo, Norway.
| | - Tomm Bernklev
- Vestfold Hospital Trust, Research and Development, Halfdan Wilhelmsens alle 17, 3116 Tønsberg, Norway; Institute of Clinical Medicine, University of Oslo, Klaus Torgårds vei 3, 0372 Oslo, Norway.
| | - Charlotte Gibbs
- Telemark Hospital Trust, Dept of Endocrinology, Ulefossvegen 55, 3710 Skien, Norway.
| | - Ragnar Bekkhus Moe
- Østfold Hospital Trust, Dept of Internal Medicine, Kalnesveien 300, 1714 Grålum, Norway.
| | - Dag Hofsø
- Vestfold Hospital Trust, Morbid Obesity Centre and Section of Endocrinology, Halfdan Wilhelmsens alle 17, 3116 Tønsberg, Norway.
| | - Lars-Petter Jelsness-Jørgensen
- Østfold University College, Dept of Health and Welfare, Pb 770, 1757 Halden, Norway; Østfold Hospital Trust, Dept of Internal Medicine, Kalnesveien 300, 1714 Grålum, Norway.
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Kim PJ, Kumar A, Elmarsafi T, Lehrenbaum H, Anghel E, Steinberg JS, Evans KK, Attinger CE. Comparison of Completion Rates for SF-36 Compared With SF-12 Quality of Life Surveys at a Tertiary Urban Wound Center. J Foot Ankle Surg 2018; 56:1031-1035. [PMID: 28842088 DOI: 10.1053/j.jfas.2017.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Indexed: 02/03/2023]
Abstract
Patient-reported outcome measures derived from quality of life instruments are an important tool in monitoring disease progression and treatment response. Although a number of validated instruments are available, the Short Form-36 (SF-36) quality of life survey is the most widely used. It is imperative that the patients answer all the questions in this instrument for appropriate analysis and interpretation. It has been hypothesized that fewer questions (i.e., the Short Form-12 [SF-12]), will result in greater survey completion rates. The present study was a randomized prospective study comparing the completion rates for the SF-36 and SF-12 quality of life surveys. Patients presenting with a chronic wound were asked to complete the SF-36 or SF-12 survey. After an a priori power analysis was performed, the completion rates, patterns of skipped questions, and demographic information were analyzed using t tests for continuous variables or Fisher's exact test for categorical variables and both multivariate linear regression and logistic regression. A total of 59 subjects (30 completed the SF-12 and 29 completed the SF-36) participated in the present study. The SF-12 group had an 80% (24 of 30) completion rate compared with a 55% (16 of 29) completion rate for the SF-36 group (p < .05). However, the length of the survey did not affect the completion rate nor was a statistically detectable pattern of skipped questions found. College graduates were more likely to complete both surveys compared with high school graduates (p < .07). Although it is unclear why, our study results indicate that the SF-12 yields a higher total survey completion rate. However, completion appears independent of the shorter survey length.
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Affiliation(s)
- Paul J Kim
- Associate Professor, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC.
| | - Anagha Kumar
- Biostatistician, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Tammer Elmarsafi
- Diabetic Limb Salvage Fellow, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Hannah Lehrenbaum
- Medical Student, Georgetown University School of Medicine, Washington, DC
| | - Ersilia Anghel
- Diabetic Limb Salvage Fellow, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - John S Steinberg
- Associate Professor, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Karen K Evans
- Associate Professor, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Christopher E Attinger
- Associate Professor, Department of Plastic Surgery, MedStar Georgetown University Hospital, Washington, DC
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Saffari M, Lin CY, O’Garo K, Koenig HG, Sanaeinasab H, Pakpour AH. Psychometric properties of Persian Diabetes-Mellitus Specific Quality of Life (DMQoL) questionnaire in a population-based sample of Iranians. Int J Diabetes Dev Ctries 2018. [DOI: 10.1007/s13410-018-0648-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Rekleiti M, Souliotis K, Sarafis P, Kyriazis I, Tsironi M. Measuring the reliability and validity of the Greek edition of the Diabetes Quality of Life Brief Clinical Inventory. Diabetes Res Clin Pract 2018; 140:61-71. [PMID: 29596953 DOI: 10.1016/j.diabres.2018.01.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 10/10/2017] [Accepted: 01/23/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUND The present study focuses on studying the validity and reliability of the Greek edition of DQOL-BCI. DQOL-BCI includes 15 questions-elements that are evaluated on a 5-grade scale like Likert and two general form-shapes. METHODS The translation process was conducted in conformity with the guidelines of EuroQol group. A non-random sample of 65 people-patients diagnosed with diabetes I and II was selected. The questionnaire that was used to collect the data was the translated version of DQOL-BCI, and included the demographic characteristics of the interviewees. The content validity of DQOL-BCI was re-examined from a team of five experts (expert panel) for qualitative and quantitative performance. The completion of the questionnaire was done via a personal interview. RESULTS The sample consisted of 58 people (35 men and 23 women, 59.9 ± 10.9 years). The translation of the questionnaire was found appropriate in accordance to the peculiarities of the Greek language and culture. The largest deviation of values is observed in QOL1 (1.71) in comparison to QOL6 (2.98). The difference between the standard deviations is close to 0.6. The statistics results of the tests showed satisfactory content validity and high construct validity, while the high values for Cronbach alpha index (0.95) reveal high reliability and internal consistency. CONCLUSIONS The Greek version of DQOL-BCI has acceptable psychometric properties and appears to demonstrate high internal reliability and satisfactory construct validity, which allows its use as an important tool in evaluating the quality of life of diabetic patients in relation to their health.
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Affiliation(s)
- Maria Rekleiti
- Department of Nursing, University of Peloponnese, Sparta, Greece.
| | - Kyriakos Souliotis
- Department of Social and Educational Policy, University of Peloponnese, Korinthos, Greece.
| | - Pavlos Sarafis
- Nursing Department, Cyprus University of Technology, Limassol, Cyprus.
| | - Ioannis Kyriazis
- Director - Internal Medicine Department & Diabetes Outpatient Cllinic, KAT General Hospital, Athens, Greece.
| | - Maria Tsironi
- Department of Nursing, University of Peloponnese, Sparta, Greece.
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Foster ED, Bridges ND, Feurer ID, Eggerman TL, Hunsicker LG, Alejandro R. Improved Health-Related Quality of Life in a Phase 3 Islet Transplantation Trial in Type 1 Diabetes Complicated by Severe Hypoglycemia. Diabetes Care 2018; 41:1001-1008. [PMID: 29563196 PMCID: PMC5911786 DOI: 10.2337/dc17-1779] [Citation(s) in RCA: 73] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 02/04/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Attaining glycemic targets without severe hypoglycemic events (SHEs) is a challenging treatment goal for patients with type 1 diabetes complicated by impaired awareness of hypoglycemia (IAH). The CIT Consortium Protocol 07 (CIT-07) trial showed islet transplantation to be an effective treatment for subjects with IAH and intractable SHEs. We evaluated health-related quality of life (HRQOL), functional health status, and health utility before and after pancreatic islet transplantation in CIT-07 trial participants. RESEARCH DESIGN AND METHODS Four surveys, the Diabetes Distress Scale (DDS), the Hypoglycemic Fear Survey (HFS), the Short Form 36 Health Survey (SF-36), and the EuroQoL 5 Dimensions (EQ-5D), were administered repeatedly before and after islet transplantation. Summary statistics and longitudinal modeling were used to describe changes in survey scores from baseline and to characterize change in relation to a minimally important difference (MID) threshold of half an SD. RESULTS Improvements in condition-specific HRQOL met the MID threshold. Reductions from baseline in the DDS total score and its four DDS subscales (all P ≤ 0.0013) and in the HFS total score and its two subscales (all P < 0.0001) were observed across all time points. Improvements were observed after both 1 and 2 years for the EQ-5D visual analog scale (both P < 0.0001). CONCLUSIONS In CIT-07, 87.5% of the subjects achieved the primary end point of freedom from SHE along with glycemic control (HbA1c <7% [<53 mmol/mol]) at 1 year post-initial islet transplantation. The same subjects reported consistent, statistically significant, and clinically meaningful improvements in condition-specific HRQOL as well as self-assessments of overall health.
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Affiliation(s)
- Eric D Foster
- Clinical Trials Statistical and Data Management Center, Department of Biostatistics, University of Iowa, Iowa City, IA
| | - Nancy D Bridges
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD
| | - Irene D Feurer
- Departments of Surgery and Biostatistics, Vanderbilt University Medical Center, and Vanderbilt Transplant Center, Nashville, TN
| | - Thomas L Eggerman
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD
| | - Lawrence G Hunsicker
- Clinical Trials Statistical and Data Management Center, Department of Biostatistics, University of Iowa, Iowa City, IA
| | - Rodolfo Alejandro
- Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, FL
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Boden MT. Prevalence of mental disorders and related functioning and treatment engagement among people with diabetes. J Psychosom Res 2018; 106:62-9. [PMID: 29455901 DOI: 10.1016/j.jpsychores.2018.01.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 11/20/2017] [Accepted: 01/05/2018] [Indexed: 11/20/2022]
Abstract
AIMS To examine prevalence, functioning and treatment associated with all DSM-5 12-month mood, anxiety, eating and substance use disorders among people with diabetes in data obtained from the National Epidemiologic Survey on Alcohol and Related Conditions-III. METHODS Through multistage stratified randomized sampling a sample representative of the United States civilian population was obtained. Prevalence of diabetes (Type 1 and 2), DSM-5 disorders, physical and mental functioning, and treatment utilization were assessed via telephone interview. Analyses of weighted data (N=36,138) included calculation of descriptive statistics, and chi-square, logistic and linear regression analyses. RESULTS Participants with (vs. without) diabetes (9.3% of weighted sample) had a significantly: (a) higher prevalence of any anxiety disorder and posttraumatic stress disorder (with and without adjustment for sociodemographic characteristics), and any mood disorder, major depressive disorder and specific phobia (with adjustment), (b) lower prevalence of any substance use disorder and alcohol and tobacco use disorders (with and without adjustment), and cannabis use disorder (without adjustment). Among participants with diabetes, mental disorder prevalence was consistently associated with sex and age, and to a lesser frequency, race/ethnicity. Lower levels of physical and mental functioning were found among participants with diabetes and a comorbid mental disorder. A minority of participants with diabetes and a comorbid mental disorder received treatment for mood and anxiety disorders, and few received treatment for eating and substance use disorders. CONCLUSIONS Multiple types of mood, anxiety, eating and substance use disorders are prevalent, problematic, and often untreated among people with diabetes.
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Khatib ST, Hemadneh MK, Hasan SA, Khazneh E, Zyoud SH. Quality of life in hemodialysis diabetic patients: a multicenter cross-sectional study from Palestine. BMC Nephrol 2018; 19:49. [PMID: 29490623 PMCID: PMC5831192 DOI: 10.1186/s12882-018-0849-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 02/20/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Both diabetes and hemodialysis can seriously impair patients' health related quality of life (HRQOL). This study seeks to obtain data which will help to address the factors associated with impaired HRQOL in hemodialysis patients with diabetes in Palestine. METHODS A cross-sectional study was performed in multiple centers in the period from November 2016 to June 2017. We utilized the Arabic version of EuroQoL 5 Dimensions 5 Levels (EQ-5D-5L) scale and EuroQol-visual analogue scale (EQ-VAS) to measure patients' HRQOL. The study was conducted in six dialysis centers in the North of West Bank, Palestine. Descriptive and comparative statistics were used to describe clinical and socio-demographic features of patients. Multiple linear regression analysis was used to determine the association between clinical and socio-demographic factors and HRQOL score. RESULTS One hundred and forty one diabetic patients undergoing hemodialysis were enrolled in our study. Overall, 52.5% of them (74 patients) were males; the patients had a mean age of 60.32 with 52.5% of them aged below 60. The mean ± standard deviation of EQ-5D-5L index and EQ-VAS score was 0.314 ± 0.4 and 50.85±22.43, respectively. The findings of this study suggest that female patients, uneducated patients, unemployed patients, unmarried patients, and patients with more chronic diseases and comorbidities had a significant poor HRQOL scores (p values <0.05). Variables such as marital status and occupational status were significantly (p < 0.05) associated with the QOL score. More specifically, married status and employed patients positively associated with QOL score (β = 0.22; p = 0.016 and β = 0.27; p = 0.013, respectively). CONCLUSIONS Among diabetic patients undergoing hemodialysis, married status and being employed were associated with modestly higher scores of QOL. We recommend that healthcare providers give more attention to diabetic dialysis patients who are unemployed and unmarried, as they are at a higher risk of having impaired HRQOL.
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Affiliation(s)
- Sohaib T. Khatib
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Mohammad K. Hemadneh
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Samer A. Hasan
- 0000 0004 0631 5695grid.11942.3fDepartment of Medicine, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
| | - Emad Khazneh
- 0000 0004 0631 5695grid.11942.3fNephrology Unit, Internal Medicine Department, An-Najah National University Hospital, An-Najah National University, Nablus, 44839 Palestine
| | - Sa’ed H. Zyoud
- 0000 0004 0631 5695grid.11942.3fPoison Control and Drug Information Center (PCDIC), College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
- 0000 0004 0631 5695grid.11942.3fDepartment of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839 Palestine
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Bujang MA, Adnan TH, Mohd Hatta NKB, Ismail M, Lim CJ. A Revised Version of Diabetes Quality of Life Instrument Maintaining Domains for Satisfaction, Impact, and Worry. J Diabetes Res 2018; 2018:5804687. [PMID: 30327784 PMCID: PMC6169225 DOI: 10.1155/2018/5804687] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 06/12/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Diabetes quality of life (DQoL) instrument has been widely used to measure quality of life among diabetes patients. This study aimed to develop a revised version of DQoL instrument that incorporated issues of redundancies in the items and strengthen the basis of validity of the instrument. METHODS This was a cross-sectional study where diabetes patients were recruited from December 1, 2014, until end of March 2015 at a public health clinic in Peninsular Malaysia. A questionnaire that included patients' information and DQoL instrument was distributed to patients. Item selection of DQoL instrument was conducted to screen and finalize the items based on issues of missing values and redundancy. Validity testing was conducted for the revised DQoL instrument based on exploratory factor analysis, confirmatory factor analysis, and Rasch analysis. RESULTS The pattern structure matrix yielded three domains similar to the original version with 18 items. The minimum factor loading from the structure matrix was 0.358. The item's and person's reliability was excellent with 0.92 and 0.84 for "satisfaction" domain, 0.98 and 0.60 for "impact" domain, and 0.99 and 0.57 for "worry" domain, respectively. Confirmatory factor analysis has dropped 5 items and the revised version of DQoL contained 13 items. Composite reliability of the revised version was computed for "satisfaction" domain (0.922; 95% CI: 0.909-0.936), "impact" domain (0.781; 95% CI: 0.745-0.818), and "worry" domain (0.794; 95% CI: 0.755-0.832). CONCLUSION A revised version of DQoL that maintains the conceptualization of "satisfaction," "impact," and "worry" with 13 items was successfully developed.
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Affiliation(s)
- Mohamad Adam Bujang
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia
| | - Tassha Hilda Adnan
- National Clinical Research Centre, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | | | - Mastura Ismail
- Health Clinic Seremban 2, Ministry of Health Malaysia, Seremban Negeri Sembilan, Malaysia
| | - Chien Joo Lim
- Clinical Research Centre, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia
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Juárez-Rojop IE, Fortuny-Falconi CM, González-Castro TB, Tovilla-Zárate CA, Villar-Soto M, Sanchez ER, Hernández-Díaz Y, López-Narvaez ML, Ble-Castillo JL, Pérez-Hernández N, Rodríguez-Pérez JM. Association between reduced quality of life and depression in patients with type 2 diabetes mellitus: a cohort study in a Mexican population. Neuropsychiatr Dis Treat 2018; 14:2511-2518. [PMID: 30323600 PMCID: PMC6175568 DOI: 10.2147/ndt.s167622] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Diabetes mellitus is a chronic disease that requires attention and commitment on the part of patients; improving the quality of life of these patients reduces health costs, morbidity, and mortality. We focused on investigating the factors related with the quality of life and depression symptomatology in patients with type 2 diabetes. PARTICIPANTS AND METHODS A total of 173 Mexican patients with type 2 diabetes were recruited. An interview face-to-face, a sociodemographic characteristics questionnaire, the Short Form 36 (SF-36), and the Clinical Epidemiological Studies of Depression were applied. The biochemical parameters measured were blood glucose, cholesterol, triacylglycerol levels, and glycated hemoglobin. RESULTS In all SF-36 subscales, female patients had lower scores in comparison with male patients; individuals ≥65 years of age showed less physical function. We observed that married patients presented a better quality of life than people who were widowed or divorced (P<0.05). Those with high rates of lipids showed decreased scores all the subscales of SF-36. Finally, we observed that depression was the major factor that decreased quality of life in patients with diabetes. CONCLUSION Our results suggest that untreated and unrecognized depression can decrease the quality of life in patients with diabetes mellitus type 2. Therefore, health care professionals need to consider these findings when treating patients with diabetes. Due to the limited number of patients included in the present study, more studies are needed, studying larger samples in order to provide conclusive results.
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Affiliation(s)
- Isela Esther Juárez-Rojop
- Multidisciplinary Academic Division of Health Sciences, Juarez Autonomous University of Tabasco, Villahermosa, Tabasco, Mexico
| | - Carlos Mario Fortuny-Falconi
- Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco, Tabasco, Mexico,
| | - Thelma Beatriz González-Castro
- Multidisciplinary Academic Division of Jalpa de Méndez, Juarez Autonomous University of Tabasco, Jalpa de Méndez, Tabasco, Mexico
| | - Carlos Alfonso Tovilla-Zárate
- Multidisciplinary Academic Division of Comalcalco, Juarez Autonomous University of Tabasco, Comalcalco, Tabasco, Mexico,
| | - Mario Villar-Soto
- Psychiatric Care Services, Hospital of high specialty "Gustavo A. Rovirosa Pérez", Ministry of Health, Villahermosa, Tabasco, Mexico
| | - Ester Rodríguez Sanchez
- Psychiatric Care Services, Hospital of high specialty "Gustavo A. Rovirosa Pérez", Ministry of Health, Villahermosa, Tabasco, Mexico
| | - Yazmín Hernández-Díaz
- Multidisciplinary Academic Division of Jalpa de Méndez, Juarez Autonomous University of Tabasco, Jalpa de Méndez, Tabasco, Mexico
| | - María Lilia López-Narvaez
- Pediatric Care Services, General Hospital of Yajalon "Dr. Manuel Velasco Suarez", Yajalon, Chiapas, Mexico
| | - Jorge L Ble-Castillo
- Multidisciplinary Academic Division of Health Sciences, Juarez Autonomous University of Tabasco, Villahermosa, Tabasco, Mexico
| | - Nonanzit Pérez-Hernández
- Department of Molecular Biology, National Institute of Cardiology Ignacio Chávez, Mexico City, Mexico
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