Pattern of Self-care practices among type 2 diabetes patients in Southwest, Nigeria

Background

Self-care practices in individuals with diabetes are important skills required to effectively prevent, manage, and limit complications associated with diabetes since patients spend considerably less time with health care providers than spend alone to manage their diabetes condition.

Aims

The aim of the study was to assess self-cate practices and their determinants among patients with type 2 diabetes. Hence, this study aimed at assessing self-care practices and their determinants among patients with type 2 diabetes.

Materials and Methods

This cross-sectional, descriptive, multi-center study was conducted among 348 type 2 diabetes patients selected from six tertiary hospitals in Southwest Nigeria. Descriptive statistical analysis was employed for categorical and continuous variables and multivariable logistic regression assessed association between determinant factors and adherence to self-monitoring of blood glucose (SMBG).

Results

Of the study participants, 83.1%, 66.9%, 28.4%, and 27.9% adhered to prescribed medications, physical exercise, had meal plans incorporated into their diabetes management and SMBG, respectively. There was a statistically significant association between male gender, duration of diabetes, and previous episode of hypoglycemia with adherence to SMBG practices while lower educational level and use of insulin were associated with less likelihood of adherence to prescribed medications.

Conclusion

The degree to which individuals with diabetes adhered to recommended self-care practice components were less than satisfactory especially SMBG, physical activity, and having meal plans.

Prevalence and Determinants of Complementary and Alternative Medicine (CAM) Use among Diabetes Patients in Southwestern Nigeria

INTRODUCTION

The epidemic of diabetes mellitus (DM) in African countries demands a critical assessment and review of patients' management protocols and their self-care habits. The objective of this research was to evaluate the pattern of usage of CAM, its role in the management of diabetes and possible determinants of its use in patients with diabetes.

METHODS

Subjects were recruited from six selected hospitals from four of the six States in South western, Nigeria. Participants were consecutively recruited from the diabetes clinics of the selected hospitals. Participants completed a multicomponent questionnaire which comprised three sections.

RESULTS

The majority of the subjects were females (57.7%) and of Yoruba extraction (89.7%). Their mean age was 62.58±11.80 years and their mean duration of diabetes was 7.95±6.41 years (range 1-36 years). Two hundred and forty one (62.1%) of the subjects reported the use of at least one type of CAM of which 213(88.4%) indicated using CAM as complementary to regular conventional anti-diabetic medications, while in the remaining 28 (11.6%) CAM users, it served as alternative medicine. The predictors of CAM use included male gender, and patients with at least secondary level education .

CONCLUSION

The prevalence of the use of CAM therapies is high in this study among people living with diabetes in Southwest, Nigeria. CAM is used mainly as complementary rather than as an alternative therapy. The most commonly used CAM therapy was biological therapy-Vernonia amygdalina (bitter leaf), garlic and Moringa oleifera. Orientation about CAM should be included in diabetes education at diagnosis and regularly re-enforced at subsequent clinic visits.

Mobile Phone Use in the Management of Diabetes in Nigeria: A New Potential Weapon

Diabetes Mellitus (DM) is one of the leading chronic diseases in low- and middle-income countries globally including Nigeria The morbidities and mortalities associated with diabetes especially in Nigeria, have remained unacceptably high compared to many other nations. It has become one of the leading causes of stroke, blindness, heart attack and end-stage kidney disease. Most deaths occur in those below 60 years of age, the productive segments of the population. Health situation in Nigeria is characterised by double burden of illness, grossly inadequate health spending, and inadequate healthcare personnel especially in the rural areas. Shortage of diabetes care specialist is one of the major barriers to diabetes care in Nigeria. Mobile phone has emerged as one of the potent strategies that can impact positively on diabetes care if properly harnessed. The ubiquitous access and the multitasking nature of mobile phones are great opportunities to improve diabetes prevention, patient care, encourage self-management, support healthy behavioural changes and an ideal way of providing patient-centred care at the frequency and intensity that patient desires. In addition, there is a potential for mobile phones to provide an effective way of giving support to patients in rural and remote areas where health care provider contact may be less accessible. Use of short message services (SMS) phone calls, video calls and the use of social media networking applications are some of the ways a mobile phone can be used in diabetes management.

Lipoatrophy among patients on antiretroviral therapy in Lagos, Nigeria: Prevalence, pattern and association with cardiovascular risk factors

CONTEXT

Antiretroviral therapy (ART) is linked with morphologic abnormalities such as lipoatrophy (LA), which may accompany metabolic alterations (dysglycemias, dyslipidemia and insulin resistance) that increase cardiovascular disease risk. LA and its association with metabolic alterations have been infrequently studied amongst Nigerians on ART.

AIMS

To determine the prevalence, pattern and association of LA with metabolic abnormalities and hypertension among patients on ART attending an ambulatory human immunodeficiency virus clinic in Lagos, Nigeria.

SUBJECTS AND METHODS

A cross-sectional study was carried out among patients on ART using a structured interviewer administered questionnaire. Data obtained included patients and physician's assessment of body fat changes, drug history, blood pressure, body composition assessment using bioelectrical impedance analysis and biochemical evaluation (glucose, lipids). LA was defined clinically. Data were analyzed using IBM SPSS statistical software version 21.

RESULTS

A total of 48 (33.1%) of the 145 patients had LA. The face was the most frequently affected body region. Patients with LA with lower body circumferences, skin-fold thickness and body fat (P < 0.05). The frequencies of lipid abnormalities were: Reduced high density lipoprotein-cholesterol (47.1%), elevated total cholesterol (35.6%), reduced low density lipoprotein-cholesterol (19.2%), elevated triglycerides (14.4%). Fasting plasma glucose (FPG)≥6.1 mmol/l and hypertension were present among 9.6% and 40.7% respectively. LA was not significantly associated with the presence of glucose intolerance, dyslipidemia or hypertension (P > 0.05).

CONCLUSIONS

Lipoatrophy, though commonly encountered in patients on ART in Nigeria was not associated with the presence of dyslipidemia, abnormal FPG or hypertension. Regular monitoring by the physician and increased patients awareness are necessary to reduce its prevalence and impact.

Epidemiology and patterns of hypertension in semi-urban communities, south-western Nigeria

Objective

To determine the prevalence and subtypes of hypertension among semi-urban residents in south-western Nigeria.

Methods

All adults aged 18 years or older in 10 semi-urban communities were recruited for the study. The blood pressure (BP) reading taken with a validated electronic BP monitor after at least 10 minutes of rest was used in the analysis. Hypertension was defined as BP ≥ 140/90 mmHg.

Results

Seven hundred and fifty subjects with a mean age of 61.7 ± 18.2 years participated in the study. The prevalence of hypertension was 55.5%. Stage 2 hypertension was the most common, present among 225 (54.1%) of the participants with hypertension, and 191 (45.9%) had stage 1 hypertension. Of those with hypertension, systolic–diastolic hypertension (SDH) was present among 198/416 (47.6%), while isolated systolic hypertension (ISH) and isolated diastolic hypertension (IDH) were present among 181/416 (43.6%) and 37/416 (8.9%), respectively. The prevalence of hypertension increased significantly with age.

Conclusion

The prevalence of hypertension was high in these semi-urban communities. Hence, increased awareness and integrating hypertension care into primary healthcare and other community health services in these areas may prove beneficial in ameliorating its adverse effects.

Self-reported physical activity among health care professionals in South-West Nigeria

INTRODUCTION

Physical activity (PA) is a key requirement for maintaining good health. There is growing evidence of declining PA worldwide. Physical inactivity is linked with the global obesity pandemic and increasing burden of noncommunicable diseases (NCDs) in developing countries. A barrier to PA counseling by health care providers (HCPs) is personal PA habits. Information regarding PA among HCPs in Nigeria is limited. We aimed to determine the adequacy and predictors of PA among HCPs of a tertiary health care facility in Lagos, Nigeria.

METHODS

A cross-sectional study was carried out with the International Physical Activity Questionnaire-Short Form (IPAQ-SF). Using the World Health Organization (WHO) guideline, PA was categorized as adequate or inadequate. Predictors of PA were explored with multivariate logistic regression.

RESULTS

A total of 300 HCPs were recruited, comprising 47.7% doctors and dentists, 43.3% nurses and 9.0% other HCPs. Mean age was 39.9 (9.0 years), 79.2%, 9.7% and 11.1% of the HCPs had low, moderate or high PA levels respectively. Thus, only 20.8% had adequate PA. 71.3% had body mass index (BMI) above the recommended value. BMI of ≥25 kg/m2 was associated with inadequate PA (Adjusted Odds Ratio-2.1,P=0.018).

CONCLUSION

Majority of the HCPs had inadequate PA levels according to WHO guidelines. BMI≥25 kg/m2 was associated with inadequate physical inactivity. The low level of PA implies that these HCPs are at risk for NCDs. This will have a negative impact on availability of human resource for health. There is an urgent need to establish programs to increase PA among HCPs.

Knowledge Regarding Organ Donation and Willingness to Donate among Health Workers in South-West Nigeria

BACKGROUND

Organ transplantation program in developing countries is still significantly dwarfed. Health workers are undeniably important in the success of transplantation.

OBJECTIVE

To assess the knowledge and attitude of health workers toward organ donation in South-West Nigeria with a view to explaining reasons for these shortcomings.

METHODS

In a cross-sectional study conducted on 850 health care workers, self-administered questionnaires were used to obtain information from participants.

RESULTS

Of 850 participants, 766 (90.1%) returned their completed questionnaires. The mean±SD age of participants was 36.7±9.2 years. Majority (93.3%) of participants had heard of organ donation; 82.5% had desirable knowledge. Only 29.5% and 39.4% would be willing to donate and counsel potential organ donors, respectively; 36.5% would consider signing organ donation cards. Only 19.4% believed that organ transplantation is often effective and 63.4% believed they were permitted by their religion to donate. Permission by religion (OR 3.5; 95% CI 2.3 to 5.3), good knowledge (OR 2.9; 95% CI 1.4 to 5.7), readiness to sign donation cards (OR 2.6; 95% CI 1.7 to 3.8), discuss organ donation (OR 2.7; 95%CI 8.0 to 63.8), and knowing somebody who had donated (OR 2.9) independently influenced willingness to donate organ.

CONCLUSION

There is disparity in knowledge of organ donation and willingness to donate among health care workers. Efforts should be intensified to give comprehensive and appropriate education to health care workers about organ donation to bridge this gap.

Pseudohyperglycemia: Effects of Unwashed Hand after Fruit Peeling or Handling on Fingertips Blood Glucose Monitoring Results

BACKGROUND

Self-monitoring of blood glucose (SMBG) is an important component of management for diabetes mellitus (DM), especially in T1DM and T2DM patients who are on insulin therapy. Adequate blood glucose monitoring and prompt intervention are necessary to prevent blood glucose (BG) fluctuation and delay long-term diabetes complications. People with DM are advised to clean their hands before SMBG to remove any dirt or food residue that might affect the reading.

AIM

The study tested the hypothesis that falsely elevated BG levels from fingertip occur after peeling or handling fruits in an unwashed hand.

METHODS

Fifty apparently healthy nondiabetes volunteers were enrolled. Capillary BG samples were collected from the fingertips after peeling or handling apple, orange, banana, watermelon, and pawpaw, followed by no hand washing for 1 h, cleaning the fingertip with alcohol swab once, five times, and washing hand thoroughly with tap water and drying. These samples were then analyzed with two different glucose meters.

RESULTS

The mean BG values, measured from fingertip blood samples after peeling, and handling any of the fruits followed by no hand washing were significantly high, even after cleaning fingertip with a swab of alcohol once. However, there were no significant difference in BG levels measured after peeling and handling fruits followed by hand washing and the level of BG before peeling and handling fruits.

CONCLUSION

Handling of peeled fruits with no hand washing with tap water is associated with overestimation of capillary BG (Pseudohyperglycemia) monitored with glucose meters.