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1.
Vasc Health Risk Manag ; 16: 367-377, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33061398

RESUMO

Background: High-intensity statin is recommended in high-risk type 2 diabetes (T2D); however, statin dose dependently increases the risk of developing new-onset diabetes, can potentially worsen glycemic control in T2D, and may cause cognitive impairment. This study aimed to investigate the effect of statin intensification on glucose homeostasis and cognitive function in T2D. Materials and Methods: T2D patients who were taking simvastatin ≤20 mg/day were randomized to continue taking the same dosage of simvastatin (low-dose simvastatin group; LS, n=63) for 12 weeks, or to change to atorvastatin 40 mg/day for 6 weeks, and if tolerated, atorvastatin was increased to 80 mg/day for 6 weeks (high-dose atorvastatin group; HS, n=62). Fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), plasma insulin, homeostatic model assessment of insulin resistance (HOMA-IR) and of ß-cell function (HOMA-B), cognitive functions using Montreal Cognitive Assessment (MoCA), and Trail Making Test (TMT) were assessed at baseline, 6 weeks, and 12 weeks. Results: Mean age of patients was 58.8±8.9 years, and 72% were female. Mean baseline FPG and HbA1c were 124.0±27.5 mg/dl and 6.9±0.8%, respectively. No differences in baseline characteristics between groups were observed. Change in HbA1c from baseline in the LS and HS groups was -0.1% and +0.1% (p=0.03) at 6 weeks, and -0.1% and +0.1% (p=0.07) at 12 weeks. There were no significant differences in FPG, fasting plasma insulin, HOMA-B, HOMA-IR, MoCA score, or TMT between groups at 6 or 12 weeks. Conclusion: Switching from low-dose simvastatin to high-dose atorvastatin in T2D resulted in a slight increase in HbA1c (0.1%) without causing cognitive decline.


Assuntos
Atorvastatina/administração & dosagem , Glicemia/efeitos dos fármacos , Cognição/efeitos dos fármacos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Substituição de Medicamentos , Inibidores de Hidroximetilglutaril-CoA Redutases/administração & dosagem , Sinvastatina/administração & dosagem , Idoso , Atorvastatina/efeitos adversos , Biomarcadores/sangue , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/psicologia , Feminino , Hemoglobina A Glicada/metabolismo , Homeostase , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/efeitos adversos , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Sinvastatina/efeitos adversos , Tailândia , Fatores de Tempo , Teste de Sequência Alfanumérica , Resultado do Tratamento
2.
Diabetes Metab Syndr ; 14(5): 1583-1587, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32947759

RESUMO

AIMS: To explore the impact of the coronavirus disease lockdown on diabetes patients living in Jeddah, Saudi Arabia, in terms of their compliance with medication intake and lifestyle habits, and quality of life. METHODS: In this cross-sectional, qualitative prospective study, a questionnaire was administered over the telephone to diabetes patients who had attended National Guard primary care centers in Jeddah, Saudi Arabia. The survey included questions on demographic data, type of diabetes, medications used, comorbidities, medication compliance, and daily habits before and after the lockdown, and those assessing patients' psychological parameters during the past month by using the Kessler Psychological Distress Scale (K10). Data analysis was performed using SPSS program version 26. RESULTS: Totally, 394 patients participated. All of them had type 2 diabetes, and 37.6% had only one comorbidity. Antidiabetic monotherapy was used in 76.4% of the patients, while combination therapy was used in 23.6%. The compliance score before the lockdown was significantly higher (18.49 ± 3.05) than that after it (17.40 ± 3.25) (p-value <0.001). The average psychological assessment score was 9.78 ± 4.14 (range 8-35). Male participants and smokers had a significantly better psychological status than female participants (p-value = 0.002) and non-smokers (p value < 0.001), respectively. CONCLUSIONS: The patients' levels of compliance with medications and healthy lifestyle habits were significantly reduced after the lockdown. These findings highlight the need for healthcare professionals to encourage diabetes patients to adhere to healthy lifestyle habits and use telemedicine during lockdowns to ensure optimal blood glucose control and reduce the incidence of complications.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Adesão à Medicação/estatística & dados numéricos , Quarentena/psicologia , Adulto , Infecções por Coronavirus , Estudos Transversais , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral , Estudos Prospectivos , Pesquisa Qualitativa , Qualidade de Vida , Arábia Saudita , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-32784771

RESUMO

Diabetes causes significant disabilities, reduced quality of life and mortality that imposes huge economic burden on societies and governments worldwide. Malaysia suffers a high diabetes burden in Asia, but the magnitude of healthcare expenditures documented to aid national health policy decision-making is limited. This systematic review aimed to document the economic burden of diabetes in Malaysia, and identify the factors associated with cost burden and the methods used to evaluate costs. Studies conducted between 2000 and 2019 were retrieved using three international databases (PubMed, Scopus, EMBASE) and one local database (MyCite), as well as manual searches. Peer reviewed research articles in English and Malay on economic evaluations of adult type 2 diabetes conducted in Malaysia were included. The review was registered with PROSPERO (CRD42020151857), reported according to PRISMA and used a quality checklist adapted for cost of illness studies. Data were extracted using a data extraction sheet that included study characteristics, total costs, different costing methods and a scoring system to assess the quality of studies reviewed. The review identified twelve eligible studies that conducted cost evaluations of type 2 diabetes in Malaysia. Variation exists in the costs and methods used in these studies. For direct costs, four studies evaluated costs related to complications and drugs, and two studies were related to outpatient and inpatient costs each. Indirect and intangible costs were estimated in one study. Four studies estimated capital and recurrent costs. The estimated total annual cost of diabetes in Malaysia was approximately USD 600 million. Age, type of hospitals or health provider, length of inpatient stay and frequency of outpatient visits were significantly associated with costs. The most frequent epidemiological approach employed was prevalence-based (n = 10), while cost analysis was the most common costing approach used. The current review offers the first documented evidence on cost estimates of diabetes in Malaysia.


Assuntos
Efeitos Psicossociais da Doença , Diabetes Mellitus Tipo 2/economia , Custos de Cuidados de Saúde/estatística & dados numéricos , Gastos em Saúde/estatística & dados numéricos , Adulto , Complicações do Diabetes/economia , Diabetes Mellitus Tipo 2/psicologia , Humanos , Malásia , Qualidade de Vida , Perfil de Impacto da Doença
4.
Artigo em Inglês | MEDLINE | ID: mdl-32752228

RESUMO

This study evaluated the short-term efficacy of brief group cognitive behavioral therapy (BG-CBT) in reducing diabetes-related distress (DRD), lowering hemoglobin A1c (HbA1c), improving food consumption behavior, increasing physical activity, and improving medication adherence behavior. A quasi-experimental pretest/post-test design with follow-up assessments was used with an experimental and a control group. Participants were patients with uncontrolled type 2 diabetes mellitus (T2DM) and moderate or high diabetes-related distress recruited from the Diabetes Mellitus Clinic of Hang Dong Hospital, Chiang Mai, Thailand. Fifty-six eligible participants were purposively selected and enrolled, then randomly assigned to either the BG-CBT group or the control group. The BG-CBT group received six brief weekly sessions of cognitive behavioral group therapy, while the control group received conventional care. Baseline data were collected at week 0 (pretest) and at week 6 (post-test), including food consumption behavior, physical activity, and adherence to medication regimes, as well as a blood examination to determine levels of HbA1c at the week 12 follow-up. DRD was assessed using the Diabetes Distress Scale (DDS-17) and analyzed using descriptive statistics, including pair t-test and independence t-test results. The BG-CBT had a significant effect on the amelioration of diabetes distress, improvement of food consumption behavior, and reduction of HbA1c levels, demonstrating the effectiveness of BG-CBT in maintaining diabetes control in people with T2DM-related distress.


Assuntos
Terapia Cognitivo-Comportamental , Diabetes Mellitus Tipo 2 , Psicoterapia de Grupo , Estresse Psicológico , Idoso , Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/terapia , Feminino , Hemoglobina A Glicada , Humanos , Masculino , Pessoa de Meia-Idade , Estresse Psicológico/etiologia , Estresse Psicológico/terapia , Tailândia
5.
J Med Life ; 13(2): 132-137, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32742503

RESUMO

Diabetes mellitus (DM) is a chronic metabolic disorder with significant co-morbidities and healthcare burdens. Many large studies have investigated the association between perceived stress and DM; however, none investigated this in a larger Indian population. We hypothesized stress as one of the reasons for the progression of people with prediabetes into DM. The present study was, therefore, planned to report on associations between perceived stress and blood glucose markers stratified by diabetic status. The current descriptive study was a subset analysis of the nationwide cross-sectional survey, conducted in all Indian zones under the National Multicentric Diabetes Control Program. The study examined the perceived stress levels using a perceived stress scale (PSS-10) in people with prediabetes (n=649) and DM (n=485) and then segregated them into three categories (minimum, moderate, and severe). Blood glucose markers (fasting blood glucose, postprandial blood glucose, and HbA1c) were evaluated to report their association with the perceived stress. The study revealed a significantly higher HbA1c level in people with prediabetes, particularly those with severe perceived stress (6.12 ± 0.27) compared to other categories. Those with DM had a higher fasting blood glucose level, particularly with severe perceived stress (239.28 ± 99.52). An increased HbA1c level is noted in severely stressed people with prediabetes, requiring a comprehensive analysis with a longitudinal study of the role of perceived stress in the progression of prediabetes into DM. Additionally, higher fasting blood glucose levels in patients with DM and severe perceived stress suggests the need for establishing comprehensive diabetic care inclusive of stress management.


Assuntos
Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/psicologia , Estado Pré-Diabético/sangue , Estado Pré-Diabético/psicologia , Estresse Psicológico/sangue , Estudos Transversais , Humanos , Índia
6.
Nutrients ; 12(8)2020 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-32759636

RESUMO

The COVID-19 lockdown clearly affected the lifestyle of the population and entailed changes in their daily habits, which involved potential health consequences, especially on patients with Type 2 Diabetes Mellitus (T2DM). We aimed to examine the impact of the lockdown caused by COVID-19 pandemic on both nutrition and exercise habits, as well as the psychological effects in patients with T2DM, compared to their usual diet and physical activity level previous to the complete home confinement. We also intended to analyse any potential variables that may have influenced these lifestyle modifications. A Food Frequency Questionnaire (FFQ), Physical Activity Questionnaire (IPAQ), Food Craving Questionnaire-State (FCQ-S) and Food Craving Questionnaire-Trait (FCQ-T) were used. Our results showed an increase in vegetable, sugary food and snack consumption. An association between levels of foods cravings and snack consumption was also found. Data also showed a high percentage of physical inactivity before the COVID-19 lockdown, which was exacerbated during the home confinement. These findings emphasise the great importance to do further research with larger study samples to analyse and explore dietary habits and to develop public health policies to promote a healthy lifestyle in terms of diet and physical activity in these patients, especially after this strict period of lockdown.


Assuntos
Infecções por Coronavirus/complicações , Diabetes Mellitus Tipo 2/complicações , Dieta , Exercício Físico , Comportamento Alimentar , Pandemias , Pneumonia Viral/complicações , Comportamento Sedentário , Idoso , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/virologia , Fissura , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/virologia , Lanches , Isolamento Social , Inquéritos e Questionários
7.
Health Qual Life Outcomes ; 18(1): 265, 2020 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-32746841

RESUMO

BACKGROUND: Individuals with diabetes mellitus have difficulty solving problems in meaningful occupations and have similar difficulties with self-care regimens. We examined the effects of an occupation-based intervention supported with problem-solving therapy in individuals with type 2 diabetes mellitus on participation in and satisfaction with meaningful occupations, diabetes-related psychosocial self-efficacy, preferred coping strategies and individual well-being. METHODS: This study was planned as a single-blind, randomised controlled study with a 3-month follow-up involving 67 adults with type 2 diabetes. The Canadian Occupational Performance Measure, Diabetes Empowerment Scale, Brief COPE and five-item World Health Organisation Well-Being Index were used. This programme included evaluations, diabetes education, and problem-solving therapy. The intervention was conducted for 6 weeks, and each weekly session lasted approximately 60 min. Differences between groups were analysed using the Mann-Whitney U test, and the Friedman test was used to calculate group-time interaction differences (i.e., baseline, after 6 weeks and after 3 months). RESULTS: All participants identified the most significant occupational performance problems in self-care as personal care. Significant improvement was reported in the intervention group compared to the control group regarding participation in meaningful occupation, satisfaction with performance, psychosocial self-efficacy, and well-being results (p < 0.001) after the programme and 3 months of follow-up. Participant use of effective coping strategies, active coping and acceptance strategies, and self-efficacy, as revealed by the results, suggested improvement in favour of the intervention group (p < 0.05). CONCLUSIONS: Occupation-based problem-solving therapy encourages participation in meaningful occupations and improves psychosocial self-efficacy, effective coping styles, and well-being in patients with type 2 diabetes mellitus. Problem-solving therapies that incorporate individuals' priorities via meaningful occupation can be used to lead to a meaningful and quality life for individuals with type 2 diabetes mellitus. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT03783598 . Retrospectively Registered. First Posted-December 21, 2018, Last Update Posted-February 18, 2020.


Assuntos
Adaptação Psicológica , Diabetes Mellitus Tipo 2/psicologia , Terapia Ocupacional/métodos , Qualidade de Vida , Autocuidado/psicologia , Adulto , Canadá , Diabetes Mellitus Tipo 2/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autoeficácia , Método Simples-Cego
8.
BMC Public Health ; 20(1): 1140, 2020 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-32689971

RESUMO

BACKGROUND: The data of the International Diabetes Federation show that about 463 million people have diabetes. Better understanding of psychosocial aspects of life with this disease has become one of healthcare priorities in this group of patients. The aim of this study was to assess the relationships between loneliness and blood glucose control in diabetic patients. METHODS: The study included 250 hospitalized patients with type 1 and 2 diabetes. The patients included in the study were those who had had diabetes for at least 1 year and received pharmacotherapy. Standardized Revised UCLA Loneliness Scale (R-UCLA) and an analysis of patient test results including 10 indicators of blood glucose control were used for data collection. Correlation analysis, i.e. Pearson's linear correlation coefficient (r, parametric method), was used for hypothesis verification. RESULTS: Less than one-fifth (16%) of the patients included in the study had higher loneliness index (based on the R-UCLA scale), and this loneliness index (total result) was significantly correlated with higher blood pressure. No significant correlations were demonstrated between loneliness and the other 9 indicators of blood glucose control. CONCLUSIONS: Systolic blood pressure was significantly correlated with loneliness in patients with diabetes. Further studies are needed to confirm these findings.


Assuntos
Diabetes Mellitus Tipo 1/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Solidão/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/psicologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Inquéritos e Questionários , Adulto Jovem
9.
Diabetes Res Clin Pract ; 166: 108314, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32653506

RESUMO

AIMS: Diabetes self-care outcomes are positively impacted by social support. Understanding the mechanisms involved can inform more effective interventions. This study tested potential cross-sectional mediation of social support through self-efficacy and diabetes distress for self-care and clinical outcomes (diet, physical activity, blood glucose monitoring, HbA1c). METHOD: We analysed a sub-sample of the Australian Diabetes MILES-2 cross-sectional online survey (N = 1727). Measures were: Diabetes Social Support Scale, Confidence in Diabetes Self-care Scale, Problem Areas In Diabetes scale, diet and physical activity subscales of the Summary of Diabetes Self-Care Activities, and self-reported HbA1c. Separate mediation path models were tested for each of the four self-care/clinical outcomes in groups with type 1 and type 2 (insulin- and non-insulin-treated) diabetes. RESULTS: Social support was associated with more optimal self-care and self-reported HbA1c outcomes. When diabetes-specific self-efficacy and distress were included as mediators, the direct path from social support became non-significant. Conversely, the indirect effects of social support through diabetes-specific self-efficacy and distress were significant across all diabetes groups and outcomes. CONCLUSION: Diabetes-specific self-efficacy and distress may be important mechanisms linking social support with diabetes self-care and clinical outcomes. Social support interventions could explore whether improving diabetes self-efficacy and decreasing diabetes distress could help improve self-care.


Assuntos
Diabetes Mellitus Tipo 2/psicologia , Autocuidado/métodos , Autoeficácia , Apoio Social , Adolescente , Adulto , Idoso , Austrália , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
10.
Diabetes Res Clin Pract ; 166: 108312, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32673698

RESUMO

AIMS: To compare the quality of diabetes care among type 2 diabetes patients with and without mental disorders during six-year follow-up in North Karelia, Finland. METHODS: All type 2 diabetes patients (n = 10190) were analysed using the electronic health records data from 2011-12 to 2015-16. The diabetes care was evaluated using the measurement activity and the achievement of the treatment targets for HbA1c and LDL. RESULTS: Monitoring of HbA1c and LDL levels improved among all patient groups, except the dementia patients. The proportion of those achieving the HbA1c target declined and those achieving the LDL target improved in all patient groups. Differences in the changes of achievement of the target HbA1c level among patients with dementia and depression were observed when compared with those having only type 2 diabetes. CONCLUSIONS: This study highlights the challenge of glucose level management as the age and comorbidities of the patients related to the care and achievements of the treatment targets. Mental disorders that are likely to affect patients' adherence to medication and other treatments should be taken into account and more support for self-care should be provided to such patients. Improvement in the achievement of LDL target address the progress in the prevention of macrovascular complications.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/psicologia , Transtornos Mentais/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Finlândia , Seguimentos , Humanos , Masculino , Transtornos Mentais/epidemiologia , Pessoa de Meia-Idade , Estudos Retrospectivos , Autocuidado , Fatores de Tempo
11.
Orv Hetil ; 161(30): 1243-1251, 2020 07.
Artigo em Húngaro | MEDLINE | ID: mdl-32653867

RESUMO

INTRODUCTION: The prevalence of diabetes mellitus is significantly increasing worldwide. Distal sensorimotor neuropathy (DSPN) is the most common and the earliest detectable microvascular complication. Due to its diverse clinical appearance and atypical symptoms, DSPN is often recognized in an advanced stage. AIM AND METHOD: In our study, the data of 431 patients who were examined using the Neurometer® between 2011 and 2018 at the Diabetic Neuropathy Center of the University of Debrecen were processed and the correlations between cardiovascular and microvascular complications, laboratory parameters and the severity of DSPN were investigated. RESULTS: The average age of patients was 63.4 years, 62% of them were women, and 92% had type 2 diabetes mellitus. The average duration of diabetes was 13.7 years. Cardiovascular disease (CVD) was diagnosed in 42% of the patients. The incidence of retinopathy was 12%, persistent microalbuminuria was 16%. Despite DSNP complaints, neuronal damage could not be detected in 19%; in the examined patients 49% had mild, 19% moderate and 13% severe neuropathy. Diabetes-related neurological damage was more serious in the presence of both diabetic retinopathy (p<0.001) and microalbuminuria (p<0.001). The incidence of these microvascular complications and the severity of DSPN showed a significant positive correlation (p<0.001). There was no correlation between the severity of peripheral neuropathy and the development of CVD, and we did not find any correlations between the severity of DSPN and CVD. CONCLUSION: Based on our investigation, correlation between the progression of diabetic neuropathy and cardiovascular complications was not found, although the progression of diabetic neuropathy indicated the development of other microvascular diseases. Peripheral neurological examination using the Neurometer® is appropriate for controlling the DSPN status and the establishment of the severity of neuropathy determines the quality of life in diabetic patients. Among these patients, the risk of CVD can be assessed by Ewing's test for autonomic nervous system function. Orv Hetil. 2020; 161(30): 1243-1251.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Neuropatias Diabéticas/epidemiologia , Retinopatia Diabética/epidemiologia , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/psicologia , Neuropatias Diabéticas/psicologia , Retinopatia Diabética/psicologia , Feminino , Humanos , Hungria/epidemiologia , Incidência , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Doenças do Sistema Nervoso Periférico/epidemiologia , Qualidade de Vida
12.
BMC Public Health ; 20(1): 887, 2020 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-32513161

RESUMO

BACKGROUND: Adequate physical activity (PA) is considered essential in diabetes management. However, evidence on the best method of promoting PA within diabetes care is inconclusive. The current work identifies perceptions on the acceptability of Intervention Group Participants (IGP) and Project Officers (POs) about the "MOVEdiabetes" intervention programme aimed at increasing PA in adults with type 2 diabetes in Oman (a retrospectively registered trial). METHODS: The "MOVEdiabetes" programme (PA consultations, pedometers and WhatsApp messages) was delivered by the POs (primary health care practitioners) in four primary care centres within a one-year cluster randomised control trial. Recruitment and retention were measured from trial attendance records. Programme satisfaction, appropriateness, and content suitability were assessed using exit surveys for both the IGP (interview based) and POs (self-administered). Open text questions on perceptions to the study programme were also included. RESULTS: Participants were randomised to an intervention group (IG, n = 122) or comparison group (CG, n = 110). The overall retention rate at three and 12 months was 92.7% [110(90.2%) IG vs 105(95.5%) CG] and 75% [82(67.2%) IG vs 92(83.6%) CG] respectively. Most (n = 14, 87.5%) POs and more than half (n = 49, 59.8%) IGP perceived the programme as very appropriate and many reported that they were "quite/ very satisfied" with the programme (n = 16, 100% PO's and n = 71, 86.6% IGP). Two thirds (n = 55, 66.0%) of IGP were very/quite likely to recommend the programme to others. PA consultations, use of pedometers and Whatsapp messages were well perceived by all. Participants recommended the inclusion of dietary advice and PA promotion for the general public. Exploring PA facilities within the community was suggested by POs. CONCLUSIONS: The "MOVEdiabetes" programme achieved a high retention rate and was perceived as satisfactory and appropriate. Results from this study suggest that it is worthwhile exploring the use of the "MOVEdiabetes" programme in clinical practice and further community links. TRIAL REGISTRATION: International Standard Randomised Controlled Trials No: ISRCTN14425284. Registered retrospectively on 12th April 2016.


Assuntos
Terapia Comportamental/métodos , Diabetes Mellitus Tipo 2/reabilitação , Exercício Físico/psicologia , Educação de Pacientes como Assunto/métodos , Atenção Primária à Saúde/métodos , Actigrafia , Adulto , Atitude do Pessoal de Saúde , Diabetes Mellitus Tipo 2/psicologia , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Omã , Projetos de Pesquisa
13.
Epidemiol Psychiatr Sci ; 29: e134, 2020 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-32484148

RESUMO

AIMS: To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries. METHODS: People with type 2 diabetes treated in out-patient settings aged 18-65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of 'upset') between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables. RESULTS: In total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS. CONCLUSION: This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.


Assuntos
Transtorno Depressivo Maior/diagnóstico , Diabetes Mellitus Tipo 2/complicações , Programas de Rastreamento/métodos , Qualidade de Vida , Estresse Psicológico/etiologia , Adulto , Idoso , Transtorno Depressivo Maior/epidemiologia , Transtorno Depressivo Maior/psicologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Estudos Prospectivos , Escalas de Graduação Psiquiátrica/estatística & dados numéricos , Angústia Psicológica , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Adulto Jovem
14.
Diabetes Metab Syndr ; 14(5): 917-920, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32574982

RESUMO

BACKGROUND AND AIMS: During the current pandemic of COVID-19, India is under lockdown which could cause disruption in diet and lifestyle in patients with type 2 diabetes (T2DM). We aimed to study lifestyle changes and other common issues related to treatment in our previously seen and treated patients with T2DM. METHODS: Patients (n, 150) who were regularly following up before lockdown were interviewed telephonically (after 45 days of start of lockdown) regarding lifestyle changes, stress and other diabetes-related questions. RESULT: Carbohydrate consumption and frequency of snacking increased in 21% and 23% patients, respectively. Interestingly, 27% patients reported an increase in consumption of fruits. Exercise duration was reduced in 42% and weight gain occurred in 19% patients. Frequency of doing self-monitoring of blood glucose (SMBG) was decreased in 23% patients. 'Mental stress' of any kind was reported in 87% patients. Availability of medicines and insulin was uninterrupted in 91% patients. Knowledge about telemedicine was present in 69% and majority (92%) of these patients preferred video consultation. CONCLUSION: During 45 days of lockdown increase in carbohydrate intake, decrease in exercise, decreased SMBG and widespread mental stress in patients with T2DM was recorded, factors which may destabilize or exacerbate hyperglycemia and hypertension. Some positive changes (e.g. increased intake of fruits) were also observed.


Assuntos
Automonitorização da Glicemia/estatística & dados numéricos , Infecções por Coronavirus/complicações , Diabetes Mellitus Tipo 2/complicações , Exercício Físico , Estilo de Vida , Pneumonia Viral/complicações , Quarentena/estatística & dados numéricos , Estresse Psicológico/etiologia , Adulto , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Infecções por Coronavirus/virologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/psicologia , Feminino , Seguimentos , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pneumonia Viral/virologia , Prognóstico , Isolamento Social , Estresse Psicológico/psicologia , Inquéritos e Questionários
15.
Artigo em Inglês | MEDLINE | ID: mdl-32560531

RESUMO

Menopause is a natural period resulting from the decrease in hormonal activity of the ovaries. Growing hormonal deficiencies and changes in the body influence a variety of functions in women, leading to depression and decreased quality of life. The relationship between body composition, the severity of depressive and climacteric symptoms and the quality of life of women with type 2 diabetes and healthy women in the perimenopausal period was studied. Statistically significant differences were observed between the study and control groups regarding all body composition parameters except for protein and the content of torso soft tissues (p < 0.05). In both the study and control groups, resulting symptoms were significantly correlated with numerous body composition parameters (e.g., body mass, fat tissue mass, minerals, abdominal circumference), while symptoms of depression were significantly correlated with similar parameters only in the control group. A statistically relevant relationship was observed between the study and control groups with respect to quality of life in certain domains. The quality of life of women suffering from type 2 diabetes was worse compared with healthy women. Analysis of body composition showed significant differences between healthy women and those with type 2 diabetes. Healthy women showed a tendency to establish a link between body composition and depressiveness.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Diabetes Mellitus Tipo 2/psicologia , Perimenopausa/fisiologia , Perimenopausa/psicologia , Qualidade de Vida , Composição Corporal/fisiologia , Depressão/fisiopatologia , Depressão/psicologia , Feminino , Humanos , Sobrepeso/fisiopatologia , Sobrepeso/psicologia , Psicologia
16.
Health Qual Life Outcomes ; 18(1): 182, 2020 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-32539861

RESUMO

BACKGROUND: Nearly a quarter of the population in the UAE has type 2 diabetes mellitus (T2DM), and this medical condition is associated with poorer oral health. The effects on oral health-related quality of life (OHRQoL), however, have not been examined in this population. Therefore, the objective of this study was to assess the impact of oral health problems, such as caries and periodontitis, on OHRQoL among Arab patients with and without T2DM. METHODS: This matched case-control study included 88 diabetic and 88 non-diabetic participants recruited from University Dental Hospital Sharjah and University Hospital Sharjah, UAE. Participants completed a sociodemographic questionnaire as well as the Oral Health Impact Profile short form (OHIP-14), which measures OHRQoL. Clinical examinations were conducted to assess participants' dental caries status, using the Decayed Missing Filled Teeth (DMFT) Index, and periodontal condition, via clinical attachment loss (CAL) dichotomized to CAL < 3 mm and CAL ≥3 mm. Linear regression models were used to identify the association among OHIP domains, clinical attachment loss, DMFT scores, and diabetes status. RESULTS: The mean age of participants was 43.0 years. A significantly (p = 0.01) higher proportion of diabetic patients (23%) had a CAL ≥3 mm than non-diabetic patients (10%). No significant differences in OHIP scores were observed between diabetic and non-diabetic patients. The results of the linear regression suggested that irrespective of diabetic status, DMFT scores were significantly associated with physical disability, physical pain, psychological discomfort, and psychological disability, as well as total OHIP scores. CAL was significantly associated with the handicap domain. Among non-diabetic patients, OHIP scores were significantly associated with DMFT scores in five OHIP domains (functional limitation, physical disability, physical pain, psychological discomfort, psychological disability), as well as total OHIP scores. Among diabetic patients, CAL was significantly associated with both the social disability and handicap domains, while only the handicap domain reached statistical significance among non-diabetic patients. CONCLUSIONS: Participants who had decayed teeth, irrespective of their diabetic status, reported substantial physical and psychological impacts on OHRQoL. CAL also had a significant impact on OHRQoL, being primarily associated with the OHIP handicap domain in both diabetic and non-diabetic patients.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Saúde Bucal , Qualidade de Vida , Adulto , Estudos de Casos e Controles , Cárie Dentária/complicações , Cárie Dentária/psicologia , Diabetes Mellitus Tipo 2/psicologia , Pessoas com Deficiência/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Periodontite/complicações , Periodontite/psicologia , Inquéritos e Questionários , Perda de Dente/complicações , Perda de Dente/psicologia , Emirados Árabes Unidos
17.
Rev Med Suisse ; 16(697): 1206-1209, 2020 Jun 10.
Artigo em Francês | MEDLINE | ID: mdl-32520460

RESUMO

Diabetes self-management (DSM) is a process based on a series of complex learnings. The conceptualization of the role of the emotional dimensions that underlie and structure this process is critical to better understand why living with diabetes can become a burden. A clinical case illustrates the intertwining of the affective and cognitive dimensions of diabetes burden and its influence on DSM skills. Emotional regulation is a recognized determinant to implement effective and long-term DSM skills as well as access to DSM interventions. In order to improve DSME/S interventions efficacy, the role of emotional dimensions, new technologies and therapeutic advances needs to be considered.


Assuntos
Diabetes Mellitus/terapia , Autocuidado , Autogestão , Diabetes Mellitus/psicologia , Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/terapia , Regulação Emocional , Humanos
18.
Diabetes Technol Ther ; 22(7): 527-534, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32522031

RESUMO

Aim: To evaluate the effects of a prolonged lockdown due to Coronavirus (COVID-19) on the adoption of newer technologies and changes in glycemic control on patients with type 2 diabetes (T2D) in India. Methods: The study population included a random list of 3000 individuals with T2D derived from 30,748 individuals who had visited a large tertiary diabetes center during the past year. The survey was carried out through a telephonic interview. A structured questionnaire was used to collect information on changes in lifestyle, access and challenges to diabetes care and use of technologies such as telemedicine facilities and use of self-monitoring of blood glucose (SMBG), etc. Results: Of the 2510 individuals successfully interviewed (83.7% response rate), 382 (15.2%) reported having attempted to consult their health care providers during the lockdown, of whom only 30.6% utilized the telemedicine facility. However, 96 (82%) of those who utilized the telemedicine facility (n = 117) were happy with their experience and 68 (58.1%) were willing to continue to use the facility in the future. Only 11.4% of participants utilized online support for management of diabetes. Use of SMBG increased significantly from 15.5% to 51.3% during the lockdown. There was an improvement in glycemic control during the lockdown (HbA1c:before vs. during lockdown: 8.2% ± 1.9% vs. 7.7% ± 1.7%, P < 0.001) in a nonrandomly selected subset of subjects (n = 205). Conclusions: Acceptance of telemedicine facilities remains suboptimal in this Asian Indian population, in spite of high levels of satisfaction among those who utilized it. The COVID-19 pandemic and the subsequent lockdown have not adversely affected metabolic control in our patients, and indeed there appears to be an improvement in HbA1c levels. Greater accessibility and acceptance of technology could help individuals with diabetes to maintain better contact with their physicians and ensure better metabolic control in the future.


Assuntos
Infecções por Coronavirus/prevenção & controle , Diabetes Mellitus Tipo 2/terapia , Pandemias/prevenção & controle , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Quarentena/estatística & dados numéricos , Telemedicina/estatística & dados numéricos , Adulto , Betacoronavirus , Glicemia/análise , Automonitorização da Glicemia/estatística & dados numéricos , Estudos Transversais , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente/estatística & dados numéricos , Quarentena/psicologia , Telemedicina/métodos
19.
Int J Equity Health ; 19(1): 80, 2020 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-32487086

RESUMO

BACKGROUND: It is important for people with Type 2 Diabetes Mellitus (T2DM) to eat healthily. However, implementing dietary advice in everyday life is difficult, because eating is not a distinguishable action, but a chain of activities, embedded in social practices and influenced by previous life experiences. This research aims to understand why and how eating practices are developed over the life-course by investigating influential life experiences - turning points - and coping strategies for eating practices of people with T2DM. METHODS: The Salutogenic Model of Health guided the study's objective, study design and analysis. Seventeen interviews were performed and analysed based on the principles of interpretative phenomenological analysis. Narrative inquiry and the creation of timelines and food boxes were used as tools to facilitate reflection on turning points and eating practices. RESULTS: Turning points for unhealthier eating were experiences that strongly disturbed the participants' emotional stability. These experiences included psychosocial trauma, physical health disorders, job loss, and smoking cessation. Turning points for healthier eating were experiences that significantly changed participants views on life and made participants reflective about the effects of current eating practices on future health and life goals. These turning points included confrontation with ill-health, becoming a parent, psychosocial therapy, and getting married. Notably, turning points for healthier eating seemed only to happen when life was relatively stress-free. All participants experienced turning points for healthier eating, yet, not all participants succeeded in improving their diets. Two coping styles were distinguished: active and passive coping. Active coping individuals were able to act in line with their personal intentions, whereas passive coping individuals could not. Differences between active and passive coping styles seemed to be explained by differences in available resources important for adapting and maintaining a healthy diet. CONCLUSION: Disadvantaged childhood and later life adversities together with the inability to manage the mental stress explained the development unhealthier eating practices. All participants experienced turning points for healthier eating that caused eating to become a priority in their life. Yet, the fact that not all were able to eat as they intended, advocates for nutritional guidance for people with T2DM, with a greater emphasis on reflexivity, psycho-social well-being and social support.


Assuntos
Adaptação Psicológica , Diabetes Mellitus Tipo 2/psicologia , Dieta Saudável/psicologia , Nível de Saúde , Modelos Teóricos , Estresse Psicológico , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Países Baixos/epidemiologia
20.
Niger J Clin Pract ; 23(6): 775-782, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32525111

RESUMO

Objective: The aim of this study was to investigate the relationship between anxiety level and quality of life in patients with diabetes mellitus and the sociodemographic factors affecting them. Materials and Methods: This cross-sectional study enrolled 150 patients with DM who presented to the endocrinology clinic of Gaziantep University Sahinbey Research and Training Hospital for outpatient treatment between March 2017 and April 2017. The Beck Anxiety Inventory (BAI) and Eortc-Qlqc30 Quality of Life Scale (EORTC- QLQ-C30) were used to evaluate anxiety levels and quality of life of the patients. Results: The mean score of the patients obtained from BAI was 18 ± 13 and 51.4 ± 26 from EORTC- QLQ-C30. Mean body mass index of patients' was 27.03. There was a statistically significant negative correlation between BAI and EORTC QLQ-C30 (r:-0.359) and sub scales in terms of physical function (r: -0.253), emotional function (r: -0.201), role function (r: -0.308), cognitive function (r: -0.309) (P < 0.05). There was a statistically significant positive correlation between BAI and the symptom subscales of EORTC QLQ-C30 in terms of pain score (r: 0.276), fatigue score (r: 0.305), dyspnea score (r: 0.198), insomnia score (r: 0.247), loss of appetite score (r: 0.216) (P < 0.05). Conclusion: A negative relationship was determined between anxiety levels and quality of life. Age, marital status, number of spouses, co inhabitants at home, educational status, living place were related with both quality of life and anxiety levels of DM patients. Increasing the psychosocial support systems of individuals with DM may reduce their anxiety levels and increase quality of life.


Assuntos
Depressão/etiologia , Diabetes Mellitus Tipo 2/psicologia , Qualidade de Vida/psicologia , Adolescente , Adulto , Idoso , Ansiedade/epidemiologia , Ansiedade/etiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/epidemiologia , Dispneia/epidemiologia , Fadiga/epidemiologia , Fadiga/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/epidemiologia , Escalas de Graduação Psiquiátrica , Características de Residência , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Cônjuges , Inquéritos e Questionários , Turquia/epidemiologia , Adulto Jovem
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