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   2013| October-January  | Volume 4 | Issue 3  
    Online since January 12, 2017

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Factors influencing self-management of Diabetes Mellitus; a review article
G Kisokanth, S Prathapan, J Indrakumar, J Joseph
October-January 2013, 4(3):6-6
To review recent data to identify the factors influencing the effective self-management of Diabetes Mellitus (DM). A review of the published literature on self-management of diabetes was performed. This involved searching databases using the search terms Self -management of Diabetes Mellitus, DM and its management, management of type 2 DM, prevalence of diabetes and risk factors for DM. Included studies were conducted in different parts of the world between 1993 and 2013. An attempt was made to contact corresponding authors for further information for this study. We included 34 articles in our review. Self-management of diabetes were consistent with those found in several studies, i.e. individuals most regularly followed their prescribed medication regimen and least regularly followed recommendation for lifestyle changes of diet and exercise. The import ant determinants of self- management are transient situational factors such as environmental factors, psychological factors and social factors. Interventions to promote better self-management have reported in several studies. Initial improvement in better glucose control can be achieved by self-management education. Successful self-management of DM requires that individuals with DM frequently monitor their blood glucose levels and take required action in order to keep blood sugar within a physiological level . This can be achieved by self -management education, self-monitoring and social support. Cultural influences also have interfered with successful diabetes self-management. The chronic care model is recommended for the self-management of DM.
[ABSTRACT]   Full text not available  [PDF]
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Factors associated with the interest for life style behavior modification among non-diabetic adults
AC Mathew, S Jose, N Jacob, P Rathan, K Suvetha, S Kumar
October-January 2013, 4(3):4-3
Diabetes is a major public health problem in India. Increased physical activity and healthy eating are the cornerstones of diabetes prevention. The perception of a need to change is considered essential in the behavior change process. However, the existing literature on individual's interest to change health behavior is limited. In this paper, we assessed the factors associated with interest for life style behavior modifications among adults by carrying out a cross sectional study in Neelambur, South India. A total of 500 adults were randomly selected. Four hundred and fifty five adults who are non-diabetic were interviewed using a pre-tested specifically designed questionnaire. In general, men were more likely to have interest in life style behavior changes than women (adjusted odds ratio (OR) = 1.778, 95% Confidence Interval (CI) 1.135, 2.785). Those having positive family history of diabetes were more likely to have interest in life style behavior changes than those who did not have positive family history (adjusted OR = 1.714, 95% CI 1.102, 2.665). Among the modifiable factors, those having higher education (adjusted OR = 3.752, 95% CI 1.558, 9.033), those who previously received life style counseling (adjusted OR = 3.028 95% CI 1.837, 4.991), those performing leisure time physical activity (adjusted OR = 3.923, 95% CI 2.220, 6.931) and those having higher knowledge about risk factors of diabetes (adjusted OR = 1.014, 95% CI 1.006, 1.021) were significantly associated with interest in life style behavior changes. In conclusion, the vast majority of the study participants did not perceive an interest to increase their physical activity levels and healthy eating. The interest for life style behavior changes was high among people having higher knowledge on diabetes risk factors. We recommend that, the client perceptions need to be evaluated in health counseling in order to facilitate life style behavior modifications in diabetes prevention.
[ABSTRACT]   Full text not available  [PDF]
  2,266 1,385 -
Economic burden of diabetes in people living with the disease; a field study
A.C.V. Loganathan, KR John
October-January 2013, 4(3):5-5
Diabetes Mellitus is a growing epidemic and the cost of treating diabetes is largely increasing. The objective of the study was to assess and quantify the economic burden of treating diabetes in Chennai among various socio-economic groups with a specific focus on middle-income and middle- aged group. A prevalence-based 'Cost-of-Illness' study for diabetes care was conducted in six different outpatient clinics located in Chennai, India during the months of May and August 2011. A pre-tested questionnaire was administered to collect the data from 100 randomly selected persons with diabetes. The annual mean direct cost for each person with diabetes was estimated to be Indian Rupee (INR) 23,818 (USD 380). The INR 22, 720 (USD 363) spent on medicines accounted for the largest share of direct costs (95%). Comparing annual median direct medical cost incurred by different income groups of people with diabetes, the study revealed that the middle-income group incurs 74% less direct medical costs than the lower income group and no significant difference with high-income groups. The middle-aged group incurs 80% more direct medical costs than their younger counterparts, but 17% more compared to the higher age group. The study found that age, gender and education levels had no significant role in affecting the medical costs. This study concluded that people with diabetes make substantial expenditures - costs that can be saved by prevention, public awareness and health insurance plans specific to diabetes care. Research and programmes need to be initiated to minimize costs and prevent the epidemic.
[ABSTRACT]   Full text not available  [PDF]
  2,612 452 -
Relationship between periodontitis and diabetes among adults in Brunei Darussalam
P Lim, E Kruger, M Tennant
October-January 2013, 4(3):3-3
Periodontitis is one of the major causes of tooth loss and is consistently associated with various systemic diseases (periodontitis is often considered as the 6th complication of diabetes). The association of periodontitis and diabetes are well documented and a plausible biological mechanism associated with capillary dysfunction has been identified. In Brunei, there is no systematic linking of medical and dental providers in the management of patients with diabetes. The aim of this study was to evaluate some of the factors associated with periodontitis in adults with and without diabetes in Brunei Darussalam. Information on variables including gender, age, socio-economic status, smoking, fasting blood glucose levels (FBG) and periodontal health status of patients with diabetes and patients without diabetes were obtained from the Integrated Health Screening and Promotion for Civil Services (IHS) program. The study population comprised of 259 participants with diabetes (46.5%), and 298 without diabetes (53.5%). Patients with diabetes were 3 times more likely to have severe periodontitis (13.5%) compared to participants without diabetes (4.4%). Patients with undiagnosed diabetes were 12 fold and 1.5 fold more likely to have severe periodontitis compared to participants without diabetes and patients with uncontrolled diabetes respectively. In the study it was observed that patients with diabetes were more likely to suffer from severe periodontitis, especially if they were smokers or their diabetes was uncontrolled or undiagnosed. Among participants with and without diabetes, both age and socioeconomic status (SES) were significantly associated with severe periodontitis. It is recommended that dental care should be included in the management of patients with diabetes.
[ABSTRACT]   Full text not available  [PDF]
  2,277 394 -
Paresthesia of post-treatment painful diabetic neuropathy and its relation with glycemic control
S Takayama, Y Takahashi, Y Uchigata
October-January 2013, 4(3):1-1
Post-treatment painful diabetic neuropathy (PPN) usually develops several weeks after a rapid improvement in glycemic control and presents as dramatic, severe and refractory paresthesia in the lower extremities. We report a case of a Japanese patient with type 2 diabetes. The patient had experienced a long, untreated diabetic period of several years combined with poor glycemic control. Glycemic correction was performed 2 times, with PPN that occurred after the first treatment and no PPN after the second treatment. This case indicates that factors such as the speed of glycemic control, body weight trends, and the patient's mental condition may cause PPN. When a patient with poor glycemic control has rapid improvement in glycemic control, PPN and a mental conflict may occur. It is important that both the physical and mental aspects of the patient's situation and condition is communicated carefully and thoroughly to patients with PPN.
[ABSTRACT]   Full text not available  [PDF]
  2,257 357 -
Reasons for complications of type 2 diabetes mellitus observed in the United Arab Emirates: Physicians' opinion
E Mathew, A Mathew, J Muttappallymyalil, J Sreedharan, S.A.M. Ibrahim
October-January 2013, 4(3):7-7
The study explored diabetic complications and their reasons as observed by practicing physicians in the United Arab Emirates (UAE). A cross sectional study collected opinion of 107 multinational practicing physicians identified from across UAE using a snowballing technique. The majority of participants were males (81%); 62% from clinics and 38% from hospitals. More than 50% had experience in UAE for over 5 years. Fifty eight percent of physicians practicing in clinics and 80.6% from hospitals felt they had facilities for monitoring diabetes mellitus complications. The highest ranked complication was cardiovascular (64%) followed by peripheral neuropathy and ocular complications. They attributed the complications to poor glycemic control (22.4%), sedentary life -style (11.2%), smoking (10.3%), diet and co-morbidity (9.3% each) and obesity (4.7%); whereas the reasons for poor glycemic control were mainly low compliance (25.2%), life-style (18.7%), lack of awareness about the silent disease and complications (14%), finance (5.6%) and depression (0.9%). While no age, gender or occupational difference was reported, 57% of 46 who responded felt Asians were more affected. Cardiovascular complications and peripheral neuropathy were the most reported complications. The reasons for poor glycemic control were mainly low compliance, lifestyle and lack of awareness. Nation-wide campaigns and locally relevant professional training may improve the situation.
[ABSTRACT]   Full text not available  [PDF]
  2,278 331 -
Atypical Antipsychotic olanzapine induced diabetic ketoacidosis
AK Singh, PK Agrawal, J Ahmad
October-January 2013, 4(3):2-2
Atypical antipsychotic agents have been associated with hyperglycemia and diabetic ketoacidosis. We are reporting a case report of olanzapine associated with diabetic ketoacidosis.
[ABSTRACT]   Full text not available  [PDF]
  2,162 367 -