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Clifford, Rhonda Marise. "Pharmaceutical care in diabetes mellitus." Curtin University of Technology, School of Pharmacy, 2004. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=14951.
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People with diabetes mellitus are more likely to die from cardiovascular causes than those without diabetes, and modifiable risk factors, such as hyperglycaemia, dyslipidaemia and hypertension can be targeted in intervention programs to decrease this risk. In addition to tertiary care for patients with diabetes, there is a need for simple programs to be implemented in the community that allow the benefits of improved metabolic and blood pressure control to be realised more widely. Pharmaceutical care comprises the detection, prevention and solution of drug-related problems in a quantifiable form, so that outcomes of care can be easily reviewed and monitored. Previous studies of pharmaceutical care programs in patients with diabetes do not provide conclusive evidence of the benefit of pharmaceutical care. The aim of this research was to evaluate the impact of the provision of pharmaceutical care to patients with diabetes mellitus in an Australian context. In order to develop a pharmaceutical care program, the characteristics of an Australian cohort of patients with diabetes were reviewed. The Fremantle Diabetes Study (FDS), was a community-based prospective observational study of diabetes care, control and complications in a postcode-defined region of 120 097 people surrounding the port city of Fremantle in Western Australia. It was intended that the FDS annual reviews would provide important local information in order to design and implement a prospective pharmaceutical care program. A pilot pharmaceutical care program was subsequently developed for use in a diabetes outpatient clinic. This program was then modified for use in a community-based sample of type 2 diabetes mellitus patients, drawn from the FDS cohort.Demographic parameters, including ethnicity and treatment details, were reviewed at study entry for the full FDS cohort and then over time for a subset of patients that returned for four subsequent annual assessments. Insulin use was more common in patients of Southern European origin compared with the Anglo-Celt group irrespective of the level of glycaemia, at baseline. This difference persisted during subsequent follow-up but was not associated with improved glycaemic control. These findings demonstrated that there are important ethnic differences in the management of patients with type 2 diabetes mellitus. The pilot pharmaceutical care program was carried out in high-risk diabetes mellitus patients attending a hospital outpatient clinic. The patients had poor glycaemic control, dyslipidaemia, hypertension and/or were on three or more prescription medications. In the pharmaceutical care arm, a clinical pharmacist reviewed and monitored all aspects of the patients' drug therapy in collaboration with other health care professionals at six weekly intervals for six months. The control patients received usual outpatient care. Seventy-three patients were recruited into the study, of whom 48 (66%) were randomised to receive pharmaceutical care. One in six patients was taking complementary medicines. The pharmaceutical care program provided patients with important medication information that resulted in changes to drug therapy. However, the six-month program did not lead to an improvement in glycaemic control. The next phase of the study adapted the pilot hospital-based pharmaceutical care program to a community-based setting.
Two hundred and two type 2 diabetes mellitus FDS patients were recruited, of whom 101 (50%) were randomised to the pharmaceutical care program, and all were followed for 12-months. There were significant reductions in risk factors associated with coronary heart disease in the case but not the control group over time, specifically glycaemic control, lipid levels, and blood pressure. Glycosylated haemoglobin fell from 7.5% to 7.0% (P<0.0001), total cholesterol fell from 5 mmol/L to 4.6 mmol/L (P<0.0001), systolic blood pressure fell from 158 mmHg to 143 mmHg (P<0.0001) and diastolic blood pressure fell from 77mmHg to 71mmHg (P<0.0001). Multiple linear regression analysis confirmed that pharmaceutical care program involvement was an independent predictor of benefit after adjustment for key variables. The 10-year coronary heart disease risk for patients without a previous coronary event was reduced by 4.6% over the 12-month study period in the pharmaceutical care group (P<0.0001), while there was no change in the controls (P=0.23). This phase of the study showed that medium-term individualised pharmaceutical care reduced vascular risk factors in a community-based cohort of patients with diabetes and that provision of a multifactorial intervention can improve health outcomes in type 2 diabetes mellitus. As part of the pharmaceutical care program, a high level of complementary medicine use was found. As a result, a study of complementary medicine use was undertaken in 351 patients from the FDS. A convenience sample of FDS patients was interviewed regarding their use of complementary medicines. A literature search was conducted to assess the potential impact of these medicines on diabetes, concomitant medications or diabetes-related co-morbidities.
Eighty-three of 351 (23.6%) patients with diabetes had consumed at least one complementary medicine in the previous year and 42% (77/183) of the products potentially necessitated additional patient monitoring or could be considered potentially inappropriate for a diabetic patient. The data indicated the need for patient disclosure of complementary medicine use and adequate monitoring for complementary medicine-related adverse events, as part of the pharmaceutical care process. The pharmaceutical care model was established to provide a framework by which drug use could be improved to enhance patients' clinical and health-related quality of life outcomes. For the present study, a straightforward pharmaceutical care program was adapted from a hospital setting to a community setting, where the principal requirement was a clinical pharmacist who had completed a self-directed diabetes-training program. In this context, clinically relevant parameters improved over the course of the study period. Pharmaceutical care programs such as this can begin the process of translating the findings of large and expensive clinical trials into standard clinical practice.
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Elrayah-Eliadarous, Hind. "Economic burden of diabetes on patients and their families in Sudan /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-450-1/.
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Aly, Fatima Zahra. "Oral yeast infection among patients with diabetes mellitus." Thesis, University of Edinburgh, 1993. http://hdl.handle.net/1842/19616.
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Patients with insulin-dependent diabetes mellitus (IDDM) (n = 231) or non-insulin dependent diabetes mellitus (NIDDM) (n &61 205) were selected as models for investigation of oral yeast infection in immunocompromised host. The general objectives were: 1. to assess the contributions of genetic and environmental factors to colonization by yeast and development of denture stomatitis; 2. to assess the effects of the differential distribution of H and Lewis blood group antigens on epithelial cells of secretors and non-secretors on attachment of C. albicans. Predisposing factors contributing to colonization and development of denture stomatitis are distinct for individuals with IDDM compared with those with NIDDM. By multivariate analyses, palatal and overall oral carriage of yeast among individuals with IDDM was associated with age (p < 0.01). The factor contributing to palatal carriage of yeasts among individuals with NIDDM was poor glycaemic control (p &60 0.05); carriage in the oral cavity as a whole was influenced additionally by non-secretion of ABH blood group antigens. Introduction of a denture altered the risk factors. For individuals with IDDM, overall oral carriage was associated with the presence of retinopathy (p < 0.05) and palatal carriage by poor glycaemic control (p < 0.05) and age (p < 0.05). For those with NIDDM palatal carriage was associated with continuous presence of the denture (p < 0.01) and overall oral carriage with raised plasma glucose levels (p < 0.05). Denture stomatitis was associated with poor glycaemic control among subjects with IDDM and for those with NIDDM with continuous wearing of dentures, large numbers of yeasts and non-secretion. Host pathogen interactions underlying the increased susceptibility of non-secretors to colonization were explored. Buccal epithelial cells (BEC) from secretor and non-secretor donors were assessed by flow cytometry for their ability to bind yeasts. C. albicans 2346 which expresses an adhesion that binds fucose, the immunodominant sugar of the H and Lewis blood group antigens, was used. There was a trend for BEC from non-secretors to bind more C. albicans 2346 compared with BEC from secretors. These results suggested that Lea antigen present at higher levels on cells from non-secretors might be one of the receptors for C. albicans 2346.
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Mbaya, John Kabamba. "Lay beliefs of type 2 diabetic patients at Prince Mshiyeni Memorial Hospital, Durban." Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/547.
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Thesis (M Med(Family Medicine))--University of Limpopo (Medunsa Campus) 2010.Aim & Objectives Aim: To explore the lay beliefs of type 2 diabetic patients seen at Prince Mshiyeni Memorial Hospital. Objectives: To understand lay beliefs of effective life long management of type 2 diabetes patients and consequently to make recommendations of improving management of diabetes in conjunction with the findings of the study. Methodology Study Design: An exploratory study from a qualitative perspective using free attitude interviews as a data collection technique. Setting: Prince Mshiyeni Memorial Hospital a district hospital located in Umlazi in the outskirts of Durban, South Africa. Study Population: All type 2 diabetic patients above the age of 40 on treatment for 18 months or more. Ten respondents were purposively selected using maximum variation sampling strategy. Participants were asked individually to give an account of their beliefs and experience in the management of diabetes. All interviews were tape recorded, transcribed verbatim, and analyzed to identify emerging themes. Results The interpretative thematic analysis generated the following main themes: 1) Combination therapy 2) Modern versus Traditional 3) The bitter stuff 4) Traditional healers and alternative remedies viii 5) Stress: Physical, financial, emotional, psychosocial strain 6) Spiritual believes: Religious and Traditional 7) Eating right food and loose weight Conclusions This study has described most lay beliefs about the management of type 2 diabetes in this setting. The research has identified that type 2 diabetic patients seen at Prince Mshiyeni Memorial Hospital in Umlazi South of Durban held different diabetes management beliefs based on their respective initial symptom perception and beliefs, their illness origin and healing beliefs, their spiritual and traditional beliefs and values and to a significant extent, the beliefs of spouses or life partner in couples and of family members. These findings have challenged the functionality of the health care in its capacity to respond to the population expectations based on their ethnic, spiritual and cultural background.
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Zaczek, Anna. "Cataract surgery in patients with diabetes mellitus : clinical studies /." Stockholm, 1999. http://diss.kib.ki.se/1999/91-628-3557-2/.
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Dhatariya, Ketan. "The management of hospital in-patients with diabetes mellitus." Thesis, University of East Anglia, 2017. https://ueaeprints.uea.ac.uk/65366/.
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In the UK, the prevalence of diabetes in adults in the general population is currently reported as just over 6% in 2014-15 [1]. This rose from a prevalence of 5.5% in 2010. However, the most recent data from the 2016 United Kingdom National Diabetes In-patient Audit reported that the prevalence of diabetes amongst hospitalised in-patients was 17% [2]. This represented a rise of over 15% since the first National Diabetes In-patient Audit was carried out in 2010, and was the same rise in prevalence seen in the general population during that time. Thus diabetes is disproportionately over represented in the in-patient population. It has been recognised for many years that in-patients with diabetes experience ‘glucose-related’ harms. Any form of dysglycaemia is associated with increased harms – in terms of poor outcomes (however that is defined) and also increased mortality [3]. For many years it was well recognised that having long term high glucose concentrations was associated with an increased risk of developing the long term micro and macrovascular complications of diabetes. It was only with the publication of the two seminal trials, the Diabetes Control and Complications Trial in type 1 diabetes and the United Kingdom Prospective Diabetes Study in type 2 diabetes that showed conclusively that in an outpatient population tight glycaemic control was associated with a reduced risk of developing those complications [4,5]. However, to date whilst there are a great deal of data to show that high glucose concentrations are associated with harm in hospitalised in-patients with diabetes, there are almost no data to show that improving glucose concentrations is associated with benefit. However, most authorities agree that glucose concentrations between 6.0 and 10.0mmol/l (with an acceptable range of 4.0 to 12.0mmol/l) are likely to be most beneficial (or rather, least likely to be associated with harm). In the UK there is an organisation called the Joint British Diabetes Societies for Inpatient Care group (JBDS), of which I am a senior member. JBDS is a group of professionals interested in the care of in-patients with diabetes. This group, which is funded by Diabetes UK and the Association of British Clinical Diabetologists and is a collaboration between these two national organisations and the National Diabetes Inpatient Specialist Nurse Group, had as it’s ‘mission statement’ the focus on producing evidence based or, where this was not possible, consensus based, clinical guidelines for the management of diabetes in hospitalised in-patients. These guidelines were designed to be used by non-specialists, and written in a user friendly way to make them clinically useful. I have been involved in writing or contributing to most of the guidelines produced by the group, and have been the lead author on two of the most widely read / used documents – peri-operative care and diabetic ketoacidosis. Indeed, as a result of my involvement in these writing groups, I am now recognised as an international expert on these two subjects. I am regularly invited to speak on these subjects, but also invited to write about them as well. This thesis is a journey through various aspects of my involvement in in-patient care for patients with diabetes from the time I was first appointed as a consultant in Norwich in 2004 to the spring of 2017. In particular my hypothesis is that because of the work I and others have published, the management of in-patients with diabetes has improved the care of this vulnerable group.
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Manfredi, M. "Characteristics of Candida isolates from patients with diabetes mellitus." Thesis, University College London (University of London), 2006. http://discovery.ucl.ac.uk/1444965/.
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The present research has investigated the molecular characterization of oral yeasts in healthy individuals from different dental clinical settings in the United Kingdom, and patients from the UK and Italy who were affected by diabetes mellitus (DM) to determine the impact of DM upon candidal infection of the mouth. In the present study of patients with DM from the UK and Italy a lower than expected incidence of oral candidal infections (7/249, 2.8%) was observed. The presence of oral yeasts and genotypic diversity of C. albicans was also not influenced by DM. There was no significant difference between the presence of oral yeasts in Italian and UK DM patients. However, more (p=0.04) C. dubliniensis isolates were found in non-DM individuals. Higher levels of Candida adhesion to fibronectin-coated paramagnetic beads were observed in isolates from DM patients. Isolates from patients with low oral yeast loads adhered significantly (p=0.0T) more than those from patients with high oral yeast loads. In general, there was no difference in proteolytic activity of isolates from DM or control patients. Candida isolates from UK DM patients had significantly greater in vitro resistance to azole antifungal agents (miconazole p<0.0001 fluconazole p=0.02 ketoconazole p=0.01) than those from Italian DM patients. In addition, C. albicans isolates from all examined patients were more susceptible to fluconazole (p=0.0008) and miconazole (p=0.01) than non-C. albicans strains. PCR fingerprinting and subsequent phylogenetic analysis revealed that C. albicans isolates from UK DM patients were the most diverse (p<0.0001) in comparison to those from Italian DM patients or from healthy subjects. Finally, it was observed that the activity of a rat IgM monoclonal anti-idiotypic antibody (mAbKlO) and a synthetic decapeptide (KP) had a significant dose- dependant fungicidal activity upon a wide spectrum of C. albicans and non-C albicans isolates from patients with and without DM.
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Hanna, Natashi, and Salih Sonia Samir. "Övergången från pediatrisk vård till vuxenvård vid typ 1 diabetes : Patienternas upplevelser." Thesis, Ersta Sköndal högskola, Institutionen för vårdvetenskap, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:esh:diva-4999.
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Bakgrund: Diabetes typ 1 är en sjukdom som medför stora förändringar i en persons liv. I denna förändring ingår flera övergångar, b.la. att övergå från frisk till sjuk men också övergå från pediatrisk vård till vuxenvård. Det är organisatoriska skillnader mellan den pediatriska vården och vuxenvården. Sjuksköterskan har olika roller i de två olika vårdformerna och på så sätt stöttas patienterna på olika sätt. Syfte: Syftet med denna studie var att beskriva patienternas upplevelser av övergång från pediatrisk vård till vuxenvård vid diabetes typ 1. Metod: Författarna har använt sig av en litteraturöversikt för att strukturera och skapa en överblick över det valda området och för att besvara syftet. Författarna har använt sig av tio vetenskapliga originalartiklar där de sammanställt ett resultat som svarar på denna litteraturöversikts Resultat: Resultatet visade att patienterna hade personliga åsikter kring utmaningarna under övergången. Patienterna hade olika inställningar inför övergången från pediatrisk vård till vuxenvård. Patienterna ansåg att förbättringar borde göras på organisationsnivå p.g.a. brist på struktur under övergången samt dålig kommunikation med patienterna. Diskussion: Sjuksköterskor är i behov av kunskap angående patienternas upplevelser av övergången för att kunna förbättra sin egen roll. När patienter övergår från pediatrisk vård till vuxenvård upplever de stress och påfrestningar på grund av sämre vägledning från den pediatriska vården. Både den pediatriska vården och vuxenvården är i behov av en praktisk struktur för övergången, detta för att dämpa känslor av oro som kan uppkomma hos patienterna.Background: Diabetes type 1 is a disease that causes big changes in a person's life. The changes include various transitions, for an example transition from healthy to ill but also the transition from pediatric care to adult care. There are organizational differences between the pediatric care and adult care. Nurses have different roles in these two different treatment modalities that leads to the support being different too. Aim: The aim of this study was to describe patient’s experiences of transition from pediatric care to adult care of diabetes type 1. Method: A literature overview was used to structure and give the reader an overview of the selected area and to answer the purpose. Ten original scientific articles were used to compiled research that fulfill the purpose of this study Results: The result showed the patients personal views about the challenges during the transition. Patients had different feelings about the transition from pediatric care to adult care. The patients felt that improvements should be made in the organization level due to the bad structure during the transition. According to patients improvements should also be made with communication. Discussions: Nurses are in need of more knowledge about patients experiences of transition in order to improve their own role as a nurse. The patients feel stress and strain because of the transition from pediatric care to adult care. The patients felt stress also because there was no guidance from the health system under the transition period. The pediatric care and the adult care are in need of a structure to be able to decrease the unrest for patients.
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Pepe, Banza Kalenga. "The Profile of patients diagnosed with type 2 diabetes mellitus at Vanga Hospital, Dr Congo." Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/780.
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Thesis (Family Medicine)) -- University of Limpopo, 2010.Background In the Vanga Health Zone, diabetic patients have idea that diabetes is due to witchcraft, which idea can interfere with the prevention and management of their disease. The purpose of this study was to determine the profile of patients diagnosed with type 2 diabetes mellitus at Vanga Hospital, Democratic Republic of Congo (DR Congo). Methods A cross-sectional study was designed with use of a questionnaire to a systematic sample of type 2 diabetic patients attending the diabetic clinic of Vanga hospital for at least six months and resident at Vanga health zone. Results Only 2.1 % of the participants believe in a scientific cause for diabetes; 53.5 % of them do not think that their disease is due to the fact that they crossed over a path where some ritual was performed and, 89.2 % of the participants believe that God deserted the person who suffered from diabetes and expect that prayer will rectify the disease. The majority of participants (65.6 %) had poor glycaemic control. Correlation analysis has shown that glycaemia level was not significantly associated with sociodemographic characteristics or health belief factors. Conclusion The majority of patients at the Vanga diabetic clinic have a greater need for management strategies to improve their glycaemic control. Keywords: type 2 diabetes mellitus, health beliefs, knowledge, sub-Saharan Africa, rural
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Walker, Kelly N. "Family functioning and diabetic ketoacidosis in pediatric patients with type i diabetes." [Gainesville, Fla.] : University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0004901.
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Thesis (M.S.)--University of Florida, 2004.Typescript. Title from title page of source document. Document formatted into pages; contains 42 pages. Includes Vita. Includes bibliographical references.
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Turk, E. (Eva). "Patient reported outcomes in elderly patients with Diabetes Mellitus Type 2 in Slovenia." Doctoral thesis, Oulun yliopisto, 2013. http://urn.fi/urn:isbn:9789526203263.
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Abstract The aim of this thesis was to measure patient reported outcomes, such as health related quality of life and general diabetes knowledge of elderly diabetes mellitus type 2 (DMT2) patients in Slovenia. Patient reported outcomes demonstrate patient perspectives when evaluating the delivery of care. In Slovenia, a new, multidisciplinary model of chronic care was introduced in 2011, which yet needs to demonstrate the efficiency, care improvement and cost reduction. Thus, another aim of the study was to research if multidisciplinary teams in diabetes care are economically viable. To achieve the above, the study was divided into 4 subprojects. Firstly, the general level of diabetes knowledge of elderly DMT2 patients (n=179) was measured. Secondly, the reliability and validity of generic, European Quality of Life- 5 Dimensions (EQ-5D), and disease specific, Audit on Diabetes Dependent Quality of Life (ADDQoL ) instruments were examined. Thirdly, health related quality of life of elderly diabetic patients (n=285) was assessed. Fourthly, the systematic literature review on the cost-effectiveness of multidisciplinary teams was conducted. The data were collected during the period 2011–2012. The main contributions of the current thesis can be summarised as follows: This was the first study to measure general diabetes knowledge of elderly DMT2 patients in Slovenia. The results showed that the place of living does not have an impact neither on diabetes knowledge nor the health related quality of life of these patients. Secondly, a pioneering example of measuring health related quality of life (HRQoL) in elderly diabetic patients in Slovenia, using a validated and reliable instrument (ADDQoL) was provided. A study to evaluate the relationships between diabetic and other co-existing chronic medical conditions on health related quality of life was performed. As part of that study, the reliability and validity of the instruments (EQ-5D and ADDQoL) were measured, and the analysis showed that both instruments are reliable. Thirdly, a systematic way of finding evidence for understanding the cost-effectiveness of multidisciplinary teams was applied. The results of the literature review show weak improvements in the economic outcomes. In general, the thesis contributes to the improved understanding of patient reported outcomes in elderly diabetic patients, which can be a measure in assessing diabetes care program in Slovenia, and offers a basis for a national evaluation of the Model Practices. Furthermore, patient reported outcomes of elderly diabetic patients is important to Slovenian decision makers to identify and implement appropriate interventions for achieving better management of diabetes and ultimately improving the quality of life of diabetes patientsTiivistelmä Tutkimuksen tarkoitus oli mitata iäkkäiden tyypin 2 diabetespotilaiden itse ilmoittamia tuloksia, kuten terveyteen liittyvä elämänlaatu ja yleinen diabetekseen liittyvä tietämys Sloveniassa. Tulokset valottavat potilaiden näkökulmaa hoidon arvioinnissa. Sloveniassa otettiin 2011 käyttöön monitieteellinen hoitomalli, jonka tehoa sekä kykyä parantaa hoitoa ja vähentää hoitokustannuksia ei ole osoitettu. Toisena tavoitteena oli selvittää, onko moniammatillisten tiimien käyttö diabeteshoidossa taloudellisesti järkevää. Tutkimus jaettiin neljään osaprojektiin. Ensin mitattiin iäkkäiden tyypin 2 diabetespotilaiden (n=179) yleistä diabetestietämystä. Toiseksi selvitettiin geneerisen European Quality of Life- 5 Dimensions- (EQ-5D) ja diabeteskohtaisen ADDQoL -mittarin luotettavuus ja validiteetti. Kolmanneksi arvioitiin iäkkäiden diabetespotilaiden (n=285) terveyteen liittyvää elämänlaatua. Neljänneksi tehtiin moniammatillisten tiimien kustannus¬tehokkuutta koskeva systemaattinen kirjallisuuskatsaus. Tiedot kerättiin vuosina 2011–2012. Tulokset voidaan tiivistää seuraavasti: Kyseessä oli ensimmäinen tutkimus, jossa mitattiin iäkkäiden tyypin 2 diabetespotilaiden yleistä diabetestietämystä Sloveniassa. Tulosten mukaan asuinpaikka ei vaikuta potilaiden diabetestietämykseen tai terveyteen liittyvään elämänlaatuun. Toiseksi, Sloveniassa toteutettiin pioneerihanke, jossa mitattiin iäkkäiden potilaiden terveyteen liittyvää elämänlaatua (HRQoL) validoidun ja luotettavan instrumentin (ADDQoL) avulla. Tutkimuksessa selvitettiin diabeteksen ja muiden pitkäaikaissairauksien yhteisvaikutusta terveyteen liittyvään elämänlaatuun. Osana tutkimusta selvitettiin instrumenttien (EQ-5D ja ADDQoL) luotettavuus ja validiteetti. Molemmat osoittautuivat luotettaviksi. Kolmanneksi, tutkimuksessa etsittiin systemaattisesti näyttöä moniammatillisten tiimien kustannustehokkuuden arvioimiseksi. Kirjallisuuskatsauksen mukaan taloudellinen tulos paranee vain vähän. Tutkimus lisää tietoa potilaiden ilmoittamista tuloksista iäkkäiden diabetespotilaiden kohdalla, mitä voidaan käyttää diabeteshoito-ohjelman arvioinnissa Sloveniassa sekä mallikäytäntöjen kansallisen arvioinnin perustana. Diabetespotilaiden itse ilmoittava terveystieto on Slovenian päätöksentekijöille tärkeää sopivien interventioiden löytämisessä ja toteuttamisessa, kun halutaan parantaa diabeteshoitoa ja potilaiden elämänlaatua
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Påhlsson, Hans-Ivar. "Methodological aspects of toe blood pressure measurements for evaluation of arterial insuffiency in patients with diabetes /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-181-4/.
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Hägglund, Adel, and Suan Cing Nem. "Patienters erfarenheter av egenvård vid Diabetes Mellitus Typ 2 : Literaturstudie." Thesis, Högskolan i Gävle, Avdelningen för hälso- och vårdvetenskap, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-28823.
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Bakgrund: Diabetes typ 2 (DMT2) står för majoriteten av all diabetes i Sverige som internationellt, vilket har satts i samband med vår moderna livsstil, minskad fysisk aktivitet och en tilltagande ökning av kroppsvikt. Orsaken kan t.ex. relateras till patientens ärftliga betingad eller individens levnadsvanor. Egenvård är viktig för att förebygga eller minska senkomplikationer. Syftet: Syftet med det föreliggandeexamensarbetetvar attbeskriva vuxna patienters erfarenheter av egenvård vid DMT2samt granska datainsamlingsmetoder och urvalsgrupp använts i artiklarna. Metod: Litteraturstudieutfördes med en beskrivande design där sammanfattas 12 kvalitativa artiklar. Huvudresultat:Patienter hade positiv inställning livsstilsförändringar och började ta ansvar för sin egenvård. En del patienter hade svårigheter att ta till sig kunskaper och tillämpa dessa i sin egenvård, arbetssituation påverkad, låg inkomst och en känsla av utanförskap både från hemmet och omgivningen. En del av patienter upplevde socialt stöd från familj och närstående samt hade god kontakt med vården. Slutsats:Föreliggande examenarbetevisade att patientens levnadssituation, relation till sin omgivning måste sättas i centrum. Patienten möjlighet att få en vårdkontakt förbättras, med syfte att ge individanpassad kunskap, motivera och ge mer tid. Vidare forskning bör undersöka familjens förhållningssätt till personen som har DMT2 för att få en djupare förståelse om vad familjen kan göra för att skapa en holistisk syn. Nyckelord: DMT2, Egenvård, Erfarenhet, Vuxna patienterBackground:Diabetes type 2 (DMT2) accounts for the majority of all diabetes in Sweden as well as global, which has been associated with our modern lifestyles, reduced physical activities and an increase in body weight. Causes can be, for example, related to the patient's hereditary condition or the individual's living habits. Self-care is important to prevent or reduces the late complications. Aim: The aim of the present thesis was to describe adult patients’ experiences of self-care with DMT2 and examine the data collection methods and sample group used of the articles. Methods: A literature study was conducted with a descriptive design summarizing 12 qualitative articles. Main result: Patients had positive attitude to lifestyle changes and began taking responsibility for their self-care. Some patients had difficulty in acquiring knowledge and applying them for their own care, affected in work situation, weak income and a sense of alienation both at home and surrounding. Some of patients experienced social support from family and close relatives and had good contact with healthcare. Conclusion: The present study shows that the patient's living situation, relationship with his surrounding, must be placed at the center. The patient possibilities for care contact should be improved in order to give him individualized knowledge, motivate and give more time. Further research should investigate the family's approach to the person with DMT2 to gain a deeper understanding of what the family can do to create holistic view. Keyword: Adult patients,DMT2, Experience, Self-care,
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Taslimuddin, Shaheda. "Immune response to insulin in type 1 diabetic patients." Thesis, University of Bath, 1990. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.257186.
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Grant-Thomson, Richard Grant. "Periodontal disease and type 1 diabetes mellitus in young patients /." [St. Lucia, Qld. : s.n.], 2002. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16646.pdf.
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Dula, Erin, Brady Workman, Saravanan Elangovan, and Jacek Smurzynski. "Investigation of Auditory Processing Deficits in Patients with Diabetes Mellitus." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/1580.
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The incidence of Diabetes Mellitus (DM) is about 9.6% in the US, and its prevalence is increasing rapidly and globally (NIDDKD, 2007). A common, but under-recognized, complication of DM is hearing difficulties. Although epidemiological studies (Bainbridge, et al., 2008) suggests that individuals with diabetes are twice as likely to have hearing loss as non-diabetic individuals, research on DM-related auditory deficits is relatively sparse and have been inconclusive and/or ambiguous regarding the nature of the hearing loss. We tested the hypothesis that the DM-related listening difficulties are manifestations of subclinical deficit(s) in higher-order auditory processing. Following a routine audiological evaluation, we examined a group of adult DM (Type II) patients with tests that assessed peripheral (high-frequencyaudiometry) and central processing (spatial listening, listening in competing noise, temporal processing and contralateral-suppression of OAEs) abilities. Our results indicate elevated high frequency pure-tone (>4 kHz) thresholds, increased difficulty listening in competing noise, poorer spatial listening skills, and poorer temporal processing abilities in the group of DM patients when compared to controls. These results suggest that central auditory processing deficits in patients with DM are more striking than commonly investigated peripheral deficits and thus contribute, and probably exacerbate, the functional listening difficulties experienced by these patients.
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Ramasobane, Maureen Khanyisa Mlati. "A description of the knowledge, understanding and outcome of disease management in diabetic patients in dedicated, semi-dedicated and non-dedicated institutions." Thesis, University of Limpopo (Medunsa Campus), 2010. http://hdl.handle.net/10386/211.
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Thesis (MSc.(Med.)(Pharmacy))--University of Limpopo, 2010.Diabetes Mellitus (DM) is a self -managed condition and it is essential for patients to have the relevant knowledge, skills and attitudes needed for successful diabetes management. Follow-up and proper counselling are major components in diabetes management as these will improve adherence and optimise diabetes management. The aim of this study was to compare the knowledge, understanding and outcome of the disease management in four health institutions ; a dedicated institution, a semi-dedicated institution and two non-dedicated institution. The study objectives were: To describe the level of knowledge and understanding of diabetic patients in the management of their condition at the different institutions , to describe the outcome of diabetes management at the different institutions , to describe consulting and dispensing times for diabetic patients at the different institutions , and to obtain patients’ perceptions on the quality of the health care services pertaining to the treatment of their diabetes. A total of 120 patients were interviewed, 30 per institution. A questionnaire was used to collect data for the different objectives. Prospective and retrospective data were collected. Knowledge of DM was assessed in ten patients from each institution. Patients were asked to explain their understanding on five aspects of the condition. Median scores for patients from the two non-dedicated institutions were compared using Wilcoxon two-sample test, and were found not to differ significantly for any of the questions or the overall score. The groups did not differ significantly in their understanding of whether there was a cure for diabetes mellitus and in their understanding of hypoglycaemia and its management. Patients at the dedicated clinic were significantly more knowledgeable of the condition, it’s causes and their overall understanding of the questions asked. Hyperglycaemia and its management were understood significantly better by the patients at the dedicated iv institution than those at the non-dedicated institutions , with patients at the semi-dedicated institution not differing significantly from either group. The outcome of diabetes management was recorded from the patients file for a six month period. The proportions of elevated blood pressure results recorded at the three institution types differed significantly. The semi-dedicated institution had a significantly higher proportion of uncontrolled blood pressure results (33 of 55 results recorded, or 60%) than the non-dedicated institutions (32 of 91, 35%) or the dedicated institution (9 of 36, 25%,). None of the ten patients at the semi-dedicated institution had all their values within the controlled range, as compared to six of 20 at the non-dedicated and six of ten at the dedicated institution. The glucose control was least achieved in patients at the semidedicated institution, where only one of ten (10%) of patients had no recorded value outside the controlled range, as opposed to four of ten (40%) at the dedicated institution and nine of eighteen (50%) at the non-dedicated institutions. Median visit times differed between all types of institutions. Time spent on consulting and dispensing was the shortest at the non-dedicated (median=7min), it took longer at the semi-dedicated (median=9), and longest at the dedicated institution (median=18min). The patient’s perception on the quality of care was recorded for patients. They were asked whether they were satisfied with the amount of time that they spent with the healthcare worker. Patient satisfaction with visit time was not linked to the duration of the visit. Actual visit time did appear to be linked to patients’ perception of whether they got enough time to ask questions. As for perceived quality of service, fewer patients were informed about their progress at the non-dedicated institution than at the others. Family members of fewer patients were educated at the dedicated than at the other institutions. More patients at the dedicated institution than at the other institutions were informed of treatment changes. Suggestions for improvement of patient care were made by 18% of v patients attending non-dedicated institutions , 23% of patients at the semi-dedicated institution and 63% at the dedicated institution. The conclusion based on the results is that the more dedicated a service is, the better the diabetic care of patients. Patients at the dedicated clinic had more time with the health worker during consultation and dispensing of treatment. They were informed about treatment changes more than the patients at other institutions. Patients at the dedicated clinic also showed a better knowledge and understanding of their condition than patients in other institutions. They also had higher affirmative responses in terms of lifestyle modification as compared to the other institutions.
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Hörnsten, Åsa. "Experiences of diabetes care - patients' and nurses' perspectives /." Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-258.
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Zelada, Henry, Antonio Bernabe-Ortiz, and Helard Manrique. "Inhospital Mortality in Patients with Type 2 Diabetes Mellitus: A Prospective Cohort Study in Lima, PeruHenry Zelada." Hindawi Publishing Corporation, 2016. http://hdl.handle.net/10757/595272.
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Objective. To estimate cause of death and to identify factors associated with risk of inhospital mortality among patients with T2D. Methods. Prospective cohort study performed in a referral public hospital in Lima, Peru. The outcome was time until event, elapsed from hospital admission to discharge or death, and the exposure was the cause of hospital admission. Cox regression was used to evaluate associations of interest reporting Hazard Ratios (HR) and 95% confidence intervals. Results. 499 patients were enrolled. Main causes of death were exacerbation of chronic renal failure (38.1%), respiratory infections (35.7%), and stroke (16.7%). During hospital stay, 42 (8.4%) patients died. In multivariable models, respiratory infections (HR = 6.55, ), stroke (HR = 7.05, ), and acute renal failure (HR = 16.9, ) increased the risk of death. In addition, having 2+ (HR = 7.75, ) and 3+ (HR = 21.1, ) conditions increased the risk of dying. Conclusion. Respiratory infections, stroke, and acute renal disease increased the risk of inhospital mortality among hospitalized patients with T2D. Infections are not the only cause of inhospital mortality. Certain causes of hospitalization require standardized and aggressive management to decrease mortality.
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Leurs, Paul B. "Tissue factor pathway inhibitor in patients with diabetes mellitus an epiphenomenon? /." Maastricht : Maastricht : UPM, Universitaire Pers Maastricht ; University Library, Maastricht University [Host], 2001. http://arno.unimaas.nl/show.cgi?fid=6971.
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Lindberg, Gustav, and Love Sedell. "Egenvård vid diabetes mellitus typ 2 : - patienters erfarenhet." Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-43934.
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Bakgrund: Diabetes mellitus typ 2 är en kronisk folksjukdom. Sjukdomen kan leda till flera komplikationer både långsiktig och kortsiktigt. För att undvika komplikationer utförs därför egenvård. Vid egenvård tar sjuksköterskan tillvara på patientens resurser och låter patienten vara så självständig som möjligt. För att minska kostnaderna för vården men även ge patienterna större frihet att leva sina liv. Syfte: Att beskriva patienters erfarenheter av egenvård vid diabetes mellitus typ 2 Metod: En kvalitativ litteraturöversikt med induktiv ansats utifrån 12 artiklar, som analyserats med Fribergs femstegsmodell. Resultat: Två teman presenterades i resultatet ” Social påverkan av egenvården” och ”kunskapens betydelse för egenvården”. Slutsats: Patienters erfarenheter av egenvård visar att sociala grupper kan stötta men även skapa frustration. Kulturella och socioekonomiska tillhörigheter har en stor inverkan på egenvården. Kunskapen påverkar inställning till egenvård. Det är därför tydligt att det finns ett behov av individanpassad information. Egenvård är komplext men väldigt nödvändigt. Det finns många erfarenheter som påverkar egenvården. Dessa är baserade på patienternas och andras förståelse för egenvård och dess utmaningar. Sökord: Diabetes mellitus typ 2, Self care, kvalitativ, patientperspektiv.Background: Type 2 diabetes is a wide-spread chronic disease. Untreated diabetes leads to complications both long-term and short-term. Therefore, in order to avoid complications, self-care is performed, which means that the nurse takes advantage of the patients’ resources to let the patient be as independent as possible and therefore something that is desirable to maintain. This to reduce the cost of hospital care and give patients more freedom to live their lives. Purpose: To describe patients' experiences of self-care with diabetes mellitus type 2. Method: A qualitative review of literature with inductive approach based on 12 articles, analyzed by means of using Friberg's five step model. Result: Two repeated themes presented in the result "Social impact on selfcare" and "knowledge impact on self-care". Conclusion: Patients experiences of selfcare are that social groups can both be supporting but also frustrating. Culture and socioeconomic status have a big impact on selfcare. Knowledge affects compliance to selfcare. There is a need for personalization of information. Self-care is a complex but highly necessary resource, there are many experience’s that affect self-care. These factors are based on others' and their own understanding of self-care and its challenges. Keywords: Diabetes mellitus type 2, Self-care, qualitative, patients’ experience
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Delaguila, Michael Anthony. "Assessment of physical activity in patients with diabetes /." Thesis, Connect to this title online; UW restricted, 1998. http://hdl.handle.net/1773/10935.
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Watts, Gerald F. "Practical aspects of screening for and monitoring microalbuminuria in diabetes mellitus." Thesis, University of Southampton, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.316492.
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Yue, Pui-hang, and 余珮珩. "Social support and self-rated health among older adults with diabetes mellitus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1999. http://hub.hku.hk/bib/B31250798.
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Dahlan, Agus Abdurahim. "Effects of insulin on sleep in patients with insulin-dependent diabetes mellitus." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1996. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq23983.pdf.
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Pereira, Arias Alberto Martin. "Regulation of postabsorptive glucose production in patients with type 2 diabetes mellitus." [Amsterdam : Amsterdam : Thela-Thesis] ; Universiteit van Amsterdam [Host], 2000. http://dare.uva.nl/document/56918.
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Lam, Chun-yin Julia, and 林駿瑛. "Psychosocial correlates of illness control and adjustment in patients with diabetes mellitus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 1997. http://hub.hku.hk/bib/B29873034.
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Lam, Chun-yin Julia. "Psychosocial correlates of illness control and adjustment in patients with diabetes mellitus /." Hong Kong : University of Hong Kong, 1997. http://sunzi.lib.hku.hk/hkuto/record.jsp?B19882257.
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Aljasser, Arwa. "Sub-clinical auditory neural deficits in patients with type 1 diabetes mellitus." Thesis, University of Manchester, 2017. https://www.research.manchester.ac.uk/portal/en/theses/subclinical-auditory-neural-deficits-in-patients-with-type-1-diabetes-mellitus(f38802ad-19e7-4e6a-a674-339490bb3bf7).html.
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Diabetes mellitus (DM) is associated with a variety of sensory complications. Very little attention has been given to auditory neuropathic complications in DM. Three studies were designed to determine whether type 1 DM affects neural coding of the rapid temporal fluctuations of sounds, and how any deficits may impact on real-world listening tasks. Participants were 30 young normal-hearing type 1 DM patients, and 30 age-, sex-, and audiogram-matched healthy controls. The study in Chapter 4 used non-invasive electrophysiological measures of auditory nerve (AN) and brainstem function using the click-evoked auditory brainstem response (ABR), and of brainstem neural temporal coding using the sustained frequency-following response (FFR). There were no significant differences between DM patients and controls in the ABR. However, the DM group showed significantly lower FFR responses. The results of the study in Chapter 4 demonstrate that type 1 DM can impair phase locking to the temporal envelope and temporal fine structure (TFS) in the absence of a reduction in hearing sensitivity as measured by PTA and that FFR may provide an early indicator of neural damage in DM, before any abnormalities can be identified using standard clinical tests. In Chapter 5, behavioural tests of temporal coding (interaural phase difference, IPD, discrimination and the frequency difference limen, FDL), as well as tests of speech perception in noise were conducted. The DM group showed significantly higher IPD and FDL thresholds, as well as worse speech-in-noise performance. In Chapter 6, the Speech, Spatial and Qualities (SSQ) hearing scale was used to determine whether type 1 DM is associated with self-report of auditory disability in the absence of an elevation in audiometric threshold. The DM group had significantly lower overall SSQ scores and consistently reported significantly more difficulties than the control group on the Speech, Spatial and Qualities subscales. Overall, the findings of the studies in this thesis suggest that type 1 DM is associated with degraded neural temporal coding in the brainstem in the absence of an elevation in audiometric threshold, and that this deficit may impact on real-world hearing ability.
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Armstrong, Dometrives. "Educational Module Toolkit to Assist Adult Patients with Type II Diabetes Mellitus." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4498.
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Diabetes is a challenging chronic disease for adult patients to manage effectively. Poor adherence to prescribed medications treatment is one of the main reasons for poor blood sugar control. Despite healthcare providers' efforts to emphasize the importance of taking medications, adult patients with Type II diabetes frequently present with complications related to persistent failure to adhere to prescribed medication regimen. These patients should thoroughly understand why adhering to a strict medication regimen to maintain control of their blood sugar is so important. The purpose of this project, guided by Orem's self-care deficit nursing theory, was to develop an educational module toolkit that identifies best practices for nurses to address issues of medication adherence with adult patients with Type II diabetes. Future implementation of these toolkit resources may enhance nurses' ability to teach adult patients how to adhere to their medication regimen. Five participants, all considered professional diabetes content experts, were invited to evaluate the educational module toolkit subject matter. The completion response rate was 100% (n = 5). The content experts rated survey items using a 5-point Likert scale where 1= strongly disagree, 2= disagree, 3= not applicable, 4 = agree and 5= strongly agree and responded to 2 questions that allowed for narrative feedback. The experts were satisfied with the content of the educational module toolkit; suggesting that the toolkit may serve as a functional guide for nurses assisting adult patients with diabetes. Improved medication regimen compliance may produce cascading effects; helping these patients achieve a better quality of life while producing positive social change within their families and communities.
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Ollawa, Josephine Onyekachi. "An Instructional Module for Nurses to Teach Patients with Gestational Diabetes Mellitus." ScholarWorks, 2019. https://scholarworks.waldenu.edu/dissertations/7713.
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Gestational diabetes mellitus (GDM) is a carbohydrate metabolism issue during pregnancy that is dangerous for mother and the baby. GDM occurs in 1 out of 3 diabetic women in 16.2% of live births. GDM knowledge and treatment practices among nurses were found inadequate when nurses’ effectiveness in treating a disease they have a shallow knowledge about (GDM) was investigated in the local medical facility. A GDM instructional module was applied and its effectiveness in promoting nurse’s use of GDM education as a treatment strategy tested. The total concept for knowledge and care, empowerment and the social cognitive theories grounded this research. Methodology was Mixed. A population/patient problem-intervention-comparison-outcome-time (PICOT) design was applied in the analysis of data from a sample size {n=40}, whereby the treatment group (TG=20) had an intervention, and control group (CG=20) did not. Data was analyzed descriptively and inferentially with t-test statistic, including the Cohen’s d test for effect size. Evidence showed a significantly high post-intervention gain in scores CG and TG, higher among DNPs than other nurses. Also, the Cohen’s d test indicated high magnitude effect size. Overall confidence in GDM treatment method improved. A comparison of mean test completion time and scores indicated that TG completed the posttest at a shorter time than CG. Knowledge improvement results were TG 27%; CG 2%. GDM education is an effective path to positive social change, beneficial to nurses, the medical facility and the community. Improved GDM treatment means a healthier population and increased productivity for the community. GDM education is non-medicated and more affordable - a huge savings for the community.
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黃鉦沅 and Ching-yuen Wong. "Impact of diet on vascular function in patients with type II diabetes mellitus." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2009. http://hub.hku.hk/bib/B42904936.
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Wong, Ching-yuen. "Impact of diet on vascular function in patients with type II diabetes mellitus." Click to view the E-thesis via HKUTO, 2009. http://sunzi.lib.hku.hk/hkuto/record/B42904936.
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Rudolphi, Pernilla, and Desirée Burenlind. "Distriktssköterskors erfarenheter av att samtala om sexuell hälsa med patienter med diabetes mellitus : District nurse´s experiences of talking about sexual health with patients with diabetes mellitus." Thesis, Karlstads universitet, Fakulteten för hälsa, natur- och teknikvetenskap (from 2013), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kau:diva-65112.
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Introduktion: Diabetes mellitus är en av de folksjukdomar som många människor drabbas av. Det finns ett samband mellan diabetes mellitus och sexuell hälsa. Flera forskningsstudier visar att distriktssköterskor upplever svårigheter att samtala om sexuell hälsa med patienter. Syfte: Syftet var att belysa distriktssköterskors erfarenheter av att samtala om sexuell hälsa med patienter med sjukdomen diabetes mellitus. Metod: Kvalitativ metod med en induktiv ansats valdes. Semistrukturerade intervjuer genomfördes med tio distriktssköterskor och data har analyserats med hjälp av kvalitativ innehållsanalys. Resultat: Studiens huvudfynd resulterade i fem kategorier: män informeras om komplikationer, kvinnors sexuella hälsa försummas, frågan uppskattas, ett känsligt ämne och erfarenheter saknas. I resultatet framkom att majoriteten av deltagarna ansåg att sexuell hälsa var ett viktigt ämne att samtala med patienterna om, ändock lyfts sällan ämnet under samtalet. Det var främst patienten själv som tog upp ämnet. Konklusion: Studien visade att sexuell hälsa är ett ämne som oftast inte samtalas om med patienter inom primärvården. Det beror mycket på den enskilda distriktssköterskans kunskap och rutiner huruvida patienter med diabetes mellitus bjuds in till samtal om sexuell hälsa.Introduction: Diabetes mellitus is one of the people's diseases that many people suffer from. There is a connection between diabetes mellitus and sexual health. Several research studies show that district nurses experience difficulties in talking about sexual health with patients. Purpose: The aim was to describe district nurses' experiences of talking about sexual health with patients with diabetes mellitus disease. Method: Qualitative method with an inductive approach was chosen. Semi-structured interviews were conducted with ten district nurses and data were analyzed using qualitative content analysis. Results: The main findings of the study resulted in five categories: men are informed about complications, women's sexual health neglected, the subject is estimated, a sensitive subject and experience is lacking. The result showed that the majority of participants felt that sexual health was an important subject to talk about with the patients, but rarely raised the subject during the conversation. It was primarily the patient himself who raised the subject. Conclusion: The study showed that sexual health is a topic that is usually not discussed with primary care patients. It depends a lot on the individual district nurse's knowledge and routines whether patients with diabetes mellitus are invited to interviews about sexual health.
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Edmundsson, David. "Chronic exertional compartment syndrome of the lower leg a novel diagnosis in diabetes mellitus: a clinical and morphological study of diabetic and non-diabetic patients /." Doctoral thesis, Umeå : Department of Surgical and Perioperative Sciences, Othopaedics, Department of Integrative Medical Biology, Anatomy, Umeå university, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-33694.
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Adegbola, Saheed Adekunle. "Assessment of the level of adherence to treatment among type 2 diabetic patients in Matlala District Hospital." Thesis, University of Limpopo ( Medunsa Campus ), 2010. http://hdl.handle.net/10386/414.
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Thesis (M Med (Family Medicine))--University of Limpopo, 2010.The number of diabetic patients will continue to rise even in rural settings and the burden of this disease will continue to take its effect on the limited resources of these communities. The effect of such burden will be more pronounced if we are to add the various complications associated with substandard management of diabetes mellitus. The first step in assessing the level of care we give to this category of patients is to measure their level of adherence, in an effort to expose the pitfalls on both the side of the patients and on the side of the health care provider. The aim of the study is to assess the level of adherence to treatment among type2 diabetic patients in Matlala district hospital; Limpopo Province. This cross-sectional study used the convenience method of sampling with the aid of a tested, structured questionnaire, to obtain data from respondents between December 2009 and March 2010, a period of 4 months. The excel computer program was used for data capturing. Percentages and numbers were used for interpretation and cross tabulation was used to determine association. The result of the study indicated that 137 {70%} of the respondents adhere to diabetes treatment. There were two demographical characteristics that are significantly associated with non adherence: age {p=0.028} and employment status {p=0.018}. Of those respondents that keep their appointments, 98% are adherent to treatment. When considering reasons for poor adherence; 29% of respondents stated that the clinic did not have their pills, 16% stated that they forgot to take their medication and 14% stated that they travelled to visit ix and did not take enough pills with them. On the reasons for poor adherence to lifestyle: 29% of the respondents said that they were too old, 22% stated no specific reason, 13% struggled to motivate themselves and 10% simply forgot what to do. Most, 68%, of the respondents that adhere to the recommended use of medication agreed that they take it at meal time, 14% set a reminder, 8% employed the assistance of a treatment supporter and other respondents used other means to remember. The study revealed an above average level of adherence in my setting and it will be logical to assess whether this corresponds to the metabolic control expected of good adherence. More is needed to be done on the reasons why our patients do not adhere to both medication and lifestyle changes and each stake holder needs to address their short comings.
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Nyström, Thomas. "On endothelial function in type 2 diabetic patients with coronary artery disease /." Stockholm : Karolinska institutet, 2005. http://diss.kib.ki.se/2005/91-7140-318-3/.
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Bowman, Louise Jane. "The role of antiplatelet therapy in the management of patients with diabetes mellitus." Thesis, University of London, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.510782.
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Ternulf, Nyhlin Kerstin. "Patients' experiences in the self-management of diabetes mellitus : walking a fine line." Doctoral thesis, Umeå universitet, Medicin, 1990. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-101774.
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This study focuses on how diabetic patients manage to handle their disease,what has facilitated and what has impaired that process. The approach was to use a qualitative method as to enable the researcher to fathom the patients' point of view and to highlight their own experiences.Thus, the study is observational, describing processes, and does not aspire to give verification of the processes described. The study is based on interviews with 48 insulin dependent diabetic patients including newly diagnosed patients, patients who were regarded as well adapted with long duration of the disease but with no complications, and patients who had developed vascular complications. They were chosen in that way as to give a broad range of experiences representing different faces of the illness. It was found that the self-management of diabetes is an intricate matter, embodying categories that could be expressed as; Walking a fine line, Managing oneself physically, Managing oneself emotionally, Mastering life, Evading the problem of managing and Managing the health care system. Walking a fine line elucidates much of the behavioural variation in the data. It captures the patient's need to balance his emotional and physiological state, as well as his interactions with the health care system. Patients who manage the balancing act may enjoy good health but they are walking a fine line between maintaining this state and falling below par. It seemed that the ideal situation of interaction between the health care system and the patient was not applied in the context of the diabetic patients' everyday life. Patients had to invest considerable effort to cope, not just with their own condition, which is complex enough, but with the system officially charged to help them.Diss. (sammanfattning) Umeå : Umeå universitet, 1990, härtill 5 uppsatser.
digitalisering@umu
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Alshorman, H. M. "The association between periodontal disease and Type 2 diabetes mellitus in Jordanian patients." Thesis, Queen's University Belfast, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.479254.
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Stewart, Murray Willis. "Lipoprotein compositional abnormalities in non-insulin dependent diabetes mellitus patients with mild hyperlipidaemia." Thesis, University of Southampton, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.296467.
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Mackie, Scott W. "Ophthalmic dysfunction in patients with diabetes mellitus and the relation to driving performance." Thesis, Glasgow Caledonian University, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309401.
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Elangovan, Saravanan, Jacek Smurzynski, Emily Crewe, and Erin Dula. "Investigation of Auditory Processing Deficits in Patients With Type II Diabetes Mellitus (DM)." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1569.
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The incidence of DM is 9.6% in the USA with its prevalence increasing globally (NIDDKD, 2005). A common, but under-recognized complication of DM is hearing difficulty (~ 93%). However, the nature of this often sub-clinical dysfunction is still poorly understood. The aim of this study is to better understand DM-related hearing loss.
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Chai, Jim. "Patients' lived-experience of using insulin treatment for type 2 diabetes mellitus management." Thesis, University of Nottingham, 2015. http://eprints.nottingham.ac.uk/28039/.
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The prevalence of Type 2 diabetes mellitus (T2DM) has increased dramatically over the past 10 years in Malaysia due to the modernisation of the country. The most recent national health survey revealed that more than 15.2% of Malaysian adults are suffering from the diseases. Insulin treatment has been demonstrated to play a clinically significant role to improve glycaemic control among selected Type 2 diabetes mellitus (T2DM) patients. However, studies from several local hospitals showed that more than half of T2DM patients are reluctant to initiate insulin treatment. There is an increasing trend for the Malaysian healthcare sector to invest in understanding patients’ health experiences. This qualitative study focused on T2DM patients’ insights about their lived-experience of using insulin treatment as part of their diabetes management. This study aimed to understand the facilitators, which encourage patients to accept insulin treatment and also the psychological, social and behavioural barriers to effective diabetes management. Drawing on interview data with 37 participants, the three main barriers to initiate insulin treatment were worries about inability to handle using insulin, a sense of personal failure and negative perceptions of injections due to past experiences. The facilitators that encourage patients to accept insulin treatment were prior exposure to insulin injections, better side effect profile and wanting a better quality of life. However, there were many obstacles faced by T2DM patients when coping with insulin treatment such as the restriction of lifestyle and concerns about social acceptance. In general, knowledge of T2DM and insulin treatment are still lacking among the Malaysians interviewed in this study. There are still many distorted beliefs and misconceptions about insulin among T2DM patients. At the same time, patients’ concerns and beliefs regarding insulin use are greatly influenced by their experience and support from others. Many participants felt embarrassed and self-conscious when self-injecting insulin in public places. They felt that the Malaysian public often associate the use of injections to drug abuse. Social stigma is one key point, which leads to poor adherence to insulin treatment. Thus it is crucial to increase public awareness about insulin treatment in order to help these patients to be more comfortable about injecting, and also to encourage other people to be more open minded towards insulin treatment. Apart from raising public awareness, there is a need to empower T2DM patients with adequate knowledge through early, simplified, tailored education focusing on the disease nature and the role of insulin. Making them more aware of their health condition and the uses of modern insulin devices at an early stage will better prepare them mentally for insulin therapy.
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Pye, Theresa. "Impact of Group Medical Visits for Adult Patients with Type 2 Diabetes Mellitus." UNF Digital Commons, 2011. http://digitalcommons.unf.edu/etd/378.
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Diabetes is a condition that is primarily self-managed and lifestyle modifications such as diet, exercise, and weight management are necessary to reduce morbidity and mortality. Motivation to implement lifestyle modifications through self management is an integral part of disease management and studies have shown group medical visits are more effective than individual appointments in this patient population. The purpose of this project was to develop, implement and evaluate an evidencebased group medical visit program for up to a maximum of 8 adult patients with type 2 diabetes in a family practice setting for six months. Seven participants with abnormal A1C results accepted the invitation to attend group medical visits. Here surrounded by peers with the same diagnosis, they were able to learn and discuss methods to self manage their type 2 diabetes. At the conclusion post survey results indicate positive change in some lifestyle behaviors and improvement with hemoglobin A1C. However there was no improvement in weight management. A cost analysis reveals group medical visits may generate a small profit when compared to individual visits. Group medical visits may offer an effective means to motivate patients to make lifestyle change to reduce risk.
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Chan, Wan-Chen, and 戰琬珍. "To Evaluate the Medical Resources Utilization of Uremia in Diabetes Mellitus and Non-Diabetes Mellitus Patients." Thesis, 2007. http://ndltd.ncl.edu.tw/handle/38989329886614696615.
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碩士元智大學
資訊管理學系
95
During the past ten years, Diabetes Mellitus has been in either fourth or fifth place of the ten major causes of 11% to 13% death in Taiwan of people above the age of 40, suffer from Diabetes Mellitus. The complication incidence rate is 14% to 34%, which includes retinopathy, neuropathy, nephropathy and heart disease. Diabetes Mellitus with Uremia is the most common complication and is the main cause of death. According to a survey, it costs NT 21 Billion per year to cure Diabetes, 85.54% of the cost spent on Diabetes Mellitus with Uremia patients. 40% to 80% of the patients who have suffered Diabetes Mellitus after 15 to 20 years will develop neuropathy, and in five years, half of these patients will need Dialysis which not only influences the patient''s quality of life, but can also increase the medical utilization of resources. Data concerning the medical utilization in the years 2003 to 2005 were analyzed. According to age, education, marital status, complication kind and complication number and these factors influenced the number of inpatient visits, inpatient stays and inpatient expenditures. The medical resources utilization of Uremia in Diabetes Mellitus patients were more than Non-Diabetes Mellitus patients. Each result showed statistical significance. In conclusion, it is very important to establish public health policies for the elderly and a reliable standardized payment rate of Diagnosis Related Groups, and to get hospitals to join in with diabetes mellitus disease management. This would help to raise the medical quality and control the costs.
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Matwa, Princess Nonzame. "Experiences and footcare practices of patients with diabetes mellitus." Thesis, 2012. http://hdl.handle.net/10210/6758.
Full textAbstract:
M.Cur.The former Transkei is a predominantly rural region of the Eastern Cape Province. The poor infrastructure in this area results in inaccessibility of the available health services. The majority is ill equipped to deliver optimum diabetes care. There is an increase of lower limb amputations and lack of knowledge among patients with diabetes in the former Transkei. These complications can be prevented by patient education on self-management and appropriate footcare procedures. This qualitative study was conducted to explore and describe the experiences and footcare practices of diabetic patients who live in the rural areas of Transkei. A sample of 15 participants was drawn from Umtata Hospital Diabetic Clinic register through predetermined selection criteria. The sample consisted of five men aged 49 - 74 years, and ten women aged 30 - 64 years. Five patients (two men and three women) had foot ulcers or an amputation, while ten patients had no obvious foot problems. In-depth phenomenological interviews were conducted with all 15 patients. Interviews were tape recorded in Xhosa, transcribed, and translated into English for analysis. Direct observation of footcare was done with eight patients from the sample. Content analysis of the phenomenological interviews was facilitated by a protocol; and a checklist guided direct observation of footcare. A debate took place among the three coders to come to a consensus about the themes that emerged from their individual analyses. Guba's model of trustworthiness was utilised to ensure that the findings of this study reflect the truth. Ethical considerations were based on the guidelines cited by the Democratic Nursing Organisation of South Africa (1998: 2.3.1-2.3.4) and the South African Medical Research Council (1993: 32-44). Findings revealed predominantly negative experiences in the internal and external environments of the persons with diabetes; as well as poor footcare knowledge and practices. The recommendations relate to improving diabetes as well as footcare knowledge and skills through education; promoting adherence to diabetes treatment regimens; providing emotional support; improving the selfimage of persons with diabetes; changing health beliefs; improving the quality of diabetes care in public health facilities; and increasing diabetes awareness among employers of diabetic persons.
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Li, Weng Fong, and 李文豐. "Risk factors of diabetic nephropathy in patients with type 2 diabetes mellitus." Thesis, 2019. http://ndltd.ncl.edu.tw/handle/hmn4fj.
Full textAbstract:
碩士美和科技大學
生技科技系健康產業碩士班
107
The global prevalence of diabetes continues to rise.Hyperglycemia and diabetes not only increase the risk of death,but also cause complications of large and small blood vessels and neuropathy such as nephropathy. It’s a major threat to the health of peoples and a considerable burden of social and economic costs.To explore the risk factors of diabetic nephropathy in patients with type 2 diabetes mellitus.This is a cross-sectional, retrospective study. The medical records were collected of patients with diabetic nephropathy from January 2015 to December 2018.UACR and eGFR were used to define nephropathy.Demographic and biochemistry results were used for univariate analysis and multivariate analysis, using Chi-square test, independent sample t-test and logistic regression analysis. We enrolled 1256 patients with type 2 diabetes in this study, 400 peoples with albuminuria (UACR ≧ 30 mg/g) among 1011 people, the prevalence of albuminuria is 31.8%. 322 peoples had eGFR ≦ 60 ml/min/1.73 m2 among 1234 people, the prevalence of nephropathy is 25.7%.Univariate analysis using independent sample t-test and chi-square test found that education level, exercise, age, diabetes duration, systolic blood pressure, diastolic blood pressure, fasting blood glucose level, glycosylated hemoglobin (HbA1c) level, triglyceride level , high density cholesterol level (HDL), total cholesterol level, serum albumin level,hemoglobin level, uric acid level were statistically different between two groups classified by UACR. Education level, drinking, smoking, age, diabetes duration, systolic blood pressure, fasting blood glucose level, glycosylated hemoglobin (HbA1C) level, high density cholesterol level (HDL), serum albumin level, hemoglobin level, uric acid level were statistically different between two groups classified by eGFR. Diabetic nephropathy defined by UACR. Logistic regression found that, the risk of diabetic nephropathy increases 1.1 times (P < 0.001, 95% CI = 1.05-1.14), if diabetes duration increases 1 year; for every 1% increase in glycated hemoglobin, the risk of diabetic nephropathy increases 1.23 times (P < 0.001, 95%CI=1.10-1.37); higher serum albumin, lower risk of diabetic nephropathy (P=0.002, 95% CI=0.31-0.78); for every 1 mg/dl increase in uric acid, the risk of diabetic nephropathy increases 1.25 times (P=0.001, 95% CI=1.10-1.42). Diabetic nephropathy defined by eGFR, the risk of diabetic nephropathy increases 1.13 times(P<0.001, 95% CI=1.07-1.20) , if diabetes duration increases 1 year; for every 1 mmHg increases of systolic blood pressure, the risk of diabetic nephropathy increases 1.02 times (P=0.016, 95%CI=1.00-1.04); for every 1% increase in glycated hemoglobin, the risk of diabetic nephropathy increases 1.44 times (P<0.001, 95% CI=1.22-1.70); higher hemoglobin, lower risk of diabetic nephropathy (P= 0.002, 95% CI=0.63-0.89); for every 1 mg/dl increase in uric acid, the risk of diabetic nephropathy increases 1.31 times (P=0.001,95% CI=1.12-1.55).Patients with type 2 diabetes have predictors for diabetic nephropathy, including diabetic duration, glycated hemoglobin, systolic blood pressure, serum albumin, uric acid, and hemoglobin. In addition to tight control of blood glucose, people with type 2 diabetes should pay attention to control blood pressure and monitor biochemical indicators such as serum albumin, uric acid and hemoglobin to slow the progression to diabetic nephropathy.
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chu, chiu ying, and 邱盈珠. "Risk factors of diabetic retinopathy in patients with type 2 diabetes mellitus." Thesis, 2018. http://ndltd.ncl.edu.tw/handle/5n97h5.
Full textAbstract:
碩士美和科技大學
護理系健康照護碩士班
106
Background: The number of patients diagnosed with diabetes mellitus (DM) is increasing daily. Diabetic retinopathy is one of the most important reasons for non-traumatic blindness, and the medical expenses caused by the disease are considerable. The disease can seriously affect the quality of life for the patients and their families. The study is aimed to discover the possible factors that are related to diabetic retinopathy. Methods: This is a cross-sectional, retrospective study. We collected the medical record of type 2 DM patients who underwent mydriatic examination by the ophthalmologist during July 2010-November 2017. Basic demographic data and the biochemistry report were analyzed, using Chi-square test, independent sample T-Test and regression analysis. Results: A total of 849 people were included in the study, and 668 patients being either non-proliferative or proliferative retinopathy. There were significantly differences in age, disease duration, family history of DM, glycosylated hemoglobin (HbA1C) level, total cholesterol level, low density cholesterol level (LDL) and the diagnosis of metabolic syndrome among those with or without DM retinopathy (p<0.05). Logistic regression analysis showed the risk of retinopathy in women was 1.43 times that of men (p=.044,95% ci=1.01-2.03); the risk increased 1.06 times (p=.001,95%ci=1.03-1.08) for every 1 more year of DM duration; the risk increased 1.01 time with every 1mg/dl increase in total cholesterol (p=.048,95%ci=1.00-1.01); the risk increased 1.23 times with every 1% increase in HbA1C level; the risk for betel nut users doubles (p=.048,95%ci=1.00-3.98);those with the family history of DM has 1.41 times of risk (P=.034，95%CI=1.03-1.95). Conclusion: This study found out other than the traditional risk factors such as sex, disease duration, family history of diabetes, HbA1C level, cholesterol level, betel nut use is also associated with the risk of DM retinopathy. To prevent the development of DM retinopathy, avoiding betel nut use, and well control of blood glucose and lipid profile are very important.
50
Bor-Yi and 廖柏夷. "Sleep quality and diabetes mellitus control in patients with type 2 diabetes." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/82697797304415814348.
Full textAbstract:
碩士中山醫學大學
護理研究所
99
Introduction: Sleep problem is common in type 2 diabetics. Poor sleep quantity and quality may affect glucose tolerance and homeostasis, hence affecting glycemic control. This study examined sleep patterns in patients with type 2 diabetes. Method and materials: One hundred and thirty-one (55 males and 76 females) type 2 diabetics aged 30-81 years (mean ± SD = 61.8±10.7) voluntarily participated in this cross-sectional study. The average duration of diabetes since diagnosed was 9.7±7.3 years. Sleep quality was assessed by the Pittsburg Sleep Quality Index (PSQI). Glycemic control was assessed by hemoglobin A1c (HbA1c). Results: In participants, 70.2% of diabetics had poor glycemic control (HbA1c >7). The mean global PSQI score was 7.0±4.2, and 62.6% of participants were identified as poor sleepers (PSQI≧5). Their mean sleep efficiency was 82.8±14.8% with an average sleep of 6.2±1.5 hours a night. The leading causes to disturb night time sleep were nocturia (87%) and cough or snoring (56.5%). In contrast, only 3.1% claimed having more than 9 hours of sleep a night. Excessive daytime sleep was 32.8%. There was no correlation between sleep and glycemic control in these diabetics (r=0.038 p= 0.666). Conclusion: Patients with diabetes suffer from poor sleep quality. Majority of patients experience nocturia and cough during night time.