Journal articles: 'Non-adherence, diabetes complications'

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Bashir, Dr Rasha Kamal, Dr Imad Eldin Eljack Ahmed, and Dr Tasabeh Mustafa Ali. "Medication Adherence and Affecting Factors among Type Two Diabetic Patients, Attending Al-Daraga Health Center, Wad Madani Al Kubra, Gezira State, Sudan, (2020)." Academic Journal of Research and Scientific Publishing 3, no. 27 (July 5, 2021): 05–26. http://dx.doi.org/10.52132/ajrsp.e.2021.271.

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Type II diabetes mellitus and its complication are becoming more prevalent in Sudan. The most important predictor of reduction of morbidity and mortality due to diabetes complication is the level of glycemic control achieved. In Sudan diabetes mellitus (DM) is common public health problem, in 2017 about 12% developed serious complications. This study aimed to identify the general characteristics of type II diabetic patients, relevant diabetic characteristics duration, treatment, control and complications. Also to determine level of adherence, and reason behind non adherence medications. A cross-sectional study of randomly selected 360 patients of type II diabetic patient that attend at Al-Daraga Health Center, Wad Madani,Al Kubra locality, Gezira state ,during period from September – October 2020, found that there's statistically significant showed the relation between marital status, socioeconomic status, level of education , Occupation and factors affect adherence in taken medications at ( p value less than 0.05) also There’s significant relation between causes with patients not adhered to used medications (p value 0.000), The socioeconomic status contributed factors in diabetes mellitus complication because the low income level about 213(59.2%). Type II diabetic patients was associated with higher glycated hemoglobin seen among younger age groups. It is also showing the important of Group discussion with the patients to increase awareness of adhering to treatment plan. This study will be helpful in providing evidence regarding the importance of adherence should be emphasized and empowered within the diabetic population.

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J., Veeresh, Vasanth R. Chavan, Mohammad Arshad, Raghunandan M., and Mohd Fayazuddin. "Non-adherence to anti- diabetic therapy and its consequences among type-2 diabetic patients in a tertiary care hospital." International Journal of Basic & Clinical Pharmacology 6, no. 6 (May 23, 2017): 1348. http://dx.doi.org/10.18203/2319-2003.ijbcp20172038.

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Background: Despite the extensive therapy options available for various stages of type 2 diabetes, studies have indicated that less than 50% of patients achieve the glycemic goals. Failure to attain the desired therapeutic goal might be related to inadequate adherence. Objectives of present study were to determine the extent of non-adherence to antidiabetic medications and identify reasons for the same.Methods: A cross-sectional, observational, questionnaire-based study was conducted to assess the level of non-adherence to antidiabetic therapy among type 2 diabetics attending medicine outpatient department or admitted to the wards of a tertiary care hospital from Jan 2015 to Jan 2016. A pretested and validated questionnaire was used to assess the level of adherence. Reasons for missing medications were also elicited. Data thus collected was analysed using a suitable statistical software.Results: Out of the 210 study participants, 55.2% were females. Most participants were in the age group of 51-60. The mean duration of diabetes was 8.17± 5.39. The most common diabetes-related complication was Diabetic Keto Acidosis (DKA), followed by diabetic foot ulcer. The average number of drugs per prescription was 1.98 ± 1.05. Poor glycemic control was observed in 58% and non-adherence to treatment in 45.2% of study participants.Conclusions: Good adherence to antidiabetic therapy is fundamental for good glycemic control which in turn prevents the occurrence of short and long-term complications of diabetes. Poor doctor-patient intercommunication and inadequacy on part of physicians to adjust medications negatively affect adherence. Active participation of the patient is also equally important.

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Inbaraj, Leeberk Raja, Carolin Elizabeth Georg, Nan Lin Kham, and Gift Norman. "Prevalence, perceptions and practices associated with non-adherence to diabetes medications in primary care setting: A cross sectional study in urban Bangalore." Asian Journal of Medical Sciences 7, no. 6 (October 31, 2016): 106–9. http://dx.doi.org/10.3126/ajms.v7i6.15256.

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Background: Adherence to diet and drugs, blood glucose monitoring, foot care, exercise and early recognition of the complications, are the crucial elements for tertiary prevention of Diabetes Mellitus. Non compliance can lead to poor glycemic control which can eventually aggravate complications and lead to disability and mortality. This study aimed at estimating prevalence of non-adherence and identify perceptions and practices associated with non-adherence.Materials and Methods: A cross sectional study was conducted in a primary care clinic in a disadvantaged community Hundred patients with Diabetes were recruited and interviewed using a semi-structured questionnaire.Results: Non adherence rate was 30%. Those who are unable to remember multiple doses (37.5%) were 2.77 (95% CI: 0.94-8.15) times more likely to non-adhere to the treatment than those who are able to remember multiple doses (16.7%).Similarly Patients who often discontinued medications and switched over to alternative system medicines tended to be non- adherent 8.5 (95% CI:1.6- 45.0) times more than those who continued treatment without interruption. Non adherence was not associated with age, gender, education level, and cost of medication and duration of diabetes. People who were illiterate and elderly did not know the consequences of missing doses and stopped medications when they felt better as well as resorted to traditional medicinesConclusions: Counselling sessions should focus on perceptions and ideas about diabetes. Innovative health education modalities have to be developed for illiterate and elderly people.Asian Journal of Medical Sciences Vol.7(5) 2016 106-109

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July, Rani Sauriasari, Nadia Farhanah Syafhan, and Hadijah Tahir. "The Effect of Insulin Administration on Medication Adherence in Type 2 Diabetes Mellitus Patients with Neurological Complications." JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA 9, no. 3 (December 9, 2022): 242–51. http://dx.doi.org/10.20473/jfiki.v9i32022.242-251.

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Background: Medication adherence is essential to achieving controlled blood sugar in diabetic patients. Insulin generally provides better glycemic control but is considered painful and requires special techniques. Insulin administration in patients with neurological complications requires particular consideration because these complications can cause physical and cognitive barriers. Objective: This study analyses the effect of insulin administration on medication adherence in diabetic patients with neurological complications and the influence of various confounding variables (baseline characteristics, medical and medication history). Methods: This observational study was conducted with a cross-sectional design at a government hospital in East Jakarta from September 2021 to January 2022. The sample was type 2 diabetes mellitus patients with neurological complications who received antidiabetics for at least six months. The neurological complications include central nervous disorders (such as stroke) and peripheral nervous disorders (such as neuropathy). The independent variable was insulin administration, while the dependent variable was adherence, measured using subjective methods [Adherence to Refills and Medications Scale (ARMS)] and objective methods (Medication Refill Adherence (MRA) and HbA1c]. Results: Of 175 respondents, based on the three methods (MRA, ARMS, HbA1c), 13 respondents (7.4%) were adherent, namely one respondent (1.8%) in the insulin group and 12 respondents (10.1%) in the non-insulin group. Insulin administration affects adherence to antidiabetics by 0.123 times (95% CI: 0.015 - 1.024), or patients who use insulin have 87.7% lower adherence controlled by antidiabetic changes and the total number of medicines used. Conclusion: Insulin administration significantly affects medication adherence in diabetes mellitus patients with neurological complications.

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Anderson, Robert M., James T. Fitzgerald, and Marys Oh. "The Relationship Between Diabetes-Related Attitudes and Patients' Self- Reported Adherence." Diabetes Educator 19, no. 4 (August 1993): 287–92. http://dx.doi.org/10.1177/014572179301900407.

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This study involved 1202 patients who were placed into low adherence or high adherence groups based on their answers to questionnaires. The attitudes of each group were compared for a variety of adherence behaviors. Patients who reported high levels of adherence tended to have attitudes more in accord with diabetes experts. Members of the high adherence group strongly supported the need for special training for health care professionals who treat diabetes, favored team care, accepted the importance of patient compliance, acknowledged the seriousness of non-insulin-dependent diabetes mellitus (NIDDM), and recognized the relationship between glucose control and complications. Differences in attitudes between high- and low adherence groups were more prevalent for difficult adherence areas, eg, diet and exercise, than for easy adherence areas, eg, carrying sweets or diabetic identification. An understanding of patients' attitudes can help diabetes educators and patients develop realistic and relevant self-care plans.

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S., Kavitha, Nalini G. K., Suresh R. M., Sahana G. N., Deepak P., and Jayashree V. Nagaral. "Treatment adherence and factors contributing to non adherence among type 2 diabetes mellitus patients in a tertiary care hospital: a cross sectional study." International Journal of Basic & Clinical Pharmacology 6, no. 3 (February 24, 2017): 689. http://dx.doi.org/10.18203/2319-2003.ijbcp20170838.

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Background: Diabetes mellitus (DM) is the most common endocrine disorder and major global public health problem. Lack of adherence to antidiabetic medication has lead to suboptimal blood sugar control, treatment failure, accelerated development of complications and increased mortality, thus medication adherence plays an important role in disease control. Hence present study was taken to evaluate the treatment adherence and factors affecting non adherence among Type 2 diabetes mellitus patients.Methods: A cross sectional study carried out by Department of Pharmacology and Medicine, Hassan Institute of Medical Sciences, Hassan. Total 150 patients of type 2 diabetes were recruited after taking their informed consent. Adherence to treatment and factors associated with non adherence has been assessed during a personal interview with each patient using standardized questionnaire.Results: Adherence levels were 28%, 42% and 30% for high, medium and poor adherence respectively. The overall prevalence of non adherence among respondents was 30%. Among them 77.77% were males, 44.44% belonged to age group of 41-60 years, 40% illiterate, 60% employed, 51.11% of patients with smoking and alcoholic habits were not adherent to anti diabetic treatment. Other reasons contributing to non-adherence to treatment were forget fullness (86.66 %), inadequate knowledge about side effects (80%), unhappy clinical visits (71.11 %) and lack of assistance (48.88 %).Conclusions: Results showed that patients in the area of study were moderately adherent to anti-diabetic medications. This emphasizes the need for constant motivation and education at frequent intervals to ensure better adherence.

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S. Padmanabha, Usha Rani, Maheswaran R., Shwetha Hiremath, Puneeth N., and Renuka Prithviraj. "A study to assess the treatment adherence among patients with type 2 diabetes mellitus in rural and urban population of Bengaluru, South India." International Journal Of Community Medicine And Public Health 7, no. 8 (July 24, 2020): 3105. http://dx.doi.org/10.18203/2394-6040.ijcmph20203385.

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Background: Globally, around 425 million adults are victims of diabetes with increased prevalence being noted in low and middle income countries. Diabetes was seventh leading cause of death leading to 1.6 million deaths in 2016 (WHO report). Management of diabetes is multifaceted which includes diet, physical activity, screening for complications and medications. Adherence to pharmacotherapy plays an important role in glycemic control. Hence, this study was done to assess the magnitude of treatment adherence and its associated factors among type 2 diabetics.Methods: A community based study was done on patients with type 2 DM in the rural and urban population of Bengaluru. A simple random sampling technique was followed. Medication adherence was assessed using 8 item Morisky's treatment adherence scale.Results: A total of 250 subjects were interviewed, among them 59% were male and 41% were female. The mean age of the subjects was 60.93±10.1 years. The mean treatment adherence scores was 25.9±3.1 years. Among the 250 diabetics, 62% were adherent and 38% were non adherent to anti diabetic medications. Forgetfulness to take medications was one of the reasons for non-adherence with mean scores of 3.12+0.6.Being illiterate, labourers, aged above 60 years, obesity, frequency and multiple dosage was found to be significant factors for non-adherence (p<0.05).Conclusions: Adherence to anti diabetic drugs was found to be 62%. Increased age, illiteracy, occupation, BMI, frequency and multiple doses of drugs were significant factors responsible for medication non adherence. There is a need for reinforcement of health education and motivation for diabetics to improve their medication adherence.

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Wahiduzzaman, Mohammad, M. Sahidul Islam, Sharmin Hossain, Qazi Muhammad Iqbal Hussain, Friederike Banning, and Andreas Lechner. "Prevalence and factors associated with diabetic retinopathy among type 2 diabetic patients in Bangladesh: a hospital based cross-sectional study." International Journal Of Community Medicine And Public Health 10, no. 1 (December 29, 2022): 78. http://dx.doi.org/10.18203/2394-6040.ijcmph20223529.

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Background: Diabetes mellitus is a major health problem in Southeast Asia and diabetic retinopathy is one of its most debilitating complications. Nevertheless, fundoscopy and systematic evaluation of non-adherence to drug therapy are not regularly done in individuals with diabetes in Bangladesh due to limited resources. Therefore, the prevalence of diabetic retinopathy and its determinants with non-adherence to drug therapy are not known. We, therefore, screened for diabetic retinopathy, non-adherence to drug therapy and other associated factors at a tertiary care hospital in Bangladesh.Methods: Between May 2017 to September 2017, we conducted a cross-sectional study of 489 systematically recruited asymptomatic, at least one-year type-2 diabetic individuals on medication and attending the outpatient department of the BIHS tertiary care centre in Dhaka, Bangladesh. We obtained a medical history, physical examination, routine laboratory tests, questionnaires, and fundus photography.Results: The prevalence of diabetic retinopathy among T2DM patients was 18.8%. Clinical factors associated with the presence of diabetic retinopathy were uncontrolled fasting blood glucose, known duration of diabetes of ≥10 years and self-reported non-adherence to drug therapy. With a known duration of diabetes of 15 years or more, the prevalence of diabetic retinopathy rose to 40%.Conclusions: Undiagnosed diabetic retinopathy is still common among patients in Bangladesh, even at tertiary care centres. It is associated with longer disease duration, poor metabolic control and self-reported non-adherence to therapy. Regular screening for diabetic retinopathy should therefore be implemented also in resource-limited settings and further efforts should be made to improve the patients’ drug adherence and metabolic control.

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Chappidi, Mounica, Priyadarshini Chidambaram, Shalini Sivananjiah, and Shivaraj Nallur Somanna. "Non-adherence to foot-care activities and its associated factors among patients with type 2 diabetes mellitus in an urban area of South India: a cross sectional study." International Journal Of Community Medicine And Public Health 5, no. 12 (November 24, 2018): 5089. http://dx.doi.org/10.18203/2394-6040.ijcmph20184745.

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Background: Type 2 diabetes mellitus (T2DM) is the commonest metabolic disorder with prevalence of 8.3% in India. The prognosis largely depends on complications seen in natural course of illness. Stringent adherence to self-care activities is a mandatory step in management of T2DM. Hence, this study was done to assess non-adherence to foot-care activities among patients with T2DM for associated factors and also to report findings of foot examination among non-adherent participants.Methods: A community based cross-sectional study was conducted in an urban area of Bengaluru. Using multi-stage sampling, 400 people with T2DM aged ≥18 years were selected. A pre-tested, semi-structured questionnaire was used to collect information regarding non-adherence to foot-care activities and foot examination was done for all the participants.Results: Though all the participants were aware regarding the foot-care activities, 86.7% of participants were not adherent. Females and those with lower monthly income had 2.91 and 3.47 significantly higher odds of being non-adherent to foot-care activities, respectively.Conclusions: The prevalence of non-adherence to foot-care activities among people with T2DM was observed to be high. Hence, more importance should be given to motivate people with T2DM in their follow-up visits regarding adherence to foot-care activities to avoid occurrence of complications.

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Mousavizadeh, Seyedeh Narjes, and Zahra Banazadeh. "Loss of Time in the Treatment Adherence Process: A Qualitative Study in a Sample of Iranian People with Diabetes." Journal of Medicine and Life 13, no. 3 (July 2020): 293–99. http://dx.doi.org/10.25122/jml-2019-0110.

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Diabetes is a significant public health problem and one of the causes of death and disability globally. One of the main problems with diabetes control is the lack of adherence to therapeutic regimens in people with diabetes. This study investigates the experiences and views of the Iranian people with diabetes to identify the challenges of the process of adherence to treatment. A grounded theory research design was used, incorporating in-depth interviews to collect the data. Using purposeful sampling, 28 people with type 2 diabetes (9 men, 19 women) from different places were included in the study. Constant comparative analysis was undertaken to identify key categories. The main challenge in this process is losing the golden time of preventing the complications of the disease that occurs for the following reasons: cultural habits and values, religious beliefs (believing diabetes was God’s will), resistance to change due to age, job conditions, lack of harmony in the family, and non-shared decision-making in the health system. People with diabetes go through trial and error in order to achieve awareness and insight, and consequently, adherence to treatment. Therefore, they need help and support to achieve insight and adherence to treatment faster and without complications. In fact, if the care plan is designed to encourage active patient participation by the treatment team in the shortest possible time, the time to achieve compliance will be shorter and will have the least side effects for these people.

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Boshe, Bisrat Desalegn, Getachew Nenko Yimar, Aberash Eifa Dadhi, and Worku Ketema Bededa. "The magnitude of non-adherence and contributing factors among adult outpatient with Diabetes Mellitus in Dilla University Referral Hospital, Gedio, Ethiopia." PLOS ONE 16, no. 3 (March 4, 2021): e0247952. http://dx.doi.org/10.1371/journal.pone.0247952.

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Introduction The global prevalence of Diabetes Mellitus (DM) has increased alarmingly over the last two decades. On top of this, the issues of non-adherence to the prescribed medicines further fuel the DM- related complications to become one of the top causes of mortality and morbidity. Despite the considerable efforts in addressing the poor adherence issues, there are still plenty of problems ahead of us yet to be addressed. The objective of this study was to determine the extent of non-adherence and its contributing factors among diabetic patients attending the medical Referral clinic of Dilla University Referral Hospital. Methods The institutional-based descriptive cross-sectional study was carried out among patients with diabetes mellitus attending the medical referral clinic of Dilla University Referral Hospital. A systematic random sampling method was used to recruit study participants, and tool was adopted to assess for adherence. A pretested semi-structured questionnaire was used to collect information on factors influencing non-adherence to the diabetic medications, and in-depth interview questionnaire was used for key informant interviews for the qualitative part. Data analysis was carried out using SPSS-20. Results The overall prevalence of non-adherence to diabetic treatment regimen among the study participants was 34.0%. The study revealed that cost of transport to the hospital and taking alcohol were significantly associated with non-adherence to the diabetic treatment regimen with the (AOR = 6.252(13.56, 28.822); p < 0.000) and (AOR = 13.12(8.06, 44.73); p<0.002) respectively. Conclusions The study revealed that significant numbers of participants were non-adherent to the Diabetes Mellitus treatment regimens. Intensive counseling, and health education on the importance of good adherence and negative consequences of poor adherence need to be discussed with the patients before starting the medications, and amidst follow up.

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H C, Nandini, Akshay Gali, and Sushma Muraraiah. "Assessment of Factors Influencing Adherence to Antidiabetic Drugs among Patients with Type 2 Diabetes Mellitus at a Tertiary Care Hospital in India." Pharmacology and Clinical Pharmacy Research 5, no. 1 (April 1, 2020): 7. http://dx.doi.org/10.15416/pcpr.v5i1.26507.

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Diabetes mellitus is a chronic endocrine disorder that requires long-term treatment. Non-adherence to anti-diabetic drugs is common and associated with poor outcomes. Non-adherence leads to complications, higher incidence of hospital admissions and imposes economic burden. Hence, the present study was undertaken to measure adherence to anti-diabetic medication and factors contributing to it. This cross-sectional study was conducted among patients on anti-diabetic medication after taking their informed consent in a tertiary care hospital in India. Each patient’s demographic, clinical, and treatment data along with the adherence to treatment has been assessed during a personal interview with each patient using Medication Adherence Report Scale (MARS-5). Factors contributing to medication adherence was assessed using chi-square test. A total of 250 patients were recruited in the study. The mean age was 54 years and non-adherence to anti-diabetic medications was 21.6%. Univariate Analysis showed that marital status, education status, good glycemic control, illness >5years had a statistically significant association (p=<0.05) with self-reported adherence to anti-diabetic medication.

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Nathani, Pratiksha Shankarlal, Pratik R. Kharat, Satish Wadde, and Sheetal Kamdar. "LBODP058 Evaluation Of Factors Associated With The Development Of Diabetic Retinopathy Based On A Case-control Study." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A275—A276. http://dx.doi.org/10.1210/jendso/bvac150.568.

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Abstract Objectives Diabetic Retinopathy (DR) is a microvascular complication of diabetes mellitus (DM) and one of the leading causes of irreversible vision loss, particularly in the most productive age group. Several epidemiological studies have found that diabetics worldwide and in India have a high prevalence of DR. Risk estimation of various factors has been performed earlier however there is dearth of case control studies among the diabetics who developed DR and those who were unaffected. This study was planned to identify the sociodemographic, disease related and lifestyle related risk factors for development of DR among diabetics which could broadly be categorized under modifiable and non-modifiable factors. Findings from the study could help clinicians develop predictors and risk-based screening programs for early detection of DR. Material & Methods In this age and gender matched case control study, total 256 diabetes mellitus patients (96% type 2) were recruited equally in groups with diabetic retinopathy (DR) and without it. Diagnosis of DR was done by fundal examination as per the Early Treatment for Diabetic Retinopathy Study (ETDRS) standard. Adherence to diabetes medications was measured using four items in vernacular language adapted from the MMAS-4 (Morisky Medication Adherence Scale). Univariate and multivariate binary logistics regression was performed to find the independent risk (Odd's ratio) and modified Odd's ratio respectively. Results There was parity between cases and controls in terms of gender distribution and age. Mean age of DR and non-DR group was 63.7 ± 9.5 and 63.3 ± 10.4 years respectively. Independent risk factors for development of DR were presently on insulin therapy (OR=2.87,p=0. 0001), smoking (OR=1.92,p=0. 02), alcoholism(OR=2.62,p=0. 03), sedentary lifestyle(OR=2.72,p=0. 0008), non-adherence to diabetes medications (OR=14. 08,p=0. 0001), non-adherence to dietary advice (OR=4.41,p=0. 0001), presence of other microvascular complications (OR=3.79,p=0. 0001), dyslipidemia (OR=1.85,p=0. 02) and hypertension (OR=5.91,p=0. 0001). On multivariate logistics regression analysis, non-adherence to medicine (Exp(B)=7.89,p=0. 0001) and hypertension (Exp(B)=1.16,p=0. 0001) were predictors of development of DR . Type of occupation, education, socioeconomic status and type of diabetes did not have any correlation with development of DR among diabetics. Conclusion Diabetics under insulin therapy and with hypertension have a seriously increased risk of developing DR. Smoking, alcohol abuse, sedentary lifestyle, failure to take diabetes medications, and failure to follow dietary advice are independent risk factors for developing DR that can be modified through lifestyle changes in diabetics. DR should be monitored more closely in patients with other microvascular complications and dyslipidemia. Presentation: No date and time listed

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Shrestha, Tirtha Man, Laxman Bhusal, Shankar Raut, Rajan Ghimire, and Poonam Shrestha. "Factors Associated with Non-Adherence to Antihypertensive Medication among Hypertensive Patients in Community." Journal of Karnali Academy of Health Sciences 2, no. 1 (June 11, 2019): 53–59. http://dx.doi.org/10.3126/jkahs.v2i1.24417.

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Objective: Hypertension is one of the common non-communicable health problems. While pharmacologic intervention is the most efficient way to control hypertension; non-adherence to medication is accounted as a significant cause for complications. This study was to address and to determine the magnitude of non-adherence among hypertensive patients by summarizing the associated risks factors among patients in community level. Method: This is a cross sectional study conducted on hypertensive patients who visited the community health clinic at Dhading, Nepal on 9th and 10th June 2018 using a pre structured questionnaire. Patients were sampled by nonprobability purposive sampling method. Effect of age, gender, marital status, employment, education level, presence of diabetes, cerebrovascular disease, current smoker, and family history of hypertension were analyzed by compliance of antihypertensive drugs using frequency distribution, chi-square test, and logistic regression. For all of the analysis p value <0.5 was considered as significance. Results: 150 patients were included in the study, out of whom 48 patients were found adherent and 102 patients non-adherent to antihypertensive medication. Out of total population 46% (n=69) were male and 54% (n=81) were female with no significant difference between compliant and noncompliant groups (OR= 1.512, p-=0.292). Mean age of patients in complaint group was 57 years and in non-compliant group was 52 years with odds ratio of 0.959 (p= 0.004, 95% C.I =0.933-0.987). However, there was no significant effect of marital status, employment status, and family history of hypertension on adherence to anti-hypertensive medication. Presence of diabetes had significant effect on adherence to medication (OR= 8.494, p= 0.014). The most common reason for non-adherence was the fear of getting stuck with medication for lifetime (n=31, 30.3%) followed by the use of ayurvedic/home remedy (n=27, 26.5%), unaware of complications (n=16, 15.7%), life style modification (n=14, 13.7%), and financial weakness (n=9, 8.8%). Pearson’s correlation of these reasons was between -1 to 0 with p value <0.5. Conclusion: Fear of taking medication lifelong was the major reason for non-adherence; however, age and comorbid health conditions like diabetes have a significant effect on adherence to medication. Health care awareness and counseling can help these patients to overcome the fear of taking medication for lifetime, which can increase the medication compliance rate.

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Formosa, Cynthia, Anthea Borg, Nikolaos Papanas, and Stephen Mizzi. "Adherence to Therapeutic Footwear in Type 2 Diabetes in Malta." Experimental and Clinical Endocrinology & Diabetes 128, no. 04 (December 17, 2018): 244–45. http://dx.doi.org/10.1055/a-0808-4111.

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Abstract Background The literature reports that people living with diabetes do not adhere to their prescribed therapeutic footwear as instructed. The reason for this is still uncertian although certain footwear characteristics seem to reasons reported leading to reduced level of adherence. Objectives To explore the reasons for current adherence or otherwise to prescribed stock footwear amongst patients living with type-2 diabetes. Methods An exploratory qualitative design method using an Interpretative Phenomenological Analysis [IPA] was employed in this research. Employing purposive sampling, twelve participants were recruited and interviewed. Interviews were recorded, transcribed and later analysed. Results Common themes that emerged from this study fell under 2 main categories including ‘Adherence’ and ‘Non – Adherence’ to wearing the prescribed stock footwear. A number of themes were identified with regards to the reasons for such adherence or otherwise by respective participants including footwear characteristics, service provision, peer pressure and the patient’s knowledge and attitudes. Conclusion This study demonstrated suboptimal adherence to wearing therapeutic footwear among people with type 2 diabetes. Although the literature highlights the importance of adherence to therapeutic footwear in high risk populations for the prevention of diabetic foot complications, this study provides the reasons as to why patients still do not comply in wearing their prescribed therapeutic footwear. In order to improve behavioral changes patients would require on-going care, empowerment and support combined with educational programs to achieve a higher level of adherence. More research is warranted to explore further psychosocial interventions in diabetes care.

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Imran, Mohammed, and Joslin Jose Plathottam. "A study on treatment adherence among patients with type 2 diabetes mellitus attending diabetic clinic." International Journal Of Community Medicine And Public Health 4, no. 5 (April 24, 2017): 1701. http://dx.doi.org/10.18203/2394-6040.ijcmph20171787.

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Background: Diabetes is one among chronic diseases requiring long term medication and its prevalence is increasing globally. Adherence to prescribed treatment among diabetes patients is very important for good glycemic control. Poor glycemic control following poor adherence is associated with increasing risk of complications, disease progression, morbidity and mortality with increasing costs of care. Hence, the present study was undertaken to assess the adherence of diabetic patients with their prescribed medications.Methods: The study involved 200 diabetic patients on oral anti-diabetic medication visiting out-patient diabetic clinic in a teaching hospital, Bangalore, who met required criteria. Information was collected using predesigned questionnaires by personally interviewing selected patients.Results: A total of 122 patients (61 %) were non-adherent with medication; 36 (18%) and 42 (21%) of patients were moderately adherent and adherent to treatment respectively. Among non adherent patients, males were more (72%) compared to females (50%), which was statistically significant (P<0.05). Non adherence was more among employed (69%) patients compared to unemployed patients (54%), this was significant statistically (p >0.05). Non adherence level was very high among males with history of smoking (80%).Conclusions: It was observed that the proportion of diabetic patients who are non-adherent to their prescribed medications was high. It is recommended that patients should be counselled repeatedly by health care providers on the importance of complying with prescribed drug regimen for better compliance and treatment outcome.

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Alhagawy, Ali Jaber, Saeed Yafei, Abdulrahman Hummadi, Raed Abutaleb, Mohammed Hakamy, Turki Alzughbi, Nabeel Gharawi, et al. "Barriers and Attitudes of Primary Healthcare Physicians to Insulin Initiation and Intensification in Saudi Arabia." International Journal of Environmental Research and Public Health 19, no. 24 (December 14, 2022): 16794. http://dx.doi.org/10.3390/ijerph192416794.

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Saudi Arabia is a country with high prevalence of diabetes, uncontrolled diabetes, and diabetes-related complications. Poor glycemic control is multifactorial and could be explained in part by physician and patient reluctance toward insulin or insulin inertia. This study aimed to address physician barriers toward insulin therapy in primary care settings. It included 288 physicians from 168 primary healthcare centers (PHC) in the Jazan region of Saudi Arabia. Participants responded to questionnaire investigating physicians’ attitude and barriers to insulin initiation and intensification in PHCs. In physician opinion, the most common barriers among their patients were fear of injection, lack of patient education, fear of hypoglycemia, and difficult administration. Physicians were reluctant to initiate insulin for T2D patients mostly due to patient non-adherence to blood sugar measurement, non-adherence to appointment or treatment, elderly patients, or due to patient refusal. Physicians’ fear of hypoglycemia, lack of staff for patient education, and lack of updated knowledge were the primary clinician-related barriers. Exaggerated fears of insulin side effects, patient non-adherence, limited staff for patient’s education, patient refusal, and inadequate consultation time were the main barriers to insulin acceptance and prescription.

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Jayaraj, Naveen Prabhu, Jeevithan Shanmugam, Shanmugapriya Duraisamy, and Loganathan Padmavathy. "Prevalence and determinants of hypertension and diabetes mellitus in an urban area of Coimbatore." International Journal Of Community Medicine And Public Health 7, no. 5 (April 24, 2020): 1807. http://dx.doi.org/10.18203/2394-6040.ijcmph20201985.

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Background: Owing to change in behavior and lifestyle patterns, diabetes mellitus and hypertension are in increasing trend worldwide. They are associated with various complications resulting in high morbidity. Early detection of these would necessitate the prevention of complications associated with it and improves the quality of life of the people. The objective of the study was to assess the prevalence and determinants of diabetes mellitus and hypertension among urban population in the field practice area of a tertiary care hospital in Coimbatore.Methods: 299 individuals of both sexes belonging to six wards in the field practice area of a tertiary care hospital in Coimbatore were randomly selected and screened for diabetes mellitus and hypertension. Diagnosis was based on American Diabetic Association and JNC 7 guidelines for diabetes mellitus and hypertension respectively. Data on various factors associated was collected using pretested validated semi structured questionnaire.Results: Overall prevalence of diabetes mellitus and hypertension was found to be 32.44% and 38.8% respectively with newly diagnosed diabetes mellitus and hypertension of 4.02% and 7.37%. Overall adherence was found to be 80%. Factors such as elderly age, sedentary life style, non-vegetarian diet, obesity are found to be associated with both diabetes mellitus and hypertension.Conclusions: Almost one in every third person found to be having either diabetes mellitus/hypertension or both with 20% non-adherence to treatment. This high prevalence necessitates the need for adoption of various strategies to combat the risk factors and to promote healthy life style.

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ALSHAYBAN, Dhfer, and Royes JOSEPH. "THE IMPACT OF MEDICATION ADHERENCE ON HEALTH-RELATED QUALITY OF LIFE OF DIABETIC PATIENTS IN THE KINGDOM OF SAUDI ARABIA: FINDINGS FROM A CROSS-SECTIONAL STUDY." Periódico Tchê Química 17, no. 34 (March 20, 2020): 867–73. http://dx.doi.org/10.52571/ptq.v17.n34.2020.891_p34_pgs_867_873.pdf.

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Diabetes is a common chronic disease that is considered as one of the fastest-growing health problems in the world. Adherence to medications could be an important factor in reducing these complications and improving the quality of life. The purpose of this research was to assess the impact of treatment adherence on health-related quality of life in patients with type 2 diabetes. A multicenter cross-sectional study was carried out among 368 diabetes patients. General Medication Adherence Scale was used to assess the adherence level and EuroQol-5D to assess the quality of life. The results show that 19%, 21%, and 23% of patients had maintained low medication adherence due to patient’s intentional or unintentional behavior due to additional diseases or pills burden and due to financial constraints, respectively. Overall, 43% (n=162) participants had maintained high medication adherence, and 37% (n=138) had maintained low medication adherence to antidiabetic drugs. Nearly one-third (31%) of patients with high overall adherence had perfect health state in comparison with 4% among patients with low adherence. Further, the lower proportion (21%) of patients with high overall adherence had perfect health state in comparison with that among patients with low adherence (34%). In addition to the overall adherence, the association was statistically significant for the domains related to non-adherence due to the patient’s intentional or unintentional behavior (p-value 0.001) and non-adherence due to additional diseases or pills burden (p-value 0.001) after taking into account of socio-demographic and clinical characteristics. In conclusion, the findings suggest that the policymakers should establish an intervention to improve adherence to diabetic treatment, and thus improve the quality of life for the type 2 diabetic patients.

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Bell, Ronny, Satomi Imai, Ann Rafferty, Nancy Ruth Gaskins Little, Nancy Winterbauer, and Huabin Luo. "Influenza and Pneumonia Vaccinations among North Carolina Adults with Diabetes." American Journal of Health Behavior 45, no. 2 (March 1, 2021): 216–25. http://dx.doi.org/10.5993/ajhb.45.2.2.

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Objectives: In this study, we sought to elucidate the influenza and pneumonia vaccination practices of adults with diabetes in North Carolina. Methods: Using North Carolina Behavioral Risk Factor Surveillance System data, we examined 2011-2018 trend data and demographic and health factors (2014-2018) in influenza (influenza vaccine receipt in the past year among adults ages 18+ years) and pneumonia (lifetime pneumonia vaccination receipt for adults ages 65+ years) vaccination adherence. Results: Influenza and pneumonia vaccination adherence rates were consistently higher for adults with versus without diabetes and remained relatively stable over the study period for both groups. Among adults with diabetes, factors associated with higher influenza vaccination rates included non-Hispanic white race, age 65+ years, poorer health, having insurance, and being a non-smoker. Pneumonia vaccination rates among adults with diabetes were higher for non-Hispanic Whites and those in poorer health. Conclusions: Adults with diabetes may be more likely to receive influenza and pneumonia vaccinations compared to adults without diabetes, but these rates remain below recommended levels. African Americans, younger adults, those without health insurance and cigarette smokers are vulnerable to being non-compliant with vaccination recommendations that could reduce their risk of developing and suffering complications from these diseases

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Pourhabibi, Nasrin, Bahram Mohebbi, Roya Sadeghi, Elham Shakibazadeh, Mojgan Sanjari, Azar Tol, and Mehdi Yaseri. "Determinants of Poor Treatment Adherence among Patients with Type 2 Diabetes and Limited Health Literacy: A Scoping Review." Journal of Diabetes Research 2022 (July 4, 2022): 1–10. http://dx.doi.org/10.1155/2022/2980250.

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Prevention of complications and successful control of diabetes require preventive and therapeutic measures. Patients’ nonadherence to medication and diet regimens and healthcare protocols is associated with significant therapeutic and economic consequences. The present scoping review aims to identify determinants of poor treatment adherence among patients with type 2 diabetes and limited health literacy in 2021. This scoping review was conducted in five stages: designing a research question, searching and extracting related studies, selecting related studies, tabulating information, and reporting results. Data were collected from six foreign electronic databases (Embase, Science Direct, PubMed, Google Scholar, Scopus, and Web of Science) and four Iranian electronic databases (MagIran, SID, IranDoc, and IranMedex) using keywords “Type 2 diabetes”, “barriers”, “treatment”, “medication”, “adherence”, “non-adherence”, “limited adherence”, and “limited health literacy” from January 2010 to November 2021. From an initial 146 articles, 18 articles were eligible for review. Eighteen studies involving 3925 patients with T2DM from eight countries were included. The prevalence of nonadherence ranged from 42% to 74.3%. Barriers to treatment adherence, which were common among the articles, included economic problems, poor communication with healthcare team, lack of family support, lack of knowledge, misconceptions, and limited health literacy. The results of the present study provided modifiable and nonmodifiable factors affecting treatment adherence among patients with type 2 diabetes. Modifiable factors are essential by performing appropriate interventions with the target group and health professionals.

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Chepulis, Lynne, Christopher Mayo, Brittany Morison, Rawiri Keenan, Chunhuan Lao, Ryan Paul, and Ross Lawrenson. "Metformin adherence in patients with type 2 diabetes and its association with glycated haemoglobin levels." Journal of Primary Health Care 12, no. 4 (2020): 318. http://dx.doi.org/10.1071/hc20043.

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ABSTRACT INTRODUCTIONMetformin is the initial medication of choice for most patients with type 2 diabetes. Non-adherence results in poorer glycaemic control and increased risk of complications. AIMThe aim of this study was to characterise metformin adherence and association with glycated haemoglobin (HbA1c) levels in a cohort of patients with type 2 diabetes. METHODSPrescription and dispensing data were used for this study. Primary care clinical and demographic data were collected from 10 general practices (October 2016–March 2018) and linked to pharmaceutical dispensing information. Metformin adherence was initially measured by calculating the proportion of patients who had optimal medication cover for at least 80% of days (defined as a medication possession ratio (MPR) of ≥0.8), calculated using dispensing data. Prescription adherence was assessed by comparing prescription and dispensing data. The association between non-adherence (MPR <0.8) and HbA1c levels was also assessed. RESULTSOf the 1595 patients with ≥2 metformin prescriptions, the mean MPR was 0.87. Fewer Māori had an MPR ≥0.8 than New Zealand European (63.8% vs. 81.2%). Similarly, Māori received fewer metformin prescriptions (P=0.02), although prescription adherence did not differ by ethnicity. Prescription adherence was lower in younger patients (P=0.002). Mean HbA1c levels were reduced by 4.8 and 5.0mmol/mol, respectively, in all and Māori patients with an MPR ≥0.8. Total prescription adherence reduced HbA1c by 3.2mmol/mol (all P<0.01). DISCUSSIONEthnic disparity exists for metformin prescribing, leading to an overall reduction in metformin coverage for Māori patients. This needs to be explored further, including understanding whether this is a patient preference or health system issue.

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Booysen, Bernice L., and Arina C. Schlemmer. "Reasons for diabetes patients attending Bishop Lavis Community Health Centre being non-adherent to diabetes care." South African Family Practice 57, no. 3 (May 1, 2015): 6. http://dx.doi.org/10.4102/safp.v57i3.3810.

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Background: Non-adherence to diabetes care is a concern at Bishop Lavis Community Health Centre (BLCHC) as it results in many diabetes complications that could have been avoided. The aim was to explore the reasons for people with diabetes in the Bishop Lavis area being non-adherent to diabetes care.Methods: A qualitative study was undertaken. Focus groups and in-depth interviews were conducted with patients who had uncontrolled blood sugar and non-compliance. The framework method was used to analyse the data.Results: The main findings in this study were that the following had a negative impact on compliance with diabetes care: (1) poor knowledge of diabetes mellitus; (2) drug treatment barriers such as shift work and not knowing the importance of taking medication regularly; (3) lifestyle adjustment barriers: dietary barriers and lack of exercise; (4) staff and clinic visit problems, for example over-burdened public health-care facilities; and (5) poor support structures including support from family, the community and financially as well as poor infrastructure.Conclusion: The main findings in this study were consistent with many of the previous studies done on adherence, i.e. patient barriers, disease and drug-regime barriers and doctor–patient relationship barriers. However, in this poverty-stricken area these participants also face other constraints that influence their compliance behaviour. These include (1) over-burdened public health care facilities, (2) insufficient education, (3) poor support structures, (4) infrastructure that is not wheelchair-friendly, (5) unsafe communities, (6) low income and unemployment.

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Moradi, Maryam, Mahla Salarfard, Zahra Abedian, Seyed Reza Mazloum, and Ehsan Mousa Farkhani. "The Relationship Between Underlying Factors and Treatment Adherence in Women With Gestational Diabetes." Journal of Arak University Medical Sciences 23, no. 6 (February 1, 2021): 828–39. http://dx.doi.org/10.32598/jams.23.6.6192.1.

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Background and Aim: The adherence of diabetic patients to the recommended treatment regimens is among the major challenges in diabetes control. Dietary adherence is low in pregnant women with gestational diabetes. Non-compliance can reduce the beneficial effects of treatment, symptoms, and signs, increase complications, or even cause death. Therefore, further research on the determinants of follow-up behaviors is essential. Methods & Materials: This was a descriptive-analytical study. In total, 260 women with gestational diabetes treated with diet referring to healthcare centers, and Imam Reza (AS), Ghaem, and Umm Al-Banin Hospitals in Mashhad City, Iran participated in this research. The study subjects were selected using convenience, multistage, class, and cluster sampling methods. The required data were collected using a demographic and pregnancy profile questionnaire and a researcher-made questionnaire of adherence to the treatment regimen. The obtained data were analyzed by inferential statists and regression tests in SPSS v. 16. Ethical Considerations: This study was registered with ethics code of IR.MUMS.NURSE.REC.1397.091 in the ethics committee of Mashhad University of Medical Sciences. Results: The regression analysis results indicated that dietary adherence, blood glucose monitoring, and exercise adherence scores presented a significant and positive effect on the total treatment adherence score (P<0.001). Furthermore, education (P=0.044), unwanted (P=0.006), or unplanned pregnancy (P=0.21) provided a positive and significant effect on the overall score of treatment adherence. Women with a history of diabetes in first-degree relatives (P=0.010) and those with a history of miscarriage (P=0.021) obtained higher scores of total treatment adherence. Conclusion: According to the present study findings, some demographic and pregnancy characteristics can affect the rate of adherence to the treatment regimen in women with gestational diabetes. Healthcare providers need to pay attention to the impact of these factors in improving adherence to patients’ treatment regimens.

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Bonikowska, Iwona, Katarzyna Szwamel, and Izabella Uchmanowicz. "Adherence to Medication in Older Adults with Type 2 Diabetes Living in Lubuskie Voivodeship in Poland: Association with Frailty Syndrome." Journal of Clinical Medicine 11, no. 6 (March 19, 2022): 1707. http://dx.doi.org/10.3390/jcm11061707.

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Purpose: Diabetic patients aged 65 years or older are more likely to be frail than non-diabetic older adults. Adherence to therapeutic recommendations in the elderly suffering from diabetes and co-existent frailty syndrome may prevent complications such as micro- or macroangiopathy, as well as significantly affect prevention and reversibility of frailty. The study aimed at assessing the impact of frailty syndrome (FS) on the level of adherence to medication in elderly patients with type 2 diabetes (DM2). Patients and Methods: The research was carried out among 175 DM2 patients (87; 49.71% women and 88; 50.29% men) whose average age amounted to 70.25 ± 6.7. Standardized research instruments included Tilburg frailty indicator (TFI) to assess FS and adherence in chronic disease scale questionnaire (ACDS) to measure adherence to medications. Results: The group of 101 (57.71%) patients displayed medium, 39 (22.29%)—low, and 35 (20.00%)—high adherence. As many as 140 of them (80.00%) were diagnosed with frailty syndrome. The median of the average result of TFI was significantly higher in the low adherence group (p ˂ 0.001) (Mdn = 9, Q1–Q3; 7–10 pt.) than in the medium (Mdn = 6, Q1–Q3; 5–9 pt.) or high adherence (Mdn = 6.00, Q1–Q3; 4.5–8 pt.) ones. The independent predictors of the chance to be qualified to the non-adherence group included three indicators: TFI (OR 1.558, 95% CI 1.245–1.95), male gender (OR 2.954, 95% CI 1.044–8.353), and the number of all medications taken daily (each extra pill decreased the chance of being qualified to the non-adherence group by 15.3% (95% CI 0.728–0.954). Conclusion: Frailty syndrome in elderly DM2 patients influenced medical adherence in this group. The low adhesion group had higher overall TFI scores and separately higher scores in the physical and psychological domains compared to the medium and high adhesion groups.

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Putri, Novita Kartika, Lensi Natalia Tambunan, and Rizki Muji Lestari. "Hubungan Tingkat Pengetahuan tentang Diabetes Mellitus dengan Kepatuhan Minum Obat." Jurnal Surya Medika 8, no. 2 (August 31, 2022): 57–62. http://dx.doi.org/10.33084/jsm.v8i2.3857.

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Background: Diabetes Mellitus is a group of metabolic diseases characterized by increased blood glucose levels (hyperglycemia). Knowledge results from knowing a person about an object through his senses. Knowledge also includes information that is known and realized by someone. The patient’s non-compliance with DM treatment is currently caused by the patient’s non-compliance regarding treatment for DM patients, which should take a long time according to the severity of DM disease. As a result, DM often causes complications (chronic), especially in the structure and function of blood vessels, and over time, it will cause other complications that are quite fatal. Destination: To find out the relationship between the level of knowledge about Diabetes Mellitus and adherence to taking medication. Method: Using the Literature Review method, supported by Google Scholar in searching for Literature by searching for journals from the last 3 (three) years 2017-2020, and Literature using Indonesian. Result: The are 6 articles snowing that the (P Value) is 0,001, mark 0,001<0,05. So Ho is rejected, and Ha is accepted, which means there is a relationship between knowledge of DM patients and patient compliance with taking medication. Conclusion: From the results of this study, it can be concluded that the level of knowledge of people with Diabetes Mellitus and Compliance with taking medication. This shows that the knowledge of DM patients is generally at a moderate level, which means that the patient’s knowledge is quite good. The patient’s level of medication adherence is low even though the patient knows that taking DM drugs must be routinely and continuously taken so that blood sugar stability does not create complications in other diseases.

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Nogueira, Thaïs Florence D., and Mariana Porto Zambon. "Reasons for non-adherence to obesity treatment in children and adolescents." Revista Paulista de Pediatria 31, no. 3 (September 2013): 338–43. http://dx.doi.org/10.1590/s0103-05822013000300010.

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OBJECTIVE To analyze the reasons for non-adherence to follow-up at a specialized outpatient clinic for obese children and adolescents. METHODS Descriptive study of 41 patients, including information from medical records and phone recorded questionnaires which included two open questions and eight closed ones: reason for abandonment, financial and structural difficulties (distance and transport costs), relationship with professionals, obesity evolution, treatment continuity, knowledge of difficulties and obesity complications. RESULTS Among the interviewees, 29.3% reported that adherence to the program spent too much time and it was difficult to adjust consultations to patientsâ€(tm) and parentsâ€(tm) schedules. Other reasons were: childrenâ€(tm)s refusal to follow treatment (29.3%), dissatisfaction with the result (17.0%), treatment in another health service (12.2%), difficulty in schedule return (7.3%) and delay in attendance (4.9%). All denied any relationship problems with professionals. Among the respondents, 85.4% said they are still overweight. They reported hurdles to appropriate nutrition and physical activity (financial difficulty, lack of parentsâ€(tm) time, physical limitation and insecure neighborhood). Among the 33 respondents that reported difficulties with obesity, 78.8% had emotional disorders such as bullying, anxiety and irritability; 24.2% presented fatigue, 15.1% had difficulty in dressing up and 15.1% referred pain. The knowledge of the following complications prevailed: cardicac (97.6%), aesthetic (90.2%), psychological (90.2%), presence of obesity in adulthood (90.2%), diabetes (85.4%) and cancer (31.4%). CONCLUSIONS According to the results, it is possible to create weight control public programs that are easier to access, encouraging appropriate nutrition and physical activities in order to achieve obesity prevention.

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Alodhaib, Ghaida, Imtinan Alhusaynan, Ahmer Mirza, and Yasser Almogbel. "Qualitative Exploration of Barriers to Medication Adherence Among Patients with Uncontrolled Diabetes in Saudi Arabia." Pharmacy 9, no. 1 (January 11, 2021): 16. http://dx.doi.org/10.3390/pharmacy9010016.

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Uncontrolled diabetes is associated with macrovascular and microvascular complications that compromise the quality of life; however, the patients’ perspectives about medication non-adherence are unclear. We aimed to understand patient behavior and explore the barriers to medication adherence in uncontrolled diabetes patients. We employed a qualitative method of face-to-face interviews conducted with adult patients in Saudi Arabia who had uncontrolled diabetes mellitus (glycosylated hemoglobin >7% or fasting blood glucose >7.2 mmol/L). All interviews were audio-recorded and analyzed using thematic analysis. The interviews were conducted for 68 patients. Sixty-seven patients were suffering from Diabetes Mellitus Type 2, and one patient was suffering from Diabetes Mellitus Type 1. We identified the barriers to medication adherence and classified them under six main factors: patients-, medications-, healthcare-, provider-, social-, and disease-related factors. The main barriers identified were the use of alternatives, hard-pressed for time, polypharmacy, bad relationship with the physician, cultured beliefs, self-alteration of the dose, exposed side effects, ineffective medications, refusal of insulin, multiple doctor visits, uncontrolled diet, and forgetfulness. Multiple barriers that prevented the patients from medication adherence were related to poor knowledge, counseling, psychological management, and social support. Appropriate educational programs, suitable patient-specific counseling, and close follow-ups would be required to improve the knowledge, outcomes, and quality of life in uncontrolled diabetes patients.

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Alodhaib, Ghaida, Imtinan Alhusaynan, Ahmer Mirza, and Yasser Almogbel. "Qualitative Exploration of Barriers to Medication Adherence Among Patients with Uncontrolled Diabetes in Saudi Arabia." Pharmacy 9, no. 1 (January 11, 2021): 16. http://dx.doi.org/10.3390/pharmacy9010016.

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Uncontrolled diabetes is associated with macrovascular and microvascular complications that compromise the quality of life; however, the patients’ perspectives about medication non-adherence are unclear. We aimed to understand patient behavior and explore the barriers to medication adherence in uncontrolled diabetes patients. We employed a qualitative method of face-to-face interviews conducted with adult patients in Saudi Arabia who had uncontrolled diabetes mellitus (glycosylated hemoglobin >7% or fasting blood glucose >7.2 mmol/L). All interviews were audio-recorded and analyzed using thematic analysis. The interviews were conducted for 68 patients. Sixty-seven patients were suffering from Diabetes Mellitus Type 2, and one patient was suffering from Diabetes Mellitus Type 1. We identified the barriers to medication adherence and classified them under six main factors: patients-, medications-, healthcare-, provider-, social-, and disease-related factors. The main barriers identified were the use of alternatives, hard-pressed for time, polypharmacy, bad relationship with the physician, cultured beliefs, self-alteration of the dose, exposed side effects, ineffective medications, refusal of insulin, multiple doctor visits, uncontrolled diet, and forgetfulness. Multiple barriers that prevented the patients from medication adherence were related to poor knowledge, counseling, psychological management, and social support. Appropriate educational programs, suitable patient-specific counseling, and close follow-ups would be required to improve the knowledge, outcomes, and quality of life in uncontrolled diabetes patients.

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Rodríguez, Patricia Vera, Zully Vera, Olga Maciel, Lupe Marin, Gladys Mabel Maidana, Gina Marin, and Gustavo H. Marin. "Evaluation of the Health Impact of the National Diabetes Program in Paraguay." Journal of Drug Delivery and Therapeutics 11, no. 2 (March 15, 2021): 58–62. http://dx.doi.org/10.22270/jddt.v11i2.4597.

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The clinical evolution of a diabetic patient is linked to its compliance with non-pharmacological measures such as diet, physical activity, acquiring habits, medical controls and also with its pharmacological treatment. In different Latin American countries such as the Republic of Paraguay, there are National Programs to provide free support and treatment to the diabetic population that mostly have vulnerable social conditions. However, the impact of these government policies is not routinely evaluated. In order to establish the achievements of a state diabetes program, the present study was carried out. Methodology: This is a descriptive, cross-sectional study with an analytical stage. Results: low adherence to non-pharmacological measures such as diet and physical activity was detected. A high percentage of patients were overweight (38%) or obese (46.5%). 75% of the population enrolled in this study did not comply with the program recommendations regarding the time and frequency of physical activities, nor they complied with the minimum 6 daily meals required. Only 37% of the patients had normal levels of glycated hemoglobin and 51.3% of them had pharmacological treatment adherence. Low compliance was observed in relation to regular medical examinations (which were under free coverage by the program) that are transposed in 22% of retinal studies and 60% in 24-hour urine analysis for the early detection of complications such as retinopathy and nephropathy. Conclusion: Despite the economic and logistical efforts carried out by State programs in order to care of people with diabetes mellitus, data showed a low adherence of patients to the proposed pharmacological and non-pharmacological measures. A personalized follow-up strategy is necessary to improve treatment adherence and to obtain better therapeutic results. Keywords: Diabetes, adherence, treatment measures, National Program

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Lai Ying, Chong, and Noraida Mohamed Shah. "ADHERENCE TO INSULIN TREATMENT IN CHILDREN WITH TYPE I DIABETES MELLITUS AT A HOSPITAL IN MALAYSIA." Asian Journal of Pharmaceutical and Clinical Research 10, no. 11 (November 1, 2017): 356. http://dx.doi.org/10.22159/ajpcr.2017.v10i11.20130.

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Objective: This study aimed to evaluate adherence to insulin treatment and identify factors that influence adherence in children with T1DM at a tertiary care hospital in Malaysia.Methods: Patients were identified from the pharmacy computer system based on the prescribed insulin therapy from 2010 to 2014. Medical records of screened patients were then retrieved from the medical record department. Adherence was assessed via the medication possession ratio (MPR) and glycated hemoglobin A1c value. Patients were classified as adherent or non-adherent if the MPR calculated for the prescribed insulin regimen was ≥80% or <80%, respectively. Patients with A1c values <7.5% based on medical records were also classified as adherent.Results: A total of 57 patients were included in this study, with a 57.9% male predominance and a mean age of 14.39 ± 3.41 years. Thirty-nine (68.4%) and three patients (5.3%) were classified as adherent to insulin treatment according to MPR and A1c values, respectively. Poor agreement between the MPR and A1c value in determining adherence was found based on kappa analysis (kappa = −0.108, p=0.009). There was no association between age, sex, race, presence of comorbidities, or duration of T1DM diagnosed and adherence based on the A1c value (p>0.05). These predictors were also found to be insignificant based on multiple logistic regression analysis (p>0.05).Conclusion: Adherence to insulin treatment based on the A1c measurement was generally poor among children with T1DM. Further prospective research should be performed in this area to identify reasons for the non-adherence to insulin treatment so that appropriate interventions can be instituted to improve adherence and ultimately prevent complications from the disease.

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Cai, Cindy X., Yixuan Li, Scott L. Zeger, and Melissa L. McCarthy. "Social determinants of health impacting adherence to diabetic retinopathy examinations." BMJ Open Diabetes Research & Care 9, no. 1 (September 2021): e002374. http://dx.doi.org/10.1136/bmjdrc-2021-002374.

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IntroductionThis study evaluates the association of multidimensional social determinants of health (SDoH) with non-adherence to diabetic retinopathy examinations.Research design and methodsThis was a post-hoc subgroup analysis of adults with diabetes in a prospective cohort study of enrollees in the Washington, DC Medicaid program. At study enrollment, participants were given a comprehensive SDoH survey based on the WHO SDoH model. Adherence to recommended dilated diabetic retinopathy examinations, as determined by qualifying Current Procedural Terminology codes in the insurance claims, was defined as having at least one eye examination in the 2-year period following study enrollment.ResultsOf the 8943 participants enrolled in the prospective study, 1492 (64% female, 91% non-Hispanic Black) were included in this post-hoc subgroup analysis. 47.7% (n=712) were adherent to the recommended biennial diabetic eye examinations. Not having a regular provider (eg, a primary care physician) and having poor housing conditions (eg, overcrowded, inadequate heating) were associated with decreased odds of adherence to diabetic eye examinations (0.45 (95% CI 0.31 to 0.64) and 0.70 (95% CI 0.53 to 0.94), respectively) in the multivariate logistic regression analysis controlling for age, sex, race/ethnicity, overall health status using the Chronic Disability Payment System, diabetes severity using the Diabetes Complications Severity Index, history of eye disease, and history of diabetic eye disease treatment.ConclusionsA multidimensional evaluation of SDoH revealed barriers that impact adherence to diabetic retinopathy examinations. Having poor housing conditions and not having a regular provider were associated with poor adherence. A brief SDoH assessment could be incorporated into routine clinical care to identify social risks and connect patients with the necessary resources to improve adherence to diabetic retinopathy examinations.

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Aji Wibowo, Much Ilham Novalisa, Febiana Melisa Fitri, Nanang Munif Yasin, Susi Ari Kristina, and Yayi Suryo Prabandari. "Kepatuhan Minum Obat pada Pasien Diabetes Melitus Tipe 2 di Beberapa Puskesmas Kabupaten Banyumas." Jurnal Kefarmasian Indonesia 11, no. 2 (August 31, 2021): 98–108. http://dx.doi.org/10.22435/jki.v11i2.3635.

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Diabetes mellitus (DM) is considered as ”the mother of all diseases" because it causes many complications. Knowing and measuring medication adherence may have a greater effect on DM patients. Several studies in Indonesia used a questionnaire scale to measure adherence, however they do not validate the study population, so it could still be found anomalous correlation analysis between adherence and clinical data even though it measured in the same country and scale. This study measure the adherence level of type 2 diabetes patients, evaluates the validity of the medication adherence scale, and analyze the correlation with the clinical outcome of type 2 diabetes patients in four health centers in Banyumas district. The study uses a cross-sectional design in Prolanis type 2 DM patients of January -April 2020. The adherence is measured by MARS-10, backward-forward translation method followed by content and internal validation. Clinical outcome is evaluated based on fasting blood glucose measurement. The results of the MARS-10 Gregory index analysis showed content validity in the high category (IG ≥ 0.8). The content validity showed the results of 9 questions with the value of r count> r table (n = 30, r table = 0.361). Reliability analysis showed Cronbach's Alpha 0.747> 0.6. The measurement showed 80.3% was adherent patients and 19.3% was non-adherent patients. Correlation analysis showed that there was no significant relationship (p> 0.05) between patient adherence and clinical outcome. Those results showed that type 2 diabetes mellitus patients in 4 health centers were categorized as adherent but not correlated with the clinical outcome. This was enable due to the clinical outcome was simultaneously influenced by several factors: general factors, individual factors, and unpredictable factors.

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Cangialosi, Peter, Mark Liotta, Diana Finkel, Shobha Swaminathan, and Steven Keller. "601. Disparities in Diabetes Care: Smoking Cessation among Women and Minorities Living with HIV at an Urban Academic Medical Center." Open Forum Infectious Diseases 7, Supplement_1 (October 1, 2020): S363. http://dx.doi.org/10.1093/ofid/ofaa439.795.

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Abstract Background People living with HIV (PLWH) and diabetes mellitus are at increased risk of developing significant medical complications such as atherosclerotic cardiovascular disease. Disproportionate rates of diabetes and HIV among minority groups raise the issue of how demographic disparities may impact care. The American Diabetes Association (ADA) 2020 guidelines for diabetes care recommend optimal glycemic levels (A), blood pressure control (B), lipid reduction (C), and smoking cessation (N), commonly referred to as ABC or ABCN criteria. This quality assessment project examines diabetes management in PLWH by gender, race/ethnicity, and BMI, in a predominantly minority-serving clinic, as assessed by rates of guideline adherence to the above metrics. Methods This project was reviewed and approved by the Rutgers IRB. Patients from an HIV registry of University Hospital Infectious Disease Outpatient clinic in Newark, NJ were reviewed for a diagnosis of diabetes and both a clinic visit and an A1c score recorded between 2/1/2019 and 1/31/2020. Achieving glycemic target was defined as HbA1c < 7.5 for patients < 65 and HbA1c < 8 for patients > 65. Target adherence criteria also included a blood pressure average of < 140/90 over this period and an LDL-c of < 100 mg/dL. Non-smoking status includes both former and never smokers. Results Of 1035 patients reviewed, a total of 172 met criteria. Adherence rate for achieving goal HbA1c was 61.6% (95% CI 54.2-68.6, n=172). Blood pressure and LDL-c adherence rates were 65.1% (95% CI 57.7-71.8, n=172) and 67.4% (95% CI 60.1-74.0, n=172), respectively. ABC and ABCN rates were 24.4% (95% CI 18.6-31.4, n=172) and 18.6% (95% CI 13.5-25.1, n=172). The overall smoking rate, as well as the rates in the female subgroup, those with BMI 18.5-24.9, and the non-Hispanic black subgroup were significantly higher than the national average (P< 0.05). Table 1: Demographic Data of PLWH and Diabetes Table 2: Adherence to ABCN Criteria in Diabetes Care by Demographics for PLWH from 2/1/2019 – 1/31/2020 Conclusion For diabetic PLWH, smoking cessation requires improvement, particularly in female, normal BMI, and non-Hispanic black subgroups. These findings, in addition to a majority overweight patient population, highlight the need for increased education and interventions aimed at nutritional counseling and risk factor mitigation among all patient subgroups. Disclosures All Authors: No reported disclosures

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Spandana, M. S. . "Importance of Healthy Lifestyle, Medication Adherence and Regular Follow Up in Diabetic Patients: A Mini Review." International Journal of Preclinical and Clinical Research 3, no. 1 (April 8, 2022): 11–16. http://dx.doi.org/10.51131/ijpccr/v3i1.22_17.

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Diabetes Mellitus is a chronic illness affecting a huge part of the world. The global prevalence of diabetes in the recent years has increased to a large extent to reach epidemic proportions. This is mainly due to the adaptation of new lifestyle affecting the quality of life in the recent times. The drastic surge in the occurrence of diabetes has transformed the disease into an alarming social, financial, clinical and public health issue. The disease is associated to numerous clinical manifestations that affect human health on a chronic term. Some common complications include cardiovascular diseases, neuropathy, retinopathy, nephropathy, cognitive disorders and dementia. There are a wide range of pharmacological treatment options for diabetes patients but it does not help in keeping the condition in control. Hence, it is important to include non-pharmacological interventions to manage the illness. A change in the present lifestyle is the most important intervention. Dietary patterns of the patients must be modified to achieve a greater regulation on fluctuation of the glycaemic levels in the body. Physical activity and exercise aid in a better utilization of glucose, along with increasing insulin sensitivity. Exercise must be planned according to the condition of the disease in the patient to avoid complications. Energy restriction through diet and exercise also helps in weight loss, further dealing with the complications associated with obesity. Furthermore, maintaining a better sleep hygiene, adherence to treatment and regular follow up are considered to be some of the interventions that support improvement of diabetic health. Hence, the present study concludes that these interventions provide a healthy lifestyle that can result in a better management of the disease. Keywords: Diabetes Mellitus, Mediterranean Diet, Physical Activity, Exercise, Adherence

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Shukla, Prashant, Shikha Palta, Anita Gupta, and Vijay K. Sehgal. "A study to evaluate compliance in patients of diabetes mellitus in a North-Indian tertiary care hospital." International Journal of Basic & Clinical Pharmacology 7, no. 3 (February 22, 2018): 480. http://dx.doi.org/10.18203/2319-2003.ijbcp20180661.

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Background: The objective of the study was to determine level of adherence and recognize various causative factors which can affect the compliance in the diabetic patients.Methods: This was an observational study. The study was conducted by enrolling patients of the outpatient department of Medicine of Rajindra Hospital, Government Medical College, Patiala, Punjab. To assess adherence, a questionnaire was administered to the patients - Morisky Medication Adherence Scale (MMAS) -8 item questionnaire. The various factors affecting compliance was determined by a researcher made questionnaire.Results: Out of a total of 100 subjects, age range extended from 18 years to 80 years. The mean age was 57.52±12.33years. 51% of patients were females and 49% was males. Analysis of MMAS- 8 item scores of patients showed that 52% of patients had low adherence, 29% had medium while 19% had high adherence to the treatment. Only 30% patients were compliant i.e. with HbA1C value of 7 or less while 70% patients were non-compliant i.e. with HbA1C value of more than 7.Conclusions: Compliance to medical treatment is influenced by a myriad of factors. In order to promote compliance, it is necessary to increase awareness about the disease, possible complications and treatment guidelines among patients as well as their family members.

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Chima, Charles C., Brenna Swanson, Nnabuchi Anikpezie, and Jason L. Salemi. "Alleviating diabetes distress and improving diabetes self-management through health coaching in a primary care setting." BMJ Case Reports 14, no. 4 (April 2021): e241759. http://dx.doi.org/10.1136/bcr-2021-241759.

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Considering the rising global burden of diabetes and its complications, effective interventions for addressing barriers to diabetes self-management are needed. Diabetes distress, a psychological barrier to diabetes self-management, has become increasingly recognised in the literature, but effective and feasible ways of addressing it in routine primary care settings are not known. We present the case of a middle-aged non-Hispanic white American woman with poorly controlled diabetes (haemoglobin A1c (HbA1c): 13.9%) and elevated diabetes distress (baseline Diabetes Distress Scale Score: 2.53) who participated in a health coaching intervention. After the 5-month programme, which included eight 45 minute long sessions with a trained health coach, the patient achieved and sustained a 0.8-point reduction in diabetes distress, an improvement in insulin adherence and a 3.6-point reduction in HbA1c. This case demonstrates a novel approach to managing diabetes distress that entails providing patients a safe, nonjudgemental space to express their feelings and explore challenges with diabetes self-management.

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Zaniolo, Orietta. "Costs of diabetes in Italy." Farmeconomia. Health economics and therapeutic pathways 10, no. 2 (June 15, 2009): 73–81. http://dx.doi.org/10.7175/fe.v10i2.165.

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Among chronic diseases, diabetes is one of the most impacting on healthcare expenditures. This impact is expected to continue growing over time, because of increasing prevalence and earlier diagnosis, with subsequent longer duration of the disease. A review of the main Italian cost of illness studies has been conducted, with a focus on papers addressing the cost structure of diabetes care and those exploring the resources determining the expenditure difference between diabetic and non-diabetic patients. According to different sources, in Italy the yearly average direct cost for diabetes management ranges from € 2,340 to 2,990 per patient. Drugs account for 22-34% of this burden, while 52-60% is due to hospitalization. Of the pharmaceutical expenditure, only 10-11% is related to oral hypoglycemic drugs. Complications account for a large share of diabetes costs: vascular complications induce a 70-100% cost increase. Several studies compared health care expenditures for diabetic patients with those for matched control patients without diabetes. These studies point out that diabetic patients have higher health costs due to an increase in the prevalence of use of health care resources and/or an increase in their prescribed amount. As expected, this gap is mainly due to the treatment of diabetes complications, as opposed to routine disease management; furthermore, some evidence showed that cost increases related to diabetes diagnosis are also caused by drugs, hospitalizations and specialist consultations required for managing disorders traditionally considered not related to diabetes. Consistently with international literature data, our review suggests that the improvement of therapy adherence, together with the adoption of strategies specifically prescribed in order to prevent or delay complications, may be able to ameliorate long term clinical and quality of life outcomes, with a marginal increment of health expenditures.

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M., Manobharathi, Kalyani P., John William Felix A., and Arulmani A. "Factors associated with therapeutic non-compliance among type 2 diabetes mellitus patients in Chidambaram, Tamilnadu, India." International Journal Of Community Medicine And Public Health 4, no. 3 (February 22, 2017): 787. http://dx.doi.org/10.18203/2394-6040.ijcmph20170759.

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Background: Diabetes mellitus is one of the most common non-communicable diseases causing many serious complications worldwide. Therapeutic non-compliance leads to treatment failure thus making diabetes a serious problem to both the individuals and the health care providers. There are many factors which influence patient’s compliance. The aim of this study is to assess the frequency of therapeutic compliance and factors associated with therapeutic non-compliance.Methods: A descriptive cross-sectional study was conducted among type 2 diabetes mellitus patients attending the urban health centre, Chidambaram. Compliance and factors associated with non-compliance were assessed using Morisky Medication adherence questionnaire.Results: 108 diabetic patients were enrolled. The overall compliance rate was found to be 39.8%. A statistically significant association was found between non-compliance and associated chronic diseases (p=0.007), financial problems to buy the medicines (p=0.001), reporting side effects with the prescribed medicines (p=0.049), missed at least one dose in last one week(p=0.01).Conclusions: Majority of the patients were non-compliant. This emphasizes the need of strengthening health system and improving patients knowledge through teaching programs.

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Earle, Matthew, Brian Ault, and Caitlin Bonney. "Euglycemic Diabetic Ketoacidosis in Concurrent Very Low-carbohydrate Diet and Sodium-glucose Transporter-2 Inhibitor Use: A Case Report." Clinical Practice and Cases in Emergency Medicine 4, no. 2 (April 23, 2020): 185–88. http://dx.doi.org/10.5811/cpcem.2020.2.45904.

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Introduction: With the incredibly high incidence of Type 2 Diabetes in the current population of emergency department patients, it is critical for clinicians to understand the possible complications of the treatment of this disease. Medication like canagliflozin are more common to encounter on patient’s home medication lists and clinicians should be aware of how these medications, alone or combined with dietary modifications, can result in significant pathology and even mortality if not appropriately treated. Case Report: We report a case of a patient with type II diabetes mellitus who presented with euglycemic diabetic ketoacidosis in the setting of concurrent use of canagliflozin, a sodium-glucose transporter-2 (SGLT-2) inhibitor, and strict adherence to a low-carbohydrate ketogenic diet for weight control. Discussion: Euglycemic ketoacidosis has previously been observed in both diabetic and non-diabetic patients following strict ketogenic diets, as well as in diabetic patients being treated with SGLT-2 inhibitors. Conclusion: As more patients choose ketogenic diets for weight control and diabetes management, clinicians should be aware of this potentially life-threatening complication in patients concurrently taking SGLT-2 inhibitors.

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Pezeshki, Babak, Ehsan Bahramali, Amir Ansari, Aliasghar Karimi, Mojtaba Frajam, and Azizallah Dehghan. "Impact of Physical Activity on the Incidence of Vascular Diseases in Adults with Type 2 Diabetes Mellitus." Galen Medical Journal 8 (May 20, 2019): 1549. http://dx.doi.org/10.31661/gmj.v0i0.1549.

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Background: Diabetes mellitus (DM) is a common metabolic disease worldwide and has many complications. The vascular events are the major complication of DM that have an important effect on mortality and disability. The physical activity (PA) enhances the vascular function by several pathways. The aim of this study was to evaluation of the relationship between PA and vascular diseases in patients with DM.Materials and Methods: This research was performed as the case-control study that was extracted from a prospective epidemiological research study in Iran (PERSIAN). The patients with type 2 DM more than six months defined as case group and the non-DM subjects in control group with ratio 1:2, and both groups were matched in the term of age and sex. The MET score was used to evaluate the level of PA and blood glucose, lipid profile, body mass index, overweight, dyslipidemia, glomerular filtration rate, myocardial infarction (MI), unstable angina, and stroke.Results: Overall, 1242 patients with DM were extracted, and 2484 non-diabetic subjects were investigated. In the case group, 355(28.6 %) and 887(71.4%) were men and women, respectively, the and 710 (28.6%) men and 1774(71.4%) women in control group. The mean MET score was 30 and 40.97 in the DM and non-DM groups, respectively (P˂0.001). The frequency of MI, stroke, and cardiac ischemia were 44 (3.5%), 37 (3%), and 267 (21.5%), respectively in DM group, and 54 (2.2%), 43 (1.7%), and 389 (15.7%), respectively in non-DM group.Conclusion: The incidence of vascular events associated with PA level in patients with DM and adherence to regular PA reduce the vascular events and DM complications. [GMJ.2019;inpress:e1549]

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Cestario, Elizabeth do Espirito Santo, Anderson Aparecido Santim, Beatriz Beretta Alves, Beatriz Pereira Alcarde, Beatriz Sanches Rodrigues, Catarina De Souza Nascimento, Fernanda De Almeida Spósito, et al. "Prevalence, Knowledge and Treatment of Systemic Arterial Hypertension in A Campaign Day." European Journal of Medical and Health Sciences 4, no. 1 (January 13, 2022): 14–20. http://dx.doi.org/10.24018/ejmed.2022.4.1.1126.

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Hypertension affects 1.4 billion of the world population, being considered the main cause of cardiovascular diseases and, therefore, an important cause of premature and preventable mortality worldwide. It is associated with complications such as atherosclerotic coronary artery disease, congestive heart failure, stroke, intracerebral hemorrhage, and chronic kidney disease. Given this prevalence and risk, strategies were created to control the disease, such as changes in lifestyle and use of medications. However, non-adherence to treatment is a frequent concern and it is associated with adverse results and an increased number of complications. Therefore, the present study aims to present the incidence of arterial hypertension in the population of a city in the inland part of São Paulo, relating it to its risk factors, adherence to treatment and disease control. The objective is evaluating the incidence and rate of uncontrolled systemic arterial hypertension on a campaign day in a city in the inland part of São Paulo. The method is observational, cross-sectional, descriptive, population-based study, random sample of 545 individuals, 231 women and 314 men, collected in a city in the northwest of São Paulo on a campaign day. The study showed a prevalence of 46.24% for hypertensive patients, with 88.9% adherence to treatment and pressure loss of 34.23%. Among the analyzed hypertensive patients, there was a higher incidence among the elderly, obese, and people with diabetes mellitus. Regarding adherence and disease control, better results were noted among patients with complications such as AMI and thrombotic events, and less adherence among obese, alcoholics and smokers. The results of the present study are consistent with literature data, showing that even with knowledge of the disease, part of the population does not have adequate treatment, showing the need for integrated health policies for early diagnosis, distribution and treatment regulation, and actions to improve lifestyle.

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Kohut, Anna, O. Potapov, I. Frankova, M. Bobryk, J. Komisarenko, and O. Chaban. "Multidisciplinary Intention: Revealing The Consequence of Psychosocial Factors on the Adherence to Treatment of the Patients with Type 2 Diabetes Mellitus." Mental Health: Global Challenges Journal 2, no. 1 (October 15, 2019): 15–17. http://dx.doi.org/10.32437/mhgcj.v2i1.43.

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Background: Diabetes Mellitus type 2 (T2DM) has been becoming a globalworld health problem affecting countries with different income level (Mogre,Johnson, Tzelepis, Shaw, & Paul, 2017). The low level of compliance and theincreased level of the diabetes distress has been closely associated with destituteglycemic control. Some diabetes-specific psychological variables may beimportant for psychological status of patients and glycemic control to theachievement of individual glycemic targets (Indelicato et al., 2017). Therefore,alexithymia – psychological clinical characteristic of the reduced emotionalcomponent that could have been associated with the metabolic syndrome inpatients with type 2 diabetes, for example (Lemche, Chaban, & Lemche, 2014). Itis important to consider the clinical evaluation of mental aspects in patients withT2DM, however, in order to preventing potentially unfavorable self-care behaviorleading to complications of this disease, including a decrease in the quality of lifelevel (Conti et al., 2017). Patient's level of the quality of life is the one of mainimportant components of treatment adherence and clinical decision making forimproving the effectiveness of therapy (Chaban, Khaustova, & Bezsheiko, n.d.).The low level of medication compliance and quality of life could have beenaddicted in consequence to non-adherence and respectively – inefficiency oftherapy of these patients. Therefore, multidisciplinary connection – involvingmental health care specialists can potentially improve treatment effectiveness(Kogut at al., 2018).

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Pezeshki, Babak, Ehsan Bahramali, Amir Ansari, Aliasghar Karimi, Mohammad Sabet, Mojtaba Frajam, and Azizallah Dehghan. "Impact of Physical Activity on the Incidence of Vascular Diseases in Adults with Type 2 Diabetes Mellitus." Galen Medical Journal 8 (May 20, 2019): e1549. http://dx.doi.org/10.31661/gmj.v8i0.1549.

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Background: Diabetes mellitus (DM) is a common metabolic disease worldwide and has many complications. Vascular events are the major complication of DM, which have an important effect on mortality and disability. Physical activity (PA) enhances the vascular function by several pathways. The aim of this study was to evaluate the relationship between PA and vascular diseases in patients with DM. Materials and Methods: This study was performed as a case-control study extracted from a prospective epidemiological research study in Iran. Patients with type 2 DM for more than six months as a case group were compared to sex- and age-matched healthy control subjects. The metabolic equivalent of task score was used to evaluate the level of PA and blood glucose, lipid profile, body mass index, overweight, dyslipidemia, glomerular filtration rate, myocardial infarction, unstable angina, and stroke. Results: Overall, 1242 patients with DM were extracted, and 2484 non-DM subjects were investigated. In the case group, 355 (28.6%) and 887 (71.4%) subjects were men and women, respectively, and 710 (28.6%) men and 1774 (71.4%) women were in the control group. The mean metabolic equivalent of task score was 30 and 40.97 in the DM and non-DM groups, respectively (P˂0.001). The frequency of myocardial infarction, stroke, and cardiac ischemia was 44 (3.5%), 37 (3%), and 267 (21.5%) in the DM group, and 54 (2.2%), 43 (1.7%), and 389 (15.7%) in the non-DM group, respectively. Conclusion: The incidence of vascular events associated with PA level in patients with DM and adherence to regular PA reduced vascular events and DM complications. [GMJ.2019;8:e1549]

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Skelly, Anne H., James R. Marshall, Brenda P. Haughey, Paul J. Davis, and Robert G. Dunford. "Self-Efficacy and Confidence in Outcomes as Determinants of Self-Care Practices in Inner-City, African-American Women with Non-Insulin-Dependent Diabetes." Diabetes Educator 21, no. 1 (February 1995): 38–46. http://dx.doi.org/10.1177/014572179502100107.

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The puipose of this study was to examine the extent to which Perceived self-efficacy and confidence in outcomes, selected demographic variables, and disease characteristics (age, duration of diabetes, presence of documented complications) affect an individual's adherence over time to a diabetes regimen of home glucose testing, medication/insulin administration, diet, and exercise. A convenience sample of 118 inner-city, African-American women with type II, non-insulin-dependent diabetes mellitus receiving outpatient care at a large urban hospital were asked to complete measures of each of the psychosocial variables on two occasions, separated by an interval of 4 to 5 months, and coinciding with their next scheduled clinic visit. Bivariate and multivariate analyses at Times 1 and 2 demonstrated the ability of self-efficacy alone to explain diet, exercise, and home-testing behaviors while suggesting variability within individuals in sense of self-efficacy over time.

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Agarwala, Sourav, Md Asif Ansari, Uttam Kumar Paul, and Arup Bandyopadhyay. "A qualitative study on non-adherence to oral hypoglycemic agents in type 2 diabetics." International Journal of Advances in Medicine 4, no. 4 (July 20, 2017): 1099. http://dx.doi.org/10.18203/2349-3933.ijam20173239.

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Background: Non-adherence to oral hypoglycaemic agents is both a global and ubiquitous problem during treatment of type 2 diabetes mellitus. This leads to unwanted persistence and aggregation of hyperglycemia as well as many of the complications of diabetes mellitus and even to early death. However, there have been quite a few studies on this issue but different studies have shown different reasons of non-adherence because of this confusion and also because no studies have been done in Bihar and North Bengal, the present authors decided to go for a qualitative study on this issue.Methods: This study was conducted in the medicine OPD of two medical colleges one in Bihar and another in north Bengal. The study method was one of the qualitative descriptive nature in which open interviews are conducted on non-compliant diabetic patients. Audio recording was taken in each case after taking written permission from the patients as well as from the institutional ethical committee. A transcript in English was made manually of each audio recording and then transcript analysis was done using categories and codes.Results: The results showed existence for four broad categories, viz, adverse effect, economic issues, availability and alternative treatment. Each category was divided into several codes like - adverse effects into weakness, hypoglycemia, organ damage, vertigo and fear; economic issues into high cost, low income, lifelong high expenditure and family crisis; availability into total non-availability, local non-availability, travel expenses and problems to buy from distance and brand non-availability; lastly alternative treatment included Ayurveda, Homeopathy and jori-buti. The last two categories, viz, non-availability and alternative therapy are very much unique in our study.Conclusions: It can be concluded that non-adherence is very much a problem in our places as it is in other places, nationally and globally. But it is slightly different here. We must find out solutions for this problem and start interventions immediately.

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Hiwa S. Namiq, Kawa A. Obeid, and Dilan A. Mohammed. "Role of Pharmaceutical Care in Type 2 Diabetic Patients in Kirkuk City." Al Mustansiriyah Journal of Pharmaceutical Sciences 20, no. 4 (April 18, 2022): 169–81. http://dx.doi.org/10.32947/ajps.v20i4.788.

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Background and objectives. Diabetes Mellitus is a chronic metabolic disorder that negatively affects patient’s quality of life and creates a huge burden on both patients and health care system. Effective pharmaceutical intervention could result in a tighter disease control, reducing long term complications and improving the quality of life. Methods: In this study, a prospective clinical trial was performed to evaluate the role of pharmaceutical care in reducing complications and in improving the quality of life among patients with T2DM.A total of 189 patients were included and divided into two groups; the first group: consisted of 95 patients, comprised the intervention group who received regular pharmaceutical care on monthly basis. The rest 94 patients were allocated to the non-intervention group who only received usual medical care. Patient selection was carried out according to certain inclusion and exclusion criteria. Two categories of data were recorded from each participant at 6 time points during the study period. The first category was assessment of risk factors of complication such as hypertension, hyperlipidemia, uncontrolled hyperglycemia, physical inactivity and smoking. The second category was current status of diet and quality of life. Results: The number of drug therapy problems non-adherence to medication and HBA1c were significantly reduced and quality of life was significantly improved among intervention group. Other Clinical and blood parameters were not affected. Conclusion: Pharmacist collaboration with physicians regarding management of type II diabetes patients have yielded a better patient management outcome, reduced risk factors and improved the quality of life in those patients.

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Mulyadi, Mulyadi, Didik Mulyono, and Sriyatun Sriyatun. "The Relationship Between Level of Knowledge About Diet With Diabetes Mellitus Diet Compliance at Pangkur Public Health Center, Ngawi Regency." Jurnal Midpro 13, no. 1 (June 1, 2021): 69. http://dx.doi.org/10.30736/md.v13i1.292.

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Diabetes Mellitus (DM) is a non-communicable disease that often causes health problems in the community. One way to avoid complications of DM is to adjust the diet. Adherence to the DM diet is a problem for DM patients in the community. The purpose of this study was to determine the relationship between the level of knowledge about diet with dietary compliance in patients with diabetes mellitus. This research is a quantitative study using a cross sectional design. A sample of 37 respondents was taken using the Simple Random Sampling technique. Bivariate analysis conducted in this study used the Spearman test. The results of the study obtained Pearson correlation with p value = 0.000 <0.05 with a correlation level of 0.779. In conclusion, there is a relationship between the level of knowledge about diet and dietary compliance in patients with diabetes mellitus with a very strong correlation level. Knowledge about diabetes mellitus is one of the factors in increasing dietary compliance in people with diabetes mellitus. Health workers should be more active in involving families in the care of patients with diabetes mellitus.

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Pan, Tania, Aparajita Dasgupta, Sweta Suman, Bobby Paul, Rajarshi Banerjee, and Jayeeta Burman. "Assessment of glycaemic control in patients with type 2 diabetes: a clinic-based study in a slum of Kolkata." International Journal Of Community Medicine And Public Health 5, no. 11 (October 25, 2018): 4768. http://dx.doi.org/10.18203/2394-6040.ijcmph20184566.

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Background: Although diabetes is a chronic condition, it can be controlled and managed to prevent complications. Long-standing diabetes with poor glycaemic control leads to many complications. This study aims to assess the glycaemic control status and its associated factors among type 2 diabetes patients attending Urban Health Centre in a slum of Kolkata, West Bengal.Methods: A clinic-based cross-sectional study was conducted among 184 diabetic patients attending clinic at Urban Health Centre, Chetla from October-December 2017. Each respondent was interviewed using a structured schedule to collect data on sociodemographic characteristics, physical activity, disease profile and self-care activities. Height and weight were measured. Individuals with PPBS ≥160 mg/dl were said to have poor glycaemic control. Data entry and analysis was done using SPSS version 16.0.Results: Out of 184 participants, 37.5% had poor glycaemic control. Mean (±SD) age of the participants was 51.64 (9.64) years. Median duration of diabetes was 4 years. 104 (56.5%) had overweight/ obesity. Only 26.6% had satisfactory dietary practice. Test results revealed ≥4 years duration of diabetes, overweight/ obesity, smoking, unsatisfactory diet and non-adherence to medications as significant predictors of poor glycaemic control, explaining 31.6% of the variance of glycaemic control with non-significant Hosmer–Lemeshow statistics.Conclusions: The study has identified factors associated with poor glycaemic control among the study participants. Emphasis on promoting a healthy lifestyle which includes a healthful eating plan, cessation of smoking, maintaining optimum body weight and strictly adhering of prescribed medications would go a long way in maintaining good glycaemic control.

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Vizcaino, Maricarmen. "Hatha Yoga Practice for Type 2 Diabetes Mellitus Patients: A Pilot Study." International Journal of Yoga Therapy 23, no. 2 (January 1, 2013): 59–65. http://dx.doi.org/10.17761/ijyt.23.2.b57106j138027205.

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Objective: This study was conducted to examine the impact of Hatha yoga on glycemic control, psychological and physiological stress, and self-care for individuals with type 2 diabetes mellitus (T2DM). Methods: Ten sedentary individuals with T2DM who were non-insulin dependent, free of diabetes-related complications, and had no previous yoga experience completed therapeutic yoga classes for 6 weeks, 3 times per week . Glycemic control measures included fasting blood glucose, glycated hemoglobin, and fasting insulin. The State-Trait Anxiety Inventory, Perceived Stress Scale, and salivary cortisol were used to assess levels of stress, and the Summary of Diabetes Self-care Activities questionnaire was used to assess regimen adherence. Results: No significant changes in glucose control or physiological stress were found; however, significant changes in perceived stress, state anxiety, and self-care behaviors were detected. Conclusions: Preliminary findings support further investigation of the benefits of Hatha yoga as a complementary therapy for those with T2DM.

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Journal articles on the topic 'Non-adherence, diabetes complications'

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