This study will be focussing on the experiences of Xhosa-speaking patients with DM utilising the NMMM public hospitals complex. In the OPD patients are assessed and treated for all chronic conditions including DM, and patients are seen at monthly intervals or when necessary. The OPD serves the neighbouring black population from the surrounding townships as well as the informal settlements. The effects of urbanisation have resulted in this area having a semi–rural, semi-urban population that is mostly Xhosa speaking. The bulk of the population is unemployed, while others are living on a minimal income. Unemployment in the Eastern Cape ranges from 40% in rural areas, rising to 50 - 60% in the urban areas (Proposed aluminium Pechiney smelter within the Coega IDZ, 2002:4-8). In some homes there is no or little money to buy food, and even less to make use of a health service. Some people live on either a social grant for the elderly, a grant for young children or a disability grant and most people in this area have an income below the level at which payment of taxes for contribution to the economy is possible.

Mitochondria are found in all cells of the body except red blood cells. Mitochondria is the organelle that produces the most ATP in the body, which is the cells energy carrier. All processes in the body require energy in one way or another, hence the function of mitochondria is very important. In mitochondrial disease, there is an impairment in the function of the mitochondria, where the respiration usually is affected. Mitochondria play a big role in the regulation of glucose-stimulated insulin secretion of the pancreatic β-cells hence why diabetes often can be caused by mitochondrial dysfunction. Diabetes often requires treatment to achieve normal blood sugar levels. Metformin, rosiglitazone and troglitazone are three drugs for treatment of type 2 diabetes and have been proven to affect mitochondrial function or the body negatively, hence why it is important to be careful with which treatment that is used in case of mitochondrial diabetes. The purpose of this ex vivo model with human mitochondria were to investigate with high resolution respirometry whether the antidiabetic drugs could reduce the respiration in mitochondria and at what concentration it became significant. The results showed that metformin did not decrease the respiration at all with additions in the range of 10 µM to 100 µM, which rosiglitazone and troglitazone did. The therapeutic concentrations of the drugs are lower than the concentrations investigated in this study. However, since healthy cells are used in this study the effect that the drugs have on impaired mitochondria could be different. The conclusion of this study is that there was a significant decrease in the respiration for two of three drugs and should be carefully used. Further studies with impaired mitochondria should be performed to really see what affect these drugs have.

Studies investigating the use of behavioral techniques in the treatment of health-related problems have recently received considerable emphasis. Problems such as enuresis (Atthowe, 1972; Nordquist, 1971), obesity (Stuart, 19137), alcoholism (Miller, 1972; Sobell and Sobell, 1973), chronic pain (Fordyce, Fowler, Lehman, and DeLateur, 1975·), and asthma (Neisworth, 1972; Renne and Creer. 1976) have been treated by the use of behavioral techniques. Katz and Zlutnick (1975) mention two critical areas in which behavior analysis is particularly applicable to health care: a) rehabilitation, and b) patient management. Rehabilitation involves learning behaviors related to specific physical disabilities, for example stroke patients relearning walking skills, and amputees learning various self-care and vocational skills. Patient management involves increasing or decreasing specific patient behaviors to ensure they follow prescribed treatment plans. Patients with chronic dieases such as diabetes or multiple sclerosis must often be placed on stringent medical regimens. Thus, compliance with physicians 1 requests to take medication, follow diets, or engage in exercise is a vital component of patient management and must be maintained if a patient is to sustain optimal health. In view of these considerations, knowledge of the conditions under which

Thesis (M. A. (Psychology)) -- University of Limpopo, 2021 / Diabetes has been noted globally and nationally as one of the leading causes of mortality. Studies have also shown that this morbid condition has a negative impact on the psychological well-being of those affected. The aim of this study was to survey the psychological well-being and quality of life of diabetic patients in Ga-Dikgale community, Limpopo Province, South Africa. The objectives of the study were to establish the psychological well-being and quality of life of diabetic patients at clinics in Ga-Dikgale according to gender and age. Using the General Health Questionnaire (GHQ) and the Quality of Life Indexes (QoLI), data was collected from 200 diabetic patients from clinics at Ga-Dikgale. The Kruskal-Wallis test results, amongst others, show that there are no statistically significant differences between the genders on the General Health questionnaire, (1) = 1.19, p = 0.22. The study recommends that outcomes of the psychological well-being and quality of life of diabetic patients can be improved if health practitioners factor in variances in modifying diabetes education and supportive care for individuals diagnosed with chronic conditions such as diabetes in association with mental health experts to ensure that the psychological well-being of these patients is prioritised. There is also a need to assess the psychological well-being and quality of life of diabetic patients in comparison to non-diabetic patients in rural communities such as Ga-Dikgale / VLIR-UOS (Flemish University Council)

The purpose of this study was to observe and compare the blood glucose response of individuals with documented noninsulin dependent diabetes (NIDDM) and controls after they consumed a peanut butter and cracker snack product (Austin "Toasty" crackers). Twenty-one subjects with NIDDM (15 with current NIDDM and 6 with previously abnormal glucose tolerance [prevAGT]) and 11 controls participated. Height, weight, body mass index (BMI) and age of subjects were recorded and statistically compared. Subjects tested their own blood glucose using the One Touch II glucometer, and participated on two separate occasions which were designated session 1 and session 2. Blood glucose was measured before eating the test food, every 15 (+3) minutes for two hours after eating, and at 150 and 180 minutes. Mean peak blood glucose value and the time at which glucose peaked were identified and compared among the groups. Repeated measures ANOV A was used to compare blood glucose response curves of the NIDDM group, the control group, and the PrevAGT group; slope of the line after the peak was of interest. The null hypothesis was that the groups would not differ in their blood glucose responses. / Master of Science

The aim of this study was to explore and describe the experiences of diabetes mellitus patients at the Piggs Peak Hospital in Swaziland, from the time of diabetes diagnosis to living with diabetes, adherence to treatment and implementing diabetes self-care. A descriptive, exploratory, contextual qualitative research was conducted. Data was gathered through semi-structured interviews with 26 participants purposively selected on diabetes days at the hospital. Data was analysed qualitatively. Results revealed that patients present late for diagnosis. Being diagnosed causes psychological distress of varying intensity and duration. Hospital visits are burdensome due to financial and transport challenges, as well as service shortcomings. Self-care activities are difficult due to financial challenges and nonconducive social circumstances at home. Social support is lacking. Diabetes patients fear insulin use and prefer oral tablets. It is concluded that diabetes self-care is burdensome for most patients of the PPH in Swaziland. The service providers, stakeholders, and government need to explore strategies for mitigating effects of various barriers to self-care as revealed in this study. / Health Studies / M.A. (Public Health)

The aim of this study was to explore and describe the experiences of diabetes mellitus patients at the Piggs Peak Hospital in Swaziland, from the time of diabetes diagnosis to living with diabetes, adherence to treatment and implementing diabetes self-care. A descriptive, exploratory, contextual qualitative research was conducted. Data was gathered through semi-structured interviews with 26 participants purposively selected on diabetes days at the hospital. Data was analysed qualitatively. Results revealed that patients present late for diagnosis. Being diagnosed causes psychological distress of varying intensity and duration. Hospital visits are burdensome due to financial and transport challenges, as well as service shortcomings. Self-care activities are difficult due to financial challenges and nonconducive social circumstances at home. Social support is lacking. Diabetes patients fear insulin use and prefer oral tablets. It is concluded that diabetes self-care is burdensome for most patients of the PPH in Swaziland. The service providers, stakeholders, and government need to explore strategies for mitigating effects of various barriers to self-care as revealed in this study. / Health Studies / M.A. (Public Health)

Submitted in partial compliance with the requirements of the Master’s Degree in Technology: Homoeopathy, Durban University of Technology, Durban, South Africa, 2016, / Background Diabetes mellitus is a metabolic disorder with various aetiologies, characterised by hyperglycaemia, resulting from defects of carbohydrate, fat and protein metabolism due to the deficient action of insulin on target tissues caused by insensitivity to or lack of insulin or both. The long term effects of diabetes mellitus frequently include retinopathy, nephropathy and neuropathy and an increased risk of other diseases such as cardiac, peripheral arterial and cerebrovascular disease. According to the International Diabetes Federation (IDF) 387 million people have diabetes mellitus and this number is predicted to rise to 592 million worldwide by 2035. In 2014 diabetes mellitus caused 4.9 million deaths worldwide and every 7 seconds a person dies from diabetes mellitus. The growing incidence of diabetes mellitus is a worldwide concern because of the increase of economic costs and burden of disease that is due to the cardiovascular complications and the co-morbidities. Objective The aim of this double-blind, randomised clinical trial was to determine the efficacy of Syzygium jambolanum (Java plum) 6CH and Syzygium jambolanum (Java plum) homoeopathic mother tincture on daily fasting blood glucose and glycosylated haemoglobin levels in type 2 diabetes mellitus patients on Metformin® in the treatment of type 2 diabetes mellitus. Material and Method A sample consisted of 24 volunteers selected on the basis of inclusion and exclusion criteria. These participants were then randomly divided into two groups, 13 in the group receiving the homoeopathic potency and 11 in the group receiving the homoeopathic mother tincture. Each participant attended a total of five consultations with the researcher over a period of 14 weeks that included a 2 week baseline period followed by a 12 week treatment period, at the Durban University of Technology (DUT) or Kenneth Gardens Homoeopathic Day Clinic. At each consultation a detailed and comprehensive homoeopathic case history (Appendix D) was taken and a physical examination (Appendix E) was performed by the researcher. Participants were required to fill in a log sheet (Appendix C1 and C2) with their fasting blood glucose readings daily for 14 weeks, which included a 2 week baseline period followed by a 12 week treatment period. Participants were also required to have their glycosylated haemoglobin measurements tested pre- and post-treatment. Results Both groups reflected a statistically significant reduction in fasting blood glucose levels as compared to the baseline. The mean fasting blood glucose level in week 1 was 11.8802 whereas in week 13 the mean blood glucose level was 8.6590 with a p value ≤ 0.05 for the Syzygium jambolanum 6CH group and the mean blood glucose level in week 1 was 9.0338 with a standard whereas in week 13 the mean blood glucose level was 6.8591 with a p value ≤ 0.05 in the Syzygium jambolanum homoeopathic mother tincture. However there was no significant differences between the two groups (Syzygium jambolanum 6CH and Syzygium jambolanum homoeopathic mother tincture), the significance score was 0.623 when comparing reduction in fasting blood glucose levels. Both groups reflected a statistically non-significant reduction in the glycosylated haemoglobin (HbA1C) and there were no significant differences between the two groups when comparing reduction in HbA1C levels. Conclusion Both homoeopathic preparations of Syzygium jambolanum (mother tincture and 6CH) significantly reduce fasting blood glucose levels in patients with type 2 diabetes mellitus. This result suggests that Syzygium jambolanum has beneficial anti-diabetic effects and warrants further investigation. / M

In order to better tailor treatment to specific populations, factors which contribute to health disparities among different racial/ethnic groups must be examined. Among Mexican American individuals, the high rate of diabetes represents a significant contributor to overall health. The present study focuses on factors affecting diabetes status among Mexican Americans born in either Mexico or the United States using the 2007 – 2008 NHANES data set. Comparisons were made between diabetes status based on self-report and clinical classification using HbA1c. Results indicated that within the diabetic subsample, Mexican Americans born in Mexico were twice as likely to be incorrectly classified as non-diabetic, when they actually were diabetic, when using a self-report method. In contrast, nativity did not result in differences in diabetes incidence using the HbA1c clinical cut-score diagnostic classification. Age, BMI, gender, nativity, and health insurance coverage were found to have varying relationships to diabetes prevalence and HbA1c levels, but time in the U.S. for Mexico-born individuals was not found to uniquely predict diabetes incidence. Analyses also demonstrated that Mexico-born males, as compared to the other groups, had significantly higher HbA1c levels. Further research is necessary to better understand the relationships among these factors. However, findings do demonstrate a need for more objective disease classification, particularly when examining immigration status and diabetes. Additionally, the complexity of these interactions establishes a need for specific health intervention for foreign-born populations which might be missed by self-report screening asking about presence of disease and exacerbated by an oversimplification of the “healthy immigrant effect”.

Type 2 diabetes (T2DM) has an estimated incidence of nearly 11 million US adults aged 65 years and older. Evidence suggests that the quality of the marital relationship is an important factor for diabetes related health outcomes affecting self-management and adherence (Kiecolt-Glaser & Newton, 2001). However, an individual in need may compensate for primary support that is unavailable or not optimal by looking for other sources of support, which may be important for health outcomes (Rini, et al., 2008). The present study examined compensation for poor spousal support through other social relationships. A total of 12,640 participants reported they had diabetes and were married (Male = 6,317 and Female = 6,323), and of this group 1,084 men and 583 women had died over the course of the study period. Women reported lower spousal support, but significantly more aggregated social support across relationships than men. Few persons reported low spousal support and low support compensation, rendering the cell sizes highly unequal and the associated data uninterpretable. Ancillary analyses were conducted with the idea that some variance in total compensation support may moderate mortality risk finding that higher aggregated social support across non-spousal relationships was associated with lower risk of death accounting for ~3% of the variance in the final model. The current findings demonstrate how an individual can compensate for a poor primary support relationship through a broader support network. These findings should guide future research to focus on how individuals build, maintain, and seek support from social relationships.