• Refine Query
  • Source
  • Publication year
  • to
  • Language
  • 409
  • 157
  • 114
  • 89
  • 50
  • 46
  • 21
  • 19
  • 5
  • 4
  • 3
  • 3
  • 3
  • 2
  • 2
  • Tagged with
  • 1124
  • 1124
  • 1124
  • 344
  • 245
  • 190
  • 149
  • 128
  • 128
  • 125
  • 123
  • 120
  • 118
  • 118
  • 97
  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
691

Red Raspberries Attenuate Blood Glucose Spike Of A High Glycemic Load Breakfast Cereal

Martin, Dante J 01 June 2024 (has links) (PDF)
Blood glucose (BG) spikes increase chronic disease risk in those with and without diabetes. The fiber and phytonutrient content of fruit, such as raspberries has the potential to attenuate the BG spike of a high glycemic load (HGL) meal. We examined the effect of red raspberries (RRs) on the BG spike when added to a HGL meal. In this randomized cross-over trial, 16 university students were given breakfast cereal and almond milk (control), the control breakfast with 140g added RRs, and the control breakfast with sugar equivalent to the sugar content of the RRs (50% sugar increase from control). Meals given on 3 separate test days, being separated by a 1-week washout period. BG was measured at: fasting then 15 min, 30 min, 60 min, 90 min, and 120 min postprandial. Repeated measures ANOVA was performed to investigate differences in peak minus baseline BG (spike) and glucose incremental area under the curve (IAUC). The added RR meal had a lower BG spike compared to the added sugar meal (-12.8 mg/dL, CI: -22.8 to -2.79, p = 0.0083). Additionally, a lower BG was seen comparing the added RR meal to the control meal (-10.9 mg/dL, CI: -20.9 to -0.83, p = 0.0318). There were no significant differences for IAUC and the timing of peak BG among the meals. RR effect is likely attributed to high fiber-to-sugar ratio, polyphenol content, and greater amount of beneficial micronutrients. Based on obtained results from this pilot study, the practice of adding RRs to HGL meals such as breakfast, seems to reduce risk for T2DM in health populations through BG spike attenuation.
692

Implementation of Community-Based Lifestyle Programs for Individuals with Type 2 Diabetes Mellitus in Southwest and Central Virginia: Formative and Process Evaluation

Jiles, Kristina Ashleigh 05 February 2020 (has links)
Type 2 Diabetes Mellitus (T2D) is a major public health issue. Diabetes prevalence is growing and is the 7th leading cause of death in the US. Virginia has a slightly higher prevalence than the national average. Community-based diabetes lifestyle management programs that include a physical activity component are effective at improving glycemic control and influencing lifestyle behavior changes among people with T2D. The Balanced Living with Diabetes (BLD) program uses an active learning approach to improve glycemic control and healthful lifestyles. The Lifelong Improvements through Fitness Together (LIFT) program uses behavioral strategies to improve functional fitness, participant engagement, and program adherence. Participant retention is a challenge for community-based program. Participants may start the program, but then fail to complete the program and/or adhere to program recommendations. Two pilot studies were conducted to evaluate strategies for increasing participant retention and improving outcomes. The first evaluated the implementation and impact of a retention plan implemented in BLD programs conducted from 2015-2017. There were more participants returned to the reunion class session prior the development of the retention plan. There were improvements in some health behavior and self-efficacy indicators in programs that used the retention materials, however, impacts on outcomes were mixed. Preliminary findings showed that the retention plan could be a tool for providing additional support to participants, however strategies for dissemination of the retention plan needs to be reevaluated. The second study evaluated the impact on participant engagement and program outcomes when the LIFT program is incorporated with the BLD program. There was an increase in participant retention, self-efficacy and one health behavior for physical activity and health behaviors related to diet in BLD+LIFT programs. Extension Agents are willing to implement the BLD+LIFT programs, however, clarity of program logistics is needed prior to implementation. Extension Agents indicated that implementation of these programs in locations with older adults that have greater disability may not be the best locations. Having larger studies on the effect of incorporation of LIFT with the BLD with older adult populations that have fewer co-morbidities are needed to determine the impact of addition of the LIFT program with the BLD program on program outcomes. / Doctor of Philosophy / Type 2 Diabetes is a chronic disease in which the body does not use insulin as it should or does not produce enough insulin. The Centers for Disease Control and Prevention (CDC) indicates that the prevalence of diabetes was 23.1 million among US adults in 2015. The prevalence of diabetes in Virginia is slightly higher than the national average. Community-based diabetes lifestyle management programs that include a physical activity component are effective in improving glycemic control and influencing lifestyle behavior changes among people with T2D. The Balanced Living with Diabetes (BLD) program uses an active learning approach to influence better glycemic control and healthful lifestyles. The Lifelong Improvements through Fitness Together (LIFT) program uses behavioral strategies to improve functional fitness, participant engagement, and program adherence. The challenge with implementing community-based programs is retention. Participants may initially agree to participate in a program, but then fail to complete the program and/or follow program recommendations. Two pilot studies were conducted to evaluate strategies for increasing participant retention and program outcomes. The first evaluated the implementation and impact of a retention plan implemented in BLD programs conducted from 2015-2017. There were more participants returned prior to the development of the retention plan. There were improvements in some health behavior and self-efficacy indicators in programs that used the retention materials, however, impacts on outcomes were mixed. Findings showed that the retention plan could be a useful tool for providing additional support to participants, however distribution of the retention plan needs to be reevaluated. The second study evaluated the impact of program outcomes when the LIFT program is combined with the BLD program. There was an increase in participants' self-confidence to perform physical activity and making changes in their diet in BLD+LIFT groups. Extension Agents were enthusiastic about conducting more BLD+LIFT programs, however, program procedures and the time commitment needs to be understood before doing so. Expanding the conduct of BLD programs that incorporate the LIFT program can be effective in improving glycemic control and increasing physical activity, however, working with organizations that service people that have diabetes with fewer health conditions that limit physical activity may be more effective.
693

Patientutbildningar för stöd till egenvård hos vuxna med typ 2-diabetes : en litteraturöversikt / Patient education that encourages self-care to adults with type 2-diabetes : a literature review

Liljekvist, Marianne, Selley, Katarina January 2024 (has links)
Bakgrund   Det spås att 1,3 miljarder människor kommer att lida av diabetes år 2050, där typ 2-diabetes är den främsta orsaken till den snabba ökningen. Ohälsosamma livsstilsvanor kombinerat med ärftlighet och ålder ökar risken för att drabbas av sjukdomen. Behandling av typ 2-diabetes innefattar medicinering samt livsstilsförändringar för att uppnå god egenvård och stabila blodglukosvärden. Vårdpersonal spelar en viktig roll i att involvera och motivera personer med typ 2-diabetes till egenvård. Det finns ett behov av att belysa patientutbildningar som stödjer egenvård och sprida framgångsrika exempel för att främja god hantering av sjukdomen. Syfte  Att belysa patientutbildningar för stöd till egenvård hos vuxna med typ 2-diabetes. Metod  En icke-systematisk litteraturöversikt som baserades på 13 vetenskapliga originalartiklar med kvalitativ och kvantitativ ansats har genomförts. Systematisk datainsamling genomfördes för att inhämta artiklar från databaserna PubMed och CINAHL, med hjälp av identifierade sökord. Artiklarna har genomgått kvalitetsgranskning utifrån Sophiahemmet Högskolas bedömningsunderlag för vetenskaplig klassificering och kvalitet. Resultatet sammanställdes och analyserades med en integrerad dataanalys. Resultat Två huvudteman framkom ur sammanställningen av studiens resultat - Utbildningar för ökad kunskap och motivation samt Stärkt egenvårdsförmåga. Kunskap och utbildning har visat sig spela en betydande roll för att möjliggöra för patienter med typ 2-diabetes att genomföra nödvändiga livsstilsanpassningar och utöva god egenvård. En känsla av kontinuerligt stöd har visat sig vara en viktig motivationsfaktor. Resultatet visade att patienter som känner stöd är mer benägna att ta ansvar för sin egenvård och därmed minska risken för komplikationer och uppleva god livskvalitet trots sjukdom.  Slutsats Oavsett utbildningsmetod är deltagarnas engagemang och motivation till förändring avgörande faktorer. Grupputbildningar och individuella interventioner ger positiva resultat av ökad sjukdomskunskap och motivationen för egenvård. Personcentrerad vård är av största vikt för att säkerställa framgången för patientutbildningar för personer med typ 2-diabetes. / Background It is projected that 1.3 billion people will suffer from diabetes by 2050, type 2 diabetes being the primary cause of its rapid increase. Poor lifestyle habits combined with heredity and age increase the risk of type 2 diabetes. Treatment involves medication and lifestyle changes. Healthcare professionals play a crucial role in involving and motivating patients towards self-care. There is a need to highlight education programs that support self-care and spread examples to promote better management of the disease. Aim To highlight patient education that encourages self-care to adults with type 2 diabetes. Method A non-systematic literature review was conducted, analyzing 13 scientific original articles using both qualitative and quantitative approaches. Systematic data collection was carried out to retrieve articles from the databases PubMed and CINAHL, using identified search terms. Articles underwent a quality assessment based on the evaluation criteria for scientific classification and quality from Sophiahemmet University. The results were compiled and analyzed using an integrated data analysis.  Results Two main themes emerged in the compilation of the results - Education for increased knowledge and motivation, and Enhanced self-care ability. Knowledge and education play significant roles in enabling patients with type 2 diabetes to make necessary lifestyle adjustments and practice good self-care. A sense of support has proven to be a motivating factor. Patients who feel supported are more likely to take responsibility for their self-care, reducing the risk of complications and can experience a good quality of life despite their disease. Conclusions Regardless of education method, a participant's commitment and motivation to change are crucial factors. Both group training and individual interventions yield positive results in disease knowledge and motivation for self-care. Person-centered care is essential in ensuring the success of self-care programs for individuals with type 2 diabetes.
694

Sjuksköterskors uppfattningar om hälsofrämjande insatser vid typ 2 diabetes inom primärvården : En litteraturöversikt / Nurses’ perceptions of working with health promotion in type 2 diabetes within primary care : A literature review

Jonsson, Oana, Tesfagergish, Semhar Haile January 2024 (has links)
Bakgrund Typ 2 diabetes är en snabbt växande kronisk sjukdom som förväntas öka kraftigt runt om i världen och leder till svåra komplikationer. Hälsofrämjande arbete är en central dimension vid typ 2 diabetes som ger patienterna möjlighet att aktivt främja sin hälsa och förbygga sjukdom. Syfte Syftet var att beskriva sjuksköterskors uppfattningar av det som påverkar arbetet med hälsofrämjande insatser vid typ 2 diabetes inom primärvården. Metod En strukturerad litteraturöversikt baserad på femton vetenskapliga artiklar publicerade mellan åren 2013 och 2023. Artiklarna var av kvalitativ design och inhämtade från databaserna CINAHL och PubMed. Artiklarna har analyserats med Fribergs fyrstegsmetod där resultaten sammanställdes till en ny helhet. Resultat Resultat presenteras i tre huvudkategorier: patienternas förutsättningar, sjuksköterskors förhållningssätt och organisatoriska förutsättningar följt av sju underkategorier: Behov av kunskap, förmåga till kunskapsinhämtning, eget ansvar, personcentrerat förhållningssätt, stödjande roll, tidsbrist och teamarbete. Slutsats Hälsofrämjande insatser påverkas av tre centrala dimensioner som interagerar med varandra: patient, sjuksköterska och sjukvårdsorganisationen. För att kunna arbeta hälsofrämjande behöver sjuksköterskan organisationens stöd och en arbetsmiljö som möjliggör personcentrerad vård vid hälsofrämjande insatser. / Background Type 2 diabetes is a rapidly growing chronic disease that is expected to increase significantly worldwide and it can lead to severe complications. Health promoting work is central dimension in type 2 diabetes that enables patients to actively promote their health and prevent illness. Aim The aim is to describe nurses' perceptions of factors influencing work with health promotion in type 2 diabetes within primary care. Method A structured literature review based on fifteen scientific articles published between 2013 and 2023. The articles are of qualitative design and were searched in the databases CINAHL and PubMed. Fifteen articles were analysed using Friberg's integrated synthesis method. Results The results are presented in three main categories: patients' conditions, nurses' approaches, and organizational conditions, followed by seven subcategories: Need of knowledge, ability to acquire knowledge, self-responsibility, person-centered approach, supportive role, lack of time and teamwork. Conclusions Health promotion interventions are influenced by three central dimensions that interact with each other: the patient, the nurse, and the healthcare organization. To work with health promotion, the nurse needs the support of the organization and a work environment that enables person-centered care in health promotion interventions.
695

Patienters upplevelser av sjuksköterskeledd patientutbildning i egenvård vid diabetes typ 2 : En litteraturöversikt / Patients' experiences of nurse-led patient education in self-care for type 2 diabetes : A literature review

Daniel, Ihuoma, Kim, Ekaterina January 2024 (has links)
Bakgrund: Typ 2-diabetes är en kronisk sjukdom som drabbar miljontals människor runt om i världen, och antalet personer som får diagnosen ökar varje år. Förekomsten av sjukdomen är till stor del kopplad till ohälsosamma livsstilsvanor, såsom dålig kost, otillräcklig fysisk aktivitet, hög alkoholkonsumtion och rökning. Sjukdomen kräver förändringar i livsstil och egenvård. I syfte att stödja egenvård är patientutbildning en viktig aspekt i vården av personer med typ 2-diabetes. Syfte: Syftet var att belysa hur patienter med diabetes typ 2 upplever sjuksköterskeledd patientutbildning i egenvård. Metod: En litteraturöversikt där systematisk sökning genomfördes i databaser CINAHL, PubMed och PsycInfo. Det var begränsat till artiklar som publicerats den senaste 10 åren, skrivna på engelska och enbart vuxna. Sexton artiklar inkluderas, varav femton kvalitativa och med blandad metod. En induktiv innehållsanalys genomfördes utifrån Tomas och Hardens tematiska analys i tre steg. Resultat: Resultatet visade varierande upplevelser av patientutbildning som gavs av sjuksköterska, och det framkom olika faktorer som hade betydelse för egenvård. Resultatet presenteras genom två huvudteman: (1) Upplevelser av kunskap och information (2) Betydelse av relationer och stöd för lärande. Slutsats: Sjuksköterskeledd patientutbildning hade positiv effekt på deltagarnas kunskap om sjukdomen, och ökade förståelse för egen roll och ansvar. Sjuksköterskor uppfyller en viktig roll i att utbilda, stödja och skapa förutsättningar för egenvård. Det framkom även vissa kunskapsluckor och barriärer som gör det svårt för patienter att omsätta kunskapen i det dagliga livet. Vidare forskning i området är nödvändigt för att främja egenvården. / Background: Type 2 diabetes is a chronic disease that affects millions of people around the world, and the number of people being diagnosed is increasing every year. The occurrence of the disease is largely linked to unhealthy lifestyle habits, such as poor diet, insufficient physical activity, overweight/obesity, excessive alcohol consumption and smoking. The disease requires changes in lifestyle and self-care. Patient education is therefore an important aspect in the care of people with type 2 diabetes. Aim: A literature review that highlights how patients with type 2 diabetes experience nurse-led patient education in self-care. Methods: A literature review in which a systematic search was carried out in databases CINAHL, PubMed and PsycInfo. It was limited to articles published in the last 10 years, written in English and adults only. Sixteen articles are included, of which fifteen are qualitative and with a mixed method. An inductive content analysis was carried out using Tomas and Harden's three step thematic analysis. Results: The results showed varying experiences of patient education given by nurses, and different factors emerged that were important for self-care. The results are presented through two main themes: (1) Experiences of knowledge and information (2) Importance of relationships and support for learning. Conclusions: Nurse-led patient education had a positive effect on the participants' knowledge of the disease, and increased understanding of their own role and responsibility. Nurses fulfill an important role in educating, supporting, and creating conditions for self-care. There were also certain knowledge gaps and barriers that made it difficult to implement the knowledge in daily life. Further research in the area is necessary to promote self-care.
696

Hur ska jag träna? : Effekter av träning hos patienter med typ 2 diabetes / How should i exercise? : Effects of exercise for patients with diabetes mellitus type 2

Salehian Dardashti, Rasmus, Tufvesson, Jakob January 2024 (has links)
Bakgrund Diabetes mellitus typ 2 är en sjukdom vars prevalensen ökar i världen. Behandlingen består av läkemedel och egenvårdsåtgärder, innehållande bland annat hälsosam kost och ökad fysisk aktivitet. Stöttande anhöriga kan öka följsamheten för behandlingen.     Syfte Att undersöka effekter av fysisk träning för personer med DMT2. Metod En kvantitativ litteraturanalys genomfördes. Databassökning i Pubmed och Cinahl. Nio randomiserade kontrollerade studier granskades enligt Olsson och Sörensens mall för kvantitativa studier. Analysen av studierna gjordes i enlighet med Popenoes mall. Resultat Interventionerna bestod av tre olika typer av träning: Aerob fysisk aktivitet, muskelstärkande fysisk aktivitet och högintensiv intervallträning. Studierna varierade i längd mellan 10 veckor och ett år och mätvärdena var bland annat hba1c, olika typer av kroppsfett och plasmaglukos. Minskning av fettmassa var signifikant i alla studier förutom en och hba1c minskade signifikant i tre studier.   Konklusion Resultatet kan tyda på att en minskning av fett kan ske vid träningsinterventioner, att MFA kan öka den fettfri massa och att HIIT och AFA kan öka kondition för personer med DMT2. / Background Type 2 diabetes mellitus is a disease whose prevalence is increasing worldwide. Treatment consists of medication and self-care measures, including a healthy diet and increased physical activity. Supportive family members can increase adherence to treatment. Aim To investigate the effects of physical exercise on people with diabetes mellitus type 2 Methods A quantitative literature analysis was conducted. Database search in PubMed and Cinahl. Nine randomised controlled trials were reviewed according to Olsson and Sörensens template for quantitative studies.  The studies were analysed according to the Popenoe template. Results The interventions consisted of three different types of exercise: Aerobic physical activity, muscle-strengthening physical activity and high-intensity interval training. The studies varied in length from 10 weeks to one year and the measurements included hba1c, fat mass and plasma glucose. Reduction in fat mass was significant in all but one study and hba1c decreased significantly in three studies. Conclusion The results may indicate that a reduction in fat can occur with exercise interventions, that MFA can increase fat-free mass and that HIIT and AFA can increase fitness for people with DMT2.
697

Distriktssköterskors förutsättningar för hälsofrämjande samtal med patienter som har diabetes typ 2 : En kvalitativ studie / District nurses' presuppositions in health-promoting conversations with patients with type 2 diabetes : A qualitative study

Bergqvist, Marina, Kihlgren, Felicia January 2024 (has links)
Bakgrund: Diabetes typ 2 har blivit en av vår tids största folkhälsosjukdomar. Det som är hoppfullt är att sjukdomen går att fördröja och till och med förhindra med sunda levnadsvanor. För de redan drabbade går det att göra mycket för att förbättra hälsan och förhindra följdsjukdomar. Distriktssköterskor har en central roll i diabetesvård inom primärvård, för att genom det hälsofrämjande samtalet motivera patienter till egenvård. Syfte: Syftet med studien var att belysa förutsättningar som distriktssköterskor inom primärvård har för hälsofrämjande samtal med patienter som har diabetes typ 2. Metod: Studien genomfördes med kvalitativ metod där 14 distriktssköterskor svarade på en enkät med öppna frågor. Resultatet bearbetades med hjälp av kvalitativ innehållsanalys. Resultat: Förutsättningar för goda hälsofrämjande samtal påverkas av distriktssköterskans utbildning, avsatt tid för samtalet och möjligheten att inhämta och lämna ut adekvat information. Teamarbetet är av betydelse och den viktigaste teammedlemmen är patienten. Det är viktigt att patienten känner delaktighet i samtalet för att bli motiverad att ta ansvar för sin hälsa. Konklusion: Utbildning, tid och information är viktiga premisser för ett bra patientmöte. Det visade sig också att samarbete med andra professioner och samarbete med patienten är viktigt för ett bra teamarbete. / Background: Type 2 diabetes has become one of the biggest public health diseases of our time. What is hopeful is that the disease can be delayed and even prevented with healthy lifestyle habits. For those already affected, there is much you can do yourself to improve your health and prevent sequelae. The district nurse has a central role in diabetes care in primary care, in order to motivate the patient to self-care through the health-promoting conversation. Aim: The purpose of the study was to highlight the presuppositions that district nurses in primary care have for health-promoting conversations with patients who have type 2 diabetes. Method: The study was conducted using a qualitative method where 14 district nurses answered a questionnaire with open questions. The results were processed using qualitative content analysis. Findings: Presuppositions for good health-promoting conversations are affected by the district nurse's education, the time allocated for the conversation and the ability to obtain and provide adequate information. Teamwork is important and the most important team member is the patient. It is important that the patient feels participation in the conversation in order to be motivated to take responsibility for their health. Conclusion: Education, time and information are important premises for a good patient meeting. It also showed that collaboration with other professions and collaboration with the patient is important for good teamwork.
698

Is lifestyle modification effective for glycemic control among type II diabetic adults in Southeast Asia?

Htoo, Zaw Wai January 1900 (has links)
Master of Public Health / Human Nutrition / Richard R. Rosenkranz / Background: Type 2 diabetes mellitus (T2DM) is a costly and burdensome lifelong disease, and without proper glycemic control, severe life-threatening complications result. In Southeast Asia, the prevalence of T2DM is forecast to increase markedly from 2000 to 2030. Although literature reviews on lifestyle modification for glycemic control are available, these are mainly for the Western context, and there is a dearth of evidence for Southeast Asians who are at greater risk of T2DM and have differing patterns of diet, physical activity and body composition than Western populations. Objective: To systematically review literature on the effectiveness of lifestyle modification interventions for glycemic control in T2DM patients from Southeast Asia. Methods: Randomized controlled trials (RCT) with interventions ≥ 8 weeks that compared HbA1c or blood glucose for intervention (lifestyle modification) versus control groups were identified from searches in Cochrane Library, CINAHL, PubMed, ProQuest, Science Direct, SPORTDiscus, Scopus and Web of Science. Results: Seven RCTs (679 participants) meeting inclusion and exclusion criteria were identified. There was a significant reduction in HbA1c% (MD = -0.56%; 95% CI = -0.95,-0.16%; p = 0.006; n = 5 studies) and in blood glucose mg/dl (MD = -16.76 mg/dl; 95% CI = -31.36, -2.17 mg/dl; p = 0.02; n = 4 studies) over 3 months for lifestyle modification intervention groups. Lifestyle interventions included diet (n = 2), exercise (n = 2), and general lifestyle interventions (n = 3). Duration of interventions ranged from 12 weeks to 6 months. Studies included populations from Thailand (n = 5) and Malaysia (n = 2). Conclusion: Overall, lifestyle modification interventions are effective for the glycemic control of T2DM patients in countries of Southeast Asia.
699

Prescribing patterns of hypoglycaemic drugs in the treatment of Type 2 Diabetes Mellitus in public institutions in Lesotho / M.A. Marite

Marite, M A January 2014 (has links)
The aim of the study was to evaluate type 2 diabetes mellitus (DM) medicine management in Government Clinics in Maseru, Lesotho. A two-dimensional research method was employed, consisting of a literature review and an empirical investigation. The objective of the literature review was to provide information on the pathophysiology, signs and symptoms, diagnosis, treatment and clinical management of DM. The empirical investigation consisted of a descriptive pharmacoepidemiological study, in which data for analysis was collected retrospectively from patients‘ medical records (―bukanas‖) at dispensing points, a using data collection tool. The selected study sites were Domiciliary Health Center, Mabote, Likotsi, and Qoaling filter clinics in Maseru district of Lesotho. Data on costs of antidiabetic agents was collected from purchase invoices provided by the pharmacy department of Domiciliary Health Center. Results showed that the overall ratio of males to females was 1.3. There were no statistical difference in DM prevalence between males and females in the different clinics (p = 0.48). The mean age of males and females was 57.5 ± 14.2 years and 58.6 ± 11.3 years, respectively (Cohen‘s d = 0.07). DM was more prevalent in patients 59 to 69 years for both males and females, with the exception of Mabote and Qoaling filter clinics, where DM was more prevalent in patients 49 to 59 years. These differences in prevalence were not statically significant. Overall, 20% (n = 69) of the study sample had DM alone, while 80.0% of patients had DM concurrently with hypertension. The odds ratio implicated that women were 1.7 times more likely to have hypertension concurrently with Type 2 Diabetes Mellitus. The mean blood glucose level at 95% confidence interval for females and males were 10.1 ± 5.9 mmol/L (95% CI: 10.1–11.7) and 10.9 ± 6.2 mmol/L (95% CI: 11.0–14.0) respectively. The difference in the mean blood glucose levels of males vs. females was not statistically significant (p = 0.07). In both males and females there were outliers as high as 33.3 mmol/L. Metformin 850 mg given three times, metformin 500 mg three times a day, glibenclamide 10 mg daily and glibenclamide 5 mg twice daily are oral hypoglycaemic agents that were first, second, third and fourth choice treatment of DM at all four study sites at a frequency of 54.2% (n = 160), 27.7% (n = 82), 4% (n = 12) and 2.7% (n = 27), respectively. Actraphane® 20 units in the morning and 10 units in the evening was prescribed at a frequency of 11.6% (n = 432) in comparison to other Actraphane®-containing regimens. The frequencies of prescribing metformin and Actraphane® as combination therapies represented 10.6% (n = 40), 7.1% (n = 27), and 6.6% (n = 25), respectively, for Actraphane® 20 units in the morning and 10 units in the evening, plus metformin 500 mg three times per day; Actraphane® 20 units in the morning and 10 units in the evening plus metformin 850 mg three times per day; and Actraphane® 30 units in the morning and 15 units in the evening plus metformin 850 mg three times per day. The combination therapy of metformin and glibenclamide were prescribed at frequencies of 24.6% (n = 172), 22.9% (n = 160), and 13.4% (n = 94) respectively for glibenclamide 10 mg daily plus metformin 850 mg three times per day, glibenclamide 5 mg daily plus metformin 850 mg three times per day, and glibenclamide 5 mg once a day plus metformin 500 mg three times per day as first, second and third choice treatments at all study sites. The total cost incurred for all the oral drugs prescribed alone within different regimens was M75.6 with the weighted average cost per patient of M0.81 ± 2.06 per day compared to the cost of Actraphane® which was M40 660.52 per month at a weighted average daily cost of M21.43 ± 6.23 per patient. The overall cost of Actraphane® and metformin combination therapy amounted to M50 676.50, at an average cost per patient of M21.77 ± 6.80 per day. The cost of combination therapy consisting of metformin and glibenclamide amounted to M377.10, at a weighted average cost amounting to M0.49 ± 0.16 per patient, per day. Based on the results of this study some conclusions were reached on the prevalence of DM, prescribing patterns and the cost of antidiabetic agents. Recommendations pertaining to the clinics and further research were made. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014
700

Prescribing patterns of hypoglycaemic drugs in the treatment of Type 2 Diabetes Mellitus in public institutions in Lesotho / M.A. Marite

Marite, M A January 2014 (has links)
The aim of the study was to evaluate type 2 diabetes mellitus (DM) medicine management in Government Clinics in Maseru, Lesotho. A two-dimensional research method was employed, consisting of a literature review and an empirical investigation. The objective of the literature review was to provide information on the pathophysiology, signs and symptoms, diagnosis, treatment and clinical management of DM. The empirical investigation consisted of a descriptive pharmacoepidemiological study, in which data for analysis was collected retrospectively from patients‘ medical records (―bukanas‖) at dispensing points, a using data collection tool. The selected study sites were Domiciliary Health Center, Mabote, Likotsi, and Qoaling filter clinics in Maseru district of Lesotho. Data on costs of antidiabetic agents was collected from purchase invoices provided by the pharmacy department of Domiciliary Health Center. Results showed that the overall ratio of males to females was 1.3. There were no statistical difference in DM prevalence between males and females in the different clinics (p = 0.48). The mean age of males and females was 57.5 ± 14.2 years and 58.6 ± 11.3 years, respectively (Cohen‘s d = 0.07). DM was more prevalent in patients 59 to 69 years for both males and females, with the exception of Mabote and Qoaling filter clinics, where DM was more prevalent in patients 49 to 59 years. These differences in prevalence were not statically significant. Overall, 20% (n = 69) of the study sample had DM alone, while 80.0% of patients had DM concurrently with hypertension. The odds ratio implicated that women were 1.7 times more likely to have hypertension concurrently with Type 2 Diabetes Mellitus. The mean blood glucose level at 95% confidence interval for females and males were 10.1 ± 5.9 mmol/L (95% CI: 10.1–11.7) and 10.9 ± 6.2 mmol/L (95% CI: 11.0–14.0) respectively. The difference in the mean blood glucose levels of males vs. females was not statistically significant (p = 0.07). In both males and females there were outliers as high as 33.3 mmol/L. Metformin 850 mg given three times, metformin 500 mg three times a day, glibenclamide 10 mg daily and glibenclamide 5 mg twice daily are oral hypoglycaemic agents that were first, second, third and fourth choice treatment of DM at all four study sites at a frequency of 54.2% (n = 160), 27.7% (n = 82), 4% (n = 12) and 2.7% (n = 27), respectively. Actraphane® 20 units in the morning and 10 units in the evening was prescribed at a frequency of 11.6% (n = 432) in comparison to other Actraphane®-containing regimens. The frequencies of prescribing metformin and Actraphane® as combination therapies represented 10.6% (n = 40), 7.1% (n = 27), and 6.6% (n = 25), respectively, for Actraphane® 20 units in the morning and 10 units in the evening, plus metformin 500 mg three times per day; Actraphane® 20 units in the morning and 10 units in the evening plus metformin 850 mg three times per day; and Actraphane® 30 units in the morning and 15 units in the evening plus metformin 850 mg three times per day. The combination therapy of metformin and glibenclamide were prescribed at frequencies of 24.6% (n = 172), 22.9% (n = 160), and 13.4% (n = 94) respectively for glibenclamide 10 mg daily plus metformin 850 mg three times per day, glibenclamide 5 mg daily plus metformin 850 mg three times per day, and glibenclamide 5 mg once a day plus metformin 500 mg three times per day as first, second and third choice treatments at all study sites. The total cost incurred for all the oral drugs prescribed alone within different regimens was M75.6 with the weighted average cost per patient of M0.81 ± 2.06 per day compared to the cost of Actraphane® which was M40 660.52 per month at a weighted average daily cost of M21.43 ± 6.23 per patient. The overall cost of Actraphane® and metformin combination therapy amounted to M50 676.50, at an average cost per patient of M21.77 ± 6.80 per day. The cost of combination therapy consisting of metformin and glibenclamide amounted to M377.10, at a weighted average cost amounting to M0.49 ± 0.16 per patient, per day. Based on the results of this study some conclusions were reached on the prevalence of DM, prescribing patterns and the cost of antidiabetic agents. Recommendations pertaining to the clinics and further research were made. / MPham (Pharmacy Practice), North-West University, Potchefstroom Campus, 2014

Page generated in 0.0316 seconds