MyMedR

User-driven health care: answering multidimensional information needs in individual patients utilizing post-EBM approaches: an operational model

Biswas R, Maniam J, Lee EW, Gopal P, Umakanth S, Dahiya S, et al.

J Eval Clin Pract, 2008 Oct;14(5):750-60.

PMID: 19018906 DOI: 10.1111/j.1365-2753.2008.00997.x

The hypothesis in the conceptual model was that a user-driven innovation in presently available information and communication technology infrastructure would be able to meet patient and health professional users information needs and help them attain better health outcomes. An operational model was created to plan a trial on a sample diabetic population utilizing a randomized control trial design, assigning one randomly selected group of diabetics to receive electronic information intervention and analyse if it would improve their health outcomes in comparison with a matched diabetic population who would only receive regular medical intervention. Diabetes was chosen for this particular trial, as it is a major chronic illness in Malaysia as elsewhere in the world. It is in essence a position paper for how the study concept should be organized to stimulate wider discussion prior to beginning the study.

Matched MeSH terms: Diabetes Mellitus, Type 2/metabolism; Diabetes Mellitus, Type 2/prevention & control; Diabetes Mellitus, Type 2/psychology

Role of lasers as an adjunct to scaling and root planing in patients with type 2 diabetes mellitus: a systematic review

Abduljabbar T, Javed F, Shah A, Samer MS, Vohra F, Akram Z

Lasers Med Sci, 2017 Feb;32(2):449-459.

PMID: 27686888 DOI: 10.1007/s10103-016-2086-5

The aim of the study was to assess the efficacy of adjunctive use of laser therapy (LT) alone or antimicrobial photodynamic therapy (aPDT) to improve clinical periodontal and HbA1c levels in patients with both chronic periodontitis (CP) and type 2 diabetes mellitus (T2DM). Electronic search of the MEDLINE, PubMed, EMBASE, Science Direct, and SCOPUS databases were combined with hand searching of articles published from 1975 up to and including March 2016 using relevant MeSH terms. Six studies were selected for this review. In these six studies, laser treatment was applied, after scaling and root planing (SRP), in two ways: Three studies used laser alone and three studies used laser with photosensitizer. All the six included studies reporting clinical periodontal and glycemic parameters showed that LT and aPDT were effective in the treatment of CP in T2DM subjects at follow-up. Two studies showed significantly better periodontal outcomes for LT as an adjunct to SRP as compared to SRP alone, whereas four studies showed comparable periodontal outcomes among adjunctive LT or aPDT with SRP. Two studies showed significant reduction of HbA1c levels in LT and aPDT as compared to SRP, whereas three studies showed comparable percentage levels at follow-up. It remains debatable whether LT or aPDT as adjunct to SRP is more effective as compared to SRP alone in the improvement of clinical periodontal and glycemic control in patients with both CP and T2DM, given that the scientific evidence is weak.

Matched MeSH terms: Diabetes Mellitus, Type 2/therapy*

Impact of Ramadan-focused diabetes education on hypoglycemia risk and metabolic control for patients with type 2 diabetes mellitus: A systematic review

Tourkmani AM, Abdelhay O, Alharbi TJ, Bin Rsheed AM, Azmi Hassali M, Alrasheedy AA, et al.

Int J Clin Pract, 2021 Mar;75(3):e13817.

PMID: 33159361 DOI: 10.1111/ijcp.13817

BACKGROUND: Ramadan fasting is regarded as a form of worship amongst Muslims. However, patients with a high risk of diabetic complications are advised to avoid fasting, as the practice is associated with significant impacts on several health factors for type 2 diabetic patients, including glycaemic control. Thus, a lack of focused education before Ramadan may result in negative health outcomes.

AIM: To evaluate the impact of a Ramadan-focused diabetes education programme on hypoglycaemic risk and other clinical and metabolic parameters.

METHODS: A systematic literature search was performed using Scopus, PubMed, Embase, and Google Scholar to identify relevant studies meeting the inclusion criteria from inception. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and guidelines were followed when performing the search and identification of appropriate studies.

RESULTS: Seventeen studies were included in this systemic review; five of them met the criteria to compile for a meta-analysis. The included studies were with various study designs, including randomised controlled trials, quasi-experimental and non-randomised studies. Overall, the results revealed a significant reduction of hypoglycemia risk (81% reduction) for fasting patients in intervention groups who received Ramadan-focused education compared with patients receiving conventional care (OR 0.19, 95% CI: 0.08-0.46). Moreover, HbA1c significantly improved amongst patients who received a Ramadan-focused diabetes education intervention, compared with those receiving conventional care.

CONCLUSION: Ramadan-focused diabetes education had a significant impact on hypoglycemia and glycaemic control, with no significant effect on body weight, blood lipids or blood pressure.

Matched MeSH terms: Diabetes Mellitus, Type 2*

Fulltext Factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia: a descriptive cross-sectional single-centre study

Ganasegeran K, Renganathan P, Manaf RA, Al-Dubai SA

BMJ Open, 2014;4(4):e004794.

PMID: 24760351 DOI: 10.1136/bmjopen-2014-004794

OBJECTIVE: To determine the prevalence and factors associated with anxiety and depression among type 2 diabetes outpatients in Malaysia.
DESIGN: Descriptive, cross-sectional single-centre study with universal sampling of all patients with type 2 diabetes.
SETTING: Endocrinology clinic of medical outpatient department in a Malaysian public hospital.
PARTICIPANTS: All 169 patients with type 2 diabetes (men, n=99; women, n=70) aged between 18 and 90 years who acquired follow-up treatment from the endocrinology clinic in the month of September 2013.
MAIN OUTCOME MEASURES: The validated Hospital Anxiety and Depression Scale (HADS), sociodemographic characteristics and clinical health information from patient records.
RESULTS: Of the total 169 patients surveyed, anxiety and depression were found in 53 (31.4%) and 68 (40.3%), respectively. In multivariate analysis, age, ethnicity and ischaemic heart disease were significantly associated with anxiety, while age, ethnicity and monthly household income were significantly associated with depression.
CONCLUSIONS: Sociodemographics and clinical health factors were important correlates of anxiety and depression among patients with diabetes. Integrated psychological and medical care to boost self-determination and confidence in the management of diabetes would catalyse optimal health outcomes among patients with diabetes.
Study site: Endocrinology Clinic, Hospital Tengku Ampuan Rahimah Hospital (HTAR), Selangor, Malaysia

Matched MeSH terms: Diabetes Mellitus, Type 2/ethnology; Diabetes Mellitus, Type 2/psychology*

Fulltext Prevalence of oral mucosal lesions in patients with type 2 diabetes attending hospital universiti sains malaysia

Al-Maweri SA, Ismail NM, Ismail AR, Al-Ghashm A

Malays J Med Sci, 2013 Jul;20(4):39-46.

PMID: 24043995 MyJurnal

Diabetes mellitus is associated with a greater likelihood of developing certain oral mucosal disorders. This study was aimed at assessing the prevalence of oral mucosal lesions (OMLs) in patients with type 2 diabetes (DM2) and to investigate the association of such lesions with metabolic control of the disease.

Matched MeSH terms: Diabetes Mellitus, Type 2

Effectiveness of medical nutrition treatment delivered by dietitians on glycaemic outcomes and lipid profiles of Arab, Omani patients with Type 2 diabetes

Al-Shookri A, Khor GL, Chan YM, Loke SC, Al-Maskari M

Diabet Med, 2012 Feb;29(2):236-44.

PMID: 21824187 DOI: 10.1111/j.1464-5491.2011.03405.x

In this randomized controlled trial we evaluated the effectiveness of medical nutritional therapy on Arab patients with Type 2 diabetes in Oman delivered by a dietitian.

Matched MeSH terms: Diabetes Mellitus, Type 2/blood; Diabetes Mellitus, Type 2/diet therapy*; Diabetes Mellitus, Type 2/epidemiology

Fulltext Type 2 diabetes in the sultanate of Oman

Al-Shookri A, Khor GL, Chan YM, Loke SC, Al-Maskari M

Malays J Nutr, 2011 Apr;17(1):129-41.

PMID: 22135872 MyJurnal

During the past four decades, Oman has undergone a rapid socioe-conomic and epidemiological transition leading to a substantial reduction in the prevalence of various communicable diseases, including vaccine-preventable diseases. Health care planning together with the commitment of policy makers has been a critical factor in this reduction. However, with rapid social and economic growth, lifestyle-related non communicable diseases have emerged as new health challenges to the country. Diabetes and obesity are leading risks posed by the chronic diseases. The burden of diabetes has increased sharply in Oman over the last decade, rising from 8.3% in 1991 to 11.6% in 2000 among adults aged 20 years and older. The World Health Organization (WHO) predicted an increase of 190% in the number of subjects living with diabetes in Oman over the next 20 years, rising from 75,000 in 2000 to 217,000 in 2025. There is a lack of awareness of the major risk factors for diabetes mellitus in the Omani population generally. As education is often the most significant predictor of knowledge regarding risk factors, complications and the prevention of diabetes, health promotion in Oman is deemed critical, along with other prevention and control measures. Suitable prevention strategies for reducing the prevalence of diabetes in Oman are discussed. Recommendations are made for reforms in the current health care system; otherwise, diabetes will constitute a major drain on Oman's human and financial resources, threatening the advances in health and longevity achieved over the past decades.

Matched MeSH terms: Diabetes Mellitus, Type 2/economics; Diabetes Mellitus, Type 2/etiology; Diabetes Mellitus, Type 2/epidemiology*; Diabetes Mellitus, Type 2/prevention & control*

Fulltext Descriptive Regional Subanalysis of a Real-World Study in Patients with Type 2 Diabetes Treated with Gliclazide MR During Fasting: DIA-RAMADAN

Hassanein M, Al Sifri S, Shaikh S, Raza SA, Akram J, Rudijanto A, et al.

Diabetes Ther, 2021 Jun;12(6):1703-1719.

PMID: 33974216 DOI: 10.1007/s13300-021-01067-1

INTRODUCTION: To analyse the safety and effectiveness of gliclazide modified release (MR) in adults with type 2 diabetes mellitus participating in Ramadan from three geographically and culturally different regions of the world included in the DIA-RAMADAN study.

METHODS: DIA-RAMADAN was a real-world, observational, international, non-comparative study. The global study population was divided into three regional subgroups, with data gathered at inclusion 6-8 weeks prior to Ramadan (V0), during Ramadan (4.5 weeks) and 4-6 weeks after Ramadan (V1). Primary endpoint was the proportion of patients reporting ≥ 1 symptomatic hypoglycaemic events (HE), which were collected using a patient diary along with other adverse events.

RESULTS: Patient numbers from the three regions were n = 564 (46.5%; Indian sub-continent), n = 354 (29.1%; Middle East) and n = 296 (24.4%; South-East Asia). Patient baseline characteristics, demographics, fasting habits and antidiabetic treatments varied between regions. There were similar proportions of symptomatic HE between regions, with no severe HE. Significant weight reductions were observed in all regions following Ramadan, along with reductions in HbA1c and fasting plasma glucose.

CONCLUSION: These real-world study data indicate that gliclazide MR is safe and effective for management of type 2 diabetes during Ramadan in all three regions studied as part of DIA-RAMADAN.

TRIAL REGISTRATION: Clinicaltrials.gov identifier NCT04132934. INFOGRAPHIC.

Matched MeSH terms: Diabetes Mellitus, Type 2

Fulltext Medicinal Potential of Isoflavonoids: Polyphenols That May Cure Diabetes

Ahmed QU, Ali AHM, Mukhtar S, Alsharif MA, Parveen H, Sabere ASM, et al.

Molecules, 2020 Nov 24;25(23).

PMID: 33255206 DOI: 10.3390/molecules25235491

In recent years, there is emerging evidence that isoflavonoids, either dietary or obtained from traditional medicinal plants, could play an important role as a supplementary drug in the management of type 2 diabetes mellitus (T2DM) due to their reported pronounced biological effects in relation to multiple metabolic factors associated with diabetes. Hence, in this regard, we have comprehensively reviewed the potential biological effects of isoflavonoids, particularly biochanin A, genistein, daidzein, glycitein, and formononetin on metabolic disorders and long-term complications induced by T2DM in order to understand whether they can be future candidates as a safe antidiabetic agent. Based on in-depth in vitro and in vivo studies evaluations, isoflavonoids have been found to activate gene expression through the stimulation of peroxisome proliferator-activated receptors (PPARs) (α, γ), modulate carbohydrate metabolism, regulate hyperglycemia, induce dyslipidemia, lessen insulin resistance, and modify adipocyte differentiation and tissue metabolism. Moreover, these natural compounds have also been found to attenuate oxidative stress through the oxidative signaling process and inflammatory mechanism. Hence, isoflavonoids have been envisioned to be able to prevent and slow down the progression of long-term diabetes complications including cardiovascular disease, nephropathy, neuropathy, and retinopathy. Further thoroughgoing investigations in human clinical studies are strongly recommended to obtain the optimum and specific dose and regimen required for supplementation with isoflavonoids and derivatives in diabetic patients.

Matched MeSH terms: Diabetes Mellitus, Type 2/drug therapy; Diabetes Mellitus, Type 2/etiology; Diabetes Mellitus, Type 2/metabolism

Association of insertion/deletion polymorphism of alpha-adrenoceptor gene in essential hypertension with or without type 2 diabetes mellitus in Malaysian subjects

Vasudevan R, Ismail P, Stanslas J, Shamsudin N, Ali AB

Int J Biol Sci, 2008;4(6):362-7.

PMID: 18953403

An insertion/deletion (I/D) polymorphism of Alpha2B-Adrenoceptor (ADRA2B) gene located on chromosome 2 has been studied extensively in related to cardiovascular diseases. The main aim of the present study was to examine the potential association of D allele frequency of I/D polymorphism of ADRA2B gene in Malaysian essential hypertensive subjects with or without type 2 diabetes mellitus (T2DM). This study includes 70 hypertensive subjects without T2DM, 65 hypertensive subjects with T2DM and 75 healthy volunteers as control subjects. Genotyping of I/D polymorphism was performed by conventional PCR method. There was significant difference found in age, body mass index, systolic/diastolic blood pressure and high density lipoprotein cholesterol level between the case and control subjects. DD genotypic frequency of I/D polymorphism was significantly higher in hypertensive subjects (42.84% vs. 29.33%; P-=0.029) and in hypertensive with T2DM subjects (46.15% vs. 29.33%; P=0.046) than control group. D allele frequency was higher in hypertensive group (67.41%) than control subjects (52.67%). However, no significant difference was found between the three genotypes of I/D polymorphism of ADRA2B gene and the clinical characteristics of the subjects. The result obtained in this study show D allele of ADRA2B gene was associated with essential hypertension with or without T2DM in Malaysian subjects.

Matched MeSH terms: Diabetes Mellitus, Type 2/complications; Diabetes Mellitus, Type 2/genetics*

Fulltext Purslane (Portulaca oleracea) Seed Consumption And Aerobic Training Improves Biomarkers Associated with Atherosclerosis in Women with Type 2 Diabetes (T2D)

Dehghan F, Soori R, Gholami K, Abolmaesoomi M, Yusof A, Muniandy S, et al.

Sci Rep, 2016 12 05;6:37819.

PMID: 27917862 DOI: 10.1038/srep37819

The aim of this study was to investigate the responses of atherosclerosis plaque biomarkers to purslane seed consumption and aerobic training in women with T2D. 196 women with T2D were assigned into; (1) placebo (PL), (2) aerobic training+placebo (AT + PL), 3) purslane seeds (PS), aerobic training+purslane seeds (AT + PS). The training program and purslane seeds consumption (2.5 g lunch and 5 g dinner) were carried out for 16 weeks. The components of purslane seed were identified and quantified by GC-MS. Blood samples were withdrawn via venipuncture to examine blood glucose, low-density lipoprotein (LDL), high-density lipoprotein (HDL), cholesterol, triglycerides (TG), creatinine, urea, uric acid, NF-κB, GLP1, GLP1R, TIMP-1, MMP2, MMP9, CRP, CST3, and CTSS expressions. Blood glucose, LDL, cholesterol, TG, creatinine, urea, and uric acid levels in the (P), (AT), and (AT + PS) groups were significantly decreased compared to the pre-experimental levels or the placebo group, while HDL, significantly increased. Furthermore, the protein and mRNA levels of NF-κB, TIMP-1, MMP2 &9, CRP, CST3, and CTSS in the (P), (AT), (AT + PS) significantly decreased compared to pre-experimental or the placebo group, while level of GLP1 and GLP1-R increased drastically. Findings suggest that purslane seed consumption alongside exercising could improve atherosclerosis plaque biomarkers through synergistically mechanisms in T2D.

Matched MeSH terms: Diabetes Mellitus, Type 2/blood; Diabetes Mellitus, Type 2/complications; Diabetes Mellitus, Type 2/therapy*

The effect of tailored consumer medicine information on patients with type 2 diabetes mellitus: A randomised controlled interventional study

Munsour EE, Awaisu A, Hassali MAA, Abdoun E, Dabbous Z, Zahran N, et al.

Int J Clin Pract, 2020 Aug;74(8):e13527.

PMID: 32386077 DOI: 10.1111/ijcp.13527

INTRODUCTION: In patients with diabetes, better health communication is associated with better health outcomes including medication adherence and glycaemic control. The conventional patient information leaflet does not consider the cultural and behavioral perspectives of diverse patient populations. Consumer medicine information (CMI) is a written information about the prescription drugs developed by organisations or individuals other than a drug manufacturer that is intended for distribution to consumers at the time of medication dispensing.

OBJECTIVE: This study aimed to evaluate the impact of CMI on medication adherence and glycaemic control among patients with type 2 diabetes in Qatar.

METHODS: We developed and customised CMI for all the anti-diabetic medications used in Qatar. A randomised controlled trial in which the intervention group patients (n = 66) received the customised CMI with usual care, while the control group patients (n = 74) received usual care only, was conducted. Self-reported medication adherence and haemoglobin A1c (HbA1c ) were the primary outcome measures. Glycaemic control and medication adherence parameters were measured at baseline, 3 months, and 6 months in both groups. Medication adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS-8).

RESULTS: Although the addition of CMI resulted in better glycaemic control, this did not reach statistical significance, possibly because of the short-term follow-up. The median MMAS-8 score improved from baseline (6.6 [IQR = 1.5]) to 6-month follow-up (7.0 [IQR = 1.00]) in the intervention group. In addition, there was a statistically significant difference between the intervention and the control groups in terms of MMAS-8 score at the third visit (7.0 [IQR = 1.0]) vs 6.5 (IQR = 1.25; P-value = .010).

CONCLUSION: CMI for anti-diabetic medications when added to usual care has the potential to improve medication adherence and glycaemic control among patients with type 2 diabetes. Therefore, providing better health communication and CMI to patients with diabetes is recommended.

Matched MeSH terms: Diabetes Mellitus, Type 2/blood; Diabetes Mellitus, Type 2/drug therapy*

A QSAR model for predicting antidiabetic activity of dipeptidyl peptidase-IV inhibitors by enhanced binary gravitational search algorithm

Al-Fakih AM, Algamal ZY, Lee MH, Aziz M, Ali HTM

SAR QSAR Environ Res, 2019 Jun;30(6):403-416.

PMID: 31122062 DOI: 10.1080/1062936X.2019.1607899

Time-varying binary gravitational search algorithm (TVBGSA) is proposed for predicting antidiabetic activity of 134 dipeptidyl peptidase-IV (DPP-IV) inhibitors. To improve the performance of the binary gravitational search algorithm (BGSA) method, we propose a dynamic time-varying transfer function. A new control parameter,
μ
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compared to obtained results by BGSA, indicating the best prediction performance of the proposed TVBGSA model. The results clearly reveal that the proposed TVBGSA method is useful for constructing reliable and robust QSARs for predicting antidiabetic activity of DPP-IV inhibitors prior to designing and experimental synthesizing of new DPP-IV inhibitors.

Matched MeSH terms: Diabetes Mellitus, Type 2/drug therapy

Prevalence and determinants of restless leg syndrome in type 2 diabetes mellitus (T2DM) in Pakistan

Nawaz MS, Nawaz MS, Shah KU, Mustafa ZU, Ahmed A, Sajjad Ahmed H, et al.

Diabetes Metab Syndr, 2021 Feb 13;15(2):525-528.

PMID: 33668002 DOI: 10.1016/j.dsx.2021.02.013

BACKGROUND AND AIMS: Restless legs syndromes (RLS) are intrinsic sleeping disorder and its prevalence rate is 10-15% in general population but it is observed that prevalence rate is different in diabetes patients. Current study aims to find prevalence and determinants of RLS in people living with type 2 diabetes mellitus in Pakistan.

METHOD: A multicenter cross-sectional observational study was conducted in 388 diabetes patients attending daily diabetes clinics and teaching hospitals in Pakistan's twin city between August 2019 and February 2020. The chi-square test and linear regression were used to detect RLS-related factors in type 2 diabetes mellitus.

RESULTS: The prevalence of RLS found was; 3.1% patients with diabetes were suffering from very severe RLS, 23.5% from severe RLS, 34% from moderate RLS, 21.1% from mild RLS and 18.3% from non-RLS. Gender, age, education, blood glucose fasting (BSF), blood glucose random (BSR) and HBA1c were found to be significant predictors of RLS in patients with diabetes.

CONCLUSION: Policy makers can develop local interventions to curb the growing RLS prevalence by keeping in control the risk factors of RLS in people living with type 2 diabetes.

Matched MeSH terms: Diabetes Mellitus, Type 2

Association between knowledge and medication adherence in patients with type 2 diabetes mellitus in Pakistan. [Abstract]

Nazir SU, Hassali MA, Saleem F, Bashir S, Aljadhey H

Value Health, 2015 Nov;18(7):A613.

PMID: 26533439 DOI: 10.1016/j.jval.2015.09.2128

Objectives: Diabetes mellitus is a serious health problem. Medication adherence is a key determinant of therapeutic success in patients with diabetes mellitus. The purpose of this study was to assess medication adherence and its potential association with diabetes related knowledge in patients with type 2 diabetes mellitus.
Methods: This study was carried out at the outpatient clinics of a public sector teaching hospital in Sargodha, Pakistan. Besides demographic and disease-related questions, previously validated questionnaires, Morisky Medication Adherence Scale and Michigan diabetes knowledge test was used to assess the medication adherence and diabetes related knowledge, respectively. Descriptive statistics were used to determine the demographic and disease characteristics of the patients while Spearman rank correlation was employed to measure the association between medication adherence and knowledge.
Results: Three hundred and ninety two patients were interviewed. Out of 392 patients, 245 (62.5%) of the patients had average knowledge about diabetes while 282 (71.9 %) were categorized as poor adherent. Only 13 patients (3.3 %) were considered as good adherent in the study. The correlation coefficient between total scores of knowledge and total medication adherence score was 0.036 (p< 0.05), indicating a weak correlation between knowledge scores and adherence level.
Conclusions: Knowledge of diabetes mellitus among these patients was average; however, adherence to drug therapy was also poor. Patients’ knowledge about diabetes had positive association with medication adherence. Improving diabetes knowledge of people can result in better adherence, which may result in better control of diabetes.

Matched MeSH terms: Diabetes Mellitus, Type 2

Nazir SU, Hassali MA, Saleem F, Bashir S, Aljadhey H

Prim Care Diabetes, 2016 Apr;10(2):136-41.

PMID: 26476867 DOI: 10.1016/j.pcd.2015.09.004

AIMS: The purpose of this study was to investigate the association of diabetes-related knowledge and treatment adherence with glycaemic control among patients with type 2 diabetes mellitus (T2DM) in Pakistan.
METHODS: The study was designed as a questionnaire-based, cross-sectional analysis. T2DM patients attending a public outpatient clinic in Sargodha, Pakistan, were targeted for the study. In addition to the demographic information, the Urdu version of Michigan Diabetes Knowledge Test and Morisky Medication Adherence Scale was used for data collection. Patients' medical records were reviewed for glycated haemoglobin levels (HbA1c). Descriptive statistics were used to elaborate sociodemographic characteristics. The Spearman's Rho correlation was used to measure association of disease-related knowledge and treatment adherence with glycaemic control. SPSS V 20.0 was used for data analysis and p<0.05 was taken as significant.
RESULT: In total, 392 T2DM patients were included in the study. The mean age (SD) of these patients was 50.77±9.671 years, 56.6% were males and 90% (n=353) of respondents were married. The mean (SD) duration of disease was 5.58 (4.09) years with median HbA1c of 9.00 (IQR=8.20-10.40). The median knowledge score was 8.0 (IQR=6.0-10.0), while the median adherence score was 4.7 (IQR=3.0-6.0). HbA1c had non-significant and weak negative association with diabetes-related knowledge (r=-0.036, p=0.404) and treatment adherence (r=-0.071, p=0.238).
CONCLUSION: There was negative association reported between HbA1c, treatment adherence and diabetes-related knowledge. Greater efforts are clearly required to investigate other factors affecting glycaemic control among T2DM patients in Pakistan.
KEYWORDS: Adherence; Correlation; Diabetes-related knowledge; Glycaemic control; Type 2 diabetes

Matched MeSH terms: Diabetes Mellitus, Type 2

Fulltext A cross-sectional assessment of health-related quality of life among type 2 diabetic patients in Pakistan

Nazir SU, Hassali MA, Saleem F, Bashir S, Hashmi F, Aljadhey H

J Pharm Bioallied Sci, 2016 Jan-Mar;8(1):64-8.

PMID: 26957872 DOI: 10.4103/0975-7406.171734

OBJECTIVE: This study aims to describe the health-related quality of life (HRQoL) profile of Type 2 diabetes mellitus (T2DM) population attending outpatient clinics in Sargodha City, Pakistan.
METHODS: The study was designed as a cross-sectional descriptive survey. T2DM patients attending a tertiary care institute in Sargodha, Pakistan were targeted for the study. The EuroQol EQ-5D was used for the assessment of HRQoL and was scored using values derived from the UK general population survey. Descriptive statistics were used for the elaboration of sociodemographic characteristics. The Chi-square test was used to depict the possible association between study variables and HRQoL. Where significant associations were noted, Phi/Cramer's V was used for data interpretation accordingly. SPSS version 21 (SPSS Inc., Chicago, IL, USA) was used for data analysis and P < 0.05 was taken as significant.
RESULTS: Three hundred and ninety-two patients were approached for the study. The cohort was dominated by males (n = 222, 56.60%) with 5.58 ± 4.09 years of history of T2DM. The study highlighted poor HRQoL among the study participants (0.471 ± 0.336). Gender, marital status, education, monthly income, occupation, location and duration of the disease were reported to be significantly associated with HRQoL (P < 0.001).
CONCLUSION: T2DM imposes a negative effect on HRQoL of the patients. Attention is needed to highlight determinants of HRQoL and to implement policies for better management of T2DM, particularly in early treatment phases where improving HRQoL is still possible.
KEYWORDS: EQ-5D; Pakistan; health-related quality of life; type 2 diabetes mellitus

Matched MeSH terms: Diabetes Mellitus, Type 2*

A pilot study measuring knowledge and attitudes towards diabetes mellitus In Kedah, Malaysia [Abstract]

Saleem F, Hassali MA, Verma AK, Aljadhey H

Value Health, 2015 Nov;18(7):A614-5.

PMID: 26533446 DOI: 10.1016/j.jval.2015.09.2138

Objectives: An adequate disease-related knowledge is important in treatment and management of ailments. Within this context, patients are needed to have correct knowledge and positive attitude especially when they are faced with an emergence of chronic diseases. The aim of this study therefore is to assess the level of type 2 diabetes mellitus (T2DM) awareness and disease related attitude among general population at Bujang Valley, Merbok, Kedah, Malaysia.
Methods: A questionnaire based, cross sectional study was conducted. The Diabetes Attitude Scale was used to assess the knowledge and attitude of respondents towards T2DM. Data was described descriptively and SPSS v.22 was used for data analysis.
Results: Out of three hundred and seventy seven respondents, majority of the respondents (n=156, 41.4%) were in age group of more than 40 years old and the cohort was dominated by Malay ethnic group. Females subjugated over males (n=229, 60.7%) and the highest number of respondents were working as businessman (n=115, 30.5%). Corresponding to the marital status, majority of the respondent were married (n=247, 65.5%). Majority of the respondents (n=274, 72.7%) were reported as healthy with no chronic disease. The respondents reported certain misapprehensions where they believed that T2DM have lesser complications, blood glucose control is needed for Type 1 Diabetes Mellitus only and the emotional effects of T2DM are minor.
Conclusions: The study reported insufficient level of knowledge among the respondents in management of T2DM. General population needs to have good collaboration with healthcare professionals to get more education and knowledge related to T2DM for their empowerment.

Matched MeSH terms: Diabetes Mellitus, Type 2

Does adherence to the therapeutic regimen associate with health related quality of life: Findings from an observational study of type 2 diabetes mellitus patients in Pakistan

Nazir SR, Hassali MA, Saleem F, Bashir S, Aljadhey H

Pak J Pharm Sci, 2017 Nov;30(6):2159-2165.

PMID: 29175785

Patient adherence with a therapeutic regimen predicts successful treatment and reduces the severity of negative complications. The purpose of this work was to find the relationship between general Health Related Quality of Life (HRQoL) and compliance to the treatment among type 2 diabetes mellitus patients (T2DM) in Sargodha, Pakistan. The research was planned as a cross-sectional survey. T2DM patients attending a tertiary care institute in Sargodha, Pakistan were targeted for the study. The Urdu version of the Morisky Medication Adherence Scale (MMAS-Urdu) and EuroQol Quality of Life Scale were employed to evaluate adherence to treatment regimen and HRQoL correspondingly. Descriptive statistics were used for the elaboration of socio-demographic characteristics. The Spearman rank order test was employed to determine the relationship between medicine adherence and HRQoL. P<0.05 was considered statistically significant. A total of 392 patients were selected for the survey. Most participants were males (n=222, 56.6%) with 5.58±4.09 years of history of T2DM. Majority of respondents (n=137, 34.9%) were categorized in age group of 51 to 60 years with mean age of 50.77±9.671 years. The present study highlighted that individuals with type 2 diabetes mellitus had decreased HRQoL (0.4715±0.3360) and poor medication adherence (4.44±1.8). Significant, yet weak positive correlations were observed between medication adherence and HRQoL (r=0.217 and 0.136 for EQ-5D and EQVAS respectively). Although the association between adherence to therapeutic regimen and HRQoL in the present study cohort was significant, it was rated as weak, hence failed in producing an overall impression on quality of life. The study highlights the need of identifying other individual factors affecting HRQoL among T2DM patients in Pakistan.

Matched MeSH terms: Diabetes Mellitus, Type 2/diagnosis; Diabetes Mellitus, Type 2/drug therapy*; Diabetes Mellitus, Type 2/epidemiology; Diabetes Mellitus, Type 2/psychology

Hypoglycemia in Type 2 Diabetes Mellitus patients: A review article

Tourkmani AM, Alharbi TJ, Rsheed AMB, AlRasheed AN, AlBattal SM, Abdelhay O, et al.

Diabetes Metab Syndr, 2018 Sep;12(5):791-794.

PMID: 29678605 DOI: 10.1016/j.dsx.2018.04.004

Hypoglycemia is an essential issue for diabetic patients and considered a limiting factor in the glycemic management. Heterogeneity of the diseases in Type 2 Diabetes Mellitus can affect the frequency of hypoglycemia, especially when the patient has cardiovascular diseases. There are several factors that lead to hypoglycemia including sulfonylurea therapy, insulin therapy, delaying or missing a meal, physical exercise, or alcohol consumption. Long-term studies reported that repeated hypoglycemia could increase the risk of cardiovascular diseases. During Ramadan fasting, diabetic patients have high incidence of hypoglycemia. Therefore, focused education about hypoglycemia in routine life of diabetic patients and during fasting in Ramadan is important to reduce the complications.

Matched MeSH terms: Diabetes Mellitus, Type 2/blood*; Diabetes Mellitus, Type 2/diagnosis; Diabetes Mellitus, Type 2/epidemiology*

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