Diabetes Care Practices Research Articles

Changes in diabetes care and management practices during the COVID-19 pandemic

Abstract Background We examined changes in diabetes care and management practices before and during the COVID-19 pandemic. Methods Population-based data regarding four diabetes-related healthcare engagement and four self-management indicators were obtained from adults with diabetes surveyed in 19 US States and Washington DC through the Behavioral Risk Factor Surveillance System. Using logistic regression, we estimated changes in the prevalence of each indicator, overall and by sociodemographic subgroups in 2019 (before the pandemic) and 2021 (during the pandemic). Results Between 2019 and 2021, the prevalence of biannual HbA1c tests reduced by 2.6 percentage points (pp; 95% confidence interval: −4.8, −0.4), from 75.4% to 73.1%, and prevalence of annual eye exams fell by 4.0 pp (−6.2, −2.8), from 72.2% to 68.7%. The composite indicator of engagement with healthcare for diabetes control fell by 3.5 pp (−5.9, −1.1), from 44.9% to 41.9%. Of self-management behaviors, avoidance of smoking increased by 2.0 pp (0.4, 3.6) from 84.7% to 87.1%. Conclusions The findings suggest a deterioration of the uptake of evidence-based, preventive health services requiring laboratory services and clinical examination for diabetes control during the pandemic. On the other hand, smoking rates decreased, suggesting potential positive impacts of the pandemic on health behaviors in people with diabetes.

Validity And Reliability Of Digital Health Education On Diabetic Foot Care Based On Health Belief Model Among Type Ii Diabetic Patients

The study aims to evaluate the effectiveness of digital health education on diabetic foot care among type II diabetic patients using the Health Belief Model (HBM). A total of 30 participants were recruited from local diabetes clinics to receive digital health education focused on diabetic foot care practices. To ensure the validity and reliability of the assessment tools, we employed multiple methods. Content validity was established through expert reviews, while construct validity was examined using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA), which confirmed a good factor structure aligned with the HBM constructs. Reliability was assessed using Cronbach’s alpha for internal consistency, which showed acceptable values ranging from 0.67 to 0.84, and test-retest reliability with Intraclass Correlation Coefficients (ICC) ranging from 0.74 to 0.78. The results indicate that the digital health education program significantly improved the participants' understanding and practices related to diabetic foot care. These findings underscore the potential of digital education interventions for chronic disease management, particularly for enhancing self-care behaviors in diabetic patients. Future studies should consider larger sample sizes to further validate these tools and results. Overall, this study provides evidence supporting the effectiveness of digital health education for diabetic foot care and validates the reliability and validity of the instruments used.

Patients’ knowledge of diabetic foot self-care practice: A cross-sectional study

This study evaluated the patients’ knowledge of diabetic foot self-care practice. A cross-sectional study was conducted to assess patients' understanding of diabetic foot care practices at the diabetic center in Merjan Medical City. The study was conducted from October 15, 2023 to April 1, 2024. An extensive review of relevant literature informed the development of the study instrument, consisting of two sections and 22 items. Data were collected using a developed questionnaire administered through interviews with available contacts who facilitated access to the study sample. Each interview lasted approximately 10 to 15 minutes. The data collection period was extended from December 1, 2023, to January 1, 2024. Most of the respondents (52%) were between 50 and 59 years of age. The sample was predominantly male, comprising 28 patients (56%). A significant portion (84%) were married, and 44% had literacy skills. Most participants were employed (36%), with 72% residing in urban areas. Most respondents (68%) reported inadequate economic status, and a majority (76%) had a family history of diabetes mellitus. Additionally, the highest percentage of the study sample (80%) had been living with the disease for more than one year. Most of the sample (42%) had a fair level of knowledge regarding diabetic foot self-care at the diabetic center in Merjan Medical City. Providing comprehensive education to registered patients who regularly visit the center is essential, focusing on foot self-care activities to enhance their knowledge and practices.

A mobile serious game about diabetes self-management: Design and evaluation

Type 2 Diabetes Mellitus (T2DM) is a chronic condition that requires ongoing self-management and education. In recent years, there has been a growing interest in utilizing mobile serious games as a tool for patient education and engagement. This article presents the development of DiaPo, a mobile serious game designed to improve self-management education for patients with T2DM. DiaPo integrates gamification techniques to increase patient engagement and motivation while providing essential information about disease management. The development of DiaPo followed a structured design process, utilizing the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) educational system. This systematic approach allowed for the integration of best practices in educational game design and diabetes care. The development team consisted of experts in medical informatics, game design, and diabetes care, ensuring a multidisciplinary approach to the game's creation. The game's narrative focuses on a T2DM patient who earns positive points for making healthy lifestyle choices and negative points for poor ones. This gamified approach aims to reinforce positive behaviors and provide immediate feedback on negative ones. Interactive animations confirm or deny options selected by the player, further enhancing the learning experience. DiaPo offers a flexible and adaptable platform suitable for diverse audiences, promoting inclusiveness and accessibility in T2DM education. DiaPo represents a novel approach to self-management education for patients with T2DM, utilizing gamification techniques and a multidisciplinary design process to create an engaging and informative mobile serious game. By promoting inclusiveness and accessibility, DiaPo has the potential to empower patients with T2DM to take an active role in their disease management. As the field of mobile serious games continues to evolve, DiaPo stands as a promising tool for improving T2DM education and patient outcomes.

Evaluating diabetic foot care knowledge and practices at education level.

Diabetic foot is one of the complications in type 2 diabetes mellitus. Adequate knowledge and practice are an important aspect to control further deteriorating conditions such as ulcers and amputations. Thus, the objective of this cross-sectional study was to investigate the impact of the education levels of diabetic patients on diabetic foot care knowledge and practice. This cross-sectional study with a convenient sampling technique was conducted on 534 patients with diabetes mellitus from public and private care hospitals. The data was collected using a validated, pretested and structured bilingual (Arabic, English) questionnaire. There were 534 patients interviewed, 39.1% of whom were males and 60.9% of whom were females and 61.4% of the patients had had T2DM for over 10 years. There was a significant difference in education levels between the male and female patients (53.8% and 46.2%, P = .001). Furthermore, 83.9% patients were married. The difference in education between the married and the single, divorced, and widowed patients was significant (P = .007). Patients with uncontrolled HbA1c were 2.43 times more likely to have hypertension (RR = 2.43, P = .03), while patients with highly uncontrolled diabetes had 3.1 times more chances of hypertension (RR = 3.1, P = .009). Heart disease prevalence was 3.27 times higher in diabetes patients with uncontrolled HbA1c and 3.37 times higher in patients with highly uncontrolled HbA1c. Patients with diabetes who have been diabetic for more than 10 years have a greater risk of heart disease (RR = 2.1; P = .03). Patients with lower education levels exhibited more diabetic complications compared to patients with higher education levels (P < .05). The present study highlights the importance of education and awareness campaigns targeting diabetic patients, especially those with lower education levels, to improve diabetes control and prevent, or manage, comorbidities. Healthcare providers should also prioritize patient education and medication adherence to improve diabetes management and reduce the risk of complications.

Assessing perceptions of nursing knowledge, attitudes, and practices in diabetes management within Chinese healthcare settings.

Effective management of diabetes mellitus (DM) involves comprehensive knowledge, attitudes, and practices (KAP) by nurses, which is essential for optimal patient care and aiding patients in their self-management of the condition. This survey evaluates nurses' self-assessed knowledge, attitudes, and practices (KAP) related to diabetes management, focusing on their perceptions of personnel expertise and care approaches. Using a stratified sampling method, the survey was disseminated across various online platforms from January 2023 to February 2024 within China, including WeChat and Sina Weibo. We employed binary logistic regression and Chi-square tests to explore the statistical correlates of KAP related to DM. A total of 4,011 nurses participated, revealing significant perceived knowledge deficiencies in specialized DM management areas, with only 34% (n = 1,360) proficient in current pharmacological treatments. Attitudinal assessments showed that 54% (n = 2,155) recognized the importance of cultural competence in dietary counseling. Practices were strong in routine glucose monitoring (96%, n = 3,851) but weaker in psychological support (68%, n = 2,736). Regression analysis indicated significant effects of experience on KAP, where nurses with 1-5 years of experience were more likely to show better knowledge (OR = 1.09; p = 0.08), and those with advanced degrees demonstrated higher competence (OR = 1.52; p = 0.028). Marital status influenced attitudes, with single nurses more likely to exhibit positive attitudes (OR = 0.49; p < 0.001), and work environment impacted knowledge, with hospital-based nurses more knowledgeable (OR = 1.15; p = 0.14). Additionally, gender differences emerged, with male nurses showing greater knowledge (OR = 1.65; p = 0.03) and better practices in diabetes care (OR = 1.47; p = 0.04). The study underscores the critical need for targeted educational programs and policy interventions to enhance nursing competencies in DM management. While the study provides valuable insights into nurses' perceptions of their competencies, future research should incorporate objective knowledge assessments to ensure a comprehensive understanding of their actual capabilities. Interestingly, the data also suggests a substantial opportunity to leverage technology and inter-professional collaboration to further enhance DM management efficacy among nurses, fostering an integrated care approach.

Diabetes self-care activities and its correlates in patients with diabetic neuropathy.

Diabetic neuropathy is the most common chronic complication observed in patients with diabetes and has significant clinical implications, such as decreased quality of life and increased morbidity and mortality rates. Studies on the factors affecting diabetes self-care activities pertaining to patients with diabetic neuropathy are limited. Therefore, a more in-depth study targeting individuals with diabetic neuropathy is required to develop patient-centred nursing interventions. This study aimed to identify diabetes self-care activities among patients with diabetic neuropathy and determine their correlates. This study employed a descriptive correlational design and the study subjects consisted of 99 patients with diabetic neuropathy. Descriptive statistics and hierarchical regression analyses were used to analyse the factors affecting diabetes self-care activities. This study follows the STROBE guidelines to ensure rigorous reporting of cross-sectional studies. Our findings revealed positive correlations between diabetes self-care activities and factors including knowledge of diabetes foot care, diabetes foot care practices, interpretation of diabetic neuropathy and foot care confidence. Foot care confidence positively correlated with diabetes foot care knowledge, practices and interpretation of neuropathy, but negatively related to diabetic stress. In determining the impact of these factors on diabetes self-care activities, hierarchical regression analysis revealed that patients with higher diabetes foot care practices and foot care confidence demonstrated higher levels of diabetes self-care activities. The study findings confirmed that diabetic foot care practices and foot care confidence significantly influenced self-care activities in patients with diabetic neuropathy. Considering these results, customizing the intervention content to match diabetic foot care practices and diabetic foot care confidence can enhance self-care activities in patients with diabetic neuropathy. Survey questionnaires were completed by patients with diabetic neuropathy in this study.

Development and validation of an interprofessional collaborative educational module on the self-management of foot for individuals with type II diabetes mellitus

Background Insufficient awareness of foot self-care among diabetic individuals results in diabetic foot ulcers. The management of diabetes and diabetic foot ulcers demands a well-coordinated approach that involves multiple healthcare providers (HCPs). The present study aims to develop and validate an interprofessional collaborative (IPC) educational program involving HCPs to efficiently oversee and instruct the public on appropriate strategies for self-managing diabetic foot health. Methods The research group worked on creating an educational module titled ‘An Interprofessional Collaborative Educational Module on Self-Management of Foot for Individuals with Type II Diabetes Mellitus.’ The objective of this module was to promote the adoption of proper practices in self-managing foot health for individuals with type 2 diabetes mellitus. A panel of 13 experts participated in a two-stage validation process using the Delphi method to assess the module and its educational resources. Subsequently, the module was tested on a group of 30 participants, i.e., individuals with diabetes, with its efficacy evaluated through conversation analysis and in-depth interviews. Results The three-month-long module included three sessions • 1: Diabetes and its health implications • 2: Diabetic foot and self-management • 3: Interprofessional education in diabetic foot care The mode of content delivery was via Whatsapp, and the educational resources, in the form of pamphlets, flowcharts, handouts, case-based cartoons, and videos on diabetes, including diabetic foot, its risks, and self-management, were shared regularly. All participating experts consensually validated the module and educational resources. Analysis of in-depth interviews revealed that the module immensely benefitted the participants and helped them improve their knowledge and practices of foot care in diabetes. Conclusions The study concludes that IPC educational modules can enhance adherence to proper diabetic foot care practices, potentially reducing the occurrence of foot ulcers and amputations, and ultimately improving the quality of life for individuals with diabetes.

Nurse-led family-based approach in primary health care for patients with type 2 diabetes mellitus: a qualitative study

ABSTRACT Purpose The prevalence of Type 2 diabetes is rapidly increasing, with 537 million people estimated to have diabetes in 2021. The literature suggests that nurses can deliver effective person-centred diabetes care and that families can be essential in supporting patients. Thus, a Nurse-led Family-based (NLFB) approach may be particularly effective. This study aims to explore the perceptions of nurses, adults with type 2 diabetes, and family members regarding the NLFB intervention. Methods Guided by the UK Medical Research Council Framework, this seminal study adopted a qualitative, descriptive approach with content analysis. Data were obtained through 16 semi-structured, in-depth interviews. Themes emerged based on an inductive process using constant comparison (Graneheim and Lundman 2004). The COREQ checklist was used in ensuring rigour. Results Three main themes emerged includes: (1) nurses’ experiences with current diabetes care practices, (2) stakeholders’ views on the development of a NLFB approach, and (3) merging the nurse-led family aspects into the diabetes care. The key challenges are the dominant medical model, lack of specialist nurses, and time. The key facilitators are knowledge and social support. Conclusion The study recommends stakeholders embrace nursing empowerment strategies and involve families to enhance the nurses’ advanced roles and family inclusion in healthcare.

Training of Community Health Workers in Diabetes Lead to Improved Outcomes for Diabetes Screening and Management in Low- and Middle-Income Countries: Protocol for a Systematic Review.

Diabetes is a growing concern worldwide, particularly in low- and middle-income countries (LMICs). Type 2 diabetes mellitus constitutes a significant proportion of cases and is associated with debilitating microvascular complications. Type 2 diabetes mellitus is steadily increasing among the LMICs where many barriers to health care exist. Thus, task shifting to community health workers (CHWs) has been proposed as a solution to improve diabetes management in these settings. However, CHWs often lack the necessary training to manage diabetes effectively. Thus, a systematic review is required to present evidence of the highest degree for this intervention. This study aims to establish the protocols for a systemic review. Using the Participants Intervention Comparator Outcome Time Study Design (PICOTS) framework, this study outlines a systematic review aiming to evaluate the impact of training programs for CHWs in diabetes management in LMICs. Quantitative studies focusing on CHWs, diabetes training, focusing on diabetes management outcomes like hemoglobin A1c levels and fasting blood glucose levels, between January 2000 and December 2023 and found on databases such as PubMed, Ovid MEDLINE, Evidence Based Medicine Reviews, BASE, Google Scholar, and Web of Science will be included. We will include randomized controlled trials but will also include observational studies if we find less than 5 randomized controlled trials. An author committee consisting of 3 reviewers will be formed, where 2 reviewers will conduct the review independently while the third will resolve all disputes. The Cochrane Methods Risk of Bias Tool 2 will be used for assessing the risk of bias and the Grading of Recommendations, Assessment, Development and Evaluation approach for the meta-analysis and narrative synthesis analysis will be used. The results will be presented in a PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) diagram. The review will begin in May 2024 and conclude in 3 months. The review will synthesize existing evidence and provide insights into the effectiveness of such programs, informing future research and practice in diabetes care in LMICs. PROSPERO CRD42022341717; https://tinyurl.com/jva2hpdr. PRR1-10.2196/57313.

Evaluation of diabetic foot care knowledge, determinants of self‐care practices and the efficacy of health education

AbstractTo evaluate the risk factors connected with diabetic foot care and investigate the impact of health education on promoting proper diabetic foot care practices. An explanatory and mixed‐method study was performed. We administered a structured pretest questionnaire to patients diagnosed with Type 2 diabetes who frequented our health examination center and community health clinics. The survey encompassed patient demographics, basic knowledge concerning diabetic foot care, and self‐care practices pertaining to diabetic foot care. Concurrent assessments and scoring were carried out. Following the survey, patients underwent health education sessions focusing on foot self‐care behaviours. Their progress was reevaluated after 2 weeks to gauge its effectiveness. We identified educational attainment, diabetes duration, regular follow‐up, and blood sugar control as critical factors influencing knowledge about foot care and self‐care practices related to it. Pearson correlation analysis demonstrated a positive relationship between scores for diabetic foot care knowledge and scores for self‐care behaviours (r = 0.32, p &lt; 0.001). Health education led to a significant improvement in the self‐care behaviours of diabetic patients. A variety of factors affect the occurrence of diabetic foot complications and the self‐care behaviours associated with diabetic foot care. Health education proves to be an effective means of enhancing diabetic foot care behaviours.

Living with depression and diabetes: A qualitative study in Bangladesh and Pakistan.

Diabetes and depression are both serious health conditions. While their relationship is bidirectional and each condition adversely affects outcomes for the other, they are treated separately. In low and middle income countries, such as Bangladesh and Pakistan, health systems are already stretched and the integration of diabetes and depression care is rarely a priority. Within this context through interviews with patients, healthcare workers and policy makers the study explored: lived experiences of people living with depression and diabetes, current practice in mental health and diabetes care and barriers and perspectives on integrating a brief psychological therapy into diabetes care. The findings of the study included: differing patient and practitioner understandings of distress/depression, high levels of stigma for mental health and a lack of awareness and training on treating depression. While it was apparent there is a need for more holistic care and the concept of a brief psychological intervention appeared acceptable to participants, many logistical barriers to integrating a mental health intervention into diabetes care were identified. The study highlights the importance of context and of recognising drivers and understandings of distress when planning for more integrated mental and physical health services, and specifically when adapting and implementing a new intervention into existing services.

Review and Evaluation of European National Clinical Practice Guidelines for the Treatment and Management of Active Charcot Neuro-Osteoarthropathy in Diabetes Using the AGREE-II Tool Identifies an Absence of Evidence-Based Recommendations.

Background: Charcot neuro-osteoarthropathy (CNO) is a rare but devastating complication of diabetes associated with high rates of morbidity; yet, many nonfoot specialists are unaware of it, resulting in missed and delayed diagnosis. Clinical practice guidelines (CPGs) have proven useful in improving quality of care and standardizing practice in diabetes and diabetic foot care. However, little is known about the consistency in recommendations for identification and management of active CNO. Aim: The aim of this study is to review European national diabetes CPGs for the diagnosis and management of active CNO and to assess their methodological rigor and transparency. Methods: A systematic search was performed to identify diabetes national CPGs across Europe. Guidelines in any language were reviewed to explore whether they provided a definition for active CNO and recommendations for diagnosis, monitoring, and management. Methodological rigor and transparency were assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE-II) tool, which comprises 23 key items organized within six domains with an overall guideline assessment score of ≥ 60% considered to be of adequate quality to recommend use. Each guideline was assessed by two reviewers, and inter-rater agreement (Kendall's W) was calculated for AGREE-II scores. Results: Seventeen CPGs met the inclusion criteria. Breadth of CNO content varied across guidelines (median (IQR) word count: 327; Q1 = 151; Q3 = 790), and 53% provided a definition for active CNO. Recommendations for diagnosis and monitoring were provided by 82% and 53%, respectively, with offloading being the most common management recommendation (88%). Four guidelines (24%) reached threshold for recommendation for use in clinical practice (≥ 60%) with the scope and purpose domain scoring highest (mean (SD): 67%, ± 23%). The remaining domains had average scores ranging between 19% and 53%. Inter-rater agreement was strong (W = 0.882; p < 0.001). Conclusions: European national CPGs for diabetes provide limited recommendations on active CNO. All guidelines showcased deficits in their methodology, suggesting that more rigorous methods should be employed for diabetes CPG development across Europe.

Improving pharmaceutical practice in diabetes care using point-of-care glycated haemoglobin testing in the community pharmacy.

To evaluate the use of point-of-care testing to detect new cases of diabetes mellitus at a Brazilian public community pharmacy. This cross-sectional study included individuals without a previous diagnosis of diabetes mellitus who met the criteria for screening according to the Brazilian Diabetes Society, which were identified during their presence at a Brazilian public community pharmacy. The measurements of HbA1c were performed using a Cobas b101 device (Roche Diagnostics) and were categorized according to the following classification established by the Brazilian Society of Diabetes: HbA1c <5.7%, normal; HbA1c between 5.7% and 6.4%, pre-diabetes; and HbA1c >6.4%, new diagnosis of T2DM. One hundred and eight users met the inclusion criteria. The patients' mean age was 54.4 (± 15.4) years old, ranging from 22 to 80 years old. Eighty (74.1%) participants presented with glycated haemoglobin levels over the standard threshold, of which 58 (72.5%) were in the pre-diabetes range (glycated haemoglobin levels between 5.7% and 6.4%), and 22 (27.5%) had glycated haemoglobin levels >6.4%, which corresponds to a new diagnosis of type 2 diabetes mellitus. The use of point-of-care glycated haemoglobin testing allowed community pharmacists at a Brazilian public community pharmacy to identify health system users with glycated haemoglobin alterations that corresponded to the pre-diabetes state or a new diagnosis of type 2 diabetes mellitus. This presented a good opportunity to refer these users to diabetes diagnosis and treatment services.

Collaborative practice in type 2 diabetes management in a developing country: A qualitative study of perceptions and attitudes of key stakeholders.

To explore collaborative practice and perceptions and attitudes of key stakeholders on collaboration in type 2 diabetes management in a tertiary care setting. Understanding collaborative practice in diabetes care in developing countries helps to design and provide patient-centred and cost-effective care. An exploratory qualitative study. Interviews were undertaken with 30 patients and 18 health professionals and policymakers. Thematic data analysis was undertaken to explore collaborative practice and examine participant perspectives on collaboration in diabetes management. We compared the findings with D'Amour's Collaboration Framework to determine the level of collaboration. Most participants reported a lack of collaborative practice in diabetes management, while they appreciated its importance in improving care. Perceptions varied with respect to what constituted collaborative practice. Three themes were identified: (1) perspectives of key stakeholders on current practice of collaboration; (2) impediments to collaborative practice; (3) strategies to improve collaborative practice. Analyses of the themes using D'Amour's Collaboration Framework indicated a low level of collaboration among physicians, nurses, pharmacists and policymakers, which was attributed to workload and time pressures on health professionals, power dynamics and lack of role clarity of all actors in collaborative action. Participants commented on the need to improve collaboration by establishing strong leadership and governance at different healthcare structure levels, which is committed to coordinating collaboration and developing collaborative frameworks and policies that guide collaborative undertaking. Perceived shortcomings of collaboration were attributed to inadequate resources, power dynamics, a lack of strong team functioning and policies. Participants' positive perceptions provide an opportunity to improve collaborative practice through incorporation of collaborative frameworks and policies. The findings in this study inform development of tailored and patient-centred diabetes care in tertiary care settings in sub-Saharan Africa. The study was reported in accordance with the COREQ checklist. Patients or the public were not involved in the design, analysis or interpretation of the data in this study. However, patients and healthcare providers participated in pilot interviews, which helped refine the interview guides. The summary of the findings of the study was also discussed with patients and healthcare providers, where they provided feedback.

Diabetes care practices and outcomes in 40.000 children and adolescents with type 1 diabetes from the SWEET registry during the COVID-19 pandemic

AimsThis study aimed to provide a global insight into initiatives in type 1 diabetes care driven by the COVID-19 pandemic and associations with glycemic outcomes. MethodsAn online questionnaire regarding diabetes care before and during the pandemic was sent to all centers (n = 97, 66,985 youth with type 1 diabetes) active in the SWEET registry. Eighty-two responded, and 70 (42,798 youth with type 1 diabetes) had available data (from individuals with type 1 diabetes duration >3 months, aged ≤21 years) for all 4 years from 2018 to 2021. Statistical models were adjusted, among others, for technology use. ResultsSixty-five centers provided telemedicine during COVID-19. Among those centers naive to telemedicine before the pandemic (n = 22), four continued only face-to-face visits. Centers that transitioned partially to telemedicine (n = 32) showed a steady increase in HbA1c between 2018 and 2021 (p < 0.001). Those that transitioned mainly to telemedicine (n = 33 %) improved HbA1c in 2021 compared to 2018 (p < 0.001). ConclusionsChanges to models of care delivery driven by the pandemic showed significant associations with HbA1c shortly after the pandemic outbreak and 2 years of follow-up. The association appeared independent of the concomitant increase in technology use among youth with type 1 diabetes.

Type 1 diabetes patient experiences and management practices during the COVID-19 pandemic in rural Uganda.

The COVID-19 pandemic has impacted various aspects of the lives of persons with chronic diseases, including type 1 diabetes (T1D). However, the diabetes care experiences and practices adopted by persons living with T1D after the declaration of the COVID-19 pandemic in Uganda have not been well documented. We investigated diabetes management practices and experiences of persons with T1D during the COVID-19 pandemic lockdown in a rural district of southwestern Uganda. Using interactive sequential explanatory mixed methods, we conducted a cross-sectional study of persons with T1D aged 18-25 years, their caregivers and health workers. Quantitative data was exclusively collected from patients with T1D using Kobo Toolbox™ and analysed with SPSS™ version26; qualitative interviews were used to elicit responses from purposively selected patients with T1D, plus caregivers and health workers that were analysed using a thematic framework approach. The study enrolled 51 (24 males) patients with T1D; diabetes duration (mean ± SD) 6.6 ± 5 years. Access to insulin syringes significantly worsened in 19.6% of participants (p = 0.03). Insulin injection frequency (p = 0.01), blood glucose monitoring (p = 0.001) and meal frequency (p = 0.0001) significantly decreased. Qualitative interviews highlighted COVID-19 restriction measures had reduced household income, frequency of clinic visits, and access to food, diabetes support and social services. Experiences and practices were consistent with decisions to prioritise survival, even with known risks around metabolic control. The online version contains supplementary material available at 10.1007/s40200-023-01222-4.

Practice of Diabetic Self Care Among Diabetic Farmers in University of Calabar Teaching Hospital Calabar, Nigeria

The study analysed the practice of diabetic self care among diabetic farmers in University of Calabar Teaching Hospital Calabar, Nigeria. One hundred and twenty (120) respondents were selected through a multi-stage sampling procedure from diabetic rural farmers attending diabetic clinic in the University of Calabar Teaching Hospital. Data collected were analyzed using descriptive and inferential statistics such as frequency, percentage, mean, standard deviation and chi-square test respectively. The study revealed that a good proportion (52.5%) of the respondents were males while 47.5% were females. The study revealed through a check list that majority (75.00%) had regular blood glucose check, 70.00 percent had contact with health care providers whenever infections occurred, while 60.83 percent had their meal plan regularly. Constraints affecting diabetic self care practice include lack of technical knowhow on the practice of self care, negative attitude towards diabetes and poor communication between agricultural extension workers, health extension workers and the rural farmers in the study area. The chi square test indicated that, there was no significant relationship between level of education and practice of self-care among diabetic rural farmers in the study area at 5% level of significance with an X2 value of 5.99. The study calls for greater synergy between rural farmers, agricultural extension agents, health workers and diabetic clinics in the study area. This will bring hope and courage to diabetic rural farmers in the study area. How to Cite: John B. Effion, Imaobong O. Enenyi, 2023. "Practice of Diabetic Self Care Among Diabetic Farmers in University of Calabar Teaching Hospital Calabar, Nigeria." Journal of Agriculture and Crops, vol. 9, pp. 302-308.

Diabetes Professional Care conference 2022: key updates

Health care professionals working in diabetes flocked to the Diabetes Professional Care conference, held over two days in London's Olympia venue, in November 2022. The programme covered a wide range of topics, reflecting the latest best practice and knowledge in diabetes care, providing an opportunity to access high-quality and practical information to share with their colleagues. Joy Ogden reports on some of the highlights of the conference.

Nurses’ competencies and resource availability in the care of diabetes mellitus patient attending primary health care Centres in Anambra State

Diabetes mellitus is a global public health concern with a rise in prevalence rate in Nigeria. There is increase in report on the high mortality rate of the diabetes at different communities as a result of the incompetence of care by the nurses and other health workers. This study was aimed at determining the competencies of nurses and availability of resource for diabetes mellitus care at Primary Health Care Centres in Anambra State. Design: Cross sectional survey. Method: Questionnaire was adopted for the collection data from 158 nurses and midwives from the Primary Health Care Centres in the selected local government areas of Anambra state. Data was analysed using statistical package for social sciences (SPSS) version 20 Spearman Rank Order Correlation was used to determine the relationship between socio-demographic characteristics and level of competency in diabetes care among the primary health care nurses at significant level of P&lt;0.05. and the result was presented in tables and frequencies. Result: The study revealed poor theoretical knowledge of diabetes mellitus care (36.97%) by the nurses, although their perceived skill and perceived practice towards diabetes care was good. Also, there was adequate material resources for diabetes mellitus care in majority of the primary health care centres. There was no significant association between the nurses age and knowledge competence but a significant relationship was found between the nurses years of work experiences and their skills (Rho = -0.221, P = 0.005). Therefore, there is need to bridge the gap between theory and practice in diabetes care among nurses and midwives in primary health care.