Health Status Of Type Research Articles

Exploring changes in the distribution of health status in type 2 diabetes over time - methodological aspects for estimating years lost due to disability for Germany

Abstract Knowledge of the severity distribution (SD) of certain diseases is crucial for calculating the years lost due to disability (YLD), as the time spent with a disease is explicitly weighted on the health state level. Depending on the disease, different severity levels are considered. In most cases, the SDs vary from mild, moderate, severe to most severe. This is different in the context of diabetes, where an explicit distinction is made according to the sequelae resulting from the disease progression. In general, these include diabetic neuropathy (with foot ulcers or amputations) and (mild or moderate) vision impairments including blindness due to diabetic retinopathy. These complications cause a considerable loss of quality of life for those affected and high costs for the healthcare system. However, the progression of many of the sequelae can be avoided through (secondary) preventive measures. Estimating the degree of severity is therefore an important indicator of the population affected and in need for care. Due to a lack of data, the Global Burden of Disease Study often uses time-invariant and regionally fixed SDs. Important insights as to the temporal variance of SDs thus remain unnoticed. As part of the BURDEN 2020 pilot project in Germany, SD for diabetes-related complications were estimated from routine health insurance data for the year 2017. In a follow-up project (BURDEN 2.0), these results will also be available for the years 2017 to 2022. If there are any changes in the proportion of individual health conditions, implications can be generated from routine healthcare data of those affected. The SDs overall and according to certain sequelae will be presented over time and discussed. Also, the resulting YLD over time for type 2 diabetes will be examined, including changes in the prevalence of the disease. This makes it possible to analyse and interpret the burden of disease due to diabetes during the years 2017 to 2022.

Correlation between self-efficacy and health status of Type 2 Diabetes Mellitus patients in primary health care

The health status of Type 2 Diabetes Mellitus (T2DM) patients is observed to decrease simultaneously along with the length of time. Despite the various treatment management offered in primary care, a decrease in health status is also observed among patients in Indonesia as shown by the low self-care ability. Therefore, this research aimed to analyze the relationship between self-efficacy and the health status of patients in primary care in Indonesia to provide evidence for the development of care management interventions for T2DM patients.The research used a descriptive analytical method with a cross-sectional design, including 327 T2DM patients in primary health care selected through cluster random sampling. Data collection used the Indonesian version of the Diabetes Management Self-Efficacy Scale (DMSES) and Short Form 12 (SF-12) questionnaires which had been tested for validity and reliability. The data obtained were analyzed using the Pearson Product Moment test with a significance value of 0.01.The results obtained an r-value of 0.485 with a p-value of 0.00, showing a significant relationship between self-efficacy and health status in T2DM patients (0.00<0.01; CI 99%).In conclusion, this study highlights a significant correlation between self-efficacy and the health status of individuals diagnosed with T2DM. The findings emphasize the pivotal role of self-efficacy in shaping the health outcomes of patients with T2DM.

Telomeres do not always shorten over time in individuals with type 1 diabetes

AimsWe aimed to determine how white blood cell (WBC) telomeres and telomere length change over time are associated with health status in type 1 diabetes. MethodsRelative telomere length (rTL) was measured in WBC DNA from two time-points (median 6.8 years apart) in 618 individuals from the Finnish Diabetic Nephropathy Study by quantitative PCR, with interassay CV ≤ 4%. ResultsBaseline rTL correlated inversely with age and was shorter in men. Individuals in the shortest vs. longest rTL tertile had adverse cardiometabolic profiles, worse renal function, and were prescribed more antihypertensive and lipid-lowering drugs. While overall rTL tended to decrease during the median 6.8-years of follow-up, telomeres shortened in 55.3% of subjects, lengthened in 40.0%, and did not change in 4.7%. Baseline rTL correlated inversely with rTL change. Telomere lengthening was associated with higher HDL-Cholesterol (HDL-C), HDL-C/ApoA1, and with antihypertensive drug and (inversely) with lipid-lowering drug commencement during follow-up. Correlates of rTL percentage change per-annum (adjusted model) were baseline BMI, eGFR, previous retinal laser treatment, HDL-C, and HDL-C/ApoA1. ConclusionsTelomere length measurements may facilitate the treatment and monitoring of the health status of individuals with type 1 diabetes.

Impact of Diabetes Education on Health Status of Diabetes Patients in Khartoum State

Diabetes education, with its role in improvement in knowledge, attitude and practice, lead to better control of the disease, and is accepted to be an important part of diabetes management. The Study aimed to determine the effect of diabetes education on health status of type 2 diabetes patients attending Diabetes Mini Clinics at Primary Health Care centers in Khartoum state, Sudan. The study design was quasi-experimental. Sample of seventy-eight type 2 diabetes patients was selected from eleven reverence family health centers, which contain diabetes mini clinic. Seventy of participants continued until the end of the study. A pre –post questionnaire was used to collect the data, which entered and analyzed by using Statistical Package for the Social Sciences, percentage, mean and standard deviation and paired T. test were used to analyze the data. The level of statistical significance was set at P. value ˂ 0.05. The results showed Diabetes education had positive effect on glycemic control (P. value = .001), diastolic blood pressure (P. value = .017), and quality of life (P. value = .001). The study recommended that coverage of primary health care centers with diabetes education service is very important and other studies is needed for more evaluation. 

Assessment of Serum Advanced Glycation End-Product Level and Its Effect on Periodontal Health Status in Type 2 Diabetic Patients with Chronic Periodontitis

Assessment of Serum Advanced Glycation End-Product Level and Its Effect on Periodontal Health Status in Type 2 Diabetic Patients with Chronic Periodontitis

Salivary flow rate and oral health status in type 2 diabetics

Introduction. Decreased salivary flow is frequently associated with numerous diseases such as diabetes mellitus and may lead to numerous oral diseases. The aim of this study was to compare salivary flow rate and oral health status in type 2 diabetics and healthy controls. Material and methods. The study involved 90 patients, divided into the three groups: 30 with well controlled (HbA1c<9%), 30 will poorly controlled (HbA1c?9%) diabetes and 30 healthy subjects. The following clinical parameters were determined: decayed, missing and filled teeth (DMFT); plaque index (PI), sulcus bleeding index (SBI), probing pocket depth (PPD) and clinical attachment level (CAL). Culture of Candida spp. specimens were obtained from tongue dorsum and inoculated into Sabouraud Dextrose Agar. Saliva was collected using ?a spit technique?. Results. Highest mean of unstimulated salivary flow was in healthy subjects; however significant difference between groups was not observed. Stimulated salivary flow results indicate significant reduction in diabetics as well as significant relation between metabolic control and salivary flow. Unstimulated and stimulated salivary flows were negatively and significantly correlated with periodontal parameters and DMFT. Conclusion. The present findings indicate that decreased salivary flow rate could have a significant impact on oral health status in type 2 diabetics.

Association between health locus of control and oral health status in type 2 diabetics - A cross sectional comparative study

Background: Diabetes mellitus (DM) is a highly prevalent metabolic disorder which has life-long acute and chronic complications, constituting a huge global public health burden. The influence of diabetes on oral health is established. However, literature assessing psychosocial aspects that are necessary for managing metabolic control and oral health in diabetics is scarce. Aim: To determine the association between health locus of control and oral health among patients with Type 2 DM in Bengaluru City. Materials and Methods: A cross-sectional conducted among 300 participants with and without type 2 DM visiting government hospitals in Bengaluru City from November 2017 to September 2019. The Multidimensional Health Locus of Control (MHLC) Scale (Internal [IHLC], Powerful Others [PHLC], and Chance [CHLC]) and the WHO pro forma 2013 were used to assess health locus of control and oral health, respectively. Chi-square, Spearman's correlation, and multivariate hierarchical linear regression were applied. The statistical significance was considered at P

How psychosocial outcomes impact on the self-reported health status in type 2 diabetes patients: Findings from the Diabetes Attitudes, Wishes and Needs (DAWN) study in eastern China.

IntroductionThe deleterious effects of psychosocial outcomes on diabetic patients’ health have not been fully investigated yet. This study was aimed to explore how psychosocial outcomes impacted on the health status of Chinese patients with type 2 diabetes.MethodsA mix of stratified sampling and typical sampling were used to select diabetic patients in Jiangsu Province to conduct individual interviews. Health status was measured by EuroQol Visual Analogue Scale (VAS). Psychosocial outcomes were measured by instruments used in the Diabetes Attitudes, Wishes and Needs survey, including psychological well-being, diabetes distress, patient empowerment, self-management, and patient reported healthcare provision. Clinical characteristics measured included diabetes comorbidities, complications and treatment. OLS regression analyses were used to estimate how health status varied with different characteristics.ResultsAltogether 1614 patients with type 2 diabetes aged 18–65 years from 6 districts/counties in Jiangsu Province were included in the study. With general characteristics and clinical factors controlled for, psychological well-being among all psychosocial outcomes had the most significant association with health status, with a difference of 9.2 in VAS scores between likely depression and good well-being. VAS scores were also significantly lower in patients with high diabetes distress and significantly higher in those more frequently conducting physical activities. Other psychosocial outcomes were not significantly associated with health status.ConclusionsLikely depression and diabetes-related distress are negatively associated with health status while frequently conducting physical activities are positively associated with health status of type 2 diabetes patients aged 18–65 years from 6 districts/counties in Jiangsu Provinces. These findings underscore the necessity of undertaking routine assessment for depression and diabetes distress and prioritizing interventions on promoting regular physical activities in diabetic patients to improve health management and achieve better health outcomes.

Correlation between Salivary Glucose and Blood Glucose and the Implications of Salivary Factors on the Oral Health Status in Type 2 Diabetes Mellitus Patients.

Aims and Objectives:The purpose of this study was to estimate and assess any correlation between random capillary blood glucose (RCBG) and unstimulated whole salivary glucose (UWSG), as well as to estimate various salivary parameters, such as flow rate, pH, buffering capacity, and the influence of these factors on the oral health status in type 2 diabetes mellitus (DM).Materials and Methods:Sixty individuals suffering from type 2 DM and 40 healthy individuals in the age group of 30–60 years were included in the study. RCBG was estimated using glucometer and UWSG was estimated using photocolorimeter. Salivary parameters such as flow rate, pH, and buffering capacity were assessed using GC® Saliva kit. Oral health status was recorded using the Russell's periodontal index (RPI) and the Decayed Missing Filled Teeth (DMFT) index. The Statistical Package for the Social Sciences version 16 was used for statistical analysis.Results:Type 2 diabetics had higher mean values for RCBG levels and UWSG. Type 2 diabetics had low mean salivary flow rate, pH, and buffering capacity. Type 2 diabetics had higher mean values for RPI.Conclusion:Among the salivary factors studied, salivary glucose significantly influenced the periodontal status in Type 2 diabetics.

Impact of glycemic control on oral health status in type 2 diabetes individuals and its association with salivary and plasma levels of chromogranin A

ObjectiveTo evaluate the effect of glycemic control status in type 2 diabetes mellitus (T2DM) individuals on clinical oral health indicators and to compare the concentrations of plasma and salivary chromogranin A (CHGA) among nondiabetic subjects and T2DM patients, exploring their associations. DesignIn this cross-sectional study, 32 patients with controlled T2DM, 31 with poorly controlled T2DM and 37 nondiabetic subjects underwent a clinical and periodontal examination. CHGA concentrations were determined in saliva and plasma with ELISA. ResultsPoorly controlled T2DM group exhibited significantly higher mean buffering capacity, plaque index and bleeding on probing than other groups (P<0.05). No difference was found to DMFT (decayed, missed and filled teeth) index between groups. Sites with clinical attachment loss (CAL) of 4 and 5–6mm were significantly higher in both diabetic groups compared to control group (P<0.05). Poorly controlled T2DM group had significantly higher sites with CAL≥7mm than other groups (P=0.001). Significantly higher plasma and salivary CHGA levels were found in T2DM groups (P<0.05). In both diabetic groups, probing depths 5–6mm and CAL 5–6mm were associated with higher salivary CHGA concentration (P<0.05). ConclusionsThe findings revealed that T2DM patients were more prone to periodontal tissue damage than to caries risk. The results also provide some evidence that the degree of attachment loss deteriorates significantly with poor glycemic control in T2DM (CAL≥7mm). Moreover, the results suggest that high concentrations of salivary CHGA are associated with worse periodontal parameters and T2DM, and this could be related to the pathogenesis of both diseases.

Assessment of Nutrition Education and Health Status of Type 2 Diabetic Patients at a Government-owned Hospital, Lagos

Objective: The study examined the influence of nutrition education on the health status of patients with type 2 diabetes treated at Gbagada General Hospital, Lagos. Theory, Prior Research, Rationale: The incidence of diabetes is on the increase in Nigeria and uniform, documented nutrition education is lacking. Study Design, Setting, Participants, and Intervention: A questionnaire and a 24-hour food recall were administered to 73 subjects. Outcome,Measures andAnalysis: The 24 hour dietary recall was used to collect data on energy and nutrient intake. The results were was analyzed using descriptive statistics and percentages. Results: Results showed that the mean change in weight and fasting blood sugar among patients was 8.57+9.04kg and 35+26.54mg/dl respectively. There were also differences between initial and final body mass index of the patients. The overall energy (kcal) intake was 1688.9+381.2, while calcium (mg) was 301.3+47.1; protein (g) was 50.5+7.9. More than half of the subjects were overweight/obese. The result showed that though the nutrition education given by the hospital is inadequateminimal, nutrition education had a significant (r1⁄40.713) positive correlation with the health status of the patients. Conclusions and Implications: It is recommended that a wider choice of indigenous foods be included in the list of diabetic foods with special emphasis on portion control techniques. Obesity prevention and weight management programs need to be designed and implemented since many patients were either obese or overweight. Funding: None.

Obese versus non-obese patients with type 2 diabetes: patient-reported outcomes and utility of weight change

ABSTRACTIntroduction: This study (1) used patient-reported outcome measures to assess and compare the health status of type 2 diabetes patients with and without obesity and (2) assessed the value of weight change among obese and non-obese subgroups, using standard gamble (SG) utility methodology.Methods: Among a sample with type 2 diabetes in the United Kingdom, individuals with obesity (BMI ≥ 30 kg/m2) were identified and compared to non-obese patients. Patients completed the EQ‑5D, Psychological General Well-Being Index, Appraisal of Diabetes Symptoms, and Diabetes Symptom Checklist – Revised (DSC‑R). SG interviews assessed the utility of the ‘basic’ type 2 diabetes health state anchored to respondents’ body weight, as well as health states with altered weight.Results: A total of 129 patients (74 obese; 55 non-obese) completed interviews (mean age 55.9 years; 64.3% male). Obese patients reported lower health status (EQ‑5D VAS; between-group difference: p < 0.001) and greater symptom impact (several DSC‑R scales, p < 0.05). Utilities of the basic health state were 0.86 (obese) and 0.91 (non-obese; p = 0.02). Hypothetical health states with higher weight received lower utilities, whereas reduced weight was associated with increased utility. There was a between-group difference in the disutility associated with 5% higher weight (obese 0.068; non-obese 0.051; p = 0.03).Discussion: Compared with non-obese patients, the obese group reported lower health status and greater symptom impact. SG interviews found an inverse relationship between weight and utility. Furthermore, obese patients with type 2 diabetes may value weight change differently than non-obese patients. Study limitations include the sample size and the use of a patient sample, rather than a sample selected from the general population. Overall, the results demonstrate that utilities can differ by patient subgroups, even among patients with the same diagnosis.

Impaired health status in Type D patients following PCI in the drug-eluting stent era

Background Drug-eluting stenting reduces restenosis post-percutaneous coronary intervention (PCI), but subgroups of patients may not benefit optimally from this procedure. We examined the impact of Type D personality on health status over time and the clinical relevance of Type D as a predictor of impaired health status at 12 months in unselected post-PCI patients. Methods Consecutive patients ( n = 692) participating in the Rapamycin-Eluting Stent Evaluated At Rotterdam Cardiology Hospital (RESEARCH) registry completed the Type D Scale at 6 months and the Short Form Health Survey 36 (SF-36) at 6 and 12 months post-PCI. Results Although there was a significant improvement in health status over time ( p < 0.001), Type D patients reported a substantially lower score on all health status domains of the SF-36 compared with non-Type D patients ( p < 0.001). Type D personality was an independent predictor of impaired health status on all SF-36 sub domains at 12 months except for physical functioning, adjusting for baseline demographic and clinical variables and health status at 6 months. In these adjusted analyses, Type D personality increased the likelihood of impaired health status at 12 months post-PCI from 60% (OR: 1.60; 95% CI: 1.04–2.46) to almost 300% (OR: 3.99; 95% CI: 2.52–6.32), varying among the parameters analyzed. Conclusions Type D personality was associated with impaired health status in post-PCI patients treated in the drug-eluting stent era. The role of personality factors as determinants of clinical outcome and health status should not be overlooked as these factors may have much explanatory power.