Priority Non-communicable Diseases Research Articles

IJCM_140A: A Study On The Medication Compliance Among Adult Registered Patients With Type II Diabetes Mellitus In The Urban Health Training Centre Of MMCRI, Mysuru

Background: Globally, diabetes is one of the four priority noncommunicable diseases targeted for action because of its higher burden and complications. Good Medication adherence is essential to reduce complications of diabetes and its adverse outcomes. Non-adherence to diabetic medications is one of the critical public health challenges. Irregular access to medications, increased number of drugs, presence of side effects and lack of awareness were some of the primary reasons reported for poor adherence. Hence there is a need to assess the magnitude of these reasons so that suitable interventional measures may be adopted to reduce medication non-adherence among people with diabetes. Objective: 1) To estimate the proportion of medication compliance among registered patients with type 2 diabetes mellitus in the urban health training center of MMCRI, Mysuru 2) To assess the influence of determinants on medication compliance among study subjects. Methodology: A community-based cross-sectional study was conducted among registered type 2 Diabetes Mellitus patients under Urban Health Training Centre, Nazarbad from June 2021 to May 2022 using Multistage random sampling. Medication Adherence was assessed using Morisky’s Medication Adherence Scale. Descriptive statistics, Chi-square test were used for the statistical analysis Results: 48.6% of males and 51.3% of females were involved in the study. 58.6% had good medication adherence, 5.9% had medium medication adherence and 35.45% had poor medication adherence.. In this study, we found that as the age increased the patients had poor adherence to diabetic medications. Also, socioeconomic status, gender, educational status were found to be significantly associated with adherence to medication. Conclusion: As the prevalence of Diabetes Mellitus continues to rise in India, it is increasingly important to maintain and improve the patient’s adherence to medication for to prevent complications and to provide a better quality of life.

Assessment of Knowledge Attitude, and Practice of Type 2 Diabetes Mellitus in Selected Hospital of Somalia

Diabetes is a serious, chronic disease that occurs either when the pancreas does not produce enough insulin (a hormone that regulates blood sugar, or glucose), or when the body cannot effectively use the insulin it produces. Diabetes is an important public health problem, one of four priority non-communicable diseases (NCDs) targeted for action by world leaders. Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades. Socioeconomic and demographic characteristics of the respondents showed that. Age- majority of the respondent’s age were 33 (25-30%) comprising (33 N=80), 18 (22.5) their age was 30-35, 16 (20.0%) were age 35-40 while 40-45 were 13 (16.2%). Table shows the characteristics of study participants stratified by their gender. The respondent of 49 (61.2%) were males and 31 (38.8%) were females. As see the table above that most of the participants was married while few numbers were windowed and divorced. 15 Were single (18.8%), 58 were Married (72.5%), 3 were widow (3.8%) and 4 were divorced (5.0%). The majority respondents reported to have attained are never go to school education, 53 (66.2%) while of the respondents, secondary education were 8 (10.0%) and also 3 (3.8%) were primary. 12 (15.0%) had Diploma. While 4 (5.0%) was Bachelor degree and above education. The table above shows that majority of the respondents were self employment 33 (41.2%), while the house wife was in second number of respondents were 31 (38.8%) Civil society were 11(13.8) and Health workers also were 5(6.2).

Analysis of the health status of patients with type 1 and type 2 diabetes mellitus living in urban and rural areas of the Saratov region (according to the data of the federal register of patients with diabetes mellitus)

BACKGROUND: The World Health Organization considers diabetes mellitus as a significant public health problem, including this disease as one of the four priority noncommunicable diseases. Over the past few decades, the prevalence of diabetes has been steadily increasing and represents a significant threat to the public health of the world’s population. In connection with the territorial features of residence and the availability of medical care to residents of urban and rural areas, studies that include an analysis of the incidence of diabetes mellitus, disability and mortality of the urban and rural population from complications of this disease are one of the important mechanisms for monitoring the health status of the population, which predetermines the improvement and implementation strategies aimed at improving the demographic situation.AIM: To conduct a comparative retrospective analysis of the health indicators of patients with type 1 and type 2 diabetes mellitus living in urban and rural areas of the Saratov region.MATERIALS AND METHODS: Information on life expectancy, morbidity, complications, causes of disability, direct causes of death in patients with type 1 and type 2 diabetes mellitus living in the Saratov region in urban and rural areas was obtained from the Federal Register of Patients with Diabetes; information on the urban and rural population of the Saratov region was obtained from official statistical sources published on the website of the Federal State Statistics Service. Mathematical, statistical and analytical research methods were used. Statistical data processing was carried out using the Microsoft Excel 2019 program. The significance of the difference between the average and relative values was assessed using the Student’s t-test. The presence of a relationship between the signs was determined using the Pearson coefficient. The Mann-Whitney U-test was used to compare populations by quantitative characteristics. The significance level was determined at t>2 and p<005. Data were presented as P ± m, where P is the relative value and m is its standard error, and M ± m, where M is the mean value and m is its standard error.RESULTS: A higher average life expectancy was noted for people with type 2 diabetes, regardless of place of residence, in comparison with the same indicator in the Saratov region. The average life expectancy of patients with type 1 diabetes is 18 years lower than in the Saratov region for those living in urban areas and 17 years for rural residents. There is an excess of the levels of primary and general morbidity in people suffering from type 1 and 2 diabetes and living in rural areas over the same indicators of urban residents. The main causes of death in both urban and rural patients with type 1 and 2 diabetes are: chronic cardiovascular insufficiency, cerebrovascular accident and acute cardiovascular diseases. Disability rates in patients with type 2 diabetes living in urban areas are lower than in rural areas.CONCLUSION: Analysis of data from the Federal Register of Patients with Diabetes Mellitus in the Saratov Region showed high levels of primary and general morbidity, disability and mortality in patients with type 1 and 2 diabetes living in rural areas. Also, frequently occurring complications from the cardiovascular system were identified in all patients with type 1 and type 2 diabetes, regardless of the place of residence. The relationship between the levels of morbidity, mortality, disability, the incidence of complications and the place of residence of patients with type 1 and type 2 diabetes is not statistically significant.

POTENSI SIANIDIN POLY(LACTIC-CO-GLYCOLIC ACID)-POLYETHYLEN GLYCOL YANG DIMODIFIKASI FUSED FOLLICLE UNTUK MENINGKATKAN SENSITIVITAS DAN SEKRESI INSULIN DALAM MENANGANI PENYAKIT DIABETES MELITUS TIPE 2

ABSTRACT
 Introduction: Type 2 diabetes mellitus is one of the four priority non-communicable diseases according to WHO. WHO data in 2015 showed that as many as 415 million people in the world suffer from type 2 diabetes mellitus. Even in Indonesia in 2013, the prevalence of people with diabetes has increased to 6.9%. Currently, the most common treatment for type 2 diabetes mellitus is the administration of metformin. However, long-term administration will cause lactic acidosis and kidney damage. Because of this, new alternatives are needed that minimize the side effects, for example by using herbal ingredients. Cyanidin is a natural flavonoid that has the effect of increasing insulin sensitivity and secretion.
 
 Discussion: Cyanidin has the potential to increase insulin receptor sensitivity and increase insulin secretion. To increase insulin sensitivity, cyanidin can inhibit the downregulation of Glut4 expression and decrease the level of RBP 4 expression. As an increase in insulin secretion Cyanidin increases the expression of GLUT2, Kir6.2, and Cav1.2 genes that play a role in insulin secretion. Unfortunately, Cyanidin has low bioavailability and is unstable. Therefore, Cyanidin encapsulation will increase the availability of cyanidin in the blood and is easily concentrated into pancreatic cells
 Conclusion: The Fc-modified Cyanidin PLGA-PEG combination has the potential to be a new alternative in the treatment of type 2 diabetes mellitus
 Keywords: Type 2 Diabetes Mellitus, Cyanidin, Fc-modified Cyanidin PLGA-PEG

Improving glycemic control in patients with type 2 diabetes mellitus through a peer support instant messaging service intervention (DiabPeerS): study protocol for a randomized controlled trial

BackgroundDiabetes mellitus is one of the four priority non-communicable diseases worldwide. It can lead to serious long-term complications and produces significant costs. Due to the chronicle character of the disease, it requires continuous medical treatment and good therapy adherence of those suffering. Therefore, diabetes self-management education (DSME) (and support DSMES) plays a significant role to increase patient’s self-management capacity and improve diabetes therapy. Research indicates that these outcomes might be difficult to maintain. Consequently, effective strategies to preserve the positive effects of DSMES are needed. Preliminary results show that peer support, which means support from a person who has experiential knowledge of a specific behavior or stressor and similar characteristics as the target population, is associated with better outcomes in terms of HbA1c, cardiovascular disease risk factors or self-efficacy at a lower cost compared to standard therapy. Peer-supported instant messaging services (IMS) approaches have significant potential for diabetes management because support can be provided easily and prompt, is inexpensive, and needs less effort to attend compared to standard therapy. The major objective of the study is to analyze the impact of a peer-supported IMS intervention in addition to a standard diabetes therapy on the glycemic control of type 2 diabetic patients.MethodsA total of 205 participants with type 2 diabetes mellitus will be included and randomly assigned to an intervention or control group. Both groups will receive standard therapy, but the intervention group will participate in the peer-supported IMS intervention, additionally. The duration of the intervention will last for 7 months, followed by a follow-up of 7 months. Biochemical, behavioral, and psychosocial parameters will be measured before, in the middle, and after the intervention as well as after the follow-up.DiscussionType 2 diabetes mellitus and other non-communicable diseases put healthcare systems worldwide to the test. Peer-supported IMS interventions in addition to standard therapy might be part of new and cost-effective approaches to support patients independent from time and place.Trial registrationClinicalTrials.govNCT04797429. Registered on 15 March 2021.

Effectiveness of self-management health promotion education package among diabetic patients in Pokhara Metropolitan City, Nepal

ABSTRACT Diabetes is on an increasing trend, and it is one of the four priority non-communicable diseases (NCDs) and major public health problems. Studies indicate that educational programs are effective in the management of diabetes. The objective of this study was to determine the effectiveness of a diabetes self-management education program among diabetic patients in Pokhara Metropolitan City, Nepal. The study design was a pre-test and post-test interventional study among 60 diabetic patients. Questionnaires were used to collect information about demographic variables and Health Belief Model (HBM) constructs. Data were collected before the educational intervention program and after the educational intervention program. Paired t-test was performed to assess the effectiveness of an educational intervention. This study showed the effectiveness of the self-management health promotion educational package. The results showed a significant increase in each construct of HBM and self-management practice after the educational intervention (p < 0.0001). The mean value of perceived susceptibility was increased from 2.94 to 3.49; perceived severity was increased from 2.83 to 3.08; the perceived benefit was increased from 3.09 to 3.55; the perceived barrier was decreased from 2.44 to 2.00, self-efficacy was increased from 3.06 to 3.48 and self-management practice was increased from 3.02 to 3.46. The intervention was effective to the diabetes patients; there was an increase in perceived susceptibility, perceived severity, perceived benefit, self-efficacy, and self-management practice except for the perceived barrier. Educational programs should be focusing on the behavioral theory that plays a significant role in the self-efficacy and control of diabetes.

Does engagement in frequent physical activity improve diabetes mellitus among older adults in India? A propensity score matching approach

Background and aimsDiabetes is a major chronic condition and was identified as one of the four priority non-communicable diseases that the United Nations targeted because of its increasing disease burden. The present study aims to examine the impact of physical activity on improving diabetes mellitus among older adults in India. MethodsThis study utilizes data from India's first nationally representative longitudinal ageing survey (2017–18). Descriptive along with bivariate analysis was used to present the preliminary results. Additionally, Propensity score matching (PSM) analysis was used. ResultsAbout 14% of older adults suffered from diabetes. Eighteen percent of older adults did frequent physical activity. The estimated average treatment effect on the treated (ATT) values in treated and control groups were 0.123 and 0.147, respectively, indicating that the prevalence of diabetes among older adults was reduced by 2.5% points because of frequent physical activity. The average treatment effect on the untreated (ATU) results indicates that among older adults who did not do frequent physical activity, if they did frequent physical activity, the prevalence of diabetes is likely to decrease by 2.2% points. ConclusionOur findings show that frequent physical activity is associated with a lower risk of diabetes in older adults. The results underscore the need to develop strategies of promoting an active lifestyle by maintaining physical activity to combat the diabetes epidemic in the older population.

The Relation between Estradiol Levels and Body Mass Index with Fasting Blood Glucose Levels in Premenopausal Women in Padang in 2017

Premenopause is a transitional period that occurs due to decreased generative or endocrine function of the ovaries. In premenopausal women, there is a decrease in estrogen hormone levels and an increase in Body Mass Index (BMI) so that it will increase the risk of diabetes mellitus which is one of the four priority non-communicable diseases. The incidence of diabetes mellitus in women is much higher when compared to men. The research was conducted in the city of Padang, with an observational, cross-sectional design. The sampling technique used was multistage random sampling with a sample of 99 premenopausal women. The estradiol level was assessed by ELISA method, BMI was assessed by weight (kg) divided by height (m) squared, fasting blood glucose level was assessed by the enzymatic photometric method. The correlation between estradiol levels and fasting blood glucose levels was analyzed by using the Pearson Correlation test. The correlation between BMI and fasting blood glucose levels was analyzed by using the Pearson Correlation test. The mean of estradiol level was (148,689±49,417) pg/ml. Average Body Mass Index (BMI) was included in the Obese category I (26.5 kg/m2). The mean fasting blood glucose level was (98,766±6,549) mg/dL. There is a correlation between estradiol levels and fasting blood glucose levels (p value = 0.007 and r value = 0.270). In addition, there is a correlation between BMI and fasting blood glucose levels (p value = 0.023). The conclusion of this study is that there is a significant correlation between estradiol levels and fasting blood glucose. There is a significant correlation between BMI and fasting blood glucose Keywords: Estradiol Levels, Body Mass Index, Fasting Blood Glucose Levels, Premenopause.

Factors associated with control of type 2 diabetes mellitus in North Iran

Backround. Diabetes is an important public health problem, one of four priority noncommunicable diseases targeted for action by world leaders. The aim of this study was to investigate the factors affecting diabetes control in patients with type 2 diabetes in the rural areas of northern Iran. Methods. This study was conducted following a descriptive-analytical cross-sectional study design based on the data of 308 patients with type 2 diabetes in the rural areas of Golestan province. The samples were selected through two-stage stratified random sampling. Data were collected using a questionnaire (completed by the interviewer) and by measuring the blood glucose, blood pressure, and lipid profile of patients and also using data from patients’ records. Data were analyzed using descriptive and analytical statistics and SPSS version 19. Results. The mean age of patients was 57 ± 15 years and 220 patients (71%) were female. Fifty-five percent of patients had a family history of diabetes and 69% had comorbidity. The mean vegetable intake in patients was 3 days a week with 1.5 servings per day and only 20% had exercise at least three times a week. The proportion of patients with adequately controlled glycated hemoglobin (HBA1c), blood pressure (BP), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were 27, 91, 31, 41 and 55.5%, respectively. There was also a significant relationship between the controlled blood glucose with increasing age, absence of comorbidity, the number of nutrition counseling, and lowering blood triglycerides. Conclusion. The results of this study showed poor blood glucose control in the studied geography. Therefore, considering these data, it seems necessary to review the national plan for the prevention and control of diabetes.

Preventive scope of Nishamalaki Churna (combination of turmeric and Indian gooseberry powder) in type 2 DM: Review

Diabetes mellitus is a fastest growing serious global health problem. In 2000, India with 31.7 million diabetic population topped the world followed by China (20.8 million) respectively. Poor glycaemic control has been observed in the Indian diabetic population which in long term lead to various micro and macro vascular complications. Diabetes is one of four priority non-communicable diseases (NCDs) targeted by all health agencies for the Prevention and Control of NCDs. Turmeric (Curcuma longa) and Indian Gooseberry (Emblica officinalis) powder in combination called as Nisha Amalaki Churna showed significant hypoglycemic, antioxidant and hyperlipidemia effect in many experimental and human research. Ayurveda strongly recommended its significant effect in the management of diabetes (Prameha). The present write up is an effort to discuss the opportunities of an effective herbal combination Nishamalaki Churna as preventive and health promotive dimensions in Type 2 Diabetes Mellitus.

Detection of Omic Markers of the Nervous System Adverse Effects in Children with a Combined Exposure to Airborne Chemicals and Conditions of Educational Environment

Introduction: The rationale of prognostic and predictive molecular biomarkers of malfunctioning of homeostatic control mechanisms is important for solving the tasks of early diagnosis and prevention of priority noncommunicable diseases. Our objective was to detect omic markers of adverse effects of a combined exposure to airborne contaminants and factors of educational environment on the nervous system of children. Materials and methods: We studied school outdoor and indoor concentrations of certain air pollutants, the intensity of the educational process, and plasma proteins characterizing nervous system adverse effects in children aged 7–10 with a combined exposure to various factors of educational environment in the primary school with various types of educational programs and hygienic conditions. Results: We established that blood manganese, nickel, lead, chromium, benzene, xylene, and phenol levels among the schoolchildren of the study group were 1.2–2.4 times higher than those in the control group. The phenol concentration in blood is a proven marker of the inhalation exposure. We also identified such violations of the educational process as uneven distribution of study loads, an increase in the maximum permissible load, a 1.2-fold increase in intellectual loads, shortening of the break between basic and optional classes, and a 1.5-fold increase in intensity of the training mode. We obtained mass spectra of the peptides reflecting changes in homeostasis on the molecular level. As a result of establishing a direct causal relationship between the increase in the relative mass of a Kazal-type 5 serine protease inhibitor, the increased blood phenol level, effects of intellectual loads, routine and distribution of the training load, the Kazal-type 5 serine protease inhibitor was proved to be an omic marker of the combined exposure to ambient phenol and the factors of educational environment. Conclusions: An increase in the relative mass of the Kazal-type 5 serine protease inhibitor following the combined exposure to airborne phenol and educational factors is a molecular indicator of its prognostically unfavorable involvement into the pathogenesis of functional disorders of the nervous system in the form of vegetative-vascular dystonia.

Antidiabetic Potential of Methanolic Extract of Leave and Bark of Bangladeshi Medicinal Plant Bauhinia acuminata L on Mice

Diabetes mellitus the one of four priority non-communicable diseases is an important public health issue across the world. The disease is associated with abnormalities in Carbohydrate, Protein and Fat metabolism affecting 422 million adults globally (WHO). Though many antidiabetic agents have been introduced in the modern drug arsenal in the recent past, still diabetes and the related complications continue to be alarming health problem in developed as well as in developing countries. Hopefully, there are many plants has been reported to have potent antidiabetic activity and have been used for a long time in traditional medicine. However, the screening for potent antidiabetic molecule from natural sources is still going on. The antidiabetic activity was evaluated in normal and Streptozotocin (STZ) induced diabetic mice. Remarkable lowering of blood glucose levels (90.19% by leaf extract and 76.86% by bark extract compared to positive control)of the test animals depicts that the methanolic leaf and bark extract exhibited significant property (P<0.05) compared to diabetic control group. Dose dependent effect was also reflected in the test results. Control animals were found to be stable in their body weight while diabetic mice showed significant reduction in body weight during 7 days. The antidiabetic activity produced by a single mechanism or multiple glucose lowering mechanism may be involved.