Successful Diabetes Management Research Articles

Application of the Social Cognitive Theory to Predict Self-Care Behavior among Type 2 Diabetes Patients with Limited Health Literacy

Background and Objective: Although compliance with self-care behaviors is necessary for the successful management of diabetes, patients with diabetes often refuse favorable self-care. This study was conducted to determine the factors influencing self-care behaviors among type-2 diabetic patients who had limited health literacy based on social cognitive theory (SCT). Materials and Methods: A cross-sectional study was conducted among 293 diabetic patients with limited health literacy that was identified by S-TOFHLA. The data were collected using the summary of diabetes self-care activities, diabetes management self-efficacy scale, outcome expectancies questionnaire, and a researcher-made questionnaire for collecting data related to self-regulation and social support constructs. Data were analyzed by SPSS ver.22 using multiple linear regression to determine the predictors of self-care behaviors. Results: In the case of patient’s adherence to self-care tasks, they had the best adherence to medication regime and the worst adherence to physical activity. Employment status (p <0.032, β=3.57), supplementary insurance (p <0.018, β=1.74), and history of participating in diabetes education classes (p <0.044, β=1.63) were predictors of self-care behaviors in the studied patients. Among the SCT constructs, perceived self-efficacy (p <0.001, β=0.21) predicted self-care ability. The mean score of self-care increased around 0.21 by increasing one single unit of self-efficacy. Overall, these factors predicted 67% (R2 = 0.67) of self-care changes. Conclusions: The results of this study showed that self-efficacy and demographic variables are significant predictors to improve self-care ability among diabetic patients with limited health literacy.

Assessment of Patient Satisfaction with On-Site Point-of-Care Hemoglobin A1c Testing: An Observational Study

IntroductionPoor glycemic control is a serious challenge in successful diabetes management. Given the low adherence and compliance with HbA1c testing frequency and the corresponding delay in the appropriate medication adjustment, point-of-care testing (POCT) for HbA1c provides an opportunity for better control of diabetes and higher patient satisfaction. The data with this regard are limited in Saudi Arabia. Therefore, we aimed to assess the level of patient satisfaction associated with the POCT service implementation for HbA1c and evaluate the differences between the number of requested and conducted HbA1c tests before and after POCT implementation and its effect on glycemic control in Saudi clinical practice.MethodsWe conducted a single-center ambispective descriptive cohort study in Riyadh, Saudi Arabia. This study had two phases: the retrospective phase (January 2017 to December 2017) and the prospective phase (January 2018 to December 2018). Patient satisfaction was assessed using the patient satisfaction questionnaire short form (PSQ-18) and on-site HbA1c point-of-care testing (HbA1c-POCT) satisfaction questionnaire.ResultsThis study included 75 patients with diabetes (37% type 1, 63% type 2) with a mean age of 44.35 (± 17.97) years. The adherence to physician recommendations for HbA1c testing frequency increased from 24% to 85% (before and after POCT implementation, respectively). High levels of satisfaction across seven dimensions of PSQ-18 (77–88%) were reported towards the provided healthcare service after POCT implementation. Furthermore, a high level of agreement on the statements of the on-site HbA1c-POCT satisfaction questionnaire was also observed. Finally, the mean HbA1c level has significantly improved after POCT implementation compared to the traditional HbA1c laboratory testing before POCT implementation [8.34 ± 0.67 and 8.06 ± 0.62, respectively, p < 0.001).ConclusionHbA1c testing at POCT improved adherence to recommendations for HbA1c testing frequency for better glycemic control and higher patient satisfaction. POCT reduces turnaround time, improves glycemic control, and facilitates the decision-making process. HbA1c measurement with POC devices is recommended to be implemented in diabetes treatment centers. All of the described benefits of POCT come together to make HbA1c testing the most common procedure for diabetes management at the point of care.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13300-021-01126-7.

Development and evaluation of a culturally tailored education module for type 1 diabetes in a resource-constrained setting: protocol for a mixed-methods study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Diabetes education is the key to successful diabetes management. There is a need for an education module for type 1 diabetes (T1D) that is culture-specific and suited to resource constraints.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A mixed-methods study will be conducted, in three phases, to develop and evaluate a culturally tailored diabetes education module for Indian children with T1D and their families. During the first phase, a qualitative study among health professionals and families of children with T1D for need assessment will be conducted. During the second phase, based on the themes from the last phase, an educational module will be developed. The third phase will involve an evaluation of the content, feasibility and effectiveness of the proposed module. The content evaluation will be done using the standardized 'suitability assessment of materials' checklist. For feasibility, a mixed-method approach will be used with iterative cycles of satisfaction scale, semi-structured interview and feasibility and observation checklist. The module will be revised after each cycle till no new changes are suggested. The effectiveness will be assessed by a quasi-experimental controlled trial assessing glycemic control, health-related quality of life, clinically important events and self-management practices in T1D children at baseline and three and six months.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study aims at development and validation of a novel culturally tailored diabetes education module for children with T1D, suited to their resource constraints. A module designed with the inputs from all stakeholders, and evaluated using iterative cycles, has the potential to suit the dynamic nature of diabetes management in children.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Trial registration:&lt;/strong&gt; Trial registration number is CTRI/2021/04/032739.&lt;/p&gt;

46-LB: Humor and A1C: The Interaction between Humor and Diabetes Control

Humor and A1C: The Interaction Between Humor and Diabetes Control There is increasing evidence of specific medical and psychological benefits associated with humor within diabetes populations. The benefits of maintaining good diabetes control are also well established. The more general relationship between humor and diabetes control however remains unexplored. The purpose of this study was to examine if there was a difference between people with diabetes with an A1C ≤ 6.99% versus those ≥ 7.0% on four disparate types of humor. The sample consisted of 284 participants, 65.5% with type 1 diabetes, 68.3% female, 89.1% Caucasian, and 68.7% college educated. Participants completed the Humor Styles Questionnaire (HSQ) and were divided into two groups, A1C ≤ 6.99% and A1C ≥ 7.0%. The A1C ≤ 6.99% group scored significantly higher on both types of positive humor, affiliative humor (P &amp;lt; 0.01) and self-enhancing humor (P &amp;lt; 0.05). There was no significant difference between participants on either type of negative humor, aggressive humor (P &amp;gt; 0.05) or self-defeating humor (P &amp;gt; 0.05). Results indicate that good control (A1C ≤ 6.99%) is associated with positive humor. These findings provide evidence that there is an association between American Diabetes Association recommended levels of control and positive humor styles. Implications are extensive and important. Regardless of if humor contributes to better control, or better control leads to a better sense of humor, humor is the common denominator. In either case the existence of positive humor is connected to reduced medical complications, psychological complications, and successful diabetes management. Since humor is free, readily available, and can be developed and strengthened, it is suggested as a viable treatment component. Furthermore, results confirm and add support to the evidence that including humor in diabetes education leads to improved diabetes education outcomes. Disclosure D. S. Greene: None.

Knowledge and behavior changes in clinician after training of partnership for Diabetes Control in Indonesia

Background and aimsOne of the main determinants of successful diabetes management is the quality of healthcare provider including general practitioner and internist which can be increased through medical training. This study aimed to describe the changes of clinician’s knowledge and behavior of comprehensive diabetes management training program around Indonesia. MethodWe conducted a three-day training program for general practitioners and internists for 3.5 years, 2013 to 2016. All clinicians invited as voluntary participant to send their patient data from medical record. Each participant was expected to submit a minimum of 25 type 2 diabetes (T2DM) set patient data before and 6 months after training program to analyze the impact of program in physician knowledge and behavior related to diabetes management. Result120 of 489 voluntary participants submitted completed baseline data with 4676 patient data. Meanwhile, only 32 participants that submitted completed data of 6 months before after training with 886 patient data. Most of parameters were improve before and after program. The greatest and lowest improvement were on A1c measurement (21%) and smoking assessment (2%). ConclusionIntensive seminar and training was not enough to empower diabetes management. This research might push the creation of clinical practice program that were tailored to each care facilities and integrated within routine care aimed at continual improvement of its healthcare worker.

Patient Markers of Successful Diabetes Management.

For individuals with diabetes, diabetes health status may not align with A1C targets. Patients may use nonclinical targets when assessing their diabetes management success. Identifying these targets is important in developing patient-centered management plans. The purpose of this study was to identify patient markers of successful diabetes management among patients in an urban academic health system. A secondary analysis of semistructured interviews was completed with 89 adults with type 1 or type 2 diabetes. Participants had a recent diabetes-related emergency department (ED) visits or hospitalization or were primary care patients with an A1C >7.5%. Interviews were conducted to saturation. Demographic data were collected via self-report and electronic medical records. Interviews were analyzed using conventional content analysis. This analysis focused on patient perceptions of successful management coded to "measuring management success." Although most participants cited A1C or blood glucose as a marker of successful diabetes management, they had varied understanding of these metrics. Most used a combination of targets from the following categories: 1) A1C, blood glucose, and numbers; 2) engagement in medical care; 3) taking medication and medication types; 4) symptoms; 5) diet, exercise, and weight; and 6) stress management and social support. Individuals not meeting glycemic goals and/or with recent diabetes-related ED visits or hospitalizations had varied understanding of A1C and blood glucose targets. They use multiple additional markers of successful management and had a desire for management discussions that incorporate these markers. These measures should be incorporated into their care plans along with clinical targets.

Adherence and Persistence to Insulin Therapy in People with Diabetes: Impact of Connected Insulin Pen Delivery Ecosystem.

Diabetes is an increasing public health problem, and insulin is the mainstay for treatment of type 1 diabetes. In type 2 diabetes treatment, insulin therapy is used after oral or other injectable agents become inadequate to achieve glycemic control. Despite the advances in insulin therapy, management of diabetes remains challenging. Numerous studies have reported low adherence and persistence to insulin therapy, which acts as a barrier to successful glycemic control and diabetes management. The aim of this targeted review article is to provide an overview of adherence and persistence to insulin therapy in people with diabetes and to discuss the impact of the emergence of a new connected ecosystem of increasingly sophisticated insulin pens, glucose monitoring systems, telemedicine, and mHealth on diabetes management. With the emergence of a connected diabetes ecosystem, we have entered an era of advanced personalized insulin delivery, which will have the potential to enhance diabetes self-management and clinical management. Early systems promise to unlock the potential to address missed or late bolus insulin delivery, which should help to address non-adherence and non-persistence. Over time, improvements in this ecosystem have the potential to combine insulin data with previously missing contextualized patient data, including meal, glucose, and activity data to support personalized clinical decisions and ultimately revolutionize insulin therapy.

Barriers and facilitators to successful management of type 2 diabetes mellitus in Latin America and the Caribbean: A systematic review.

Given that most evidence-based recommendations for managing type 2 diabetes mellitus (T2DM) are generated in high-income settings, significant challenges for their implementation exist in Latin America and the Caribbean region (LAC), where the rates of T2DM and related mortality are increasing. The aim of this study is to identify the facilitators and barriers to successful management of T2DM in LAC, from the perspectives of patients, their families or caregivers, healthcare professionals, and/or other stakeholders. We conducted a systematic review in MEDLINE, Web of Science, SciELO, and LILACS. We included studies of disease management, prevention of complications and risk factor management. We qualitatively synthesized the verbatim text referring to barriers and/or facilitators of diabetes management according to the Theoretical Domain Framework and described their relative frequencies. We included 60 studies from 1,595 records identified. 54 studies (90%) identified factors related to the environmental context and resources, highlighting the importance of questions related to health care access or lack of resources in the health system, and the environmental context and living conditions of the patients. Issues related to "social influences" (40 studies) and "social/professional role and identity" (37 studies) were also frequently addressed, indicating the negative impact of lack of support from family and friends and clinicians' paternalistic attitude. 25 studies identified patients beliefs as important barriers, identifying issues such as a lack of patients' trust in the effectiveness of the medication and/or the doctor's advice, or preferences for alternative therapies. Successful diabetes management in LAC is highly dependent on factors that are beyond the control of the individual patients. Successful disease control will require emphasis on public policies to reinforce health care access and resources, the promotion of a patient-centred care approach, and health promoting infrastructures at environmental level.

A Successful Diabetes Management Model of Care in Long-Term Care Facilities

The management of diabetes in long-term care (LTC) facilities requires facility staff to perform most self-care activities on the behalf of the residents. A practical model of care to improve diabetes management was developed and implemented at 6 LTC facilities in the Northeast United States between 2009 and 2012. The components of the program included (1) developing an individualized education curriculum and educating LTC interdisciplinary staff; (2) educating patients and caregivers; and (3) developing a clinical care algorithm. Over 500 staff members were educated and achieved competence. There were 1031 residents screened for risk of hypo- or hyperglycemia on admission, and 245 residents (24%) experienced hypoglycemia and 240 residents (23%) experienced hyperglycemia. Hypoglycemia episodes resolved without recurrence in 73%-90% cases because of interventions initiated by LTC staff. The implementation of a practical model of diabetes management in LTC facilities can improve staff education and lead to improved diabetes management.

335-OR: A Successful Diabetes Management Model of Care in Long-Term Care Facilities

Objectives: The management of diabetes in long-term care (LTC) facilities requires facility staff to perform most diabetes self-care activities on the behalf of the residents. We describe a practical model of care to improve diabetes management in LTC facilities. Design and Methods: A diabetes management model of care was developed and implemented at six LTC facilities over 4-year period. The components of the program included: 1) developing individualized curriculum, and educating interdisciplinary staff members, 2) educating patients and families, and 3) developing a practical clinical care algorithm. Staff members were trained to identify the most likely reasons for hypo- or hyperglycemic episodes and intervention strategies based on the causes. Results: Over 500 LTC staff members were educated and achieved competence during the program implementation. The patients and families received on an average 12.5 education sessions per month in skilled nursing facilities, and 1.5 education sessions per month in nursing homes. A total of 1031 residents were screened to assess risk of hypo- or hyperglycemia on admission to LTC. During the first 2 weeks of stay, hypo- and hyperglycemic episodes occurred in 31.4% and 29.2% of residents respectively. Overall, 245 residents (23.8%) experienced ≥1 episode of hypoglycemia (glucose &amp;lt;70mg/dl). Of those 245 residents, 66.5% had 1 event, 15.5% had 2 events, and 18.0% had ≥3 events. Similarly, 240 residents (23.3%) experienced ≥1 episode of hyperglycemia (≥3 consecutive glucose readings &amp;gt;200 mg/dl) with 63.7% having 1 event, 17.9% with 2 events, and 18.4% having ≥3 events. The most common cause of either hypo- or hyperglycemia was found to be medication related. The hypoglycemia episodes resolved without recurrence in 73-90% cases and interventions reduced the number of events over time. Conclusion: Implementation of a practical model of diabetes management in LTC facilities can improve staff education leading to improved diabetes management for all residents. Disclosure S.L. Sy: None. M. Munshi: Consultant; Self; Eli Lilly and Company, Sanofi.

Patient-Centred Care for Patients With Diabetes and HIV at a Public Tertiary Hospital in South Africa: An Ethnographic Study.

Background: Healthcare systems across the globe are adopting patient-centred care (PCC) approach to empower patients in taking charge of their illnesses and improve the quality of care. Although models of patient‐centredness vary, respecting the needs and preferences of individuals receiving care is important. South Africa has implemented an integrated chronic disease management (ICDM) which has PCC component. The ICDM aims to empower chronic care patients to play an active role in disease management process, whilst simultaneously intervening at a community/ population and health service level. However, chronic care is still fragmented due to systemic challenges that have hindered the practice of PCC. In this article, we explore provider perspectives on PCC for patients with comorbid type 2 diabetes and HIV at a public tertiary hospital in urban South Africa. Methods: This study utilizes ethnographic methods, encompassing clinical observations, and qualitative interviews with healthcare providers (n=30). Interview recordings were transcribed verbatim and data were analyzed inductively using a grounded theory approach. Results: Providers reported various ways in which they conceptualized and practiced PCC. However, structural challenges such as staff shortages, lack of guidelines for comorbid care, and fragmented care, and patient barriers such as poverty, language, and missed appointments, impeded the possibility of practicing PCC. Conclusion: Health systems could be strengthened by: (i) ensuring appropriate multidisciplinary guidelines for managing comorbidities exist, are known, and available, (ii) strengthening primary healthcare (PHC) clinics by ensuring access to necessary resources that will facilitate successful integration and management of comorbid diabetes and HIV, (iii) training medical practitioners on PCC and structural competence, so as to better understand patients in their sociocultural contexts, and (iv) understanding patient challenges to effective care to improve attendance and adherence.

Living With Diabetes: Perceived Barriers of Adolescents.

Type 1 diabetes mellitus is the most common endocrine disease during infancy and adolescence. Diabetes causes serious coping problems during adolescence because of the need for continuous observation and because of diabetes-related complications. Thus, adolescents must adapt to and effectively manage their diabetes. This study was designed to determine the perceived barriers to home care in adolescents with Type 1 diabetes using the Health Promotion Model. Eighteen adolescents were selected from the qualified patients who applied to a diabetes polyclinic at a training and research hospital in western Turkey. Interview questions were created based on the Health Promotion Model. A phenomenological analysis of the data was conducted using the content analysis method. The barriers that participants identified as negatively impacting their ability to manage their disease effectively were categorized into the three themes of "negative feelings about having diabetes," "personal barriers," and "environmental barriers." The barriers identified included school, friends, family, fear of complications, lack of information, and personal characteristics, among others. This qualitative study enables us to understand what patients feel because the participants explained their difficulties in managing their disease and in maintaining metabolic control. The findings provide an understanding of the subjective experiences of adolescent patients with diabetes. The findings of this study are intended to be helpful in restructuring training in clinics, raising diabetes awareness among teachers and students, socializing diabetic adolescents, and providing family-centered education.

Abstract P295: Residential Segregation Is Associated With Uncontrolled Diabetes Among Brazilian Adults: The Brazilian Longitudinal Study Of Adult Health (elsa-brasil)

Introduction: The prevalence of type-2 diabetes is increasing globally with the sharpest increases occurring in low and middle-income countries. Residential segregation results in increased exposure to adverse neighborhood environments that may inhibit the successful management of diabetes. Moreover, due to historical and contemporary forms of structural racism, marginalized racial groups are more likely to live in these environments. Using a spatial measure of neighborhood-level economic residential segregation (hereafter, segregation) we examined the association between segregation and uncontrolled diabetes in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods: The sample included 828 Black, Brown/Mixed-Race, and White participants ages 35-74 with diagnosed diabetes and complete, geocoded information from the baseline examination of ELSA-Brasil (2008-2010). Residential segregation was based on data from the 2010 IBGE demographic census and calculated for study-defined neighborhoods using the local G i * statistic— a spatially weighted z-score that represents how much a neighborhood’s income composition deviates from the larger metropolitan area. Uncontrolled diabetes was based on 2017 ADA criteria and defined as HbA1c ≥ 7%. Multivariable logistic regression models were used to test cross-sectional associations between segregation and uncontrolled diabetes. Results: Black and Brown participants were more likely than Whites to live in highly segregated neighborhoods. The prevalence of uncontrolled diabetes increased across low, medium, and high levels of segregation (23.1% vs. 37.8% vs. 47.7%, respectively). In multivariable models adjusting for age, gender, race, education, income, and study site, segregation was positively associated with uncontrolled diabetes (OR: 1.20, 95% CI: 1.07-1.56). The association was attenuated but remained statistically significant in models adjusting for neighborhood characteristics, behavioral risk factors and time since diabetes diagnosis. (OR: 1.16; 95% CI: 1.05-1.28). In models that included segregation as a categorical variable, individuals living in highly segregated neighborhoods had a 2-fold higher risk of uncontrolled diabetes compared to individuals living in less segregated neighborhoods (High Segregation, OR: 2.20, 95% CI: 1.35-3.58; Medium Segregation, OR: 1.65, 95% CI: 1.08-2.51). Conclusions: Residential segregation may lead to disparate diabetes-related morbidity among urban-dwelling adults in Brazil. Moreover, the disproportionate clustering of Blacks and Browns within segregated neighborhoods implicates segregation as a potential driver of racial inequalities in these outcomes. Policies and/or structural interventions designed to improve neighborhood conditions may be viable strategies to improve the management of diabetes in this setting.

Proper Planning of Diet is Essential in the Management of Diabetes

India is presently the epicentre of diabetes, hypertension and heart disease. It is mainly the abrupt change in lifestyle, especially the dietary habits and excessive calorie consumption in recent times that has made the population diabetic. Hence, the successful management of diabetes depends on convincing the person to have a proper planning and control of good dietary habits.[1] Diabetes mellitus is a metabolic disease where body can properly neither use nor store energy. When one eats excess calories body responds by creating an undesirable rise in blood glucose. This can lead to hyperglycemia and associated micro- and macro vascular complications. Medical nutrition therapy or MNT is an integral part of diabetes prevention and management. One of its goals is to prevent or manage diabetes by promoting healthy food choices.[2]

Relaksasi Otot Progresif untuk Mengurangi Gejala Fatigue pada Klien Diabetes Mellitus Tipe 2 di Wilayah Kerja Pusat Kesehatan Masyarakat Kayon

Diabetes mellitus (DM) is a group of heterogeneous disorders characterised by increases in blood glucose levels or hyperglycemia. Symptoms of fatigue are a widespread clinical complaint among adults with type 2 diabetes, this is associated with and reported to be bad for health and is a significant obstacle to the successful management of diabetes. Fluctuations in glucose levels can also cause fatigue. Progressive Muscle Relaxation is one of the natural and simple relaxation techniques. Based on the research that has been done, Progressive Muscle Relaxation can help to reduce fatigue symptoms in Type 2 DM clients. Community service activities were carried out in the PKM Kayon Working Area, precisely at Posbindu Bethesda for 30 participants. The activities include providing health services in the form of blood pressure measurement and blood glucose level examination, providing health education about DM and teaching progressive muscle training. The media used are leaflets and booklets. Participants enthusiastically participated in the activities from the beginning to the end. The evaluation that has been done, the post-test results for knowledge of DM have an increase in the average value of expertise by 17.85%.

Micro Paper-Based Electrochemical Device for Small Molecule Diabetes Biomarkers

Glucose monitoring has been widely established as a successful diabetes management system. However, non-glucose markers such as, autoantibodies, hormones, proteins, and other small molecules can provide better assessments for the prediction and management of the disorder. Nevertheless, the challenges our research community faces in designing an analytical device for such markers, especially the small molecules, are the dynamic range, limit of detection, selective isolation of the analyte, higher background noise due to clinical matrix, and ability to transform the system into a cheap point-of-care device. Here, we have designed a paper-based graphene amperometric sensor that can detect a model hormone (insulin, 5808 Da) from complex serum matrix. The paper platform provides for a cheap, on-site filtration system that limits the mobility of larger molecules, and upon combining with a double-blocking step before analyte detection greatly minimizes the background noise. Insulin aptamers acts as a capture probe to selectively identify and bind to insulin. Graphene, coated on working electrode, with its superior electrical conductivity provides for improved analytical features of the detection system. The amperometric signals are achieved by flowing a solution mixture of 1 mM hydroquinone mediator and 0.5 mM H2O2 and applying a constant potential of -0.1 V. The paper-based device exhibits a picomolar limit of detection for serum insulin with a reasonably good dynamic range. Our future prospect is to advance this device further for detecting even smaller molecules (< 500 Da) in complex clinical matrices, for which no current assay methods are available.

Perceptions of patients regarding diabetes-related health communication strategies in the Free State, South Africa.

BackgroundThis study researched the perceptions of patients diagnosed with diabetes concerning diabetes-related health communication strategies in the Free State province in South Africa. The prolongation and quality of life of patients diagnosed with diabetes are affected by lifestyle choices. An enabler of risk reduction is health communication which informs, influences and motivates individuals to adopted health-focused lifestyles.AimThis study sought to describe the perceptions of patients regarding diabetes-related health communication strategies in the Free State, South Africa.SettingThis study was carried out in primary health care centres and community health care centres within the Free State province in South Africa.MethodsA qualitative, descriptive and exploratory research design was used in this study. Thirty-four patients diagnosed with type two diabetes for at least a year were purposively included in this study. Semi-structured interviews in Afrikaans, English, Sotho and Xhosa were conducted. Data analysis was through inductive reasoning and thematic analysis.ResultsThe majority of the respondents were older women having been diagnosed with diabetes for more than 5 years, with at least primary school education and of diverse South African ethnicities. The main prompting questions operationalised the term ‘perception’, probing their feelings, experiences and knowledge of health-related communication strategies as presented by a variety of information sources. After recording interviews, data were analysed according to themes, categories and sub-categories.ConclusionsThe study highlights factors that encourage patients to seek help and foster attitudes of compliance. Practical problems regarding the management of diabetes are underlined. The role of family, as well as the patient–caregiver relationship, in the acceptance and management of the disease is revealed. Societal perception of male symptomology is shown. The study offers information to stakeholders and health care workers for continued successful management of diabetes in communities.

Nano-curcumin: A Potent Enhancer of Body Antioxidant System in Diabetic Mice.

&lt;p&gt;Nano preparation of drug to be helpful in targeted delivery, which avoids any unwanted damage of adjacent healthy tissues. Antidiabetic compounds from natural and synthetic sources have been found to successful management of diabetes. Antioxidants are compound that protect cell against the damaging effects of reactive oxygen species (ROS). Curcumin has many beneficial effects against health problems; it has limited use due to its poor bioavailability as concluded by number of its pharmacokinetic studies. Since the aim of this study was to investigate the effects&lt;em&gt; &lt;/em&gt;of curcumin nanoparticles (Nano-curcumin)&lt;em&gt; &lt;/em&gt;on antioxidative enzymes i.e Glutathione peroxidase (GPx), Superoxide dismutase (SOD) and Catalase (CAT) in pancreas of diabetic mice. For the present investigation mice (&lt;em&gt;Mus musculus)&lt;/em&gt; used as experimental animal.&lt;em&gt; &lt;/em&gt;Mice were divided into four groups viz, a) Control group b) Diabetic group c) Recovery group I- Diabetic mice treated with curcumin d) Recovery group II - Diabetic mice treated with curcumin and nano-curcumin. The activity of antioxidative enzymes in the pancreas was recorded at the end of experiment. There was decrease in antioxidative enzymes in pancreas of diabetic mice compared to control. After the treatment of curcumin and curcumin nanoparticles significant increase in levels of antioxidative enzymes in recovery group I and II was observed. Moreover as compare to free curcumin nano-curcumin showed better results in enhancement of antioxidative enzymes. Thus it proves that nano-curcumin found to be potent antioxidative compound to reduced oxidative stress induced during the diabetes.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Social support effects on diabetes management by South African emerging adults: A replication and extension study

This study aimed to explore and describe the role of social support in successful living with type 1 diabetes. Informants were eight emerging adults with well-controlled type 1 diabetes (females = 5; white = 7, African = 1; mean time since diagnosis = 8.5 years, SD time since diagnosis = 6.23 years). They completed semi-structured interviews on their types and sources of social support for successful diabetes management. Thematic analysis of the data revealed important social support agents, which included family members, friends, and their healthcare professionals; as well as the social support mechanisms these individuals provided. Social support appeared to help the participants with diabetes management through facilitation of shared knowledge regarding management of type 1 diabetes, fostering a sense of belonging and companionship, and practical assistance with daily regimen tasks.

Feasibility and Acceptability of Using Smartphone Apps in Diabetes Self-Management in an Underserved Population: Qualitative Study

Background: The successful management of diabetes is a chronic endeavor. It involves a whole host of factors ranging from a consistent patient-provider relationship to regular physical activity. Not all patients with diabetes, however, have access to the resources needed for effective disease management. Health disparities contribute to a higher frequency of diabetes development in poor and minority populations. Moreover, health care disparities limit the care these patient populations receive. Because underserved populations have little to no access to traditional means of health care, providers must explore other avenues to reach this patient group. Mobile health (mHealth) has grown significantly in the last decade. With the fast-paced adoption of cell phones across all socioeconomic groups, mobile health presents the opportunity to offer patients a low-cost way to receive health information, to communicate with providers, and to self-manage chronic conditions. It has been well established that low-income, minority populations experience several barriers to receiving basic health care including uninsurance, limited transportation, and high out-of-pocket costs. The provision of health care via mobile devices may have the potential to address such health disparities. Little is known about the effectiveness of using mobile health and smartphone applications (apps) in underserved populations to help with diabetes management. Knowledge of these patients’ interest in using mobile apps to augment their home self-management may have use in future implementations. Objective: The objective of this study is to examine the perception of and willingness to use diabetes mobile health apps on smartphones in patients with limited access to primary care providers. Methods: This study used purposive sampling to select patients for personal interviews. The study was conducted at a general hospital located in a part of town with predominate minority and low-income residency, as well as the highest diabetes prevalence rates. Semi-structured interviews were conducted according to McNamara’s interview staging. A total of 15 interviews were collected and coded by the researcher according to the interpretative phenomenological analysis framework. An independent committee reviewed all interview transcripts and coding to verify trustworthiness of collection and analysis. Results: The data produced 7 clusters related to smartphone app use and mHealth, each highlighting a component of the patient experience, which supported 3 overarching themes. The themes are as follows: despite limited knowledge about health apps and varying phone use patterns, patients were all willing to try at least one diabetes-related app; apps functions should be individualized to meet each patient’s needs for maximum benefit; and barriers to app use were varied but commonly included knowledge and technological challenges and security issues. Conclusions: Personal interviews of this underserved patient population demonstrated an interest in and willingness to try mobile health apps, despite limited knowledge about the technology. Responses indicate that tailoring app choices to individual needs, instead of choosing a multi-functional one-size-fits-all app, would provide the most benefit for at-home diabetes self-management. Smartphone apps may serve as a viable low-cost resource for patients with diabetes who have limited access to traditional health care providers.