Association between availability of glucose-lowering drugs in primary health institutions and diabetes patients’medication adherence:a cross-sectional study in Shandong Province,China

Background:Primary health care system is a critical component of diabetes care and management.This article aimed to analyze the availability of glucose-lowering drugs in primary health institutions(PHIs)in China,and to explore the relationship between availability of glucose-lowering drugs and medication adherence among type 2 diabetes mellitus(T2DM)patients.Methods:This cross-sectional study conducted in Shandong Province,eastern China(hereafter referred to as Shandong),between August and December 2017.In total,2520 community-managed T2DM patients were selected from 68 PHIs in Shandong,including 62 village-level and 6 township-level PHIs.The self-developed questionnaire was used to survey the availability of glucose-lowering drugs in PHIs.Patients’medication adherence was assessed by four self-reported questions,and was classified as either adherent or non-adherent.Descriptive statistics was used to analyze the availability of glucose-lowering drugs in PHIs and the medication adherence among the T2DM patients.Multilevel logistic regression models were used to explore the relationship between the availability of glucose-lowering drugs in PHIs and patients’medication adherence.Results:A total of 1866 T2DM patients prescribed with at least one glucose-lowering drug were included in analysis.Among them,58.5%patients followed their antidiabetic treatment well.In village-level PHIs,the patient’s adherence rate was lower than in township-level PHIs(55.9%vs.61.1%,P<0.05).Among the 68 PHIs,average(2.53±0.97)glucose-lowering products(generic names)were available,which in village-level PHIs were less than in township-level PHIs(2.47 vs.3.17,P<0.05).And the number of available glucose-lowering products in PHIs was associated with the adherence of T2DM patients.Conclusion:Poor availability of glucose-lowering products was found in PHIs in Shandong.The availability of glucose-lowering products in PHIs was positively associated with patients’medication adherence,and could be enhanced to improve the control of diabetes in primary care settings.

Inclusion of wheat aleurone in gestation diets improves postprandial satiety,stress status and stillbirth rate of sows

This study investigated the effects of different amounts of wheat aleurone(WA)(0,15%,30%)inclusion in gestation diets on the reproductive performance,postprandial satiety,stress status and stereotypic be-haviors of sows.A total of 84 Landrace×Yorkshire sows(parity 4.87±1.32)at breeding were randomly allotted to one of the three isoenergetic and isonitrogenous dietary treatments based on parity and body weight.The results showed that,compared with the control(0),sows fed the WA diet had a higher serum concentration of peptide YY(PYY)(P<0.05)and glucagon like peptide-1(GLP-1)(P<0.05)and a lower concentration of saliva cortisol(P<0.01).Importantly,compared with the control group,only the 15%WA group had a higher concentration of the total antioxidant capacity(T-AOC)(P<0.05),lower pro-portions of sitting(P=0.05)and stillbirth rates(P<0.01).Accordingly,the production cost per piglet born alive($6.9 vs.$7.6)or per piglet born healthy($7.4 vs.$7.9)declined in the 15%WA group versus the control group.Overall,15%WA inclusion in gestation diets contributed to enhancing postprandial satiety,alleviating stress status and decreasing stillbirth rate of sows.This study provides a reference for the application of WA as a partial substitute for conventional feed ingredients to improve sows'repro-ductive performance.