Exercise as Component of Standard Diabetes Management, the Challenges to Improve Performance among Sudanese Type 2 Diabetes

Background: Exercise is important component of diabetes management. Regular exercise improves blood glucose, reduces hazard of cardiovascular diseases, decreases weight, increases insulin sensitivity and strengthens patients’ general health. Regular exercise can prevent or delay type 2 diabetes in those of high-risk populations. Although there are great benefits of regular exercise, unfortunately majority of people with type 2 diabetes are not active. Objectives: The main goal of this study was to assess patients adherence to regular exercise among type 2 diabetes Mellitus (T2DM) attending Ribat University Hospital Diabetic Clinic (RUHDC) Khartoum state, Sudan. Methods: Analytical cross sectional hospital based study was carried out among 351 patients from August 2012 to February 2013. Structured questionnaire and patients cards were used to collect data. Results: Out of 351 patients, female were 65.8% and male 34.2%. Patients older than 60 years 48.4%, illiterate 21.0%, only 44.2% had basic educational level, house wife 56.1% and retired 18.5%. Majority had irregular exercise program (80.1%), 12.1% specified lack of time whilst 87.9% did not specify any other reasons as barrier for regular exercise “no reason”. Daily activity was the main type of physical activity (59.8%). Although insignificant, irregular exercise was higher among female patients, their age above 60 years, patients had low education levels and those had financial problems. Conclusion: Regular exercise was low in this study. Lack of time, female, patients older than 60 years, had low education levels, and had financial problems, which were the main barriers of regular exercise. Family support, tailored patients’ education and reduction of patients’ use of technology and modern living can improve the patients’ activity.

Addition of Insulin to Treatment Regimen in Type 2 Diabetes: The Significance of Age and Duration among Sudanese Diabetic Patients

Background: Type 2 diabetes is a progressive disease and as the result of patient’s age and diabetes duration, β-cell ability for insulin secretion deteriorates continually and finally fails to meet body requirement. Intensification of treatment drug regimen including addition of insulin is critical to maintain glycemic target and reduce developing of long-term complications. Objective: The main purpose of this study was to investigate the effect of diabetes duration and patients’ age on addition of insulin to treatment regimen. Methods: A single centre, cross-sectional hospital-based study was done among 351 diabetes Mellitus (DM) patients visiting Ribat University Hospital Diabetic Clinic, Khartoum State, Sudan. Data was collected using constructed, validated and multiple-choice questionnaire. Results: From 351 patients enrolled in the study, female were 65.8% and male 34.2%. About 64.4% were on oral anti-diabetic;35.6% on insulin;about 31.6% shifted to insulin when their ages above 40 years;and 22.8% when diabetes duration was above 5 years. Co-morbidity was 54.4% and 60.2% of patients had hypertension. Conclusion: Interactions between age and longer duration of diabetes were mostly significant reasons for transferring patients to insulin. Percent of insulin users and co-morbidity was within international range.

Assessing Knowledge of Hypoglycemia Symptoms among Type 2 Diabetic Patients Using Insulin, Khartoum, Sudan

Background: Hypoglycemia is a traumatic dilemma that has a critical impact on not only the patient’s quality of life but also their families and communities. Improving Patient’s awareness and knowledge regarding hypoglycemia symptoms is crucial to avoid serious implications like loss of consciousness and even death. Objective: This study aimed to assess patients’ knowledge of hypoglycemia symptoms and source of diabetes information among insulin users type 2 diabetes. Methods: A single centre, hospital-based, analytical, and cross-sectional study was carried out among diabetic patients using insulin attended to Ribat University Hospital Diabetes Clinic (RUHDC), Khartoum State, Sudan during a period of study. A validated questionnaire was used to obtain socio-demographic characteristics of respondents and the patients’ knowledge regarding hypoglycemia symptoms was assessed whether good, medium or poor. Data were analyzed, using (SPSS). Descriptive (frequencies) and inferential statistics (association used chi-square) were used at a level of confidence p ≤ 0.05. Results: A majority of patients (52%) had poor knowledge of hypoglycemia symptoms and the common symptoms known to patients were hands tremor (67.2%), blurred vision (52.8%) and sweating (65.6%). No associations were found among hypoglycemia symptoms knowledge, socio-demographic and diabetes duration. Only (25.6%) had regular visiting to educating center and physicians were the major source of diabetes knowledge (74.4%). Conclusion: This study proved low patients hypoglycemia symptoms knowledge and physician were the main sources of information about diabetes at RUHDC. Further ideas are required in collaboration and integrated approach to filling the gap of patients’ awareness and multidisciplinary team in diabetes management.