Diabetes Self-Care Activities and Glycaemic Control among Adults with Type 2 Diabetes in Sri Lanka: A Cross-Sectional Study

The prevalence of Type 2 Diabetes Mellitus (T2DM) and its complications continue to rise across the globe including Sri Lanka. Diabetes Self-care activities (DSCA) are promising behaviors to reduce complications and to achieve good glycaemic control. There is a lack of data regarding DSCA and its association with glycaemic control among adults with T2DM in Sri Lanka. A descriptive cross-sectional study was conducted among purposively selected adults with T2DM (n = 300) in a teaching hospital, Sri Lanka to determine the association between DSCA and glycaemic control. Apre-tested interviewer-administered questionnaire which includes socio-demographic, diabetes-related information and Summary of Diabetes Self-care activities questionnaire was used to collect data. Data were analyzed by using descriptive statistics and Chi-square test. General diet (Healthy eating plan) (OR = 3.04, 95% CI = 1.04 - 8.88, p = 0.034), Physical activities (OR = 2.26, 95% CI = 1.29 - 3.97, p = 0.004), Medication adherence (OR = 2.87, 95% CI = 1.24 - 6.64, p = 0.011) were significantly associated with HbA1c. Medication adherence was significantly associated with poor fasting blood sugar (FBS) (OR = 1.90, 95% CI = 1.07 - 3.37, p = 0.028). The findings highlight the need for health professionals to implement health education programs on diabetes self-care activities for adults with T2DM to enhance their adherence to DSCA, as well as to maintain glycemic control.

Analysis of the Application Effect of Family Collaborative Care Model on Elderly Patients with Type 2 Diabetes Mellitus and the Situation of Self-Care Ability

Objective: To study the application effect of the family collaborative care model on elderly patients with type 2 diabetes mellitus and its influence on self-care ability. Methods: The elderly type 2 diabetes mellitus patients (400 cases) treated in our hospital between March 2020 and July 2023 were divided into two groups by randomized grouping method;the control group received the conventional nursing program, while the observation group received the family collaborative nursing model. Blood glucose level, self-care ability, and quality of life were compared between the groups. Results: The blood glucose level of the observation group was lower than that of the control group (P < 0.05). The self- care ability and quality of life scores of the observation group were higher than those of the control group (P < 0.05). Conclusion: The family collaborative care model for elderly patients with type 2 diabetes mellitus can promote their self- care ability, improve the effect of glycemic control, and improve their quality of life, and is suitable for further promotion and application.

Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study

Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.

Examining the association between delay discounting,delay aversion and physical activity in Chinese adults with type-2 diabetes mellitus

BACKGROUND The role of physical activity in diabetes is critical,influencing this disease's development,man-agement,and overall outcomes.In China,22.3%of adults do not meet the minimum level of physical activity recommended by the World Health Organization.Therefore,it is imperative to identify the factors that contributing to lack of physical activity must be identified.AIM To investigate the relationship among delay discounting,delay aversion,glycated hemoglobin(HbA1c),and various levels of physical activity in Chinese adults diagnosed with type 2 diabetes mellitus(T2DM).METHODS In 2023,400 adults with T2DM were recruited from the People's Hospital of Linxia Hui Autonomous Prefecture of Gansu Province.A face-to-face questionnaire was used to gather demographic data and details on physical activity,delay discounting,and delay aversion.In addition,HbA1c levels were measured in all 400 participants.The primary independent variables considered were delay discounting and delay aversion.The outcome variables included HbA1c levels and different intensity levels of physical activity,including walking,moderate physical activity,and vigorous physical activity.Multiple linear regression models were utilized to assess the relationship between delay discounting,delay aversion,and HbA1c levels,along with the intensity of different physical activity measured in met-hours per week.RESULTS After controlling for the sample characteristics,delay discounting was negatively associated with moderate physical activity(β=-2.386,95%CI:-4.370 to-0.401).Meanwhile,delay aversion was negatively associated with the level of moderate physical activity(β=-3.527,95%CI:-5.578 to-1.476)in the multiple linear regression model,with statistically significant differences.CONCLUSION Elevated delay discounting and increased delay aversion correlated with reduced levels of moderate physical activity.Result suggests that delay discounting and aversion may influence engagement in moderate physical activity.This study recommends that health administration and government consider delay discounting and delay aversion when formulating behavioral intervention strategies and treatment guidelines involving physical activity for patients with T2DM,which may increase participation in physical activity.This study contributes a novel perspective to the research on physical activity in adults with T2DM by examining the significance of future health considerations and the role of emotional responses to delays.

Diabetes and high-glucose could upregulate the expression of receptor for activated C kinase 1 in retina

BACKGROUND Diabetic retinopathy(DR)is a major ocular complication of diabetes mellitus,leading to visual impairment.Retinal pigment epithelium(RPE)injury is a key component of the outer blood retinal barrier,and its damage is an important indicator of DR.Receptor for activated C kinase 1(RACK1)activates protein kinase C-ε(PKC-ε)to promote the generation of reactive oxygen species(ROS)in RPE cells,leading to apoptosis.Therefore,we hypothesize that the activation of RACK1 under hypoxic/high-glucose conditions may promote RPE cell apoptosis by modulating PKC-ε/ROS,thereby disrupting the barrier effect of the outer blood retinal barrier and contributing to the progression of DR.AIM To investigate the role and associated underlying mechanisms of RACK1 in the development of early DR.METHODS In this study,Sprague-Dawley rats and adult RPE cell line-19(ARPE-19)cells were used as in vivo and in vitro models,respectively,to explore the role of RACK1 in mediating PKC-εin early DR.Furthermore,the impact of RACK1 on apoptosis and barrier function of RPE cells was also investigated in the former model.RESULTS Streptozotocin-induced diabetic rats showed increased apoptosis and upregulated expression of RACK1 and PKC-εproteins in RPE cells following a prolonged modeling.Similarly,ARPE-19 cells exposed to high glucose and hypoxia displayed elevated mRNA and protein levels of RACK1 and PKC-ε,accompanied by an increases in ROS production,apoptosis rate,and monolayer permeability.However,silencing RACK1 significantly downregulated the expression of PKC-εand ROS,reduced cell apoptosis and permeability,and protected barrier function.CONCLUSION RACK1 plays a significant role in the development of early DR and might serve as a potential therapeutic target for DR by regulating RPE apoptosis and barrier function.

Effect of Activities of Daily Living on Self-Care Agency in Individuals with Type 2 Diabetes

Diabetes mellitus continues to be a global health problem with increasing importance across the world by affecting the activities of daily living and self-care ability of patients due to its incidence and troubles caused by it. The present study aims at determining the effect of activities of daily living of patients with type 2 diabetes mellitus on their self-care agency. Methods: The population of this descriptive study consisted of patients with type 2 diabetes mellitus who were being treated at the internal medicine clinic of a provincial state hospital between July 2014 and November 2015 and its sample consisted of 150 diabetic patients who volunteered to take part in the study and who were open to communication. A personal information form, the Activities of Daily Living (ADL) Scale, the Instrumental Activities of Daily Living (IADL) Scale and the Self-Care Ability Scale (CAS) were used as data collecting tools. The data were analyzed using descriptive statistics (numbers, percentages, mean, standard deviation, mean rank and frequencies), the Shapiro-Wilk, Kruskal-Wallis Variance Analysis, Mann-Whitney U test and Cronbach’s alpha formula and correlation analysis. Results: Approximately 97.3% of the patients with type 2 diabetes stated that they were independent in ADL and 75.3% of them in IADL. The patients’ mean self-care ability score was found to be 83.85 ± 17.87 ADL and IADL were found to be affected by age, marital status, education, duration of disease, willingness to receive further education, and presence of another disease besides diabetes. There was a significant correlation between the self-care agency score and marital status, education, duration of disease, willingness to receive further education, presence of another disease besides diabetes, regular checking of blood sugar and compliance with diet. A significant positive correlation was found between the patients’ activities of daily living and their self-care agency. Conclusion: The patients’ activities of daily living were found to affect their self-care agency. The personal and disease-related characteristics of patients should be identified so that their self-care behaviors can be increased.

Self-Care Activities among Patients with Type 2 Diabetes in Morocco: Prevalence and Determinants

Background: Self-care is an important, though often neglected, area of type 2 diabetes management in lower and middle income countries (LMICs). In Morocco, whilst the evolution of the disease is increasing rapidly, evidence documenting disease self-care patterns remains scarce. Objectives: To estimate the prevalence of self-care activities among patients with type 2 diabetes in Morocco, and to identify the factors associated with good self-care practices. Methods: We performed a secondary analysis of data of 406 patients aged 30 years old and over, diagnosed with type 2 diabetes mellitus for at least 6 months. Self-care activities were assessed using the Moroccan version of the Summary of diabetes self-care activities. Studied factors included socio-demographics, disease features and healthcare use. Unadjusted and adjusted odds ratios were calculated using logistic regression. Results: Mean age was 55.8 ± 11.6 years old. Females represented 68.7% of the respondents. Mean estimates of the frequency of self-care practices exceeded 3.5 days per week for diet, exercise and foot-care;of these, good dietary behavior was the most prevalent (63.6%). In multivariate analysis, females displayed better dietary behavior (OR = 1.81 [1.27 - 2.58]), and less frequent foot care (OR = 1.81 [1.27 - 2.58]) than males. Lower levels of exercise were associated with being female (0.42 [0.26 - 0.68]), and belonging to the higher income category (0.55 [0.34 - 0.88]). Residents in rural areas also reported better exercise practices (1.72 [1.07 - 2.78]). Conclusion: This study draws attention to self-care practices and their determinants in the Moroccan context. Such findings should help in the design, implementation, and evaluation of self-management interventions for people with type 2 diabetes.

Knowledge about Diabetes Mellitus and Self-Care Activities before and after an Educational Program: A Pilot Study

Background: Health education has proven to be an effective strategy to enable people with diabetes mellitus to manage this condition. However, few studies in Brazilian population samples have been conducted to evaluate the effects of educational programs on diabetes knowledge and self-care. Aim: To evaluate the knowledge about diabetes mellitus and the performance of self-care activities, before and after participation in an educational program. Methods: This is an intervention study, with a quantitative approach, in a single comparison group, for the analysis of “before and after” results related to an educational program focused on self-care and concurrent physical training. The study interventions consisted of 42 exercise sessions, as well as individual educational meetings, according to the needs of each participant and through nursing consultations, using educational material prepared from the literature. The sample was initially composed of 33 adults with diabetes mellitus, but 18 completed the study. For the assessment of knowledge and self-care activities, the revised Brazilian versions of the Diabetes Knowledge Scale and the Diabetes Self-Care Activity Questionnaire were used, respectively, in the two moments of the study, that is, prior to the first educational meeting and immediately before the first physical training session, and after the last educational meeting, which ran parallel to the 42nd physical training session, making a six-month interval between the two assessment moments for each participant. Results: The analysis of knowledge about diabetes showed significant improvement after the educational program and, as for self-care, there was clinical improvement in all dimensions, but only the dimension “general diet” obtained statistically significant improvement. Conclusion: The educational program has been shown to be beneficial for improving knowledge and self-care of the disease, which reiterates the need to maintain interventions of this nature for people with diabetes mellitus.

Diabetic Retinopathy: Diagnostic Challenges and Impact of Physical Activity

Introduction: Diabetes represents a major public health challenge, affecting over 463 million people according to the World Health Organization (WHO). Among its complications, diabetic retinopathy stands out as the leading cause of blindness in industrialized countries. Physical activity is now recognized as a cornerstone of diabetes management, and its impact on diabetic retinopathy is of growing interest. Observation: Mr. A.E, a 54-year-old man, presents with progressive deterioration of his vision. Family history of diabetes and hypertension is noted. He engages in one hour of physical activity daily, including treadmill running and indoor cycling. Despite recent optical correction, his visual acuity remains at 3/10 unimproved. Ocular imaging, notably fluorescein retinal angiography and optical coherence tomography, reveals proliferative diabetic retinopathy with bilateral macular edema. Blood tests, performed after physical activity, show normal values of blood glucose and HbA1c, delaying the initiation of treatment and promoting the progression of retinopathy. Despite appropriate management, no significant improvement in visual function is observed during follow-up. Conclusion: The management of diabetic retinopathy requires an approach integrating physical activity. A better understanding of the interaction between physical activity and diabetic retinopathy is needed to optimize prevention and treatment strategies.

The Improving Effects of Diabetes Education on Diabetes Awareness and Management in Children and Adolescents with T1DM

Background: Diabetes education is crucial in empowering persons with Type 1 diabetes (T1DM) and their families to properly manage the condition by providing comprehensive knowledge, tools, and support. It boosts one’s belief in their ability to succeed, encourages following medical advice, and adds to the general enhancement of health. Objective: This study is to investigate the effectiveness of diabetes education in empowering individuals with Type 1 Diabetes Mellitus (T1DM) and their families to effectively manage the condition. Furthermore, it strives to improve nursing care for families whose children have been diagnosed with Type 1 Diabetes Mellitus (T1DM). Design: This research study investigates the efficacy of diabetes education in empowering individuals with Type 1 Diabetes Mellitus (T1DM) and their families to effectively handle the condition. Materials and Methods: A systematic search was conducted between the years 2000 and 2022, utilizing the Medline and Google Scholar databases. The purpose of the search was to uncover relevant papers pertaining to diabetes education, management of Type 1 Diabetes Mellitus (T1DM), nurse care, and empowerment. The search focused on peer-reviewed research, clinical trials, and scholarly articles that evaluated the efficacy of diabetes education in empowering individuals and families. Results: Diabetes education is crucial for understanding and controlling T1DM. It includes personalized sessions, webinars, group classes, and clinics that provide customized therapies. Comprehensive education enhances glycemic control and family dynamics. Nevertheless, the implementation of diabetes education for families requires specific standards, especially in the field of nursing. Conclusion: Diabetes education is essential for effectively managing Type 1 Diabetes Mellitus (T1DM), providing patients and families with crucial knowledge, resources, and confidence. It encourages independence in-home care and provides explicit guidelines for diabetic nurses to improve nursing care.

Physical Activity,Sedentary Behavior,and the Risk of Cardiovascular Disease in Type 2 Diabetes Mellitus Patients:The MIDiab Study

The aim of this study was to explore the associations of moderate-to-vigorous-intensity physical activity(MVPA)time and sedentary(SED)time with a history of cardiovascular disease(CVD)and multifactorial(i.e.,blood pressure(BP),body mass index(BMI),low-density lipoprotein cholesterol(LDL-C),and glycated hemoglobin A1c(HbA1c))control status among type 2 diabetes mellitus(T2DM)patients in China.A cross-sectional analysis of 9152 people with type 2 diabetes from the Multifactorial Intervention on Type 2 Diabetes(MIDiab)study was performed.Patients were grouped according to their self-reported MVPA time(low,<150 min·week−1;moderate,150 to<450 min·week−1;high,≥450 min·week−1)and SED time(low,<4 h·d–1;moderate,4 to<8 h·d–1;high,≥8 h·d–1).Participants who self-reported a history of CVD were identified as having a CVD risk.Odds ratios(ORs)and 95%confidence intervals(CIs)of CVD risk and multifactorial control status associated with MVPA time and SED time were estimated using mixed-effect logistic regression models,adjusting for China’s geographical region characteristics.The participants had a mean±standard deviation(SD)age of(60.87±8.44)years,44.5%were women,and 25.1%had CVD.After adjustment for potential confounding factors,an inverse association between high MVPA time and CVD risk that was independent of SED time was found,whereas this association was not observed in the moderate-MVPA group.A higher MVPA time was more likely to have a positive effect on the control of BMI.Compared with the reference group(i.e.,those with MVPA time≥450 min·week−1 and SED time<4 h·d–1),CVD risk was higher in the low-MVPA group:The OR associated with an SED time<4 h·d–1 was 1.270(95%CI,1.040–1.553)and that associated with an SED time≥8 h·d–1 was 1.499(95%CI,1.149–1.955).We found that a high MVPA time(i.e.,≥450 min·week−1)was associated with lower odds of CVD risk regardless of SED time among patients with T2DM.

Information Needs and Self-Care Practices of Diabetic Patients in Mbala, Northern Province, Zambia

Introduction: Diabetes mellitus (DM) is a chronic disease that occurs either when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. It is “a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both” manifested by carbohydrates, fat and protein metabolism abnormality. If untreated high blood sugar can damage the nerves, eyes, kidneys, and other organs. The purpose of this study was to assess the information needs and self-care practice of Diabetic Patients in Mbala, Northern Province Zambia. Methods: This was an analytical cross-sectional study where 105 respondents aged 18 years and above participated in the study. Participants were randomly selected. A structured interview schedule and a check list were used to collect data. Statistics Package for Social Sciences computer software package version 23.0 was used to analyze data. Chi square and fisher’s exact tests were used to test the significance of the association between Knowledge of Diabetes Mellitus, attitude towards self-care practices, self-care practices among Diabetic patients and the need for information among Diabetic patients. A 95% confidence interval and P value of 0.05 were used to ascertain the degree of significance. Multi-variate binary logistic regression model to determine predictors of self-care practices and need for information was also used. Result: On analyzing the dependent variables, more than half (61.9%), had high need for information and three quarters (85.7%) of respondents had poor self-care practices. Slightly more than half (58.1%) had high knowledge levels majority (78.1%), had a negative attitude. Significant associations were found P Conclusion: Negative attitudes and lack of information among Diabetic patients were the main reasons associated with poor self-care practices. Particular attention should therefore be given to ensuring that Diabetic patients are given adequate information on Diabetes self-care in order to improve the quality of life.

Burden of disability in type 2 diabetes mellitus and the moderating effects of physical activity

The growing diabetic epidemic has created a substantial burden,not only on the people with diabetes but also on society at large.This mini-review discussed the limitations and patterns of disability in type 2 diabetes mellitus and put forward a case for the moderating effects of physical activity(PA)in the management of diabetes.The limitations and impairments associated with diabetes include vascular,neurological,cardiac,and renal impairments.Moreover,individuals participate less in their daily lives and in their instrumental activities of daily living,which negatively impacts the quality of life of individuals with diabetes.This often leads to a loss of quality of life due to disabilities,resulting in an increased rate of disability-adjusted life years among people with type 2 diabetes mellitus.Moreover,there are psychosocial sequelae of diabetes mellitus.This necessitates looking for moderating factors that may reduce the burden of the disease.PA has been shown to be one of the factors that can mitigate these burdens.PA does this in several ways,including through the benefits it confers,such as a reduction of hemoglobin A1c,a reduction of excess fat in the liver and pancreas,and the reduction of cardiovascular risk factors,all of which favorably affect glycemic parameters.Specifically,PA regulates or moderates diabetes disability through two mechanisms:The regulation of glucolipid metabolism disorders and the optimization of body mass index and systemic conditions.Therefore,efforts should be directed at PA uptake through identified strategies.This will not only prevent diabetes or diabetes complications but will reduce its burden.

Diabetes self-care in primary health facilities in India-challenges and the way forward

India has approximately 73 million people living with diabetes and another 37 million with prediabetes while nearly 47% of the diabetes cases are undiagnosed. The high burden of poor glycemic control and early onset of complications with associated economic costs indicates a high prevalence of poor self-management practices. It is well-established that achieving patient-centered primary care consistent with a chronic care model ensures optimum diabetes self-management support and improves long-term clinical and health outcomes in diabetes patients. The public sector primary care system in India provides services free of cost to beneficiaries but lacks patient-centered care that undermines diabetes selfmanagement education and support. Furthermore, factors like poor patient knowledge of diabetes, suboptimal medication adherence, persistent clinical inertia, lack of data for monitoring and evaluation through clinical audit worsens the standards of diabetes care in primary care settings of India. There is a need for government initiatives to be directed towards the provision of comprehensive outpatient care that is inclusive of uninterrupted supply of drugs, provision of essential laboratory investigators, training and availability of qualified diabetes educators and availability of specialist support when required. Furthermore, the integration of depression screening and smoking cessation services at the primary care level is warranted.

The current status of foot self-care knowledge, behaviours, and analysis of influencing factors in patients with type 2 diabetes mellitus in China

Purpose:To investigate the knowledge and behaviours on foot self-care in patients with type 2 diabetes mellitus;analyse the influential factors,and provide information for the intervention study.Methods:A total of 5961 patients with type 2 diabetes mellitus from 144 hospitals in China were included in the study.The investigation content included patients'demographic data,foot self-care knowledge and behaviours.The investigation tools were the questionnaires on the general diabetes information,on the foot self-care knowledge,and on the foot selfcare behaviours.Results:The foot self-care knowledge was medium and the foot self-care behaviour was poor.The status of knowledge and behaviours were influenced by education,duration of diabetes mellitus,periodic inspection,and education about diabetic complications.Pearson analysis demonstrated that there was positive correlation between knowledge score and behaviour score(r?0.27,p<0.001).Conclusions:The status of foot self-care knowledge and behaviours are not optimistic.According to the patients'own characteristics,the theory of knowledge,attitude and practice applies to encouraging patients to go for periodic inspection and education about diabetic complications so as to enhance the knowledge and promote the self-care behaviours.

Automated Telephone Calls in the Follow-Up of Self-Care in Outpatients with Type 2 Diabetes: A Feasibility Study

Aims and objectives: To test an automated telephone service as a follow-up and support strategy for self-care in a population of adult Mexican patients with type 2 diabetes. Methods: The design was a two-group comparative design, with pre and post-intervention measurements. Patients were assigned into intervention (n = 31), or comparison (n = 33) groups. Over 12 weeks, each participant in the intervention group received automated phone calls with instructions to facilitate accomplishment of the treatment, and self-care activities. Two focus groups helped to appreciate patients’ follow-up experience. Randomized grouping was performed by selecting numbers from an urn;the final sample comprised 31 (48%) patients in the intervention group, and 33 (52%) in the comparison group;these procedures were performed by the case nurse management. The study was approved by the Ethics Committee of the Autonomous University of Nuevo Leon and the University of Michigan;all of the participants signed informed consent. Results: Of the 372 programmed phone calls made to the participants, 234 were completed, representing a 62.9% response rate. Phone calls may be associated to a 0.82% decrease in the HbA1c values and to lower depression scores. HbA1c measurements decreased 0.82% (M = 7.41 - 6.69;t = 25;4.11;p = ?0.001) from the baseline values over the 12-week study in the intervention group and 0.49% (M = 7.24 - 6.75;t = 26;2.11;p = 0.044) in the comparison group. Variables related to medication intake did not exhibit differences between the baseline and second measurements, except with respect to the scale of depression.

Effect of Foot Self-Care Behavior According to Severity of Diabetic Neuropathy in Japanese Patients with Diabetes

PURPOSE: Diabetic patients with severe diabetic neuropathy often have hypoesthesia and numbness. This study evaluated foot self-care behavior according to severity of diabetic neuropathy. METHODS: We used a hand-held nerve conduction test device DPN check (HDN-1000, Omron) to evaluate severity of diabetic neuropathy. Foot self-care was evaluated using the Japanese SDSCA (the Summary of Diabetes Self-Care Activities measure). Foot self-care comprised visual inspection, washing, wiping interdigital areas, and checking shoes, and was scored according to the number of days self-care which was performed in the previous week. RESULTS: The study evaluated 103 diabetic patients (age: 65.7 years, diabetes duration: 13.9 years, HbA1c: 7.3%). Total scores (out of 28 points) for self-care behavior according to neuropathy severity were 11.8 (Normal: n = 54), 10.6 (Mild: n = 27), 13.3 (Moderate: n = 17), and 10.8 (Severe: n = 5). Foot self-care scores were low in all groups, with particularly low scores in those with severe neuropathy. However, no statistically significant differences were observed. CONCLUSIONS: Foot self-care is essential in diabetes because lesions are more likely to occur in severe neuropathy. Living alone and the presence of recurrent foot lesions are associated with poor survival prognosis. Accordingly, foot-care intervention must take neuropathy severity and lifestyle factors into account. The severity of diabetic neuropathy must be determined and foot-care intervention should take lifestyle factors into account.

Diabetes knowledge and self-care practices among people living with type 2 diabetes mellitus in a diabetes clinic in Southwestern Nigeria

Objective:The objective of this study is to assess the knowledge and self-care practices of people living with type 2 diabetes mellitus(T2DM).Materials and Methods:The study was conducted in a clinic in Southwestern Nigeria.It adopted a cross-sectional design.The sample consists of 107 people living with T2DM.Data were collected using Diabetes Knowledge Questionnaire and Revised Self-care Inventory Scale.Results:The mean diabetes knowledge of the participants was 16.2±3.0 and 70.1%had inadequate knowledge of T2DM.The mean diabetes self-care practice score among the participants was 49.9±4.9,and 89.7%reported poor diabetes self-care practice.There is no significant difference in the knowledge of diabetes between male(16.42±3.42)and female(16.12±2.8)participants(t=0.45;P=0.65),and no significant difference in self-care practice of male(49.23±4.51)and female(50.06±5.07)participants(t=0.75,P=0.46).In addition,there is no correlation between age and knowledge of diabetes(r=-0.18,P=0.07)and self-care practices(r=0.08,P=0.38)of participants.No significant relationship was found between knowledge of diabetes and diabetes selfcare practices(χ^(2)=1.605,P=0.448)Conclusion:Knowledge of diabetes and self-care practices of people living with T2DM in this study were poor.Effort should be directed at improving their diabetes knowledge and self-care practices.

The moderating effect of social cognitive factors on self-management activities and HbA1c in Thai adults with type-2 diabetes

Background: Diabetes mellitus (DM) has become a serious chronic disease.Self-management strategies help persons with DM make choices which will develop skills needed to reach their goal of blood glucose control and allow them to be successful in reaching goals.Objective: To examine the impact of self-management activities on HbA1c for persons with DM and to examine the impact of social support,self-efficacy and Buddhist values as moderators on the relationship between the self-management activities and HbA1c.Method: This study is a cross-sectional design.The sample included 401 Thai adults diagnosed with type 2 diabetes,aged 20-65 years old who had at least one HbA1c test in the last three months were recruited.Participants completed four questionnaires to measure self-management activities,as well as self-efficacy,Buddhist values and social support as moderating factors on self-management activities and HbA1 c,Results: The self-management activities were negatively associated (β =-2.05,p ≤ 0.001) with HbA1c.The Social support,self-efficacy and Buddhist values had a significant interaction effect between selfmanagement activities and HbA1c (β =-0.97,p ≤ 0.05,β =-0.18,p ≤ 0.05 and β =-2.76,p ≤ 0.001).Conclusion: The diabetes self-management activities were more strongly associated with HbA1c under conditions of high social support,self-efficacy and health beliefs with Buddhist values.Future interventions for T2DM self-management programs should incorporate mechanisms to measure and support these factors.

HPTLC Phytochemical Screening and Hydrophilic Antioxidant Activities of <i>Apium graveolens</i>L., <i>Cleome gynandra</i>L., and <i>Hibiscus sabdariffa</i>L. Used for Diabetes Management

Diabetes mellitus is a socially significant disease characterized by chronic hyperglycemia and metabolic disorders of proteins, carbohydrates, and lipids due to reduced function of insulin. Medicinal plants, rich in bioactive components that promote prevention and treatment, are inexpensive and no side effects. Apium graveolens, Cleome gynandra, and Hibiscus sabdariffa from Burkina Faso were investigated for their phytochemical profile and antioxidant activities. The high-performance thin-layer chromatography profile revealed flavonoids, tannins, and sterols in these herbaceous. The Hibiscus sabdariffa methanolic extract exhibited the highest total phenolic (138.4 ± 0.5 mg GAE/g DW) and flavonoid (52.8 ± 0.6 mg RuE/g DW) contents comparatively to Cleome gynandra and Apium graveolens. Hibiscus sabdariffa methanolic extract also presented the highest antioxidant activity (IC50 = 0.31 ± 0.002 mg/mL) using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging capacity assay. A high correlation between flavonoid contents and hydrophilic antioxidant activities (r = 0.99) was observed, indicating that flavonoids contribute significatively to these herbaceous antioxidant properties. Apium graveolens, Cleome gynandra, and Hibiscus sabdariffa constitute a natural source of phenolic compounds that could be exploited in diabetes mellitus management.