Education of Hospitalized Diabetic Patients: Analysis of Training Needs among Nurses in a Lebanese Hospital - A Secondary Publication

The design of diabetes inpatient educational preparation should be based on the needs of the nurses involved in terms of skills in this area. The objective of this qualitative study is to identify the preparatory needs of nurses working in the medical and surgical units of a Lebanese hospital in terms of Survival Skills Education for Hospitalized Diabetic Patients (SSEHDP). Method: The focus group method is used for data collection using a semi-structured interview guide. The needs expressed by the thirty-two participating nurses were classified into categories of the competency framework for providing self-management education to diabetic patients proposed by the American Diabetes Association. Results: By focusing on the themes of an SSEHDP, a list of preparatory needs was drawn up. The needs identified and analyzed are then translated into general and specific learning objectives for educational preparation. Conclusion: The needs analysis is only the first step in a work that will ideally continue into the implementation and eventual evaluation of an educational program developed to help nurses acquire skills in the education of diabetic patients.

Comparison of posterior capsule opacification at 360-degree square edge hydrophilic and sharp edge hydrophobic acrylic intraocular lens in diabetic patients

·AIM: To compare posterior capsule opacification(PCO)degree and visual functions after phacoemulsification in eyes implanted with 360-degree square edge hydrophilic acrylic intraocular lens(IOL)(570C C-flex, Rayner) and sharp edge hydrophobic acrylic IOL(Sensar AR40 e,AMO) in diabetic patients.· METHODS: Sixty diabetic patients underwent uneventful phacoemulsification and randomly implanted one of the two IOLs. The PCO value was measured by retroillumination photographs and Evaluation of Posterior Capsule Opacification(EPCO) 2000 image-analysis software at 1, 6, 12, and 24 mo after surgery. Visual acuity, and contrast sensitivity in photopic and mesopic conditions were also examined at each follow up time point. The incidence of eye that required Nd:YAG laser posterior capsulotomy were also compared.·RESULTS: There was not any statistically significant difference in PCO scores between Rayner C-flex 570 C group and Sensar AR40 e group at each follow up time point. Visual acuity, Nd:YAG capsulotomy incidence and contrast sensitivity also had no significant difference during the 24 mo follow-up.·CONCLUSION: For diabetic patients, Rayner 570 C Cflex and Sensar AR40 e IOLs are same effective for prevent PCO. The 360-degree square edge design maybe is a good alternative technique to improve PCO prevention.

Effects of Nursing Intervention Based on Transtheoretical Model of Behavioral Change on Disposal of Home Medical Waste in Diabetic Patients

[Objectives]To explore the effects of nursing intervention on the disposal of home medical waste for diabetic patients.[Methods]A total of 118 diabetic patients with insulin injection at home who visited a community service center in Shiyan City during November 2020 and September 2021 were selected as the research objects to implement the intervention,and the medical waste knowledge,attitude scores and standardized medical waste disposal were compared before and after the intervention.[Results]After the intervention,the patient's medical waste knowledge score was significantly higher than that before the intervention,and the medical waste disposal attitude score was significantly higher than that before the intervention.[Conclusions]If the nursing intervention based on Transtheoretical Model(TTM)of Behavioral Change penetrates deep into patients'families and communities,it is helpful to improve the knowledge and attitude of diabetic patients on home medical waste disposal,and regulate their home medical waste disposal behavior.

Factors Affecting Medication Non Adherence in Type 2 Sudanese Diabetic Patients

Background: Medications non-adherence is responsible for treatment failure and a reason of higher cost of medical care. It had been proved that, in general, diabetic patients are non-adherent to their treatment and only a small number of them were found to be adhering with all aspects of diabetic care. Objectives: To assess and evaluate the most common factors associated with medications adherence among Type 2 Diabetes Mellitus (DM) patients attending Ribat University Hospital Diabetic Clinic (RUHDC) Khartoum state, Sudan. Methods: Single Centre Descriptive cross sectional hospital based study was carried out among 351 patients using structured questionnaire and patients cards. Results: A total of 351 patients were recruited in the study;65.8% were females. About 64.4% were on oral medications and 35.6% on insulin. Adherence to medications among total Type 2 DM patients was 45%. Main barriers to medication adherence were drugs unavailability (34.3%) and forgetfulness (30.7%). Medications knowledge was 41.2% for patients on oral medications and 38.4% for insulin users. Conclusion: Adherence to anti-diabetic drugs in this study was found to be sub-optimal but considered reasonable in comparison with that reported by many African countries. Poor medications knowledge, drug brand unavailability and forgetfulness were the main reasons for medications non adherence. Family support, improving healthcare system and changing patents’ behavior will be needed to improve medications adherence.

A Study on Oral Health-Related Quality of Life and Its Influencing Factors in Elderly Diabetic Patients

Objective:To investigate the oral health related quality of life in elderly diabetic patients and analyze its influencing factors.Methods:Convenience sampling was used to select 190 elderly patients with diabetes under the Department of Endocrinology and Department of Integrated Traditional Chinese and Western Medicine in the Affiliated Hospital of Hebei University as the research subjects.The Chinese version of the Oral Health Influence Scale(OHIP-14)was used to conduct a questionnaire survey,and univariate analysis and multiple stepwise regression analysis were used to analyze the influencing factors of oral health related quality of life in elderly diabetic patients.Results:The elderly diabetic patients'oral health related quality of life score was 34.48±3.23,which is in the middle-lower range.The findings of multivariate stepwise regression analysis revealed that the course of disease,regular visits to the dentist,sleep quality,oral health knowledge,and oral health attitude together explained 58.9%of the total variance in elderly diabetic patients in terms of their oral health related quality of life(p<0.05).Conclusion:The oral health related quality of life of elderly diabetic patients is generally low,and is affected by the duration of diabetes,sleep quality,and oral health knowledge,attitude,and behavior(regular visits to the dentist).Improving patientsJ attention to oral health problems by improving sleep as well as their own oral health knowledge,attitude,and behavior is an effective way to enhance oral health related quality of life.

Knowledge, Attitude and Practice on Common Diabetic Patients among Diabetic Complications at Egyptian Hospital in Mogadishu, Somalia

Diabetes is a chronic illness that occurs when the pancreas stops producing insulin or when the body cannot use the produced insulin. Insulin is a hormone produced by the pancreas that helps glucose from meals enters the body’s cells for energy. The overall goal is to assess diabetes patients’ knowledge, attitudes, and behaviors about prevalent diabetic complications. This research used a descriptive qualitative methodology to assess diabetes complication knowledge, attitude, and practice. Ninety-eight diabetic patients were visiting the Egyptian Hospital in Mogadishu for four weeks. The data was collected using questionnaires. Finally, SPSS 20 was utilized for analysis. The research was performed from May to July 2020 with a non-probability sample size of 98 diabetics. The bulk of responders were aged 40 - 60 (36.7%). Type 2 was the most common (47.96%). 44.9% of respondents had diabetes for more than ten years. 60.2% had regular checkups, and 54.1 percent had therapy. 52% of participants were on a diet. 63.3% of respondents do not exercise often. However, most responders know the common issues (75%). Less than half of those polled had problems (41.8%). 22% incidence of Diabetic ketoacidosis. 78.6% of respondents know variables that decrease diabetes complications, whereas 22.4% do not. 37.8% of respondents saw a doctor for diabetes problems, whereas 62.2% did not. Diabetic patients’ knowledge, attitude, and practice were satisfactory for fundamental illness entanglements and self-testing. These findings may also be due to patient notification and, therefore, long-term illness that leads them to get acquainted with things alone. However, the tendency for regular exercise was low, which may produce more specific consequences of illness. Conclusion: We find that DM patients’ KAP was adequate in terms of knowledge of diabetic complications. These results may explain the patients’ long-standing illness, which forces them to discover things independently. At the same time, just a handful of them were familiar with vasculopathy and cardiovascular disorders. However, the researchers discovered low level of attitudes and practice toward regular exercise and insufficient levels of attitudes and practice toward diet management and treatment adherence. In general, this degree of KAP is suboptimal and requires further assessment of KAP obstacles in Somalia.

Evaluation of the Physical Fitness of the Type 2 Diabetic Patients: A Necessity for the Prescription of Adapted Physical Activity

Background: Diabetes mellitus and physical inactivity are modifiable risk factors for stroke. Physical activity is one of the pillars of type 2 diabetes management. The aim of this study was to evaluate the physical fitness of a sample of type 2 diabetes patients at the CHU of Martinique (UHCM). Patients and Methods: This was a descriptive cross-sectional study, from 1st June to 30th September 2018. It consisted of the exhaustive prospective collection of data on the usual physical activity and physical fitness of type 2 diabetic patients hospitalized in the Endocrinology department of the UHCM for a short stay. The physical fitness tests of the French National Olympic and Sports Committee, validated on 13 April 2013, were used. Results: Thirty patients were included in the study. The mean age was 51.9 ± 11 years. The sex ratio was 1.5, and hypertension in 53% (n = 16) of patients was the most associated risk factor. The median duration of diabetes progression was 4 years with Q1 and Q2 quantiles of 2 and 10 years, respectively. The physical fitness evaluation noted a balance disorder with a risk of falling in 56.7% (n = 17) of patients, muscle stiffness in 20% (n = 6) of them, while 56.7% (n = 17) and 80% (n = 24) had a decrease in the muscular strength of the upper and lower limbs, respectively. The distance covered during the standard 6 min walking test was normal for 70% (n = 21) of the patients. Conclusion: The evaluation of the patient’s physical fitness allows us to assess their deconditioning to physical activity and other obstacles to physical activity to plan appropriate interventions.

Self-Care Capacities of Diabetic Patients Monitored in the Internal Medicine Unit at the Kara Teaching Hospital (CHU Kara)

Objectives: To evaluate the practice of self-care in diabetic patients monitored at the Kara Teaching Hospital, known as CHU Kara. Method: We conducted a quantitative, descriptive and cross-sectional study of 40 diabetic patients monitored at the Kara CHU. The data collection took place from February 20 to May 28, 2018 and the data was collected anonymously. Results: Out of the forty (40) respondents, 60% were male with a sex ratio of 1.5 and an average age of 56.15 years. Two-thirds (2/3) of the patients did not have the blood glucose meter. More than half (52%) did not know the normal blood glucose value and 82.5% were on a low carbohydrate diet. Eighty-two point fifty percent (82.50%) were under Oral antidiabetic (ADO). Forty percent (40%) of patients often forgot their medication. Forty-seven point-fifty percent reported frequent episodes of hypoglycaemia with dizziness (58%), tremors (53%), hunger (53%), sweat (37%), tingling (26%) and the most common gestures were: sugar ingestion (53%) and glycemic control (26%). Eighty-five (85%) said they used to feel hyperglycemia with fatigue (76%), polyuria (65%), polydipsia (44%) the most common precursors and the most frequent interventions were taking hypoglycemic drugs (74%) and controlling blood glucose (24%). Conclusion: The practice of self-care remains risky for diabetic patients. Hence the need for the establishment of adequate therapeutic education programs.

Clinicopathological Data of Breast Cancer in Diabetic Patients

Background: Diabetes mellitus and breast cancer are both chronic diseases. Breast cancer in patients with diabetes is often diagnosed at an advanced stage and has worse prognosis. Aim of work: To investigate the clinicopathological factors, hormonal receptor status and molecular subtypes of breast cancer in diabetic breast cancer patients. Patients and methods: Records of patients presenting to the radiotherapy committee of the breast cancer clinic of Ain Shams University Hospital in the period between January 2017 and January 2018 were revised regarding age, presence of diabetes, presence of comorbidities, and type of the surgery performed. Pathological data such as: Tumor size (T), LN staging (LN), ER, PR, Her2/neu and Ki67 status were also recorded. Patients were divided into 2 groups: Group (I): those with diabetes and Group (II): those without diabetes. Inclusion criteria were Breast cancer cases with proven pathological diagnosis, available IHC studies, clear record of comorbidity status, age > 18 years, cases who underwent upfront surgery. Exclusion criteria were metastatic cases, bilateral cases, cases with double primary, male breast cancer cases, and those with missing data for ER, PR and Her2/neu. Results: Retrieving data from the files of the patients that met the inclusion criteria in the allocated period revealed that 117 patients had diabetes (Group I) and 199 didn’t have the disease (Group II), There was a highly significant difference between both groups regarding the age as most of the patients with diabetes were above fifty years of age (84.6%) compared to only 44.7% of the patients without diabetes also the mean age of patients with diabetes was significantly higher (59 years) compared to 48 years of age for those without diabetes. Diabetes was associated with hypertension in most of the cases (69%). Comorbidities other than hypertension were recorded in 39 diabetic patients (33.3%) and 21 (10.6%) nondiabetic patients and the difference was statistically highly significant. In the diabetic group, the most encountered comorbidity was cardiac disease in 14.5% of patients. In the diabetic group, most of the patients underwent modified radical mastectomy (MRM) with a percentage of about 54.7% compared to 48.2% of patients for both groups respectively. Regarding pathological data apart from the finding that presence of diabetes was associated with more multiple tumors (p value: 0.013), no other statistically significant differences between both groups were found. Hormonal receptor status and molecular subtypes were also not affected by presence of diabetes in the studied breast cancer patients.

Efficacy of recombinant human epidermal growth factor plus sodium hyaluronate eye drops in diabetic dry eye post-cataract surgery

BACKGROUND Dry eye syndrome(DES)after diabetic cataract surgery can seriously affect the patient’s quality of life.Therefore,effective alleviation of symptoms in patients with this disease has important clinical significance.AIM To explore the clinical effect of recombinant human epidermal growth factor(rhEGF)plus sodium hyaluronate(SH)eye drops on DES after cataract surgery in patients with diabetes.METHODS We retrospectively evaluated 82 patients with diabetes who experienced DES after cataract surgery at Tianjin Beichen Hospital,Affiliated Hospital of Nankai University between April 2021 and April 2023.They were classified into an observation group(42 cases,rhEGF+SH eye drops)and a control group(40 cases,SH eye drops alone),depending on the different treatment schemes.The therapeutic efficacy,dry eye symptom score,tear film breakup time(TFBUT),basic tear secretion score[assessed using Schirmer I test(SIt)],corneal fluorescein staining(FL)score,tear inflammatory markers,adverse reactions during treat-ment,and treatment satisfaction were compared between the two groups.RESULTS Therapeutic efficacy was higher in the observation group compared with the control group.Both groups showed improved TFBUT and dry eye,as well as improved SIt and FL scores after treatment,with a more pronounced improvement in the observation group.Although no marked differences in adverse reactions were observed between the two groups,treatment satisfaction was higher in the observation group.CONCLUSION rhEGF+SH eye drops rendered clinical benefits to patients by effectively ameliorating dry eye and visual impairment with favorable efficacy,fewer adverse reactions,and high safety levels.Thus,this treatment should be promoted in clinical practice.

Blood Pressure Profile and Glycemic Control of Type 2 Diabetics and Hypertensives at the Yalgado Ouedraogo University Hospital: A Review of 116 Cases

Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.

Smear positive pulmonary tuberculosis among diabetic patients at the Dessie referral hospital, Northeast Ethiopia

Background:Tuberculosis(TB)is an infectious disease which is still a major cause of morbidity and mortality throughout the world.People with diabetes mellitus(DM)have a three times higher risk of developing active TB than people without diabetes.However,there is not enough credible information on the burden of pulmonary tuberculosis(PTB)among DM patients in Ethiopia,in general,and in the city of Dessie,in particular.Therefore,this study aims to determine the prevalence and associated risk factors of smear positive PTB among diabetic patients at a referral hospital in Dessie.Methods:A cross-sectional study was conducted from February 2012 to April 2012.Patient demographic characteristics were collected using a pre-tested standard questionnaire format.Spot-morning-spot sputum specimens were collected from the study participants and examined for acid-fast bacilli using direct microscopy by the Ziehl-Neelsen staining technique.Data was entered and analyzed using the SPSS version 16 statistical software and p-value<0.05 was considered as statistically significant.Results:Out of 225 TB suspected diabetic patients,52%were males and 48%were females.Their ages ranged from 12 to 82 years,with a mean age of 47.2 years.Urban residence(AOR:5.5;95%CI:1.07-28.20),history of TB(AOR:13.4;95%CI:2.74-65.73),contact with TB patients in the family(AOR:9.4;95%CI:1.822-48.50),and long duration of DM(AOR:8.89;95%CI:1.88-58.12)were independently associated with the development of active TB in people living with DM.Conclusions:The prevalence of smear positive PTB was 6.2%in TB suspected diabetic patients,which is higher compared with the general population(0.39%).Patients with a previous history of contact with TB patients,as well as those who had prolonged diabetes,were more prone to have PTB.Therefore,screening of diabetic patients for PTB infection during follow-up is necessary.

Mitochondrial haplogroups associated with Japanese centenarians, Alzheimer's patients, Parkinson's patients, type 2 diabetic patients and healthy non-obese young males

The relationships between five classes of Japanese people （i.e., 96 centenarians, 96 Alzheimer＇s disease （AD） patients, 96 Parkinson＇s disease （PD） patients, 96 type 2 diabetic （T2D） patients, and 96 healthy non-obese young males） and their mitochondrial single nucleotide polymorphism （mtSNP） frequencies at individual mtDNA positions of the entire mitochondrial genome were examined using the radial basis function （RBF） network and the modified method. New findings of mitochondrial haplogroups were obtained for individual classes. The five classes of people were associated with the following haplogroups： Japanese centenarians-M7b2, D4b2a, and B5b; Japanese AD patients-G2a, B4cl, and N9b1; Japanese PD patients-M7b2, B4e, and B5b; Japanese T2D patients-B5b, M8al, G, D4, and F1; and Japanese healthy non-obese young males-D4g and D4b1b. From the points of common haplogroups among the five classes, the cente- narians have the common haplogroups M7b2 and B5b with the PD patients and common haplogroup B5b with the T2D patients. In addition, the 112 Japanese semi-supercentenarians （over 105 years old） recently reported were also examined by the method proposed. The results obtained were the haplogroups D4a, B4c1a, M7b2, F1, M1, and B5b. These results are different from the previously reported haplogroup classifications. As the proposed analysis method can predict a person＇s mtSNP constitution and the probabilities of becoming a centenarian, AD patient, PD patient, or T2D patient, it may be useful in initial diagnosis of various diseases.

Optimizing prevention of contrast-induced acute kidney injury in type 2 diabetic patients with at least moderate renal impairment

iabetes is a key risk factor for chronic kidney disease,^1 and patients with type 2 diabetes and coronary artery disease are at hlgla risk ot caralovascular events particularly when renal function is impaired.^2-4 Decision on how and when to proceed to coronary revascularization in an individual type 2 diabetic patient should be based on the extent of coronary disease, ischemic burden, ventricular function, as well as co-morbidities （e.g., renal insufficiency）.^5,6

Effects of Acarbose on incretins in newly diagnosed type 2 diabetic patients in different carbohydrate tolerance test

Objective To evaluate the effects of Acarbose on incretin level(glucagon-like peptide 1(GLP-1)and gastric inhibitory polypeptide(GIP)of type 2 diabetes mellitus(T2DM)patients after different kinds of glucose load.Methods A total of 32 newly diagnosed T2DM patients were enrolled in this study and randomly divided into

Relationship between serum osteocalcin levels and glucolipid metabolism in elderly type 2 diabetic patients with non-alcoholic fatty liver disease

Objective To explore the relationship between serum osteocalcin levels and glucolipid metabolism in elderly type 2 diabetic patients with non-alcoholic fatty liver disease(NAFLD).Methods Data collected from 97 pa-tients with type 2 diabetes mellitus(T2DM)admitted to the Department of Geriatric Endocrinology of the First Affiliated hospital of Zhengzhou University from June

Effect of bariatric surgery on metabolism in diabetes and obesity comorbidity:Insight from recent research

Obesity is a prevalent cause of diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesity-induced DM is caused by an excessive long-term diet and surplus energy.Bariatric surgery can improve the symptoms of T2DM in some obese patients.But different types of bariatric surgery may have different effects.There are some models built by researchers to discuss the surgical procedures’effects on me-tabolism in diabetes animal models and diabetes patients.It is high time to conclude all this effects and recommend procedures that can better improve metabolism.

Effect of Continuous Nursing on Quality of Life of Patients with Diabetes Mellitus

Objective:To analyze the effect of continuous nursing on the quality of life of patients with diabetes.Methods:From August 2019 to August 2020,76 patients with diabetes were selected and randomly divided into group A and group B.group a received continuous nursing and group B received routine nursing.Results:The compliance of health education in group A was better than that in group B(P<0.05);The score of quality of life in group A was better than that in group B(P<0.05);The scores of anxiety and depression in group A were better than those in group B(P<0.05);The nursing satisfaction of group A was 97.37%,which was better than that of group B 76.32%,P<0.05.Conclusions:Continuous nursing for patients with diabetes can improve the quality of life,relieve anxiety,depression and other negative emotions,and improve nursing satisfaction.

Abnormal subchondral bone remodeling and its association with articular cartilage degradation in knees of type 2 diabetes patients

Type 2 diabetes （T2D） is associated with systemic abnormal bone remodeling and bone loss. Meanwhile, abnormal subchondral bone remodeling induces cartilage degradation, resulting in osteoarthritis （OA）. Accordingly, we investigated alterations in subchondral bone remodeling, microstructure and strength in knees from T2D patients and their association with cartilage degradation. Tibial plateaus were collected from knee OA patients undergoing total knee arthroplasty and divided into non-diabetic （n---70） and diabetes （n = 51） groups. Tibial plateaus were also collected from cadaver donors （n = 20） and used as controls. Subchondral bone microstructure was assessed using micro-computed tomography. Bone strength was evaluated by micro-finite-element analysis. Cartilage degradation was estimated using histology. The expression of tartrate-resistant acidic phosphatase （TRAP）, osterix, and osteocalcin were calculated using immunohistochemistry. Osteoarthritis Research Society International （OARSI） scores of lateral tibial plateau did not differ between non-diabetic and diabetes groups, while higher OARSI scores on medial side were detected in diabetes group. Lower bone volume fraction and trabecular number and higher structure model index were found on both sides in diabetes group. These microstructural alterations translated into lower elastic modulus in diabetes group. Moreover, diabetes group had a larger number of TRAP~ osteoclasts and lower number of Osterix~ osteoprogenitors and Osteocalcin~ osteoblasts. T2D knees are characterized by abnormal subchondral bone remodeling and microstructural and mechanical impairments, which were associated with exacerbated cartilage degradation. In regions with intact cartilage the underlying bone still had abnormal remodeling in diabetes group, suggesting that abnormal bone remodeling may contribute to the early pathogenesis of T2D-associated knee OA.

Parsimonious Model for Blood Glucose Level Monitoring in Type 2 Diabetes patients

To establish the parsimonious model for blood glucose monitoring in patients with type 2 diabetes receiving oral hypoglycemic agent treatment. One hundred and fifty-nine adult Chinese type 2 diabetes patients were randomized to receive rapid-acting or sustained-release gliclazide therapy for 12 weeks.