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Factors of Non-adherence to Antidiabetic Drugs in Type 2 Diabetics, Antananarivo Madagascar
Sitraka Angelo Raharinavalona,
Rija Eric Raherison,
Thierry Razanamparany,
Solofo Andrianarivelo Ralamboson,
Andrinirina Dave Patrick Rakotomalala,
Hanta Marie Danielle Vololontiana,
Radonirina Lazasoa Andrianasolo
Issue:
Volume 6, Issue 4, December 2021
Pages:
125-130
Received:
14 August 2021
Accepted:
6 September 2021
Published:
12 October 2021
Abstract: Introduction: The non-adherence to therapy of diabetics is grafted with heavy morbidity and mortality. Our study aims to determine the factors of non-adherence with antidiabetic drugs in type 2 diabetics. Methods: This was a descriptive and analytical cross-sectional study, carried out in the Endocrinology Unit of the Joseph Raseta University Hospital Center. Befelatanana, Antananarivo, over a period of 7 months. Adherence to treatment was assessed by the Morisky scale. Results: We retained 104 patients with an average age of 58.36 years, consisting of 52.88% of women. Adherence was high, medium, and low in 6.73%, 31.73% and 61.54% of cases, respectively. From their attending physician, explanations of the diabetic disease and their treatment were received by 90.38% and 66.35% of patients, respectively. However, these patients were aware of their disease and treatment in 18.27% and 41.35% of cases, respectively. The most observed non-adherence factors were the absence of an appointment given by the physician (30.77%), the feeling of well-being (24.04%), the lack of money (21.15%), forgetting (20.19%) and advice from a traditional practitioner (16.35%). Only the doctor's explanation for diabetes treatment was significantly associated with medication nonadherence (p=0.0310). Conclusion: Continuing medical education for physician is essential so that they can strengthen therapeutic education and follow-up for their diabetics.
Abstract: Introduction: The non-adherence to therapy of diabetics is grafted with heavy morbidity and mortality. Our study aims to determine the factors of non-adherence with antidiabetic drugs in type 2 diabetics. Methods: This was a descriptive and analytical cross-sectional study, carried out in the Endocrinology Unit of the Joseph Raseta University Hospi...
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Evaluation of C-peptide in Type 2 Diabetic Patients in Douala Cameroon: C-peptide Correlation with Arterial Hypertension and the Types of Treatment Administered
Manta Diane,
Mbango-Ekouta Noel Désirée,
Nda Mefo'o Jean Pierre,
Assiene Oyong Damase Serge,
Eloumou Bagnaka Servais,
Adiogo Dieudonné
Issue:
Volume 6, Issue 4, December 2021
Pages:
131-133
Received:
17 August 2021
Accepted:
16 October 2021
Published:
28 October 2021
Abstract: Introduction: C-peptide is the best indicator of endogenous insulin secretion; it makes it possible to optimize the treatment, and to prevent the occurrence and the evolution of the damages resulting from type 2 diabetes. The present study reports the variation of C-peptide levels according to the types of treatment administrated and the high blood pressure in type 2 diabetes in two hospitals (General Hospital and Gyneco-Obstetric and Pediatric Hospital) in the city of Douala Cameroon. Methodology Over a period of 9 months (from October, 1st 2017 to June, 30th 2018), we conducted an analytical cross-sectional study involving subjects with type 2 diabetes regularly monitored at the General Hospital and Gyneco-Obstetric and Pediatric Hospital of Douala Cameroon. Inclusion criteria we included any subject whose diagnosis of type 2 diabetes was mentioned in the medical file. The fasting C-peptide assays were performed according to the principle of electrochemiluminescence. The ANOVA and PEARSON tests were use to investigate on the one hand the correlations between the C peptide levels and the types of treatment administered, and on the other hand between the C-peptide levels and arterial hypertension. The significant threshold was set at P <0.05. Results: Our population, made up of 90 subjects, had a mean age of 58±12.31 years, sex ratio 0.8 in favor of women. The mean duration of diabetes was 8.71±6, 94 years, we had 30 hypertensive subjects under hypertensive treatment, the mean C-peptide levels was 2.50±1.68ng / ml. We found that C-peptide levels increased with patient ages (P=0.004), a significant correlation between C-peptide levels and high blood pressure (P=0.022), and C-Peptide levels varied significantly depending on the type of treatment (P=0.04). Conclusion: Type 2 diabetic patients on oral antidiabetic drugs, and having a low level of C-peptide, should undergo a modification of their treatment by the addition (or the replacement) of insulin, for better glycemic control. Diabetic and hypertensive patients are more exposed to micro and macrovascular complications. Hence the importance of instituting more assiduous blood pressure control, appropriate hypotensive therapy, as well as training patients in self-management and prevention of the onset of complications related to diabetes.
Abstract: Introduction: C-peptide is the best indicator of endogenous insulin secretion; it makes it possible to optimize the treatment, and to prevent the occurrence and the evolution of the damages resulting from type 2 diabetes. The present study reports the variation of C-peptide levels according to the types of treatment administrated and the high blood...
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The Prevalence of Type 2 Diabetes in the 27 Local Government Areas (LGAs) of Imo State
Nwaokoro Joakin Chidozie,
Onwuliri Viola Adaku,
Onyeocha Ignatius,
Onwuliri Daniel Chinemerem,
Nnodim Johnkennedy,
Ede Okorie Alison
Issue:
Volume 6, Issue 4, December 2021
Pages:
134-141
Received:
24 May 2021
Accepted:
7 July 2021
Published:
23 November 2021
Abstract: Diabetes is a homeostasis imbalance in which insulin is deficient. It poses a great public problem and economic cost. This study investigated prevalence of type 2 diabetes in Imo State, Southeastern Nigeria. Sample size consisted 3690 persons from across the state. Research instrument for data collection were questionnaires and test kits for blood sugar, blood pressure and body mass index determination (physical examination). Out of 2700 persons that responded to the question on whether they know about type 2 diabetes, 68% of them representing 1761±8.3 said “Yes”, while 32% representing 830±8.2 said “No”; a chi-square contingency analysis on the respondents’ knowledge of type 2 diabetes yielded a value of 83.26 (p<0.001). On whether they know if they are living with type 2 diabetes, 830 out of 2700 respondents which represent 11% of the responses said “Yes”, while 2340 which accounted for 89% of the responses said “No”. This puts the prevalence rate at 11%, but blood sugar screening results puts the prevalence rate at 21.1%. On the distribution of type 2 diabetes, 843±17.2 out 2700 respondents representing 34% said urban dwellers are more prone to type 2 diabetes than rural dwellers, 806±19.0 and 841±18.9 representing 32% and 35% said “No” and “No idea”, respectively; with a chi-square value of 831.44 and p-value of <0.001, there was very high significant difference on whether there is more type 2 diabetes on urban than rural On gender, 547±7.2 out 2700 respondents accounting for 21% of the responses said type 2 diabetes is more in men than women, while 656±10.4 respondents out 2700 noted that type 2 diabetes is more in women than men, 1334±10.3 out 2700 said they do not have any idea. This study revealed 11.0% prevalence rate of type 2 diabetes in Imo State. Type 2 diabetes is fast ravaging the health of the people of Imo state with many persons living with the diseases and yet are unaware of it.
Abstract: Diabetes is a homeostasis imbalance in which insulin is deficient. It poses a great public problem and economic cost. This study investigated prevalence of type 2 diabetes in Imo State, Southeastern Nigeria. Sample size consisted 3690 persons from across the state. Research instrument for data collection were questionnaires and test kits for blood ...
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The Incident Pattern and Trend of Type 2 Diabetes Among Adults in Akwa Ibom State, South-south Nigeria
Collins Amadi,
Samuel Onung,
Olufisayo Ayoade,
Emmanuel Abudu,
Fabian Unyime,
Anthony Usoro
Issue:
Volume 6, Issue 4, December 2021
Pages:
142-149
Received:
31 October 2021
Accepted:
16 November 2021
Published:
23 November 2021
Abstract: Background: Epidemiologic data indicate that the incident characteristics of type 2 diabetes mellitus (T2DM) are proper metrics to accurately define the true trajectory of the metabolic disorder. However, this is poorly characterized among Nigerians with T2DM. Hence, the current study evaluated the incident characteristics (pattern/trend) of T2DM among adult inhabitants of Akwa Ibom State, South-south Nigeria. Methods: A retrospective survey of incident adult-onset T2DM in the University of Uyo Teaching Hospital (UUTH) was conducted using 5-year (2014-2018) hospital medical data. Records of eligible cases were identified, relevant data retrieved on a well-designed research pro forma at the point of diagnosis, and acquired data analyzed using descriptive/comparative statistics. Results: A total of 47,357 adults with varied medical conditions presented in UUTH during 2014-2018 of whom 2,198 (mean age: 55.09±11.86 years) were diagnosed with T2DM, giving an overall crude incident rate (CIR) of 4.64% (95% Confidence Interval [CI]: 3.61-6.91) and age-standardized incidence rate (ASIR) of 5.36% (95%CI: 3.96-7.45). An increasing trend of the annual incident cases, CIR, and ASIR of T2DM was observed during the period (p trend <0.001). The increase was obvious among both genders, young adults, middle-aged, urban dwellers, tertiary-level educated, paralleling the rising low physical activity, overweight, and obesity (p trend <0.05). However, a decreasing trend of the CIR and ASIR was observed among the rural-dwellers (p trend <0.05). Conclusion: The incidence of adult-onset T2DM has assumed an upward trend among inhabitants of Akwa Ibom State, South-south Nigeria. Public health measures are urgently recommended to stem this trend.
Abstract: Background: Epidemiologic data indicate that the incident characteristics of type 2 diabetes mellitus (T2DM) are proper metrics to accurately define the true trajectory of the metabolic disorder. However, this is poorly characterized among Nigerians with T2DM. Hence, the current study evaluated the incident characteristics (pattern/trend) of T2DM a...
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Early-stage Hyperglycemia-induced Gut Microbial Changes Are Partially Associated with Mechanical Allodynia in db/db Mice
Xinting Wang,
Jihong Wu,
Simin Qi,
Rui Huang,
Xiaoping Wu,
Lin Tian,
Peili Wang,
Shenglan Wang
Issue:
Volume 6, Issue 4, December 2021
Pages:
150-159
Received:
27 October 2021
Accepted:
22 November 2021
Published:
2 December 2021
Abstract: Recent studies have demonstrated that pain is partially regulated by the gut microbiota. However, the association of gut microbiota with painful diabetic neuropathy, a common complication of diabetes, remains unclear. Herein, we investigated whether the gut microbiota is associated with mechanical allodynia during the early stage of hyperglycemia in 7-week-old db/db mice. The db/db mice were intraperitoneally injected with metformin for 2 weeks. Using the von Frey test and gut microbiota analyses, we investigated the association of gut microbial changes with mechanical allodynia in 7-week-old mice. In db/db mice, colonic microbial community profiles were altered, and both unweighted and weighted UniFrac distances were reduced. Colonic genus-level abundances of Alloprevotella and Prevotellaceae_UCG-001 were positively correlated with mechanical allodynia in db/db mice, while the abundance of Odoribacter was negatively correlated. Intraperitoneal injection of metformin for 2 weeks alleviated mechanical allodynia in db/db mice but did not achieve an anti-diabetic effect. Metformin altered colonic microbial communities and increased weighted UniFrac distance in db/db mice, although its analgesic effect was not associated with specific bacteria. Additionally, alteration of small intestinal microbial community profiles and reduction in weighted UniFrac distance were observed in db/db mice, which were not affected by metformin. These results provide potential evidence of the association of the gut microbiota with mechanical allodynia during early-stage of hyperglycemia.
Abstract: Recent studies have demonstrated that pain is partially regulated by the gut microbiota. However, the association of gut microbiota with painful diabetic neuropathy, a common complication of diabetes, remains unclear. Herein, we investigated whether the gut microbiota is associated with mechanical allodynia during the early stage of hyperglycemia i...
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Clinical and Biochemical Parameters at Presentation of Patients with Adrenal Insufficiency Attending a Tertiary Care Hospital
Rezwana Sobhan,
Khan Mohammad Nazmus Saqeb,
Mohammad Ibrahim,
Aleya Ferdush Monni,
Mohammad Faruque Pathan,
Mohammad Ashrafuzzaman
Issue:
Volume 6, Issue 4, December 2021
Pages:
160-166
Received:
30 October 2021
Accepted:
17 November 2021
Published:
24 December 2021
Abstract: Background: Adrenal insufficiency is the clinical manifestation of deficient production or action of glucocorticoids, with or without deficiency of mineralocorticoids and adrenal androgens. It results from primary adrenal failure or secondary adrenal disease due to impairment of the hypothalamic–pituitary axis. Patients often have nonspecific symptoms such as weakness, fatigue, lethargy, anorexia, nausea, vomiting, fever, confusion or coma. Without appropriate therapy, shock progresses to coma and death. The aim of the study was to evaluate the clinical and biochemical parameters at presentation in patients admitted with adrenal insufficiency. Methods: Patients diagnosed with adrenal insufficiency fulfilling the diagnostic criteria were considered as study population. Purposive consecutive type of sampling method was applied. Data was collected in a structured questionnaire. All the data were analysed by SPSS V 22.0. Results: A total of 100 patients of adrenal insufficiency were included in the study. The most were in the age group of 51-60 years (33%), mean age ± SD was 50.82±13.51 years & 38% were male. In our study, 100% patients had generalized weakness, 88% had GI symptoms, 41% had vertigo and 18% had weight loss. Most of them (83%) had vomiting, 70% had nausea and only 17% had anorexia. 38% patients were anaemic and 23% had shock and 33% patients presented with adrenal crisis. In this study, 82% patient were hypotensive, 46% had postural hypotension. In our study, 56% had puffy face, 49% had history of weight gain, 26% had skin thinning. Mean Hb was 10.96 gm/dl, 25% had a serum creatinine of>1.2 mg/dl. Hypoglycaemia was present in 7%, 12% had high blood urea nitrogen, 71% had hyponatraemia, 39% had hyperkalaemia, 12% had hypercalcaemia and 20% had acidosis. Conclusion: Adrenal insufficiency presented with non-specific features like fatigue, weakness, vertigo, GI symptoms, unexplained fever or weight loss and specific pattern of biochemical findings like hyponatraemia, hyperkalaemia, mild acidosis, hypercalcaemia & hypoglycaemia. So, these features should raise the suspicion of adrenal insufficiency.
Abstract: Background: Adrenal insufficiency is the clinical manifestation of deficient production or action of glucocorticoids, with or without deficiency of mineralocorticoids and adrenal androgens. It results from primary adrenal failure or secondary adrenal disease due to impairment of the hypothalamic–pituitary axis. Patients often have nonspecific sympt...
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Semaglutide as an Antidiabetic Medication: A Summary of the Evidence from the Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes Clinical Trial Program
Gurdeep Singh,
Matthew Krauthamer,
Meghan Bjalme-Evans
Issue:
Volume 6, Issue 4, December 2021
Pages:
167-174
Received:
27 November 2021
Accepted:
14 December 2021
Published:
24 December 2021
Abstract: Background: The Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes (SUSTAIN) clinical trial program was a phase III, multinational, multicenter program comprising 13 trials. Objective: Investigate the safety and efficacy of once-weekly, subcutaneous semaglutide versus other antidiabetic comparators, both as a monotherapy and in addition to other antidiabetic medications. Methods: This review summarizes the 10 trials that comprise the bulk of the evidence which led to FDA approval of semaglutide as an antidiabetic drug. Most articles were accessed via the National Center for Biotechnology Information database using pertinent search terms. Results: Semaglutide 0.5 mg and 1 mg weekly subcutaneous injection led to HA1c reductions by 1.1%–1.5% and 1.5%–1.8%, respectively. Bodyweight reduction with 0.5 mg and 1 mg dose of semaglutide ranged from 3.47–4.6 kg and 4.53–6.5 kg, respectively. SUSTAIN 6, in particular, found cardiovascular risk factor benefits, including the rate of nonfatal myocardial infarction, cardiovascular death and nonfatal strokes in high-risk patients correlated with the use of semaglutide in patients with type 2 diabetes. Conclusions: Semaglutide is superior to other glucagon-like peptide-1 receptor agonists, including exenatide, dulaglutide, and liraglutide in hemoglobin A1c reduction. It is also helpful for chronic weight loss and has cardioprotective effects.
Abstract: Background: The Semaglutide Unabated Sustainability in Treatment of Type 2 Diabetes (SUSTAIN) clinical trial program was a phase III, multinational, multicenter program comprising 13 trials. Objective: Investigate the safety and efficacy of once-weekly, subcutaneous semaglutide versus other antidiabetic comparators, both as a monotherapy and in add...
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