RESUMEN
Nigeria is one of the developing countries with a major burden of non-communicable diseases (NCDs) without a disease self-management program in its healthcare system. Thus, this study was aimed to assess the baseline self-efficacy levels of Nigerian patients with chronic NCDs at tertiary level hospitals. This is a cross sectional study of 286 NCD patients attending tertiary level clinics from 26 July to 27 October 2023. Patients were interviewed on a 10 Self-Efficacy to Manage Chronic Disease (SEMCD) item scales that were considered suitable for the Nigerian population. The 10 SEMCD questions covered: (i) Exercise regularly scale, (ii) Help from community, family and friends scale, (iii) Communication with Physician scale, (iv) Manage disease scale and (v) Manage symptom self-efficacy domains. Data were analyzed both descriptively and statistically using Student's t-tests and Chi-square tests as appropriate. The results showed that more female (59.4%) than males (40.6%) attended clinics during the study, and the mean age of the patients did not differ between gender (P > .05). About 40% of all the patients manage their NCDs with medications alone, a trend that is similar in male and female patients (P > .05). While all the patients had a relatively lower self-efficacy scores under regular exercise scale (52%-55%) and manage disease symptoms scale (53%-55%), they tended toward higher self-efficacy scores under getting assistance from community, family, and friends (79%-80%) and communication with attending physicians (81%-85%). It is concluded that Nigeria literate NCD patients registered at tertiary level institution routine clinics are less than optimal in disease self-management care. We recommend that this study population will benefit from introduction and implementation of disease self-management program in the healthcare system.
Asunto(s)
Enfermedades no Transmisibles , Autoeficacia , Humanos , Masculino , Femenino , Nigeria , Estudios Transversales , Persona de Mediana Edad , Enfermedades no Transmisibles/terapia , Enfermedad Crónica , Adulto , Anciano , Ejercicio Físico , Encuestas y CuestionariosRESUMEN
BACKGROUND: Some Nigerian studies have reported cases of the metabolic syndrome in the population. This study aims to assess the prevalence of the components of the metabolic syndrome in type 2 diabetes mellitus (T2DM) patients using the International Diabetes Federation (IDF) worldwide definition. METHODS: Eighty-nine T2DM patients were studied after an overnight fast. The patients' blood pressure, anthropometric indices, and biochemical parameters were measured. The components of the metabolic syndrome-raised blood pressure, waist circumference, triglycerides (TGs), and reduced high-density lipoprotein cholesterol (HDL-C)-were calculated using the IDF definition for the European ethnic group. RESULTS: About 25% of the patients had raised blood pressure (>130/85 mmHg), with the male patients having higher prevalence of raised systolic blood pressure (SBP>130 mmHg) than the female patients (73.3 vs. 52.3%, P<0.05). Although the prevalence of raised TGs did not differ in gender, more females than males had reduced HDL-C (77.3 vs. 46.7%, P<0.001). Although generalized obesity is similar in both gender (17.8% vs. 31.8%, P>0.05), abdominal obesity predominates significantly in female patients (97.7 vs. 68.9%, P<0.001). Overall, total obesity (P<0.05), raised blood pressure (P<0.05), raised TGs, and reduced HDL-C are significantly clustered in abdominally obese patients. CONCLUSION: It is concluded that the abdominally obese T2DM patients had a higher cluster of the components of the metabolic syndrome and are consequently at greater risk of cardiovascular disease (CVD). We recommend that diabetes education emphasizing the risk of CVD in patients with increased abdominal fat should be intensified in the developing countries.
Asunto(s)
Diabetes Mellitus Tipo 2/epidemiología , Síndrome Metabólico/epidemiología , Obesidad Abdominal/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Antropometría , HDL-Colesterol/sangre , Diabetes Mellitus Tipo 2/complicaciones , Ayuno , Femenino , Humanos , Hipertensión/complicaciones , Cooperación Internacional , Masculino , Síndrome Metabólico/complicaciones , Persona de Mediana Edad , Nigeria/epidemiología , Obesidad Abdominal/complicaciones , Factores de Riesgo , Sociedades Médicas , Triglicéridos/sangre , Circunferencia de la CinturaRESUMEN
BACKGROUND: Anaemia has been shown in previous studies to be a risk factor for cardiovascular disease in diabetic patients with chronic kidney disorder. This study was aimed to assess the prevalence of anaemia and kidney dysfunction in Caribbean type 2 diabetic patients that have been previously shown to have a high prevalence of the metabolic syndrome. METHODS: 155 type 2 diabetic patients and 51 non-diabetic subjects of African origin were studied. Anthropometric parameters were measured and fasting blood samples were collected for glucose, creatinine, glycated hemoglobin and complete blood count. Anaemia was defined as haemoglobin < 12 g/dl (F) or < 13 g/dl (M). Kidney function was assessed using glomerular filtration rate (GFR) as estimated by the four-variable Modification of Diet in Renal Disease (MDRD) study equation. Subjects were considered to have chronic kidney disease when the estimated GFR was < 60 ml/min per 1.73 m2. Comparisons for within- and between-gender, between diabetic and non-diabetic subjects were performed using Student's t-test while chi-square test was employed for categorical variables. RESULTS: The diabetic patients were older than the non-diabetic subjects. While male non-diabetic subjects had significantly higher red blood cell count (RBC), haemoglobin and hematocrit concentrations than non-diabetic female subjects (p < 0.001), the RBC and hematocrit concentrations were similar in male and female diabetic patients. Furthermore, irrespective of gender, diabetic patients had significantly higher prevalence rate of anemia than non-diabetic subjects (p < 0.05). Anaemic diabetes patients had significantly lower GFR (67.1 +/- 3.0 vs. 87.9 +/- 5.4 ml/min per 1.73 m2, p < 0.001) than non-anaemic patients. CONCLUSION: A high prevalence of anaemia was identified in this group of type 2 diabetic patients previously shown to have a high prevalence of the metabolic syndrome. It is therefore recommended that diagnostic laboratories in developing countries and elsewhere should include complete blood count in routine laboratory investigations in the management of diabetic patients.
Asunto(s)
Anemia/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Enfermedades Renales/epidemiología , Anciano , Anemia/sangre , Anemia/fisiopatología , Población Negra/estadística & datos numéricos , Glucemia/análisis , Enfermedad Crónica , Estudios Transversales , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/fisiopatología , Femenino , Tasa de Filtración Glomerular , Hemoglobina Glucada/análisis , Hematócrito , Hemoglobinas/análisis , Humanos , Enfermedades Renales/sangre , Enfermedades Renales/fisiopatología , Masculino , Persona de Mediana Edad , Prevalencia , Trinidad y Tobago/epidemiologíaRESUMEN
BACKGROUND: Anaemia has been shown in previous studies to be a risk factor for cardiovascular disease in diabetic patients with chronic kidney disorder. This study was aimed to assess the prevalence of anaemia and kidney dysfunction in Caribbean type 2 diabetic patients that have been previously shown to have a high prevalence of the metabolic syndrome. METHODS: 155 type 2 diabetic patients and 51 non-diabetic subjects of African origin were studied. Anthropometric parameters were measured and fasting blood samples were collected for glucose, creatinine, glycated hemoglobin and complete blood count. Anaemia was defined as haemoglobin < 12 g/dl (F) or < 13 g/dl (M). Kidney function was assessed using glomerular filtration rate (GFR) as estimated by the four-variable Modification of Diet in Renal Disease (MDRD) study equation. Subjects were considered to have chronic kidney disease when the estimated GFR was < 60 ml/min per 1.73 m2. Comparisons for within- and between-gender, between diabetic and non-diabetic subjects were performed using Student's t-test while chi-square test was employed for categorical variables. RESULTS: The diabetic patients were older than the non-diabetic subjects. While male non-diabetic subjects had significantly higher red blood cell count (RBC), haemoglobin and hematocrit concentrations than non-diabetic female subjects (p < 0.001), the RBC and hematocrit concentrations were similar in male and female diabetic patients. Furthermore, irrespective of gender, diabetic patients had significantly higher prevalence rate of anemia than non-diabetic subjects (p < 0.05). Anaemic diabetes patients had significantly lower GFR (67.1 +/- 3.0 vs. 87.9 +/- 5.4 ml/min per 1.73 m2, p < 0.001) than non-anaemic patients. CONCLUSION: A high prevalence of anaemia was identified in this group of type 2 diabetic patients previously shown to have a high prevalence of the metabolic syndrome.
Asunto(s)
Humanos , Riñón , Anemia , Diabetes Mellitus Tipo 2 , Indias Occidentales , Trinidad y TobagoRESUMEN
It has been reported that mixed meals are used in clinics in developing and developed countries in screening and diagnosis of diabetes. Thus, we aimed to determine the differences in 2-h plasma glucose values after non-diabetic subjects ingested 75 g pure glucose and its equivalent content in frequently consumed carbohydrate foods in Caribbean subjects. Twenty-seven apparently healthy non-diabetic subjects (nine males, 18 females) consumed 75 g pure glucose and its carbohydrate equivalent in three ethnic test foods (bread, rice and roti) at 7 days apart. Plasma glucose and insulin levels were determined in blood samples collected before and after 60, 90, 120 and 150 min of ingestion of these foods. In comparison with each of the test foods, the postprandial 1-h and 2-h plasma glucose values and the 60, 90, 120 and 150 min incremental glucose concentrations after oral glucose load were significantly higher than the corresponding values for each of the test foods (all P<0.01). In spite of these higher postprandial glucose concentrations, the postprandial insulin responses following the oral glucose load and the test foods did not significantly differ at any time point (all P>0.05). However, the test food, roti, tended to stimulate higher absolute and incremental insulin secretions than pure glucose or any other test food (all P>0.05). Generally, the correlation between 2-h plasma glucose value after the ingestion of the pure glucose and each of the test foods was significant (all correlation coefficients were greater than 0.70, P<0.01). In conclusion, different ethnic mixed meals could serve as an alternative to glucose in routine screening and diagnosis of diabetes if its available carbohydrate content is known and quantified.
Asunto(s)
Humanos , Glucosa/análisis , GlucosaRESUMEN
BACKGROUND AND OBJECTIVE: Studies suggest that the link between postprandial hyperglycaemia and cardiovascular risk in type 2 diabetes mellitus might be related to postprandial hypertriglyceridaemia and the increased levels of the highly atherogenic small and dense low density lipoprotein (LDL) particles. In this study we therefore aimed to determine which of the three popular carbohydrate foods has the highest potential of increasing postprandial triglyceride levels in type 2 diabetic patients and in healthy non diabetic individuals. METHODS: All subjects were studied on three different occasions seven days apart after an overnight fast. On each day of study, anthropometric indices were measured and after collecting fasting blood sample, subjects consumed bread, roti or rice within 10 min and water taken as wished. Subsequently, 7 ml of venous blood samples were collected at 60, 90, 120 and 150 min for insulin, glucose and lipids determinations. RESULTS: The diabetic and non diabetic healthy subjects had similar baseline body mass index, insulin, triglyceride, total and LDL-cholesterol. The mean percentage triglyceride increase after ingestion of the test foods was highest with bread and lowest with rice irrespective of diabetic status or ethnicity, and despite similar baseline triglyceride, insulin and body mass index levels, the diabetic patients of East Indian origin had comparatively higher incremental triglyceride levels for the three test foods than those of African origin. INTERPRETATION AND CONCLUSION: Contrary to anecdotal perception, the commercially prepared whole wheat bread has the highest propensity to induce hypertriglyceridaemia especially among diabetic patients of East Indian origin.
Asunto(s)
Diabetes Mellitus Tipo 2/sangre , Carbohidratos de la Dieta/efectos adversos , Hipertrigliceridemia/etiología , Periodo Posprandial , Pan/efectos adversos , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Oryza/efectos adversos , Indias OccidentalesRESUMEN
It has been reported that mixed meals are used in clinics in developing and developed countries in screening and diagnosis of diabetes. Thus, we aimed to determine the differences in 2-h plasma glucose values after non-diabetic subjects ingested 75 g pure glucose and its equivalent content in frequently consumed carbohydrate foods in Caribbean subjects. Twenty-seven apparently healthy non-diabetic subjects (nine males, 18 females) consumed 75 g pure glucose and its carbohydrate equivalent in three ethnic test foods (bread, rice and roti) at 7 days apart. Plasma glucose and insulin levels were determined in blood samples collected before and after 60, 90, 120 and 150 min of ingestion of these foods. In comparison with each of the test foods, the postprandial 1-h and 2-h plasma glucose values and the 60, 90, 120 and 150 min incremental glucose concentrations after oral glucose load were significantly higher than the corresponding values for each of the test foods (all P<0.01). In spite of these higher postprandial glucose concentrations, the postprandial insulin responses following the oral glucose load and the test foods did not significantly differ at any time point (all P>0.05). However, the test food, roti, tended to stimulate higher absolute and incremental insulin secretions than pure glucose or any other test food (all P>0.05). Generally, the correlation between 2-h plasma glucose value after the ingestion of the pure glucose and each of the test foods was significant (all correlation coefficients were greater than 0.70, P<0.01). In conclusion, different ethnic mixed meals could serve as an alternative to glucose in routine screening and diagnosis of diabetes if its available carbohydrate content is known and quantified.
Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus Tipo 2/diagnóstico , Adulto , Diabetes Mellitus Tipo 2/sangre , Dieta , Carbohidratos de la Dieta , Etnicidad , Femenino , Glucosa , Prueba de Tolerancia a la Glucosa/métodos , Humanos , Insulina/sangre , Masculino , Persona de Mediana Edad , Periodo Posprandial , Trinidad y TobagoRESUMEN
BACKGROUND & AIM: Previous studies suggest that inadequate glycaemic control in diabetic patients might be related to the type of carbohydrates the patients consume regularly. Thus, we aimed to assess glucose and insulin responses after diabetic and non-diabetic subjects ingested 3 commonly consumed carbohydrate-based foods. METHODS: Thirty-eight type-2 diabetic and 27 non-diabetic subjects were studied in 3 different occasions of 7 days apart. On each day of the study, anthropometric indices were measured and after collecting fasting blood samples, subjects randomly consumed bread, roti or rice within 10 min. Subsequently 7 ml of venous blood samples were collected at 60, 90, 120 and 150 min for determination of glucose and insulin responses. RESULTS: Although the diabetic patients were older than the healthy subjects (P < 0.05), both subjects had similar weight, body mass index and waist and hip circumferences (P > 0.05). The mean fasting and post meal plasma glucose concentrations for the 3 test foods were higher in diabetic patients than the corresponding values for the healthy subjects (all; P < 0.001). Generally, roti elicited the highest total incremental glucose responses in the diabetic patients irrespective of ethnic group (P < 0.05). CONCLUSION: There were variations in glucose and insulin responses to the 3 test foods. However, roti elicited the highest postprandial hyperglycaemia and should therefore be discouraged in regular dietary plan of diabetic patients.
Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Carbohidratos de la Dieta/administración & dosificación , Carbohidratos de la Dieta/farmacocinética , Insulina/sangre , Antropometría , Área Bajo la Curva , Estudios Cruzados , Ayuno , Femenino , Prueba de Tolerancia a la Glucosa , Humanos , Masculino , Persona de Mediana Edad , Periodo Posprandial , Indias OccidentalesRESUMEN
Summary - BACKGROUND & AIM: Previous studies suggest that inadequate glycaemic control in diabetic patients might be related to the type of carbohydrates the patients consume regularly. Thus, we aimed to assess glucose and insulin responses after diabetic and non-diabetic subjects ingested 3 commonly consumed carbohydrate-based foods. METHODS: Thirty-eight type-2 diabetic and 27 non-diabetic subjects were studied in 3 different occasions of 7 days apart. On each day of the study, anthropometric indices were measured and after collecting fasting blood samples, subjects randomly consumed bread, roti or rice within 10 min. Subsequently 7 ml of venous blood samples were collected at 60, 90, 120 and 150 min for determination of glucose and insulin responses. RESULTS: Although the diabetic patients were older than the healthy subjects (P < 0.05), both subjects had similar weight, body mass index and waist and hip circumferences (P > 0.05). The mean fasting and post meal plasma glucose concentrations for the 3 test foods were higher in diabetic patients than the corresponding values for the healthy subjects (all; P < 0.001). Generally, roti elicited the highest total incremental glucose responses in the diabetic patients irrespective of ethnic group (P < 0.05). CONCLUSION: There were variations in glucose and insulin responses to the 3 test foods. However, roti elicited the highest postprandial hyperglycaemia and should therefore be discouraged in regular dietary plan of diabetic patients.