scholarly journals The Barriers and Facilitators of Self-Management Among Adults with Type 2 Diabetes Mellitus: A Trans Theoretical Model (TTM)-Based Mixed Method Study in Iran

2020 ◽  
Vol Volume 13 ◽  
pp. 2687-2699
Author(s):  
Maryam Zare ◽  
Ali Tarighat-Esfanjani ◽  
Maryam Rafraf ◽  
Abdolreza Shaghaghi ◽  
Mohammad Asghari-Jafarabadi ◽  
...  
Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Kuan Liang Shawn Goh ◽  
Cia Sin Lee ◽  
Choon Huat Gerald Koh ◽  
Ng Ling Ling ◽  
Seng Bin Ang ◽  
...  

Abstract Background Regular supervision of patients with type-2 diabetes mellitus (T2DM) by healthcare providers is essential to optimise their glycaemic control but is challenging to achieve in current care models. Telemonitoring is postulated to bridge this gap by leveraging on internet-of-things and mobile-health technology. This study aims to determine the effectiveness of a novel telemonitoring system (OPTIMUM) in improving the glycaemic control of patients with T2DM compared with standard of care alone. Methods This mixed-method study comprises an initial randomised controlled trial involving 330 Asian adults with T2DM, aged 26–65 years old with an HbA1c of 7.5–10%, with 115 in the intervention and control arms each. Those in the intervention arm will use standardised Bluetooth-enabled devices to transmit their capillary glucose, blood pressure and weight measurements to the OPTIMUM system. Primary care physicians and nurses will remotely supervise them according to an embedded management algorithm for 6 months, including tele-education via weekly videos over 8 weeks and asynchronous tele-consultation if abnormal or absent parameters are detected. Patients in both arms will be assessed at baseline, 6, 12 and 24 months post-recruitment. The primary outcome will be their HbA1c difference between both arms at baseline and 6 months. Blood pressure and weight control; quality of life, medication adherence, confidence in self-management, diabetic literacy and related distress and healthcare utilisation using validated questionnaires; and incident retinal, renal, cardiac and cerebrovascular complications will be compared between the two arms as secondary outcomes at stipulated time-points. Intervention arm patients will be interviewed using qualitative research methods to understand their experience, acceptance and perceived usefulness of the OPTIMUM system. Discussion Overall, this study seeks to evaluate the effectiveness of cultural-adapted telemonitoring system in improving glycaemic control of Asians with type-2 diabetes mellitus compared to standard of care. The results of this trial will better inform policy makers in adopting telemedicine for population health management. Trial registration ClinicalTrials.gov NCT04306770. Registered on March 13, 2020.


2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Li Yang ◽  
Kun Li ◽  
Yan Liang ◽  
Qiuli Zhao ◽  
Dan Cui ◽  
...  

Abstract Background It has previously been established that patients who have strong barriers to their diet self-management are more likely to have weak social support; however, the key mechanisms underlying the association between these two variables have not yet been established. This study aims to examine the potential role that diet self-efficacy plays in the relationship between social support and diet behavior in patients with type 2 diabetes mellitus (T2DM). Methods It was a cross-sectional survey. Three hundred-eighty patients diagnosed with T2DM were recruited for this study from five community health centers in China. The Chronic Disease Resource Scale (CIRS), Cardiac Diet Self-efficacy Scale (CDSE), and Food Control Behavior Scale (FCBS) were used to estimate participants’ utilization of social resources, diet self-efficacy, and diet self-management, respectively. The data were analyzed utilizing structural equation modelling. Results The results suggest that both higher levels of social support and diet self-efficacy are related to higher levels of diet self-management. The mediating effect that diet self-efficacy has on the relationship between social support and diet self-management was significant (β = .30, p < .05), explaining 55.68% of the total effect of social support on diet self-management. Conclusions Diet self-efficacy plays a mediating role in the association between social support and diet behavior in patients with type 2 diabetes mellitus.


Author(s):  
Wahyu Sukma Samudera ◽  
Novita Fajriyah ◽  
Ida Trisnawati

Background: Type 2 diabetes mellitus was one of non-communicable diseases that increased of prevalence in word wide, included in Indonesia. Utilization of technology as an effort of increase of diabetes treatment is important for achieving of optimum glycemic control and to prevent of complication of diabetes mellitus. However, intervention for self management in patients with diabetes mellitus at this time still not using technology based mobile health intervention. Purpose: This study aims to verify of effectiveness of mobile health intervention on self management and glycemic control in patient with type 2 diabetes mellitus. Method: Design of this studies was used systematic review of randomized controlled trial with PRISMA approach. Article search was carried out through databases: Scopus, Science Direct, and ProQuest with randomized controlled trial design within last 10 years. Results: The finding showed 407 articles have been obtained. Articles selection process were through few steps: topic selection, full text selection, design of studies and obtained 10 articles have been as appropriate of inclusion criteria. Based on results of finding of 10 articles were showed that mobile health intervention was effective in improving of glycemic control by decreasing hbA1c, fasting blood glucose, 2 hours post pandrial. Furthermore, mobile health intervention was effective in increasing of self management in patient with type 2 diabetes mellitus and increased adherence of diabetes medication. Moreover, mobile health intervention can also improve of insulin level and lipid profile in patient with type 2 diabetes mellitus. Conclusion: Mobile health intervention was effective in improving of glycemic control and self management, and giving of facilitate communication between patient and health providers Keywords: mobile health application; self management; glycemic control; diabetes mellitus ABSTRAK Latar belakang: diabetes melitus (DM) tipe 2 merupakan salah satu penyakit tidak menular yang mengalami peningkatan angka kejadian di dunia, termasuk di Indonesia. Penggunaan teknologi sebagai upaya meningkatkan manajemen diabetes melitus sangatlah penting untuk dilakukan guna mencapai kontrol glikemik optimal dan mencegah komplikasi dari Diabetes Melitus. Namun, manajemen diri pada sebagian besar pasien Diabetes Melitus saat ini masih belum menggunakan bantuan teknologi berbasis mobile health. Tujuan: Penelitian ini bertujuan untuk memverifikasi efektivitas dari penggunaan mobile health intervention terhadap manajemen diri dan kontrol glikemik pasien dengan diabetes melitus tipe 2. Metode: desain dalam penelitian ini adalah systematic review dengan menggunakan pendekatan PRISMA. Pencarian artikel dilakukan pada beberapa database yang meliputi: Scopus, Science Direct dan ProQuest dengan desain Randomized controlled trial dalam 10 tahun terakhir. Hasil: hasil temuan didapatkan sejumlah 407 artikel penelitian. Proses seleksi artikel dilakukan beberapa tahap meliputi: seleksi topik, fullteks, desain artikel penelitian dan didapatkan 10 artikel penelitian yang sesuai dengan kriteria inklusi. Berdasarkan hasil temuan dari 10 artikel penelitian yang digunakan, menunjukkan bahwa mobile health intervention efektif dalam memperbaiki kontrol glikemik pasien diabetes melalui penurunan kadar hbA1c, gula darah puasa, 2 jam post pandrial. Selanjutnya, mobile health intervention efektif dalam meningkatkan manajemen diri pasien diabetes dan meningkatkan kepatuhan pengobatan. Selain itu, mobile health intervention juga dapat memperbaiki level insulin dan profil lipid pasien diabetes melitus tipe 2. Kesimpulan: Mobile health intervention efektif dalam memperbaiki kontrol glikemik dan meningkatkan manajemen diri pasien diabetes melitus serta memudahkan komunikasi antara pasien dengan tenaga kesehatan Kata kunci: mobile health application; manajemen diri; kontrol glikemik; diabetes melitus


2021 ◽  
Author(s):  
Elisabeth Höld ◽  
Johanna Grüblbauer ◽  
Martin Wiesholzer ◽  
Daniela Wewerka-Kreimel ◽  
Stefan Stieger ◽  
...  

Abstract Background: the context and purpose of the studyDiabetes mellitus is one of the four priority non-communicable diseases worldwide. It can lead to serious long-term complications and produces significant costs. Due to the chronicle character of the disease, it requires continuous medical treatment and good therapy adherence of those suffering. Therefore, diabetes self-management education (DSME) (and support DSMES) plays a significant role to increase patient’s self-management capacity and improve diabetes therapy. Research indicates that these outcomes might be difficult to maintain. Consequently, effective strategies to preserve the positive effects of DSMES are needed. Preliminary results show that peer support, which means support from a person who has experiential knowledge of a specific behaviour or stressor and similar characteristics as the target population, is associated with better outcomes in terms of HbA1c, cardiovascular disease risk factors or self-efficacy at lower cost compared to standard therapy. Peer-supported instant messaging services (IMS) approaches have significant potential for diabetes management because support can be provided easily and prompt, is inexpensive, and needs less effort to attend compared to standard therapy. The major objective of the study is to analyse the impact of a peer-supported IMS intervention in addition to a standard diabetes therapy on the glycaemic control of type 2 diabetic patients. Methods: how the study will be performedA total of 205 participants with type 2 diabetes mellitus will be included and randomly assigned to intervention or control group. Both groups will receive standard therapy, but the intervention group will participate in the peer-supported IMS intervention, additionally. The duration of the intervention will last for seven months, followed by a follow-up of seven months. Biochemical, behavioural and psychosocial parameters will be measured before, in the middle, and after the intervention as well as after the follow-up.Discussion: a brief summary and potential implicationsDiabetes mellitus type 2 and other non-communicable diseases put healthcare systems worldwide to the test. Peer-supported IMS interventions in addition to standard therapy might be part of new and cost-effective approaches to support patients independent from time and place.Trial registration: If your article reports the results of a health care intervention on human participants, it must be registered in an appropriate registry and the registration number and date of registration should be in stated in this section. If it was not registered prospectively (before enrollment of the first participant), you should include the words 'retrospectively registered'. See our editorial policies for more information on trial registration.ClinicalTrials.gov Identifier: NCT04797429Date of registration: 15 March 2021


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