Disease Management Programme for Diabetes Mellitus in Nepal

Dulal, Ram Krishna; Karki, Shristi

doi:10.31729/jnma.289

Cited by 8 publications

(5 citation statements)

References 6 publications

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“…This study shows significant decrease in total serum calcium level in hypertensive patients than normotensive controls and the results are in close agreement with that of others who also found a significant decrease in serum calcium in patients with essential hypertension . 7,8 Though there are not enough study describing the relation of serum calcium and hypertension, but the findings of the present study are in agreement with that of Sudhakar, Sujhata, Babu, Padmanathi and Reddy. 28 Toyuz et al also reported reduced serum calcium level in hypertensive individuals.…”

Section: Totalsupporting

confidence: 91%

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Effect of Metformin in HbA1C in Nepalese type 2 diabetes

Tiwari¹

2014

jgpeman

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Introduction: Up to now a limited number of studies compared metformin with other OHA directly and some of their results are still controversial.1 The study which compared metformin and other OHA, the ADOPT study, the U.K. Prospective Diabetes Study (UKPDS), did not include Nepalese diabetic patients . Therefore, the aim of study was the comparative evaluation of metformin and other OHA influence on glycemic control(HbA1c) in Nepalese patients with diagnosed type 2. Methods: A prospective cross sectional database of patients treated at diabetic clinic, TUTH, were analyzed. Patients with type 2 diabetes with HbA1c (A1C) data and treated with metformin and other OHA, for at least three visits were included (n = 115). Analysis by HbA1c and the type of oral agent was performed. Results: In the analyzed group of patients, the mean duration of therapy was for 9 months. Metformin was given to 48 patients and 57 patients were on other OHA. In the metformin group mean HbA1c level (from 7.8 Â± 1.8 at baseline to 6.7 Â± 0.8 at the end of analysis period; p<0.05). The highest mean HbA1c at baseline (7.8 Â± 1.8) was observed in the group treated with metformin; the same group experienced the highest drop in HbA1c levels (by .7, from 7.8 Â± 1.8 to7.1 Â± 0.9). The comparable decrease in HbA1c (by .5 from 7.6 Â± 2.1 to 7.1 Â± 1.2) was also found in the group treated with other OHA. Conclusion: We conclude that metformin is as efficacious and is a good agent of chice to reduce HbA1c. Our study provides evidence-based data to support metformin use in Nepalese individuals with type 2 diabetes.

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Section: Totalsupporting

confidence: 91%

“…6 The percentage of diabetic patients has increased from 19.04% in 2002 to 25.9% in 2009 in Nepal. 7 .…”

Section: Introductionmentioning

confidence: 99%

Effect of Metformin in HbA1C in Nepalese type 2 diabetes

Tiwari¹

2014

jgpeman

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“…Low- and middle-income countries bear a burden of about three quarters of diabetic population [ 1 ]. The prevalence of diabetes in Nepal is increasing [ 2 , 3 ] and is projected to reach 17.49% by 2020 [ 3 ]. Insulin is the indispensable component of the management of DM [ 4 ], and the proportions of patients using insulin vary from country to country [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Insulin Injection Practice among Diabetes Patients in a Tertiary Healthcare Centre in Nepal: A Preliminary Study

Poudel

Shrestha

Piryani

et al. 2017

Journal of Diabetes Research

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Introduction Proper insulin injection practice is essential for better diabetic control. This study aims to assess the insulin injection practice of patients with diabetes. Materials and Methods A cross-sectional study was conducted at Chitwan Medical College Teaching Hospital, Bharatpur, Nepal, from February 2017 to May 2017. Patients injecting insulin through insulin pens (n = 43) for a minimum of 4 weeks were consecutively recruited. Patients' baseline characteristics, current insulin injection technique, insulin transportation practice, complications of insulin injection, disposal practice of used needle, and acceptability of insulin were recorded. Descriptive statistics were performed using IBM-SPSS 20.0. Results The insulin injection technique of patients and their relatives was inadequate. The majority of patients and their relatives (25, 58.1%) mentioned that they transport their insulin cartridge without maintaining cold chain. Thirteen patients (30.2%, n = 43) reported complications of insulin injection and the most common complication among those patients was bruising (10, 76.9%, n = 13). Almost all patients disposed the used needle improperly, and the common method was disposing the needle in a dustbin and then transferring to municipal waste disposal vehicle. Insulin was accepted by just 16 (37.2%) patients. Conclusion There was a significant gap between the insulin delivery recommendation through insulin pen and current insulin injection practice.

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“…Of all 52 macro-vascular complications CAD (n=30, 57.6%) were major, followed by Stroke (n=8, 15.38%), PVD (n= 8, 15.3%), CAD, PVD (n=3, 5.76%), and CAD, Stroke (n=3,5.76%). (Dulal and Karki, 2009;Juarez et al, 2006) Figure 4, shows different therapies used by type II diabetic patients in our study. Of all these therapies, dual therapy usage was mostly identi ied.…”

Section: Resultsmentioning

confidence: 98%

An analytical study of the prevalence and prescribed pattern vascular complication for type II diabetic patient in Indian tertiary care hospitals

Sekhar

Pandiyan

et al. 2020

ijrps

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Diabetes mellitus (DM) is a common metabolic disorder. It is associated with complications which will affect the quality of life. Failure to control elevated blood sugar or inadequate treatment of diabetes could cause many complications. A prospective observational study is used to assess the prevalence of diabetic vascular complications in 105 types of II diabetic patients. A date was collected regarding patient's demographic and clinical characteristics. Based on our study criteria, males were more when compared to females in getting vascular complications & also. Complications were more prominent in the age group of 50-65years. Of all microvascular complications, Nephropathy was major, whereas, in macro-vascular complications, CAD was prominent. Poor glycemic control and a long length of ailment appear to be the most significant danger factors for these complexities. Doctors assume a significant function to endorse hostile to diabetic meds and Pharmacist plays a sharp task to assess the medicine design so as to accomplish fruitful treatment. The currently anti-diabetic drugs are effective, but a lot of factors such as patient adherence, education related to diabetes, lifestyle modification, cost and type of medication have an association with glycemic control. The commonly prescribed anti-diabetic drug was Insulin. Metformin was the most preferred drug both as monotherapy and combination therapy. Although polypharmacy was observed, drug utilization pattern can be rational owing to a higher prevalence of complications. Minimization of the occurrence of complications should be courage by early diagnosis, intensive blood glucose control and rational drug selections.

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Disease Management Programme for Diabetes Mellitus in Nepal

Abstract: Abstract

Cited by 8 publications

References 6 publications

Effect of Metformin in HbA1C in Nepalese type 2 diabetes

Effect of Metformin in HbA1C in Nepalese type 2 diabetes

Assessment of Insulin Injection Practice among Diabetes Patients in a Tertiary Healthcare Centre in Nepal: A Preliminary Study

An analytical study of the prevalence and prescribed pattern vascular complication for type II diabetic patient in Indian tertiary care hospitals

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