Public health care system, a quasi-experimental study: Acceptance and attitude to implicate clinical services

Current Therapeutic Research

et al. 2019

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Background Diabetes Mellitus is a progressive, chronic and multifactorial endocrine disorder characterized by elevated serum glucose levels. It has a direct effect to social and health related quality of life. Objective This study aimed to determine the health-related quality of life among patients with type II diabetes mellitus (T2DM) using insulin therapy. Methods Cross-sectional observational study design was used to collect data from Malaysian patients with T2DM. Subjective and objective assessments were made either by using several questionnaires or each patient's specific medication profile registered to care sites. Study participants were recruited from both public hospitals and community health clinics located in Kuala Lumpur, Malaysia. Results A total of 430 patients with T2DM were recruited in this study with a response rate of 94.7%. The oral antidiabetic medication (OAM) group consisted of 63.0% of the study population and the rest (37.0%) were Insulin users. The body mass index and glycosylated hemoglobin patterns were significantly different between groups ( P < 0.011 and P < 0.001). Insulin users showed high percentages of healthy body mass index index (44.7%) compared with OAM users (35.8%) and controlled glycemic index (glycosylated hemoglobin ≤7.5%) was significantly ( P = 0.001) better among the insulin-user group compared with the OAM group. The Euro Quality of Life–5 dimension domain analysis indicated significant differences with domains of usual work ( P < 0.047), pain and discomfort ( P < 0.041), and anxiety and depression ( P < 0.001) among insulin users versus OAM users. We also observed a significant difference between the groups regarding diet, monitoring, and disease-specific knowledge. The mean (SD) adherence score showed that insulin users were significantly ( P < 0.001) more adherent (6.09 [2.98]) than OAM were nonadherent (4.19 [4.68]). Conclusions This study suggests the valuable effect of insulin therapy among patients with T2DM compared with OAMs on health-related quality of life, medication adherence, and health state. Insulin users reported they had better diabetes-related knowledge and treatment adherence characteristics than noninsulin users.

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors of Health-Related Quality of Life Among Patients with Type II Diabetes Mellitus Who Are Insulin Users: A Multidimensional Model

Current Therapeutic Research

et al. 2019

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“…Therefore, T2DM is considered as a major threat to public health [ 5 ]. Early incidence of T2DM in adults increased the risks of both micro and macrovascular complications which in term lead to poor health-related quality of life [ 6 – 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…Diabetes management focus on multifactorial concept, several demographic, clinical as well as behavioral factors influence the patient-specific disease outcomes [ 7 , 10 ]. Glycemic control is one of the ultimate tools to evaluate the patient’s disease progression and treatment success [ 3 , 6 ] however, clinical literature showed that not only treatment but patient’s perception and self-care behavior are also strong mediating factors for glycemic control among T2DM patients [ 3 , 6 , 8 , 11 ]. Several studies have shown positive effect of self-care management to glycemic index [ 4 , 7 , 9 – 11 ], also diabetic-related knowledge is considered as an important factor for development/improvement in self-care behavior and practices [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Bridging glycated hemoglobin with quality of life and health state; a randomized case–control study among type 2 diabetes patients

et al. 2018

Diabetol Metab Syndr

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BackgroundThe aim of this study was to explore the predictors of QOL and health state and examine the relationship with glycemic control among type 2 diabetes mellitus (T2DM) patients.MethodsA randomized cross-sectional case–control study was conducted among n = 600 T2DM patients of Malaysia. Study population was distributed into three groups as: controls: patients with HbA1c ≤ 7 (n = 199), cases arm 1: with HbA1c 7–7.9 (n = 204) and cases arm 2 (n = 197): with HbA1c ≥ 8 consecutively last 3 times.ResultsParticipants with diabetes history > 10 years exhibits higher mean QOL score among all the three groups. In contrast mean health status score significantly (p < 0.001) reduced with the exposure duration of diabetes both within and intergroup assessment that participants with poor glycemic control (arm 2) had significantly higher mean QOL score with knowledge and self-care dimensions as compared to others, however mean health state scores were significantly (p < 0.001) lower in all assessment dimensions as compared to controls. The F test of significance showed that demographic and clinical parameters were strong predictors of QOL, whereas self-care activities, comorbidities, ability of positive management and BMI were significant predictors to health state for consistent glycemic control (controls) as compared to poor glycemic control (arm 2) participants.ConclusionThis study suggested that poor glycemic index reported low self-care behavior, increase barriers to daily living activities and poor ability to manage diabetes positively, which cause poor QOL and decrease health state.

“…Self-care is the one of the important factor for achieving optimal glycemic levels among patients with IDDM [ 2 , 3 ]. Diabetes patients are responsible for their daily care, such as self-monitoring blood glucose (SMBG), diet management, and insulin dose adjustments [ 5 , 6 ]. Diabetes affects the daily life functioning therefore, lowering the health status and QOL among patients [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

Women with Type 1 Diabetes Mellitus: Effect of Disease and Psychosocial-Related Correlates on Health-Related Quality of Life

Journal of Diabetes Research

et al. 2018

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Background This study is aimed at investigating the various disease-specific and health-related psychosocial concepts of HRQOL among insulin-dependent diabetes mellitus (IDDM) and understanding the gender differences in HRQOL among IDDM patients. Methods A cross-sectional observational study was conducted to assess the effect of health-related and psychosocial correlates on HRQOL of IDDM patients in Penang, Malaysia. The participants were recruited from five governmental diabetic clinics. Patients with insulin use only, IDDM diagnosed at least 1 year earlier, were identified from clinical registers. The sample was then age stratified for 20–64 years, and severe complications (e.g., end-stage renal failure, hemodialysis, and liver cirrhosis) were excluded; a total of 1003 participants were enrolled in the study. Multivariate regression analysis was used to predict the response. Results A total of 853 (100%) participants were enrolled and completed the study. Women exhibited significantly higher/better mental health (p < 0.013) and health perception scores (p < 0.001) despite high prevalence of impaired role (49.2%), social (24.2%), and physical (40.5%) functionings as compared to men. Women with longer diabetes exposure and uncontrolled glycemic levels (HbA1c) have poorer HRQOL. Availability of social support showed no significant association with either HRQOL or diabetes distress levels. Diabetes distress levels remained not associated with social support. Women also showed significantly higher association with health perception (15% versus 13% men, p < 0.001) and mental health (13% versus 11% men, p < 0.001) in diabetes-specific psychosocial factors. Thus, among women alone, diabetes-related specific and psychosocial factors explained 15% and 13% of variations in HRQOL extents, respectively. Conclusion Women exhibit extensive and significant patterns with health-related factors and diabetes-specific psychosocial factors (self-efficacy, social support, and DLC) to improve HRQOL. Also, women have significantly high reported distress levels and low social functioning compared to men.