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Is health related quality of life influenced by diabetic neuropathic pain among type II diabetes mellitus patients in Ethiopia?

ABSTRACT: BACKGROUND:Polyneuropathy is one of the commonest complications of long-standing diabetes. Progressive sensory loss can predispose patients to foot ulcer and the neuropathy oftentimes causes pain. The pain can significantly affect the quality of life of patients. OBJECTIVES:To describes the health-related quality of life of patients with type II diabetes mellitus suffering from painful diabetic peripheral neuropathy at two referral hospitals in Addis Ababa, Ethiopia, 2017. METHODS:An institution based cross sectional study with internal comparison was conducted among a sample of 220 type II diabetes mellitus patients in a 1:1 matched ratio of those with and without diabetes associated peripheral neuropathic pain. All were having regular follow up at two hospitals in Addis Ababa, Ethiopia. The Short Form (SF-36) health-related quality of life instrument was used to collect data on quality of life while basic socio-demographic and other disease specific features were collected using a structured questionnaire. Descriptive statistics was used to examine the mean scores of health related quality of life. Cronbach's alpha coefficient and Pearson's correlation coefficient were applied to estimate the internal consistency, and the level of agreement between the different domains of SF-36, respectively. To measure association between health related quality of life domains and explanatory variables, independent T-test and ANOVA were performed followed by multiple linear regression analyses. RESULTS:The health related quality of life of type II diabetes mellitus patients with peripheral neuropathic pain was poorer than those without pain in all the eight domains and the two summary scores by SF-36 (p < 0.001). Higher mean score difference was observed in Mental Component Summary Score (MCS) (14.6) compared to Physical Component Score (PCS) (9.3). Among the eight domains, the largest mean difference was found with the physical one (39.1) followed by mental health (38.2) and physical functioning (30). Pain intensity had a statistically significant negative correlation with all domains as well as the two summary scores. Younger age, a higher level of education, being single, a higher monthly income, normal body mass index, HbA1c less than seven mmo/L, absence of other diabetic complications and taking only oral hypoglycemic agents were found to predict better health related quality of life. CONCLUSION:The presence of diabetic peripheral neuropathic pain was found to negatively influence the health-related quality of life of type II diabetic patients; the greatest impact being on the 'role physical' and 'mental health' domains. Older age, presence of diabetes related complications, longer duration of illness negatively influenced the health-related quality of life.

SUBMITTER: Degu H

PROVIDER: S-EPMC6361436 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Is health related quality of life influenced by diabetic neuropathic pain among type II diabetes mellitus patients in Ethiopia?

Degu Hiwot H Wondimagegnehu Abigiya A Yifru Yared Mamushet YM Belachew Ayele A

PloS one 20190204 2

<h4>Background</h4>Polyneuropathy is one of the commonest complications of long-standing diabetes. Progressive sensory loss can predispose patients to foot ulcer and the neuropathy oftentimes causes pain. The pain can significantly affect the quality of life of patients.<h4>Objectives</h4>To describes the health-related quality of life of patients with type II diabetes mellitus suffering from painful diabetic peripheral neuropathy at two referral hospitals in Addis Ababa, Ethiopia, 2017.<h4>Meth ...[more]

PMID: 30716109

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Project description:Background/objectiveThe prevalence of diabetic ketoacidosis (DKA) in gestational diabetes mellitus (GDM) is very low. We describe a patient with GDM in whom severe DKA with intrauterine fetal demise developed in the setting of nonadherence to therapy.Case reportA 33-year-old woman, G2P0010, with no preexisting diabetes mellitus (DM) presented at 30 weeks of gestation with acute-onset altered sensorium, nausea, and emesis. GDM was diagnosed at 15 weeks of gestation with a serum glucose level of 266 mg/dL (70-134 mg/dL) after 1-hour 50-gram glucose challenge test. Glycated hemoglobin (HbA1C) was 5.9% (41 mmol/mol) at the time of GMD diagnosis. Insulin was initiated at week 20 of gestation. On presentation, serum glucose level of 920 mg/dL (70-110 mg/dL), pH of 7.02 (7.32-7.43), anion gap level of 38 mmol (5-17 mmol), bicarbonate level of 5.0 mEq/L (22-29 mEq/L), and large serum ketones were found. Ultrasound showed intrauterine fetal demise. She received intravenous fluids and continuous insulin. Following the spontaneous delivery of a nonviable fetus, DKA was resolved. Negative antiglutamic acid decarboxylase, islet cell, and zinc transporter 8 antibodies, C-peptide level of 2.4 ng/dL (1.1-4.4 ng/dL), and HbA1C level of 9% (75 mmol/mol) were found. Inpatient management included basal-bolus and sliding scale insulin therapies. Metformin was added upon discharge 7 days after admission. The HbA1C levels were 5.3% (34 mmol/mol) and 5% (31 mmol/mol) at the 3- and 6-month follow-ups, respectively. Insulin was discontinued. Currently, the patient is on metformin and glucagon-like peptide 1 receptor agonist.DiscussionThe development of insulin resistance during pregnancy is driven by multiple factors. Approximately 1% to 2% of pregnant women with impaired glucose tolerance develop DKA; most cases occur in women with type 1 DM. The approximate incidence of DKA in GDM is 0.02%.ConclusionDKA complicating GDM is extremely infrequent, but it cannot be dismissed. Early recognition along with prompt and appropriate medical and obstetrical management is critical.

Project description:IntroductionDiabetes mellitus is a metabolic disorder resulting from either loss of insulin producing cells, insufficient insulin action, or both. Knowledge can play an important role in preventing diabetes mellitus and its complications. There is limited information regarding knowledge and related factors regarding diabetes mellitus among non-diabetic adult community members in the study area. Therefore, the current study aimed to determine knowledge and associated factors towards diabetes mellitus among non-diabetes community members of Gondar city.MethodsCommunity-based cross-sectional study was conducted on non-diabetic community members from July 1-29, 2019 in Gondar city. The participants were selected randomly from each households. A structured questionnaire was used to collect the data. EpiData version 3.1 was used for data entry and SPSS version 20 was used for data processing and analysis. Descriptive statistics were calculated for most variables. Multivariable logistic regression was used to identify the associated factors. A variable was considered significantly associated at p-value<0.05.ResultA total of 633 study subjects participated in this study with a mean age of 36.12 (± 12.87) years. Of these study participants, 572 had awareness about diabetes mellitus and 51.4% (95% CI: 47.4%, 55.8%) had good knowledge. Being male [Adjusted odds ratio = 1.62 (95% CI: 1.05, 2.48)], monthly income of 3000-5000 birr [Adjusted odds ratio = 1.88 (95% CI: 1.03, 3.41)], monthly income of ?5001 birr [Adjusted odds ratio = 2.37 (95% CI: 1.17, 4.78)], previous training on diabetes mellitus [Adjusted odds ratio = 4.37 (95% CI; 3.04, 7.37)], being grade 9-12 [Adjusted odds ratio = 3.1 (95% CI: 1.09, 8.66)], having college and above educational qualification [Adjusted odds ratio = 3.70 (95% CI: 1.26, 10.85)] were significantly associated with good knowledge towards diabetes mellitus.ConclusionThe level of knowledge regarding diabetes mellitus was low among study participants which indicates a need for health education intervention. Previous training on diabetes mellitus, educational status and average monthly income and being male were the factors associated with good knowledge of participants about diabetes mellitus.

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Is health related quality of life influenced by diabetic neuropathic pain among type II diabetes mellitus patients in Ethiopia?

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Is health related quality of life influenced by diabetic neuropathic pain among type II diabetes mellitus patients in Ethiopia?

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