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      Relationship between glycemic control and perceived family support among people with type 2 diabetes mellitus seen in a rich kinship network in Southwest Nigeria


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          Objective: The practice of diabetes self-care behaviors has been cited as a foundation for achieving optimal glycemic control. Proper motivation of people with diabetes mellitus is, however, needed for the performance of these behaviors. It is therefore pertinent to know if motivation by the family will improve glycemic control in people with type 2 diabetes mellitus. This study aimed to investigate the relationship between glycemic control and perceived family support among Nigerians with type 2 diabetes mellitus.

          Methods: A cross-sectional study was conduced on 316 adults with type 2 diabetes mellitus who attended a medical outpatient clinic. Data were collected through a pretested interviewer-administered questionnaire and a standardized tool (Perceived Social Support – Family scale). Hemoglobin A 1c level was used as an indicator of glycemic control.

          Results: The proportion of participants with good glycemic control was 40.6%. Most of the participants (137, 43.8%) had strong perceived family support. Strong perceived family support ( P=0.00001, odds ratio 112.51) was an independent predictor of good glycemic control.

          Conclusion: This study shows that strong perception of family support is a predictor of glycemic control among the adults with type 2 diabetes mellitus studied. Physicians working in sub-Saharan African countries with rich kinship networks should harness the available family support of people with type 2 diabetes mellitus in their management.

          Most cited references29

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          Measures of perceived social support from friends and from family: three validation studies.

          Three studies are described in which measures of perceived social support from friends (PSS-Fr) and from family (PSS-Fa) were developed and validated. The PSS measures were internally consistent and appeared to measure valid constructs that were separate from each other and from network measures. PSS-Fr and PSS-Fa were both inversely related to symptoms of distress and psychopathology but the relationship was stronger for PSS-Fa. PSS-Fr was more closely related to social competence. PSS-Fa was unaffected by either positive or negative mood states (self-statements), but the reporting of PSS-Fr was lowered by negative mood states. High PSS-Fr subjects were significantly lower in trait anxiety and talked about themselves more to friends and sibs than low PSS-Fr subjects. Low PSS-Fa subjects showed marked verbal inhibition with sibs.
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            Prevalence of diabetes complications in people with type 2 diabetes mellitus and its association with baseline characteristics in the multinational A1chieve study

            Background Current International Diabetes Federation guidelines recommend a target HbA1c <7.0%, but many people with diabetes worldwide find this difficult to achieve, increasing their risk of developing complications. This publication examines the prevalence of diabetes complications and its association with baseline characteristics in people with type 2 diabetes who participated in the A1chieve study. Methods A1chieve was a 24-week, multinational, open-label, observational study of 66,726 people with type 2 diabetes who had begun using biphasic insulin aspart 30, insulin aspart, or insulin detemir in routine clinical care. Participants were enrolled from 28 countries across four continents (Asia, Africa, Europe and South America). Baseline measurements of disease characteristics included: glycated haemoglobin (HbA1c), fasting (FPG) and post-prandial plasma glucose (PPG), high- and low-density lipoprotein cholesterol (H- or LDL-C), systolic blood pressure (SBP), and body mass index (BMI). Data on complications and use of vascular disease preventative drugs were collected. Results Complication rates were high (27.2% had macrovascular complications and 53.5% had microvascular complications), particularly in Russia, and use of vascular disease preventative drugs was lower than expected. Age, BMI, diabetes duration, LDL-C, and SBP were positively associated, and HDL-C negatively associated, with macro- and microvascular complications (all p < 0.05). HbA1c and FPG were negatively associated with macrovascular complications (both p < 0.05), which may be linked to the cross-sectional study design. Conclusions These results suggest a worldwide failure to achieve glycaemic targets. Better diabetes management with earlier initiation and optimisation of insulin regimens (e.g., with insulin analogues in the A1chieve population) may reduce the prevalence of vascular complications, improve the lives of people with diabetes and reduce the burden on healthcare systems.
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              A Systematic Review: Family Support Integrated with Diabetes Self-Management among Uncontrolled Type II Diabetes Mellitus Patients

              The rate of type-2 diabetes mellitus (T2D) is dramatically increasing worldwide. Continuing diabetes mellitus (DM) care needs effective self-management education and support for both patients and family members. This study aimed to review and describe the impacts of diabetes mellitus self-management education (DSME) that involve family members on patient outcomes related to patient health behaviors and perceived self-efficacy on self-management such as medication adherence, blood glucose monitoring, diet and exercise changes, health outcomes including psychological well-being and self-efficacy, and physiological markers including body mass index, level of blood pressure, cholesterol level and glycemic control. Three databases, PubMed, CINAHL, and Scopus were reviewed for relevant articles. The search terms were “type 2 diabetes,” “self-management,” “diabetes self-management education (DSME),” “family support,” “social support,” and “uncontrolled glycaemia.” Joanna Briggs Institute (JBI) guidelines were used to determine which studies to include in the review. Details of the family support components of DSME intervention and the impacts of these interventions had on improving the health outcomes patients with uncontrolled glycaemia patients. A total of 22 intervention studies were identified. These studies involved different DSME strategies, different components of family support provided, and different health outcomes to be measured among T2D patients. Overall, family support had a positive impact on healthy diet, increased perceived support, higher self-efficacy, improved psychological well-being and better glycemic control. This systematic review found evidence that DSME with family support improved self-management behaviors and health outcomes among uncontrolled glycaemia T2D patients. The findings suggest DSME models that include family engagement can be a useful direction for improving diabetes care.

                Author and article information

                Family Medicine and Community Health
                Compuscript (Ireland )
                December 2018
                December 2018
                : 6
                : 4
                : 168-177
                [1] 1Family Medicine Department, Federal Medical Centre, Abeokuta, Nigeria
                Author notes
                CORRESPONDING AUTHOR: Dr. Oluwaseun Solomon Ojo Department of Family Medicine, Federal Medical Centre, Abeokuta, +234 Ogun State, Nigeria, Tel.: +234-8035020964, E-mail: ojo_teenager@ 123456yahoo.com
                Copyright © 2018 Family Medicine and Community Health

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

                : 5 April 2018
                : 5 July 2018
                Page count
                Pages: 10
                Original Research

                General medicine,Medicine,Geriatric medicine,Occupational & Environmental medicine,Internal medicine,Health & Social care
                Glycaemic control,perceived family support,Nigeria,type 2 DM,kinship


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