Glycemic Control for Type 2 Diabetes Mellitus Patients: A Systematic Review

Rakhis, Saud A Bin; AlDuwayhis, Nawaf Mohammed; Aleid, Naif; AlBarrak, Abdullah Nasser; Aloraini, Abdullah

doi:10.7759/cureus.26180

Cited by 44 publications

(46 citation statements)

References 29 publications

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“…We will evaluate the impact of the interventions on any of the following outcomes: Good glycemic control. Defined by the American college of endocrinologists as glycated hemoglobin (HbA1c %) levels below 7% or fasting blood sugar levels below 110mg/dl (6.1 mmol/l)(4). Diabetes awareness.…”

Section: Methodsmentioning

confidence: 99%

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Impact of health systems interventions in primary health settings on type 2 diabetes care and health outcomes among adults in West Africa: a systematic review protocol

Bondzie,

Jahan,

Balabanova

et al. 2023

Preprint

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Type 2 diabetes remains a major global public health challenge particularly in the African region. Though evidence exists on pharmacological agents and non-pharmacological interventions in maintaining blood glucose concentration, the health systems ability in meeting patients’ needs may be inadequate. However, the management of non-communicable diseases particularly diabetes, have been postulated to depend largely on functioning health systems. This systematic review will therefore, summarize the current evidence on existing health systems interventions in primary health settings for type 2 diabetes care and health outcomes in West Africa and would explore the impact of these system-level interventions on service availability, accessibility and quality, as well as individualized outcomes such as glycemic control, disease awareness and treatment adherence. The review will be conducted in accordance with the reporting guidance provided in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). The health system framework by Witter et al, 2019 will guide the system-level interventions and the search strategy to be explored in this review. This framework was designed to integrate the six building blocks of the World health’s organization (WHO) health systems framework and delineates how they work synergistically to improve specific health outcomes. We will search the following databases PubMed, Google scholar and Cumulated Index to Nursing and Allied Health Literature (CINAHL) between January 2000 to June 2023 and Car.info from inception to June 2023. The Cochrane Collaboration tool for assessing Risk of Bias will be implemented on each included study to assess for risk of bias. We will conduct a narrative synthesis and make comparisons across findings using Excel generated tables. The main limitation of this study is that we are likely to miss out on studies not conducted in English or French since our search would be conducted in English and French only. In Conclusion, this systematic review will outline the existing system-level interventions that aim to or already improve type 2 diabetes services in primary health facilities in West Africa and would allow for strengthening and co-production of successful interventions that can be generalised to the entire sub-region.

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Section: Methodsmentioning

confidence: 99%

“…Good glycemic control. Defined by the American college of endocrinologists as glycated hemoglobin (HbA1c %) levels below 7% or fasting blood sugar levels below 110mg/dl (6.1 mmol/l)(4).…”

Section: Methodsmentioning

confidence: 99%

Impact of health systems interventions in primary health settings on type 2 diabetes care and health outcomes among adults in West Africa: a systematic review protocol

Bondzie,

Jahan,

Balabanova

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Clinical factors, medication-related factors and behavioural factors also play crucial roles in determining glycaemic control, highlighting the complex interplay of factors that influence diabetes management outcomes. 28 A correlated study pooled odds ratio for lower extremity amputation (LEA) and reported 2.04 (95% CI: 0.91-4.57) in cohort studies comparing A1C >7.0%-7.5% versus lower A1C levels and 4.80 (95% CI: 2.80-8.13) in studies comparing A1C 8% versus 8%. Results indicated that A1C levels 8% and fasting glucose levels 126 mg/dL are associated with an increased risk of LEA in patients with DFUs.…”

Section: Glycaemic Controls In Diabetic Foot Patientsmentioning

confidence: 99%

Analysis of risk factors of infection in diabetic foot patients

Hsu,

Li,

Poon

2023

International Wound Journal

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This cross‐sectional study assessed the risk factors for infection in 150 diabetic foot patients admitted to the Xiamen University Hospital between October 2020 and October 2022. Patients were categorised as infected (n = 80) or uninfected (n = 70) cohorts. The diabetic foot was evaluated using the American Diabetic Foot Grading system, whereas ulcers were categorised using Wagner's method. Analysed were patient‐specific information, clinical data and risk factors including neuropathy, arterial disease and foot deformities. Our findings revealed no statistically significant differences between infected and uninfected cohorts concerning age, body mass index, gender, duration of diabetes or ankle‐brachial index values (p > 0.05). However, infected group had a higher proportion of smokers and reduced socio‐economic status (p < 0.05). Wagner grades indicated a greater severity in the infected group, with grade 3, grade 4 and grade 5 differing significantly (p < 0.05). Comparative analysis of ulcer characteristics revealed no statistically significant differences in ulcer surface area and depth, but the infected group had a higher prevalence of osteomyelitis and a greater number of ulcers (p > 0.05). Blood vessel complications, retinopathy, the presence of three or more ulcers, osteomyelitis and diabetic nephropathy were substantially more prevalent in the infected group, as determined by univariate analysis (p < 0.05). Subsequent multivariate logistic analysis revealed that patients with blood vessel complications, retinopathy, osteomyelitis, diabetic nephropathy and three or more ulcers were at increased risk for infection (p < 0.05). In addition, lifestyle factors, such as smoking, sedentary behaviour, inadequate foot hygiene, obesity and poor glycaemic control, were also associated with higher infection rates. A multivariate analysis of foot wound factors revealed that deeper, longer and recurrent lesions increased the likelihood of infection. Escherichia coli was the most frequently isolated bacterium from the infected group's bacterial culture, followed by Pseudomonas aeruginosa and Staphylococcus aureus. The study enhanced our comprehension of the multifactorial risk factors associated with infections in diabetic foot patients, highlighting the need for thorough clinical evaluation, lifestyle modification and vigilant infection control.

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“…Therefore, good glycaemic control in diabetics is essential to reduce the risk of these acute and chronic conditions. 1–3 This is generally achieved by self-monitoring of blood glucose levels which is predominantly conducted using electrochemical biosensors. These devices can either be enzymatic or non-enzymatic and typically employ amperometric detection.…”

Section: Introductionmentioning

confidence: 99%