Management of type 2 diabetes mellitus : a pharmacoepidemiological review
- Authors: Saugur, Anusooya
- Date: 2011
- Subjects: Diabetes , Diabetes -- Management , Diabetes -- Diet therapy , Diabetes -- Prevention , Insulin -- Therapeutic use , Hypoglycemia
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10129 , http://hdl.handle.net/10948/1635 , Diabetes , Diabetes -- Management , Diabetes -- Diet therapy , Diabetes -- Prevention , Insulin -- Therapeutic use , Hypoglycemia
- Description: Type 2 diabetes mellitus (DM) is a progressive disease characterised by hyperglycaemia caused by defects in insulin secretion and insulin action. In early stages of type 2 DM, dietary and lifestyle changes are often sufficient to control blood glucose levels. However, over time, many patients experience β cell dysfunction and require insulin therapy, either alone or in combination with oral agents. There are guidelines available to structure the management of this disease state, including both the use of oral hypoglycaemic agents and or insulin. Besides health complications, there are economic burdens associated with the management of type 2 diabetes mellitus. The aim of this study was to determine the management of type 2 DM in a South African sample group of patients drawn from a large medical aid database. The objectives of the study were: to establish the prevalence of type 2 DM relative to age, examine the nature of chronic comorbid disease states, establish trends in the prescribing of insulin relative to other oral hypoglycaemic agents, investigate cost implications, and determine trends in the use of blood and urine monitoring materials by patients. The study was quantitative and retrospective and descriptive statistics were used in the analysis. DM was found to be most prevalent amongst patients between 50 and 59 years old. Results also demonstrated that 83% of DM patients also suffered from other chronic comorbid diseases, with cardiovascular diseases, especially hypertension and hypercholesterolaemia being the most prominent. This study also revealed that DM is predominantly managed with oral hypoglycaemic agents. Changes in drug prescribing, for chronic disease states such as DM may have medical, social and economic implications both for individual patients and for society and it is envisaged that the results of this study can be used to influence future management of DM. Keywords: Pharmacoepidemiology, management, type 2 diabetes mellitus
- Full Text:
- Date Issued: 2011
- Authors: Saugur, Anusooya
- Date: 2011
- Subjects: Diabetes , Diabetes -- Management , Diabetes -- Diet therapy , Diabetes -- Prevention , Insulin -- Therapeutic use , Hypoglycemia
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: vital:10129 , http://hdl.handle.net/10948/1635 , Diabetes , Diabetes -- Management , Diabetes -- Diet therapy , Diabetes -- Prevention , Insulin -- Therapeutic use , Hypoglycemia
- Description: Type 2 diabetes mellitus (DM) is a progressive disease characterised by hyperglycaemia caused by defects in insulin secretion and insulin action. In early stages of type 2 DM, dietary and lifestyle changes are often sufficient to control blood glucose levels. However, over time, many patients experience β cell dysfunction and require insulin therapy, either alone or in combination with oral agents. There are guidelines available to structure the management of this disease state, including both the use of oral hypoglycaemic agents and or insulin. Besides health complications, there are economic burdens associated with the management of type 2 diabetes mellitus. The aim of this study was to determine the management of type 2 DM in a South African sample group of patients drawn from a large medical aid database. The objectives of the study were: to establish the prevalence of type 2 DM relative to age, examine the nature of chronic comorbid disease states, establish trends in the prescribing of insulin relative to other oral hypoglycaemic agents, investigate cost implications, and determine trends in the use of blood and urine monitoring materials by patients. The study was quantitative and retrospective and descriptive statistics were used in the analysis. DM was found to be most prevalent amongst patients between 50 and 59 years old. Results also demonstrated that 83% of DM patients also suffered from other chronic comorbid diseases, with cardiovascular diseases, especially hypertension and hypercholesterolaemia being the most prominent. This study also revealed that DM is predominantly managed with oral hypoglycaemic agents. Changes in drug prescribing, for chronic disease states such as DM may have medical, social and economic implications both for individual patients and for society and it is envisaged that the results of this study can be used to influence future management of DM. Keywords: Pharmacoepidemiology, management, type 2 diabetes mellitus
- Full Text:
- Date Issued: 2011
Resilience in families living with a Type I diabetic child
- Authors: Coetzee, Mariska
- Date: 2007
- Subjects: Diabetes in children -- South Africa , Diabetes -- Prevention , Stress (Psychology) , Adjustment (Psychology)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9922 , http://hdl.handle.net/10948/665 , Diabetes in children -- South Africa , Diabetes -- Prevention , Stress (Psychology) , Adjustment (Psychology)
- Description: Type I diabetes has the ability to promote change in the family. In truth, although the child with diabetes is the diagnosed patient, the whole family has diabetes. While the challenges that families have to face are many, families seem to have the ability to “bounce back” (i.e., they have resilience). Research on the construct of resilience, and more specifically, family resilience has surged in recent times. However, South African research on family resilience is limited. This study aimed to explore and describe the factors that facilitate adjustment and adaptation in families that include a child living with Type I diabetes. The Resiliency Model of Stress, Adjustment and Adaptation, developed by McCubbin and McCubbin (2001) served as a framework to conceptualise the families’ adjustment and adaptation process. Non-probability purposive and snowball sampling techniques were employed. Sixteen families participated in this study, providing a total of 31 participants. Participants consisted of the caregivers of a family living with a child between the ages of four and 12 with Type I diabetes. The study was triangular in nature, with an exploratory, descriptive approach. A biographical questionnaire with an open-ended question was used in conjunction with seven other questionnaires to gather data. These questionnaires were: The Family Hardiness Index (FHI), the Family Time and Routine Index (FTRI), the Social Support Index (SSI), the Family Problem-Solving Communication (FPSC) Index, the Family Crises-Oriented Personal Evaluation Scales (F-COPES), the Relative and Friend Support Index, and the Family Attachment and Changeability Index 8 (FACI8). Descriptive statistics were used to describe the biographical information. Quantitative data were analysed by means of correlation and regression analysis, and a content analysis was conducted to analyse the qualitative data. The results of the quantitative analysis indicated three significant positive correlations with the FACI8. These variables were family hardiness (measured by the FHI), family problem-solving communication (measured by the FPSC), and family time and routines (measured by the FTRI). The results of the qualitative analysis revealed that social support, the caregivers’ acceptance of the condition, and spirituality and religion were the most important strength factors that contributed to the families’ adjustment and adaptation. Although the study had a small sample and many limitations, the study could be used as a stepping-stone for future research on resilience in families living with chronic medical conditions and will contribute to family resilience research in the South African context.
- Full Text:
- Date Issued: 2007
- Authors: Coetzee, Mariska
- Date: 2007
- Subjects: Diabetes in children -- South Africa , Diabetes -- Prevention , Stress (Psychology) , Adjustment (Psychology)
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9922 , http://hdl.handle.net/10948/665 , Diabetes in children -- South Africa , Diabetes -- Prevention , Stress (Psychology) , Adjustment (Psychology)
- Description: Type I diabetes has the ability to promote change in the family. In truth, although the child with diabetes is the diagnosed patient, the whole family has diabetes. While the challenges that families have to face are many, families seem to have the ability to “bounce back” (i.e., they have resilience). Research on the construct of resilience, and more specifically, family resilience has surged in recent times. However, South African research on family resilience is limited. This study aimed to explore and describe the factors that facilitate adjustment and adaptation in families that include a child living with Type I diabetes. The Resiliency Model of Stress, Adjustment and Adaptation, developed by McCubbin and McCubbin (2001) served as a framework to conceptualise the families’ adjustment and adaptation process. Non-probability purposive and snowball sampling techniques were employed. Sixteen families participated in this study, providing a total of 31 participants. Participants consisted of the caregivers of a family living with a child between the ages of four and 12 with Type I diabetes. The study was triangular in nature, with an exploratory, descriptive approach. A biographical questionnaire with an open-ended question was used in conjunction with seven other questionnaires to gather data. These questionnaires were: The Family Hardiness Index (FHI), the Family Time and Routine Index (FTRI), the Social Support Index (SSI), the Family Problem-Solving Communication (FPSC) Index, the Family Crises-Oriented Personal Evaluation Scales (F-COPES), the Relative and Friend Support Index, and the Family Attachment and Changeability Index 8 (FACI8). Descriptive statistics were used to describe the biographical information. Quantitative data were analysed by means of correlation and regression analysis, and a content analysis was conducted to analyse the qualitative data. The results of the quantitative analysis indicated three significant positive correlations with the FACI8. These variables were family hardiness (measured by the FHI), family problem-solving communication (measured by the FPSC), and family time and routines (measured by the FTRI). The results of the qualitative analysis revealed that social support, the caregivers’ acceptance of the condition, and spirituality and religion were the most important strength factors that contributed to the families’ adjustment and adaptation. Although the study had a small sample and many limitations, the study could be used as a stepping-stone for future research on resilience in families living with chronic medical conditions and will contribute to family resilience research in the South African context.
- Full Text:
- Date Issued: 2007
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