Glycemic control, medication adherence, and injection practices among diabetic patients treated in the 3 tertiary referral hospitals in Bhutan: a call for more action
, , , , , y | 31 dic 2018
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Article Category: Brief communication (original)
Publicado en línea: 31 dic 2018
Páginas: 27 - 33
DOI: https://doi.org/10.1515/abm-2018-0028
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© 2018 Thinley Dorji et al., published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.
Measurement of glycemic control, adherence, and the injection technique score among insulin-dependent diabetic patients interviewed at the 3 tertiary hospitals in Bhutan in 2017
| Type 1 diabetes | Type 2 diabetes | Total | ||
|---|---|---|---|---|
| n | % | |||
| <7% | 1 | 45 | 46 | 39.0 |
| ≥7% | 6 | 66 | 72 | 61.0 |
| ≤130 mg/dL | 2 | 79 | 81 | 39.9 |
| >130 mg/dL | 5 | 117 | 122 | 60.1 |
| ≤180 mg/dL | 2 | 67 | 69 | 33.9 |
| >180 mg/dL | 6 | 128 | 134 | 66.1 |
| High (score 0) | 4 | 75 | 79 | 38.2 |
| Medium (score 1–2) | 4 | 97 | 101 | 48.8 |
| Low (score (3–4) | 1 | 26 | 27 | 13.0 |
| Good (score 8–10) | 4 | 96 | 100 | 49.5 |
| Fair (score 6–7) | 4 | 55 | 59 | 29.2 |
| Poor (score 0–5) | 0 | 43 | 43 | 21.3 |
The clinical and demographic profile of insulin-dependent diabetic patients interviewed at the 3 tertiary hospitals in Bhutan in 2017 (N = 207)
| Type 1 diabetes n | Type 2 diabetes n | Total | ||
|---|---|---|---|---|
| n | % | |||
| 20–29 | 7 | 6 | 13 | 6.3 |
| 30–39 | 2 | 12 | 14 | 6.8 |
| 40–49 | 0 | 35 | 35 | 16.9 |
| 50–59 | 0 | 59 | 59 | 28.5 |
| ≥60 | 0 | 86 | 86 | 41.5 |
| Farmer | 2 | 55 | 57 | 27.5 |
| Housewife | 1 | 54 | 55 | 26.6 |
| Dependent | 4 | 31 | 35 | 16.9 |
| Private sector | 1 | 32 | 33 | 15.9 |
| Government employee | 1 | 16 | 17 | 8.2 |
| Others | 0 | 10 | 10 | 4.8 |
| Cannot read or write | 1 | 101 | 102 | 49.3 |
| Monastic | 0 | 10 | 10 | 4.8 |
| Nonformal (NFE certificate) | 1 | 6 | 7 | 3.4 |
| Primary school | 0 | 33 | 33 | 15.9 |
| Secondary school | 4 | 16 | 42 | 20.3 |
| Undergraduate and above | 0 | 13 | 13 | 6.3 |
| Underweight (<18.5) | 2 | 5 | 7 | 3.4 |
| Normal (18.5–24.9) | 6 | 51 | 59 | 28.5 |
| Overweight (25–29.9) | 1 | 79 | 82 | 39.6 |
| Obese (≥30) | 0 | 59 | 59 | 28.5 |
| Hypertension | 3 | 157 | 160 | 77.3 |
| Chronic kidney disease | 1 | 48 | 49 | 23.7 |
| Dyslipidemia | 2 | 75 | 77 | 37.2 |
The 10-item checklist used to assess insulin injection technique for those among insulin-dependent diabetic patients using an insulin syringe or syringe and needle who were interviewed at the 3 tertiary hospitals in Bhutan in 2017
| No. | Steps | Mark √ if this step was demonstrated on the sponge |
|---|---|---|
| 1 | Wash hands | |
| 2 | Slowly roll the insulin vial between the palms | |
| 3 | Clean rubber stopper of insulin vial with cotton swab in spirit | |
| 4 | Draw prescribed dose of insulin | |
| 5 | Remove any air bubble in the syringe | |
| 6 | Clean injection site with cotton swab in water | |
| 7 | Pinch up the skin | |
| 8 | Push the needle into the skin at: | |
| Angle of 45° | ||
| Angle of 90° | ||
| Other angles | ||
| 9 | Count to 10 | |
| 10 | Pull the needle out straight |
Insulin self-administration practices among insulin-dependent diabetic patients interviewed at the 3 tertiary hospitals in Bhutan, 2017
| Type 1 diabetes | Type 2 diabetes | Total | ||
|---|---|---|---|---|
| n | % | |||
| Insulin syringe | 7 | 107 | 114 | 55.1 |
| “1 mL syringe and needle” | 1 | 87 | 88 | 42.5 |
| Insulin pen | 1 | 4 | 5 | 2.4 |
| Self | 7 | 147 | 154 | 74.4 |
| Caregivers | 2 | 51 | 53 | 25.6 |
| 1 | 0 | 6 | 6 | 2.9 |
| 2 | 9 | 189 | 198 | 95.7 |
| 3 | 0 | 3 | 3 | 1.4 |
| Door of refrigerator | 6 | 120 | 126 | 60.9 |
| Freezer refrigerator | 1 | 63 | 64 | 30.9 |
| Shelf of refrigerator | 2 | 8 | 10 | 4.8 |
| Earthen pots | 0 | 6 | 6 | 2.9 |
| Open environment/not refrigerated | 0 | 1 | 1 | 0.5 |
| Bruising | 0 | 38 | 38 | 18.4 |
| Scarring | 1 | 32 | 33 | 15.9 |
| Lipoatrophy | 1 | 17 | 18 | 8.7 |
| Lipohypertrophy | 2 | 7 | 9 | 4.3 |
| Inflammation | 0 | 2 | 2 | 1.0 |
| None | 5 | 102 | 107 | 51.7 |
| Dispose directly in dry | 2 | 59 | 61 | 29.5 |
| waste into municipal | ||||
| waste system | ||||
| Give to hospital in | 2 | 42 | 44 | 21.3 |
| sharps box | ||||
| Give to hospital in | 1 | 22 | 23 | 11.1 |
| plastic bag | ||||
| Bury | 0 | 32 | 32 | 15.5 |
| Burn | 1 | 20 | 21 | 10.1 |
| Dispose in sealed con- tainer into municipal | 1 | 12 | 13 | 6.3 |
| waste system | ||||
| Store at home | 2 | 11 | 13 | 6.3 |