1.Study of effectiveness of the diabetes education for patients with type 2 diabetes mellitus
Enkhjargal Ya ; Davaalkham D ; Altaisaikhan Kh ; Tserendagva D
Mongolian Medical Sciences 2013;163(1):135-140
Background
Educating diabetic patients about their diseases encourages their families to learn as much as possible about the latest medical management and approaches, as well as informing healthy lifestyle choices, and supports their responsibility in improving their condition and quality of life through well-managed self-control.
Goal
To evaluate the outcomes of diabetes education in patients with T2DM.
Materials and Methods
The cohort survey was conducted at the Diabetes center of the State Central Clinical Hospital (SCCH) and District Health centers in Ulaanbaatar. Participants included 150 newly diagnosed patients with T2DM. Data collection was done by using internationally accepted questionnaire and anthropometric measurements and biomedical outcome measures such as Haemoglobin A1c levels, high density lipid (HDL), low density lipid (LDL), total cholesterol (TCh), triglyceride (TG), fasting blood glucose (FBG), blood pressure (BP), body weight (BW) at baseline and 3rd and 6th months of the follow ups. Statistical analyses were performed with the SPSS16 software.
Results
Diabetic patient’s knowledge (p=0.029) and self control of blood glucose (5.35±1.81 days in the last week) of newly diagnosed patients with T2DM improved statistically significantly (p=0.046) after 6 months diabetes education. Psychological problem areas in diabetes (PAID) score reduced in educated group 2.86% (95%CI 1.61 to 3.23) p=0.004 and points in illness perception questionnaire (IPQ) increased 8.95% (95%CI 5.31 to 10.1) p=0.001. After 6 months, the group of the newly diagnosed patients receiving diabetes education had decreased numbers in biomedical measurements: Systolic BP decreased 8mmHg (p=0.001), diastolic BP 2 mmHg (p=0.035), some anthropometric measurements including waist circumference (WC) decreased 2cm (p=0.014). Levels of HbA1C were 1.5% lower (p=0.001) in the diabetes educated group, LDL decreased 0.7 mmol/l (p=0.0001), and HDL increased 0.2% (p=0.036).
Conclusion:
1. The data on the educated patients’ knowledge about diabetes, self control, psychosocial status, and illness perception are comparatively higher than those in the non-educated group.
2. The decrease in not only the levels of systolic and diastolic BP and WC of newly diagnosed patients with T2DM, but also levels of HbA1C and LDL together with the increase in levels of HDL indicates that the self control improves among educated patients.
2.DEPRESSIVE STATE IN NEWLY DIAGNOSED PATIENTS WITH TYPE 2 DIABETES
Enkhjargal Ya ; Davaalkham D ; Altaisaikhan Kh ; Tserendagva D
Innovation 2015;9(3):128-135
Diabetes is known to be directly and indirectly associated with stress. Many researchers have
reported that diabetes is actually induced by stress and several hormones includ¬ing cortisol
are known to be involved.14 Though tight glycemic control is viewed as a primary indicator of
favorable diabetes outcomes metabolic control , medication, and physical activity, contribute to
a patient’s success in achieving desirable glycemic control. Our study aimed to evaluate improves
depressive state in newly diagnosed patients with type 2 diabetes(T2DM) by education. The cohort survey was conducted in Ulaanbaatar. For the study we 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self-management control, beliefs about illness, depression. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software.The study involved newly diagnosed Type 2 diabetes 49,4±8,9 years men 65 (43,6%), women 85(56,7%) and 39,3% of the participants had a family history of diabetes. After 6 months self- control of blood glucose (p=0.046) significantly improved in educated newly diagnosed patients with T2DM. Problem areas in diabetes (PAID) score reduced in educated group -2.86 (95% CI
-1.61 -3.23); (p=0.004) and illness perception questionnaire (IPQ) score increased 8.95 (95% CI 5.31-10.1); (p=0.001). Outcome shows positive improvements statistically increased diabetes self-management control IPQ score and decreased score PAID in the educated newly diagnosed patients T2DM.
3.Risk factors for diabetic foot complication
Enkhjargal Ya ; Altaisaikhan Kh ; Davaalham D ; Tserendagva D
Innovation 2016;10(3):24-30
DM is the long term chronic disease that leads to late stage vascular complications and pathogeneses of chronic complication started 5-10 years ago when the diagnosed diabetes. T2DM can remain asymptomatic for many years, majority associated complications or several chronic diseases. Main risk for people with diabetes, that hyperglycemia in microvascular complications and alteration of dyslipidemia makes macro vascular complications such as foot amputation, disability, cardiovascular disease, kidney disease, blindness and stroke. Our study aimed to evaluate foot care patients of type 2 diabetes (T2DM) and determained risk factors for foot complication in newly diagnosed T2DM.
The survey was conducted in Ulaanbaatar. For the study we 188 and 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self care for foot and self-management control. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software.
The study involved mean age 20-69 years and male 43.1 %, female 56.9 % patients with T2DM who have been controlled by endocrinologists’ in hospitals s of Ulaanbaatar. Also we studied patients newly diagnosed T2DM mean age was 49.4±8.9 male 65(43.6%), female 85(56,7%) and 39.3% of the participants had a family history of diabetes.In last week self reported servey was in male 3.7 % every day foot care, 93.8 % of male without self care in foot, in female 48.5 % every day foot care (p<0.003). There were statistically significant different between BMI, WC, BFP with normal (p<0.05). The weight, BFP were statistically significant different between gender BMI, WC, blood pressure were no significant between male and female (p>0.05) in newly diagnosed T2DM. Participant’s bad glycemic control for diabetic foot risk factors are FBG, HbA1c,LDL were significantly higher than normal of health adults (p<0.05), but there were no significant TG (p>0.05). However, total cholesterol, HDL were normal level. From above results, the TG was statistically different between gender (p<0.05)
Poor control in foot care by selt management in patients with newly diagnosed T2DM. Therefore poor glycemic and metabolic control in patients newly diagnosed T2DM.
4. DEPRESSIVE STATE IN NEWLY DIAGNOSED PATIENTS WITH TYPE 2 DIABETES
Enkhjargal YA ; Davaalkham D ; Altaisaikhan KH ; Tserendagva D
Innovation 2015;9(3):128-135
Diabetes is known to be directly and indirectly associated with stress. Many researchers havereported that diabetes is actually induced by stress and several hormones includ¬ing cortisolare known to be involved.14 Though tight glycemic control is viewed as a primary indicator offavorable diabetes outcomes metabolic control , medication, and physical activity, contribute toa patient’s success in achieving desirable glycemic control. Our study aimed to evaluate improvesdepressive state in newly diagnosed patients with type 2 diabetes(T2DM) by education. The cohort survey was conducted in Ulaanbaatar. For the study we 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self-management control, beliefs about illness, depression. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software.The study involved newly diagnosed Type 2 diabetes 49,4±8,9 years men 65 (43,6%), women 85(56,7%) and 39,3% of the participants had a family history of diabetes. After 6 months self- control of blood glucose (p=0.046) significantly improved in educated newly diagnosed patients with T2DM. Problem areas in diabetes (PAID) score reduced in educated group -2.86 (95% CI-1.61 -3.23); (p=0.004) and illness perception questionnaire (IPQ) score increased 8.95 (95% CI 5.31-10.1); (p=0.001). Outcome shows positive improvements statistically increased diabetes self-management control IPQ score and decreased score PAID in the educated newly diagnosed patients T2DM.
5. Risk factors for diabetic foot complication
Enkhjargal YA ; Altaisaikhan KH ; Davaalham D ; Tserendagva D
Innovation 2016;10(3):24-30
DM is the long term chronic disease that leads to late stage vascular complications and pathogeneses of chronic complication started 5-10 years ago when the diagnosed diabetes. T2DM can remain asymptomatic for many years, majority associated complications or several chronic diseases. Main risk for people with diabetes, that hyperglycemia in microvascular complications and alteration of dyslipidemia makes macro vascular complications such as foot amputation, disability, cardiovascular disease, kidney disease, blindness and stroke. Our study aimed to evaluate foot care patients of type 2 diabetes (T2DM) and determained risk factors for foot complication in newly diagnosed T2DM. The survey was conducted in Ulaanbaatar. For the study we 188 and 150 patients newly diagnosed T2DM, who have met the inclusion criteria and agreed with informed consent. We have evaluated self care for foot and self-management control. We measured anthropometric measurements, blood pressure (BP), levels of HbA1C, lipids and fasting blood glucose (FBG) at the baseline, in 3 and up to 6 months in educated and noneducated groups. Statistical analyses was performed using SPSS 16 software. The study involved mean age 20-69 years and male 43.1 %, female 56.9 % patients with T2DM who have been controlled by endocrinologists’ in hospitals s of Ulaanbaatar. Also we studied patients newly diagnosed T2DM mean age was 49.4±8.9 male 65(43.6%), female 85(56,7%) and 39.3% of the participants had a family history of diabetes.In last week self reported servey was in male 3.7 % every day foot care, 93.8 % of male without self care in foot, in female 48.5 % every day foot care (p<0.003). There were statistically significant different between BMI, WC, BFP with normal (p<0.05). The weight, BFP were statistically significant different between gender BMI, WC, blood pressure were no significant between male and female (p>0.05) in newly diagnosed T2DM. Participant’s bad glycemic control for diabetic foot risk factors are FBG, HbA1c,LDL were significantly higher than normal of health adults (p<0.05), but there were no significant TG (p>0.05). However, total cholesterol, HDL were normal level. From above results, the TG was statistically different between gender (p<0.05) Poor control in foot care by selt management in patients with newly diagnosed T2DM. Therefore poor glycemic and metabolic control in patients newly diagnosed T2DM.
6.Hormonal and lipid profile in infertility women with polycystic ovary syndrome
Algirmaa N ; Amarjargal O ; Battulga G ; Altaisaikhan Kh ; Munkhtsetseg D ; Bolorchimeg B
Mongolian Medical Sciences 2020;194(4):17-24
Introduction:
PCOS prevalence is 5-10 percent among reproductive age women in worldwide. It is caused by
imbalance of sex hormones which ultimately leads to menstrual irregularities, infertility, anovulation
and other metabolic disturbances. Most women with chronic anovulation is caused by polycystic
ovary syndrome [PCOS] The Rotterdam criteria is useful diagnostic tool for PCOS. In Mongolia
there is almost no study on PCOS related infertility and there are increasing trend infertility among
reproductive aged women with PCOS, lead us to conduct the study.
Objective:
The aim of this study was to estimate incidence of PCOS and to study clinical and biochemical
characteristics of PCOS among infertility women.
Material and Methods:
We used the cross-sectional and case control study designs. Total 1334 infertility women enrolled
in this study. The study was conducted after approval from the Ethical and research review board of
the hospital, and written informed consent was taken from all the women. Among 114 women with
PCOS were found by Rotterdam’s criteria at the Infertility and reproductive department, National
Center for Maternal and Child Health, between December, 2018 - 2019. Total of 43 females with
PCOS were screened among 1334 infertile women. All parameters were assessed either with ELISA
in 43 infertile PCOS women and 17 age matched apparently healthy controls diagnosed according
to Rotterdam consensus. IDF diagnostic criteria for MS was used. The PCOS patients divided into
following groups: (1) with MS ( n=42) and (2) without MS (n=72).
Results:
The main age, body mass index (BMI), and duration of infertility were 28.7±4.1 years, 27.3±5.2 kg/
m² and 4.4±3.1y, respectively. Among patients 57.9% of them have oligomenorrhea, 22.8% with
amenorrhea, primary infertility 57.0% and 51.9% with hirsutism and acne 50.8%. As a result of
hormone assays were LH 9.3±3.5mIU/ml, LH/FSH 1.6 ±0.83 [0.1-3.6], AMH 6.1ng/ml ±3.6 /2.9-21.0/.
The prevalence of MS was 36.8%. The variables including age (30.9±4.9), body mass (75.9±11.6kg)
and also some metabolic parameters which is hypertension (133.6/88.4±13.6 mm Hg), WC (94.1±8.6
cm) and high triglyceride (1.8±1.0 mmol/l) were observed in MS group compared to without MS group.
Conclusion
Among 1334 women with infertility, the incidence of PCOS 8.7% (116), close to the prevalence in
other countries. Considering the diagnose was confirmed of three criteria by the Rotterdam criteria.
We found out that the prevalence of metabolic syndrome was 35.3% among infertility women with
PCOS. Age, BMI, WC, amenorrhea, acne and acanthosis nigricans, were highly related to metabolic
syndrome.