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.Study of clinical and biochemical characterizes of newly diagnosed patients with t2dm
Oyuntugs B ; Enkhjargal YA ; Suvd J
Mongolian Medical Sciences 2011;158(4):26-29
Background: Since life style of the nation has changed, the prevalence of T2DM has steadily increased. According to T2DM related studies, estimated number of people with diabetes is 80.000 in Mongolia. Despite this, total number of diabetic patients registered in Mongolia is only 7000. Thus, approximately 90% of people with diabetes are undiagnosed and untreated.Objective: to assess anthropometric and laboratory parameters of newly diagnosed patients with T2DM.Materials and Methods: It was cross sectional study included 133 patients with type 2 diabetes newly diagnosed at the district hospital of Ulaanbaatar. We measured height, weight and waist circumference and analyzed body fat by bio-impedance analyzer machine. Fasting blood glucose, HbA1c, triglyceride, HDL-C, LDL-C were determined by methods of laboratory in venous plasma. We defined as subjects with metabolic syndrome used the IDF new definition of 2009.Results: 44.4% of all participants were male and 55.6% were female and mean age of all participants was 49.1±8.5. According to BMI 85.7% of patients was obese and overweight and 84.2% of patients identified central obesity by measuring waist circumference. In analyzing of body composition, 100% of all patients determined high body fat. 27.1% of men and 36.4% of women diagnosed arterial hypertension. According to HbA1c (%) level the 94% of patients determined 7.5 and above. The hypertriglyceridemia was 59.4%, hyper LDL-C was 76.7% and hypo HDL-C was 12% and increased LDL: HDL ratio was 8.1%. The prevalence of metabolic syndrome among the newly diagnosed patients with T2DM was 69.6%, male 66.1% and female 72.9%. Conclusion: Obese is major risk factor for T2DM in Mongolia. The study shows that assessing body fat is major identifying method of obese (p<0.03) and statistically significant association of high body fat mass with WC in diabetic patients (p<0.05). The prevalence of several risk factors of DM complications among newly diagnosed patients with T2DM is higher.
5. 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.
6. 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.
7.Evaluation of nurse’s knowledge about prevention and nursing care of pressure ulcer
Bolor-Erdene T ; Odontuya D ; Enkhjargal Ya
Innovation 2019;13(1):25-29
Background:
Pressure ulcer is the worldwide problem which does not depend on age group
and any patients could suffer from. Nursing human resource, working load, hospital equipment
supply, well-organized training, lack of scientific study are influencing the prevention and
nursing care for patients with pressure ulcer although the prevention of ulcer’s depends on
continuous nursing care. Therefore, we aimed to improve participation of nurses and evaluate
knowledge of nurses on pressure ulcer.
Methods:
Total of 249 nurses who are working in primary and referral level were chosen as
study participants. We used cross-sectional study of analytic study and standard questionnaire
with Likert scale. Furthermore, we operated evaluative standard questions of Pieper and Mott
(PUKT; 1995), standard questions of pressure ulcer evaluation and nurse’s knowledge. All
statistics analysis done by using SPSS 21.0 program.
Results:
237 (95.2%) were females, 12 (4,8%) were males were participated in the study and
122 (49,0%) had received Diploma, 125 (50,2%) of them had received bachelor degree and
2 (0,8%) had master degrees. Furthermore, 175 of all participants were nurse practitioners and
74 of them were clinical nurse specialists. The knowledge regarding nursing care on pressure
ulcer was evaluated as 2,41% were excellent, 20,88% were with average-knowledge and
76,71% were with poor-knowledge. Nurse’s knowledge regarding Evaluation of pressure ulcer
were measured as 65,68% were with poor-knowledge, 33,33% were with average, and 0,8%
were with excellent knowledge. Finally, knowledge about nursing care on pressure ulcer,
14,86% were evaluated as average, 85,14% were with poor-knowledge.
Conclusion
Most of nurse’s knowledge regarding prevention and nursing care for pressure
ulcer is inadequate. Therefore, there is a need to improve nurse’s knowledge about prevention
and nursing care on pressure ulcer.
8.Validity and reliability of the Mongolian version of the world health organization’s quality of life questionnaire (WHOQOLBREF) in patients with type 2 diabetes
Enkhjargal Ya ; Bulgan M ; Altaisaikhan H
Innovation 2020;14(1):18-23
Background:
Diabetes mellitus (DM) is a chronic progressive metabolic disorder. According
to International Diabetes Foundation (IDF) estimation in 2019, globally 463 million adults have
diabetes among the population aged 20-79. If this trend continues, 700 million of people will have
diabetes by 2045, and the larger increases will occur in low- and middle-income countries. In
Mongolia, the prevalence of Diabetes 5.4%. Regularly assessing the quality of life (QOL) in the
control of patients with diabetes is important to evaluate the effectiveness of management, to
plan treatment and thus to improve monitoring. Meaningful. The purpose of our study was to
evaluate the Validity and Reliability of the Mongolian Version of the World Health Organization’s
Quality of Life Questionnaire (WHOQOLBREF) in patients with Type 2 Diabetes.
Methods:
The cross sectional survey was conducted in Ulaanbaatar. For the study 150 patients
with T2DM were recruited, who have met the inclusion criteria and agreed to the informed
consent. In the study, self-management control, beliefs about illness, depression were assessed.
Additionally, anthropometric measurements, blood pressure (BP), levels of glucated hemoglobin
level (HbA1C), lipids and fasting blood glucose (FBG) at the baseline and after 3 months follow
ups were measured. Statistical analyses was performed using SPSS 21 software.
Results:
The study involved newly diagnosed Type 2 diabetes with mean age of 49,4±8,9 years.
65 men (43,6%), 85 women (56,7%) and 39,3% of the participants had a family history of diabetes.
The Cronbach’s alpha for analysis of the reliability of the WHOQOLBREF was a=0.74-0.84. The
patient’s fasting blood glucose FBG, HbA1c, and low-density lipoproteins (LDL) were statistically
significantly higher (p <0.05) than normal and the triglyceride (TG) was increased, but it was not
statistically significant (p> 0.05). The mean TG had statistically significant (p <0.05) increase by
sex. There is a need for further study of the specific questionnaire of QOL people with diabetes.
Conclusion
The Mongolian version of the WHO Quality of Life Questionnaire evaluating
diabetes patients, the internal consistency of the questionnaire was reliable and the validity was
a = 0.74-0.84.