Evaluation of Prediabetes Dietary Care Strategies, Glycemic Monitoring and Patient Glycemic Outcomes: Insights from Healthcare Providers
DOI:
https://doi.org/10.53819/81018102t7037Abstract
Prediabetes is a condition which precedes Type 2 Diabetes. Effective strategy used in its management as well as correct glucose monitoring are key in ensuring optimum care among patients. These ensure better outcomes of care and reduced health complications. The study aimed to evaluate the dietary prescription strategies used by different healthcare providers as well as explore the use of blood sugar monitoring devices and the patient outcomes as reported by the healthcare providers. The study employed a cross-sectional design conducted in healthcare facilities across Ainamoi Subcounty, Kenya. Structured questionnaires were administered to 150 healthcare providers, collecting data on their sociodemographic characteristics, approaches to diabetes care, access to blood sugar monitoring devices as well as patient care outcomes. Data was analyzed using SPSS Version 20, utilizing descriptive statistics and chi-square tests. The findings revealed that 16.7% of participants were nutritionists, 19.3% medical officers, 20% clinical officers, 36.7% nurses, and 7.3% community health promoters. Gender and education level were significantly associated with the healthcare cadre (p<0.001), and access to glucometers varied significantly by cadre (p=0.004). More than 60% of healthcare providers across all cadres reported patient progression to Type 2 diabetes. The study concluded that all healthcare cadres play a critical role in prediabetes care and individualization of care as well as the use of low carbohydrate diet may help normalize plasma glucose levels among prediabetes patients. Blood sugar monitoring should therefore be emphasized, including adoption of advanced methods like continuous glucose monitoring. The study recommended targeted training for healthcare providers across all cadres on standardized care strategies, improved access to blood sugar monitoring tools, and the integration of technology to support patient management.
Keywords: Glucometer, glycemic outcomes, strategy of care, diabetic diets, continuous glucose monitors.
References
IDF, “Kenya-diabetes-report.pdf.” 2021.
S. F. Mohamed et al., “Prevalence and factors associated with pre-diabetes and diabetes mellitus in Kenya: results from a national survey,” BMC Public Health, vol. 18, no. 3, p. 1215, 2018, doi: 10.1186/s12889-018-6053-x.
G. G. Githinji et al., “Prevalence of diabetes and co-morbidities in five rural and semi-urban Kenyan counties, 2010–2015,” Int. J. Diabetes Dev. Ctries., vol. 38, no. 2, pp. 243–248, 2018, doi: 10.1007/s13410-017-0566-1.
M. Clement et al., “Organization of Diabetes Care Diabetes Canada Clinical Practice Guidelines Expert Committee,” Can. J. Diabetes, vol. 42, pp. S27–S35, 2018, doi: 10.1016/j.jcjd.2017.10.005.
A. B. Evert et al., “Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report,” Diabetes Care, vol. 42, no. 5, pp. 731 LP – 754, May 2019, doi: 10.2337/dci19-0014.
A. H. A. Al-ganmi, “Title Page: Factors influencing nurses’ knowledge acquisition of diabetes care and its management: a qualitative study,” pp. 0–3, 2007, doi: 10.1111/jocn.14544.
J. J. Olickal et al., “Decentralizing diabetes care from tertiary to primary care : how many persons with diabetes can be down-referred to primary care settings ?,” pp. 1–8, 2021, doi: 10.1093/pubmed/fdab156.
L. J. Trump and T. J. Mendenhall, “Community health workers in diabetes care: A systematic review of randomized controlled trials.,” Families, Systems, & Health, vol. 35, no. 3. Educational Publishing Foundation, Trump, Lisa J.: Department of Family Social Science, University of Minnesota, Twin Cities, 1985 Buford Avenue, 290 McNeal Hall, Saint Paul, MN, US, 55108, buch0245@umn.edu, pp. 320–340, 2017. doi: 10.1037/fsh0000283.
M. Aw et al., “Critical appraisal of a mHealth-assisted community-based cardiovascular disease risk screening program in rural Kenya: an operational research study,” Pathog. Glob. Health, vol. 114, no. 7, pp. 379–387, Oct. 2020, doi: 10.1080/20477724.2020.1816286.
A. S. Bolla and R. Priefer, “Blood glucose monitoring- an overview of current and future non-invasive devices,” Diabetes Metab. Syndr. Clin. Res. Rev., vol. 14, no. 5, pp. 739–751, 2020, doi: https://doi.org/10.1016/j.dsx.2020.05.016.
S. F. Clarke and J. R. Foster, “A history of blood glucose meters and their role in self-monitoring of diabetes mellitus,” Br. J. Biomed. Sci., vol. 69, no. 2, pp. 83–93, Jan. 2012, doi: 10.1080/09674845.2012.12002443.
T. Danne et al., “International Consensus on Use of Continuous Glucose Monitoring,” Diabetes Care, vol. 40, no. 12, pp. 1631–1640, Nov. 2017, doi: 10.2337/dc17-1600.
and A. Nisha Chaudharya, Vinod Kumarb, Punesh Sangwanc, Naveen Chandra Pantd, Abhishake Saxenae, Shourabh Joshif and N. Yadavg, “Personalized Nutrition and -Omics,” no. January, 2020.
S. E. Berry et al., “Human postprandial responses to food and potential for precision nutrition,” Nat. Med., vol. 26, no. 6, pp. 964–973, 2020, doi: 10.1038/s41591-020-0934-0.
M. G. Gaiser et al., “A Systematic Review of the Roles and Contributions of Peer Providers in the Behavioral Health Workforce,” Am. J. Prev. Med., vol. 61, no. 4, pp. e203–e210, 2021, doi: https://doi.org/10.1016/j.amepre.2021.03.025.
ADA, “Standards of Medical Care in diabetes — 2020,” vol. 43, no. January, 2020.
S. H. Ley, O. Hamdy, V. Mohan, and F. B. Hu, “Prevention and management of type 2 diabetes: dietary components and nutritional strategies,” Lancet, vol. 383, no. 9933, pp. 1999–2007, 2014, doi: https://doi.org/10.1016/S0140-6736(14)60613-9.
J. L. Sievenpiper, C. B. Chan, P. D. Dworatzek, C. F. Med, and S. L. W. Med, “Diabetes Canada Clinical Practice Guidelines Expert Committee,” vol. 42, pp. 64–79, 2018.
H. Kahleova, “Cardio-Metabolic Benefits of Plant-Based Diets,” pp. 1–13, 2017, doi: 10.3390/nu9080848.
Y. M. Khazrai, G. Defeudis, and P. Pozzilli, “Effect of diet on type 2 diabetes mellitus: a review,” Diabetes. Metab. Res. Rev., vol. 30, no. S1, pp. 24–33, Mar. 2014, doi: https://doi.org/10.1002/dmrr.2515.
O. T. Okube, S. Kimani, and M. Waithira, “Association of dietary patterns and practices on metabolic syndrome in adults with central obesity attending a mission hospital in Kenya : a cross- sectional study,” 2020, doi: 10.1136/bmjopen-2020-039131.
J. Salas-salvad, M. Guasch-ferr, and E. Ros, “Protective Effects of the Mediterranean Diet on,” 2016, doi: 10.3945/jn.115.218487.promoting.
GoK, “Community health services frequently asked questions,” pp. 0–2, 2022.
GoK, “The kenya gazette:Categorization of Facilities,” vol. CXII, no. 18, 2010.
E. Ugwu, E. Young, and M. Nkpozi, “Diabetes care knowledge and practice among primary care physicians in Southeast Nigeria: A cross-sectional study,” BMC Fam. Pract., vol. 21, no. 1, pp. 1–11, 2020, doi: 10.1186/s12875-020-01202-0.
C. H. Sherrill and S. Lee, “Prevalence, characteristics, and health-related quality of life of continuous glucose monitoring use according to the Behavioral Risk Factor Surveillance System 2014-2020.,” J. Manag. care Spec. Pharm., vol. 29, no. 5, pp. 541–549, May 2023, doi: 10.18553/jmcp.2023.29.5.541.
L. Chen et al., “Status of continuous glucose monitoring use and management in tertiary hospitals of China : a cross- sectional study,” pp. 1–8, 2023, doi: 10.1136/bmjopen-2022-066801.
H. Bekele, A. Asefa, B. Getachew, and A. M. Belete, “Barriers and Strategies to Lifestyle and Dietary Pattern Interventions for Prevention and Management of TYPE-2 Diabetes in Africa, Systematic Review,” J. Diabetes Res., vol. 2020, p. 7948712, 2020, doi: 10.1155/2020/7948712.
R. Kanhere, “Home-Use Medical Devices ( Glucometer And Blood Pressure Monitors ) – A Survey Of Opd Patients On Awareness , Usage , And Buying,” no. September, 2021, doi: 10.13140/RG.2.2.13618.32967.
S. Mohamed, M. Mukhtar, K. Aseed, and D. Osman, “Knowledge and Practice of Glucose Self-Monitoring Devices among Patients with Diabetes,” vol. 18, no. 1, pp. 127–138, 2023, doi: 10.18502/12591.
