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Background: The increase in diabetes prevalence is often accompanied by comorbidities and complications, which negatively impact on the quality of life of patients. Poor dietary intake and physical inactivity lead to obesity and contribute to diabetes prevalence and poor outcomes. Non-diabetic family members of patients are already at risk of developing diabetes due to a family history of the disease. Therefore, this study was aimed at developing and implementing a family-centred nutrition and exercise diabetes care programme for better outcomes and fewer new cases. Methodology: This study employed a mixed method approach, where convergent parallel design was used where quantitative and qualitative data were collected. For the quantitative strand, 400 subjects participated in the study (i.e., 200 diabetes patients and 200 family members). Diabetes patients were selected using stratified random sampling from rural clinics, while family members were selected using the sampled patients. For the qualitative strand, 17 diabetes patients were purposively sampled, and data saturation was reached. Two set of questionnaires (for patients and family members) were used to collect quantitative data, while one-on-one interviews with patients were used to collect qualitative data. Phase 2 involved development and validation of an intervention program. The validation involved a process where professional experts were used for validation using Delphi technique. Phase 3 included implementation and program evaluation wherein post-implementation quantitative survey was conducted on 100 participants (50 patients and 50 family members), who were purposively sampled from list of those who participated in Phase 1. Quantitative data was analysed using SPSS Software v27.0, while qualitative data analysed using 8 Steps of Tesch’s inductive, descriptive open coding technique. Results: In Phase 1, the results showed that over half of patients (57%), compared to 38% of family members, were obes

Diabetes Mellitus (DM) is a self -managed condition and it is essential for patients to have the relevant knowledge, skills and attitudes needed for successful diabetes management. Follow-up and proper counselling are major components in diabetes management as these will improve adherence and optimise diabetes management. The aim of this study was to compare the knowledge, understanding and outcome of the disease management in four health institutions ; a dedicated institution, a semi-dedicated institution and two non-dedicated institution. The study objectives were: To describe the level of knowledge and understanding of diabetic patients in the management of their condition at the different institutions , to describe the outcome of diabetes management at the different institutions , to describe consulting and dispensing times for diabetic patients at the different institutions , and to obtain patients’ perceptions on the quality of the health care services pertaining to the treatment of their diabetes. A total of 120 patients were interviewed, 30 per institution. A questionnaire was used to collect data for the different objectives. Prospective and retrospective data were collected. Knowledge of DM was assessed in ten patients from each institution. Patients were asked to explain their understanding on five aspects of the condition. Median scores for patients from the two non-dedicated institutions were compared using Wilcoxon two-sample test, and were found not to differ significantly for any of the questions or the overall score. The groups did not differ significantly in their understanding of whether there was a cure for diabetes mellitus and in their understanding of hypoglycaemia and its management. Patients at the dedicated clinic were significantly more knowledgeable of the condition, it’s causes and their overall understanding of the questions asked. Hyperglycaemia and its management were understood significantly better by the patients at the dedicated iv

BackgroundAlthough patients with diabetes may benefit from physical activity, few studies have examined sustained walking in this population.ObjectiveTo examine the factors associated with sustained walking among managed care patients with diabetes.DesignLongitudinal, observational cohort study with questionnaires administered 2.5 years apart.ParticipantsFive thousand nine hundred thirty-five patients with diabetes walking at least 20 minutes/day at baseline.MeasurementsThe primary outcome was the likelihood of sustained walking, defined as walking at least 20 minutes/day at follow-up. We evaluated a logistic regression model that included demographic, clinical, and neighborhood variables as independent predictors of sustained walking, and expressed the results as predicted percentages.ResultsThe absence of pain was linked to walking behavior, as 62% of patients with new pain, 67% with ongoing pain, and 70% without pain were still walking at follow-up (p = .03). Obese patients were less likely (65%) to sustain walking than overweight (71%) or normal weight (70%) patients (p = .03). Patients > or =65 years (63%) were less likely to sustain walking than patients between 45 and 64 (70%) or < or =44 (73%) years (p = .04). Only 62% of patients with a new comorbidity sustained walking compared with 68% of those who did not (p < .001). We found no association between any neighborhood variables and sustained walking in this cohort of active walkers.ConclusionsPain, obesity, and new comorbidities were moderately associated with decreases in sustained walking. Whereas controlled intervention studies are needed, prevention, or treatment of these adverse conditions may help patients with diabetes sustain walking behavior.

BackgroundAlthough patients with diabetes may benefit from physical activity, few studies have examined sustained walking in this population.ObjectiveTo examine the factors associated with sustained walking among managed care patients with diabetes.DesignLongitudinal, observational cohort study with questionnaires administered 2.5 years apart.ParticipantsFive thousand nine hundred thirty-five patients with diabetes walking at least 20 minutes/day at baseline.MeasurementsThe primary outcome was the likelihood of sustained walking, defined as walking at least 20 minutes/day at follow-up. We evaluated a logistic regression model that included demographic, clinical, and neighborhood variables as independent predictors of sustained walking, and expressed the results as predicted percentages.ResultsThe absence of pain was linked to walking behavior, as 62% of patients with new pain, 67% with ongoing pain, and 70% without pain were still walking at follow-up (p = .03). Obese patients were less likely (65%) to sustain walking than overweight (71%) or normal weight (70%) patients (p = .03). Patients > or =65 years (63%) were less likely to sustain walking than patients between 45 and 64 (70%) or < or =44 (73%) years (p = .04). Only 62% of patients with a new comorbidity sustained walking compared with 68% of those who did not (p < .001). We found no association between any neighborhood variables and sustained walking in this cohort of active walkers.ConclusionsPain, obesity, and new comorbidities were moderately associated with decreases in sustained walking. Whereas controlled intervention studies are needed, prevention, or treatment of these adverse conditions may help patients with diabetes sustain walking behavior.

IT support for home health care is an expanding area within health care IT development. Home health care differs from other in- or outpatient care delivery forms in a number of ways, and thus, the introduction of home health care applications must be based on a rigorous analysis of necessary requirements to secure safe and reliable health care. This article reports early experiences from the development of a home health care application based on emerging technologies. A prototype application for the follow-up of diabetes patients is presented and discussed in relation to a list of general requirements on home health care applications.