The course of diabetes is marked by the development of chronic complications that, in addition to affecting health, also affect the quality of life of patients. The purpose of this study was to ...compare the quality of life of patients with type 2 diabetes based on their chronic complications. The study, which was conducted from March 2019 until March 2020, included 382 diabetic patients, specific data from medical records, and the application of the World Health Organization Quality of Life-Brief questionnaire. There were more men than women included in the study, with the majority of respondents belonging to the age group of 61 to 70 years. In the quality-of-life assessment, the mean value of physical functioning was 57.14 (42.86-71.43), psychological functioning was 66.67 (54.17-79.17), social functioning 66.67 (50.00-75.00), and environmental functioning was 68.75 (50.00-75.00). The domains of social functioning were lowest in patients with diabetic retinopathy and neuropathy, while the physical functioning domains were rated lowest in patients with diabetic nephropathy, diabetic foot ulcer, and multiple chronic complications. All domains were rated lowest by patients with multiple complications and highest by those without any complications. In conclusion, differences in the assessment of quality of life of diabetic patients depend on the type of chronic complication.
Our study aimed to assess the role of a hand-held fundus camera and artificial intelligence (AI)-based grading system in diabetic retinopathy (DR) screening and determine its diagnostic accuracy in ...detecting DR compared with clinical examination and a standard fundus camera. This cross-sectional instrument validation study, as a part of the International Diabetes Federation (IDF) Diabetic Retinopathy Screening Project, included 160 patients (320 eyes) with type 2 diabetes (T2DM). After the standard indirect slit-lamp fundoscopy, each patient first underwent fundus photography with a standard 45° camera VISUCAM Zeiss and then with a hand-held camera TANG (Shanghai Zhi Tang Health Technology Co., Ltd.). Two retina specialists independently graded the images taken with the standard camera, while the images taken with the hand-held camera were graded using the DeepDR system and an independent IDF ophthalmologist. The three screening methods did not differ in detecting moderate/severe nonproliferative and proliferative DR. The area under the curve, sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, kappa (ĸ) agreement, diagnostic odds ratio, and diagnostic effectiveness for a hand-held camera compared to clinical examination were 0.921, 89.1%, 100%, 100%, 91.4%, infinity, 0.11, 0.86, 936.48, and 94.9%, while compared to the standard fundus camera were 0.883, 83.2%, 100%, 100%, 87.3%, infinity, 0.17, 0.78, 574.6, and 92.2%. The results of our study suggest that fundus photography with a hand-held camera and AI-based grading system is a short, simple, and accurate method for the screening and early detection of DR, comparable to clinical examination and fundus photography with a standard camera.
Pravilna prehrana iznimno je važna u prevenciji šećerne bolesti i regulaciji glikemije. Šećerna bolest ubraja se u kategoriju bolesti koje se uspješno mogu prevenirati, dobro liječiti te im se može ...spriječiti ili odgoditi razvoj kroničnih komplikacija. Edukacija o pravilnoj prehrani treba biti individualno prilagođena, pri čemu treba obratiti pozornost na dob bolesnika, način života, socioekonomski status, tjelesnu aktivnost i komplikacije vezane uz šećernu bolest. Kod šećerne bolesti promjena životnih navika, što uključuje pravilnu prehranu, redovitu tjelesnu aktivnost i regulaciju tjelesne mase, može uvelike pridonijeti regulaciji glikemije, a u tipu 2 u nekim slučajevima može dovesti i do njene remisije. Smjernice su rezultat suradnje zdravstvenih stručnjaka koji sudjeluju u liječenju i edukaciji osoba koje boluju od šećerne bolesti. Utemeljene su na dokazima, prema metodologiji GRADE (engl. grading of recommendations, assessment, development and evaluation) koja uz snagu dokaza opisuje i razinu preporuke. Temeljni zaključci ovih smjernica odnose se na procjenu nutritivnih potreba te primjenu medicinske nutritivne terapije, individualno prilagođene osobama sa šećernom bolešću kao i onima koji imaju i neke od
vezanih komorbiditeta.
The course of diabetes is marked by the development of chronic complications that, in addition to affecting health, also affect the quality of life of patients. The purpose of this study was to ...compare the quality of life of patients with type 2 diabetes based on their chronic complications. The study, which was conducted from March 2019 until March 2020, included 382 diabetic patients, specific data from medical records, and the application of the World Health Organization Quality of Life-Brief questionnaire. There were more men than women included in the study, with the majority of respondents belonging to the age group of 61 to 70 years. In the quality-of-life assessment, the mean value of physical functioning was 57.14 (42.86-71.43), psychological functioning was 66.67 (54.17-79.17), social functioning 66.67 (50.00-75.00), and environmental functioning was 68.75 (50.00-75.00). The domains of social functioning were lowest in patients with diabetic retinopathy and neuropathy, while the physical functioning domains were rated lowest in patients with diabetic nephropathy, diabetic foot ulcer, and multiple chronic complications. All domains were rated lowest by patients with multiple complications and highest by those without any complications. In conclusion, differences in the assessment of quality of life of diabetic patients depend on the type of chronic complication. Keywords: quality of life; type 2 diabetes; retinopathy; neuropathy; nephropathy;, diabetic foot ulcer Tijek secerne bolesti obiljezen je razvojem kronicnih komplikacija bolesti koje, osim utjecaja na zdravlje, utjecu i na kvalitetu zivota oboljelih. Cilj nam je bio istraziti kvalitetu zivota osoba sa secernom bolescu tipa 2 s kronicnim komplikacijama te je usporediti ovisno o tipu komplikacija. U istrazivanje, koje je trajalo od ozujka 2019. do ozujka 2020. godine, bile su ukljucene 382 osobe sa secernom bolescu, a koristeni su podaci iz medicinske dokumentacije te standardizirani upitnik Svjetske zdravstvene organizacije o kvaliteti zivota (WHOQOL-BREF upitnik). Udio muskaraca u istrazivanju bio je veci od udjela zena, a najvise ispitanika je pripadalo dobnoj skupini od 61 do 70 godina. Kod ocjenjivanja kvalitete zivota, srednja vrijednost fizickog funkcioniranja bila je 57,14 (42,86 -71,43), psiholoskog funkcioniranja 66,67 (54,17-79,17), socijalnog funkcioniranja 66,67 (50,00-75,00), a funkcioniranja u okolini 68,75 (50,00 - 75,00). Kod bolesnika s dijabetickom retinopatijom i neuropatijom, najnize ocjene imale su komponente socijalnog funkcioniranja, dok su kod onih s dijabetickom nefropatijom, dijabetickim stopalom i visestrukim kronicnim komplikacijama najlosije ocijenjene bile komponente fizickog funkcioniranja. Sve komponente kvalitete zivota najlosije su ocijenjene kod bolesnika s visestrukim komplikacijama, a najbolje kod onih bez komplikacija. Zakljucno, postoje razlike u ocjeni kvalitete zivota ovisno o vrsti kronicne komplikacije secerne bolesti. Kljucne rijeci: kvaliteta zivota, secerna bolest tip 2, retinopatija, neuropatija, nefropatija, dijabeticko stopalo
Background: Systematic and efficient education on patient self-management behaviour represents one of the key approaches to
diabetes treatment. The aim of this paper was to evaluate the current ...process and content of nursing assessment of illness selfmanagement
behaviour in persons with diabetes treated at a tertiary healthcare facility.
Subjects and methods: Electronic patient records of N=15,116 persons with type 2 diabetes (51.3% men) who took part in
nursing evaluation and education throughout 2011 were collected. The patients’ mean age was 65.0±11.1 years, with mean diabetes
duration of 12.6±8.3 years; they were mostly treated with oral anti-diabetic drugs (38.4%) or insulin therapy (38.5%). The likelihood
of non-participation in the nursing evaluation was predicted based on a number of patient characteristics using a multivariate
logistic regression.
Results: The nurses mostly rated the patients’ self-management knowledge and real-life application of that knowledge as appropriate;
however, in a large number of patients, the nursing evaluation was not evidenced in the electronic patient record. Multivariate
logistic regression revealed that longer diabetes duration, insulin treatment and better glyceamic control as measured by glycated
haemoglobin were associated with a higher likelihood of participating in a nursing evaluation and diabetes re-education.
Conclusion: Diabetes specialist nurses may use informal criteria when deciding which type 2 diabetes patients to interview
about diabetes knowledge and self-care. Participative research on the processes of nurses’ decision-making may be needed.
Tijek šećerne bolesti obilježen je razvojem kroničnih komplikacija bolesti koje, osim utjecaja na zdravlje, utječu
i na kvalitetu života oboljelih. Cilj nam je bio istražiti kvalitetu života osoba sa ...šećernom bolešću tipa 2 s kroničnim
komplikacijama te je usporediti ovisno o tipu komplikacija. U istraživanje, koje je trajalo od ožujka 2019. do ožujka 2020.
godine, bile su uključene 382 osobe sa šećernom bolešću, a korišteni su podaci iz medicinske dokumentacije te standardizirani
upitnik Svjetske zdravstvene organizacije o kvaliteti života (WHOQOL-BREF upitnik). Udio muškaraca u istraživanju
bio je veći od udjela žena, a najviše ispitanika je pripadalo dobnoj skupini od 61 do 70 godina. Kod ocjenjivanja kvalitete
života, srednja vrijednost fizičkog funkcioniranja bila je 57,14 (42,86 -71,43), psihološkog funkcioniranja 66,67 (54,17–
79,17), socijalnog funkcioniranja 66,67 (50,00–75,00), a funkcioniranja u okolini 68,75 (50,00 - 75,00). Kod bolesnika
s dijabetičkom retinopatijom i neuropatijom, najniže ocjene imale su komponente socijalnog funkcioniranja, dok su kod
onih s dijabetičkom nefropatijom, dijabetičkim stopalom i višestrukim kroničnim komplikacijama najlošije ocijenjene bile
komponente fizičkog funkcioniranja. Sve komponente kvalitete života najlošije su ocijenjene kod bolesnika s višestrukim
komplikacijama, a najbolje kod onih bez komplikacija. Zaključno, postoje razlike u ocjeni kvalitete života ovisno o vrsti
kronične komplikacije šećerne bolesti.
Kronične bolesti imaju dugotrajan i doživotan tijek, mogu dovesti do invalidnosti, prijevremene smrtnosti i bolesniku je smanjena kvaliteta života. Najučestalije kronične nezarazne bolesti su ...kardiovaskularne bolesti, maligne bolesti, mentalne bolesti, šećerna bolest, kronične respiratorne bolesti i bolesti mišićno-koštanog sustava. Zbog pojave bolesti u sve ranijoj životnoj dobi i sve većeg broja oboljelih poduzimaju se različite mjere prevencije bolesti i promocije zdravlja s ciljem ranog otkrivanja i sprječavanja njihovog nastanka. Patronažne sestre te mjere provode individualnim zdravstvenim savjetovanjem kroz kućne posjete i radom s grupama bolesnika oboljelih od pojedinih specifičnih bolesti, kao što su hipertenzija, dijabetes, KOPB, alkoholizam i druge bolesti. Patronažne sestre također pomažu u uspostavi komunikacije i suradnje s drugim službama i udrugama važnim za rješavanje zdravstvenog i socijalnog stanja pacijenta na razini primarne, sekundarne i tercijarne prevencije. S tim ciljem unaprijeđena je suradnja patronažne službe grada Zagreba i medicinskih sestara Sveučilišne klinike Vuk Vrhovac Kliničke bolnice Merkur za bolesnike oboljele od šećerne bolesti pokretanjem pilot projekta kao primjera dobre prakse. Cilj ovog projekta je sustavno i kontinuirano zbrinjavanje pacijenata sustavnim informatičkim povezivanjem sestrinstva na primarnoj i sekundarnoj razini zdravstvene zaštite.
